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Sample records for german hospitals umweltmedizinische

  1. Medical aspects of renewable energy shown by the example of German hospitals; Umweltmedizinische Gesichtspunkte der regenerativen Energieerzeugung am Beispiel deutscher Krankenhaeuser

    Energy Technology Data Exchange (ETDEWEB)

    Waschnewski, R.

    2007-07-01

    To what extend are renewable energy sources used in German hospitals? This is the main objective, this is paper is dealing with. The energy consumption profile is very specific in hospitals. In a questionnaire based study, 79 hospitals have been questioned to elucidate the current situation in German hospitals with respect to energy consumption, and to get an idea of the proportion of alternative energy sources already in use. Our analysis reveals that 14% of the hospitals analysed are already using renewable energy sources. Main sources already utilized are photovoltaic, solar thermal devices, and to a lower extend geothermic energy as well comes into operation. Almost three quarters of the questioned institutions claim, they are aware of funding possibilities and the option of contracting with respect to providing financial support in relation to aquisition of new establishments of alternative energy systems within their institution. Roughly half of the hospital's technical supervisors are aware of the precise energy potential of their institution. The situation about information and awareness with respect to possibilities related to the usage of green energy is deficient and should be improved, but the openness with respect to the topic in general seems to be very positive and advantage of that climate should be taken. Our survey allowed to get an initial estimate on the green energy situation in German hospitals. The focus of the discussion is channeled towards the environmental aspects of the energy production. The survey data allow to conclude that the current information situation is deficient. The data further provide insight into what are the main barriers with respect to the use of renewable energy. Based on our results future analyses can not focus on specific aspects and further evaluate approaches allowing to extend the usage of alternative energy sources in hospitals. (orig.)

  2. The German hospital malnutrition study.

    Science.gov (United States)

    Pirlich, Matthias; Schütz, Tatjana; Norman, Kristina; Gastell, Sylvia; Lübke, Heinrich Josef; Bischoff, Stephan C; Bolder, Ulrich; Frieling, Thomas; Güldenzoph, Helge; Hahn, Kristian; Jauch, Karl-Walter; Schindler, Karin; Stein, Jürgen; Volkert, Dorothee; Weimann, Arved; Werner, Hansjörg; Wolf, Christiane; Zürcher, Gudrun; Bauer, Peter; Lochs, Herbert

    2006-08-01

    Malnutrition is frequently observed in chronic and severe diseases and associated with impaired outcome. In Germany general data on prevalence and impact of hospital malnutrition are missing. Nutritional state was assessed by subjective global assessment (SGA) and by anthropometric measurements in 1,886 consecutively admitted patients in 13 hospitals (n=1,073, university hospitals; n=813, community or teaching hospitals). Risk factors for malnutrition and the impact of nutritional status on length of hospital stay were analyzed. Malnutrition was diagnosed in 27.4% of patients according to SGA. A low arm muscle area and arm fat area were observed in 11.3% and 17.1%, respectively. Forty-three % of patients 70 years old were malnourished compared to only 7.8% of patients malnutrition was observed in geriatric (56.2%), oncology (37.6%), and gastroenterology (32.6%) departments. Multivariate analysis revealed three independent risk factors: higher age, polypharmacy, and malignant disease (all PMalnutrition was associated with an 43% increase of hospital stay (PMalnutrition is associated with increased length of hospital stay. Higher age, malignant disease and major comorbidity were found to be the main contributors to malnutrition. Adequate nutritional support should be initiated in order to optimize the clinical outcome of these patients.

  3. Results of the evaluation of environmental medical documentation and progress sheets in Schleswig-Holstein from 1995 to 1999. A report on behalf of the Environmental Committee of the Schleswig-Holstein Association of Health Service Physicians; Ergebnisse der Auswertung umweltmedizinischer Dokumentations- und Verlaufsboegen in Schleswig-Holstein von 1995 - 1999. Ein Bericht im Auftrage des Umweltausschusses der Kassenaerztlichen Vereinigung Schleswig-Holstein

    Energy Technology Data Exchange (ETDEWEB)

    Wassermann, O.; Bauer, A.; Alsen-Hinrichs, C.

    2001-07-01

    documented it was possible to completely stop the exposure. 65% of these patients are reported to have experienced an alleviation of all their symptoms and 30% to have experienced alleviation of some of their symptoms. [German] Es wurde eine Dokumentation umweltmedizinischer Faelle aus den Jahren 1995-1999 in Schleswig-Holstein vorgenommen. Die Dokumentation umfasst standardisierte umweltmedizinische Fall- und Verlaufsdokumentationen. Es wurden 916 Dokumentationsboegen in die Auswertung aufgenommen. Zusaetzlich wurden 508 umweltmedizinische Verlaufsboegen in die Auswertung einbezogen. Bei 36% der Faelle wurde der Zusammenhang zwischen Schadstoffbelastung und Symptomatik aufgrund vorliegender Schadstoffmesswerte und/oder Verlaufsinformationen als 'wahrscheinlich' charakterisiert. Bei 27% der Patienten wurde aufgrund der Anamnese der deutliche Verdacht auf eine umweltmedizinische Genese der gesundheitlichen Beschwerden erhoben. Bei 13% der dokumentierten Faelle war dieser Zusammenhang unsicher. Bei 15% der dokumentierten Faelle lag eine Allergie und/oder Ueberempfindlichkeit gegenueber umweltmedizinisch relevanten Expositionsfaktoren vor. Bei 10% der Faelle wurde im Verlauf der aerztlichen Untersuchungen eine andere Erkrankung als Ursache der Beschwerden diagnostiziert bzw. ergab die umweltmedizinische Abklaerung keine Anhaltspunkte fuer relevante Schadstoffexpositionen. Es wurden Alter, Geschlecht, Symptomatik, vermutete und nachgewiesene Expositionsfaktoren sowie Verlaeufe nach Sanierungsmassnahmen/Expositionsstopp dokumentiert und insgesamt sowie in Abhaengigkeit von der Art der Exposition ausgewertet. Biozide (32%), Schimmelpilze (27%), Amalgam (22%), Loesemittel (21%) und Formaldehyd (16%) wurden am haeufigsten als umweltmedizinisch relevante Expositionsfaktoren dokumentiert. Bei 52% der 508 Patienten, deren Krankheitsverlauf dokumentiert wurde, wurde die umweltmedizinische Diagnose durch den Verlauf insgesamt und bei 23% zum Teil bestaetigt. Bei 273 (54%) der

  4. [Infection control and safety culture in German hospitals].

    Science.gov (United States)

    Hansen, Sonja; Schwab, Frank; Gropmann, Alexander; Behnke, Michael; Gastmeier, Petra

    2016-07-01

    Healthcare-associated infections (HAI) are the most frequent adverse events in the healthcare setting and their prevention is an important contribution to patient safety in hospitals. To analyse to what extent safety cultural aspects with relevance to infection control are implemented in German hospitals. Safety cultural aspects of infection control were surveyed with an online questionnaire; data were analysed descriptively. Data from 543 hospitals with a median of [IQR] 275 [157; 453] beds were analysed. Almost all hospitals (96.6 %) had internal guidelines for infection control (IC) in place; 82 % defined IC objectives, most often regarding hand hygiene (HH) (93 %) and multidrug resistant organisms (72 %) and less frequently for antibiotic stewardship (48 %) or prevention of specific HAI. In 94 % of hospitals, a reporting system for adverse events was in place, which was also used to report low compliance with HH, outbreaks and Clostridium difficile-associated infections. Members of the IC team were most often seen to hold daily responsibility for IC in the hospital, but rarely other hospital staff (94 versus 19 %). Safety cultural aspects are not fully implemented in German hospitals. IC should be more strongly implemented in healthcare workers' daily routine and more visibly supported by hospital management.

  5. [Clinical risk management in german hospitals - does size really matter?].

    Science.gov (United States)

    Bohnet-Joschko, S; Jandeck, L M; Zippel, C; Andersen, M; Krummenauer, F

    2011-06-01

    In the last years, German hospitals have implemented different measures to increase patient safety. Special importance has been attached to near miss reporting systems (critical incident reporting system, CIRS) as instruments for risk identification in health care, instruments that promise high potential for organisational learning. To gain insight into the current status of critical incident reporting systems and other instruments for clinical risk management, a survey among 341 hospitals was carried out in 2009. Questions covered a process of six steps: from risk strategy to methods for risk identification, to risk analysis and risk assessment, to risk controlling and risk monitoring. Structured telephone interviews were conducted with 341 German hospitals, featuring in their statutory quality reports certain predefined key terms that indicated the concluded or planned implementation of clinical risk management. The main objective of those interviews was to check the relation between status/organisation of self-reported risk management and both operator (private, public, NPO) and size of hospital. The implementation of near miss reporting systems (CIRS) in German hospitals has been constantly rising since 2004: in 2009, 54 % of the interviewed hospitals reported an implemented CIRS; of these, 72 % reported the system to be hospital-wide. An association between CIRS and private, public or NPO-operator could not be detected (Fisher p = 1.000); however, the degree of CIRS implementation was significantly increasing with the size of the hospital, i.e., the number of beds (Fisher p = 0.008): only 38 % of the hospitals with less than 100 beds reported CIRS implementation against 52 % of those between 100 to 500 beds, and 67 % of those with more than 500 beds. While 62 % of the hospitals interviewed reported the maintenance of a risk management committee, only 14 % reported the implementation of risk analysing techniques. As to clinical risk

  6. Management of chronic orofacial pain: a survey of general dentists in german university hospitals

    NARCIS (Netherlands)

    Wirz, Stefan; Ellerkmann, Richard K.; Buecheler, Marcus; Putensen, Christian; Nadstawek, Joachim; Wartenberg, Hans-Christian

    2010-01-01

    AIM: This survey assessed procedures performed by general dentists in German university hospitals treating patients with chronic orofacial pain (COP). METHODS: A standardized questionnaire was sent to dentists at all 42 German universities. Doctors were asked to describe demographics, diagnoses,

  7. Human resource crises in German hospitals--an explorative study.

    Science.gov (United States)

    Schermuly, Carsten C; Draheim, Michael; Glasberg, Ronald; Stantchev, Vladimir; Tamm, Gerrit; Hartmann, Michael; Hessel, Franz

    2015-05-28

    The complexity of providing medical care in a high-tech environment with a highly specialized, limited labour force makes hospitals more crisis-prone than other industries. An effective defence against crises is only possible if the organizational resilience and the capacity to handle crises become part of the hospitals' organizational culture. To become more resilient to crises, a raised awareness--especially in the area of human resource (HR)--is necessary. The aim of this paper is to contribute to the process robustness against crises through the identification and evaluation of relevant HR crises and their causations in hospitals. Qualitative and quantitative methods were combined to identify and evaluate crises in hospitals in the HR sector. A structured workshop with experts was conducted to identify HR crises and their descriptions, as well as causes and consequences for patients and hospitals. To evaluate the findings, an online survey was carried out to rate the occurrence (past, future) and dangerousness of each crisis. Six HR crises were identified in this study: staff shortages, acute loss of personnel following a pandemic, damage to reputation, insufficient communication during restructuring, bullying, and misuse of drugs. The highest occurrence probability in the future was seen in staff shortages, followed by acute loss of personnel following a pandemic. Staff shortages, damage to reputation, and acute loss of personnel following a pandemic were seen as the most dangerous crises. The study concludes that coping with HR crises in hospitals is existential for hospitals and requires increased awareness. The six HR crises identified occurred regularly in German hospitals in the past, and their occurrence probability for the future was rated as high.

  8. Posttraumatic stress disorder (PTSD) in the German Armed Forces: a retrospective study in inpatients of a German army hospital

    OpenAIRE

    Bandelow, Borwin; Koch, Manuel; Zimmermann, Peter; Biesold, Karl-Heinz; Wedekind, Dirk; Falkai, Peter

    2012-01-01

    In 2006 and 2007, around 0.4 and 0.7% of all German soldiers involved in missions abroad were registered as suffering from PTSD. The frequency of PTSD in the German Armed Forces was assessed from army records. All soldiers admitted to the German Military Hospital in Hamburg, Germany, with PTSD (n = 117) in the years 2006 and 2007 were assessed by using questionnaires and structure interviews. Risk factors associated with PTSD were identified. Of the 117 soldiers with PTSD, 39.3% were in missi...

  9. [Does co-operation research provide approaches to explain the changes in the German hospital market?].

    Science.gov (United States)

    Raible, C; Leidl, R

    2004-11-01

    The German hospital market faces an extensive process of consolidation. In this change hospitals consider cooperation as one possibility to improve competitiveness. To investigate explanations of changes in the German hospital market by theoretical approaches of cooperation research. The aims and mechanism of the theories, their relevance in terms of contents and their potential for empirical tests were used as criteria to assess the approaches, with current and future trends in the German hospital market providing the framework. Based on literature review, six theoretical approaches were investigated: industrial organization, transaction cost theory, game theory, resource dependency, institutional theory, and co-operative investment and finance theory. In addition, the data needed to empirically test the theories were specified. As a general problem, some of the theoretical approaches set a perfect market as a precondition. This precondition is not met by the heavily regulated German hospital market. Given the current regulations and the assessment criteria, industrial organization as well as resource-dependency and institutional theory approaches showed the highest potential to explain various aspects of the changes in the hospital market. So far, none of the approaches investigated provides a comprehensive and empirically tested explanation of the changes in the German hospital market. However, some of the approaches provide a theoretical background for part of the changes. As this dynamic market is economically of high significance, there is a need for further development and empirical testing of relevant theoretical approaches.

  10. [Inpatient acute pain management in German hospitals: results from the national survey "Akutschmerzzensus 2012"].

    Science.gov (United States)

    Erlenwein, J; Stamer, U; Koschwitz, R; Koppert, W; Quintel, M; Meißner, W; Petzke, F

    2014-04-01

    In 2007, the German national guidelines on "Treatment of acute perioperative and post-traumatic pain" were published. The aim of this study was to describe current structure and process data for acute pain management in German hospitals and to compare how the guidelines and other initiatives such as benchmarking or certification changed the healthcare landscape in the last decade. All directors of German departments of anesthesiology according to the DGAI ("Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin", German Society for Anesthesiology and Intensive Care) were mailed a standardized questionnaire on structures and processes of acute pain management in their hospitals. A total of 403 completed questionnaires (46 %) could be evaluated. Of hospitals, 81 % had an acute pain service (ASD), whereby only 45 % met defined quality criteria. Written standards for acute pain management were available in 97 % of the hospitals on surgical wards and 51 % on nonsurgical wards. In 96 %, perioperative pain was regularly recorded (generally pain at rest and/or movement, pain-related functional impairment in 16 % only). Beside these routine measurements, only 38 % of hospitals monitored pain for effectiveness after acute medications. Often interdisciplinary working groups and/or pain managers are established for hospital-wide control. As specific therapy, the patient-controlled analgesia and epidural analgesia are largely prevalent (> 90 % of all hospitals). In the last decade, intravenous and oral opioid administration of opioids (including slow release preparations) has become established in acute pain management. The survey was representative by evaluating 20 % of all German hospitals. The organizational requirements for appropriate pain management recommended by the German guidelines for acute pain recommended have been established in the hospital sector in recent years. However, the organizational enforcement for acute pain management in

  11. [Continuity of hospital identifiers in hospital discharge data - Analysis of the nationwide German DRG Statistics from 2005 to 2013].

    Science.gov (United States)

    Nimptsch, Ulrike; Wengler, Annelene; Mansky, Thomas

    2016-11-01

    In Germany, nationwide hospital discharge data (DRG statistics provided by the research data centers of the Federal Statistical Office and the Statistical Offices of the 'Länder') are increasingly used as data source for health services research. Within this data hospitals can be separated via their hospital identifier ([Institutionskennzeichen] IK). However, this hospital identifier primarily designates the invoicing unit and is not necessarily equivalent to one hospital location. Aiming to investigate direction and extent of possible bias in hospital-level analyses this study examines the continuity of the hospital identifier within a cross-sectional and longitudinal approach and compares the results to official hospital census statistics. Within the DRG statistics from 2005 to 2013 the annual number of hospitals as classified by hospital identifiers was counted for each year of observation. The annual number of hospitals derived from DRG statistics was compared to the number of hospitals in the official census statistics 'Grunddaten der Krankenhäuser'. Subsequently, the temporal continuity of hospital identifiers in the DRG statistics was analyzed within cohorts of hospitals. Until 2013, the annual number of hospital identifiers in the DRG statistics fell by 175 (from 1,725 to 1,550). This decline affected only providers with small or medium case volume. The number of hospitals identified in the DRG statistics was lower than the number given in the census statistics (e.g., in 2013 1,550 IK vs. 1,668 hospitals in the census statistics). The longitudinal analyses revealed that the majority of hospital identifiers persisted in the years of observation, while one fifth of hospital identifiers changed. In cross-sectional studies of German hospital discharge data the separation of hospitals via the hospital identifier might lead to underestimating the number of hospitals and consequential overestimation of caseload per hospital. Discontinuities of hospital

  12. [On the comprehensibility of German hospital quality reports: systematic evaluation and need for action].

    Science.gov (United States)

    Friedemann, J; Schubert, H-J; Schwappach, D

    2009-01-01

    This paper focuses on the current resolutions for quality reports of German hospitals as released in 2007 as well as on comprehensibility of these reports for patients. It is meant to analyse the textual information given by these quality reports. Its main objective was to attain a reliable assessment of their comprehensibility for patients on the basis of objective measuring methods. A further goal was to qualify eventual differences between large and small or private and public hospital operators. On the basis of the attained results conclusions on the appropriateness of the current legal situation and the existing criteria for quality reports were to be drawn. The textual system part of 200 German hospital reports was analysed as published in the Internet (latest download 28th May, 2007). The selection took place by means of a controlled sample. The sample structure essentially corresponds to the German hospital system structure in terms of bed numbers and its ratio of public and private operators. The analysis measured all formal text patterns as well as technical terms by means of a computer-aided device. The readability index for each text was calculated according to all known readability formulas for the German language. German hospital quality reports are readable only for those patients who dispose of above-average communicative skills. The analysed reports contain more than 10% technical terms while 17% of the chosen words and 60% of all sentences are too long. 10% of all sentences are too complex and 25% comprise more than three technical terms. To understand these texts at least an entrance qualification for higher education is required in accordance to readability indices. The texts' degree of complexity is comparable to that of philosophical papers. Most textual information given by German hospital quality reports is proven to be unreadable and incomprehensible for most patients. There are no fundamental differences concerning hospital size and

  13. Human resource crises in German hospitals?an explorative study

    OpenAIRE

    Schermuly, Carsten C; Draheim, Michael; Glasberg, Ronald; Stantchev, Vladimir; Tamm, Gerrit; Hartmann, Michael; Hessel, Franz

    2015-01-01

    Background The complexity of providing medical care in a high-tech environment with a highly specialized, limited labour force makes hospitals more crisis-prone than other industries. An effective defence against crises is only possible if the organizational resilience and the capacity to handle crises become part of the hospitals? organizational culture. To become more resilient to crises, a raised awareness?especially in the area of human resource (HR)?is necessary. The aim of this paper is...

  14. IT Decision Making in German Hospitals - Do CEOs Open the Black Box?

    Science.gov (United States)

    Thye, Johannes; Hübner, Ursula; Hüsers, Jens; Babitsch, Birgit

    2017-01-01

    Health IT and communication systems are indispensable in German hospitals for clinical as well as administrative process support. However, IT is often regarded as a "black box" for hospital CEOs. Thus, the question arises how can CEOs decide if they do not know what is in the box? In order to answer this question, half-structured interviews with 14 German hospital CEOs were conducted. They revealed three principle decision processes: the supported decision, the joint decision and the corporate level decision. In all cases, the hospital CEO and the CIO interacted to reach the final decision, most strongly in the joint decision mode and least strongly in the corporate decision mode. Only the joint decision mode definitely forced the CEO to open the "black box" of IT. In the era of digitalisation, however, CEOs must develop better competencies to decide over complex matters.

  15. Discrimination in waiting times by insurance type and financial soundness of German acute care hospitals.

    Science.gov (United States)

    Schwierz, Christoph; Wübker, Achim; Wübker, Ansgar; Kuchinke, Björn A

    2011-10-01

    This paper shows that patients with private health insurance (PHI) are being offered significantly shorter waiting times than patients with statutory health insurance (SHI) in German acute hospital care. This behavior may be driven by the higher expected profitability of PHI relative to SHI holders. Further, we find that hospitals offering private insurees shorter waiting times when compared with SHI holders have a significantly better financial performance than those abstaining from or with less discrimination.

  16. The relationship between transformational leadership and social capital in hospitals--a survey of medical directors of all German hospitals.

    Science.gov (United States)

    Hammer, Antje; Ommen, Oliver; Röttger, Julia; Pfaff, Holger

    2012-01-01

    The German hospital market has been undergoing major changes in recent years. Success in this new market is determined by a multitude of factors. One is the quality of the social relationships between staff and the presence of shared values and rules. This factor can be considered an organization's "social capital." This study investigates the relationship between social capital and leadership style in German hospitals using a written survey of medical directors. In 2008, a cross-sectional representative study was conducted with 1224 medical directors from every hospital in Germany with at least 1 internal medicine unit and 1 surgery unit. Among the scales included in the standardized questionnaire were scales used to assess the medical directors' evaluation of social capital and transformational leadership in the hospital. We used a multiple linear regression model to examine the relationship between social capital and internal coordination. We controlled for hospital ownership, teaching status, and number of beds. In total, we received questionnaires from 551 medical directors, resulting in a response rate of 45.2%. The participating hospitals had an average of 345 beds. The sample included public (41.3%), not-for-profit (46.9%), and for-profit (11.7%) hospitals. The data, which exclusively represent the perceptions of the medical directors, indicate a significant correlation between a transformational leadership style of the executive management and the social capital as perceived by medical directors. A transformational leadership style of the executive management accounted for 36% of variance of the perceived social capital. The perceived social capital in German hospitals is closely related to the leadership style of the executive management. A transformational leadership style of the executive management appears to successfully strengthen the hospital's social capital.

  17. Web-based training in German university eye hospitals - Education 2.0?

    Science.gov (United States)

    Handzel, Daniel M; Hesse, L

    2011-01-01

    To analyse web-based training in ophthalmology offered by German university eye hospitals. In January 2010 the websites of all 36 German university hospitals were searched for information provided for visitors, students and doctors alike. We evaluated the offer in terms of quantity and quality. All websites could be accessed at the time of the study. 28 pages provided information for students and doctors, one page only for students, three exclusively for doctors. Four pages didn't offer any information for these target groups. The websites offered information on events like congresses or students curricular education, there were also material for download for these events or for other purposes. We found complex e-learning-platforms on 9 pages. These dealt with special ophthalmological topics in a didactic arrangement. In spite of the extensive possibilities offered by the technology of Web 2.0, many conceivable tools were only rarely made available. It was not always possible to determine if the information provided was up-to-date, very often the last actualization of the content was long ago. On one page the date for the last change was stated as 2004. Currently there are 9 functional e-learning-applications offered by German university eye hospitals. Two additional hospitals present links to a project of the German Ophthalmological Society. There was a considerable variation in quantity and quality. No website made use of crediting successful studying, e.g. with CME-points or OSCE-credits. All German university eye hospitals present themselves in the World Wide Web. However, the lack of modern, technical as well as didactical state-of-the-art learning applications is alarming as it leaves an essential medium of today's communication unused.

  18. [Instruments of management accounting in german hospitals - potentials for competitive advantage and status quo].

    Science.gov (United States)

    Berens, W; Lachmann, M; Wömpener, A

    2011-03-01

    The aim of this study is to provide an analysis of the status quo for the usage of instruments of management accounting in German hospitals. 600 managing directors of German hospitals were asked to answer a questionnaire about the usage of management accounting instruments in their hospitals. We obtained 121 usable datasets, which are evaluated in this study. A significant increase in the usage of management accounting instruments can be observed over time. The respondents have an overall positive perception of the usage of these instruments. Cost accounting and information systems are among the most widely used instruments, while widely discussed concepts like the balanced scorecard or clinical pathways show surprisingly low usage rates. © Georg Thieme Verlag KG Stuttgart · New York.

  19. [Strategic planning: an important economic action for German hospitals].

    Science.gov (United States)

    Wiese, Christoph H R; Zink, Wolfgang; Russo, Sebastian G

    2011-11-01

    In medical systems, economic issues and means of action are in the course of dwindling human (physicians and nurses) and financial resources are more important. For this reason, physicians must understand basic economic principles. Only in this way, there may be medical autonomy from social systems and hospital administrators. The current work is an approach to present a model for strategic planning of an anesthesia department. For this, a "strengths", "weaknesses", "opportunities", and "threats" (SWOT) analysis is used. This display is an example of an exemplary anaesthetic department. © Georg Thieme Verlag Stuttgart · New York.

  20. Business intelligence and information systems in hospitals--distribution and usage of BI and HIS in German hospitals.

    Science.gov (United States)

    Bartsch, Patrick; Lux, Thomas; Wagner, Alexander; Gabriel, Roland

    2013-01-01

    This paper shows the results of a short survey taken place in February 2013 within German Hospitals. The present studies view is bottom-up and the interviews are done directly with the hospitals CIOs. There are some effects like the G-DRG implementation in Germany that are evident in the results. The survey indicates also the different methods of adapting the solutions, either by having an all-in-one solution by a single provider or by using a modular solution from multiple providers.

  1. A cross-national comparison of incident reporting systems implemented in German and Swiss hospitals.

    Science.gov (United States)

    Manser, Tanja; Imhof, Michael; Lessing, Constanze; Briner, Matthias

    2017-06-01

    This study aimed to empirically compare incident reporting systems (IRS) in two European countries and to explore the relationship of IRS characteristics with context factors such as hospital characteristics and characteristics of clinical risk management (CRM). We performed exploratory, secondary analyses of data on characteristics of IRS from nationwide surveys of CRM practices. The survey was originally sent to 2136 hospitals in Germany and Switzerland. Persons responsible for CRM in 622 hospitals completed the survey (response rate 29%). None. Differences between IRS in German and Swiss hospitals were assessed using Chi2, Fisher's Exact and Freeman-Halton-Tests, as appropriate. To explore interrelations between IRS characteristics and context factors (i.e. hospital and CRM characteristics) we computed Cramer's V. Comparing participating hospitals across countries, Swiss hospitals had implemented IRS earlier, more frequently and more often provided introductory IRS training systematically. German hospitals had more frequently systematically implemented standardized procedures for event analyses. IRS characteristics were significantly associated with hospital characteristics such as hospital type as well as with CRM characteristics such as existence of strategic CRM objectives and of a dedicated position for central CRM coordination. This study contributes to an improved understanding of differences in the way IRS are set up in two European countries and explores related context factors. This opens up new possibilities for empirically informed, strategic interventions to further improve dissemination of IRS and thus support hospitals in their efforts to move patient safety forward. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  2. [How do Turkish immigrants evaluate cultural sensitivity in a German tertiary hospital?].

    Science.gov (United States)

    Giese, Arnd; Uyar, Müberra; Henning, Bernhard F; Uslucan, Haci H; Westhoff, Timm; Pagonas, Nikolaos

    2015-01-01

    Culturally adequate medical care is a goal in Germany, but quantitative data concerning inpatients is lacking. Inpatients of a German tertiary hospital: Turkish migrants (T) and Germans (G) were interviewed in their respective native language. 121 T and 121 G were interviewed. 97.5% of T were Muslims, 82.6% of G were Christians. 88.5% of T judged religion as "important" or "very important" (G: 35.8%). 50.8% of T saw their opportunity to pray in the hospital as "bad" or "very bad" (G: 0.9%). Keeping to Islamic dietary rules in the hospital was "difficult" or "very difficult" for 90% of T. For 79.0% of female T care by a same-sex staff was "important" or "very important" (female G: 36.3%, male T: 40.0%, male G: 7.7%). The presence of a same-sex person during examinations or treatments was "much" or "very much" appreciated by 69.7% of female T, if same-sex care was impossible (female G: 25.4%, male T: 28.9%, male G: 6.1%). A retrospective analysis revealed that 5.8% of all 8988 hospital admissions during the period of study recruitment were Turkish migrants. To meet the needs of Turkish migrants German hospitals should improve the opportunity for Muslims to pray. Additionally, the cooperation with local imams should be sought. Precise descriptions of food ingredients or an adapted menu could help T to deal with Muslim dietary commandments. A culturally sensitive hospital should take into account that female as well as male T prefer to be cared of by same-sex physicians and nurses. Georg Thieme Verlag Stuttgart.

  3. [Reality of treatment in psychotherapy: Results of a survey of German psychiatric hospitals].

    Science.gov (United States)

    Laux, G; Sander, K; Artmann, S; Dreher, J; Lenz, J; Hauth, I

    2015-05-01

    Since the introduction of the qualification as specialist for psychiatry and psychotherapy, in addition to psychopharmacotherapy psychotherapy is an integral component of the treatment of mentally ill people. A survey was carried out to evaluate the reality of clinical routine use of psychotherapy in German psychiatric hospitals. Between October 2011 and March 2012 German hospitals of psychiatry and psychotherapy were contacted by the head organization, the conference of national directors (Bundesdirektorenkonferenz), to participate in a survey regarding the application of psychotherapy in the real clinical world of daily treatment. With an anonymous questionnaire, data were requested as either a printed form or online version. Data from 25 psychiatric hospitals in the year 2010 could be analysed (average number of beds 300 of which 53 were for psychosomatic/psychotherapeutic patients) and a total of 87,000 inpatients were treated whereby 34 % were diagnosed as F1 addictive disorders and 24 % as F3 affective disorders. More than 80 % of the hospitals applied group therapies of relaxation, cognitive behavior therapy, social competence training and specific techniques, such as dialectic-behavior therapy. As individual treatment methods, patients with depressive disorders were treated with cognitive behavior therapy, interpersonal psychotherapy or psychodynamic therapy in more than 50 % of the cases. Relaxation techniques were offered in most cases by the nursing staff, behavior therapy by psychologists and physicians and psychodynamic therapy mainly by psychiatrists.

  4. Lessons learnt from the MAGNET Malawian-German Hospital Partnership: the German perspective on contributions to patient care and capacity development.

    Science.gov (United States)

    Neuhann, Florian; Barteit, Sandra

    2017-07-26

    Malawi is a low-income country with one of the highest HIV prevalence rates worldwide (Kendig et al., Trop Med Health 41:163-170, 2013). The health system depends largely on external funding. Official German development aid has supported health care in Malawi for many years (German Embassy Lilongwe, The German Development Cooperation in Malawi), including placing medical doctors in various departments of the Kamuzu Central Hospital (KCH) in Lilongwe. In 2008, a hospital partnership called MAGNET (Malawi German Networking for Capacity Building in Treatment, Training and Research at KCH) evolved as part of the German ESTHER network. The partnership was abruptly terminated in 2015. We reviewed 35 partnership documents and conducted an online survey of partnership stakeholders to retrospectively assess the hospital partnership based on the Capacity WORKS model of the German Corporation for International Cooperation (GIZ). This model evaluates systems' management and implementation to understand and support the functioning of cooperation within societies. Based on this model, we considered the five success factors for cooperation management: (1) strategy, (2) cooperation, (3) steering, (4) processes, and (5) learning and innovation. In an online survey, we used an adapted version of the partnership evaluation tool by the Centers for Disease Control and Prevention (CDC). From 2008 to 2015, the MAGNET partnership contributed to capacity building and improved patient care in the KCH Medical Department through clinical care, technical support, teaching and trainings, and operations research based on mutually agreed upon objectives. The MAGNET partnership was implemented in three phases during which there were changes in leadership in the Medical Department and the hospital, contractual policies, funder priorities and the competing influences of other actors. Communication and follow up among partners worked best during phases when a German doctor was onsite. The partnership

  5. [Anaesthesia education at german university hospitals: the teachers' perspective -- results of a nationwide survey].

    Science.gov (United States)

    Goldmann, K; Steinfeldt, T; Wulf, H

    2006-04-01

    The principle purpose of this study was to collect data on the conditions and practice of anaesthesia education as well as the teaching qualification of consultants at German university hospitals. Based upon the collected data, areas of weakness and strength as well as measures required to improve anaesthesia training are described. A questionnaire containing 26 items was mailed to 607 consultants employed at 41 German university hospitals in June 2003. A total of 255 questionnaires was analysed (response rate: 43 %). Genuine training activities account for 14 % of the working hours of the participating consultants. On average, at the institutions of participating consultants, novices work for a duration of 1 month together with a consultant anaesthetist before they give anaesthetics without direct and constant supervision. When asked to describe the predominant method of training at their institution 71 % indicated "case-oriented teaching"; however, 53 % chose "see one, do one, teach one" and 49 % "learning by doing" as method of training as well (multiple choice). According to 63 % of respondents, departmental educational activities usually happen after their regular working hours. "Daily workload" (96 %), "time pressure" (96 %), "lack of time" (96 %) and "lack of personnel" (90 %) were indicated as the main obstacles of teaching. According to 80 % of respondents, a dedicated financial budget for education does not exist; instead, financial resources of third parties (industry) (58 %), of the state (for research und undergraduate education) (60 %) and of patients service (66 %) are used to ensure training of anaesthesia residents. Due to a lack of a dedicated financial budget for resident training and an increasing economic pressure, "lack of time" and "lack of personnel" are the main factors leading to the situation at German university hospitals that consultants can only spend 14 % of their working hours for teaching purposes despite of sufficient qualification

  6. Nursing practice in the prevention of pressure ulcers: an observational study of German Hospitals.

    Science.gov (United States)

    Hoviattalab, Khadijeh; Hashemizadeh, Haydeh; D'Cruz, Gibson; Halfens, Ruud J G; Dassen, Theo

    2015-06-01

    The study aimed to establish the range and extent of preventive interventions undertaken by nurses for patients who are at high risk of developing or currently have a pressure ulcer. Since 2000, the German National Expert Standard for the prevention of pressure ulcers has provided evidence-based recommendations, but limited studies have been published on its adherence in hospitals. There are also limited observational studies that investigated whether patients who are at risk of or have pressure ulcers are provided with appropriate preventative measures. A nonparticipant observational descriptive design was used. A sample of 32 adult patients who were at high risk of developing or currently had a pressure ulcer were observed during all shifts in medical and surgical wards in two general hospitals in Germany. A range of preventive interventions that were in line with the German National Expert Standard was observed. The most frequent preventive measures were 'cleaning the patients' skin' and 'minimizing exposure to moisture' that were undertaken in more than 90% of all patients. The least frequent measures were 'patient and relative education', 'assessment and recording of nutritional status'. This study demonstrates that the pressure ulcers preventive interventions as set out in the German National Expert Standard were not fully implemented. The study highlights the need for further studies on the barriers that impede the undertaking of the interventions that may prevent the development or deterioration of pressure ulcers and the delivery of evidence-based preventative care. This study provides an insight into the extent of pressure ulcers preventive practices used by nurses. The results may serve as a basis for developing an effective strategy to improve nursing practice in this area and the promotion of evidence-based practice. However, our results refer to two general hospitals and for a broader population, further studies with larger data samples are needed.

  7. Implementing 'self-help friendliness' in German hospitals: a longitudinal study.

    Science.gov (United States)

    Trojan, Alf; Nickel, Stefan; Kofahl, Christopher

    2016-06-01

    In Germany, the term 'self-help friendliness' (SHF) describes a strategy to institutionalize co-operation of healthcare institutions with mutual aid or self-help groups of chronically ill patients. After a short explanation of the SHF concept and its development, we will present findings from a longitudinal study on the implementation of SHF in three German hospitals. Specifically, we wanted to know (i) to what degree SHF had been put into practice after the initial development phase in the pilot hospitals, (ii) whether it was possible to maintain the level of implementation of SHF in the course of at least 1 year and (iii) which opinions exist about the inclusion of SHF criteria in quality management systems. With only minor restrictions, the findings provide support for the usefulness, practicability, sustainability and transferability of SHF. Limitations of our empirical study are the small number of hospitals, the above average motivation of their staff, the small response rate in the staff-survey and the inability to get enough data from members of self-help groups. The research instrument for measuring SHF was adequate and fulfils the most important scientific quality criteria in a German context. We conclude that the implementation of SHF leads to more patient-centredness in healthcare institutions and thus improves satisfaction, self-management, coping and health literacy of patients. SHF is considered as an adequate approach for reorienting healthcare institutions in the sense of the Ottawa Charta, and particularly suitable for health promoting hospitals. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Working conditions and Work-Family Conflict in German hospital physicians: psychosocial and organisational predictors and consequences

    Directory of Open Access Journals (Sweden)

    Schwappach David

    2008-10-01

    Full Text Available Abstract Background Germany currently experiences a situation of major physician attrition. The incompatibility between work and family has been discussed as one of the major reasons for the increasing departure of German physicians for non-clinical occupations or abroad. This study investigates predictors for one particular direction of Work-Family Conflict – namely work interfering with family conflict (WIF – which are located within the psychosocial work environment or work organisation of hospital physicians. Furthermore, effects of WIF on the individual physicians' physical and mental health were examined. Analyses were performed with an emphasis on gender differences. Comparisons with the general German population were made. Methods Data were collected by questionnaires as part of a study on Psychosocial work hazards and strains of German hospital physicians during April–July 2005. Two hundred and ninety-six hospital physicians (response rate 38.9% participated in the survey. The Copenhagen Psychosocial Questionnaire (COPSOQ, work interfering with family conflict scale (WIF, and hospital-specific single items on work organisation were used to assess WIF, its predictors, and consequences. Results German hospital physicians reported elevated levels of WIF (mean = 74 compared to the general German population (mean = 45, p p Conclusion In our study, work interfering with family conflict (WIF as part of Work-Family Conflict (WFC was highly prevalent among German hospital physicians. Factors of work organisation as well as factors of interpersonal relations at work were identified as significant predictors for WIF. Some of these predictors are accessible to alteration by improving work organisation in hospitals.

  9. Assessing the safety attitudes questionnaire (SAQ), German language version in Swiss university hospitals - a validation study

    Science.gov (United States)

    2013-01-01

    Background Improving patient safety has become a major focus of clinical care and research over the past two decades. An institution’s patient safety climate represents an essential component of ensuring a safe environment and thereby can be vital to the prevention of adverse events. Covering six patient safety related factors, the Safety Attitudes Questionnaire (SAQ) is a validated and widely used instrument to measure the patient safety climate in clinical areas. The objective of this study was to assess the psychometric properties of the German language version of the SAQ. Methods A survey was carried out in two University Hospitals in Switzerland in autumn 2009 where the SAQ was distributed to a sample of 406 nurses and physicians in medical and surgical wards. Following the American Educational Research Association guidelines, we tested the questionnaire validity by levels of evidence: content validity, internal structure and relations to other variables. Confirmatory factor analysis was used to examine factor structure. Cronbach’s alphas and inter-item correlations were calculated to examine internal consistency reliability. Results A total of 319 questionnaires were completed representing an overall response rate of 78.6%. For three items, the item content validity index was <0.75. Confirmatory factor analysis showed acceptable model fit (RMSEA = 0.045; CFI = 0.944) for the six-factor model. Additional exploratory factor analysis could not identify a better factor model. SAQ factor scores showed positive correlations with the Safety Organizing Scale (r = .56 - .72). The SAQ German version showed moderate to strong internal consistency reliability indices (Cronbach alpha = .65 - .83). Conclusions The German language version of the SAQ demonstrated acceptable to good psychometric properties and therefore shows promise to be a sound instrument to measure patient safety climate in Swiss hospital wards. However, the low item content validity and large number

  10. The German clinical risk management survey for hospitals: Implementation levels and areas for improvement in 2015.

    Science.gov (United States)

    Manser, Tanja; Frings, Janina; Heuser, Gregory; Mc Dermott, Fiona

    2016-01-01

    Despite the growing recognition of the need to implement systematic approaches for managing the risks associated with healthcare, few studies have investigated the level of implementation for clinical risk management (CRM) at a national level. Therefore, this study aimed to assess the current level of CRM implementation in German hospitals and to explore differences across hospital types. From March to June 2015, persons responsible for CRM in 2,617 hospitals and rehabilitation clinics in Germany were invited to participate in a voluntary online survey assessing the level of implementation for various aspects of CRM: CRM strategy, structures and processes; risk assessment (risk identification, risk analysis, risk evaluation) with a focus on incident reporting systems; risk mitigation measures; and risk monitoring and reporting. 572 hospitals participated in the survey (response rate 22 %). Most of these hospitals had a formalised, binding CRM strategy (72 %). 66 % had a centralised and 34 % a decentralised CRM structure. We also found that, despite a broad range of risk assessment methods being applied, there was a lack of integration of risk information from different data sources. Hospitals also reported a high level of implementation of critical incident reporting systems with a strong preference for local (74 %) over transorganisational systems. This study provides relevant data to inform targeted interventions concerning CRM implementation at a national level and to consider the specific context of different types of hospitals more carefully in this process. The approach to CRM assessment illustrated in this article could be the basis of a system for monitoring CRM over time and, thus, for evaluating the impact of strategy decisions at the policy level on CRM development. Copyright © 2016. Published by Elsevier GmbH.

  11. Medical Aid, Repression, and International Relations: The East German Hospital at Metema.

    Science.gov (United States)

    Borowy, Iris

    2016-01-01

    Between 1984 and 1988, the German Democratic Republic (GDR) built a hospital in a remote part of Ethiopia, close to the Sudanese border. The project evolved in a complex combination of contexts, including the general foreign policy goals of the GDR, its specific alliance with Ethiopia, the famine of 1984-85, civil war in Ethiopia, and a controversial resettlement program by the government of Mengistu Haile Mariam. Though almost unknown today, it was a high-profile project at the time, which received the personal support both by Erich Honecker in the GDR and Mengistu Haile Mariam in Ethiopia. However, their interest was directed more at the political goals the project was expected to serve than at the hospital itself. Both the preparation and the implementation of the project were extremely difficult and almost failed due to problems of transportation, of red tape, and of security. The operation of the hospital was also not ideal, involving frustrated personnel and less than complete acceptance by the local population. Ironically, for all its practical difficulties, the hospital has outlived both governments and their political goals, surviving as a medical institution. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. [Subjective job strain and job satisfaction among neurologists in German hospitals].

    Science.gov (United States)

    Bauer, J; Bendels, M H K; Groneberg, D A

    2016-06-01

    The number of sick leaves due to job strain is increasing. This study's scope is to examine working conditions of neurologists in hospitals in regard to job strain and job satisfaction. This study is part of the iCEPT-Study. The iCEPT-Study was conducted as a web based survey among physicians (n = 7090) in German hospitals. The focus was on working conditions regarding job strain. Job strain was measured by a questionnaire consisting of items and scales from the short version of the Effort-Reward-Imbalance (ERI) questionnaire and the short questionnaire for working analysis (KFZA). By calculation ratios of distinct scales according to validated stress models a conclusion could be drawn as to whether or not job strain was present. The total number of n = 354 neurologists were analyzed. The response rate was at 18.2 %. Job strain was encountered by 52.0 % (95 %-KI: 46.7|57.2) of all neurologists and no significant gender difference was present. However, resident neurologists were significantly more often exposed to job strain than attending neurologists (OR = 2.9; 95 %-KI: 1.6-4.7; p job satisfaction, 59.6 % (95 %-KI: 54.5-64.7) of all respondents stated to be satisfied with their job. Significantly more men were satisfied than women (OR = 1.5; 95 %-KI: 1.0-2.4; p job than residents (OR = 2.9; 95 %-KI: 1.7-4.8; p job strain among neurologists in German hospitals. Keeping the negative implications of mental and physical health in mind, the working conditions of neurologists must be improved. As shown in this study, a possible way to do so is to increase job control in order to decrease a major stressor at work.

  13. Working conditions and Work-Family Conflict in German hospital physicians: psychosocial and organisational predictors and consequences.

    Science.gov (United States)

    Fuss, Isabelle; Nübling, Matthias; Hasselhorn, Hans-Martin; Schwappach, David; Rieger, Monika A

    2008-10-07

    Germany currently experiences a situation of major physician attrition. The incompatibility between work and family has been discussed as one of the major reasons for the increasing departure of German physicians for non-clinical occupations or abroad. This study investigates predictors for one particular direction of Work-Family Conflict--namely work interfering with family conflict (WIF)--which are located within the psychosocial work environment or work organisation of hospital physicians. Furthermore, effects of WIF on the individual physicians' physical and mental health were examined. Analyses were performed with an emphasis on gender differences. Comparisons with the general German population were made. Data were collected by questionnaires as part of a study on Psychosocial work hazards and strains of German hospital physicians during April-July 2005. Two hundred and ninety-six hospital physicians (response rate 38.9%) participated in the survey. The Copenhagen Psychosocial Questionnaire (COPSOQ), work interfering with family conflict scale (WIF), and hospital-specific single items on work organisation were used to assess WIF, its predictors, and consequences. German hospital physicians reported elevated levels of WIF (mean = 74) compared to the general German population (mean = 45, p work, elevated number of days at work despite own illness, and consequences of short-notice changes in the duty roster. Good sense of community at work was a protective factor. Compared to the general German population, we observed a significant higher level of quantitative work demands among hospital physicians (mean = 73 vs. mean = 57, p work ability, and higher satisfaction with life in general. Compared to the German general population, physicians showed significantly higher levels of individual stress and quality of life as well as lower levels for well-being. This has to be judged as an alerting finding regarding the state of physicians' health. In our study, work

  14. Job satisfaction and the work situation of physicians: a survey at a German university hospital.

    Science.gov (United States)

    Laubach, Wilfried; Fischbeck, Sabine

    2007-01-01

    Job demands and workload of hospital physicians are increasing. The object of this survey was to examine the factors that constitute job satisfaction and to analyse physicians' work situation in the area of in-patient care. 447 physicians at a German University Hospital received questionnaires with regard to work situation, job satisfaction and personal health. Data were analysed by MANOVA and multiple regression models. A first regression model explained 53% of the variance in satisfaction with "work and profession". Among the explanatory variables "superiors and hierarchy" showed the highest beta-weight (beta = -0.49). "Personal health" also determined job satisfaction, for female physicians stronger (beta = -0.31) than for male physicians (beta = -0.11). In a second regression model on satisfaction with "Financial situation" only 18% of the variance was explained, whereby "work condition on the ward", "personal health" and "collaboration between occupational groups" showed the highest beta-weights. Among resident physicians, work conditions, superiors, hierarchy, transparency and participation in decisions are very important variables for job satisfaction. Improvements in these aspects may improve job satisfaction and help to reduce physician shortage in hospitals.

  15. NATO mission in Kosovo: historical backgrounds and informations of working as radiologist in the German field hospital

    International Nuclear Information System (INIS)

    Voelk, M.; Danz, B.

    2005-01-01

    The first part of this article describes how the NATO mission in Kosovo came into existence and focuses on the historical background and ethnical problems. The second part deals with the working conditions of a radiologist in the German field hospital in Prizren and focuses on the personnel and technical equipment in the radiological department. (orig.) [de

  16. Strategies to enhance rational use of antibiotics in hospital : a guideline by the German Society for Infectious Diseases

    NARCIS (Netherlands)

    de With, K.; Allerberger, F.; Amann, S.; Apfalter, P.; Brodt, H. -R.; Eckmanns, T.; Fellhauer, M.; Geiss, H. K.; Janata, O.; Krause, R.; Lemmen, S.; Meyer, E.; Mittermayer, H.; Porsche, U.; Presterl, E.; Reuter, S.; Sinha, B.; Strauss, R.; Wechsler-Foerdoes, A.; Wenisch, C.; Kern, W. V.

    In the time of increasing resistance and paucity of new drug development there is a growing need for strategies to enhance rational use of antibiotics in German and Austrian hospitals. An evidence-based guideline on recommendations for implementation of antibiotic stewardship (ABS) programmes was

  17. Difficulties experienced by migrant physicians working in German hospitals: a qualitative interview study.

    Science.gov (United States)

    Klingler, Corinna; Marckmann, Georg

    2016-09-23

    With Germany facing a shortage of doctors, hospitals have been increasingly recruiting physicians from abroad. Studies in other countries have shown that migrant physicians experience various difficulties in their work, which might impact the quality of patient care, physician job satisfaction, and, accordingly, retention. The experiences of migrant doctors in Germany have not been systematically studied so far and will likely differ from experiences migrant physicians make in other contexts. A thorough understanding of challenges faced by this group, however, is needed to develop adequate support structures-as required by the WHO Global Code of Practice on the International Recruitment of Health Personnel. A qualitative study was conducted to give an overview of the multifaceted difficulties migrant physicians might face in German hospitals. Twenty semi-structured interviews with foreign-born and foreign-trained physicians were conducted in German. Participants were recruited via the State Chambers of Physicians and snowballing based on a maximum variation sampling strategy varying purposefully by source country and medical specialty. The interviews were recorded, transcribed verbatim, and analysed using qualitative content analysis. Participants described difficulties relating to healthcare institutions, own competencies, and interpersonal interactions. Participants experienced certain legal norms, the regulation of licensure and application for work, and the organization of the hospital environment as inadequate. Most struggled with their lack of setting-specific (language, cultural, clinical, and system) knowledge. Furthermore, behaviour of patients and co-workers was perceived as discriminating or inadequate for other reasons. This is the first study to describe the broad range of issues migrant physicians experience in Germany. Based on this information, institutional actors should devise support structures to ensure quality of care, physician wellbeing, and

  18. Consumer attitudes about health care acquired infections: a German survey on factors considered important in the choice of a hospital.

    Science.gov (United States)

    Vonberg, Ralf-Peter; Sander, Carsten; Gastmeier, Petra

    2008-01-01

    Most patients are free in their choice of hospital for nonemergency admissions. In a nationwide survey in 1000 German households, we interviewed randomly chosen persons (age 14 and older) by phone about what they consider important when choosing a hospital. A standardized questionnaire was used. Additionally, question order was randomized prior to each interview. Demographic data included age, gender, education, and previous admissions to hospitals. Categories that might influence the choice of hospital included "distance to hospital," "friendly staff," "staff-to-patient ratio," "cleanliness," "nosocomial infection rate," "own experiences," "friend's opinion," and "facility's reputation in public media." General cleanliness, low nosocomial infection rates, and friendly staff proved to be the most important issues in our study. In contrast, the reputation of the health care facility in the public media was much less important. It seems that kindness and basic hygiene measures, both quite inexpensive factors, are key issues for patients.

  19. The trend of pressure ulcer prevalence rates in German hospitals: results of seven cross-sectional studies.

    Science.gov (United States)

    Kottner, Jan; Wilborn, Doris; Dassen, Theo; Lahmann, Nils

    2009-05-01

    Pressure ulcer prevalence rates provide useful information about the magnitude of this health problem. Only limited information on pressure ulcers in Germany was available before 2001. The purpose of this study was to compare results of seven pressure ulcer prevalence surveys which were conducted annually between 2001 and 2007 and to explore whether pressure ulcer prevalence rates decreased. The second aim was to evaluate if the measured prevalence rates of our sample could be generalised for all German hospitals. Results of seven point pressure ulcer prevalence studies conducted in 225 German hospitals were analysed. Chi-square tests, chi-square trend tests and one-way ANOVA to assess differences and trends across the years were applied. The sample was stratified according to pressure ulcer risk and speciality. Finally, study samples were compared with the potential population. In total data of 40,247 hospital patients were analysed. The overall pressure ulcer prevalence rate in German hospitals was 10.2%. Patient samples of each year were comparable regarding gender, age and pressure ulcer risk. Pressure ulcer prevalence rates decreased from 13.9% (year 2001) to 7.3% (year 2007) (pcare units remained stable. With some limitations our study results are representative for all hospitals within Germany. It is highly probable that the decrease of prevalence rates was due to an increased awareness of the pressure ulcer problem in Germany and subsequent efforts to improve pressure ulcer prevention and treatment. The quality of clinical practice regarding pressure ulcer prevention and treatment has improved. However, pressure ulcers are still relevant and require attention. In 2007, one out of 10 hospital patients who were at pressure ulcer risk had at least one pressure related skin damage.

  20. [Inadequate ICU-admissions : A 12-month prospective cohort study at a German University Hospital].

    Science.gov (United States)

    Bangert, K; Borch, J; Ferahli, S; Braune, S A; de Heer, G; Kluge, S

    2016-05-01

    Intensive care medicine (ICM) is increasingly utilized by a growing number of critically ill patients worldwide. The reasons for this are an increasingly ageing and multimorbid population and technological improvements in ICM. Inappropriate patient admissions to the intensive care unit (ICU) can be a threat to rational resource allocation and to patient autonomy. In this study, the incidence, characteristics, and resource utilization of patients inappropriately admitted to ICUs are studied. This prospective study included all consecutive patients admitted from 01 September 2012 to 31 August 2013 to the Department of Intensive Care Medicine of a German university hospital comprised of 10 ICUs and 120 beds. Inappropriate admission was defined according to category 4B of the recommendations of the Society of Critical Care Medicine (SCCM; "futility of ICU treatment" or "ICU declined by patient") and was determined in each suspected case by structured group discussions between the study team and all involved care givers including the referring team. In all, 66 of 6452 ICU admissions (1 %) were suspected to have been inappropriate on retrospective evaluation the day after admission. In 50 patients (0.8 %), an interdisciplinary consensus was reached on the inappropriateness of the ICU admission. Of these 50 patients, 41 (82 %) had previously declined ICU treatment in principle. This information was based on the patient's presumed wish as expressed by next of kin (56 %) or in a written advanced directive (26 %). In 9 patients (18 %), ICU treatment was considered futile. In all cases, a lack of information regarding a patient's wishes or clinical prognosis was the reason for inappropriate ICU admission. In this study, patients were regularly admitted to the ICU despite their contrary wish/directive or an unfavorable clinical condition. Although this was registered in only 1 % of all admissions, optimizing preICU admission information flow with regard to

  1. [Cases and duration of mechanical ventilation in German hospitals : An analysis of DRG incentives and developments in respiratory medicine].

    Science.gov (United States)

    Biermann, A; Geissler, A

    2016-09-01

    Diagnosis-related groups (DRGs) have been used to reimburse hospitals services in Germany since 2003/04. Like any other reimbursement system, DRGs offer specific incentives for hospitals that may lead to unintended consequences for patients. In the German context, specific procedures and their documentation are suspected to be primarily performed to increase hospital revenues. Mechanical ventilation of patients and particularly the duration of ventilation, which is an important variable for the DRG-classification, are often discussed to be among these procedures. The aim of this study was to examine incentives created by the German DRG-based payment system with regard to mechanical ventilation and to identify factors that explain the considerable increase of mechanically ventilated patients in recent years. Moreover, the assumption that hospitals perform mechanical ventilation in order to gain economic benefits was examined. In order to gain insights on the development of the number of mechanically ventilated patients, patient-level data provided by the German Federal Statistical Office and the German Institute for the Hospital Remuneration System were analyzed. The type of performed ventilation, the total number of ventilation hours, the age distribution, mortality and the DRG distribution for mechanical ventilation were calculated, using methods of descriptive and inferential statistics. Furthermore, changes in DRG-definitions and changes in respiratory medicine were compared for the years 2005-2012. Since the introduction of the DRG-based payment system in Germany, the hours of ventilation and the number of mechanically ventilated patients have substantially increased, while mortality has decreased. During the same period there has been a switch to less invasive ventilation methods. The age distribution has shifted to higher age-groups. A ventilation duration determined by DRG definitions could not be found. Due to advances in respiratory medicine, new

  2. The impact of a proactive chronic care management program on hospital admission rates in a German health insurance society.

    Science.gov (United States)

    Hamar, Brent; Wells, Aaron; Gandy, William; Haaf, Andreas; Coberley, Carter; Pope, James E; Rula, Elizabeth Y

    2010-12-01

    Hospital admissions are the source of significant health care expenses, although a large proportion of these admissions can be avoided through proper management of chronic disease. In the present study, we evaluate the impact of a proactive chronic care management program for members of a German insurance society who suffer from chronic disease. Specifically, we tested the impact of nurse-delivered care calls on hospital admission rates. Study participants were insured individuals with coronary artery disease, heart failure, diabetes, or chronic obstructive pulmonary disease who consented to participate in the chronic care management program. Intervention (n  = 17,319) and Comparison (n  = 5668) groups were defined based on records of participating (or not participating) in telephonic interactions. Changes in admission rates were calculated from the year prior to (Base) and year after program commencement. Comparative analyses were adjusted for age, sex, region of residence, and disease severity (stratification of 3 [least severe] to 1 [most severe]). Overall, the admission rate in the Intervention group decreased by 6.2% compared with a 14.9% increase in the Comparison group (P  management care calls can help reduce hospital admissions among German health insurance members with chronic disease.

  3. Profiling quality of care for patients with chronic headache in three different German hospitals – a case study

    Directory of Open Access Journals (Sweden)

    Hager Stefan

    2008-01-01

    Full Text Available Abstract Background Legal requirements for quality assurance in German rehabilitation hospitals include comparisons of providers. Objective is to describe and to compare outcome quality of care offered by three hospitals providing in-patient rehabilitative treatment exemplified for patients with chronic headache. Methods We performed a prospective three center observational study on patients suffering from chronic headache. Patients underwent interventions commonly used according to internal guidelines of the hospitals. Measurements were taken at three points in time (at admission, at discharge and 6 months after discharge. Indicators of outcome quality included pain intensity and frequency of pain, functional ability, depression, quality of life and health related behavior. Analyses of differences amongst the hospitals were adjusted by covariates due to case-mix situation. Results 306 patients from 3 hospitals were included in statistical analysis. Amongst the hospitals, patients differed significantly in age, education, diagnostic subgroups, beliefs, and with respect to some pain-related baseline values (covariates. Patients in all three hospitals benefited from intervention to a clinically relevant degree. At discharge from hospital, outcome quality differed significantly after adjustment according to case-mix only in terms of patients' global assessment of treatment results. Six months after discharge, the only detectable significant differences were for secondary outcomes like improved coping with stress or increased use of self-help. The profiles for satisfaction with the hospital stay showed clear differences amongst patients. Conclusion The results of this case study do not suggest a definite overall ranking of the three hospitals that were compared, but outcome profiles offer a multilayer platform of reliable information which might facilitate decision making.

  4. Antibiotics susceptibility patterns of bacteria isolated from American and German cockroaches as potential vectors of microbial pathogens in hospitals

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Fakoorziba

    2014-09-01

    Full Text Available Objective: To identify the cockroach species, their bacterial flora and antibiotics susceptibility patterns of these bacteria in Shiraz. Methods: In the present descriptive study, only two species of cockroaches were recognized. The washing solutions from the digestion systems and surfaces of 156 American and German cockroaches were cultured. The latter was found to be the commonest (89.7% in all places. Results: Overall, 18 species of bacteria were isolated and identified by standard culture methods. The most frequent bacterium isolated from both species of cockroaches in all places was Pseudomonas (41.7%. The second and third commonest bacteria were Enterobacter (39.7% and Klebsiella (32.7%, respectively. Conclusions: The antibiogram profiles showed full (100% resistance of Klebsiella, Citrobacter, Acinetobacter and Proteus to amoxicillin and ampicillin at both hospitals, while Pseudomonas showed resistance (95.7% to cephalothin. Thus it is concluded that German and American cockroaches carry multidrug resistant bacteria in two hospitals which raises alarm for stricter control measures.

  5. The Application of Standards and Recommendations to Clinical Ethics Consultation in Practice: An Evaluation at German Hospitals.

    Science.gov (United States)

    Schochow, Maximilian; Rubeis, Giovanni; Steger, Florian

    2017-06-01

    The executive board of the Academy for Ethics in Medicine (AEM) and two AEM working groups formulated standards and recommendations for clinical ethics consultation in 2010, 2011, and 2013. These guidelines comply with the international standards like those set by the American Society for Bioethics and Humanities. There is no empirical data available yet that could indicate whether these standards and recommendations have been implemented in German hospitals. This desideratum is addressed in the present study. We contacted 1.858 German hospitals between September 2013 and January 2014. A follow-up survey was conducted between October 2014 and January 2015. The data of the initial survey and the follow-up survey were merged and evaluated. The statements of the participants were compared with the standards and recommendations. The standards of the AEM concerning the tasks of clinical ethics consultation (including ethics consultation, ethics training and the establishment of policy guidelines) are employed by a majority of participants of the study. Almost all of these participants document their consultation activities by means of protocols or entries in the patient file. There are deviations from the recommendations of the AEM working groups regarding the drafting of statutes, activity reports, and financial support. The activities of clinical ethics consultation predominantly comply with the standards of the AEM and recommendations for the documentation. The recommendations for evaluation should be improved in practice. This applies particularly for activity reports in order to evaluate the activities. Internal evaluation could take place accordingly.

  6. Assessing the Safety Attitudes Questionnaire (SAQ), German language version in Swiss university hospitals--a validation study.

    Science.gov (United States)

    Zimmermann, Natalie; Küng, Kaspar; Sereika, Susan M; Engberg, Sandra; Sexton, Bryan; Schwendimann, René

    2013-09-10

    Improving patient safety has become a major focus of clinical care and research over the past two decades. An institution's patient safety climate represents an essential component of ensuring a safe environment and thereby can be vital to the prevention of adverse events. Covering six patient safety related factors, the Safety Attitudes Questionnaire (SAQ) is a validated and widely used instrument to measure the patient safety climate in clinical areas. The objective of this study was to assess the psychometric properties of the German language version of the SAQ. A survey was carried out in two University Hospitals in Switzerland in autumn 2009 where the SAQ was distributed to a sample of 406 nurses and physicians in medical and surgical wards. Following the American Educational Research Association guidelines, we tested the questionnaire validity by levels of evidence: content validity, internal structure and relations to other variables. Confirmatory factor analysis was used to examine factor structure. Cronbach's alphas and inter-item correlations were calculated to examine internal consistency reliability. A total of 319 questionnaires were completed representing an overall response rate of 78.6%. For three items, the item content validity index was <0.75. Confirmatory factor analysis showed acceptable model fit (RMSEA = 0.045; CFI = 0.944) for the six-factor model. Additional exploratory factor analysis could not identify a better factor model. SAQ factor scores showed positive correlations with the Safety Organizing Scale (r = .56-.72). The SAQ German version showed moderate to strong internal consistency reliability indices (Cronbach alpha = .65-.83). The German language version of the SAQ demonstrated acceptable to good psychometric properties and therefore shows promise to be a sound instrument to measure patient safety climate in Swiss hospital wards. However, the low item content validity and large number of missing responses for several items suggest

  7. Pediatric computed tomography practice in Japanese university hospitals from 2008–2010: did it differ from German practice?

    International Nuclear Information System (INIS)

    Yoshida, Koji; Krille, Lucian; Dreger, Steffen; Hoenig, Lars; Merzenich, Hiltrud; Yasui, Kiyotaka; Kumagai, Atsushi; Ohtsuru, Akira; Uetani, Masataka; Mildenberger, Peter; Takamura, Noboru; Yamashita, Shunichi; Zeeb, Hajo; Kudo, Takashi

    2017-01-01

    Computed tomography (CT) is an essential tool in modern medicine and is frequently used to diagnose a wide range of conditions, particularly in industrial countries, such as Japan and Germany. However, markedly higher doses of ionizing radiation are delivered during CT imaging than during conventional X-ray examinations. To assess pediatric CT practice patterns, data from three university hospital databases (two in Japan and one in Germany) were analyzed. Anonymized data for patients aged 0 to 14 years who had undergone CT examinations between 2008 and 2010 were extracted. To assess CT practice, an interdisciplinary classification scheme for CT indications, which incorporated the most common examination types and radiosensitive tissues, was developed. The frequency of CT examinations was determined according to sex, age at examination, and indications. A total of 5182 CT examinations were performed in 2955 children. Overall, the frequency of CT examinations at the Japanese university hospitals did not differ significantly from that at the German hospital. However, differences were detected in the age distribution of the patients who underwent CT examinations (the proportion of patients <5 years of age was significantly higher in Japan than in Germany) and in the indications for CT. Substantial practice differences regarding the use of CT in pediatric health care were detected between the three hospitals. The results of this study point towards a need for approaches such as clinical guidelines to reduce unwarranted medical radiation exposures, particularly abdominal and head CT, in the Japanese health system.

  8. [Caesarean section in german hospitals: validity of hospital quality report data for monitoring C-section rates].

    Science.gov (United States)

    Junghänel, K; Renz-Polster, H; Jarczok, M N; Hornemann, A; Böhler, T; De Bock, F

    2015-04-01

    It is not known if "hospital quality reports" (HQR) document Caesarean (C-) section rates at the hospital level accurately enough for use as a reliable data source when it comes to explaining regional variations of C-sections in Germany by factors at the hospital level. We aimed to answer this question using HQR from hospitals in Baden-Württemberg as data source. Diagnostic and procedure codes from HQR for the year 2008 (HQRdata), were used to calculate numbers of births, numbers of C-sections, and rates of births by C-section (CSR) for 94 of 97 hospitals in Baden-Württemberg. These numbers were compared to internal hospital (IH) data delivered upon request by 80 of 97 hospitals and stemming from vital statistics, birth registry forms, or external quality assurance datasets. There was no difference in the number of births between HQR data and IH data, but the number of C-sections and the CSR differed significantly (pCSR calculated using HQR data was 4.9 ± 17.9% higher than CSR from IH data (absolute difference 1.5 ± 5.8%). The correlation between the 2 data sources was moderate (r=0.73). Only 55% of the variance in IH data-based CSR was explained by HQR data. The proportion between highest and lowest CSR in hospitals in Baden-Württemberg was 4.9 for HQR data and 3.6 for IH data. There are significant and relevant differences between C-section rates based on ei-ther HQR or IH data. This questions routine data from HQR for 2008 as a reliable data source for research work. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Reduction of the nosocomial meticillin-resistant Staphylococcus aureus incidence density by a region-wide search and follow-strategy in forty German hospitals of the EUREGIO, 2009 to 2011

    NARCIS (Netherlands)

    Jurke, A; Kock, R; Becker, K; Thole, S; Hendrix, R; Rossen, J; Daniels-Haardt, I; Friedrich, AW

    2013-01-01

    Meticillin-resistant Staphylococcus aureus (MRSA) disseminates between hospitals serving one patient catchment area. Successful prevention and control requires concerted efforts and regional surveillance. Forty hospitals located in the German EUREGIO have established a network for combating MRSA. In

  10. Shopping in Hospitality: Situational Constructions of Customer-Vendor Relationships among Shopping Tourists at a Bazaar on the German-Polish Border

    Science.gov (United States)

    Busch, Dominic

    2010-01-01

    This article presents an analysis of a short customer-vendor dialogue between a German couple and a Polish vendor at a food bazaar on the Polish border with Germany. In this situation, interactants have to negotiate and construct framings of hospitality abroad, customer-vendor relations, as well as intercultural relations. It is assumed that…

  11. [A paradigm change in German academic medicine. Merger and privatization as exemplified with the university hospitals in Marburg and Giessen].

    Science.gov (United States)

    Maisch, Bernhard

    2005-03-01

    1. The intended fusion of the university hospitals Marburg and Giessen in the state of Hessia is "a marriage under pressure with uncalculated risk" (Spiegel 2005). In the present political and financial situation it hardly appears to be avoidable. From the point of the view of the faculty of medicine in Marburg it is difficult to understand, that the profits of this well guided university hospital with a positive yearly budget should go to the neighboring university hospital which still had a fair amount of deficit spending in the last years.2. Both medical faculties suffer from a very low budget from the state of Hessia for research and teaching. Giessen much more than Marburg, have a substantial need for investments in buildings and infrastructure. Both institutions have a similar need for investments in costly medical apparatuses. This is a problem, which many university hospitals face nowadays.3. The intended privatisation of one or both university hospitals will need sound answers to several fundamental questions and problems:a) A privatisation potentially endangers the freedom of research and teaching garanteed by the German constitution. A private company will undoubtedly influence by active or missing additional support the direction of research in the respective academic institution. An example is the priorisation of clinical in contrast to basic research.b) With the privatisation practical absurdities in the separation of research and teaching on one side and hospital care on the other will become obvious with respect to the status of the academic employees, the obligatory taxation (16%) when a transfer of labor from one institution to the other is taken into account. The use of rooms for seminars, lectures and bedside with a double function for both teaching, research and hospital care has to be clarified with a convincing solution in everyday practice.c) The potential additional acquisition of patients, which has been advocated by the Hessian state

  12. [Cost of intensive care in a German hospital: cost-unit accounting based on the InEK matrix].

    Science.gov (United States)

    Martin, J; Neurohr, C; Bauer, M; Weiss, M; Schleppers, A

    2008-05-01

    The aim of this study was to determine the actual cost per intensive care unit (ICU) day in Germany based on routine data from an electronic patient data management system as well as analysis of cost-driving factors. A differentiation between days with and without mechanical ventilation was performed. On the ICU of a German focused-care hospital (896 beds, 12 anesthesiology ICU beds), cost per treatment day was calculated with or without mechanical ventilation from the perspective of the hospital. Costs were derived retrospectively with respect to the period between January and October 2006 by cost-unit accounting based on routine data collected from the ICU patients. Patients with a length of stay of at least 2 days on the ICU were included. Demographic, clinical and economical data were analyzed for patient characterization. Data of 407 patients (217 male and 190 female) were included in the analysis, of which 159 patients (100 male, 59 female) were completely or partially mechanically ventilated. The mean simplified acute physiology (SAPS) II score at the onset of ICU stay was 28.2. Average cost per ICU day was 1,265 EUR and costs for ICU days with and without mechanical ventilation amounted to 1,426 EUR and 1,145 EUR, respectively. Personnel costs (50%) showed the largest cost share followed by drugs plus medicinal products (18%) and infrastructure (16%). For the first time, a cost analysis of intensive care in Germany was performed with routine data based on the matrix of the institute for reimbursement in hospitals (InEK). The results revealed a higher resource use on the ICU than previously expected. The large share of personnel costs on the ICU was evident but is comparable to other medical departments in the hospital. The need for mechanical ventilation increases the daily costs of resources by approximately 25%.

  13. Policy trends and reforms in the German DRG-based hospital payment system.

    Science.gov (United States)

    Klein-Hitpaß, Uwe; Scheller-Kreinsen, David

    2015-03-01

    A central structural point in all DRG-based hospital payment systems is the conversion of relative weights into actual payments. In this context policy makers need to address (amongst other things) (a) how the price level of DRG-payments from one period to the following period is changed and (b) whether and how hospital payments based on DRGs are to be differentiated beyond patient characteristics, e.g. by organizational, regional or state-level factors. Both policy problems can be and in international comparison often are empirically addressed. In Germany relative weights are derived from a highly sophisticated empirical cost calculation, whereas the annual changes of DRG-based payments (base rates) as well as the differentiation of DRG-based hospital payments beyond patient characteristics are not empirically addressed. Rather a complex set of regulations and quasi-market negotiations are applied. There were over the last decade also timid attempts to foster the use of empirical data to address these points. However, these reforms failed to increase the fairness, transparency and rationality of the mechanism to convert relative weights into actual DRG-based hospital payments. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  14. Microsatellite Instability Occurs Rarely in Patients with Cholangiocarcinoma: A Retrospective Study from a German Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

    Ria Winkelmann

    2018-05-01

    Full Text Available Immune-modulating therapy is a promising therapy for patients with cholangiocarcinoma (CCA. Microsatellite instability (MSI might be a favorable predictor for treatment response, but comprehensive data on the prevalence of MSI in CCA are missing. The aim of the current study was to determine the prevalence of MSI in a German tertiary care hospital. Formalin-fixed paraffin-embedded tissue samples, obtained in the study period from 2007 to 2015 from patients with CCA undergoing surgical resection with curative intention at Johann Wolfgang Goethe University hospital, were examined. All samples were investigated immunohistochemically for the presence of MSI (expression of MLH1, PMS2, MSH2, and MSH6 as well as by pentaplex polymerase chain reaction for five quasimonomorphic mononucleotide repeats (BAT-25, BAT-26, NR-21, NR-22, and NR-24. In total, 102 patients were included, presenting intrahepatic (n = 35, 34.3%, perihilar (n = 42, 41.2%, and distal CCA (n = 25, 24.5%. In the immunohistochemical analysis, no loss of expression of DNA repair enzymes was observed. In the PCR-based analysis, one out of 102 patients was found to be MSI-high and one out of 102 was found to be MSI-low. Thus, MSI seems to appear rarely in CCA in Germany. This should be considered when planning immune-modulating therapy trials for patients with CCA.

  15. The extent of the psychological impairment of prosthodontic outpatients at a German University Hospital

    Directory of Open Access Journals (Sweden)

    Zimmer Stefan

    2008-10-01

    considerations to future German education plans.

  16. Care of cancer patients at the end of life in a German university hospital: A retrospective observational study from 2014.

    Directory of Open Access Journals (Sweden)

    Burkhard Dasch

    Full Text Available Cancer care including aggressive treatment procedures during the last phase of life in patients with incurable cancer has increasingly come under scrutiny, while integrating specialist palliative care at an early stage is regarded as indication for high quality end-of-life patient care.To describe the demographic and clinical characteristics and the medical care provided at the end of life of cancer patients who died in a German university hospital.Retrospective cross-sectional study on the basis of anonymized hospital data for cancer patients who died in the Munich University Hospital in 2014. Descriptive analysis and multivariate logistic regression analyses for factors influencing the administration of aggressive treatment procedures at the end of life.Overall, 532 cancer patients died. Mean age was 66.8 years, 58.5% were men. 110/532 (20.7% decedents had hematologic malignancies and 422/532 (79.3% a solid tumor. Patients underwent the following medical interventions in the last 7/30 days: chemotherapy (7.7%/38.3%, radiotherapy (2.6%/6.4%, resuscitation (8.5%/10.5%, surgery (15.2%/31.0%, renal replacement therapy (12.0%/16.9%, blood transfusions (21.2%/39.5%, CT scan (33.8%/60.9%. In comparison to patients with solid tumors, patients with hematologic malignancies were more likely to die in intensive care (25.4% vs. 49.1%; p = 0.001, and were also more likely to receive blood transfusions (OR 2.21; 95% CI, 1.36 to 3.58; p = 0.001 and renal replacement therapy (OR 2.65; 95% CI, 1.49 to 4.70; p = 0.001 in the last 7 days of life. Contact with the hospital palliative care team had been initiated in 161/532 patients (30.3%. In 87/161 cases (54.0%, the contact was initiated within the last week of the patient's life.Overambitious treatments are still reality at the end of life in cancer patients in hospital but patients with solid tumors and hematologic malignancies have to be differentiated. More efforts are necessary for the timely inclusion of

  17. Anticholinergic burden and cognitive function in a large German cohort of hospitalized geriatric patients.

    Directory of Open Access Journals (Sweden)

    Barbara Pfistermeister

    Full Text Available Previous studies suggest an association between use of anticholinergic drugs in elderly patients and cognitive impairment. However, there are still limited data on the association of anticholinergic drug use and cognitive impairment as well as contribution of individual drugs to anticholinergic load using large, well-documented patient cohorts treated in geriatric units from Europe.We investigated 797,440 prescriptions to 89,579 hospitalized patients treated in geriatric units within the GiB-DAT database. Data of all patients discharged between 1 January 2013 and 30 June 2015 was included. The Anticholinergic Cognitive Burden (ACB scale was used to classify anticholinergic drugs as definite (score 2 or 3 and possible anticholinergics (score 1. Cognitive function was determined using Mini-Mental State Examination (MMSE and the standardized scale for dementia (4D+S.In two multivariable logistic regression models age, sex, number of drugs and ACB total scores were identified as variables independently associated with cognitive impairment as measured by MMSE (odds ratio per ACB unit 1.114, 95% CI 1.099-1.130 or the diagnosis dementia (odds ratio 1.159 per ACB unit, 95% CI 1.144-1.173, both p < 0.0001. High anticholinergic load was associated with patients with severe cognitive impairment (p < 0.05 for all pairwise comparisons. ACB score 3 anticholinergic drugs contributed 77.9% to the cumulative amount of ACB points in patients with an anticholinergic load of 3 and higher.Using a cross-sectional study design, a significant positive association between anticholinergic drug load and cognitive impairment in European patients treated in specialised geriatric units was found. The most frequently used definitve anticholinergic drugs were quetiapine, amitriptyline and carbamazepine.

  18. Antimicrobial usage in German acute care hospitals: results of the third national point prevalence survey and comparison with previous national point prevalence surveys.

    Science.gov (United States)

    Aghdassi, Seven Johannes Sam; Gastmeier, Petra; Piening, Brar Christian; Behnke, Michael; Peña Diaz, Luis Alberto; Gropmann, Alexander; Rosenbusch, Marie-Luise; Kramer, Tobias Siegfried; Hansen, Sonja

    2018-04-01

    Previous point prevalence surveys (PPSs) revealed the potential for improving antimicrobial usage (AU) in German acute care hospitals. Data from the 2016 German national PPS on healthcare-associated infections and AU were used to evaluate efforts in antimicrobial stewardship (AMS). A national PPS in Germany was organized by the German National Reference Centre for Surveillance of Nosocomial Infections in 2016 as part of the European PPS initiated by the ECDC. The data were collected in May and June 2016. Results were compared with data from the PPS 2011. A total of 218 hospitals with 64 412 observed patients participated in the PPS 2016. The prevalence of patients with AU was 25.9% (95% CI 25.6%-26.3%). No significant increase or decrease in AU prevalence was revealed in the group of all participating hospitals. Prolonged surgical prophylaxis was found to be common (56.1% of all surgical prophylaxes on the prevalence day), but significantly less prevalent than in 2011 (P < 0.01). The most frequently administered antimicrobial groups were penicillins plus β-lactamase inhibitors (BLIs) (23.2%), second-generation cephalosporins (12.9%) and fluoroquinolones (11.3%). Significantly more penicillins plus BLIs and fewer second-generation cephalosporins and fluoroquinolones were used in 2016. Overall, an increase in the consumption of broad-spectrum antimicrobials was noted. For 68.7% of all administered antimicrobials, the indication was documented in the patient notes. The current data reaffirm the points of improvement that previous data identified and reveal that recent efforts in AMS in German hospitals require further intensification.

  19. Genome-based analysis of Carbapenemase-producing Klebsiella pneumoniae isolates from German hospital patients, 2008-2014.

    Science.gov (United States)

    Becker, Laura; Kaase, Martin; Pfeifer, Yvonne; Fuchs, Stephan; Reuss, Annicka; von Laer, Anja; Sin, Muna Abu; Korte-Berwanger, Miriam; Gatermann, Sören; Werner, Guido

    2018-01-01

    By using whole genome sequence data we aimed at describing a population snapshot of carbapenemase-producing K. pneumoniae isolated from hospitalized patients in Germany between 2008 and 2014. We selected a representative subset of 107 carbapenemase-producing K. pneumoniae clinical isolates possessing the four most prevalent carbapenemase types in Germany (KPC-2, KPC-3, OXA-48, NDM-1). Isolates were processed via illumina NGS. Data were analysed using different SNP-based mapping and de-novo assembly approaches. Relevant information was extracted from NGS data (antibiotic resistance determinants, wzi gene/ cps type, virulence genes). NGS data from the present study were also compared with 238 genome data from two previous international studies on K. pneumoniae. NGS-based analyses revealed a preferred prevalence of KPC-2-producing ST258 and KPC-3-producing ST512 isolates. OXA-48, being the most prevalent carbapenemase type in Germany, was associated with various K. pneumoniae strain types; most of them possessing IncL/M plasmid replicons suggesting a preferred dissemination of bla OXA-48 via this well-known plasmid type. Clusters ST15, ST147, ST258, and ST512 demonstrated an intermingled subset structure consisting of German and other European K. pneumoniae isolates. ST23 being the most frequent MLST type in Asia was found only once in Germany. This latter isolate contained an almost complete set of virulence genes and a K1 capsule suggesting occurrence of a hypervirulent ST23 strain producing OXA-48 in Germany. Our study results suggest prevalence of "classical" K. pneumonaie strain types associated with widely distributed carbapenemase genes such as ST258/KPC-2 or ST512/KPC-3 also in Germany. The finding of a supposed hypervirulent and OXA-48-producing ST23 K. pneumoniae isolates outside Asia is highly worrisome and requires intense molecular surveillance.

  20. [Acute pain therapy in German hospitals as competitive factor. Do competition, ownership and case severity influence the practice of acute pain therapy?].

    Science.gov (United States)

    Erlenwein, J; Hinz, J; Meißner, W; Stamer, U; Bauer, M; Petzke, F

    2015-07-01

    Due to the implementation of the diagnosis-related groups (DRG) system, the competitive pressure on German hospitals increased. In this context it has been shown that acute pain management offers economic benefits for hospitals. The aim of this study was to analyze the impact of the competitive situation, the ownership and the economic resources required on structures and processes for acute pain management. A standardized questionnaire on structures and processes of acute pain management was mailed to the 885 directors of German departments of anesthesiology listed as members of the German Society of Anesthesiology and Intensive Care Medicine (DGAI, Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin). For most hospitals a strong regional competition existed; however, this parameter affected neither the implementation of structures nor the recommended treatment processes for pain therapy. In contrast, a clear preference for hospitals in private ownership to use the benchmarking tool QUIPS (quality improvement in postoperative pain therapy) was found. These hospitals also presented information on coping with the management of pain in the corporate clinic mission statement more often and published information about the quality of acute pain management in the quality reports more frequently. No differences were found between hospitals with different forms of ownership in the implementation of acute pain services, quality circles, expert standard pain management and the implementation of recommended processes. Hospitals with a higher case mix index (CMI) had a certified acute pain management more often. The corporate mission statement of these hospitals also contained information on how to cope with pain, presentation of the quality of pain management in the quality report, implementation of quality circles and the implementation of the expert standard pain management more frequently. There were no differences in the frequency of using the benchmarking

  1. Evaluation of psychometric properties of the German Hospital Survey on Patient Safety Culture and its potential for cross-cultural comparisons: a cross-sectional study.

    Science.gov (United States)

    Gambashidze, Nikoloz; Hammer, Antje; Brösterhaus, Mareen; Manser, Tanja

    2017-11-09

    To study the psychometric characteristics of German version of the Hospital Survey on Patient Safety Culture and to compare its dimensionality to other language versions in order to understand the instrument's potential for cross-national studies. Cross-sectional multicentre study to establish psychometric properties of German version of the survey instrument. 73 units from 37 departments of two German university hospitals. Clinical personnel (n=995 responses, response rate 39.6%). Psychometric properties (eg, model fit, internal consistency, construct validity) of the instrument and comparison of dimensionality across different language translations. The instrument demonstrated acceptable to good internal consistency (Cronbach's alpha 0.64-0.88). Confirmatory factor analysis of the original 12-factor model resulted in marginally satisfactory model fit (root mean square error of approximation (RMSEA)=0.05; standardised root mean residual (SRMR)=0.05; comparative fit index (CFI)=0.90; goodness of fit index (GFI)=0.88; Tucker-Lewis Index (TLI)=0.88). Exploratory factor analysis resulted in an alternative eight-factor model with good model fit (RMSEA=0.05; SRMR=0.05; CFI=0.95; GFI=0.91; TLI=0.94) and good internal consistency (Cronbach's alpha 0.73-0.87) and construct validity. Analysis of the dimensionality compared with models from 10 other language versions revealed eight dimensions with relatively stable composition and appearance across different versions and four dimensions requiring further improvement. The German version of Hospital Survey on Patient Safety Culture demonstrated satisfactory psychometric properties for use in German hospitals. However, our comparison of instrument dimensionality across different language versions indicates limitations concerning cross-national studies. Results of this study can be considered in interpreting findings across national contexts, in further refinement of the instrument for cross-national studies and in better

  2. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey

    Science.gov (United States)

    Brand, Serge; Colledge, Flora; Beeler, Nadja; Pühse, Uwe; Kalak, Nadeem; Sadeghi Bahmani, Dena; Mikoteit, Thorsten; Holsboer-Trachsler, Edith; Gerber, Markus

    2016-01-01

    Background Physical activity and exercise programs (PAEPs) are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. Methods All psychiatric hospitals (N=55) in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Results Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%), sports therapy (97%), activity-related psychotherapeutic interventions (95%), physiotherapy (85%), body therapies (59%), far-east techniques (57%), and hippotherapy (22%). Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. Conclusion All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not participate in PAEPs. Furthermore, those who do participate cannot continue to do so following discharge. PAEP providers need specific extended vocational trainings and believe that the potential of PA should be improved. PMID:27350748

  3. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey

    Directory of Open Access Journals (Sweden)

    Br

    2016-06-01

    Full Text Available Serge Brand,1,2 Flora Colledge,2 Nadja Beeler,2 Uwe Pühse,2 Nadeem Kalak,1 Dena Sadeghi Bahmani,1 Thorsten Mikoteit,1 Edith Holsboer-Trachsler,1 Markus Gerber2 1Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, 2Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland Background: Physical activity and exercise programs (PAEPs are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. Methods: All psychiatric hospitals (N=55 in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Results: Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%, sports therapy (97%, activity-related psychotherapeutic interventions (95%, physiotherapy (85%, body therapies (59%, far-east techniques (57%, and hippotherapy (22%. Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. Conclusion: All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not

  4. A risk-model for hospital mortality among patients with severe sepsis or septic shock based on German national administrative claims data.

    Science.gov (United States)

    Schwarzkopf, Daniel; Fleischmann-Struzek, Carolin; Rüddel, Hendrik; Reinhart, Konrad; Thomas-Rüddel, Daniel O

    2018-01-01

    Sepsis is a major cause of preventable deaths in hospitals. Feasible and valid methods for comparing quality of sepsis care between hospitals are needed. The aim of this study was to develop a risk-adjustment model suitable for comparing sepsis-related mortality between German hospitals. We developed a risk-model using national German claims data. Since these data are available with a time-lag of 1.5 years only, the stability of the model across time was investigated. The model was derived from inpatient cases with severe sepsis or septic shock treated in 2013 using logistic regression with backward selection and generalized estimating equations to correct for clustering. It was validated among cases treated in 2015. Finally, the model development was repeated in 2015. To investigate secular changes, the risk-adjusted trajectory of mortality across the years 2010-2015 was analyzed. The 2013 deviation sample consisted of 113,750 cases; the 2015 validation sample consisted of 134,851 cases. The model developed in 2013 showed good validity regarding discrimination (AUC = 0.74), calibration (observed mortality in 1st and 10th risk-decile: 11%-78%), and fit (R2 = 0.16). Validity remained stable when the model was applied to 2015 (AUC = 0.74, 1st and 10th risk-decile: 10%-77%, R2 = 0.17). There was no indication of overfitting of the model. The final model developed in year 2015 contained 40 risk-factors. Between 2010 and 2015 hospital mortality in sepsis decreased from 48% to 42%. Adjusted for risk-factors the trajectory of decrease was still significant. The risk-model shows good predictive validity and stability across time. The model is suitable to be used as an external algorithm for comparing risk-adjusted sepsis mortality among German hospitals or regions based on administrative claims data, but secular changes need to be taken into account when interpreting risk-adjusted mortality.

  5. Success of commonly used operating room management tools in reducing tardiness of first case of the day starts: evidence from German hospitals.

    Science.gov (United States)

    Ernst, Christian; Szczesny, Andrea; Soderstrom, Naomi; Siegmund, Frank; Schleppers, Alexander

    2012-09-01

    One of the declared objectives of surgical suite management in Germany is to increase operating room (OR) efficiency by reducing tardiness of first case of the day starts. We analyzed whether the introduction of OR management tools by German hospitals in response to increasing economic pressure was successful in achieving this objective. The OR management tools we considered were the appointment of an OR manager and the development and adoption of a surgical suite governance document (OR charter). We hypothesized that tardiness of first case starts was less in ORs that have adopted one or both of these tools. Using representative 2005 survey data from 107 German anesthesiology departments, we used a Tobit model to estimate the effect of the introduction of an OR manager or OR charter on tardiness of first case starts, while controlling for hospital size and surgical suite complexity. Adoption reduced tardiness of first case starts by at least 7 minutes (mean reduction 15 minutes, 95% confidence interval (CI): 7-22 minutes, P case starts figure prominently the objectives of surgical suite management in Germany. Our results suggest that the appointment of an OR manager or the adoption of an OR charter support this objective. For short-term decision making on the day of surgery, this reduction in tardiness may have economic implications, because it reduced overutilized OR time.

  6. [Patient endangerment due to device diversity? : Discussion of a risk factor based on the results of two surveys of German hospitals].

    Science.gov (United States)

    Lange, K; Brinker, A; Nowak, M; Zöllner, C; Lauer, W

    2018-05-25

    The Federal Institute for Drugs and Medical Devices (BfArM) was notified of an event in which it was not possible to sufficiently ventilate a patient suffering a severe asthma attack. It turned out that the ventilation pressures used by the device for pressure-controlled ventilation were below the values set by the user, which the user was not aware of. The ventilation pressures chosen by the user exceeded the preset alarm limits of the ventilator. This pressure and alarm management significantly differed from that of other ventilators used in the hospital. This and similar incident reports suggest that safely operating medical devices for anesthesia and intensive care may be impaired when different models of a device are used within a hospital. If different models are used, more device information needs to be stored in memory. Existing knowledge on human memory suggests that the more individual memory items (e. g. different operating rules) are stored, the greater the risk of memory interference and hence of impaired retrieval, particularly if the different items are associated with overlapping retrieval cues. This is the case when different devices are used for a single functional purpose under identical or similar circumstances. Based on individual incident reports and theoretical knowledge on an association between device diversity and use problems, this study aimed to determine the organizational conditions regarding device diversity that prevail in German hospitals. Additionally, the anesthetists' perspectives and experiences in defined clinical settings were investigated. For selected groups of medical devices, the biomedical engineers of German hospitals were surveyed about the different makes used in their hospital. Additionally, questionnaires were sent to a department of anesthesiology of a large University Hospital to investigate the personal experiences of working with different makes and models of a device. Using devices by different

  7. Children, care, career - a cross-sectional study on the risk of burnout among German hospital physicians at different career stages.

    Science.gov (United States)

    Richter, Astrid; Kostova, Petya; Harth, Volker; Wegner, Ralf

    2014-01-01

    With the increasing number of female medical students physicians' need for work-life balanced hospital jobs rises at all career stages. The Working Time Act (Arbeitszeitgesetz, ArbZG), an implementation of the European Working Time Directive into German law in 2004, should have improved the general conditions for creating flexible work. Nevertheless, the vast majority of female physicians still report an incompatibility of work and family. So far, little is known about mothers working on leading positions in the medical field. The presented study focuses on gender differences in the level of emotional exhaustion between child-rearing junior and senior physicians and different predictors of burnout. Three years after the ArbZT-enactment, 994 physicians from the listed hospital physicians in the Medical Register of the city of Hamburg participated in the cross-sectional study and completed a 60-item questionnaire (return rate of 46,5%). The questionnaire included a 22-item version of the German translation of the Maslach Burnout Inventory whereat emotional exhaustion was interpreted as the crucial predictor of burnout. Results of an univariate covariance analysis and regression analyses are reported. In the level of emotional exhaustion no gender differences were found between junior and senior physicians with children in the overall analysis. Support by the superior was the only overall predictor of burnout. Female senior physicians having children presented the highest risk of burnout. Only in this group parenting contributed significantly to the risk of burnout. Support by the superior and the relationship to colleagues are generally important predictors of burnout among hospital physicians. Parenthood only gets a crucial influence on psychomental health for female senior physicians. Still conservative role models are common in this group, thus dealing with the triple burden of work, leadership responsibility and child rearing seems to be a special female

  8. Infection prevention during anaesthesia ventilation by the use of breathing system filters (BSF): Joint recommendation by German Society of Hospital Hygiene (DGKH) and German Society for Anaesthesiology and Intensive Care (DGAI).

    Science.gov (United States)

    Kramer, Axel; Kranabetter, Rainer; Rathgeber, Jörg; Züchner, Klaus; Assadian, Ojan; Daeschlein, Georg; Hübner, Nils-Olaf; Dietlein, Edeltrut; Exner, Martin; Gründling, Matthias; Lehmann, Christian; Wendt, Michael; Graf, Bernhard Martin; Holst, Dietmar; Jatzwauk, Lutz; Puhlmann, Birgit; Welte, Thomas; Wilkes, Antony R

    2010-09-21

    An interdisciplinary working group from the German Society of Hospital Hygiene (DGKH) and the German Society for Anaesthesiology and Intensive Care (DGAI) worked out the following recommendations for infection prevention during anaesthesia by using breathing system filters (BSF). The BSF shall be changed after each patient. The filter retention efficiency for airborne particles is recommended to be >99% (II). The retention performance of BSF for liquids is recommended to be at pressures of at least 60 hPa (=60 mbar) or 20 hPa above the selected maximum ventilation pressure in the anaesthetic system. The anaesthesia breathing system may be used for a period of up to 7 days provided that the functional requirements of the system remain unchanged and the manufacturer states this in the instructions for use.THE BREATHING SYSTEM AND THE MANUAL VENTILATION BAG ARE CHANGED IMMEDIATELY AFTER THE RESPECTIVE ANAESTHESIA IF THE FOLLOWING SITUATION HAS OCCURRED OR IT IS SUSPECTED TO HAVE OCCURRED: Notifiable infectious disease involving the risk of transmission via the breathing system and the manual bag, e.g. tuberculosis, acute viral hepatitis, measles, influenza virus, infection and/or colonisation with a multi-resistant pathogen or upper or lower respiratory tract infections. In case of visible contamination e.g. by blood or in case of defect, it is required that the BSF and also the anaesthesia breathing system is changed and the breathing gas conducting parts of the anaesthesia ventilator are hygienically reprocessed.Observing of the appropriate hand disinfection is very important. All surfaces of the anaesthesia equipment exposed to hand contact must be disinfected after each case.

  9. The Role of Learning in Health Technology Assessments: An Empirical Assessment of Endovascular Aneurysm Repairs in German Hospitals.

    Science.gov (United States)

    Varabyova, Yauheniya; Blankart, Carl Rudolf; Schreyögg, Jonas

    2017-02-01

    Changes in performance due to learning may dynamically influence the results of a technology evaluation through the change in effectiveness and costs. In this study, we estimate the effect of learning using the example of two minimally invasive treatments of abdominal aortic aneurysms: endovascular aneurysm repair (EVAR) and fenestrated EVAR (fEVAR). The analysis is based on the administrative data of over 40,000 patients admitted with unruptured abdominal aortic aneurysm to more than 500 different hospitals over the years 2006 to 2013. We examine two patient outcomes, namely, in-hospital mortality and length of stay using hierarchical regression models with random effects at the hospital level. The estimated models control for patient and hospital characteristics and take learning interdependency between EVAR and fEVAR into account. In case of EVAR, we observe a significant decrease both in the in-hospital mortality and length of stay with experience accumulated at the hospital level; however, the learning curve for fEVAR in both outcomes is effectively flat. To foster the consideration of learning in health technology assessments of medical devices, a general framework for estimating learning effects is derived from the analysis. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd.

  10. [Factors affecting in-hospital mortality in patients with sepsis: Development of a risk-adjusted model based on administrative data from German hospitals].

    Science.gov (United States)

    König, Volker; Kolzter, Olaf; Albuszies, Gerd; Thölen, Frank

    2018-05-01

    Inpatient administrative data from hospitals is already used nationally and internationally in many areas of internal and public quality assurance in healthcare. For sepsis as the principal condition, only a few published approaches are available for Germany. The aim of this investigation is to identify factors influencing hospital mortality by employing appropriate analytical methods in order to improve the internal quality management of sepsis. The analysis was based on data from 754,727 DRG cases of the CLINOTEL hospital network charged in 2015. The association then included 45 hospitals of all supply levels with the exception of university hospitals (range of beds: 100 to 1,172 per hospital). Cases of sepsis were identified via the ICD codes of their principal diagnosis. Multiple logistic regression analysis was used to determine the factors influencing in-hospital lethality for this population. The model was developed using sociodemographic and other potential variables that could be derived from the DRG data set, and taking into account current literature data. The model obtained was validated with inpatient administrative data of 2016 (51 hospitals, 850,776 DRG cases). Following the definition of the inclusion criteria, 5,608 cases of sepsis (2016: 6,384 cases) were identified in 2015. A total of 12 significant and, over both years, stable factors were identified, including age, severity of sepsis, reason for hospital admission and various comorbidities. The AUC value of the model, as a measure of predictability, is above 0.8 (H-L test p>0.05, R 2 value=0.27), which is an excellent result. The CLINOTEL model of risk adjustment for in-hospital lethality can be used to determine the mortality probability of patients with sepsis as principal diagnosis with a very high degree of accuracy, taking into account the case mix. Further studies are needed to confirm whether the model presented here will prove its value in the internal quality assurance of hospitals

  11. Medical work Assessment in German hospitals: a Real-time Observation study (MAGRO – the study protocol

    Directory of Open Access Journals (Sweden)

    Mache Stefanie

    2009-06-01

    Full Text Available Abstract Background The increasing economic pressure characterizes the current situation in health care and the need to justify medical decisions and organizational processes due to limited financial resources is omnipresent. Physicians tend to interpret this development as a decimation of their own medical influence. This becomes even more obvious after a change in hospital ownership i.e. from a public to a private profit oriented organization. In this case each work procedure is revised. To date, most research studies have focused mainly on differences between hospitals of different ownership regarding financial outcomes and quality of care, leaving important organizational issues unexplored. Little attention has been devoted to the effects of hospital ownership on physicians' working routines. The aim of this observational real time study is to deliver exact data about physicians' work at hospitals of different ownership. Methods The consequences of different management types on the organizational structures of the physicians' work situation and on job satisfaction in the ward situation are monitored by objective real time studies and multi-level psycho diagnostic measurements. Discussion This study is unique in its focus. To date no results have been found for computer-based real time studies on work activity in the clinical field in order to objectively evaluate a physician's work-related stress. After a complete documentation of the physicians' work processes the daily work flow can be estimated and systematically optimized. This can stimulate an overall improvement of health care services in Germany.

  12. Editor's Choice - High Annual Hospital Volume is Associated with Decreased in Hospital Mortality and Complication Rates Following Treatment of Abdominal Aortic Aneurysms: Secondary Data Analysis of the Nationwide German DRG Statistics from 2005 to 2013.

    Science.gov (United States)

    Trenner, Matthias; Kuehnl, Andreas; Salvermoser, Michael; Reutersberg, Benedikt; Geisbuesch, Sarah; Schmid, Volker; Eckstein, Hans-Henning

    2018-02-01

    The aim of this study was to analyse the association between annual hospital procedural volume and post-operative outcomes following repair of abdominal aortic aneurysms (AAA) in Germany. Data were extracted from nationwide Diagnosis Related Group (DRG) statistics provided by the German Federal Statistical Office. Cases with a diagnosis of AAA (ICD-10 GM I71.3, I71.4) and procedure codes for endovascular aortic repair (EVAR; OPS 5-38a.1*) or open aortic repair (OAR; OPS 5-38.45, 5-38.47) treated between 2005 and 2013 were included. Hospitals were empirically grouped to quartiles depending on the overall annual volume of AAA procedures. A multilevel multivariable regression model was applied to adjust for sex, medical risk, type of procedure, and type of admission. Primary outcome was in hospital mortality. Secondary outcomes were complications, use of blood products, and length of stay (LOS). The association between AAA volume and in hospital mortality was also estimated as a function of continuous volume. A total of 96,426 cases, of which 11,795 (12.6%) presented as ruptured (r)AAA, were treated in >700 hospitals (annual median: 501). The crude in hospital mortality was 3.3% after intact (i)AAA repair (OAR 5.3%; EVAR 1.7%). Volume was inversely associated with mortality after OAR and EVAR. Complication rates, LOS, and use of blood products were lower in high volume hospitals. After rAAA repair, crude mortality was 40.4% (OAR 43.2%; EVAR 27.4%). An inverse association between mortality and volume was shown for rAAA repair; the same accounts for the use of blood products. When considering volume as a continuous variate, an annual caseload of 75-100 elective cases was associated with the lowest mortality risk. In hospital mortality and complication rates following AAA repair are inversely associated with annual hospital volume. The use of blood products and the LOS are lower in high volume hospitals. A minimum annual case threshold for AAA procedures might improve

  13. [Employee satisfaction in hospitals - validation of the Picker employee questionnaire: the German version of the "survey of employee perceptions of health care delivery" (Picker Institute Boston)].

    Science.gov (United States)

    Riechmann, M; Stahl, K

    2013-05-01

    The aim of this study was the validation of a questionnaire specially developed for the German health-care market to measure workplace-related satisfaction of all employees in direct or indirect contact to patients. Beside this, its suitability for use in human resource and quality management was tested. Based on data from a postal survey of 38 054 employees from 37 hospitals a psychometric evaluation was done via exploratory factor analysis and reliability as well as regression analysis. For testing the capability to differentiate, subgroup analyses were conducted. 14 factors (Cronbach's alpha between 0.6 and 0.9) were extracted, explaining 44% of the variance. The factors leadership and organisational culture, conditions of employment, work load and relationship to direct line manager had the strongest influence on overall employee satisfaction. Age, gender, employment status, and senior position influence job satisfaction or relevant satisfaction-related factors. Psychometric properties, the ability to differentiate between employee groups and practicability render the questionnaire well suited for use in human resource and quality management of hospitals. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Screening and contact precautions – A survey on infection control measures for multidrug-resistant bacteria in German university hospitals

    Directory of Open Access Journals (Sweden)

    Lena M. Biehl

    2017-04-01

    Full Text Available Abstract To assess the scope of infection control measures for multidrug-resistant bacteria in high-risk settings, a survey among university hospitals was conducted. Fourteen professionals from 8 sites participated. Reported policies varied largely with respect to the types of wards conducting screening, sample types used for screening and implementation of contact precautions. This variability among sites highlights the need for an evidence-based consensus of current infection control policies.

  15. [The influence of quality management on job satisfaction and work load--exemplary study in a German hospital].

    Science.gov (United States)

    Hein, Sandra; Lauterbach, Karl W; Plamper, Evelyn; Gerber, Andreas

    2009-01-01

    Surveys among employees are getting more and more relevant in hospital settings since an increase in both (1) efficiency and (2) quality in connection with (3) enhanced patient orientation will only be achieved, if at the same time the employees' health status and satisfaction are taken into account. Thus, the objective of this study was to compare the satisfaction of employees in a single hospital enquired in 2002 with that of 2005. Particular consideration was given to their view of quality management. Is there a correlation between employees' satisfaction, their degree of information on quality management, and their assessment of quality management? In the survey of 2005 employees were more satisfied with their work and their working conditions than in the previous inquiry conducted in 2002. They felt less mental stress, despite the declining length of hospitalisation combined with a higher turnover of in-hospital cases and with lower numbers of full-time staff. The employees' satisfaction, however, differed widely among the three departments with regard to the items "involvement with decisions" and "support by the superiors". The overall assessment of quality management is positive. Specific items such as the assessment of the management's commitment to quality management were strongly influenced by the employees' degree of information on quality management, which varies between departments. In the department with the lowest work satisfaction quality management was attributed a high potential for change and improvement. After quality management will have been implemented throughout the hospital, a new survey should be undertaken to evaluate whether quality management affects the employees' satisfaction with their work.

  16. Economic burden of Clostridium difficile associated diarrhoea: a cost-of-illness study from a German tertiary care hospital.

    Science.gov (United States)

    Heimann, S M; Vehreschild, J J; Cornely, O A; Wisplinghoff, H; Hallek, M; Goldbrunner, R; Böttiger, B W; Goeser, T; Hölscher, A; Baldus, S; Müller, F; Jazmati, N; Wingen, S; Franke, B; Vehreschild, M J G T

    2015-12-01

    Clostridium difficile associated diarrhoea (CDAD) is the most common cause of health-care-associated infectious diarrhoea. In the context of the German health-care system, direct and indirect costs of an initial episode of CDAD and of CDAD recurrence are currently unknown. We defined CDAD as presence of diarrhoea (≥3 unformed stools/day) in association with detection of Clostridium difficile toxin in an unformed faecal sample. Patients treated with metronidazole (PO or IV) and/or vancomycin (PO) were included. Comprehensive data of patients were retrospectively documented into a database using the technology of the Cologne Cohort of Neutropenic Patients (CoCoNut). Patients with CDAD were matched to control patients in a 1:1 ratio. Analysis was split in three groups: incidence group (CDAD patients without recurrence), recurrence group (CDAD patients with ≥1 recurrence) and control group (matched non-CDAD patients). Between 02/2010 and 12/2011, 150 patients with CDAD (114 patients in the incidence and 36 (24 %) in the recurrence group) and 150 controls were analysed. Mean length of stay was: 32 (95 %CI: 30-37), 94 (95 %CI: 76-112) and 24 days (95 %CI: 22-27; P = costs per patient of €18,460 (95 %CI: €14,660-€22,270), €73,900 (95 %CI: €50,340-€97,460) and €14,530 (95 %CI: €11,730-€17,330; P = costs, which were mostly attributable to a significantly longer overall length of stay. Innovative treatment strategies are warranted to reduce treatment costs and prevent recurrence of CDAD.

  17. [Geriatric Trauma Center DGU®: Evaluation of clinical and economic parameters : A pilot study in a german university hospital].

    Science.gov (United States)

    Knobe, M; Böttcher, B; Coburn, M; Friess, T; Bollheimer, L C; Heppner, H J; Werner, C J; Bach, J-P; Wollgarten, M; Poßelt, S; Bliemel, C; Bücking, B

    2018-04-19

    Previous studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable. The aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU). A comparison of three different treatment models (6 months each) was performed: A: Standard treatment in Orthopaedic Trauma; B: Special care pathways with improvement of the quality management system and implementation of standard operating procedures; C: Interdisciplinary treatment with care pathways and collaboration with geriatricians (ward round model). In the 151 examined patients (m/w 47/104; 83.5 (70-100) years; A: n = 64, B: n = 44, C: n = 43) pathways with orthogeriatric comanagement (C) improved frequency of postoperative mobilization (p = 0.021), frequency of osteoporosis prophylaxis (p = 0.001) and the discharge procedure (p = 0.024). In comparison to standard treatment (A), orthogeriatric comanagement (C) was associated with lower rates of mortality (9% vs. 2%; p = 0.147) and cardio-respiratory complications (39% vs. 28%; p = 0.235) by trend. In this context, there were low rates of myocardial infarction (6% vs. 0%), dehydration (6% vs. 0%), cardiac dysrhythmia (8% vs. 0%), pulmonary decompensation (28% vs. 16%), electrolyt dysbalance (34% vs. 19%) and pulmonary edema (11% vs. 2%). Duration of stay in an intensive care unit was 29 h (A) and 18 h (C) respectively (p = 0.205), with consecutive reduction in costs. A sole establishment of a special care pathway for older hip fracture patients (B) showed a lower rate of myocardial infarction (A: 11%, B: 0%, C: 0%; p = 0.035). There was a clear tendency to a better overall

  18. Effects of inpatient geriatric interventions in a German geriatric hospital: Impact on ADL, mobility and cognitive status.

    Science.gov (United States)

    Bordne, S; Schulz, R-J; Zank, S

    2015-06-01

    Given the demographic changes, the need for effective geriatric intervention is obvious. Geriatric care aims to maintain the highest possible level of independence and quality of life and to reduce the risk of need for care. This study investigated the benefits of geriatric care on functional performance, mobility and cognition. This study involved a retrospective analysis of clinical data from 646 patients. At hospital admission and discharge functional status was assessed using the Barthel index. Mobility was evaluated by means of the Tinetti test and cognition by the mini-mental state examination (MMSE). A follow-up was conducted on 112 patients 2-5 months after hospital discharge. Statistical analysis included t-tests including Cohen's d for effect size and multivariate regression analysis. The mean age of the study population was 81.1 ± 7.1 years including 439 women (68%) and 207 men (32%). There were significant average improvements for activities of daily living (ADL), mobility and cognition comparing discharge and admission scores. For functional and mobility status, effect sizes were medium to high. Regression analyses showed that ADL improvement was predicted by functional, mobile and cognitive status at admission. Follow-up analyses revealed a high percentage of former patients still living at home and an overall maintenance of ADL levels. Geriatric patients seem to experience long-term improvements during geriatric treatment, which appears to fulfill its aim of recovering independence. For a better understanding of relevant factors for the recreation of geriatric patients, further research is needed, e.g. with respect to the impact of the nutritional status.

  19. Association between hospital procedure volume and early complications after pacemaker implantation: results from a large, unselected, contemporary cohort of the German nationwide obligatory external quality assurance programme.

    Science.gov (United States)

    Nowak, Bernd; Tasche, Karl; Barnewold, Linda; Heller, Günther; Schmidt, Boris; Bordignon, Stefano; Chun, K R Julian; Fürnkranz, Alexander; Mehta, Rajendra H

    2015-05-01

    Several studies demonstrated an inverse relationship between cardioverter-defibrillator implantation volume and complication rates, suggesting better outcomes for higher volume centres. However, the association of institutional procedural volume with patient outcomes for permanent pacemaker (PPM) implantation remains less known, especially in decentralized implantation systems. We performed retrospective examination of data on patients undergoing PPM from the German obligatory quality assurance programme (2007-12) to evaluate the relationship of hospital PPM volume (categorized into quintiles of their mean annual volume) with risk-adjusted in-hospital surgical complications (composite of pneumothorax, haemothorax, pericardial effusion, or pocket haematoma, all requiring intervention, or device infection) and pacemaker lead dislocation. Overall 430 416 PPM implantations were documented in 1226 hospitals. Systems included dual (72.8%) and single (25.8%) chamber PPM and cardiac resynchronization therapy (CRT) devices (1.1%). Complications included surgical (0.92%), and ventricular (0.99%), and atrial (1.22%) lead dislocation. Despite an increase in relatively complex procedures (dual chamber, CRT), there was a significant decrease in the procedural and fluoroscopy times and complications from lowest to highest implantation volume quintiles (P for trend <0.0001). The greatest difference was observed between the lowest (1-50 implantations/year-reference group) and the second-lowest (51-90 implantations/year) quintile: surgical complications [odds ratio (OR) 0.69; confidence interval (CI) 0.60-0.78], atrial lead dislocations (OR 0.69; CI 0.59-0.80), and ventricular lead dislocations (OR 0.73; CI 0.63-0.84). Hospital annual PPM volume was directly related to indication-based implantation of relatively more complex PPM and yet inversely with procedural times and rates of early surgical complications and lead dislocations. Thus, our data suggest better performance and lower

  20. Long-Term, Low-Frequency Cluster of a German-Imipenemase-1-Producing Enterobacter hormaechei ssp. steigerwaltii ST89 in a Tertiary Care Hospital in Germany.

    Science.gov (United States)

    Wendel, Andreas F; Meyer, Sebastian; Deenen, René; Köhrer, Karl; Kolbe-Busch, Susanne; Pfeffer, Klaus; Willmann, Matthias; Kaasch, Achim J; MacKenzie, Colin R

    2018-05-11

    Enterobacter cloacae complex is a common cause of hospital outbreaks. A retrospective and prospective molecular analysis of carbapenem-resistant clinical isolates in a tertiary care center demonstrated an outbreak of a German-imipenemase-1 (GIM-1) metallo-beta-lactamase-producing Enterobacter hormaechei ssp. steigerwaltii affecting 23 patients between 2009 and 2016. Thirty-three isolates were sequence type 89 by conventional multilocus sequence typing (MLST) and displayed a maximum difference of 49 out of 3,643 targets in the ad-hoc core-genome MLST (cgMLST) scheme (SeqSphere+ software; Ridom, Münster, Germany). The relatedness of all isolates was confirmed by further maximum-likelihood phylogeny. One clonal complex of highly related isolates (≤15 allele difference in cgMLST) contained 17 patients, but epidemiological data only suggested five transmission events. The bla GIM-1 -gene was embedded in a class-1-integron (In770) and the Tn21-subgroup transposon Tn6216 (KC511628) on a 25-kb plasmid. Environmental screening detected one colonized sink trap in a service room. The outbreak was self-limited as no further bla GIM-1 -positive E. hormaechei has been isolated since 2016. Routine molecular screening of carbapenem-nonsusceptible gram-negative isolates detected a long-term, low-frequency outbreak of a GIM-1-producing E. hormaechei ssp. steigerwaltii clone. This highlights the necessity of molecular surveillance.

  1. German Vocabulary.

    Science.gov (United States)

    Coombs, Virginia M.

    This article discusses in general terms derivational aspects of English vocabulary. Citing examples of Anglo-Saxon origin, the author provides a glimpse into the nature of the interrelatedness of English, German, and French vocabulary. (RL)

  2. German Orientalism

    OpenAIRE

    Margaret Olin

    2011-01-01

    Review of: Suzanne L. Marchand, German Orientalism in the Age of Empire: Religion, Race and Scholarship, Cambridge and Washington, D.C.: Cambridge University Press, 2009. This analysis of Suzanne L. Marchand’s German Orientalism in the Age of Empire: Religion, Race and Scholarship reads her contribution in part against the background of Edward Said’s path breaking book Orientalism. Differences lie in her more expansive understanding of the term ‘Oriental’ to include the Far East and her conce...

  3. Environmental medicine field studies in the Bitterfeld and Hettstedt districts and in a control district. 1992-1994. Data book; Umweltmedizinische Untersuchungen im Raum Bitterfeld, im Raum Hettstedt und einem Vergleichsgebiet. 1992-1994. Data Book

    Energy Technology Data Exchange (ETDEWEB)

    Heinrich, J; Popescu, M; Wjst, M; Trepka, M J; Cyrys, J; Wichmann, H E

    1995-03-01

    For the purpose of establishing an inventory of environmental medicine data for the eastern Lands of Germany (of the former GDR), field studies have been carried out in the strongly polluted districts of Bitterfeld and Hettstedt and in a low-pollution control district, around Zerbst. The data were intended to reveal the environmental pollution level in various districts and regions, and to indicate regions of priority for immediate research activities to be initiated. The report covers the results compiled in the first project period, in 1992 and 1993. The data presented are for the most part tabulated data taken from the Final Report of the Bitterfeld Study (Heinrich et al.; 1994). Some tables of immunological parameters have been modified. These data are supplemented by data on internal heavy metal concentrations. The data refer to the anamnesis, especially of respiratory tract disease or allergies, complaints and symptoms, lung functional data, allergiologic findings, hematologic data (only of infants and children), immunologic parameters, and heavy metal accumulations. (orig.) [Deutsch] Fuer eine Bestandsaufnahme der umweltmedizinischen Forschung in der DDR, die Herausarbeitung von regionalen Umweltbelastungsschwerpunkten und die Darstellung des akuten Foerderungsbedarfs wurden umweltmedizinische Untersuchungen in den hochbelasteten Regionen Bitterfeld und Hettstedt sowie im gering belasteten Vergleichsgebiet Zerbst durchgefuehrt. Die vorliegende Zusammenstellung bezieht sich auf die Ergebnisse der ersten Untersuchungsetappe in den Jahren 1992/93. Es werden Daten tabellarisch zusammengestellt, die in dem Abschlussbericht der `Bitterfeld-Studie` (Heinrich, et al.; 1994) enthalten sind. Einzelne Tabellen zu immunologischen Parametern wurden modifiziert. Zusaetzlich werden die Daten durch die interne Schwermetallbelastung ergaenzt. So wird Bezug genommen auf die Krankengeschichte, speziell von Atemwegserkrankungen und Allergien, Beschwerden und Symptomen, auf

  4. Vitamin D Deficiency in Adult Patients with Schizophreniform and Autism Spectrum Syndromes: A One-Year Cohort Study at a German Tertiary Care Hospital.

    Science.gov (United States)

    Endres, Dominique; Dersch, Rick; Stich, Oliver; Buchwald, Armin; Perlov, Evgeniy; Feige, Bernd; Maier, Simon; Riedel, Andreas; van Elst, Ludger Tebartz

    2016-01-01

    Vitamin D has many immunomodulatory, anti-inflammatory, and neuroprotective functions, and previous studies have demonstrated an association between vitamin D deficiency and neuropsychiatric disease. The aim of our study was to analyze the prevalence of vitamin D deficiency in a 1-year cohort of adult inpatients with schizophreniform and autism spectrum syndromes in a naturalistic inpatient setting in Germany. Our study was comprised of 60 adult schizophreniform and 23 adult high-functioning autism spectrum patients who were hospitalized between January and December of 2015. We compared our findings with a historical German reference cohort of 3,917 adults using Pearson's two-sided chi-squared test. The laboratory measurements of 25-hydroxyvitamin D2/3 [25(OH)vitamin D] were obtained using a chemiluminescence immunoassay. In the schizophreniform group, we found decreased (vitamin D levels in 48/60 (80.0%) of the patients. In the autism spectrum group, decreased levels were detected in 18/23 (78.3%) of the patients. 25(OH)vitamin D deficiencies were found in 57.3% of the historical control group. Particularly, severe deficiencies (vitamin D values of >30 ng/ml were observed in only 5% of the schizophreniform patients, 8.7% of the autism spectrum patients, and 21.9% of the healthy controls. We found very high rates of 25(OH)vitamin D deficiencies in both patient groups and have discussed whether our findings might be related to alterations in the immunological mechanisms. Irrespective of the possible pathophysiological links between vitamin D deficiency and schizophrenia or autism spectrum disorders, a more frequent measurement of vitamin D levels seems to be justified in these patient groups. Further prospective, controlled, blinded, and randomized research should be conducted to analyze the effectiveness of vitamin D supplementation on the improvement of psychiatric symptoms.

  5. Vitamin D Deficiency in Adult Patients with Schizophreniform and Autism Spectrum Syndromes: A One-Year Cohort Study at a German Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

    Dominique Endres

    2016-10-01

    Full Text Available Introduction: Vitamin D has many immunomodulatory, anti-inflammatory, and neuroprotective functions, and previous studies have demonstrated an association between vitamin D deficiency and neuropsychiatric disease. The aim of our study was to analyze the prevalence of vitamin D deficiency in a one-year cohort of adult inpatients with schizophreniform and autism-spectrum syndromes in a naturalistic in-patient setting in Germany. Participants and methods: Our study was comprised of 60 adult schizophreniform and 23 adult high-functioning autism spectrum patients who were hospitalized Page: 2between January and December of 2015. We compared our findings with a historical German reference cohort of 3,917 adults using Pearson’s two-sided chi-squared test. The laboratory measurements of 25-hydroxyvitamin D2/3 (25(OHvitamin D were obtained using a chemiluminescence immunoassay. Results: In the schizophreniform group, we found decreased ( 30 ng/ml were observed in only 5% of the schizophreniform patients, 8.7% of the autism spectrum patients, and 21.9% of the healthy controls. Discussion: We found very high rates of 25(OHvitamin D deficiency in both patient groups, and have discussed whether our findings might be related to alterations in the immunological mechanisms. Irrespective of the possible pathophysiological links between vitamin D deficiency and schizophrenia or autism spectrum disorders, a more frequent measurement of vitamin D levels seems to be justified in these patient groups. Further prospective, controlled, blinded, and randomized research should be conducted to analyze the effectiveness of vitamin D supplementation on the improvement of psychiatric symptoms.

  6. Abridged version of the AWMF guideline for the medical clinical diagnostics of indoor mould exposure: S2K Guideline of the German Society of Hygiene, Environmental Medicine and Preventive Medicine (GHUP) in collaboration with the German Association of Allergists (AeDA), the German Society of Dermatology (DDG), the German Society for Allergology and Clinical Immunology (DGAKI), the German Society for Occupational and Environmental Medicine (DGAUM), the German Society for Hospital Hygiene (DGKH), the German Society for Pneumology and Respiratory Medicine (DGP), the German Mycological Society (DMykG), the Society for Pediatric Allergology and Environmental Medicine (GPA), the German Federal Association of Pediatric Pneumology (BAPP), and the Austrian Society for Medical Mycology (ÖGMM).

    Science.gov (United States)

    Wiesmüller, Gerhard A; Heinzow, Birger; Aurbach, Ute; Bergmann, Karl-Christian; Bufe, Albrecht; Buzina, Walter; Cornely, Oliver A; Engelhart, Steffen; Fischer, Guido; Gabrio, Thomas; Heinz, Werner; Herr, Caroline E W; Kleine-Tebbe, Jörg; Klimek, Ludger; Köberle, Martin; Lichtnecker, Herbert; Lob-Corzilius, Thomas; Merget, Rolf; Mülleneisen, Norbert; Nowak, Dennis; Rabe, Uta; Raulf, Monika; Seidl, Hans Peter; Steiß, Jens-Oliver; Szewszyk, Regine; Thomas, Peter; Valtanen, Kerttu; Hurraß, Julia

    2017-01-01

    reactions. Whether or not toxin formation occurs in individual cases is determined by environmental and growth conditions, above all the substrate. In the case of indoor moisture/mould damage, everyone can be affected by odour effects and/or mood disorders. However, this is not a health hazard. Predisposing factors for odour effects can include genetic and hormonal influences, imprinting, context and adaptation effects. Predisposing factors for mood disorders may include environmental concerns, anxiety, condition, and attribution, as well as various diseases. Risk groups to be protected particularly with regard to an infection risk are persons on immunosuppression according to the classification of the German Commission for Hospital Hygiene and Infection Prevention ( Kommission für Krankenhaushygiene und Infektionsprävention, KRINKO ) at the Robert Koch- Institute (RKI) and persons with cystic fibrosis (mucoviscidosis); with regard to an allergic risk, persons with cystic fibrosis (mucoviscidosis) and patients with bronchial asthma should be protected. The rational diagnostics include the medical history, physical examination, and conventional allergy diagnostics including provocation tests if necessary; sometimes cellular test systems are indicated. In the case of mould infections the reader is referred to the AWMF guideline "Diagnosis and Therapy of Invasive Aspergillus Infections". With regard to mycotoxins, there are currently no useful and validated test procedures for clinical diagnostics. From a preventive medicine standpoint it is important that indoor mould infestation in relevant dimension cannot be tolerated for precautionary reasons. With regard to evaluating the extent of damage and selecting a remedial procedure, the reader is referred to the revised version of the mould guideline issued by the German Federal Environment Agency ( Umweltbundesamt, UBA ).

  7. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  8. Intensified colonisation screening according to the recommendations of the German Commission for Hospital Hygiene and Infectious Diseases Prevention (KRINKO): identification and containment of a Serratia marcescens outbreak in the neonatal intensive care unit, Jena, Germany, 2013-2014.

    Science.gov (United States)

    Dawczynski, Kristin; Proquitté, Hans; Roedel, Jürgen; Edel, Brigit; Pfeifer, Yvonne; Hoyer, Heike; Dobermann, Helke; Hagel, Stefan; Pletz, Mathias W

    2016-12-01

    In 2013, the German Commission for Hospital Hygiene and Infectious Disease Prevention (KRINKO) stated that extending weekly colonisation screening from very low birth weight (VLBW) infants (Serratia marcescens. Strains were typed by Pulsed Field Gel Electrophoresis (PFGE). Over 6 months, 19 out of 159 infants acquired S. marcescens. Twelve of the nineteen patients with S. marcescens were non-VLBW infants, and they were colonised significantly earlier than were VLBW infants (median 17 vs. 28 days; p marcescens.

  9. Environmental medicine disaster - which medical knowledge is to be derived from their analysis? Pt. 3. Yusho (oil disease); Umweltmedizinische Katastrophen - Welche medizinischen Erkenntnisse bringt ihre Analyse. Teil 3. Yusho-Krankheit (Oelkrankheit)

    Energy Technology Data Exchange (ETDEWEB)

    Seidel, H.J.; Krefeldt, T. [Ulm Univ. (Germany). Inst. fuer Arbeits-, Sozial- und Umweltmedizin

    1999-02-01

    der Erhitzung, erheblich mit polychlorierten Dibenzofuranen und weiteren chlororganischen Verbindungen kontaminiert - die genaue chemische Analyse von Asservaten erfolgte wesentlich spaeter. Im Biomonitoring konnten die Kontaminanten im Blut, Fettgewebe und der Leber der betroffenen Personen festgestellt werden. Die Intoxikation erwies sich as teratogen und fetotoxisch, beim Mortalitaetsspektrum der erwachsenen Opfer fiel lediglich ein vermehrtes Auftreten von Lebertumoren auf. Der Vorfall gab in Japan den entscheidenen Anstoss, sich mit den vielfaeltig eingesetzten PCBs auch oekotoxikologisch zu befassen. Es enstanden umweltmedizinische Regelwerke, schliesslich wurde 1972 ein generelles PCB-Verbot ausgesprochen. (orig.)

  10. Prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) among pigs on German farms and import of livestock-related MRSA into hospitals

    NARCIS (Netherlands)

    Köck, R; Harlizius, J; Bressan, N; Laerberg, R; Wieler, L H; Witte, W; Deurenberg, R H; Voss, A; Becker, K; Friedrich, A W

    The aim of this study was to evaluate the prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) among pigs and estimate the impact of this animal reservoir on human healthcare. Nasal swabs were derived from 1,600 pigs at 40 German farms. The MRSA were

  11. Prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) among pigs on German farms and import of livestock-related MRSA into hospitals.

    NARCIS (Netherlands)

    Kock, R.; Harlizius, J.; Bressan, N.; Laerberg, R.; Wieler, L.H.; Witte, W.; Deurenberg, R.H.; Voss, A.; Becker, K.; Friedrich, A.W.

    2009-01-01

    The aim of this study was to evaluate the prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) among pigs and estimate the impact of this animal reservoir on human healthcare. Nasal swabs were derived from 1,600 pigs at 40 German farms. The MRSA were

  12. Assessment of cardiovascular disease risk in patients with schizophrenia spectrum disorders in German psychiatric hospitals: results of the pharmacoepidemiologic CATS study.

    Science.gov (United States)

    Deuschle, M; Paul, F; Brosz, M; Bergemann, N; Franz, M; Kammerer-Ciernioch, J; Lautenschlager, M; Lederbogen, F; Roesch-Ely, D; Weisbrod, M; Kahl, K G; Reichmann, J; Gross, J; Umbreit, J

    2013-08-01

    Patients with severe mental illness are at high risk for metabolic and cardiac disorders. Thus, monitoring of cardiovascular risks is imperative and schedules for screening for lipids, glucose, body mass index (BMI), waist-hip ratio and blood pressure have been developed. We intended to analyze screening for metabolic disorders in German patients with schizophrenia spectrum disorders in routine psychiatric care. We included 674 patients with any F2 diagnosis in out- and inpatient settings and analyzed metabolic screening procedures as practiced under conditions of usual care. Except BMI (54 %), all other values were documented only in a minority of patients: waist circumference (23 %), cholesterol (28 %), fasting glucose (19 %), triglycerides (25 %) and blood pressure (37 %). We found evidence for less than perfect quality of blood pressure measures. The group of patients who met the individual metabolic syndrome ATP III criteria was comparable to the US CATIE trial. We conclude that frequency and quality of metabolic monitoring in German in- and outpatients settings are not in accordance with the respective recommendations. Similar to previous reports we found evidence for a high prevalence of metabolic disturbances in German patients with schizophrenia spectrum disorders.

  13. Teaching German-Americana

    Science.gov (United States)

    Tolzmann, Don Heinrich

    1976-01-01

    A university course entitled "The German-Americans" attempted to study and evaluate German culture in the U. S. Lecture topics and term paper theses are listed and a selected annotated bibliography of German-American culture is included. (CHK)

  14. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...

  15. German Studies in America. German Studies Notes.

    Science.gov (United States)

    Sander, Volkmar; Osterle, Heinz D.

    This volume contains two papers, "German Studies in America," by Volkmar Sander, and "Historicism, Marxism, Structuralism: Ideas for German Culture Courses," by Heinz D. Osterle. The first paper discusses the position of German studies in the United States today. The greatest challenge comes from low enrollments; therefore,…

  16. [German ophthalmologists and NSDAP

    Science.gov (United States)

    Rohrbach, Jens Martin

    2008-01-01

    Approximately 40-45 % of all German physicians joined the National Socialist German Workers Party (NSDAP) until 1945. Reasons for party membership are manifold and still a matter of debate. Very likely, the extraordinary high representation of medical doctors in the NSDAP was rather a result of active entry than recruitment by the party. There are only few data concerning the willingness of ophthalmologists to become a party member ("Parteigenosse", "Pg"). According to the list of University teachers in Germany ("Hochschullehrerkarte"; Federal Archive, Berlin), the list of the members of the German Ophthalmological Society (DOG) of 1934 and especially the list of NSDAP-members (Federal Archive, Berlin) the following conclusions can be drawn: 1. Directors of German University eye hospitals (chairmen) were members of the NSDAP with a frequency of 23% in 1933 and 48% in 1938 as well as in 1943. The motivation for joining the party was most likely the perspective of acceleration of the academic career. 2. "Only" 30% of the ophthalmologists working in private praxis were "Pg" (until 1945). 3. Both chairmen and ophthalmologists in private praxis were equally hindered to join the NSDAP between May 1st 1933 and May 1st 1937 when the party temporarily stopped registration. 4. The majority of ophthalmologists who joined the NSDAP were born between 1880 and 1900 and thus had taken part in World War I as soldiers or had experienced the times of need after WW I. Only few ophthalmologists succeeded in the NS-hierarchy and probably only one ophthalmologist, Walther Löhlein from Berlin, came in personal contact with Adolf Hitler who was constantly in fear for his sight after his eye injury in October 1918. The "Law for the prevention of genetically disabled offsprings" ("Gesetz zur Verhütung erbkranken Nachwuchses") from July 14th, 1933 separated ophthalmologists into two parties: those advocating sterilization to a high degree and those recommending sterilization only

  17. [Falling Short of Minimum Volume Standards, Exemptions and Their Consequences from 2018 Onwards. Complex Procedures on Oesophagus and Pancreas in German Hospitals from 2006 to 2014].

    Science.gov (United States)

    de Cruppé, Werner; Geraedts, Max

    2018-03-16

    The minimum volume standards for hospitals in Germany, in force since 2004, provide four exemptions for non-complying hospitals. This study investigates the extent and importance of these exemptions for complex procedures on the oesophagus and pancreas for all non-complying hospitals and for the revised minimum volume regulations in force since the beginning of 2018. Longitudinal, descriptive analyses of data on minimum volume standards and their exemptions for complex procedures on the oesophagus and pancreas, as presented by the hospital quality report cards of the reporting years from 2006 to 2014. For each year and both procedures, about 120 hospitals with some 500 cases report non-compliance with the minimum volume standards. Of these a third report no exemptions (with 180 procedures), a third state emergencies (110), and another third report exemptions due to internal hospital restructuring (210). Ensuring geographical access to care as an exemption is of no importance. After the three year exemption period for installation of a new service line, 20% of the hospitals with procedures on the oesophagus and 30% on the pancreas complied with the minimum volume standards. After the two-year period for staff realignment, the figures were 40 and 50%, respectively. Exemptions do not entirely explain all procedures performed by hospitals not complying with the minimum volume standards. The revised minimum volume regulations' restructuring of exemptions to "emergencies" and "new or renewed service lines" with a two year exemption period, are concordant with the empirical findings of this study. Georg Thieme Verlag KG Stuttgart · New York.

  18. Variations over time in the effects of age and sex on hospitalization rates before and after admission to a nursing home: A German cohort study.

    Science.gov (United States)

    Hoffmann, Falk; Allers, Katharina

    2017-08-01

    We examined hospitalization rates for nursing home residents before and after their entry to the home, stratified by sex and age. A cohort study was conducted using data from a large health insurance fund on 127,227 residents aged 65 years and over newly admitted to a nursing home between January 1, 2010, and December 31, 2014. We assessed hospitalization rates and proportions being hospitalized in 6-month intervals one year before nursing home placement and up to 5 years thereafter. Multiple Poisson regression models were fitted to calculate relative risks (RR). Mean age was 84.0 years and 74.6% of the cohort were females. Hospitalization rates were 194.4 per 100 person-years (PY) in the 12 months before entry to the nursing home and 120.0 per 100 PY thereafter. Rates were highest immediately before entry in both sexes. The influence of age was most pronounced in the 12-7 months before entry (RR: 2.37 for 65-74 vs. 95+ years) and declined thereafter (1.29-1.38 up to month 24 after entry). In contrast, the influence of sex was greater after entry (RR: 1.13 for males vs. females in the 12-7 months before and 1.23-1.31 up to month 24 after entry). Hospitalization rates of nursing home residents are much higher in Germany than in other Western countries. We have provided some insight into the influence of age and sex on hospitalization rates, which varied over the period (time before and after entry to the nursing home) analyzed. We urgently recommend that future studies on the hospitalization of residents stratify their analyses by sex, age and period. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Web-based Training an deutschen Universitäts-Augenkliniken – Lehre 2.0? [Web-based Training in German University Eye Hospitals – Education 2.0?

    Directory of Open Access Journals (Sweden)

    Handzel, Daniel M.

    2011-08-01

    Full Text Available [english] Purpose: To analyse web-based training in ophthalmology offered by German university eye hospitals. Methods: In January 2010 the websites of all 36 German university hospitals were searched for information provided for visitors, students and doctors alike. We evaluated the offer in terms of quantity and quality. Results: All websites could be accessed at the time of the study. 28 pages provided information for students and doctors, one page only for students, three exclusively for doctors. Four pages didn’t offer any information for these target groups. The websites offered information on events like congresses or students curricular education, there were also material for download for these events or for other purposes. We found complex e-learning-platforms on 9 pages. These dealt with special ophthalmological topics in a didactic arrangement. In spite of the extensive possibilities offered by the technology of Web 2.0, many conceivable tools were only rarely made available. It was not always possible to determine if the information provided was up-to-date, very often the last actualization of the content was long ago. On one page the date for the last change was stated as 2004. Conclusion: Currently there are 9 functional e-learning-applications offered by German university eye hospitals. Two additional hospitals present links to a project of the German Ophthalmological Society. There was a considerable variation in quantity and quality. No website made use of crediting successful studying, e.g. with CME-points or OSCE-credits. All German university eye hospitals present themselves in the World Wide Web. However, the lack of modern, technical as well as didactical state-of-the-art learning applications is alarming as it leaves an essential medium of today’s communication unused. [german] Zielsetzung: Analyse der webbasierten ophthalmologischen Lernprogramme, welche von den Internetseiten der Universitäts-Augenkliniken in

  20. Physicians' occupational stress, depressive symptoms and work ability in relation to their working environment: a cross-sectional study of differences among medical residents with various specialties working in German hospitals.

    Science.gov (United States)

    Bernburg, Monika; Vitzthum, Karin; Groneberg, David A; Mache, Stefanie

    2016-06-15

    This study aimed to analyse and compare differences in occupational stress, depressive symptoms, work ability and working environment among residents working in various medical specialties. 435 German hospital residents in medical training working in 6 different medical specialties participated in a cross-sectional survey study. Physicians were asked about their working conditions and aspects of mental health and work ability. The Copenhagen Psychosocial Questionnaire, the Work Ability Index, the ICD-10 Symptom Rating and the Perceived Stress Questionnaire were used to measure working conditions, mental health and work ability. Results show that up to 17% of the physicians reported high levels of occupational distress and 9% reported high levels of depressive symptoms. 11% of the hospital physicians scored low in work ability. Significant differences between medical specialties were demonstrated for occupational distress, depressive symptoms, work ability, job demands and job resources. Surgeons showed consistently the highest levels of perceived distress but also the highest levels of work ability and lowest scores for depression. Depressive symptoms were rated with the highest levels by anaesthesiologists. Significant associations between physicians' working conditions, occupational distress and mental health-related aspects are illustrated. Study results demonstrated significant differences in specific job stressors, demands and resources. Relevant relations between work factors and physicians' health and work ability are discussed. These findings should be reinvestigated in further studies, especially with a longitudinal study design. This work suggests that to ensure physicians' health, hospital management should plan and implement suitable mental health promotion strategies. In addition, operational efficiency through resource planning optimisation and work process improvements should be focused by hospital management. Published by the BMJ Publishing Group

  1. [Prevention of medical device-related adverse events in hospitals: Specifying the recommendations of the German Coalition for Patient Safety (APS) for users and operators of anaesthesia equipment].

    Science.gov (United States)

    Bohnet-Joschko, Sabine; Zippel, Claus; Siebert, Hartmut

    2015-01-01

    The use and organisation of medical technology has an important role to play for patient and user safety in anaesthesia. Specification of the recommendations of the German Coalition for Patient Safety (APS) for users and operators of anaesthesia equipment, explore opportunities and challenges for the safe use and organisation of anaesthesia devices. We conducted a literature search in Medline/PubMed for studies dealing with the APS recommendations for the prevention of medical device-related risks in the context of anaesthesia. In addition, we performed an internet search for reports and recommendations focusing on the use and organisation of medical devices in anaesthesia. Identified studies were grouped and assigned to the recommendations. The division into users and operators was maintained. Instruction and training in anaesthesia machines is sometimes of minor importance. Failure to perform functional testing seems to be a common cause of critical incidents in anaesthesia. There is a potential for reporting to the federal authority. Starting points for the safe operation of anaesthetic devices can be identified, in particular, at the interface of staff, organisation, and (anaesthesia) technology. The APS recommendations provide valuable information on promoting the safe use of medical devices and organisation in anaesthesia. The focus will be on risks relating to the application as well as on principles and materials for the safe operation of anaesthesia equipment. Copyright © 2015. Published by Elsevier GmbH.

  2. The German Birth Order Register - order-specific data generated from perinatal statistics and statistics on out-of-hospital births 2001-2008

    OpenAIRE

    Michaela Kreyenfeld; Rembrandt D. Scholz; Frederik Peters; Ines Wlosnewski

    2010-01-01

    Until 2008, Germany’s vital statistics did not include information on the biological order of each birth. This resulted in a dearth of important demographic indicators, such as the mean age at first birth and the level of childlessness. Researchers have tried to fill this gap by generating order-specific birth rates from survey data, and by combining survey data with vital statistics. This paper takes a different approach by using hospital statistics on births to generate birth order-specific...

  3. [Quality assurance in coding expertise of hospital cases in the German DRG system. Evaluation of inter-rater reliability in MDK expertise].

    Science.gov (United States)

    Huber, H; Brambrink, M; Funk, R; Rieger, M

    2012-10-01

    The purpose of this study was to evaluate differences in the D-DRG results of a hospital case by 2 independently coding MKD raters. Calculation of the 2-inter-rater reliability was performed by examination of the coding of individual hospital cases. The reasons for the non-agreement of the expert evaluations and suggestions to improve the process are discussed. From the expert evaluation pool of the MDK-WL a random sample of 0.7% of the 57,375 expertises was taken. Distribution equality with the basic total was tested by the χ² test or, respectively, Fisher's exact test. For the total of 402 individual hospital cases, the G-DRG case sums of 2 experts of the MDK were determined independently and the results checked for each individual case for agreement or non-agreement. The corresponding confidence intervals with standard errors were analysed to test if certain major diagnosis categories (MDC) were statistically significantly more affected by differing expertise results than others. In 280 of the total 402 tested hospital cases, the 2 MDK raters independently reached the same G-DRG results; in 122 cases the G-DRG case sums determined by the 2 raters differed (agreement 70%; CI 65.2-74.1). Different DRG results between the 2 experts occurred regularly in the entire MDC spectrum. No MDC chapter in which significant differences between the 2 raters arose could be identified. The results of our study demonstrate an almost 70% agreement in the evaluation of hospital cost accounts by 2 independently operating MDK. This result leaves room for improvement. Optimisation potentials can be recognised on the basis of the results. Potential for improvement was established in combination with regular further training and the expansion of binding internal code recommendations as well as exchange of code-relevant information among experts in internal forums. The presented model is in principle suitable for cross-border examinations within the MDK system with the advantage that

  4. Rare earth germanates

    International Nuclear Information System (INIS)

    Bondar', I.A.; Vinogradova, N.V.; Dem'yanets, L.N.

    1983-01-01

    Rare earth germanates attract close attention both as an independent class of compounds and analogues of a widely spread class of natural and synthetic minerals. The methods of rare earth germanate synthesis (solid-phase, hydrothermal) are considered. Systems on the basis of germanium and rare earth oxides, phase diagrams, phase transformations are studied. Using different chemical analysese the processes of rare earth germanate formation are investigated. IR spectra of alkali and rare earth metal germanates are presented, their comparative analysis being carried out. Crystal structures of the compounds, lattice parameters are studied. Fields of possible application of rare earth germanates are shown

  5. Rare earth germanates

    International Nuclear Information System (INIS)

    Bondar', I.A.; Vinogradova, N.V.; Dem'yanets, L.N.

    1983-01-01

    From the viewpoint of structural chemistry and general regularities controlling formation reactions of compounds and phases in melts, solid and gaseous states, recent achievements in the chemistry of rare earth germanates are generalized. Methods of synthesizing germanates, systems on the base of germanium oxides and rare earths are considered. The data on crystallochemical characteristics are tabulated. Individual compounds of scandium germanate are also characterized. Processes of germanate formation using the data of IR-spectroscopy, X-ray phase analysis are studied. The structure and morphotropic series of rare earth germanates and silicates are determined. Fields of their present and possible future application are considered

  6. Quality Control and Complication Screening Programme of Chinese Medicinal Drugs at the First German Hospital of Traditional Chinese Medicine - A Retrospective Analysis.

    Science.gov (United States)

    Melchart, Dieter; Hager, Stefan; Dai, Jingzhang; Weidenhammer, Wolfgang

    2016-01-01

    The use of drugs derived from plants is a cornerstone of Traditional Chinese Medicine (TCM). Yet, too little is known about risk and safety of Chinese medicinal drugs (CMD). Therefore, the TCM hospital Bad Kötzting has developed a quality control and complication screening programme in order to ensure a safe administration of TCM drugs to their patients. All Chinese medicinal drugs delivered to the hospital between September 1, 2012 and December 31, 2013 entered the quality control program and were screened for microbial contamination, aflatoxin, pesticides and heavy metals. A routinely applied complication screening programme monitored liver enzymes in all patients. Case causality assessment by CIOMS scale and identification of admitted herbs were conducted. Additionally, side effects of patients were identified by a routinely performed web-based documentation system. In 5 of 23 investigated samples (21.7%) the initial testing showed microbial contamination (2), pesticide (2) and heavy metals (1). The drugs were tested for authenticity and adulterations, respectively. All 994 patients (mean age 52.6 years; 72.6% female) admitted were available for analysis. 448 (45.1%) of all patients reported having perceived at least one side effect of treatment. They experienced mainly gastrointestinal symptoms (13.6%), neurovegetative symptoms (10.8 %), temporary deteriorations of pain (8.8%), diarrhoea (5.9%), nausea (1.6%) and vomiting (0.5%). Further, 6 patients with a more than 2-fold elevation (compared to maximum normal value or elevated admission values) of ALT were found in the systematic laboratory control with a non-conclusive causality assessment for TCM-drugs. Approximate incidence rates and analysed drugs associated with liver damage revealed a low rate of liver injury. Patients should be informed of the gastrointestinal symptoms caused by and potential hepatotoxicity of TCM herbs. © 2016 S. Karger GmbH, Freiburg.

  7. Dry skin and pressure ulcer risk: A multi-center cross-sectional prevalence study in German hospitals and nursing homes.

    Science.gov (United States)

    Lechner, Anna; Lahmann, Nils; Neumann, Konrad; Blume-Peytavi, Ulrike; Kottner, Jan

    2017-08-01

    Pressure ulcers are a serious health problem in medical and nursing care. Therefore, effective prevention is crucial. Major pressure ulcer risk factors have been identified but the particular role of dry skin (xerosis cutis) is unclear. To investigate possible associations between dry skin and pressure ulcers focusing on the sacrum/trochanter and at heel/ankle skin areas. Two multicenter cross-sectional studies. In 2014 and 2015 thirty nursing homes and thirteen hospitals in Germany participated. In total 3837 participants were included. Mean age was 76.1 (SD 15.5) years. Skin assessments and data collection were performed by trained nurses based on a standardized data collection form. Descriptive comparisons and multilevel logistic regressions predicting pressure ulcers at sacrum/trochanter and ankle/heel were conducted. The prevalence of skin dryness at the trunk was significantly higher for subjects with pressure ulcers category 2+ at the sacral area compared to without (39.0% vs. 24.4%, p=0.010). Adjusted to demographic variables, mobility and type of institution dry skin at the trunk was no longer associated with pressure ulceration (OR 1.11 (95% CI 0.62-2.00)). 71.9% of patients with heel/ankle pressure ulcers category 2+ were affected by dry skin at legs or feet, compared to 42.8% of subjects without pressure ulcers (pStudy results indicate that dry skin at the feet may be considered as a risk factor for heel pressure ulcer development. Skin dryness may be less important for sacral pressure ulcers. Therefore, the variable skin status should be better defined in future studies and pressure ulcer risk models. Results further support differences in pressure ulcer aetiologies between anatomical locations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. [German nurses during the First World War].

    Science.gov (United States)

    Wagner, Franz

    2014-06-01

    Nurses from several German organisations participated in the First World War. For the most part, they did not work on the frontline but at the rear, in hospital trains, hospitals or refugee camps. They cared forwounded soldiers and faced epidemics of infectious diseases. The journal of the national association of nurses, which continued to be published during the war, provides a snapshot of their concerns and their questioning regarding the profession and its evolution.

  9. Maury Journals - German Vessels

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — German vessels observations, after the 1853 Brussels Conference that set International Maritime Standards, modeled after Maury Marine Standard Observations.

  10. Health Information in German (Deutsch)

    Science.gov (United States)

    ... Tools You Are Here: Home → Multiple Languages → German (Deutsch) URL of this page: https://medlineplus.gov/languages/german.html Health Information in German (Deutsch) To use the sharing features on this page, ...

  11. [Sample German LAPS.

    Science.gov (United States)

    Rosenthal, Bianca

    Four learning activity packages (LAPS) for use in secondary school German programs contain instructional materials which enable students to improve their basic linguistic skills. The units include: (1) "Grusse," (2) "Ich Heisse...Namen," (3) "Tune into Your Career: Business Correspondence 'Auf Deutch'," and (4) "Understanding German Culture."…

  12. Impact of New Shift Models for Doctors Working at a German University Hospital for Gynaecology and Obstetrics Four Years After Implementation. Can They Meet the European Working Time Directive Without Increasing Costs?

    Science.gov (United States)

    Maschmann, J; Holderried, M; Blumenstock, G; Bamberg, M; Rieger, M A; Wallwiener, D; Brucker, S

    2013-07-01

    Background: The impact of the European Working Time Directive and subsequent collective wage agreements for doctors from 2006 onwards were substantial. So far, no systematic evaluation of their application in Germany has been performed. We evaluated the impact four years after implementation of new shift models in a University Hospital for Gynaecology and Obstetrics (UHGO). Methods: A new shift model was created together with doctors of Tübingen UHOG in 2007 and implemented in 2008. Documentation of working hours has hence been done electronically. Adherence to the average weekly working time limit (AWTL) and the maximum of 10 h daily working time (10 h-dwt) was evaluated, as well as staffing costs in relation to case-weight points gathered within the German DRG (diagnosis related groups) System. Results: Staff increased from a mean of 44.7 full time equivalent (FTE) doctors in 2007 to 52.5 FTE in 2009, 50.8 in 2010, and 54.5 in 2011. There was no statistically significant difference of the monthly staff expenditures per case-weight between the years 2009 or 2010 vs. 2007. 2011, however, was significantly more expensive than 2007 (p = 0.02). The internal control group (five other departments of the university hospital) did not show an increase during the same period. AWTL were respected by 90, 96, and 98 % in 2009, 2010, and 2011, respectively. Of all shifts 10 h-dwt was exceeded by 7.4 % in 2009, 1.3 % in 2010, and 2.6 % in 2011, with significant differences between 2009 and both, 2010 and 2011 (p < 0.001), and between 2010 and 2011 (p = 0.02). Discussion: AWTL and 10 h-dwt could be continuously respected quite well after implementation of the new shift model without increasing the cost/earnings ratio for the first two years. However, in 2011 the ratio increased significantly (p = 0.02).

  13. Word order in the Germanic languages

    DEFF Research Database (Denmark)

    Holmberg, Anders; Rijkhoff, Jan

    1998-01-01

    The Germanic branch of Indo-European consists of three main groups (Ruhlen 1987: 327):- East Germanic: Gothic, Vandalic, Burgundian (all extinct);- North Germanic (or: Scandinavian): Runic (extinct), Danish, Swedish, Norwegian, Icelandic, Faroese;- West Germanic: German, Yiddish, Luxembourgeois, ...

  14. German Business in Russia

    Directory of Open Access Journals (Sweden)

    Irakliy D. Gvazava

    2013-01-01

    Full Text Available Since Perestroika German-Russian relationships have been steadily developing fueled by close contacts between the leaders of both countries. Boris Yeltsin and Helmut Kohl, Vladimir Putin and Gerhard Schröder, Dmitry Medvedev and Angela Merkel had friendly relations resulted in some fruitful business projects, intergovernmental economic forums etc. In my article I will consider the activities of German companies in Russia, advantages, barriers and expectations

  15. German energy market 2016

    International Nuclear Information System (INIS)

    Schiffer, Hans-Wilhelm; Weltenergierat, Berlin

    2017-01-01

    The basic orientation of the German energy supply to the increased use of renewable energies, while increasing energy efficiency, is prediscribed by the German government's energy concept and determines the market development. A current overview of the German energy market is given, which provides also this year a concentrated Compilation of the key data of the energy industry. As in the years before, the article not only summarizes general facts about the energy mix, but also goes into detail on the development of the individual energy sources, petroleum, natural gas, brown coal and hard coal, electricity as well as renewable energies. Furthermore, the price trends of international markets and in the domestic market are explained. A current overview of the development of greenhouse gas emissions concludes the contribution. [de

  16. German Idealism Today

    DEFF Research Database (Denmark)

    This collection of essays provides an exemplary overwiew of the diversity and relevance of current scholarship on German Idealism. The importance of German Idealism for contemporary philosophy has recieved growing attention and acknowledgment throughout competing fields of contemporary philosophy...... scholarly debates beyond merely antiquarian perspectives. This renaissance has been a major factor of current efforts to bridge the gap between so-called "nalytic" and so-called "continental" philosophy. The volume provides a selection of readings that contributes to systematic treatments of philosophical...

  17. DEMorphy, German Language Morphological Analyzer

    OpenAIRE

    Altinok, Duygu

    2018-01-01

    DEMorphy is a morphological analyzer for German. It is built onto large, compactified lexicons from German Morphological Dictionary. A guesser based on German declension suffixed is also provided. For German, we provided a state-of-art morphological analyzer. DEMorphy is implemented in Python with ease of usability and accompanying documentation. The package is suitable for both academic and commercial purposes wit a permissive licence.

  18. On German Unity 1

    African Journals Online (AJOL)

    German Democratic Republic (GDR) acceded to the Federal Republic of .... living and the shortage of foreign exchange forced the government of the .... manded a great deal of empathy and care above and beyond the normal call of duty. ... The periods of service completed by conscripts in the NPA were set off against the.

  19. Storytelling and German Culture.

    Science.gov (United States)

    Cooper, Connie S. Eigenmann

    The genre of fairytales, one structured form of storytelling, has been labeled "Marchen." German culture is orally transmitted in this generic form, and can be traced to a collection of 210 fairytales, the Grimm brothers'"Kinder-und Taus-Marchen," first published shortly after 1800. For this study, research questions were posed…

  20. Music to Teach German By.

    Science.gov (United States)

    Schulte, Leo

    1985-01-01

    Discusses how music can be intergrated with regular lesson plans to teach German vocabulary, grammar, and history and to give insights into German culture. Also included are sources for basic background information, a list of recordings of the German music, and notes on selecting and presenting it in the language class. (SED)

  1. [Adjustment of the German DRG system in 2009].

    Science.gov (United States)

    Wenke, A; Franz, D; Pühse, G; Volkmer, B; Roeder, N

    2009-07-01

    The 2009 version of the German DRG system brought significant changes for urology concerning coding of diagnoses, medical procedures and the DRG structure. In view of the political situation and considerable economic pressure, a critical analysis of the 2009 German DRG system is warranted. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2008 and 2009 based on the publications of the German DRG-institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). The relevant diagnoses, medical procedures and German DRGs in the versions 2008 and 2009 were analysed based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2009 focus on the development of the DRG structure, DRG validation and codes for medical procedures to be used for very complex cases. The outcome of these changes for German hospitals may vary depending in the range of activities. The German DRG system again gained complexity. High demands are made on correct and complete coding of complex urology cases. The quality of case allocation in the German DRG system was improved. On the one hand some of the old problems (e.g. enterostomata) still persist, while on the other hand new problems evolved out of the attempt to improve the case allocation of highly complex and expensive cases. Time will tell whether the increase in highly specialized DRG with low case numbers will continue to endure and reach acceptable rates of annual fluctuations.

  2. School of German Language

    Directory of Open Access Journals (Sweden)

    Sergei V. Evteev

    2014-01-01

    Full Text Available Department of German is one of the oldest language departments at MGIMO. Since its foundation in 1944 the military experienced teachers of the department, most of whom were native speakers, have begun to develop a unique method of teaching the German language, thereby revolutionize learning this foreign language. The first steps made under the supervision of the Department of Antonina V. Celica. The department refused to conventional time and is still used in universities such as the Moscow Linguistic University, separate teaching phonetics, grammar and vocabulary, which was due to the specific objectives set for the teaching staff: prepare for short term specialists in international relations, active Germanspeaking. The department can be proud of its graduates, many of whom continue his career in the walls of native high school. Many graduates have dedicated their lives to serving the State in the Ministry of Foreign Affairs.

  3. Marlene Dietrich in the German Classroom: A German Film Project--Humanities through the Golden Age of German Cinema.

    Science.gov (United States)

    Flippo, Hyde

    1993-01-01

    Marlene Dietrich and other classic performers of German cinema can serve to open up a whole new realm for students of German, at secondary and postsecondary levels. By researching and viewing German and American film classics, students have opportunity to learn more about German language and an important element of German culture that has had…

  4. [The fate of Polish psychiatry under German occupation during World War II].

    Science.gov (United States)

    Leidinger, Friedrich

    2014-07-01

    Polish psychiatry was since its origin deeply influenced by German (Austrian) and Russian psychiatry. After the German assault Polish psychiatric patients were the first victims of mass executions, and the first to be killed by new developed "gassing" technology. Especially cruel was the fate of Jewish patients. German "health policy" in occupied Poland was only "starvation or shooting". Some hospitals continued working under German rule and received patients from Germany in the framework of Nazi-"euthanasia". The article describes the mostly ignored facts of the close link between the medical programme of annihilation of the "unfit" and the genocide of Poles and Jews. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Electricity: the German example

    International Nuclear Information System (INIS)

    Huet, Sylvestre

    2013-01-01

    The author proposes some comments on the content of the Energiewende, i.e. the definition of the energy transition in Germany which aims at producing and consuming a green energy, without carbon nor nuclear. He comments the German energy mix for 2010 in terms of electricity production per origin (nuclear, coal and lignite, gas, oil, wind, solar photovoltaic, other renewable sources) and of installed capacities per origin. He notices that gas and coal still have a major weight in this mix, and discusses the content of a scenario based 100 per cent renewable energies as it has been studied by the Fraunhofer Institute, notably in terms of production level and of costs

  6. Baltic, Slavic, Germanic

    Directory of Open Access Journals (Sweden)

    Frederik Kortlandt

    2017-02-01

    Full Text Available The western Indo-European vocabulary in Baltic and Slavic is the result of an Indo-European substratum which contained an older non-Indo-European layer and was part of the Corded Ware horizon. The numbers show that a considerable part of the vocabulary was borrowed after the split between Baltic and Slavic, which came about when their speakers moved westwards north and south of the Pripet marshes. Germanic and Balto-Slavic were never contiguous Indo-European dialects at any stage of their prehistory.

  7. East German medical aid to Nicaragua: the politics of solidarity between biomedicine and primary health care.

    Science.gov (United States)

    Borowy, Iris

    2017-01-01

    Between 1979 and 1989 the government of the German Democratic Republic provided health assistance to Sandinista Nicaragua. After initial relief aid, the Sandinista embrace of a primary health care-based health system made East German health support difficult. The non-convertible currency, the repressive quality of the East German leadership, and the lack of experience with primary health care processes all limited its potential to provide support. After 1985, when implementation of this system stalled, East German health assistance was revitalized with the donation of the Hospital Carlos Marx. Providing medical services to three hundred thousand people, it combined elements of a strictly East German institution, using German personnel and equipment, with some integration into local systems.

  8. East German medical aid to Nicaragua: the politics of solidarity between biomedicine and primary health care

    Directory of Open Access Journals (Sweden)

    Iris Borowy

    Full Text Available Abstract Between 1979 and 1989 the government of the German Democratic Republic provided health assistance to Sandinista Nicaragua. After initial relief aid, the Sandinista embrace of a primary health care-based health system made East German health support difficult. The non-convertible currency, the repressive quality of the East German leadership, and the lack of experience with primary health care processes all limited its potential to provide support. After 1985, when implementation of this system stalled, East German health assistance was revitalized with the donation of the Hospital Carlos Marx. Providing medical services to three hundred thousand people, it combined elements of a strictly East German institution, using German personnel and equipment, with some integration into local systems.

  9. German atomic low meeting 2004

    International Nuclear Information System (INIS)

    Ossenbuehl, F.

    2005-01-01

    The conference report on the German atomic law meeting 2004 contains 14 contributions on the German atomic legislation within four parts: Damage precaution in the operational phase; Legal general requirements for the final disposal - considerations ''de lege lata'' and ''de lege ferenda''. Financing of the site searching by a statutory company (''Verbandsmodell''). Atomic supervision authority - federal executive administration or federal self administration?

  10. German visits to CERN

    CERN Multimedia

    2007-01-01

    State secretary to Germany's Federal Ministry of Education and Research, Frieder Meyer-Krahmer, with CERN's Director-General Robert Aymar.On 21 February, Professor Frieder Meyer-Krahmer, State Secretary to Germany's Federal Ministry of Education and Research, came to CERN. He visited the ALICE and ATLAS experiments and the computing centre before meeting the CERN's Director-General, some German physicists and members of the top management. The Minister of Science, Research and the Arts of the Baden-Württemberg regional government, Peter Frankenberg, and CERN's Director-General, Robert Aymar, signing an agreement on education. In the background: Sigurd Lettow, CERN's Director of Finance and Human Resources, and Karl-Heinz Meisel, Rector of the Fachhochschule Karlsruhe. The Minister of Science, Research and the Arts of the Baden-Württemberg regional government, Prof. Peter Frankenberg, visited CERN on 23 February. He was accompanied by the Rector of the Fachhochschule Karlsruhe, Prof. Karl-Heinz Meisel, and b...

  11. The German Middleway as Precursor for Single Embryo Transfer. A Retrospective Data-analysis of the Düsseldorf University Hospitalʼs Interdisciplinary Fertility Centre – UniKiD

    Science.gov (United States)

    Kliebisch, T. K.; Bielfeld, A. P.; Krüssel, J. S.; Baston-Büst, D. M.

    2016-01-01

    Introduction: Patients receiving fertility treatment in Germany appear to be disadvantaged in comparison to those in other countries due to the restrictive Embryo Protection Act (“Embryonenschutzgesetz, ESchG”), which prohibits the selection of a “top” embryo. The so-called German Middleway (“Deutscher Mittelweg, DMW”) now provides for a liberal interpretation of the ESchG by allowing the culture of numerous pronuclear stages (2PN stage). Materials and Methods: Retrospective cohort study of 2 assisted reproduction treatment cycles in n = 400 patients between the ages of 21 and 45 years, either treated 2× conservatively or 1× conservatively and 1× liberally according to DMW. Results: Pregnancy was achieved in 35 % of patients in the DMW group and 31 % of controls. The birth rate among controls was 28.5 % and 30.5 % in the DMW group. Most pregnancies resulted from the culture of 4 × 2PN stages. Conclusion: Patients in the DMW group had significantly higher pregnancy and birth rates compared to their previous cycles despite significantly increased age and significantly fewer transferred embryos. Key factors were the number of 2PNs generated and the quality of embryos transferred. Thus it can be assumed that particularly older patients with adequate ovarian reserves will benefit from DMW, i.e. the transfer of fewer embryos of the best possible quality. PMID:27365539

  12. Becoming German: Integration, Citizenship and Territorialization of Germanness

    DEFF Research Database (Denmark)

    Fogelman, Tatiana

    2017-01-01

    understandings of integration and Germanness, this paper highlights the neglected aspect of the ascendance of Integrationspolitik since the turn of the century: namely how it superseded previous regime of completely bifurcated migration policy for "foreigners" on the one hand, and so-called "settlers" of German......, seen ever more as residing within its state territory rather than some diffuse cultural-linguistic space. Moving our understanding of Germanness beyond the "ethnic nationhood model" (Faist 2008), I argue thus that, in conjunction with the new citizenship law, the emergence of Integrationspolitik...

  13. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings - Guideline of the German Society for Hospital Hygiene (DGKH).

    Science.gov (United States)

    Külpmann, Rüdiger; Christiansen, Bärbel; Kramer, Axel; Lüderitz, Peter; Pitten, Frank-Albert; Wille, Frank; Zastrow, Klaus-Dieter; Lemm, Friederike; Sommer, Regina; Halabi, Milo

    2016-01-01

    Since the publication of the first "Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems) in hospitals" (http://www.krankenhaushygiene.de/informationen/fachinformationen/leitlinien/12) in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section "Ventilation and air conditioning technology" attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care.

  14. How old are Germanic lambs?

    DEFF Research Database (Denmark)

    Vrieland, Seán D.

    2017-01-01

    Gothic and Gutnish lamb with the meaning ‘sheep’ sets these two languages apart from the rest of Germanic, and is the most common piece of evidence used to claim they share a close connection. Yet the same meaning is found in the descendants of Proto-Fennic *lambaz, a loan from Proto-Germanic, an......Gothic and Gutnish lamb with the meaning ‘sheep’ sets these two languages apart from the rest of Germanic, and is the most common piece of evidence used to claim they share a close connection. Yet the same meaning is found in the descendants of Proto-Fennic *lambaz, a loan from Proto...

  15. … but You Are Not German." -- Afro-German Culture and Literature in the German Language Classroom

    Science.gov (United States)

    Schenker, Theresa; Munro, Robert

    2016-01-01

    Units and classes dedicated to multiculturalism in Germany have predominantly focused on Turkish-German literature and culture. Afro-Germans have been a minority whose culture and literature have only marginally been included in German classes, even though Afro-Germans have been a part of Germany for centuries and have undergone efforts at…

  16. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings – Guideline of the German Society for Hospital Hygiene (DGKH

    Directory of Open Access Journals (Sweden)

    Külpmann, Rüdiger

    2016-02-01

    Full Text Available Since the publication of the first “Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems in hospitals” ( in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section “Ventilation and air conditioning technology” attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care.

  17. Coursebook of German: Gender Aspect

    OpenAIRE

    Aleksandra Valeryevna Filippova

    2015-01-01

    The present article regards Aspekte 1 coursebook of German as a foreign language in the context of the gender policy initiated at the end of the last century by sociolinguists and by the representatives of the so called feminist criticism of the German language. This policy has been carried out up to date, and, according to many sociological and linguistic research, it is aimed at destructing gender stereotypes in teaching and reference materials. The use of this policy is conditioned by the ...

  18. Intelligibility of Standard German and Low German to Speakers of Dutch

    NARCIS (Netherlands)

    Gooskens, C.S.; Kürschner, Sebastian; van Bezooijen, R.

    2011-01-01

    This paper reports on the intelligibility of spoken Low German and Standard German for speakers of Dutch. Two aspects are considered. First, the relative potential for intelligibility of the Low German variety of Bremen and the High German variety of Modern Standard German for speakers of Dutch is

  19. [The "Psychiatrie-Enquete" - the German Report on the State of Psychiatry in 1975].

    Science.gov (United States)

    Finzen, Asmus

    2015-10-01

    Forty years ago an expert-commission submitted a report on the deplorable state of German psychiatric care, called the "Psychiatrie-Enquete" to the Bundestag, the German parliament. The Report initiated a substantial change of Psychiatric services in the country. Inhuman treatment and living conditions were superseded. Mental hospitals were not completely abolished. But they lost their importance in favour of decentralized psychiatric services including departments at general hospitals, day hospitals and outpatient services. Custodial care was largely successfully developed into therapeutic and rehabilitative care. This article attempts a mildly critical evaluation of the Enquête 40 years after. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Neuropathological research at the "Deutsche Forschungsanstalt fuer Psychiatrie" (German Institute for Psychiatric Research) in Munich (Kaiser-Wilhelm-Institute). Scientific utilization of children's organs from the "Kinderfachabteilungen" (Children's Special Departments) at Bavarian State Hospitals.

    Science.gov (United States)

    Steger, Florian

    2006-09-01

    During National Socialism, the politically motivated interest in psychiatric genetic research lead to the founding of research departments specialized in pathological-anatomical brain research, the two Kaiser Wilhelm-Institutes (KWI) in Berlin and Munich. The latter was indirectly provided with brain material by Bavarian State Hospitals, to three of which "Kinderfachabteilungen" (Special Pediatric Units) were affiliated. As children became victims of the systematically conducted child "euthanasia" in these Special Pediatric Units, this paper will address the question whether and to which extent the organs from victims of child "euthanasia" were used for (neuro-) pathological research at the KWI in Munich. By means of case studies and medical histories (with focus on the situation in Kaufbeuren-Irsee), I will argue that pediatric departments on a regular base delivered slide preparations, that the child "euthanasia" conduced in these departments systematically contributed to neuropathological research and that slide preparations from victims of child "euthanasia" were used in scientific publications after 1945.

  1. Yoga Therapy in the German Healthcare System.

    Science.gov (United States)

    Cramer, Holger

    2018-05-09

    An estimated 15.7 million Germans are currently practicing yoga or are at least interested in starting to practice, and they often perceive yoga as a therapeutic approach. From a healthcare system perspective, the situation is less clear. Here, yoga is only recognized as a recreational or preventive activity. When yoga teachers fulfill specific qualifications, their preventive yoga classes are covered by the statutory health insurances. Only those with additional qualifications in medicine or psychotherapy, however, can independently use and promote "yoga therapy." The general perception of yoga in Germany as a preventive practice is reflected in the professional organization of yoga providers. Most providers are considered to be yoga teachers rather than yoga therapists and are organized mainly in yoga teacher associations. Despite the uncertain legal framework, yoga is now considered in a number of medical guidelines; in a number of hospitals, yoga is part of multimodal inpatient treatment programs and is delivered by physical therapists or members of other health professions. An increasing number of yoga therapy clinical trials are conducted in Germany, and efforts are underway to establish yoga therapy as an accepted adjunct treatment approach for selected medical conditions within the German healthcare system.

  2. New German abortion law agreed.

    Science.gov (United States)

    Karcher, H L

    1995-07-15

    The German Bundestag has passed a compromise abortion law that makes an abortion performed within the first three months of pregnancy an unlawful but unpunishable act if the woman has sought independent counseling first. Article 218 of the German penal code, which was established in 1871 under Otto von Bismarck, had allowed abortions for certain medical or ethical reasons. After the end of the first world war, the Social Democrats tried to legalize all abortions performed in the first three months of pregnancy, but failed. In 1974, abortion on demand during the first 12 weeks was declared legal and unpunishable under the social liberal coalition government of chancellor Willy Brandt; however, the same year, the German Federal Constitution Court in Karlsruhe ruled the bill was incompatible with article 2 of the constitution, which guarantees the right to life and freedom from bodily harm to everyone, including the unborn. The highest German court also ruled that a pregnant woman had to seek a second opinion from an independent doctor before undergoing an abortion. A new, extended article 218, which included a clause giving social indications, was passed by the Bundestag. When Germany was unified, East Germans agreed to be governed by all West German laws, except article 218. The Bundestag was given 2 years to revise the article; however, in 1993, the Federal Constitution Court rejected a version legalizing abortion in the first 3 months of the pregnancy if the woman sought counsel from an independent physician, and suggested the recent compromise passed by the Bundestag, the lower house of the German parliament. The upper house, the Bundesrat, where the Social Democrats are in the majority, still has to pass it. Under the bill passed by the Bundestag, national health insurance will pay for an abortion if the monthly income of the woman seeking the abortion falls under a certain limit.

  3. HOW COULD HOSPITALS ACT IN AN AGEING SOCIETY?

    Directory of Open Access Journals (Sweden)

    Leuca Mirela

    2011-12-01

    Full Text Available The demographic changes are of great importance for all European societies. Their impact and effects have multiple, deep facets. Each European healthcare and welfare system will be facing considerable changes in the new demographic context. The hospital sector plays an important role in each health system. This paper focuses on the impact of the demographic changes on hospitals, presents and analyzes statistical data for the German hospitals sector in order to underline the importance of the older age groups for the number of the hospital inpatient cases, the provided range of medical services and disciplines and for the hospital disease costs. The paper also reveals main findings from 30 interviews conducted in 2010 with German health experts (from hospitals, health insurance companies, universities, institutes and regional healthcare policy makers that accepted to answer questions referring to the demographic impact on the German healthcare system and hospital sector. The results of the interviews show that hospitals will have to act and react to the demographic changes. German hospitals might play different roles in the healthcare service provision for older people when engaging in new models of integrated care that will have to be developed. Processes, structures, human resources expertise, hospital service provision and medical departments will undergo major changes in response to the demographic challenges. Networks, centres of excellence for older persons and integrated care will probably be indispensable structures of the German healthcare system in the future. Strategic partnerships with pre- and post-hospital healthcare service providers are considered to be top priorities for German hospitals when facing the demographic challenge. Central case management and process optimization can be essential factors of success in the hospital care of the older, multimorbid patients. Acute geriatric medicine will be a main quality feature for the

  4. Immobile Complex Verbs in Germanic

    DEFF Research Database (Denmark)

    Vikner, Sten

    2005-01-01

    the V° requirements or the V* requirements. Haider (1993, p. 62) and Koopman (1995), who also discuss such immobile verbs, only account for verbs with two prefix-like parts (e.g., German uraufführen ‘to perform (a play) for the first time' or Dutch herinvoeren ‘to reintroduce'), not for the more...... frequent type with only one prefix-like part (e.g., German bauchreden/Dutch buikspreken ‘to ventriloquize'). This analysis will try to account not only for the data discussed in Haider (1993) and Koopman (1995) but also for the following: - why immobile verbs include verbs with only one prefix-like part...... are immobile, - why such verbs are not found in Germanic VO-languages such as English and Scandinavian....

  5. [Orthopedic and trauma surgery in the German DRG system 2008].

    Science.gov (United States)

    Franz, D; Kaufmann, M; Siebert, C H; Windolf, J; Roeder, N

    2008-04-01

    The German DRG (diagnosis-related groups) system has been modified and updated into version 2008. For orthopedic and trauma surgery significant changes concerning coding of diagnoses, medical procedures and the DRG structure were made. The modified version has been analyzed in order to ascertain whether the DRG system is suitably qualified to fulfill the demands of the reimbursement system or whether further improvements are necessary. Analysis of the severity of relevant side-effect diagnoses, medical procedures and G-DRGs in the versions 2007 and 2008 was carried out based on the publications of the German DRG institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2008 focused on the development of DRG structure, DRG validation and codes for medical procedures. The outcome of these changes for German hospitals may vary depending on the range of activities. G-DRG system has become even more complex and the new regulations have also resulted in new problems associated with complications.. High demands are made on correct and complete coding of complex orthopedic and trauma surgery cases. Quality of case allocation within the G-DRG system has been improved. Nevertheless, further improvements of the G-DRG system are necessary, especially for cases with severe injuries.

  6. The Danish Press during the German Occupation

    DEFF Research Database (Denmark)

    Roslyng-Jensen, Palle

    2010-01-01

    Censorship, self-censorship in Danish newspapers and Danish Radio during the German occupation of Denmark 1940-45......Censorship, self-censorship in Danish newspapers and Danish Radio during the German occupation of Denmark 1940-45...

  7. A Suggested Curriculum Outline for German in Secondary Schools

    Science.gov (United States)

    Clutterbuck, J. M.

    1975-01-01

    Outlines a four-year program of German study aiming to give students a basic ability in spoken and written German, knowledge of German culture, and preparation for advanced German study. Study topics and textbooks are included. (CHK)

  8. Metrical Phonology: German Sound System.

    Science.gov (United States)

    Tice, Bradley S.

    Metrical phonology, a linguistic process of phonological stress assessment and diagrammatic simplification of sentence and word stress, is discussed as it is found in the English and German languages. The objective is to promote use of metrical phonology as a tool for enhancing instruction in stress patterns in words and sentences, particularly in…

  9. Dividend Policy of German Firms

    NARCIS (Netherlands)

    Goergen, M.; Renneboog, L.D.R.; Correia Da Silva, L.

    2004-01-01

    German firms pay out a lower proportion of their cash flows than UK and US firms.However, on a published profits basis, the pattern is reversed.Company law provisions and accounting policies account for these conflicting results.A partial adjustment model is used to estimate the implicit target

  10. The German radiation protection standards

    International Nuclear Information System (INIS)

    Becker, Klaus; Neider, Rudolf

    1977-01-01

    The German Standards Institute (DIN Deutsches Institut fuer Normung, Berlin) is engaged in health physics standards development in the following committees. The Nuclear Standards Committee (NKe), which deals mainly with nuclear science and technology, the fuel cycle, and radiation protection techniques. The Radiology Standards Committee (FNR), whose responsibilities are traditionally the principles of radiation protection and dosimetry, applied medical dosimetry, and medical health physics. The German Electrotechnical Commission (DKE), which is concerned mostly with instrumentation standards. The Material Testing Committee (FNM), which is responsible for radiation protection in nonmedical radiography. The current body of over one hundred standards and draft standards was established to supplement the Federal German radiation protection legislation, because voluntary standards can deal in more detail with the specific practical problems. The number of standards is steadily expanding due to the vigorous efforts of about thirty working groups, consisting of essentially all leading German experts of this field. Work is supported by the industry and the Federal Government. A review of the present status and future plans, and of the international aspects with regard to European and world (ISO, etc.) standards will be presented

  11. Headstart German Program. Cultural Notes.

    Science.gov (United States)

    Defense Language Inst., Monterey, CA.

    This module provides cultural information that will be helpful to military personnel in understanding some aspects of the German way of life. The topics covered in the booklet are: housing, postal services, forms of address, courtesies, getting around, driving, hotels, restaurants, beer and wine, recreation, entertainment, health spas, shopping,…

  12. The founding of Zemun Hospital

    Directory of Open Access Journals (Sweden)

    Milanović Jasmina

    2014-01-01

    Full Text Available This year Zemun Hospital - Clinical Hospital Center Zemun celebrates 230th anniversary of continuous work, thus becoming the oldest medical facility in Serbia. The exact date of the hospital founding has been often questioned in history. Various dates appeared in the literature, but the most frequent one was 25th of February 1784. Until now, the document which confirms this has never been published. This article represents the first official publication of the document which confirms that Zemun Hospital was indeed founded on this date. The first hospitals started emerging in Zemun when the town became a part of the Habsburg Monarchy. The first sanitary facility ever formed was the “Kontumac” - a quarantine established in 1730. Soon after, two more confessional hospitals were opened. The Serbian (Orthodox Hospital was founded before 1769, whereas the German (Catholic Hospital started working in 1758. Both hospitals were financed, amongst others, by the Town Hall - the Magistrate. In order to improve efficiency of these hospitals, a decision was made to merge them into a single City Hospital. It was founded on 25th February 1784, when the General Command ordered the Magistrate of Zemun to merge the financess of all existing hospitals and initiate the construction of a new building. Although financially united, the hospitals continued working in separate buildings over a certain period of time. The final, physical merging of these hospitals was completed in 1795. [Projekat Ministarstva nauke Republike Srbije, br. 47030

  13. Excessive Profits of German Defense Contractors

    Science.gov (United States)

    2014-09-01

    its business unit Thyssen Krupp Marine Systems, is a German defense contractor. (2) Tognom AG Tognum AG owned the MTU Friedrichshafen GmbH before... Friedrichshafen provided engines for many ships of the German Navy and for German battle tanks, such as the Leopard I and Leopard II. MTU refers to the

  14. [German influences on Romanian medical terminology].

    Science.gov (United States)

    Răcilă, R G; Răileanu, Irena; Rusu, V

    2008-01-01

    The medical terminology plays a key part both in the study of medicine as well as in its practice. Moreover, understanding the medical terms is important not only for the doctor but also for the patients who want to learn more about their condition. For these reasons we believe that the study of medical terminology is one of great interest. The aim of our paper was to evaluate the German linguistic and medical influences on the evolution of the Romanian medical terminology. Since the Romanian-German cultural contacts date back to the 12th century we had reasons to believe that the number of German medical words in Romanian would be significant. To our surprise, the Romanian language has very few German words and even less medical terms of German origin. However, when we searched the list of diseases coined after famous medical personalities, we found out that 26 % of them bore the names of German doctors and scientists. Taken together this proves that the German medical school played an important role on the evolution of Romanian medicine despite the fact that the Romanian vocabulary was slightly influenced by the German language. We explain this fact on the structural differences between the Romanian and German languages, which make it hard for German loans to be integrated in the Romanian lexis. In conclusion we state that the German influence on the Romanian medical terminology is weak despite the important contribution of the German medical school to the development of medical education and healthcare in Romania. Key

  15. Layers of root nouns in Germanic

    DEFF Research Database (Denmark)

    Hansen, Bjarne Simmelkjær Sandgaard

    2017-01-01

    The root-noun declension became productive in early Germanic, containing (I) inherited root nouns, (IIa) original substrate or loan words, and transitions from other declensions in (IIb) Proto-Germanic and (III) North Germanic. As ablaut was abolished, the inherited type would display ablaut grades...

  16. Enriching the Curriculum with Pennsylvania German

    Science.gov (United States)

    Meindl, Joerg

    2016-01-01

    The German classroom should prepare students for the linguistic diversity of the target culture, including regional varieties and German spoken outside of the D-A-CH region. Because textbooks do not often include materials on regional varieties, this article presents a model to incorporate Pennsylvania German (PG) into the curriculum. The model…

  17. Silent Film in the German Classroom.

    Science.gov (United States)

    Caldwell, David

    In addition to using films in the German classroom to introduce students to German culture and history, it is important to show and study the film as film. This procedure emphasizes the importance of the film as a part of creative arts in Germany and demands student participation in observation and discussion. Many German silent films are…

  18. "We call it Springbok-German!": language contact in the German communities in South Africa.

    OpenAIRE

    Franke, Katharina

    2017-01-01

    Varieties of German are spoken all over the world, some of which have been maintained for prolonged periods of time. As a result, these transplanted varieties often show traces of the ongoing language contact as specific to their particular context. This thesis explores one such transplanted German language variety – Springbok- German – as spoken by a small subset of German Lutherans in South Africa. Specifically, this study takes as its focus eight rural German communities acr...

  19. Abortion checks at German-Dutch border.

    Science.gov (United States)

    Von Baross, J

    1991-05-01

    The commentary on West German abortion law, particularly in illegal abortion in the Netherlands, finds the law restrictive and in violation of the dignity and rights of women. The Max-Planck Institute in 1990 published a study that found that a main point of prosecution between 1976 and 1986, as reported by Der Spiegal, was in border crossings from the Netherlands. It is estimated that 10,000 annually have abortions abroad, and 6,000 to 7,000 in the Netherlands. The procedure was for an official to stop a young person and query about drugs; later the woman would admit to an abortion, and be forced into a medical examination. The German Penal Code Section 218 stipulates abortion only for certain reasons testified to by a doctor other than the one performing the abortion. Counseling on available social assistance must be completed 3 days prior to the abortion. Many counseling offices are church related and opposed to abortions. Many doctors refuse legally to certify, and access to abortion is limited. The required hospital stay is 3-4 nights with no day care facilities. Penal Code Section 5 No. 9 allows prosecution for uncounseled illegal abortion. Abortion law reform is anticipated by the end of 1992 in the Bundestag due to the Treaty or the Unification of Germany. The Treaty states that the rights of the unborn child must be protected and that pregnant women relieve their distress in a way compatible with the Constitution, but improved over legal regulations from either West or East Germany, which permits abortion on request within 12 weeks of conception without counseling. It is hoped that the law will be liberalized and Penal Code Section 5 No. 9 will be abolished.

  20. The German Economy and U.S.-German Economic Relations

    Science.gov (United States)

    2009-11-30

    Should the SPD and The Left overcome existing differences, the grouping could represent a leftward shift in German politics. Alliance ’90 / The...and replaced it with less generous social assistance benefits already available to poor individuals, regardless of employment history . These changes...director at Volkswagen . 48Hans-Werner Sinn, Can Germany Be Saved?, p. 108. 49 Alister Miskimmon and Walter E. Paterson, “Conclusion: coping with the

  1. Urban Green Infrastructure: German Experience

    OpenAIRE

    Diana Olegovna Dushkova; Sergey Nikolaevich Kirillov

    2016-01-01

    The paper presents a concept of urban green infrastructure and analyzes the features of its implementation in the urban development programmes of German cities. We analyzed the most shared articles devoted to the urban green infrastructure to see different approaches to definition of this term. It is based on materials of field research in the cities of Berlin and Leipzig in 2014-2015, international and national scientific publications. During the process of preparing the paper, consultations...

  2. German cross-cultural psychology

    OpenAIRE

    Trommsdorff, Gisela

    1986-01-01

    The present study deals with German-language cross-cultural research in different fields of psychology which attempts to achieve one Or more goals of cross-cultural psychology. First, methodological problems are discussed, followed by a selective presentation of cross-cultural research in personality, clinical, ethological, developmental, and social psychology. The theoretical and methodological advancement of these studies is investigated with respect to four approaches - universals in cross...

  3. Operational Art and the German 1918 Offensives

    OpenAIRE

    Zabecki, D T

    2009-01-01

    At the tactical level of war the Germans are widely regarded as having had the most innovative and proficient army of World War I. Likewise, many historians would agree that the Germans suffered from serious, if not fatal, shortcomings at the strategic level of war. It is at the middle level of warfare, the operational level, that the Germans seem to be the most difficult to evaluate. Although the operational was only fully accepted in the 1980s by many Western militaries as...

  4. Out of the German parliament into the German Museum?

    International Nuclear Information System (INIS)

    Lieb, E.

    1989-01-01

    It is currently discussed whether the German Bundestag can deal with the interdepartmental problems of technology assessment with the Commissions of Inquiry on the one hand and whether it has adequate instruments available with the department-related standing Bundestag committees in order to deal with technology assessment. In its report the Commission of Inquiry for Technology Assessment of the past legislative period came to the conclusion that the US parliamentary advisory model which has been realized with OTA could, of course, not be transferred to the situation of the German Bundestag without hesitation, but that the Bundestag should also have a permanent scientific department staff with a sufficient number of personnel and material. The congress was to offer the possibility to discuss the problems of technology assessment with regard to this up-to-date background with experts and members of parliament of the various commissions of inquiry and commissions of the Bundestag which were summoned in order to judge essential technologies and also to solve the problem of the institutionalization of technology assessment. (orig./DG) [de

  5. Coursebook of German: Gender Aspect

    Directory of Open Access Journals (Sweden)

    Aleksandra Valeryevna Filippova

    2015-09-01

    Full Text Available The present article regards Aspekte 1 coursebook of German as a foreign language in the context of the gender policy initiated at the end of the last century by sociolinguists and by the representatives of the so called feminist criticism of the German language. This policy has been carried out up to date, and, according to many sociological and linguistic research, it is aimed at destructing gender stereotypes in teaching and reference materials. The use of this policy is conditioned by the fact that there is a problem of women discrimination in the textbooks, which provide classical gender stereotypes, where, in spite of modern social changes, women are still overrepresented in the private domain and underrepresented in the public sphere. Apart from that, gender stereotypes and gender asymmetry are embedded in the language, where the woman is often not referred to directly while the man is used in the generalizing meaning of "human". The gender asymmetry is reflected in the idioms as well. Nevertheless the analysis of modern coursebooks reveals both some changes in the presentation of women and men's occupations and in the language due to the usage of so-called "gender neutral" forms. The objective of our research lies in the linguistic analysis of the usage of the "gender neutral" forms as well as in the coursebooks on phraseology in order to find out gender asymmetries. In addition, the author focuses on gender stereotypes, men and women's behavioral patterns in different domains of life, and positive changes in the image of men and women represented in the Aspekte German coursebook.

  6. German Policy Towards Muslim Communities

    Directory of Open Access Journals (Sweden)

    Liudmila R. Sadykova

    2014-01-01

    Full Text Available The past two-three decades can be characterized by the period of global migration and sharp jump of migratory streams is connected with globalization and with the economic factor, generating labor movement behind resources from Third World countries to the countries with deficiency of labor. The desire to receive comfort life becomes the major reason, and the migrant makes the decision being guided by private interest more often instead of external factors. Western Europe became one of the most important center of gravity of migrants. During the post-war period the need of Europe in foreign labor for restoration of the economy destroyed by war, laid the foundation of mass international migration to this region. Globalization of migratory streams, penetration of foreign culture groups into structure of accepting society and prevalence of multicultural, multiethnic societies are important characteristics of a modern era. Western Europe became one of the most important centers of gravity of migrants. During the post-war period, the need of Europe in foreign labor for restoration of the economy destroyed by war laid the foundation of mass international migration to this region. Special relevance the problem of reception of immigrants, in particular from the Muslim countries, got for the former colonial powers, in particular Great Britain, France, and the Netherlands. Germany also faced this problem; migrants workers from other countries were required for the post-war restoration. Now Germany still is one of the main centers of an attraction of migrants, and concentration of them in this country annually increases. Despite the steps taken by the German government on elimination of Muslim isolation in the German society, its efforts did not bear fruits so far. The majority of Muslims live their life and are still torn off from high life of the country. A possible threat of destruction of the German community appeared when the various ethnic groups

  7. German risk study of PWR's

    International Nuclear Information System (INIS)

    Kafka, P.

    1983-01-01

    In this paper, first the status of German Risk Study is presented briefly. Specific reference is made to the investigations in Phase B of the study and related programs. Significant elements involved in the risk assessment for NPPs, mainly in the field of system and structural reliability analyses are mentioned. In particular, important outcomes and limiting facts in the process of a Probabilistic Risk Assessment (PRA) to evaluate the safety standard and above all the influence of individual components or subsystems on core melt frequency are discussed. (orig.)

  8. 63rd German radiological congress

    International Nuclear Information System (INIS)

    1982-01-01

    The book of abstracts contains abstracts of 171 papers read at the German Radiological Congress in Berlin as well as abstracts of two papers not read for lack of time. Further, there are 31 brief descriptions of the scientific exhibition. Subjects: Diagnosis of gall bladder diseases and inflammatory diseases of the large intestine; hyperthermia and irradiation in tumour therapy; nuclear methods in the diagnosis of growing and displacing processes, skeletal diseases, thromboses, embolisms, gastrointestinal and liver affections; new techniques and methods, diagnostics of the spinal tract; radiooncology; carcinoma of the ovaries; diagnostics and therapy of tumours of the lungs; computerized tomography; angiography; ultrasonic diagnosis. (MG) [de

  9. German Librarianship and Munich Libraries

    Directory of Open Access Journals (Sweden)

    Osman Ümit Özen

    1994-06-01

    Full Text Available There are 27 municipal libraries including the Central Public Library in Munich. The other important libraries in the city are Bayern State National Library, Maximillian University Library, a technical highschool library and the "Deutsches Musuem" Library. All these libraries are financed locally. The author introduces these libraries briefly and compares German libraries with Turkish libraries. He concludes that although theoretically there are not distinctive differences, in practice, buildings and their layout are better in Germany where more variety of services are offered. In Turkey standardization has not been realized yet. Turkey needs to computerize and network to improve the services offered in an efficient way.

  10. Hospitals; hospitals13

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  11. Tinnitus functional index: validation of the German version for Switzerland.

    Science.gov (United States)

    Peter, Nicole; Kleinjung, Tobias; Jeker, Raphael; Meyer, Martin; Klaghofer, Richard; Weidt, Steffi

    2017-05-05

    Different standardized questionnaires are used to assess tinnitus severity, making comparisons across studies difficult. These questionnaires are also used to measure treatment-related changes in tinnitus although they were not designed for this purpose. To solve these problems, a new questionnaire - the Tinnitus Functional Index (TFI) - has been established. The TFI is highly responsive to treatment-related change and promises to be the new gold standard in tinnitus evaluation. The aim of the current study was to validate a German version of the TFI for a German-speaking population in Switzerland. At the ENT department of the University Hospital Zurich, 264 subjects completed an online survey including the German version for Switzerland of TFI, Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and sociodemographic variables. Internal consistency of the TFI was calculated with Cronbach's alpha coefficient. Pearson correlation coefficients were used for the test-retest reliability of the TFI and to investigate convergent and discriminant validity between the THI and the BDI and BAI, respectively. Factor analysis was assessed using a principal component analysis with oblique rotation. The different factors extracted were then compared with the original questionnaire. The German version of the TFI for Switzerland showed an excellent internal consistency (Cronbach's alpha of 0.97) and an excellent test-retest reliability of 0.91. The convergent validity with THI was high (r = 0.86). The discriminant validity with BAI and BDI showed moderate results (BAI: r = 0.60 and BDI: r = 0.65). In the factor analysis only five factors with one main factor could be extracted instead of eight factors as described in the original version. Nevertheless, relations to the original eight subscales could be demonstrated. The German version of the TFI for Switzerland is a suitable instrument for measuring the impact of tinnitus

  12. A German catastrophe? German historians and the Allied bombings, 1945-2010

    NARCIS (Netherlands)

    von Benda-Beckmann, B.R.

    2010-01-01

    As one of the major symbols of German suffering, the Allied bombing war left a strong imprint on German society. To a much wider extent than is often claimed, the Allied bombings became part of German debates on the Second World War. In both the GDR as well as the Federal Republic before and after

  13. French pollution and German lignite

    International Nuclear Information System (INIS)

    Foos, Jacques

    2015-01-01

    After having recalled that the German energy transition is based on a complete shutting down of nuclear power stations to replace them by renewable energy sources on the one hand, and by coal (lignite, i.e. the dirtiest coal) and gas on the other hand to compensate the intermittency of the former ones, this article notices that pollution peaks occurred in France when an eastern of north-eastern wind was blowing, and not in case of western wind. The author then wanders whether this pollution comes from Germany, and more particularly from the releases of lignite-fuelled power stations. Then, the author comments the high level of pollution associated with coal extraction and exploitation in Germany, causing thousands of deaths and resulting in lung diseases or cancers, myocardial infractions. The author then makes a parallel between, on the one hand, the ignorance of this German pollution and, on the other hand, evacuation measures around Fukushima for a radioactivity which the author considers as less dangerous in terms of life expectancy

  14. [King's Parkinson's disease pain scale : Intercultural adaptation in the German language].

    Science.gov (United States)

    Jost, W H; Rizos, A; Odin, P; Löhle, M; Storch, A

    2018-02-01

    Pain is a frequent symptom of idiopathic Parkinson's disease and has a substantial impact on quality of life. The King's Parkinson's disease pain scale (KPPS) has become internationally established and is an English-language, standardized, reliable and valid scale for evaluation of pain in idiopathic Parkinson's disease. This article presents a validated version in German. The German translation was adapted interculturally and developed using an internationally recognized procedure in consultation with the authors of the original publication. The primary text was first translated by two bilingual neuroscientists independently of one another. Thereafter, the two versions were collated to generate a consensus version, which was accepted by the translators and preliminarily trialled with 10 patients. Hereafter, the German version was re-translated back into English by two other neurologists, again independently of one another, and a final consensus was agreed on using these versions. This English version was then compared with the original text by all of the translators, a process which entailed as many linguistic modifications to the German version as the translators considered necessary to generate a linguistically acceptable German version that was as similar as possible to the original English version. After this test text had been subsequently approved by the authors, the German text was applied to 50 patients in two hospitals, and reviewed as to its practicability and comprehensibility. This work led to the successful creation of an inter-culturally adapted and linguistically validated German version of the KPPS. The German version presented here is a useful scare for recording and quantifying pain in empirical studies, as well as in clinical practice.

  15. The Dividend Policy of German Firms

    NARCIS (Netherlands)

    Andres, C.; Betzer, A.; Goergen, M.; Renneboog, L.D.R.

    2008-01-01

    Abstract: German firms pay out a lower proportion of their cash flows, but a higher proportion of their published profits than UK and US firms. We estimate partial adjustment models and report two major findings. First, German firms base their dividend decisions on cash flows rather than published

  16. The Dividend Policy of German Firms

    NARCIS (Netherlands)

    Andres, C.; Betzer, A.; Goergen, M.; Renneboog, L.D.R.

    2008-01-01

    German firms pay out a lower proportion of their cash flows, but a higher proportion of their published profits than UK and US firms. We estimate partial adjustment models and report two major findings. First, German firms base their dividend decisions on cash flows rather than published earnings as

  17. German Schools Abroad: Hotspots of Elite Multilingualism?

    Science.gov (United States)

    Sander, Anne E; Admiraal, Wilfried

    2016-01-01

    While multilingualism itself is a widely analyzed topic, a study about multilingualism at German schools abroad is so far unique. This quantitative study investigates the differences in the size of German expressive and receptive vocabulary between monolingual and multilingual students, aged between 5 and 11 years. A cohort of 65 multilingual…

  18. Massive job cuts threaten East German science

    CERN Multimedia

    Hamer, M

    1990-01-01

    German reunification could result in thousands of scientists losing their jobs. At the end of this year the East German state budget for science will run out. Scientists in the East are keen to find Western support to protect their research (1 page).

  19. When do German Firms Change their Dividends?

    NARCIS (Netherlands)

    Correia Da Silva, L.; Goergen, M.; Renneboog, L.D.R.

    2002-01-01

    Anecdotal evidence suggests that the dividend policy of German firms is more flexible than the one of their Anglo-American counterparts.This paper analyses the decision to change the dividend for a panel of 221 German firms from 1984 to 1994.The choice of the period of study is motivated by the fact

  20. Lexical Reading in Dysfluent Readers of German

    Science.gov (United States)

    Gangl, Melanie; Moll, Kristina; Jones, Manon W.; Banfi, Chiara; Schulte-Körne, Gerd; Landerl, Karin

    2018-01-01

    Dyslexia in consistent orthographies like German is characterized by dysfluent reading, which is often assumed to result from failure to build up an orthographic lexicon and overreliance on decoding. However, earlier evidence indicates effects of lexical processing at least in some German dyslexic readers. We investigated variations in reading…

  1. Facebook Used in a German Film Project

    Science.gov (United States)

    Leier, Vera

    2011-01-01

    Looking for a way to make German language study more relevant and to step out of the conventional classroom setting, I introduced Facebook (FB) as a learning platform to my intermediate German students at the University of Canterbury, New Zealand. The students took part in a film competition. A FB group was created and the films were uploaded. The…

  2. DIMA – Annotation guidelines for German intonation

    DEFF Research Database (Denmark)

    Kügler, Frank; Smolibocki, Bernadett; Arnold, Denis

    2015-01-01

    This paper presents newly developed guidelines for prosodic annotation of German as a consensus system agreed upon by German intonologists. The DIMA system is rooted in the framework of autosegmental-metrical phonology. One important goal of the consensus is to make exchanging data between groups...

  3. Teaching German Culture: An Alternative Approach.

    Science.gov (United States)

    Ray, Maruta L.

    1985-01-01

    Describes a college course on German culture in which the criterion for the inclusion of any topic in the syllabus is its mention--preferably recurrent--in the German press. Additional emphasis is placed upon the historical background of the current events. Classes are a combination of films, lectures, discussions, and student reports. (SED)

  4. Fine-grained information extraction from German transthoracic echocardiography reports.

    Science.gov (United States)

    Toepfer, Martin; Corovic, Hamo; Fette, Georg; Klügl, Peter; Störk, Stefan; Puppe, Frank

    2015-11-12

    Information extraction techniques that get structured representations out of unstructured data make a large amount of clinically relevant information about patients accessible for semantic applications. These methods typically rely on standardized terminologies that guide this process. Many languages and clinical domains, however, lack appropriate resources and tools, as well as evaluations of their applications, especially if detailed conceptualizations of the domain are required. For instance, German transthoracic echocardiography reports have not been targeted sufficiently before, despite of their importance for clinical trials. This work therefore aimed at development and evaluation of an information extraction component with a fine-grained terminology that enables to recognize almost all relevant information stated in German transthoracic echocardiography reports at the University Hospital of Würzburg. A domain expert validated and iteratively refined an automatically inferred base terminology. The terminology was used by an ontology-driven information extraction system that outputs attribute value pairs. The final component has been mapped to the central elements of a standardized terminology, and it has been evaluated according to documents with different layouts. The final system achieved state-of-the-art precision (micro average.996) and recall (micro average.961) on 100 test documents that represent more than 90 % of all reports. In particular, principal aspects as defined in a standardized external terminology were recognized with f 1=.989 (micro average) and f 1=.963 (macro average). As a result of keyword matching and restraint concept extraction, the system obtained high precision also on unstructured or exceptionally short documents, and documents with uncommon layout. The developed terminology and the proposed information extraction system allow to extract fine-grained information from German semi-structured transthoracic echocardiography reports

  5. German versus Nordic Board Models

    DEFF Research Database (Denmark)

    Ringe, Georg

    2016-01-01

    Board structure is an important component of the individual governance of firms, and the appropriateness of the various models is one of the most debated issues in corporate governance today. A comparison of the Nordic and German approaches to the structure of corporate boards reveals stark...... conceptual differences, as emphasized by the 2014 Lekvall Report on the Nordic Corporate Governance Model. This article provides a conceptual comparison between the two approaches to board structure and confirms the fundamental divergence between both models. However, relying on a number of recent legal...... changes and developments in business practice, the article argues that board practices in the two systems effectively blur the structural distinction, and that board organization is converging in practice. It thereby contributes to the broader debates on functionality and comparative corporate law...

  6. German standard problem No. 2

    International Nuclear Information System (INIS)

    Burkhardt, R.

    1980-02-01

    The German Standard Problem Nr. 2 (primary circuits) is meant to check whether the presently available computing programs dealing with ECCS problems are suitable to reflect with sufficient accuracy reload and flooding processes. Changing from conventional calculation methods to the ''best-estimate'' method requires for possibility of exact comparison, as is the case here because of experimental results from the primary circuit test plant. The test plant of KWU Erlangen with primary circuit modeups on a 1:134 scale with exact level indications allows comparative testing where emergency cooling water is loaded into the system filled with saturated steam over cold lanes, or rather over the annulus modeup. The report on hand goes into detail about calculations, anticipated results and their comparison to experimental results. (orig./RW) [de

  7. German General Staff Officer Education and Current Challenges

    National Research Council Canada - National Science Library

    Groeters, Thomas

    2006-01-01

    "German General Staff Officer Education and Current Challenges" examines the institutional education of German General Staff Officers, as experienced by the author, and offers a "Conceptual Competency...

  8. Urban Green Infrastructure: German Experience

    Directory of Open Access Journals (Sweden)

    Diana Olegovna Dushkova

    2016-06-01

    Full Text Available The paper presents a concept of urban green infrastructure and analyzes the features of its implementation in the urban development programmes of German cities. We analyzed the most shared articles devoted to the urban green infrastructure to see different approaches to definition of this term. It is based on materials of field research in the cities of Berlin and Leipzig in 2014-2015, international and national scientific publications. During the process of preparing the paper, consultations have been held with experts from scientific institutions and Administrations of Berlin and Leipzig as well as local experts from environmental organizations of both cities. Using the German cities of Berlin and Leipzig as examples, this paper identifies how the concept can be implemented in the program of urban development. It presents the main elements of green city model, which include mitigation of negative anthropogenic impact on the environment under the framework of urban sustainable development. Essential part of it is a complex ecological policy as a major necessary tool for the implementation of the green urban infrastructure concept. This ecological policy should embody not only some ecological measurements, but also a greening of all urban infrastructure elements as well as implementation of sustainable living with a greater awareness of the resources, which are used in everyday life, and development of environmental thinking among urban citizens. Urban green infrastructure is a unity of four main components: green building, green transportation, eco-friendly waste management, green transport routes and ecological corridors. Experience in the development of urban green infrastructure in Germany can be useful to improve the environmental situation in Russian cities.

  9. Hospital Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  10. HCAHPS - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  11. A multi-perspective cost-effectiveness analysis comparing rivaroxaban with enoxaparin sodium for thromboprophylaxis after total hip and knee replacement in the German healthcare setting

    Directory of Open Access Journals (Sweden)

    Zindel Sonja

    2012-07-01

    Full Text Available Abstract Background Patients undergoing major orthopaedic surgery (MOS, such as total hip (THR or total knee replacement (TKR, are at high risk of developing venous thromboembolism (VTE. For thromboembolism prophylaxis, the oral anticoagulant rivaroxaban has recently been included in the German diagnosis related group (DRG system. However, the cost-effectiveness of rivaroxaban is still unclear from both the German statutory health insurance (SHI and the German hospital perspective. Objectives To assess the cost-effectiveness of rivaroxaban from the German statutory health insurance (SHI perspective and to analyse financial incentives from the German hospital perspective. Methods Based on data from the RECORD trials and German cost data, a decision tree was built. The model was run for two settings (THR and TKR and two perspectives (SHI and hospital per setting. Results Prophylaxis with rivaroxaban reduces VTE events (0.02 events per person treated after TKR; 0.007 after THR compared with enoxaparin. From the SHI perspective, prophylaxis with rivaroxaban after TKR is cost saving (€27.3 saving per patient treated. However, the cost-effectiveness after THR (€17.8 cost per person remains unclear because of stochastic uncertainty. From the hospital perspective, for given DRGs, the hospital profit will decrease through the use of rivaroxaban by €20.6 (TKR and €31.8 (THR per case respectively. Conclusions Based on our findings, including rivaroxaban for reimbursement in the German DRG system seems reasonable. Yet, adequate incentives for German hospitals to use rivaroxaban are still lacking.

  12. [The boycott against German scientists and the German language after World War I].

    Science.gov (United States)

    Reinbothe, R

    2013-12-01

    After the First World War, the Allied academies of sciences staged a boycott against German scientists and the German language. The objective of the boycott was to prevent the re-establishment of the prewar dominance of German scientists, the German language and German publications in the area of international scientific cooperation. Therefore the Allies excluded German scientists and the German language from international associations, congresses and publications, while they created new international scientific organizations under their leadership. Medical associations and congresses were also affected, e. g. congresses on surgery, ophthalmology and tuberculosis. Allied physicians replaced the "International Anti-Tuberculosis Association" founded in Berlin in 1902 with the "Union Internationale contre la Tuberculose"/"International Union against Tuberculosis", founded in Paris in 1920. Only French and English were used as the official languages of the new scientific organizations, just as in the League of Nations. The boycott was based on the fact that the German scientists had denied German war guilt and war crimes and glorified German militarism in a manifesto "To The Civilized World!" in 1914. The boycott first started in 1919 and had to be abolished in 1926, when Germany became a member of the League of Nations. Many German and foreign physicians as well as other scientists protested against the boycott. Some German scientists and institutions even staged a counter-boycott impeding the resumption of international collaboration. The boycott entailed an enduring decline of German as an international scientific language. After the Second World War scientists of the victorious Western Powers implemented a complete reorganization of the international scientific arena, based on the same organizational structures and language restrictions they had built up in 1919/1920. At the same time scientists from the U.S.A. staged an active language and publication policy, in

  13. German diabetes management programs improve quality of care and curb costs.

    Science.gov (United States)

    Stock, Stephanie; Drabik, Anna; Büscher, Guido; Graf, Christian; Ullrich, Walter; Gerber, Andreas; Lauterbach, Karl W; Lüngen, Markus

    2010-12-01

    This paper reports the results of a large-scale analysis of a nationwide disease management program in Germany for patients with diabetes mellitus. The German program differs markedly from "classic" disease management in the United States. Although it combines important hallmarks of vendor-based disease management and the Chronic Care Model, the German program is based in primary care practices and carried out by physicians, and it draws on their personal relationships with patients to promote adherence to treatment goals and self-management. After four years of follow-up, overall mortality for patients and drug and hospital costs were all significantly lower for patients who participated in the program compared to other insured patients with similar health profiles who were not in the program. These results suggest that the German disease management program is a successful strategy for improving chronic illness care.

  14. Biliary atresia: lessons learned from the voluntary German registry.

    Science.gov (United States)

    Leonhardt, J; Kuebler, J F; Leute, P J; Turowski, C; Becker, T; Pfister, E-D; Ure, B; Petersen, C

    2011-03-01

    Aim of the study was to carry out a 5-year survey of German patients with biliary atresia (BA) and to launch a discussion regarding the feasibility of voluntary registries in unregulated healthcare systems. A retrospective analysis of German BA patients born between 2001 and 2005, based on data collected from the voluntary European Biliary Atresia Registry (EBAR), was carried out and supplemented by data from all BA patients who underwent liver transplantation at the only 4 pediatric transplantation centers (pLTx) in Germany which are so far not registered at EBAR. Survival rates were calculated using Kaplan-Meier analysis and compared by Cox regression to determine the predictive value of age at surgery and the influence of the center size (fewer or more than 5 patients/study period) on overall survival and survival with native liver. A critical review of the 148 German EBAR charts revealed that 11 patients (7.4%) had no biliary atresia. The remaining 137 patients from EBAR together with 46 BA patients who underwent LTx without prior registration at EBAR were evaluated with a median follow-up of 39 months (range: 25-85 months). 29 hospitals performed a total of 159 Kasai procedures, but only 7 centers treated 5 or more patients (116 patients, range: 5-68), and 22 hospitals performed less than 5 KP (43 patients, range: 1-4). Primary LTx was performed in 21 patients (11.5%) and 3 patients died without surgical intervention. 16 patients were lost to follow-up (8.7%). Overall survival after 2 years was 83.3% (139 patients), including 105 patients (63%) who had undergone LTx and 34 patients (20.3%) with native liver. 28 patients died (16.7%), 8 after LTx (5.8%). The experience of the center was the only factor with a significant predictive value for jaundice-free survival with native liver (p=0.001). 25% of all German BA patients were not registered at EBAR, and 29 clinics were involved in the surgical management of BA patients. Therefore a new approach consisting of

  15. German energy market 2014; Deutscher Energiemarkt 2014

    Energy Technology Data Exchange (ETDEWEB)

    Schiffer, Hans-Wilhelm [World Energy Council, London (United Kingdom). World Energy Resources; Weltenergierat - Deutschland, Berlin (Germany). Arbeitsgruppe ' Energie fuer Deutschland'

    2015-03-15

    In 2014 the German government's primary goal of engaging German power suppliers to step up their production of renewable energy while speeding up energy efficiency improvement measures continued to dominate the debate. The present article provides an updated overview of the German energy market. Following on from last year's edition it gives a condensed synopsis of key indicators of the energy economy. Besides summarising general facts about the energy mix it goes into detail about the following individual energy resources: crude oil, natural gas, brown coal, hard coal, nuclear energy and renewable energies. It also explains current price trends in both the international and domestic markets.

  16. Comparison between Dutch and German buildings

    Energy Technology Data Exchange (ETDEWEB)

    Lony, R.J.M.; Molenaar, D.J.; Rietkerk, J.; Schuiling, D.J.B.W.; Zeiler, W. [TU/e, Univ. of Technology Eindhoven (Netherlands); Brunk, M. [RWTH Aachen (Germany)

    2006-07-01

    German buildings are often seen as an example to Dutch architects and Dutch building services consultants. Goal of this article is to examine and to understand differences between the Dutch and German top office buildings. Objective is to examine to which extent these buildings were designed intelligently. An Intelligent Building is one that provides a productive cost effective environment through the optimisation of six basic elements; site, skin, systems, structures, services, space plan and staff and the interrelationship between them. Based on these six aspects the comparison is made between Dutch and German buildings. (orig.)

  17. German causative events with placement verbs

    Directory of Open Access Journals (Sweden)

    De Knop Sabine

    2016-06-01

    Full Text Available Several studies have described the semantic uses of German posture verbs, but only few have dealt with German placement verbs. The present study wants to make up for this gap. Starting from a collection of examples from the core corpora of the Digitales Wörterbuch der Deutschen Sprache (DWDS and some former studies on posture verbs, it first describes the variety of the most common German placement verbs stellen (‘to put upright’, legen (‘to lay down’, setzen (‘to set’ and stecken (‘to stick’.

  18. German Bowel Cancer Center: An Attempt to Improve Treatment Quality

    Directory of Open Access Journals (Sweden)

    Olof Jannasch

    2015-01-01

    Full Text Available Background. Colorectal cancer remains the second most common cause of death from malignancies, but treatment results show high diversity. Certified bowel cancer centres (BCC are the basis of a German project for improvement of treatment. The aim of this study was to analyze if certification would enhance short-term outcome in rectal cancer surgery. Material and Methods. This quality assurance study included 8197 patients with rectal cancer treated between 1 January 2008 and 31 December 2010. We compared cohorts treated in certified and noncertified hospitals regarding preoperative variables and perioperative outcomes. Outcomes were verified by matched-pair analysis. Results. Patients of noncertified hospitals had higher ASA-scores, higher prevalence of risk factors, more distant metastases, lower tumour localization, lower frequency of pelvic MRI, and higher frequencies of missing values and undetermined TNM classifications (significant differences only. Outcome analysis revealed more general complications in certified hospitals (20.3% versus 17.4%, p=0.03. Both cohorts did not differ significantly in percentage of R0-resections, intraoperative complications, anastomotic leakage, in-hospital death, and abdominal wall dehiscence. Conclusions. The concept of BCC is a step towards improving the structural and procedural quality. This is a good basis for improving outcome quality but cannot replace it. For a primary surgical disease like rectal cancer a specific, surgery-targeted program is still needed.

  19. [The Rockefeller Foundation and its efforts toward a reorientation of German medicine and public health in the 1950s].

    Science.gov (United States)

    Schleiermacher, Sabine

    2010-01-01

    The Rockefeller Foundation invested substantial funds into promoting the development of public health as a discipline and a re-orientation of medical training in West Germany to support the democratization of German society. Not limiting itself to the simple provision of literature, the Foundation pursued a two-pronged strategy. Firstly, the Foundation organized a program for German university physicians and public health officers to visit various universities and teaching hospitals in the USA and Canada. A second aim was to establish training institutes for postgraduate physicians. However, rather than simply imposing the US model, the Foundation intended to adapt it to the German context, in the form of a postgraduate course for physicians that integrated practical experience with a university setting. My research to date shows that the Foundation's activities did not meet with much enthusiasm from German medical professionals. Intellectual, cultural, cognitive and political differences impaired constructive collaboration between the Foundation's staff and local practitioners and academics.

  20. Joint crisis plans and psychiatric advance directives in German psychiatric practice.

    Science.gov (United States)

    Radenbach, Katrin; Falkai, Peter; Weber-Reich, Traudel; Simon, Alfred

    2014-05-01

    This study explores the attitude of German psychiatrists in leading positions towards joint crisis plans and psychiatric advance directives. This topic was examined by contacting 473 medical directors of German psychiatric hospitals and departments. They were asked to complete a questionnaire developed by us. That form contained questions about the incidence and acceptance of joint crisis plans and psychiatric advance directives and previous experiences with them. 108 medical directors of psychiatric hospitals and departments responded (response rate: 22.8%). Their answers demonstrate that in their hospitals these documents are rarely used. Among the respondents, joint crisis plans are more accepted than psychiatric advance directives. There is a certain uncertainty when dealing with these instruments. Our main conclusion is that German psychiatry needs an intensified discussion on the use of instruments for patients to constitute procedures for future critical psychiatric events. For this purpose it will be helpful to collect more empirical data. Furthermore, the proposal of joint crisis plans in psychiatric hospitals and departments should be discussed as well as the possibility of consulting an expert during the preparation of a psychiatric advance directive.

  1. Attitudes Concerning Postmortem Organ Donation: A Multicenter Survey in Various German Cohorts.

    Science.gov (United States)

    Uhlig, Constantin E; Böhringer, Daniel; Hirschfeld, Gerrit; Seitz, Berthold; Schmidt, Hartmut

    2015-10-13

    The aim of this study was to characterize postmortem organ donation attitudes in various German cohorts. Employees of 2 German cities and 2 German university hospitals, employees of a German automobile enterprise, and members of a German Medical Society were administered a questionnaire about postmortem organ and tissue donation attitudes. Demographic data and general attitudes were questioned and focused on: I) willingness to donate organs, II) holding a donor card, and III) having discussed the topic with the family. Of 5291 participants, 65.2% reported favoring postmortem organ donation. Missing negative experiences, the idea that donation is helpful, a non-medical professional environment, excellent general health, gender, agreement with the brain-death paradigm, and age significantly influenced the participants' attitudes. Participants were more likely to possess donor cards and had discussed more often with family members if they agreed with the brain-death paradigm and considered donation to be helpful. Males and older participants were the most likely to neglect donor cards, and Catholics, Protestants, and participants with poor health were the least likely to donate organs. Interest in receiving more information was expressed by 38.1% and 50.6% of participants refusing donation of all or of specific organs, respectively, and suggested the internet (60.0%) and family doctors (35.0%) as preferred sources of information. Public campaigns in Germany should focus on males and older people as regards donor cards, and females, younger, and religiously affiliated persons as regards the general willingness to donate organs postmortem.

  2. Validation and reliability of the VF-14 questionnaire in a German population.

    Science.gov (United States)

    Chiang, Peggy Pei-Chia; Fenwick, Eva; Marella, Manjula; Finger, Robert; Lamoureux, Ecosse

    2011-11-21

    To evaluate the validity, reliability, and measurement characteristics of the Visual Function 14 (VF-14) in a German sample using Rasch analysis. This was a clinic-based, cross-sectional study with 184 patients with low vision recruited from an outpatient clinic at a German eye hospital. Participants underwent a clinical examination and completed the German VF-14 scale. The validity of the VF-14 scale was assessed using Rasch analysis. The main outcome measure was the overall functional score provided by the VF-14. After collapsing two response categories for items 13 and 14, the VF-14 scale satisfied fundamental criteria to achieve fit to the Rasch model, namely, ordered thresholds, the ability to distinguish between different strata of participant ability, absence of misfitting items, no evidence of unidimensionality, and no significant differential item functioning for key sociodemographic covariates. The VF-14 is able to discriminate between participants with different levels of vision impairment and across different cultural groups. The VF-14 is a valid, reliable, and unidimensional questionnaire for use in a German population. These findings contribute to the growing evidence base for second generation patient reported outcome measures in ophthalmology, and support the use of the German VF-14 in tertiary eye clinics in Germany to capture the impact of visual impairment on visual function from the patient's perspective and to inform low vision rehabilitation and interventions.

  3. African Americans Who Teach German Language and Culture.

    Science.gov (United States)

    Fikes, Robert Jr.

    2001-01-01

    A large number of black scholars have pursued advanced degrees in the German language, history, and culture. Describes the history of African American interest in the German language and culture, highlighting various black scholars who have studied German over the years. Presents data on African Americans in German graduate programs and examines…

  4. Crossing the Lexicon: Anglicisms in the German Hip Hop Community

    Science.gov (United States)

    Garley, Matthew E.

    2012-01-01

    The influence of English on German has been an ongoing subject of intense popular and academic interest in the German sphere. In order to better understand this language contact situation, this research project investigates anglicisms--instances of English language material in a German language context--in the German hip hop community, where the…

  5. USA: German in the Changing Landscape of Postsecondary Education

    Science.gov (United States)

    Tatlock, Lynne

    2010-01-01

    This article identifies recent indicators of the state of German Studies in the United States with special attention to postsecondary enrollments in German. It additionally reviews challenges to the postsecondary teaching of German as they manifest themselves both locally and nationally, including the positioning of German Studies in the life of…

  6. A German format for pupils’ training

    CERN Multimedia

    Antonella Del Rosso

    2012-01-01

    Every year CERN welcomes thousands of pupils from schools worldwide for a half-day visit to the Laboratory. However, since 2011 about ten selected students from Germany have been given the opportunity to experience CERN in much greater depth. They are fully sponsored by the German Ministry of Education and supported by an organising structure at TU Dresden - the Dresden University of Technology - led by Michael Kobel. It’s an investment that's paying off in Germany.   The German teachers who participated in the “Netzwerk Teilchenwelt” project, at CERN last week. “Netzwerk Teilchenwelt” is a project that involves 23 German universities, the DESY Laboratory, several schools and, of course, CERN. Launched in 2010 with a contribution from the German Ministry for Science and Research of about 1 million euros over three years, the project has so far involved over 4,000 students and 500 teachers. “Thanks to this project, both pupils...

  7. NPPCI - topics in the German Democratic Republic

    International Nuclear Information System (INIS)

    Ziegenbein, D.

    1986-01-01

    This paper summarizes research and development activities in the field of computerized operator support systems, self-powered detectors, boiling diagnostic and loose part detection systems in the German Democratic Republic

  8. The German Physical Society Under National Socialism

    Science.gov (United States)

    Hoffmann, Dieter; Walker, Mark

    2004-12-01

    The history of the German Physical Society from 1933 to 1945 is not the same as a comprehensive history of physics under Adolf Hitler, but it does reflect important aspects of physicists' work and life during the Third Reich.

  9. Approaching German Culture: A Tentative Analysis

    Science.gov (United States)

    Tinsley, Royal; Woloshin, David

    1974-01-01

    A comparative analysis of the five universal problems of cultural orientation: 1) human nature, 2) social relations, 3) man and nature, 4) time, 5) space, as they are reflected in German and American culture. (PP)

  10. German approach to VLLW management

    International Nuclear Information System (INIS)

    Broecking, D.

    1997-01-01

    Waste generated in German nuclear facilities is exhaustively and selectively manage through a system adapted to the waste's characteristics. The management of the waste ensures that the impact on the workers, population and the environment is acceptable. This is done through a detailed documentation and quality assurance program which applies not only to radioactive waste but also to cleanable material used within a licensed practice. In Germany the producer is responsible for the waste generated in a licensed facility and is therefore responsible for the correct disposal, which depends on the waste's characteristics. Since the waste producer requires a license for all activities involving radioactive substances, the atomic authority is continuously informed and can therefore monitor the producer for compliance with the regulations. The use and disposal of all material in a licensed practice is documented and can therefore be traced by the authorities. Clearance is seen in Germany as the best way of managing non-radioactive material in a licensed practice. Germany has developed clearance procedures which guarantee that after clearance the radiological impact is negligible. (author)

  11. German innovation initiative for nanotechnology

    Science.gov (United States)

    Rieke, Volker; Bachmann, Gerd

    2004-10-01

    In many areas of nanotechnology, Germany can count on a good knowledge basis due to its diverse activities in nanosciences. This knowledge basis, when paired with the production and sales structures needed for implementation and the internationally renowned German talent for system integration, should consequently lead to success in the marketplace. And this is exactly the field of application for the innovation initiative "Nanotechnologie erobert Märkte" (nanotechnology conquers markets) and for the new BMBF strategy in support of nanotechnology. Until now, aspects of nanotechnology have been advanced within the confines of their respective technical subject areas. However, the primary aim of incorporating them into an overall national strategy is to build on Germany's well-developed and internationally competitive research in science and technology to tap the potential of Germany's important industrial sectors for the application of nanotechnology through joint research projects (leading-edge innovations) that strategically target the value-added chain. This development is to be supported by government education policy to remedy a threatening shortage of skilled professionals. To realize that goal, forward-looking political policymaking must become oriented to a uniform concept of innovation, one that takes into consideration all facets of new technological advances that can contribute to a new culture of innovation in Germany. And that includes education and research policy as well as a climate that encourages and supports innovation in science, business and society.

  12. German innovation initiative for nanotechnology

    International Nuclear Information System (INIS)

    Rieke, Volker; Bachmann, Gerd

    2004-01-01

    In many areas of nanotechnology, Germany can count on a good knowledge basis due to its diverse activities in nanosciences. This knowledge basis, when paired with the production and sales structures needed for implementation and the internationally renowned German talent for system integration, should consequently lead to success in the marketplace. And this is exactly the field of application for the innovation initiative 'Nanotechnologie erobert Maerkte' (nanotechnology conquers markets) and for the new BMBF strategy in support of nanotechnology. Until now, aspects of nanotechnology have been advanced within the confines of their respective technical subject areas. However, the primary aim of incorporating them into an overall national strategy is to build on Germany's well-developed and internationally competitive research in science and technology to tap the potential of Germany's important industrial sectors for the application of nanotechnology through joint research projects (leading-edge innovations) that strategically target the value-added chain. This development is to be supported by government education policy to remedy a threatening shortage of skilled professionals. To realize that goal, forward-looking political policymaking must become oriented to a uniform concept of innovation, one that takes into consideration all facets of new technological advances that can contribute to a new culture of innovation in Germany. And that includes education and research policy as well as a climate that encourages and supports innovation in science, business and society

  13. German-Brazilian nuclear deal

    International Nuclear Information System (INIS)

    Krugmann, H.

    1981-01-01

    Examination of the arguments in favor of the nuclear deal with West Germany and the resulting program suggests that revisions of both are in order to make them more compatible with Brazil's national interests. The deficiencies of current policy appear to be too weighty and numerous to be ignored. Sooner or later the government will have to move toward adjusting its nuclear agreement with West Germany, if not for the reasons discussed here then for lack of capital. Current estimates of the nuclear package lie in the range of $25 to $30 billion, compared to an initial projection of about $5 billion. The deal has become so expensive that it would draw capital from the hydropower and alcohol programs essential for the short and medium-term energy needs of the country. Mr. Krugman feels the Brazilian government should hold off on further nuclear contracts. And it should thoroughly reassess what Brazil's nuclear energy and technology requirements are and how to meet them. There are indications that the reassessment process is already underway. As long as the German nuclear industry depends on the sale of technology to Brazil, the Brazilian government will have considerable bargaining power to enforce further changes in the deal. If this power is used wisely, the result could be cooperation between the two countries toward nuclear options that are consistent with Brazil's energy and development needs

  14. Franco-German nuclear cooperation

    International Nuclear Information System (INIS)

    Leny, J.C.; Huettl, A.

    1996-01-01

    Nuclear energy is the number one power source in the European Union. However, the first generation units would be replaced from the year 2010 onwards. In this prospect, Siemens and Framatome have drawn together in designing and commercializing a common product initially destined for the export market which has become the EPR (European Pressurized water Reactor) project. The two companies have floated with equal participation the NPI (Nuclear Power International) sub-company to manage this project. The French and German utilities participate to the financing of the project, at present at the basic stage, and the safety authorities of both countries have carried out a joint evaluation of EPR safety. With a 1500 Mwe capacity, EPR will be equipped with advanced safety systems more performing than the existing systems. Conceivers want to maintain the economic competitiveness of EPR with respect to coal power plants. EPR will take over the oldest power plants by producing a safer and cheaper energy to provide for the needs of the developed countries and then of the developing countries with no risk for the environment. An enormous effort of communication must be carried out to reduce the public anxiety and to calm down the nuclear debate and show up its merits, in particular in Europe, where its contribution is vital. (J.S.)

  15. The German reactor safety study

    International Nuclear Information System (INIS)

    Birkhofer, A.

    1980-01-01

    The most important results of the German risk study of a nuclear power plant equipped with a pressurized water reactor were published in August 1979. The main volume of the study with the approach used and the results elaborated has been available for reference since late 1979. Eight technical volumes contain detailed descriptions and documentations of the investigations carried out. The reference facility used as a basis for the technical plant studies was unit B of the Biblis Nuclear Power Station, a KWU PWR of 3750 MW thermal power. This contribution provides more detailed explanations of the methods and the results of the risk study illustrated by examples. The description refers to accident categories and categories of radioactivity releases, probabilities of specific sequences of accident events, and the damage associated with core meltdown accidents as a function of various types of failure. For purposes of evaluation and application of the results the limits in the basic assumptions of the study are referred to. (orig./HP) [de

  16. On the intonation of German intonation questions

    DEFF Research Database (Denmark)

    Petrone, Caterina; Niebuhr, Oliver

    2014-01-01

    German questions and statements are distinguished not only by lexical and syntactic but also by intonational means. This study revisits, for Northern Standard German, how questions are signalled intonationally in utterances that have neither lexical nor syntactic cues. Starting from natural......, but represents a separate attitudinal meaning dimension. Moreover, the findings support that both prenuclear and nuclear fundamental frequency (F0) patterns must be taken into account in the analysis of tune meaning....

  17. The Great War and German Memory

    DEFF Research Database (Denmark)

    Leese, Peter

    2012-01-01

    Review essay on Jason Crouthamel, The Great War and German Memory. Society, Politics and Psychological Trauma, 1914-18 (2009) and Anton Kaes, Shell Shock Cinema: Weimar Culture and the Wounds of War (2009)......Review essay on Jason Crouthamel, The Great War and German Memory. Society, Politics and Psychological Trauma, 1914-18 (2009) and Anton Kaes, Shell Shock Cinema: Weimar Culture and the Wounds of War (2009)...

  18. German Foreign Fighters in Syria and Iraq

    Science.gov (United States)

    2016-03-01

    depressed and less integrated into their new societies.29 Germany’s Turkish population exemplifies this integration deficit. Of Germany’s 4.3 million...the German Chancellor in a YouTube video, for example), the German press tends to abandon their earlier self-restraint and freely publishes the...Germany’s most well-known Salafist preachers. In addition to being mentored by Pierre Vogel, Cuspert appeared in YouTube recordings at Islam

  19. A German Perspective on Security Research

    Science.gov (United States)

    Thoma, Klaus; Hiller, Daniel; Leismann, Tobias; Drees, Birgit

    Prior to 2007, there was no coherent federal approach to conceptualise and fund security research in Germany. This changed with the initiation of the national program for civil security research, managed by the German Ministry for Education and Research (BMBF). Over the course of only four years a continuous build-up of national capacities on civil security was established to better protect German citizens, commodities and infrastructures against terrorism, organised crime and the effects of man-made and natural disasters.

  20. Accent, Intelligibility, and the Role of the Listener: Perceptions of English-Accented German by Native German Speakers

    Science.gov (United States)

    Hayes-Harb, Rachel; Watzinger-Tharp, Johanna

    2012-01-01

    We explore the relationship between accentedness and intelligibility, and investigate how listeners' beliefs about nonnative speech interact with their accentedness and intelligibility judgments. Native German speakers and native English learners of German produced German sentences, which were presented to 12 native German speakers in accentedness…

  1. [Leadership in the hospital].

    Science.gov (United States)

    Schrappe, Matthias

    2009-01-01

    Current concepts in leadership and governance on the level of supervisory board, management and departments are often considered as insufficient to cope with the profound structural change which actually takes place in the German health care system. While vertical and horizontal disconnecting is typical of the professional bureaucracy of hospitals, transition from functional to divisional structure further increases this risk. Accordingly, medical experts are oriented towards their professional peers and patient care on the one side; on the other side the management gets isolated and looses operative and strategic control. Several studies provide evidence for the relevance of role models to serve as agents of change, which are now developed into the concept of "Clinical Governance": evidence-based medicine, guidelines, continuous quality improvement, safety culture, resource accountability and organisational learning. The present situation makes it necessary to extend this conception, which focuses on the departmental level in an organisation with divisional features, to one of "Clinical Corporate Governance". This term, which also includes supervisory structures and the management board and is relevant for the total hospital and company, respectively, is based on the corporate governance concept. Inside the hospital, the management and the heads of the departments have to agree that (1) experts really need to be integrated into the decision process, and that (2) the outcomes of the entire hospital have to be regarded as equal or superior to the aims of a single department. The public image of the hospital should be one of a strong and reliable partner in health care and health care business on a local, regional and national level. Members of the supervisory board should clearly put corporate aspects above political and other implications and pay attention to personal independence from the leaders of the medical departments.

  2. Dictionary for veterinary science and biosciences. German-English/English-German. With trilingual appendix: Latin terms

    International Nuclear Information System (INIS)

    Mack, R.

    1988-01-01

    This dictionary has been compiled as a result of many years experience of translating German texts in the biological sciences, particularly veterinary medicine. The author's aim is to supplement the standard German-English general dictionaries with technical terms to in the fields of anatomy, microbiology, physiology, parasitology, pathology, pharmacology, toxicology and zootechny, with special reference to domestic animals and their diseases. (orig.) [de

  3. DDR-Landeskundliches im Deutschunterricht (East German Culture in the German Lesson).

    Science.gov (United States)

    Wazel, Gerhard

    1988-01-01

    Demonstrates with concrete examples from the texts of a German class for advanced learners how aspects of East German culture can be realized in vocabulary, in lectures, and in the development of listening comprehension and speaking skills. Texts are appended. (DJD)

  4. 94th German Roentgen congress. Program and abstracts

    International Nuclear Information System (INIS)

    2013-01-01

    The volume includes the abstracts of the 94th German Roentgen congress concerning the following topics: Interventional oncology; mammary carcinoma; medical care and imaging; news in radio-oncology; regional therapy of lung malign tumors; medical ontology intelligent searching strategy; image fusion; oncology - imaging in screening; cardiovascular emergency - an update; innovations in the physics of radiology; risk management and budget; mobile computing; mammary diagnostics; elucidation and liability benchmarking in radiology; cost and performance in the medical office; research: innovation or self-purpose; cost refunding PET/CT and MRT PET; economic strategy in health care; options of radiological practice in medical offices and hospitals; trends in imaging; radiological diagnostics in emergency cases; X-ray regulations; neuroradiology; muscuskeletal radiology; chest radiology; pediatric radiology, radiation protection for the medical personnel.

  5. How do German bilingual schoolchildren process German prepositions? – A study on language-motor interactions

    Science.gov (United States)

    Bischoff, Heike; Strozyk, Jessica Vanessa; Bryant, Doreen; Kaup, Barbara

    2018-01-01

    While much support is found for embodied language processing in a first language (L1), evidence for embodiment in second language (L2) processing is rather sparse. In a recent study, we found support for L2 embodiment, but also an influence of L1 on L2 processing in adult learners. In the present study, we compared bilingual schoolchildren who speak German as one of their languages with monolingual German schoolchildren. We presented the German prepositions auf (on), über (above), and unter (under) in a Stroop-like task. Upward or downward responses were made depending on the font colour, resulting in compatible and incompatible trials. We found compatibility effects for all children, but in contrast to the adult sample, there were no processing differences between the children depending on the nature of their other language, suggesting that the processing of German prepositions of bilingual children is embodied in a similar way as in monolingual German children. PMID:29538404

  6. How do German bilingual schoolchildren process German prepositions? - A study on language-motor interactions.

    Science.gov (United States)

    Ahlberg, Daniela Katharina; Bischoff, Heike; Strozyk, Jessica Vanessa; Bryant, Doreen; Kaup, Barbara

    2018-01-01

    While much support is found for embodied language processing in a first language (L1), evidence for embodiment in second language (L2) processing is rather sparse. In a recent study, we found support for L2 embodiment, but also an influence of L1 on L2 processing in adult learners. In the present study, we compared bilingual schoolchildren who speak German as one of their languages with monolingual German schoolchildren. We presented the German prepositions auf (on), über (above), and unter (under) in a Stroop-like task. Upward or downward responses were made depending on the font colour, resulting in compatible and incompatible trials. We found compatibility effects for all children, but in contrast to the adult sample, there were no processing differences between the children depending on the nature of their other language, suggesting that the processing of German prepositions of bilingual children is embodied in a similar way as in monolingual German children.

  7. Mortality of German travellers on passenger vessels.

    Science.gov (United States)

    Oldenburg, Marcus; Herzog, Jan; Püschel, Klaus; Harth, Volker

    2016-01-01

    In the past two decades, more and more Germans decided to spend their holidays on a passenger vessel. This study examined the frequencies and causes of deaths of German travellers aboard passenger vessels of all flags. The shipboard deaths of all German travellers within the time period from 1998 to 2008 were counted using the German civil central register in Berlin. The available documentation in this register provides information on frequencies, circumstances and causes of deaths on ships. In the above-mentioned period of time, the total cohort of German travellers on cruise ships is estimated to be 5.97 million persons. During the 11-year examination period, 135 shipboard deaths of German passengers [102 males (75.6%) and 33 females (24.4%)] were recorded. Out of these travellers, 110 died on cruise ships. When considering only the passengers on cruise ships (without those on ferries) an average crude mortality rate of 1.8 per 100,000 German passengers was calculated. The crude mortality rate of shipboard death for males and females was 2.5 and 0.8 per 100,000 German passengers with a mean age of 71.2 years [standard deviation (SD) 16.0 years] and 73.3 years (SD 16.0 years), respectively. Significantly, more deceased travellers older than 70 years were observed on traditional cruise ships and resort vessels than on passenger ferries (P = 0.001). The causes of death were documented in 85 cases (63.0%). Out of these documented deaths, 82 (96.5%) cases were regarded to be natural causes (particularly circulatory diseases) and 3 (3.5%) as unnatural causes (twice drowning and once an accidental fall). In spite of the large proportion of unknown causes of death, this study argues for a high significance of internal causes of deaths among German passengers. Thus, ship's doctors-particularly those on traditional cruise ships-should be well experienced in internal and geriatric medicines. © The Author 2016. Published by Oxford University Press on behalf of

  8. Psychiatric care in the German prison system.

    Science.gov (United States)

    Lehmann, Marc

    2012-01-01

    The purpose of this paper is to describe the nature of medical care within the German penal system. German prison services provide health care for all inmates, including psychiatric care. The reached level of equivalence of care and ethical problems and resource limitations are discussed and the way of legislation in this field since 2006 reform on federal law is described. The article summarizes basic data on German prison health care for mentally ill inmates. The legislation process and factors of influence are pointed out. A description of how psychiatric care is organized in German prisons follows. It focuses on the actual legal situation including European standards of prison health care and prevention of torture, psychiatric care in German prisons themselves, self harm and addiction. Associated problems such as blood born diseases and tuberculosis are included. The interactions between prison staff and health care personal and ethic aspects are discussed. The legislation process is still going on and there is still a chance to improve psychiatric care. Mental health problems are the major challenge for prison health care. Factors such as special problems of migrants, shortage of professionals and pure statistic data are considered. The paper provides a general overview on psychiatric services in prison and names weak points and strengths of the system.

  9. German neutron scattering conference. Programme and abstracts

    Energy Technology Data Exchange (ETDEWEB)

    Brueckel, Thomas (ed.)

    2012-07-01

    The German Neutron Scattering Conference 2012 - Deutsche Neutronenstreutagung DN 2012 offers a forum for the presentation and critical discussion of recent results obtained with neutron scattering and complementary techniques. The meeting is organized on behalf of the German Committee for Research with Neutrons - Komitee Forschung mit Neutronen KFN - by the Juelich Centre for Neutron Science JCNS of Forschungszentrum Juelich GmbH. In between the large European and international neutron scattering conferences ECNS (2011 in Prague) and ICNS (2013 in Edinburgh), it offers the vibrant German and international neutron community an opportunity to debate topical issues in a stimulating atmosphere. Originating from ''BMBF Verbundtreffen'' - meetings for projects funded by the German Federal Ministry of Education and Research - this conference series has a strong tradition of providing a forum for the discussion of collaborative research projects and future developments in the field of research with neutrons in general. Neutron scattering, by its very nature, is used as a powerful probe in many different disciplines and areas, from particle and condensed matter physics through to chemistry, biology, materials sciences, engineering sciences, right up to geology and cultural heritage; the German Neutron Scattering Conference thus provides a unique chance for exploring interdisciplinary research opportunities. It also serves as a showcase for recent method and instrument developments and to inform users of new advances at neutron facilities.

  10. German neutron scattering conference. Programme and abstracts

    International Nuclear Information System (INIS)

    Brueckel, Thomas

    2012-01-01

    The German Neutron Scattering Conference 2012 - Deutsche Neutronenstreutagung DN 2012 offers a forum for the presentation and critical discussion of recent results obtained with neutron scattering and complementary techniques. The meeting is organized on behalf of the German Committee for Research with Neutrons - Komitee Forschung mit Neutronen KFN - by the Juelich Centre for Neutron Science JCNS of Forschungszentrum Juelich GmbH. In between the large European and international neutron scattering conferences ECNS (2011 in Prague) and ICNS (2013 in Edinburgh), it offers the vibrant German and international neutron community an opportunity to debate topical issues in a stimulating atmosphere. Originating from ''BMBF Verbundtreffen'' - meetings for projects funded by the German Federal Ministry of Education and Research - this conference series has a strong tradition of providing a forum for the discussion of collaborative research projects and future developments in the field of research with neutrons in general. Neutron scattering, by its very nature, is used as a powerful probe in many different disciplines and areas, from particle and condensed matter physics through to chemistry, biology, materials sciences, engineering sciences, right up to geology and cultural heritage; the German Neutron Scattering Conference thus provides a unique chance for exploring interdisciplinary research opportunities. It also serves as a showcase for recent method and instrument developments and to inform users of new advances at neutron facilities.

  11. German precursor study: methods and results

    International Nuclear Information System (INIS)

    Hoertner, H.; Frey, W.; von Linden, J.; Reichart, G.

    1985-01-01

    This study has been prepared by the GRS by contract of the Federal Minister of Interior. The purpose of the study is to show how the application of system-analytic tools and especially of probabilistic methods on the Licensee Event Reports (LERs) and on other operating experience can support a deeper understanding of the safety-related importance of the events reported in reactor operation, the identification of possible weak points, and further conclusions to be drawn from the events. Additionally, the study aimed at a comparison of its results for the severe core damage frequency with those of the German Risk Study as far as this is possible and useful. The German Precursor Study is a plant-specific study. The reference plant is Biblis NPP with its very similar Units A and B, whereby the latter was also the reference plant for the German Risk Study

  12. Enteric methane emissions from German dairy cows

    DEFF Research Database (Denmark)

    Dammgen, U; Rosemann, C; Haenel, H D

    2012-01-01

    Up to now, the German agricultural emission inventory used a model for the assessment of methane emissions from enteric fermentation that combined an estimate of the energy and feed requirements as a function of performance parameters and diet composition, with the constant methane conversion rate......, as stated by IPCC. A methane emission model was selected here that is based on German feed data. It was combined with the hitherto applied model describing energy requirements. The emission rates thus calculated deviate from those previously obtained. In the new model, the methane conversion rate is back......-calculated from emission rates and gross energy intake rates. For German conditions of animal performance and diet composition, the national means of methane conversion rates range between 71 kJ MJ(-1) and 61 kJ MJ(-1) for low and high performances (4700 kg animal(-1) a(-1) in 1990 to 7200 kg animal(-1) a(-1...

  13. The German risk study. Pt. 2

    International Nuclear Information System (INIS)

    Burkart, K.

    1980-01-01

    A severe nuclear power plant accident can be followed by a considerable release of radioactive effluents into the atmosphere. Due to atmospheric dispersion, areas of different sizes can be contaminated. The corresponding doses can cause early illnesses, early fatalities, latent effects and genetic effects. They are accompanied by economic effects. Within the consequence model of the German Risk Study, early and late fatalities and genetically significant doses are calculated. The calculations are based on real data or phenomena such as the population around 19, present or future German sites, or 115 real weather sequences, as well as on models such as an atmospheric dispersion model, a dose model, a model of protective actions or a health effects model. Within this lecture, the consequence model applied in the German Risk Study will be discussed in detail and the results will be presented. (orig./RW)

  14. [Cost assessment for endoscopic procedures in the German diagnosis-related-group (DRG) system - 5 year cost data analysis of the German Society of Gastroenterology project].

    Science.gov (United States)

    Rathmayer, Markus; Heinlein, Wolfgang; Reiß, Claudia; Albert, Jörg G; Akoglu, Bora; Braun, Martin; Brechmann, Thorsten; Gölder, Stefan K; Lankisch, Tim; Messmann, Helmut; Schneider, Arne; Wagner, Martin; Dollhopf, Markus; Gundling, Felix; Röhling, Michael; Haag, Cornelie; Dohle, Ines; Werner, Sven; Lammert, Frank; Fleßa, Steffen; Wilke, Michael H; Schepp, Wolfgang; Lerch, Markus M

    2017-10-01

    Background  In the German hospital reimbursement system (G-DRG) endoscopic procedures are listed in cost center 8. For reimbursement between hospital departments and external providers outdated or incomplete catalogues (e. g. DKG-NT, GOÄ) have remained in use. We have assessed the cost for endoscopic procedures in the G-DRG-system. Methods  To assess the cost of endoscopic procedures 74 hospitals, annual providers of cost-data to the Institute for the Hospital Remuneration System (InEK) made their data (2011 - 2015; § 21 KHEntgG) available to the German-Society-of-Gastroenterology (DGVS) in anonymized form (4873 809 case-data-sets). Using cases with exactly one endoscopic procedure (n = 274 186) average costs over 5 years were calculated for 46 endoscopic procedure-tiers. Results  Robust mean endoscopy costs ranged from 230.56 € for gastroscopy (144 666 cases), 276.23 € (n = 32 294) for a simple colonoscopy, to 844.07 € (n = 10 150) for ERCP with papillotomy and plastic stent insertion and 1602.37 € (n = 967) for ERCP with a self-expanding metal stent. Higher costs, specifically for complex procedures, were identified for University Hospitals. Discussion  For the first time this catalogue for endoscopic procedure-tiers, based on § 21 KHEntgG data-sets from 74 InEK-calculating hospitals, permits a realistic assessment of endoscopy costs in German hospitals. The higher costs in university hospitals are likely due to referral bias for complex cases and emergency interventions. For 46 endoscopic procedure-tiers an objective cost-allocation within the G-DRG system is now possible. By international comparison the costs of endoscopic procedures in Germany are low, due to either greater efficiency, lower personnel allocation or incomplete documentation of the real expenses. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Fifty years of German nuclear legislation

    International Nuclear Information System (INIS)

    Heller, W.

    2006-01-01

    The political situation and the state of legislation after World War II make it difficult to pinpoint a precise date of origin of German nuclear legislation. The restrictions imposed by the Allied High Commission (AHC) without any exception put a ban on the production of uranium and thorium metal as well as the construction of nuclear reactors. These restrictions were lifted expressly when the German Atomic Energy Act (AtG) entered into force on January 1, 1960, i.e. much later than the formal step of gaining sovereignty, which was marked by the protocol of May 5, 1955 terminating the Occupation Statute. In October 1955, the German federal government established the then Federal Ministry for Atomic Matters also in an attempt to reconnect to developments in nuclear fission in other parts of the Western world. To supersede the AHC law, the German federal government in December 1956 publicized a draft Atomic Energy Act. It is safe, therefore, to consider that year the starting point of German atomic legislation. This step was followed by deliberations preparatory to the adoption of the Atomic Energy Act. In 1957, however, adoption failed because no two-thirds majority was reached to amend the Basic Law, i.e. the Constitution. As a consequence, some federal states saw the need to adopt state legislation to regulate this area. On December 3, 1959, a new draft Atomic Energy Act was adopted by the German federal parliament after the second and third readings - coupled with an amendment to the Basic Law on that same day - with the votes of the opposition and with one abstention. (orig.)

  16. [The role of patient flow and surge capacity for in-hospital response in mass casualty events].

    Science.gov (United States)

    Sefrin, Peter; Kuhnigk, Herbert

    2008-03-01

    Mass casualty events make demands on emergency services and disaster control. However, optimized in- hospital response defines the quality of definitive care. Therefore, German federal law governs the role of hospitals in mass casualty incidents. In hospital casualty surge is depending on resources that have to be expanded with a practicable alarm plan. Thus, in-hospital mass casualty management planning is recommended to be organized by specialized persons. To minimise inhospital patient overflow casualty surge principles have to be implemented in both, pre-hospital and in-hospital disaster planning. World soccer championship 2006 facilitated the initiation of surge and damage control principles in in-hospital disaster planning strategies for German hospitals. The presented concept of strict control of in-hospital patient flow using surge principles minimises the risk of in-hospital breakdown and increases definitive hospital treatment capacity in mass casualty incidents.

  17. Structure of the German electricity industry

    International Nuclear Information System (INIS)

    1992-01-01

    The German integrated association is a union of those electric power supply utilities in the Federal Republic of Germany which cooperate in the integrated operation of 220 kV and 380 kV. The German integrated association (DVG) was founded in 1948. Its main task is to create the technical, operational and legal conditions for the cooperation in the national and international integrated system. The inclusion of the new Federal States has been practiced for the first time with the 320 MW power station in Offleben. (DG) [de

  18. Level 2 PRA for a German BWR

    International Nuclear Information System (INIS)

    Sassen, F.; Rapp, W.; Tietsch, W.; Roess, P.

    2007-01-01

    A concept for a Level 2 Probabilistic Risk Assessment (L2 PRA) for a German Boiling Water Reactor (BWR) has been developed taking into account the role of L2 PRA within the German regulatory landscape. According to this concept, a plant specific evaluation of the severe accident phenomenology as well as analyses of the accident progression for the severe accident scenarios has been performed. Furthermore a plant specific MELCOR 1.8.6 model has been developed and special MELCOR source term calculations have been performed for the different release paths. This paper will present examples from the different areas described above. (author)

  19. Darwin: German mystic or French rationalist?

    Science.gov (United States)

    Ghiselin, Michael T

    2015-01-01

    The notion that Charles Darwin embraced the German Romantic tradition seems plausible, given the early influence of Alexander von Humboldt. But this view fails to do justice to other scientific traditions. Darwin was a protégé of the Englishman John Stevens Henslow and was a follower of the Scott Charles Lyell. He had important debts to French scientists, notably Henri Milne-Edwards, Etienne and Isidore Geoffroy Saint-Hilaire, and Alphonse de Candolle. Many Germans were quite supportive of Darwin, but not all of these were encumbered by idealistic metaphysical baggage. Both Darwin and Anton Dohrn treated science as very much a cosmopolitan enterprise.

  20. 'German Angst' vs 'Danish Easy Going'?

    DEFF Research Database (Denmark)

    Fersch, Barbara

    2012-01-01

    national lines. Whereas insecurity and its related fear and anxiety played a huge role in the German interviews (‘German Angst’), the Danish freelancers attached less importance to the topic of insecurity and showed almost no sign of related anxiety (‘Danish Easy-going’). Some reasons for this can be found...... in the different social security backgrounds and welfare state programmes of the two countries, but these differences cannot explain the very different ways of talking about and dealing with the topic. Therefore, I suggest that the differences can be understood in the context of trust as a multi...

  1. German family policy at the crossroads

    DEFF Research Database (Denmark)

    Wüst, Miriam

    2009-01-01

    Comparative studies of welfare reforms encounter two problems. First, the counterfactual problem is that in the real world schemes and their reforms do not coexist simultaneously and are hard to compare. Second, the contextual problem derives from the absence of comparable measures for change. Mi...... introduce a new concept of fairness and a focus on gender equality to German family policies........ Microsimulation helps to overcome these problems. It compares policy options - actual reforms or reform plans - simultaneously and provides a comparable measure: the disposable income of model families. This article uses a type-case approach to investigate recent reforms of the German parental leave benefit...

  2. German energy policy in deregulated Europe

    International Nuclear Information System (INIS)

    Kuhnt, D.

    2000-01-01

    The author argues in favor of a more fact-oriented German energy policy: Firstly, German energy policy must accept the new European framework of a market economy. This means that German utilities must no longer be burdened with the implementation of political objectives. The German power industry needs a level playing field for competition on a European scale. Consequently, also the European partner countries should not limit themselves to the minimum conditions of the Single Market Directive in opening their markets. Secondly, German energy policy must develop new forms of cooperation with the power industry so as to maintain domestic employment and the addition of value despite considerably stronger competitive pressure. Also the conflicting targets of sustainability, continuity of supply, and economic viability must not only be discussed, but must be turned into productive approaches. Thirdly, this means that there must be no inadmissible solution in matters nuclear. If the German power industry is to remain strong, in the interest of domestic jobs and opportunities for the future, it must not lose any more domestic market share to other European companies. Fourthly, we need a new energy policy which takes cognizance of the results of market development in a more rational, less emotional way. In this respect, it should be limited henceforth to supporting renewable energies and technologies so as to enhance energy efficiency in line with market requirements. Fifthly, German energy policy must not commit the mistake of enforcing deregulation and, at the same time, exempting large segments of the market from competition. Thus, the planned expansion of renewable energies, and the increase in cogeneration to more than thirty percent of the German electricty generation, by way of quotas and revenues for electricity from these sources fed into the public grid, are incompatible with competition in Europe. The electricity tax within the framework of the eco tax, the

  3. Satisfaction with rehabilitative health care services among German and non-German nationals residing in Germany: a cross-sectional study.

    Science.gov (United States)

    Brzoska, Patrick; Sauzet, Odile; Yilmaz-Aslan, Yüce; Widera, Teresia; Razum, Oliver

    2017-08-11

    Rehabilitation following medical conditions is largely offered as in-patient service in Germany. Foreign-national residents use rehabilitative services less often than Germans and attain less favourable treatment outcomes. These differences are independent of demographic, socioeconomic and health characteristics. Satisfaction with different aspects of rehabilitative care presumably affects the effectiveness of rehabilitative services. We compared the degree of satisfaction with different domains of the rehabilitative care process between Germans and non-German nationals residing in Germany. We used data from a cross-sectional rehabilitation patient survey annually conducted by the German Statutory Pension Insurance Scheme. The sample comprises 274 513 individuals undergoing medical rehabilitation in 642 hospitals during the years 2007-2011. Participants rated their satisfaction with different domains of rehabilitation on multi-item scales. We dichotomised each scale to low/moderate and high satisfaction. For each domain, a multilevel adjusted logistic regression analysis was conducted to examine differences in the levels of satisfaction between German and non-German nationals. Average marginal effects (AMEs) and 99.5% CI were computed as effect estimates. AMEs represent differences in the probability for the occurrence of the outcome. Turkish nationals had a higher probability for being less satisfied with most aspects of their rehabilitation, with AMEs ranging between 0.05 (99.5% CI 0.00 to 0.09) for 'satisfaction with psychological care' and 0.11 (99.5% CI 0.08 to 0.14) for 'satisfaction with treatments during rehabilitation'. Patients from former Yugoslavia and from Portugal/Spain/Italy/Greece were as satisfied as Germans with most aspects of their rehabilitation. Turkish nationals are less satisfied with their rehabilitative care than other population groups. This may be attributable to the diversity of the population in terms of its expectations towards

  4. Unmet supportive care needs: a cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer.

    Science.gov (United States)

    Lam, Wendy W T; Au, Angel H Y; Wong, Jennifer H F; Lehmann, Claudia; Koch, Uwe; Fielding, Richard; Mehnert, Anja

    2011-11-01

    The comparison of psychosocial needs across different cultural settings can identify cultural and service impacts on psychosocial outcomes. We compare psychosocial needs in Hong Kong Chinese and German Caucasian women with breast cancer. Completed questionnaires were collected from 348 Chinese and 292 German women with breast cancer for assessing unmet psychosocial needs (Supportive Care Needs Survey Short Form), psychological distress (the Hospital Anxiety and Depression scale), and listed physical and psychological symptoms. Only 11% of the participants reported not needing help for any of the 34 items. More German (14%) than Chinese women (8%) reported no unmet needs (χ(2) = 6.16, P = .013). With both samples combined, the Health System and Information domain unmet needs were the most prevalent, apart from one Psychological need domain item, "Fear about the cancer spreading." Chinese and German samples differed significantly in prevalence and patterns of unmet psychosocial needs. Multivariate adjustment for demographic, clinical, and sample characteristics, psychological distress, and symptoms showed that significantly greater unmet Health system and Information, and Patient care and support domain needs, associated with the presence of symptoms (β = .232, P German group membership, among others. German women reported more anxiety (t = 10.45, P German, but not Chinese women reporting greater anxiety and depression had greater unmet Psychological and Sexuality domain needs (P culture-specific differences in supportive care needs exist. Hong Kong Chinese women prioritize needs for information about their disease and treatment, whereas German Caucasian women prioritize physical and psychological support. Planning for cancer supportive care services or interventions to reduce unmet needs must consider cultural and/or health service contexts.

  5. German and Ukrainian Phonological Isomorphs. Typology: Germanic and Slavic Languages. German-Ukraine-Slavic Contrasting Correspondence Vocabulary

    Science.gov (United States)

    Petryshyn, Ivan

    2016-01-01

    The works of many scholars on Germanic and Slavic Languages do not really try to contrast the two biggest Indo-European language families, but analyse them seperately, as any close comparison seem to be unconvincible. In many works, we find some parts that usually would deal with loan words/borrowings/barbarisms. And, yet, we noticed that there…

  6. Hospital staffing and hospital costs.

    Science.gov (United States)

    Andrew, R R

    1976-08-07

    A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

  7. Toxicity of Cypermethrin and Chlorpyrifos Against German Cockroach [ Blattella germanica (Blattaria: Blattellidae)] Strains from Hamadan, Iran.

    Science.gov (United States)

    Nazari, Mansour; Motlagh, Behrouz Alipourian; Nasirian, Hassan

    German cockroach has relatively short life cycle and reproduce rapidly. It is the most common medically and public health pest. As a result, it is essential to combat this pest. Cypermethrin and chlorpyrifos are used by private companies in Hamadan to control Blattella germanica. It seems necessary to determine its susceptibility levels to these insecticides. The aim of this study was to determine the susceptibility levels of B. germanica strains to cypermethrin and chlorpyrifos in Hamadan. In this study, the German cockroach strains were collected from two hospitals (Fatemiyeh and Atiyeh) in Hamadan and transfered to the insectarium. The cockroach strains were reared under the same laboratory condition. Then their sensitivity levels were considered to 1, 2, 4, 8 and 16 mg m -2 for cypermethrin and 0.82, 1.65, 3.31, 6.63, 9.945 and 13.26 mg m -2 for chlorpyrifos using surface contact method. Results based on insecticide treated doses, B. germanica strains showed different percent mortality to the insecticides ranged from 13.3-100. The LD 50 and LD 90 and regression lines of the treated insecticides against German cockroach strains indicate that Fatemiyeh Hospital strain is more susceptible to the treated insecticides than Atiyeh Hospital strain. The LD 50 and LD 90 of chlorpyrifos are also lower than cypermethrin, indicated that chlorpyrifos is more effective than cypermethrin against German cockroach. As the slopes of the regression lines are observed mild in this study indicate that the population of the cockroach strains is very heterogeneous. It can be a symbol of insecticides resistance to cypermethrin and chlorpyrifos. As chlorpyrifos and cypermethrin insecticides are also used for residual spraying by private companies and the doses which provide more than 90% mortality are below the WHO recommended insecticide doses. Therefore, chlorpyrifos and cypermethrin insecticides can be used for B. germanica control in Hamadan within regular monitoring and preventive

  8. [Caught between economic pressure and work-life balance--perspectives on emigration of German health professionals to Austria].

    Science.gov (United States)

    Schmidt, A E; Klambauer, E

    2014-05-01

    Given the increasing lack of medical doctors in Germany, this study aimed to investigate the professional situation and the push and pull factors of German medical specialists working in Austrian hospitals. This explorative study is based on semi-structured interviews with 14 specialists working in Austria, who completed their education partly or fully in Germany. The material has been interpreted using qualitative content analysis. Better work-life balance, higher quality of life and more favourable working conditions represent major reasons for German specialists to stay in Austria. Moreover, the higher density of medical doctors in Austrian hospitals can have an impact on the distribution of responsibilities among health-care personnel, and on hospital performance. In the light of recent reforms in the German health-care system, the study underlines the importance of qualitative factors for the satisfaction of German medical doctors. These factors should be further analysed in order to avoid a brain drain of high-qualified health care staff in the future. © Georg Thieme Verlag KG Stuttgart · New York.

  9. [Economic aspects of anesthesia. I. Health care reform in the German Republic].

    Science.gov (United States)

    Bach, A; Bauer, M

    1998-03-01

    Implications for Hospitals and Departments of Anaesthesiology. This article outlines the new German health care laws and their impact on the statutory health care system, hospitals and anaesthesia departments. The German health care system provides coverage for all citizens, although financial support from the public sector is on the downgrade. Hence, pressure to reduce public sector health care spending is likely to continue in the near future. Hospital costs account for one-third of total health care spending in Germany, and hospitals are facing increasing economic constraints: the volume and the charges for specific medical treatments are negotiated between the hospitals and the insurance agencies (or sickness funds) in advance. Only part of hospital care is still reimbursed on the basis of a per diem rate, and an increasing number of services are based on fixed payments per case or treatment. Reducing the costs for this treatment is therefore of utmost importance for hospitals and hospital departments. The prospective payment system and the pressure to contain costs demand a controlling system that allows for cost accounting per case. However, an economic evaluation must include comparative analysis of alternative therapeutic options in terms of both costs and outcome. Economic aspects challenge the traditional relationship between physicians and patients: doctors are still the advocates of their patients, but also act as agents for their institutions. Nevertheless, not only economic issues, but also ethical priorities and the value of an anaesthetic practice must be considered in the era of cost containment. Anaesthetists must be actively involved in providing high-quality care with its obvious benefits for the patient and be able to resist efforts to cut out expensive treatment modalities regardless of their benefits.

  10. [Orthopedic and trauma surgery in the German-DRG-System 2009].

    Science.gov (United States)

    Franz, D; Windolf, J; Siebert, C H; Roeder, N

    2009-01-01

    The German DRG-System was advanced into version 2009. For orthopedic and trauma surgery significant changes concerning coding of diagnoses, medical procedures and concerning the DRG-structure were made. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2008 and 2009 based on the publications of the German DRG-institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2009 focussed on the development of DRG-structure, DRG-validation and codes for medical procedures to be used for very complex cases. The outcome of these changes for German hospitals may vary depending in the range of activities. G-DRG-System gained complexity again. High demands are made on correct and complete coding of complex orthopedic and trauma surgery cases. Quality of case-allocation within the G-DRG-System was improved. Nevertheless, further adjustments of the G-DRG-System especially for cases with severe injuries are necessary.

  11. High-Speed Maglev Trains; German Safety Requirements

    Science.gov (United States)

    1991-12-31

    This document is a translation of technology-specific safety requirements developed : for the German Transrapid Maglev technology. These requirements were developed by a : working group composed of representatives of German Federal Railways (DB), Tes...

  12. China as A Growing Strategic Market for German Business

    Institute of Scientific and Technical Information of China (English)

    Zhu Zijun

    2011-01-01

    @@ German Companies view China as a more strategically important market, despite their concerns over China's regulatory environment, according to a re-port from the German Chamber of Commerce in China.

  13. The perception of the fehmarnbelt connection among german stakeholders

    DEFF Research Database (Denmark)

    Lohse, Sandrina; Jespersen, Per Homann

    This report gives an overview of the planned improvements of the German hinterland infrastructure connected to the fixed Fehmarn Belt Link (FBL), as well as the views of the key German stake holders towards the FBL.......This report gives an overview of the planned improvements of the German hinterland infrastructure connected to the fixed Fehmarn Belt Link (FBL), as well as the views of the key German stake holders towards the FBL....

  14. Maize synfuel for E. German market

    Energy Technology Data Exchange (ETDEWEB)

    1980-10-31

    Bijenkorf Starch Company (ZBB) in the Netherlands plans to produce 30 million litre/year of alcohol gasoline additive for the East German market. Start up is scheduled for 1983 with costs around $33 million. Production costs are estimated at 95 Dutch cents/litre.

  15. Phocine Distemper in German Seals, 2002

    Science.gov (United States)

    Wohlsein, Peter; Beineke, Andreas; Haas, Ludwig; Greiser-Wilke, Irene; Siebert, Ursula; Fonfara, Sonja; Harder, Timm; Stede, Michael; Gruber, Achim.D.; Baumgärtner, Wolfgang

    2004-01-01

    Approximately 21,700 seals died during a morbillivirus epidemic in northwestern Europe in 2002. Phocine distemper virus 1 was isolated from seals in German waters. The sequence of the P gene showed 97% identity with the Dutch virus isolated in 1988. There was 100% identity with the Dutch isolate from 2002 and a single nucleotide mismatch with the Danish isolate. PMID:15200869

  16. Dictionary of chemistry. English/German

    International Nuclear Information System (INIS)

    Wenske, G.

    1992-01-01

    This English/German dictionary covers more than 100.000 terms from chemistry, chemical engineering and related fields. It also contains molecular formulas, as well as numerous synonyms and areas of application. IUPAC terminology is emphasized, and outdated or rare terminology is indicated. (MM) [de

  17. Gifted Education in German-Speaking Europe

    Science.gov (United States)

    Ziegler, Albert; Stoeger, Heidrun; Harder, Bettina; Balestrini, Daniel Patrick

    2013-01-01

    The authors first briefly describe how the concepts of talents and giftedness found in German-speaking Europe have evolved in the school system and in general over the past two centuries, and how the variety of gifted-education efforts found within and beyond schools as well as counseling efforts attest to these changes. They then discuss four…

  18. German Submarine Offensives and South African Countermeasures

    African Journals Online (AJOL)

    Evert

    Scientia Militaria vol 44, no 1, 2016, pp 168-189. doi: 10.5787/44-1-1166 ..... report the presence of a body of German submarines moving south towards Cape Town. Despite ...... London: Arms and Armour Press, 1989, 100–101; Keegan op.

  19. The German Interlinguistics Society Gesellschaft fur Interlinguistik.

    Science.gov (United States)

    O Riain, Sean

    2003-01-01

    Describes the German interlinguistics society Gesellschaft fur Interlinguistik (GIL), which was founded to bring together interlinguistics and esperantology scholars. Highlights GIL's principal fields of activity and discusses its role in the fields of international linguistic communication, language planning, esperantolgy, and the teaching of…

  20. On the German Language in America.

    Science.gov (United States)

    Lewis, Brian A.

    Sociolinguistic patterns among German immigrants to the United States of America are examined in this paper. Earlier studies in this area, including Wolfgang Viereck's work published in "Orbis" in 1967 and 1968, are examined. Through an analysis of the immigration patterns of the citizens of Glarus, Switzerland, in 1845 to New Glarus,…

  1. Recent Developments in German Corporate Governance

    NARCIS (Netherlands)

    Goergen, M.; Manjon, M.C.; Renneboog, L.D.R.

    2004-01-01

    We contrast the features of the German corporate governance system with those of other systems and discuss the recent regulatory initiatives.For example, the rules on insider trading and anti-trust have been strengthened.The Restructuring Act has been revised to prevent minority shareholders from

  2. German energy market 2016; Deutscher Energiemarkt 2016

    Energy Technology Data Exchange (ETDEWEB)

    Schiffer, Hans-Wilhelm [World Energy Council, London (United Kingdom). World Energy Resources; Weltenergierat, Berlin (Germany). Arbeitsgruppe Energie fuer Deutschland

    2017-03-15

    The basic orientation of the German energy supply to the increased use of renewable energies, while increasing energy efficiency, is prediscribed by the German government's energy concept and determines the market development. A current overview of the German energy market is given, which provides also this year a concentrated Compilation of the key data of the energy industry. As in the years before, the article not only summarizes general facts about the energy mix, but also goes into detail on the development of the individual energy sources, petroleum, natural gas, brown coal and hard coal, electricity as well as renewable energies. Furthermore, the price trends of international markets and in the domestic market are explained. A current overview of the development of greenhouse gas emissions concludes the contribution. [German] Die im Energiekonzept der Bundesregierung vorgegebene Grundausrichtung der deutschen Energieversorgung hin zur verstaerkten Nutzung erneuerbarer Energien bei gleichzeitiger Steigerung der Energieeffizienz bestimmt die Marktentwicklung. Vorliegend wird ein aktueller Ueberblick ueber den deutschen Energiemarkt gegeben, der auch in diesem Jahr eine konzentrierte Zusammenstellung der zentralen Eckdaten der Energiewirtschaft leistet. Wie in den Jahren zuvor fasst der Artikel nicht nur allgemeine Fakten zum Energiemix zusammen, sondern geht auch ausfuehrlich auf die Entwicklung der einzelnen Energietraeger Erdoel, Erdgas, Braun- und Steinkohle, Elektrizitaet sowie regenerative Energien ein. Ferner werden die Preistendenzen auf den internationalen Maerkten und im Inland erlaeutert. Eine aktuelle Uebersicht ueber die Entwicklung der Treibhausgas-Emissionen schliesst den Beitrag ab.

  3. Latitudinal Variation of Germane in Jovian Atmosphere

    Science.gov (United States)

    Hyder, A.; Lunine, J. I.; Wang, D.

    2017-12-01

    Wang et al (2016) presented a chemical-dynamical model for Jupiter's atmosphere that predicted abundances of Germane and other disequilibrium species as a function of latitude, under the assumption that only vertical transport is relevant and no horizontal advection occurs. The model disagrees with the latitudinal distributions derived from high-resolution spectral data acquired from the CRIRES instrument at the VLT as described in Giles et al. 2017. Wang et al. 2016 predicts a maximum molar abundance of Germane at (0.7±0.2) ppb with depletion at higher latitudes, while Giles et al. 2017 predicts a constant molar abundance of Germane at 0.58 ppb with no depletion. We explore an empirical horizontal term for the diffusive transport coefficient as a function of latitude, which does not produce a satisfactory result unless highly arbitrary variations of the vertical eddy mixing term as a function of latitude are imposed. We therefore also explore a horizontal wind from the equator that produces a constant latitudinal profile by transporting Germane-rich gas to the poles, effectively producing a Hadley cell. References: Giles, R. S., Fletcher, L. N., & Irwin, P. G. (2017). Latitudinal variability in Jupiter's tropospheric disequilibrium species: GeH 4, AsH 3 and PH 3. Icarus, 289, 254-269. Wang, D., Lunine, J.I., Mousis, O., 2016. Modeling the disequilibrium species for Jupiter and Saturn: implications for Juno and Saturn entry probe. Icarus 276, 21-38.

  4. The implications of the German Risk Study

    International Nuclear Information System (INIS)

    Birkhofer, A.; Koeberlein, K.

    1980-01-01

    The methods and results of the German Risk Study published in 1979 are summarized and its implications for reactor safety are discussed. It has led to suggestions that risk analysis should be more widely used for nuclear and other technological systems. It has also identified the need for specific system modifications and confirmed trends in safety research. (author)

  5. Review of the German Reactor Safety Study

    International Nuclear Information System (INIS)

    Bayer, A.

    1980-01-01

    The accident risks in German nuclear power plants are reviewed. Parameters influencing the extent and consequences of an accident are differentiated. Risks of normal operation, war, and sabotage have not been considered. Measures taken by the operating shaft in the course of an accident are taken into account. The knowledge thus gained can be applied in the planning of emergency measures. (DG) [de

  6. German and Russian Adolescents' Environmental Awareness.

    Science.gov (United States)

    Szagun, Gisela; Pavlov, Vladimir I.

    German (n=610) and Russian (n=610) adolescents in 3 age groups, 12, 15, and 18 years, were given a questionnaire assessing their feelings towards environmental destruction, their readiness for pro-environmental action, and their ethical attitude toward nature. In both nationalities anxiety, sadness, and anger about environmental destruction were…

  7. Germans, History, and the Nazi Past.

    Science.gov (United States)

    Young, Anne P.

    1981-01-01

    Discusses opposite findings of researchers concerning the amount of time given to the study of Hitler and the Third Reich in German Secondary Schools. Considers the relationship among scholarly work on the Nazi era, influences of the work on secondary school teachers, impact of curriculum reform, and effects of government educational…

  8. Attitudes of German Student Teachers on Inclusion

    Science.gov (United States)

    Baar, Robert

    2016-01-01

    The contribution discusses attitudes of German Teacher Training Students on Inclusion based on an empirical analysis containing three elements: Evaluation of students' written exams, results of a survey with closed as open questions and the interpretation of group discussions among students about inclusion. One can see that, though the found-out…

  9. The Eichmann Trial on East German Television

    NARCIS (Netherlands)

    Keilbach, Judith

    2014-01-01

    abstractThe trial against Adolf Eichmann was one of the first transnational media events on television. Its world-wide coverage required transnational cooperation. Using East German television reports about the trial this article argues that although the event transcended national borders it

  10. The Eichmann Trial on East German Television

    Directory of Open Access Journals (Sweden)

    Judith Keilbach

    2014-06-01

    Full Text Available The trial against Adolf Eichmann was one of the first transnational media events on television. Its world-wide coverage required transnational cooperation. Using East German television reports about the trial this article argues that although the event transcended national borders it maintained at the same time ideological boundaries.

  11. The Advanced German Course: A Multidimensional Approach.

    Science.gov (United States)

    Lutcavage, Charles

    1990-01-01

    Describes an advanced language course that focuses on modern German culture and society, and emphasizes advanced reading, grammar, conversation, and composition. This framework can be enhanced by regular incorporation of audio and video technology into the program as a means of heightening students' awareness of language and topical issues.…

  12. German Cultural Packets 13 and 14.

    Science.gov (United States)

    Atlanta Public Schools, GA.

    These German culture packets are designed to accompany A-LM Level II and include a statement of the rationale behind the unit, the objectives of the packet, the activities themselves, and a brief evaluation by the student. The activities involve the use of the basic text, the student workbook, corresponding tapes, and fellow students as partners…

  13. Introduction to German Culture: An Interdisciplinary Approach.

    Science.gov (United States)

    Roig, Kathleen

    1985-01-01

    Describes a course, taught in English, entitled "Introduction to German Culture," which was designed to meet the needs of students who have visited or plan to visit Germany and want to take a course in its contemporary culture, politics, and social problems. (SED)

  14. Suicidal ideation in German primary care

    NARCIS (Netherlands)

    Wiborg, J.F.; Gieseler, D.; Lowe, B.

    2013-01-01

    OBJECTIVE: To examine suicidal ideation in a sample of German primary care patients. METHODS: We conducted a cross-sectional study and included 1455 primary care patients who visited 1 of 41 general practitioners (GPs) working at 19 different sites. Suicidal ideation and psychopathology were

  15. Organization of the German nuclear industry

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    Corporate ownership within the German nuclear industry has evolved constantly during the last decade, and recent acquisitions and mergers, reunification of the country, as well as preparation for a unified European power market, have led to many significant changes during the past two years. The country's nuclear industry continues to struggle under an increasingly anti-nuclear political environment, yet nuclear power provided more than one-third of Germany's total electricity generation in 1991. As in many countries, particularly in western Europe, many German companies involved in different facets of the nuclear industry are interrelated. Usually as a means of horizontal or vertical integration, the country's nuclear utilities own, directly or indirectly, shares in uranium mining projects; conversion, enrichment, and fabrication companies; or other utilities' nuclear power plants. The utilities own partial interests in companies in supporting industries as well, including transportation firms, waste management companies, uranium broker/traders, and nuclear equipment manufacturers. While the majority of the companies owned are German, numerous investments are made in non-German firms also

  16. Lernen Wir Deutsch: Part I, German.

    Science.gov (United States)

    Dade County Public Schools, Miami, FL.

    Instructional objectives of the Dade County Public Schools Quinmester Program in German for use with "Lernen Wir Deutsch: Part 1" focus on the development of basic skills through the use of short dialogues and structured exercises. The contents of this guide focus on: (1) course description, (2) broad goals and performance objectives,…

  17. Lernen Wir Deutsch!: Part 2, German.

    Science.gov (United States)

    Dade County Public Schools, Miami, FL.

    Instructional objectives of the Dade County Public Schools Quinmester Program in German for use with "Lernen Wir Deutsch: Part 2" focus on development of basic skills through the use of short dialogues and structured exercises. The grammar of the course includes the study of nouns, pronouns, and verbs. Possessive determiners are…

  18. Improving Critical Thinking and Authenticity in Testing Business German

    DEFF Research Database (Denmark)

    Egbert, Maria; Maxim, Hiram

    1998-01-01

    in Business German, the Priifung Wirtschaftsdmtsch Intmnational [International Business German Examination] (PWD) and the Zertijikat I)mtschfur den Bmuf [German Cer- tificate for Professional Purposes] (ZDfB), test only students' information retrieval skills and fail to assess their critical thinking...

  19. Christian mission agencies and the question of slavery in German ...

    African Journals Online (AJOL)

    ... to the imperial designs of their government, with little commitment to improving the wellbeing of Cameroonians. Little wonder colonial and missionization exploitation which is inseparable from the modern understanding of slavery was at its highest during the German era. Keywords: German Cameroon, German missions, ...

  20. The German Program and International Education: A Comprehensive Model.

    Science.gov (United States)

    McConeghy, Patrick M.

    1990-01-01

    Argues for a comprehensive approach toward teaching German as a second language in response to students' needs to acquire a global perspective. Rather than stressing only syntax, grammar, and vocabulary, German language education should also attempt to teach sensitivity to, knowledge of, and insight into German culture. (JL)

  1. [Hand surgery in the German DRG System 2007].

    Science.gov (United States)

    Franz, D; Windolf, J; Kaufmann, M; Siebert, C H; Roeder, N

    2007-05-01

    Hand surgery often needs only a short length of stay in hospital. Patients' comorbidity is low. Many hand surgery procedures do not need inpatient structures. Up until 2006 special procedures of hand surgery could not be coded. The DRG structure did not separate very complex and less complex operations. Specialized hospitals needed a proper case allocation of their patients within the G-DRG system. The DRG structure concerning hand surgery increased in version 2007 of the G-DRG system. The main parameter of DRG splitting is the complexity of the operation. Furthermore additional criteria such as more than one significant OR procedure, the patients' age, or special diagnoses influence case allocation. A special OPS code for complex cases treated with hand surgery was implemented. The changes in the DRG structure and the implementation of the new OPS code for complex cases establish a strong basis for the identification of different patient costs. Different case allocation leads to different economic impacts on departments of hand surgery. Whether the new OPS code becomes a DRG splitting parameter has to be calculated by the German DRG Institute for further DRG versions.

  2. Steam generators. English-German, German-English. Dampferzeuger. Englisch-Deutsch, Deutsch-Englisch

    Energy Technology Data Exchange (ETDEWEB)

    Junge, H D

    1986-01-01

    This pocket dictionary contains the most important technical terms relating to steam generators both in English-German and German-English. Part of the terms go with additional definitions or explanations. Furthermore numerous examples are presented to explain the underlying rules for the formation of word combinations. In addition, entries include a number of general terms, as experience shows that suitable equivalents for use in technical texts are often needed precisely by the specialist. (HAG).

  3. Cross-linguistic vowel variation in trilingual speakers of Saterland Frisian, Low German, and High German.

    Science.gov (United States)

    Peters, Jörg; Heeringa, Wilbert J; Schoormann, Heike E

    2017-08-01

    The present study compares the acoustic realization of Saterland Frisian, Low German, and High German vowels by trilingual speakers in the Saterland. The Saterland is a rural municipality in northwestern Germany. It offers the unique opportunity to study trilingualism with languages that differ both by their vowel inventories and by external factors, such as their social status and the autonomy of their speech communities. The objective of the study was to examine whether the trilingual speakers differ in their acoustic realizations of vowel categories shared by the three languages and whether those differences can be interpreted as effects of either the differences in the vowel systems or of external factors. Monophthongs produced in a /hVt/ frame revealed that High German vowels show the most divergent realizations in terms of vowel duration and formant frequencies, whereas Saterland Frisian and Low German vowels show small differences. These findings suggest that vowels of different languages are likely to share the same phonological space when the speech communities largely overlap, as is the case with Saterland Frisian and Low German, but may resist convergence if at least one language is shared with a larger, monolingual speech community, as is the case with High German.

  4. Can soda fountains be recommended in hospitals?

    Science.gov (United States)

    Chaberny, Iris F; Kaiser, Peter; Sonntag, Hans-Günther

    2006-09-01

    Mineral water (soda water) is very popular in Germany. Therefore, soda fountains were developed as alternatives to the traditional deposit bottle system. Nowadays, different systems of these devices are commercially available. For several years, soda fountains produced by different companies have been examined at the University Hospital of Heidelberg. In 1998, it was possible for the first time to observe and evaluate one of these systems over a period of 320 days in a series of microbiological examinations. The evaluation was implemented on the basis of the German drinking water regulation (Anonymous, 1990. Gesetz über Trinkwasser und Wasser für Lebensmittelbetriebe (Trinkwasserverordnung - TrinkwV) vom 12. Dezember 1990. Bundesgesetzblatt 66, 2613ff). Initially, the bacteria counts exceeded the reference values imposed by the German drinking water regulation in almost 50% of the analyses. Pseudomonas aeruginosa was also detected in almost 38% of the samples. After a re-arrangement of the disinfection procedure and the removal of the charcoal filter, Pseudomonas aeruginosa was not detectable any more. However, the bacteria counts still frequently exceeded the reference values of the German drinking water regulation. Following our long-term analysis, we would not recommend soda fountains in high-risk areas of hospitals. If these devices are to be used in hospitals, the disinfection procedures should be executed in weekly or fortnightly intervals and the water quality should be examined periodically.

  5. Robots drive the German radical prostatectomy market: a total population analysis from 2006 to 2013.

    Science.gov (United States)

    Groeben, C; Koch, R; Baunacke, M; Wirth, M P; Huber, J

    2016-12-01

    To assess trends in the distribution of patients for radical prostatectomy in Germany from 2006 to 2013 and the impact of robotic surgery on annual caseloads. We hypothesized that the advent of robotics and the establishment of certified prostate cancer centers caused centralization in the German radical prostatectomy market. Using remote data processing we analyzed the nationwide German billing data from 2006 to 2013. We supplemented this database with additional hospital characteristics like the prostate cancer center certification status. Inclusion criteria were a prostate cancer diagnosis combined with radical prostatectomy. Hospitals with certification or a surgical robot in 2009 were defined as 'early' group. Linear covariant-analytic models were applied to describe trends over time. Annual radical prostatectomy numbers declined from 28 374 (2006) to 21 850 (2013). High-volume hospitals (⩾100 cases) decreased from 87 (22.0%) in 2006 to 43 (10.4%) in 2013. Low-volume hospitals (200 cases per year contrary to the overall trend (Pdecentralization of radical prostatectomy in Germany. The driving force for this development might consist in the overall decline of radical prostatectomy numbers. The most important factor for achieving higher caseloads was the presence of a robotic system. In order to optimize outcomes of radical prostatectomy additional health policy measures might be necessary.

  6. Explanatory models of addictive behaviour among native German, Russian-German, and Turkish youth.

    Science.gov (United States)

    Penka, S; Heimann, H; Heinz, A; Schouler-Ocak, M

    2008-01-01

    In Germany, the public system of addiction treatment is used less by migrants with addictive disorders than by their non-migrant counterparts. To date, the literature has focused primarily on language, sociocultural factors, and residence status when discussing access barriers to this part of the health care system. However, little attention has been paid to cultural differences in explanatory models of addictive behaviour. This is surprising when we consider the important role played by popular knowledge in a population's perceptions of and responses to illnesses, including their causes, symptoms, and treatment. In the present study, we examined explanatory models of addictive behaviour and of mental disorders in 124 native German und Russian-German youth and compared these models to those observed in an earlier study of 144 German and Turkish youth. We employed the free listing technique German and to compile the terms that participating subjects used to describe addictive behaviour. Subsequently, we examined how a subset of our study population assigned these terms to the respective disorders by means of the pile sort method. Although the explanatory models used by the German and Russian-German youth in our study were surprisingly similar, those employed by Turkish youth did not make any fundamental distinction between illegal and legal drugs (e.g. alcohol and nicotine). German and Russian-German youth regarded eating disorders as "embarrassing" or "disgraceful", but Turkish youth did not. Unlike our German and Russian-German subjects, the Turkish youth did not classify eating disorders as being addictive in nature. Moreover, medical concepts crucial to a proper understanding of dependence disorders (e.g. the term "physical dependence") were characterised by almost half of our Turkish subjects as useless in describing addictions. These findings show that it is impossible to translate medical or everyday concepts of disease and treatment properly into a different

  7. German words: still used by Japanese obstetrics and gynecology doctors.

    Science.gov (United States)

    Matsubara, Shigeki

    2018-03-01

    German used to be frequently employed in Japanese obstetric and gynecologic (OBGYN) practice; however, it is now less frequently used. Description and analysis of this situation may shed some light on the change of OBGYN practice and education in Japan, which may at least partly hold true to counties other than Japan. Three eras were classified according to the relationship between German and Japanese OBGYN, with each era characterized. Frequently used German words in Japanese OBGYN practice were described as examples. German words have become less frequently used with each successive generation. Even though English may suffice in practical OBGYN practice, German usage will still be passed on to these new generations.

  8. The reliability of the German version of the Richards Campbell Sleep Questionnaire.

    Science.gov (United States)

    Krotsetis, Susanne; Richards, Kathy C; Behncke, Anja; Köpke, Sascha

    2017-07-01

    The assessment of sleep quality in critically ill patients is a relevant factor of high-quality care. Despite the fact that sleep disturbances and insufficient sleep management contain an increased risk of severe morbidity for these patients, a translated and applicable instrument to evaluate sleep is not available for German-speaking intensive care settings. This study aimed to translate the Richards Campbell Sleep Questionnaire (RCSQ), a simple and validated instrument eligible for measuring sleep quality in critically ill patients, and subsequently to evaluate the internal consistency of the German version of the RCSQ. Furthermore, it also aimed to inquire into the perception of sleep in a sample of critically ill patients. The RCSQ was translated following established methodological standards. Data were collected cross-sectionally in a sample of 51 patients at 3 intensive care units at a university hospital in Germany. The German version of the RCSQ showed an overall internal consistency (Cronbach's alpha) of 0·88. The mean of the RSCQ in the sample was 47·00 (SD ± 27·57). Depth of sleep was rated the lowest and falling asleep again the highest of the RCSQ sleep items. The study demonstrated very good internal consistency of the German version of the RCSQ, allowing for its application in practice and research in German-speaking countries. Quality of sleep perception was generally low in this sample, emphasizing the need for enhanced care concepts regarding the sleep management of critically ill patients. Relevance to clinical practice Assessment of self-perception of sleep is crucial in order to plan an individually tailored care process. © 2017 British Association of Critical Care Nurses.

  9. Experience and results of MELCOR application for German PWRs

    International Nuclear Information System (INIS)

    Sonnenkalb, M.

    1999-01-01

    An introduction into severe accident research work performed at GRS with regard to the use of the MELCOR code is given in Chapter One of the paper. Experience in applying MELCOR 1.8.3 for German PWRs and results of MELCOR calculations done within the project 'Accident management - Mitigation' for German LWRs are presented in Chapter Two. This 3-year project was finished February 1998. It was funded by the German Ministry for Environment, Nature Conservation and Nuclear Safety - BMU. In Chapter Three, a short overview of a training course on 'Phenomenology of Severe Accidents in PWR-Plants' is given. Mainly due to the interest from German NPPs GRS developed this special training session in 1996. Since 1996 it has been held several times for operators, shift personnel and the management board of two different German NPPs and for lecture of the German NPP training centre in Essen. In Chapter Four, results of the application of MELCOR 1.8.4 for German PWRs are presented. This work is done within a new project on 'Accident Management - Mitigation' for German LWRs. It was started in March 1998 and is again funded by the German Federal Ministry BMU. An objective of this project is to perform further MELCOR calculations, to be used within a PSA level 2 study for a German PWR, which is done at GRS in parallel. The experience of using MELCOR for German PWRs are summarised in Chapter Five. (author)

  10. [Systematic Readability Analysis of Medical Texts on Websites of German University Clinics for General and Abdominal Surgery].

    Science.gov (United States)

    Esfahani, B Janghorban; Faron, A; Roth, K S; Grimminger, P P; Luers, J C

    2016-12-01

    Background: Besides the function as one of the main contact points, websites of hospitals serve as medical information portals. As medical information texts should be understood by any patients independent of the literacy skills and educational level, online texts should have an appropriate structure to ease understandability. Materials and Methods: Patient information texts on websites of clinics for general surgery at German university hospitals (n = 36) were systematically analysed. For 9 different surgical topics representative medical information texts were extracted from each website. Using common readability tools and 5 different readability indices the texts were analysed concerning their readability and structure. The analysis was furthermore stratified in relation to geographical regions in Germany. Results: For the definite analysis the texts of 196 internet websites could be used. On average the texts consisted of 25 sentences and 368 words. The reading analysis tools congruously showed that all texts showed a rather low readability demanding a high literacy level from the readers. Conclusion: Patient information texts on German university hospital websites are difficult to understand for most patients. To fulfill the ambition of informing the general population in an adequate way about medical issues, a revision of most medical texts on websites of German surgical hospitals is recommended. Georg Thieme Verlag KG Stuttgart · New York.

  11. Cross-sectional environmental study comparing two highly polluted areas in Germany (Bitterfeld and Hettstedt) with a control region; Umweltmedizinische Untersuchungen im Raum Bitterfeld, im Raum Hettstedt und einem Vergleichsgebiet 1992-2000. Bd. 1: Textband. Bd. 2: Publikationen. Bd. 3: Untersuchungsdokumente und Frageboegen. Abschlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Heinrich, J.; Frye, C.; Hoelscher, B.; Meyer, I.; Pitz, M.; Cyrys, J.; Schneller, H.; Wjst, M.; Wichmann, H.E.

    2001-10-01

    The aim of the environmental epidemiologic study was to determine possible negative effects on the health of children in the very polluted areas of Bitterfeld and Hettstedt in comparison to the less polluted areas of Anhalt-Zerbst (Eastern Germany). The time changes of the health parameters were recorded along with the running redevelopments during the time period of 6 years. The study design consisted of three repeated regional cross sectional studies in 1992/93, 1995/96 and 1998/99. In all, there was information of 7.611 questionnaires to be analysed (participation rate: 89%, 75% and 75%). Children living in the most polluted area of Hettstedt had a noticeable higher risk for non allergic respiratory diseases and symptoms compared to children living in the control area of Anhalt-Zerbst. During the time of the examinations in 1992 till 1999 a clear statistically significant decrease in the prevalences of these restrictions of health could be shown. Children without indoor pollutants in their homes profited most by the improvement of ambient air quality. The better lung function (FVC, FEV{sub 1}) between 1992 and 1999 underlines the improvement of the respiratory health. Children living in both polluted ares have allergies more often (physician's diagnosis, symptoms, allergy specific antibodies). The incidence of asthma, the bronchial hyperreactivity and atopic exzema increased, the prevalence of rhinitis and allergic sensitization did not increase. The body burden with lead and cadmium was higher in children living in polluted areas, but it decreased during the period of observation. In 1997, however, the lead concentration in blood increased a little, parallel to the higher lead concentration in settled dust in Hettstedt at that time. (orig.) [German] Ziel der umweltepidemiologischen Studie war es, moegliche gesundheitliche Beeitraechtigungen von Kindern in den Belastungsgebieten Bitterfeld und Hettstedt i. Vgl. zu dem wenig belasteten Gebiet Anhalt

  12. Cross-sectional environmental study comparing two highly polluted areas in Germany (Bitterfeld and Hettstedt) with a control region; Umweltmedizinische Untersuchungen im Raum Bitterfeld, im Raum Hettstedt und einem Vergleichsgebiet 1992-2000. Bd. 1: Textband. Bd. 2: Publikationen. Bd. 3: Untersuchungsdokumente und Frageboegen. Abschlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Heinrich, J; Frye, C; Hoelscher, B; Meyer, I; Pitz, M; Cyrys, J; Schneller, H; Wjst, M; Wichmann, H E

    2001-10-01

    The aim of the environmental epidemiologic study was to determine possible negative effects on the health of children in the very polluted areas of Bitterfeld and Hettstedt in comparison to the less polluted areas of Anhalt-Zerbst (Eastern Germany). The time changes of the health parameters were recorded along with the running redevelopments during the time period of 6 years. The study design consisted of three repeated regional cross sectional studies in 1992/93, 1995/96 and 1998/99. In all, there was information of 7.611 questionnaires to be analysed (participation rate: 89%, 75% and 75%). Children living in the most polluted area of Hettstedt had a noticeable higher risk for non allergic respiratory diseases and symptoms compared to children living in the control area of Anhalt-Zerbst. During the time of the examinations in 1992 till 1999 a clear statistically significant decrease in the prevalences of these restrictions of health could be shown. Children without indoor pollutants in their homes profited most by the improvement of ambient air quality. The better lung function (FVC, FEV{sub 1}) between 1992 and 1999 underlines the improvement of the respiratory health. Children living in both polluted ares have allergies more often (physician's diagnosis, symptoms, allergy specific antibodies). The incidence of asthma, the bronchial hyperreactivity and atopic exzema increased, the prevalence of rhinitis and allergic sensitization did not increase. The body burden with lead and cadmium was higher in children living in polluted areas, but it decreased during the period of observation. In 1997, however, the lead concentration in blood increased a little, parallel to the higher lead concentration in settled dust in Hettstedt at that time. (orig.) [German] Ziel der umweltepidemiologischen Studie war es, moegliche gesundheitliche Beeitraechtigungen von Kindern in den Belastungsgebieten Bitterfeld und Hettstedt i. Vgl. zu dem wenig belasteten Gebiet Anhalt-Zerbst zu

  13. Different zooplankton structures in the German Bight

    Science.gov (United States)

    Martens, P.; Brockmann, U.

    1993-06-01

    In August 1982, a net of 48 stations with altogether 208 samples was investigated in the eastern German Bight with respect to temperature, salinity, as well as the amount and species composition of the mesozooplankton (>80 μm). The data were arranged into different structures by means of a cluster analysis. Four different clusters were found: (a) a “Wadden sea water” with few holoplankton organisms but a higher amount of spionid larvae; (b) a “German Bight water” with a maximum occurrence of turbellaria ( Alaurina composita) and medium concentrations of copepods; (c) a mixing area between these two water masses with highest amounts of Oikopleura dioica, Temora longicornis, Acartia sp., mussel larvae and larvae of the spionid worms; (d) a “North Sea water” mass with highest concentrations of Pseudocalanus elongatus, Paracalanus parvus und Oithona similis. The differences in the concentrations of the species mentioned between the four clusters were significant on the 0.1%-level.

  14. Methane in German hard coal mining

    International Nuclear Information System (INIS)

    Martens, P.N.; Den Drijver, J.

    1995-01-01

    Worldwide, hard coal mining is being carried out at ever increasing depth, and has, therefore, to cope with correspondingly increasing methane emissions are caused by coal mining. Beside carbon dioxide, chloro-fluoro-carbons (CFCs) and nitrogen oxides, methane is one of the most significant 'greenhouse' gases. It is mainly through the release of such trace gases that the greenhouse effect is brought about. Reducing methane emissions is therefore an important problem to be solved by the coal mining industry. This paper begins by highlighting some of the fundamental principles of methane in hard coal mining. The methane problem in German hard coal mining and the industry's efforts to reduce methane emissions are presented. The future development in German hard coal mining is illustrated by an example which shows how large methane volumes can be managed, while still maintaining high outputs at increasing depth. (author). 7 tabs., 10 figs., 20 refs

  15. Making sense of the German Wikipedia community

    Directory of Open Access Journals (Sweden)

    Rikke Frank Jørgensen

    2012-08-01

    Full Text Available This article presents the findings from a qualitative study of the German Wikipedia community, focusing on how people engaged with Wikipedia make sense of norms, collaborative practices and means of regulation within the community. The study highlights the strong focus on the quality of the end-product (the encyclopedia in the German community, stressing that article quality is seen as more important than the wiki-process as such. As the community has grown, an increasing number of rules and mechanisms have been deployed to resolve various issues and conflicts, however the interviewees do not perceive Wikipedia as being bureaucratic, but rather describe it as a “rule-governed anarchy”. The findings suggest that people contribute for a variety of reasons, yet point to reactions from and interactions with fellow Wikipedians as one of the strongest motivational drivers for participation.

  16. 14th German nuclear law symposium

    International Nuclear Information System (INIS)

    Burgi, Martin

    2013-01-01

    Nuclear law is still relevant and topical. The nuclear power phase-out in response to the nuclear accident of Fukushima and the turnaround in German energy policy raise new legal issues. In several lectures of practioners and scientists the 14th German Nuclear Law Symposium examined questions regarding the retrofitting of nuclear power plants, their decommissioning and disposal, the current developements in the European nuclear and radiation protection law and the search for a final nuclear waste repository. The nuclear law provides examples for central challenges of administrative law, such as the independence of authorities and the protection of third parties. The discussions between the almost 150 participants are documented in several reports.

  17. Psychological training of German science astronauts.

    Science.gov (United States)

    Manzey, D; Schiewe, A

    1992-07-01

    Although the significance of psychosocial issues of manned space flights has been discussed very often in recent literature, up to now, very few attempts have been made in North-America or Europe to provide astronaut candidates or spacecrew members with some kind of psychological training. As a first attempt in this field, a psychological training program for science astronauts is described, which has been developed by the German Aerospace Research Establishment and performed as part of the mission-independent biomedical training of the German astronauts' team. In contrast to other training concepts, this training program focused not only on skills needed to cope with psychosocial issues regarding long-term stays in space, but also on skills needed to cope with the different demands during the long pre-mission phase. Topics covered in the training were "Communication and Cooperation", "Stress-Management", "Coping with Operational Demands", "Effective Problem Solving in Groups", and "Problem-Oriented Team Supervision".

  18. West German Jewry: Guilt, Power and Pluralism

    Directory of Open Access Journals (Sweden)

    Anthony d. Kauders

    2010-04-01

    Full Text Available The essay will address the history of West German Jewry using the concept of guilt as its guiding theme. Jews in West Germany had a bad conscience on account of living in the “land of the murderers.” This bad conscience not only distinguished them from other Jewish communities, it also explains much of what characterized West German Jewry from 1945 to 1989: its particular economic structure; its especially close ties to Israel; its preoccupation with democratization; its power arrangements; and its communal life. The essay will address these issues, and trace a development that led from a close-knit, ideologically homogeneous group to one that became ever more pluralistic in the 1970s and 1980s.

  19. Defining Multidrug Resistance of Gram-Negative Bacteria in the Dutch–German Border Region—Impact of National Guidelines

    Directory of Open Access Journals (Sweden)

    Robin Köck

    2018-01-01

    Full Text Available Preventing the spread of multidrug-resistant Gram-negative bacteria (MDRGNB is a public health priority. However, the definition of MDRGNB applied for planning infection prevention measures such as barrier precautions differs depending on national guidelines. This is particularly relevant in the Dutch–German border region, where patients are transferred between healthcare facilities located in the two different countries, because clinicians and infection control personnel must understand antibiograms indicating MDRGNB from both sides of the border and using both national guidelines. This retrospective study aimed to compare antibiograms of Gram-negative bacteria and classify them using the Dutch and German national standards for MDRGNB definition. A total of 31,787 antibiograms from six Dutch and four German hospitals were classified. Overall, 73.7% were no MDRGNB according to both guidelines. According to the Dutch and German guideline, 7772/31,787 (24.5% and 4586/31,787 (12.9% were MDRGNB, respectively (p < 0.0001. Major divergent classifications were observed for extended-spectrum β-lactamase (ESBL -producing Enterobacteriaceae, non-carbapenemase-producing carbapenem-resistant Enterobacteriaceae, Pseudomonas aeruginosa and Stenotrophomonas maltophilia. The observed differences show that medical staff must carefully check previous diagnostic findings when patients are transferred across the Dutch–German border, as it cannot be assumed that MDRGNB requiring special hygiene precautions are marked in the transferred antibiograms in accordance with both national guidelines.

  20. Defining Multidrug Resistance of Gram-Negative Bacteria in the Dutch-German Border Region-Impact of National Guidelines.

    Science.gov (United States)

    Köck, Robin; Siemer, Philipp; Esser, Jutta; Kampmeier, Stefanie; Berends, Matthijs S; Glasner, Corinna; Arends, Jan P; Becker, Karsten; Friedrich, Alexander W

    2018-01-26

    Preventing the spread of multidrug-resistant Gram-negative bacteria (MDRGNB) is a public health priority. However, the definition of MDRGNB applied for planning infection prevention measures such as barrier precautions differs depending on national guidelines. This is particularly relevant in the Dutch-German border region, where patients are transferred between healthcare facilities located in the two different countries, because clinicians and infection control personnel must understand antibiograms indicating MDRGNB from both sides of the border and using both national guidelines. This retrospective study aimed to compare antibiograms of Gram-negative bacteria and classify them using the Dutch and German national standards for MDRGNB definition. A total of 31,787 antibiograms from six Dutch and four German hospitals were classified. Overall, 73.7% were no MDRGNB according to both guidelines. According to the Dutch and German guideline, 7772/31,787 (24.5%) and 4586/31,787 (12.9%) were MDRGNB, respectively ( p Dutch-German border, as it cannot be assumed that MDRGNB requiring special hygiene precautions are marked in the transferred antibiograms in accordance with both national guidelines.

  1. Can German wine cooperatives compete on quality?

    Directory of Open Access Journals (Sweden)

    Schamel Guenter H.

    2015-01-01

    Full Text Available The paper analyzes how German cooperative wineries compete with private (i.e. non-cooperative wineries regarding reputation, quality categorization and varietal selection. Among the reasons why German cooperatives lag behind in terms of reputation for quality wine are organization principles of cooperatives and the difficulty to manage growers supplying grapes of different qualities. Cooperatives turn their supply of grapes into wine often classified as quality wine without much distinction. Conversely, privately owned wineries growing their own grapes may have more control over quality along their production chain and are able to produce more distinctive wines. In turn, they gain more reputation with final consumers with respect to quality. We analyze data for private and cooperative wineries from Germany. Our objective is to identify key differences in terms of reputation for quality wine production. Specifically, we look at interaction effects based on organizational form (cooperative vs. private and the German wine quality categorization (i.e. basic quality wine vs. Kabinett, Spätlese, or Auslese as well as varietal effects. We employ a hedonic pricing model to test the hypothesis that wines produced by private producers receive a reputation premium relative to cooperatives. Moreover, we hypothesize that private wineries receive a price premium relative to coopera- tives for other than basic quality wines and distinct varieties such as Riesling and Pinot Noir. The empirical analysis confirms both hypotheses. The estimated coefficients indicate that cooperatives are unable to gain quality premium for most quality cat- egories and gain price premiums only for non-distinct varieties such as Lemberger and Dornfelder. We can argue that German cooperatives are stuck in the low quality corner of the quality and variety spectrum and are currently not able to compete with private wineries in terms of quality. This result supports the observation

  2. Alexithymia in the German general population.

    Science.gov (United States)

    Franz, Matthias; Popp, Kerstin; Schaefer, Ralf; Sitte, Wolfgang; Schneider, Christine; Hardt, Jochen; Decker, Oliver; Braehler, Elmar

    2008-01-01

    The Toronto-Alexithymia-Scale (TAS-20) is used worldwide as a valid measurement of alexithymia. Until now, population-based standardization and cut-off values of the German TAS-20 version have not been available. This study provides these by means of a representative German sample and by investigating the factorial structure of the TAS-20. Data were generated from a representative random sample of the German general population (1,859 subjects aged between 20 and 69). The TAS-20 sum score was normally distributed. The mean value was 49.5 (SD=9.3) in men and 48.2 (SD=9.2) in women. Divorce, single and low social status were associated with enhanced sum scores. Ten percent of the population exceeded the TAS-20 sum score threshold of >or=61. The 66th percentile reached 53 for men and 52 for women. Factor analysis identified three factors that match the scales of the English original version. An additional fourth factor ("importance of emotional introspection") was extracted. Total explanation of variance by these four factors was 52.27%. The sum score of the German TAS-20 version is suited for the standardized measure of alexithymia. For selecting alexithymic individuals in experimental studies, the cut-off >or=61 is possibly too restrictive. Therefore, we propose the 66th percentile for the identification of high alexithymics. The TAS-20 sum score is associated with important socio-demographic variables. The factorial structure is reliable; the fourth factor ("importance of emotional introspection") provides differentiation of content and allows for enhanced explanation of variance.

  3. Nuclear energy and German foreign policy

    International Nuclear Information System (INIS)

    Kaiser, K.

    1979-01-01

    The author shows that the present foreign-policy situation with regard to the nuclear-energy complex is due to political and energy-policy origins. He is further of the opinion that the expansion of nuclear energy - in spite of internal political difficulties - will continue in the long term. Hence breeders and reconditioning will become realities. For German foreign policy this means that it must also carry responsibilities on a global scale in this respect. (orig.) [de

  4. Right Face: Understanding German Political Developments

    Science.gov (United States)

    1994-06-16

    years passed, invested Germancarliamentary life , and politics in general, with ar increasing amount of friction and frustra-ton. The new German state...Wranslated by William C. Kirby, Cambridge: .arvaro ° Uiversity Press, 1981. George F. Kennan, The Decline of Bismarck’s European Order, .7anco-Russian...continental Empire, free from the economic pressure of Britain, America, and France. The costs of the war in human life and resources fed procressively more

  5. Remarks on the german regulation of crowdfunding

    OpenAIRE

    Tröger, Tobias

    2017-01-01

    Crowdfunding is a buzzword that signifies a sub-set in the new forms of finance facilitated by advances in information technology usually categorized as fintech. Concerns for financial stability, investor and consumer protection, or the prevention of money laundering or funding of terrorism hinge incrementally on including the new techniques to initiate financing relationships adequately in the regulatory framework. This paper analyzes the German regulation of crowdinvesting and finds that it...

  6. Control rooms in German nuclear power plants

    International Nuclear Information System (INIS)

    Hoffmann, E.

    1999-01-01

    The paper explains and illustrates the dissimilarity in design and equipment of control rooms in German NPPs, as well as a historical survey of the general principles and approaches applied in the evolution of control room technology, including backfitting activities. Experience obtained from daily operation as well training at the simulators is taken as a basis to formulate fundamental requirements for modification or novel design approaches. (orig./CB) [de

  7. Ileocecocolic volvulus in a German shepherd dog

    Science.gov (United States)

    Javard, Romain; Specchi, Swan; Benamou, Jérôme; Lapointe, Catherine; Deffontaines, Jean-Baptiste; Planté, Jérôme; d’Anjou, Marc-André

    2014-01-01

    This report describes an ileocecocolic volvulus in a German shepherd dog with risk factors of previous abdominal surgeries and concurrent chronic enteropathy. Contrast-enhanced computed tomography (CT) with multiplanar reformatting was more sensitive than abdominal radiographs or ultrasound to obtain a diagnosis, because of the presence of a “whirl-sign” on CT. A combination of colopexy and cecopexy was succesfully used to treat the patient’s condition. PMID:25392556

  8. Hospital Inspections

    Data.gov (United States)

    U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  9. Interaction of oxygen vacancies in yttrium germanates

    KAUST Repository

    Wang, Hao

    2012-01-01

    Forming a good Ge/dielectric interface is important to improve the electron mobility of a Ge metal oxide semiconductor field-effect transistor. A thin yttrium germanate capping layer can improve the properties of the Ge/GeO 2 system. We employ electronic structure calculations to investigate the effect of oxygen vacancies in yttrium-doped GeO 2 and the yttrium germanates Y 2Ge 2O 7 and Y 2GeO 5. The calculated densities of states indicate that dangling bonds from oxygen vacancies introduce in-gap states, but the system remains insulating. However, yttrium-doped GeO 2 becomes metallic under oxygen deficiency. Y-doped GeO 2, Y 2Ge 2O 7 and Y 2GeO 5 are calculated to be oxygen substoichiometric under low Fermi energy conditions. The use of yttrium germanates is proposed as a way to effectively passivate the Ge/dielectric interface. This journal is © 2012 the Owner Societies.

  10. The Litvinenko polonium-210 case - German experiences

    International Nuclear Information System (INIS)

    Kirchner, Gerald; Kroeger, Emily A.

    2008-01-01

    This paper brings together the measurement results taken and the lessons learned by the German Federal Office for Radiation Protection during the polonium-210 incident in Hamburg in late 2006. The incident was pivotal in confirming the importance of the defence against nuclear hazards in Germany and for highlighting the role of communication in the success of a deployment. The background of the case is reviewed and an overview of the German defence against nuclear hazards is given. The various measurement tasks, both at the scene and in the laboratory, and their results are summarized along with the communication challenges experienced. The main conclusions are that the traces of polonium-210 found at the sites were of little radiological consequence and the German defence against nuclear hazards in Germany delivered an excellent and measured response to the incident. However, communication challenges still exist and communication with the public and the emergency responders has to be given high priority during future deployments in order to ensure their success. (author)

  11. German energy market 2017; Deutscher Energiemarkt 2017

    Energy Technology Data Exchange (ETDEWEB)

    Schiffer, Hans-Wilhelm [Weltenergierat - Deutschland, Berlin (Germany). Arbeitsgruppe Energie fuer Deutschland; World Energy Council, London (United Kingdom). World Energy Resources

    2018-03-15

    The basic orientation of the German energy supply as specified in the energy concept of the Federal Government towards the increased use of renewable energies with simultaneous increase of energy efficiency still determines the market development. In the present case, a current overview of the German energy market 2017 is given, which provides a concentrated compilation of the key figures of the energy industry. As in previous years, the article not only summarizes general facts about the energy mix, but also deals in detail with the development of the individual energy sources oil, natural gas, brown and hard coal, nuclear energy and renewable energies. Furthermore, the price trends are explained on the international markets and inland. An overview of the development of greenhouse gas emissions from 1990 to 2017 concludes the contribution. [German] Die im Energiekonzept der Bundesregierung vorgegebene Grundausrichtung der deutschen Energieversorgung hin zur verstaerkten Nutzung erneuerbarer Energien bei gleichzeitiger Steigerung der Energieeffizienz bestimmt nach wie vor die Marktentwicklung. Vorliegend wird ein aktueller Ueberblick ueber den deutschen Energiemarkt 2017 gegeben, der eine konzentrierte Zusammenstellung der zentralen Eckdaten der Energiewirtschaft leistet. Wie in den Jahren zuvor fasst der Artikel nicht nur allgemeine Fakten zum Energiemix zusammen, sondern geht auch ausfuehrlich auf die Entwicklung der einzelnen Energietraeger Erdoel, Erdgas, Braun und Steinkohle, Kernenergie sowie regenerative Energien ein. Ferner werden die Preistendenzen auf den internationalen Maerkten und im Inland erlaeutert. Eine Uebersicht ueber die Entwicklung der Treibhausgas-Emissionen von 1990 bis 2017 schliesst den Beitrag ab.

  12. The new German radiation protection ordinance

    International Nuclear Information System (INIS)

    Pfeffer, W.; Weimer, G.

    2003-01-01

    According to European law, the Basic Safety Standards (BSS) published by the European Council in 1996 and the Council Directive on health protection of individuals against dangers of ionising radiation in relation to medical exposure had to be transferred into national law within due time. In 2001 the new Ordinance for the Implementation of the Euratom Guidelines on Radiation Protection] was published, which replaces the old Radiation Protection Ordinance. The new German Ordinance adapts the European Directive to German law, covering the general principles but even giving more details in many fields of radiation protection. The BSS scope certainly is much broader than the prescriptions important for the field of radiation protection in nuclear power plants. According to the scope of this workshop on occupational exposure in nuclear power plants - and as the BSS most probably will be quite familiar to all of you - after a short general overview on relevant contents of the German Ordinance, this presentation will focus on the main issues important in the operation of NPP and especially on some areas which may give rise to necessary changes caused by the new Ordinance. (A.L.B.)

  13. Hospital marketing.

    Science.gov (United States)

    Carter, Tony

    2003-01-01

    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

  14. Regional variation in hospital admission rates in the Netherlands, Belgium, Northern France and Nordrhein-Westfalen.

    NARCIS (Netherlands)

    Noordt, M. van; Zee, J. van der; Groenewegen, P.P.

    1992-01-01

    For the analysis of regional variations in hospital admission rates a model was set up, including both supply and demand indicators. Data were gathered for regions in four health care systems (the Dutch, Belgian, French and German), for 1982, 1979, 1974 (France 1982 only). Hospital bed supply proved

  15. German Atomic Energy Act turns fifty

    International Nuclear Information System (INIS)

    Schneider, Horst

    2009-01-01

    The German Atomic Energy Act entered into force on January 1, 1960. It turns fifty at the beginning of 2010. Is this a reason to celebrate or rather the opposite? Lawyers, in principle, can view old pieces of legislation from 2 perspectives: On the one hand, aged laws are treated in a spirit of veneration and are celebrated as proven. On the other hand, an anniversary of this kind can be a welcome reason for demands to abolish or, at least, fundamentally renew that law. Over the past half century, the German Atomic Energy Act went through stormy and varied phases both of a legal and a political character. Its 50 th anniversary is likely to spark off very conflicting evaluations as well. A review of legal history shows that the German or, rather, the Federal German Atomic Energy Act (AtG) was not a first-of-its-kind piece of legislation but stemmed from the 1957 EURATOM Treaty, in a way representing a latecomer of that treaty. The Atomic Energy Act experienced a number of important developments throughout its history: - In 1975, compulsory licensing of fuel element factories was introduced. - The back end of the fuel cycle, especially final storage, were incorporated in the Atomic Energy Act comprehensively first in 1976. - In 1985, legislators decided in favor of unlimited nuclear liability. - In 1994 and 1998, only some innovations in special items were introduced under the headings of environmental impact assessment and suitability for repository storage because the controversy about nuclear power did not permit a fundamental alignment towards a more comprehensive modern safety law. - The decision to opt out of the peaceful uses of nuclear power in 2002 drew the final line so far of decisions about directions of nuclear law in a major amendment. In parallel, the decisions by the Federal Constitutional Court and the Federal Administrative Court in the late 1970s and, above all, the 1980s provided important assistance which has remained valid to this day. What is

  16. Learning from the Germans? History and Memory in German and European Discourses of Integration

    Directory of Open Access Journals (Sweden)

    Andrew Beattie

    2007-08-01

    Full Text Available History and memory appear to be increasingly important to discussions of European values and identity, as exemplified by references to ‘bitter experiences’ and ‘divided pasts’ in the draft EU constitution. The article takes recent suggestions that Europe could learn from German experiences of confronting multiple difficult pasts as its starting point, and considers critically what lessons those German experiences might in fact hold for ‘Europe’. It explores similarities and differences in the two integration contexts and their dominant approaches to, and assumptions about history and public memory. Specifically, it considers debates about the east-west division of the Cold War and about the place of communism and nazism in public memory. Contrary to common assumptions, the article argues that German experiences are not necessarily worth of European emulation.

  17. Crystal chemistry of germanates: Characteristic structural features of Li,Ge-germanates

    International Nuclear Information System (INIS)

    Ilyushin, G.D.; Dem'yanets, L.N.

    2000-01-01

    Crystallochemical classification of eleven compounds from the Li-germanate family is suggested. Depending on the set of the primary building units (PBU) (M-octahedra of the composition [GeO 6 ] and T-tetrahedra of the composition [GeO 4 ]) and the type of their 'condensation', these germanates are divided into three crystallochemical groups: framework MT-structures (four phases), condensed MT-structures (two phases), and tetrahedral T-condensed structures (five phases). The structural characteristics of the framework Li,Ge-germanates are considered, i.e., their symmetry, crystallographically independent sets of the primary building units, framework architecture, and the types of chains and layers of the (Ge,O)-radicals

  18. [Cardiovascular medicine in the German diagnosis-related group--(G-DRG) system 2005].

    Science.gov (United States)

    Fürstenberg, T; Bunzemeier, H; Roeder, N; Reinecke, H

    2005-05-01

    The German diagnosis-related Group (G-DRG) System has recently been published in its third version. From 2005 on, this system will be the definite measure for the budgets of nearly all german hospitals. The preliminary phase with no budget reduction or redistribution being made and in which an inappropriate classification system had no negative impact on reimbursement has, thus, come to an end. At present, many hospitals are struggling in an economic competition about the independence or maintenance of the hospital or several sub-departments. The changes in the classification system with regard to a marked increase in the number of G DRGs, a modified grouping-logic, more properly determined reductions and extra charges for low and high outlier as well as the introduction of further additional charges contribute thereby to a better covering of services and treatments of cardiovascular patients. However, while many of the known problems have been eliminated, there are still weaknesses in the G-DRG System even concerning cardiovascular medicine. The G-DRG System has to be adapted continuously with consultation of the clinical expertise of the respective medical societies. The most important new aspects and changes in the G-DRG System 2005 and the accompanied execution regulations are explained with special view on cardiology.

  19. Curriculum design and German student exchange for Sino-German Bachelor program majored in optoelectronics engineering

    Science.gov (United States)

    Zheng, Jihong; Fuhrmann, Thomas; Xu, Boqing; Schreiner, Rupert; Jia, Hongzhi; Zhang, Wei; Wang, Ning; Seebauer, Gudrun; Zhu, Jiyan

    2017-08-01

    Different higher education backgrounds in China and Germany led to challenges in the curriculum design at the beginning of our cooperative bachelor program in Optoelectronics Engineering. We see challenges in different subject requirements from both sides and in the German language requirements for Chinese students. The curriculum was optimized according to the ASIIN criteria, which makes it acceptable and understandable by both countries. German students are integrated into the Chinese class and get the same lectures like their Chinese colleagues. Intercultural and curriculum challenges are successfully solved. The results are summarized to provide an example for other similar international programs.

  20. Nutritional deficiencies in German middle-class male alcohol consumers: relation to dietary intake and severity of liver disease

    DEFF Research Database (Denmark)

    Bergheim, I.; Parlesak, Alexandr; Dierks, C.

    2003-01-01

    . SETTING: Southern Germany. SUBJECTS: Seventy-six hospitalized German middle-class alcohol consumers with different stages of alcoholic liver disease (ALD) and 22 healthy control subjects. METHODS: Subjects and controls were nutritionally assessed and mineral and vitamin content was measured in blood...... increase in carbohydrates (Pvitamin E, micronutrient intake of alcoholics was equal to that of controls; however, blood vitamin (vitamin C, retinol, lycopene, alpha- and gamma-carotene) and trace element (selenium, zinc) concentrations of alcohol-drinking patients were lower...

  1. Acquisition of German pluralization rules in monolingual and multilingual children

    Directory of Open Access Journals (Sweden)

    Eugen Zaretsky

    2013-10-01

    Full Text Available Existing studies on plural acquisition in German have relied on small samples and thus hardly deliver generalizable and differentiated results. Here, overgeneralizations of certain plural allomorphs and other tendencies in the acquisition of German plural markers are described on the basis of test data from 7,394 3- to 5-yearold monolingual German and bi/multilingual immigrant children tested with a modified, validated version of the Marburger Sprachscreening (MSS language test and 476 children tested with the SETK 3-5 language test. Classified correct and wrong answers to MSS and SETK 3-5 plural items were compared. The acquisition patterns of immigrants corresponded to those of younger German children. Both monolingual German and immigrant children demonstrated generally the same universal frequency and phonetically/phonologically based error patterns, irrespective of their linguistic background, but with different tendencies such as overgeneralization of -s by German children only.

  2. A German colony in Jutland: the evidence of Christian names

    DEFF Research Database (Denmark)

    Eggert, Birgit

    2013-01-01

    Denmark lost the war in 1848-50 against the German States, and Danish nationalism had arisen throughout the country. For this reason the descendants of the German immigrants had a need culturally or politically to show their Danish identity through the names about 20 years before the language......In 1760, invited by king Frederik V, immigrants came to Denmark from the southern parts of Germany. Uninhabited moorlands in Jutland needed to be cultivated and the German immigrants were offered a number of inducements to settle in Viborg County. Many of the German immigrants settled in a single...... parish, Frederik’s Parish. Here the German language was used for services in the parish church until 1856. Thereafter German and Danish services alternated, and from 1870 the church language was solely Danish. This investigation shows that in 1801, after about 40 years in Denmark, the immigrants...

  3. The German-Jewish soldier: from participant to victim.

    Science.gov (United States)

    Penslar, Derek

    2011-01-01

    The story of German-Jewish soldiers and veterans of World War I illustrates how, under circumstances of inclusion (even if incomplete) rather than vicious persecution, Jewish suffering in wartime, and with it the forms of collective memory and strategies for commemoration of the dead, could closely parallel, even intersect with, the suffering of Germans as a whole. To be sure, the points of intersection were accompanied by points of deflection. Even when Jews served, fought, suffered and died as German soldiers, their interpretations of the war experience, and their communities’ postwar memory and commemorative practices, differed from those of other Germans. In many ways, however, German-Jewish veterans suffered the aftermath of the war as did other Germans; they shared the prevailing fury over war guilt and reparations, and they retained a strong pride in their military service, a pride through which they interpreted the events of 1933–1945.

  4. Dictionary of radiological engineering. [English, French, and German]. Fachwoerterbuch der radiologischen Technik

    Energy Technology Data Exchange (ETDEWEB)

    Neuder, G F; Ullrich, H M

    1980-01-01

    In the present book an attempt has been made to record the current terminology in the field of radiological technology - for the present in the three languages English, German and French. It is hoped that this will contribute to a world-wide understanding amongst all those practising radiology. This is meant to include in a equal way radiologists in hospitals and private practice as well as those engaged in planning, developing, manufacturing or distributing radiological units. (orig.) 891 MG/orig. 892 MR.

  5. [History of Medical Mycology in the former German Democratic Republic].

    Science.gov (United States)

    Seebacher, C; Blaschke-Hellmessen, Renate; Kielstein, P

    2002-01-01

    After the Second World War the development of medical mycology in Germany had taken a very different course in the east and west parts depending on the political division. In this respect our contribution deals with the situation in the former German Democratic Republic. Efficient mycological centres were founded step by step almost in all medical universities on the basis of the mycological laboratories in dermatological hospitals competent for diagnostic work, but also for teaching and scientific research. In this context biologists were the main stay of mycology, they finally were integrated to the same degree in the universities like physicians. The effectiveness of the Gesellschaft für Medizinische Mykologie der DDR (GMM), its board of directors and its working groups as well as the topics of human and animal mycology during this period are described. Especially the merger of the GMM with the Deutschsprachige Mykologische Gesellschaft after the reunification of Germany without problems and the kind co-operation of Prof. Dr. Johannes Müller during this procedure are emphasized.

  6. GERMANISMS IN THE NORTH ČAKAVIAN DIALECT

    Directory of Open Access Journals (Sweden)

    Marija Turk

    2005-01-01

    Full Text Available This paper deals with Germanisms in some local idioms of the North Čakavian dialect. Phonological, morphological and word-formation variants of Germanisms are identified. Special attention is paid to the semantic fields and to the spatial, temporal, functional and stylistic stratification of the Germanisms, and to the degree to which they are recognized and used by speakers who belong to different generations.

  7. On the contrast between Germanic and Romance negated quantifiers

    OpenAIRE

    Robert Cirillo

    2009-01-01

    Universal quantifiers can be stranded in the manner described by Sportiche (1988), Giusti (1990) and Shlonsky (1991) in both the Romance and Germanic languages, but a negated universal quantifier can only be stranded in the Germanic languages. The goal of this paper is to show that this contrast between the Romance and the Germanic languages can be explained if one adapts the theory of sentential negation in Zeijlstra (2004) to constituent (quantifier) negation. According to Zeijlstra’s theor...

  8. Assessment of accident risks from german nuclear plants

    International Nuclear Information System (INIS)

    Heuser, F.W.

    1979-01-01

    The German risk study are presented. The main objectives can be summed up as follows: (a) An assessment of the societal risk due to accidents in nuclear power plants with reference to German conditions; (b) To get experience in the field of risk analysis and to provide a basis for estimation of uncertainties; (c) To provide guidance for future activities in the German Reactor Safety Research Program. Finally several conclusions reached by this study are discussed. (author)

  9. Optical Properties of Tm(3+) Ions in Alkali Germanate Glass

    Science.gov (United States)

    Walsh, Brian M.; Barnes, Norman P.; Reichle, Donald J.; Jiang, Shibin

    2006-01-01

    Tm-doped alkali germanate glass is investigated for use as a laser material. Spectroscopic investigations of bulk Tm-doped germanate glass are reported for the absorption, emission and luminescence decay. Tm:germanate shows promise as a fiber laser when pumped with 0.792 m diodes because of low phonon energies. Spectroscopic analysis indicates low nonradiative quenching and pulsed laser performance studies confirm this prediction by showing a quantum efficiency of 1.69.

  10. Sibling Rivalry in Educational Attainment: The German Case

    OpenAIRE

    Ira N. Gang; Thomas Bauer

    2000-01-01

    Recent studies exploring sibling rivalry in the allocation of household resources in the U.S. produce conflicting results. We contribute to this discussion by addressing the role of sibling rivalry in educational attainment in Germany. Using the German Socioeconomic Panel (GSOEP) we are able to distinguish how the effects of sibling rivalry vary by cultural affiliation, i.e., among families of West German, East German and foreign origin. We also point out and correct for a reference group pro...

  11. The Contemporary System of German Economic Diplomacy

    Directory of Open Access Journals (Sweden)

    Roman O. Raynkhardt

    2015-01-01

    Full Text Available The article deals with the description and analysis of functioning of the German national system of economic diplomacy. The author provides a brief summary of historical and economic background, stages and conditions of its development from the 1950-s to present time. He casts light upon the procedures and mechanisms of interaction between the key national economic-diplomatic agents i.e. ministries, agencies, other authorized bodies, public and private institutes outlining their usage of concrete economic, administrative and legal instruments in the course of respective policy measures. The author looks into the distinctive features which encompass the essence of the model: a two-level system with three pillars: foreign representations of the MFA, Germany Trade and Investment Agency, chambers of commerce. The above elements do not overlap each other's functions, but complement them; their functioning is based upon interministeriality and the single window concept. A special focus is made on the practice of economic-diplomatic agents, especially chambers of commerce, using private public partnership instruments. In general, notwithstanding recurring negative trends of the domestic and global business climate (oil crisis in the 1970-s, recession of the late 2000s - early 2010s the German economy demonstrated of high resistibility to exogenous shocks compared to other economies and according to the absolute values of its macroeconomic indicators. Alongside other economic and noneconomic factors this stability can to a certain extent be explained by an efficient system of economic diplomacy. Established in the 1970s it keeps on evolving in order to stand up to new challenges. At any stage of the business cycle it constitutes a pillar of the German economy and, ultimately, of the economy of the European Union.

  12. Epidemiology of Extended-Spectrum β-Lactamase-Producing E. coli and Vancomycin-Resistant Enterococci in the Northern Dutch-German Cross-Border Region.

    Science.gov (United States)

    Zhou, Xuewei; García-Cobos, Silvia; Ruijs, Gijs J H M; Kampinga, Greetje A; Arends, Jan P; Borst, Dirk M; Möller, Lieke V; Holman, Nicole D; Schuurs, Theo A; Bruijnesteijn van Coppenraet, Lesla E; Weel, Jan F; van Zeijl, Jan H; Köck, Robin; Rossen, John W A; Friedrich, Alexander W

    2017-01-01

    Objectives: To reveal the prevalence and epidemiology of extended-spectrum β-lactamase (ESBL)- and/or plasmid AmpC (pAmpC)- and carbapenemase (CP) producing Enterobacteriaceae and vancomycin-resistant enterococci (VRE) across the Northern Dutch-German border region. Methods: A point-prevalence study on ESBL/pAmpC/CP producing Enterobacteriaceae and VRE was carried out in hospitalized patients in the Northern Netherlands ( n = 445, 2012-2013) and Germany ( n = 242, 2012). Healthy individuals from the Dutch community ( n = 400, 2010-2012) were also screened. In addition, a genome-wide gene-by-gene approach was applied to study the epidemiology of ESBL- Escherichia coli and VRE. Results: A total of 34 isolates from 27 patients (6.1%) admitted to Dutch hospitals were ESBL/pAmpC positive and 29 ESBL- E. coli , three pAmpC- E. coli , one ESBL- Enterobacter cloacae , and one pAmpC- Proteus mirabilis were found. In the German hospital, 18 isolates (16 E. coli and 2 Klebsiella pneumoniae ) from 17 patients (7.7%) were ESBL positive. In isolates from the hospitalized patients CTX-M-15 was the most frequently detected ESBL-gene. In the Dutch community, 11 individuals (2.75%) were ESBL/pAmpC positive: 10 ESBL - E. coli (CTX-M-1 being the most prevalent gene) and one pAmpC E. coli . Six Dutch (1.3%) and four German (3.9%) hospitalized patients were colonized with VRE. Genetic relatedness by core genome multi-locus sequence typing (cgMLST) was found between two ESBL- E. coli isolates from Dutch and German cross-border hospitals and between VRE isolates from different hospitals within the same region. Conclusion: The prevalence of ESBL/pAmpC- Enterobacteriaceae was similar in hospitalized patients across the Dutch-German border region, whereas VRE prevalence was slightly higher on the German side. The overall prevalence of the studied pathogens was lower in the community than in hospitals in the Northern Netherlands. Cross-border transmission of ESBL- E. coli and VRE seems

  13. Epidemiology of Extended-Spectrum β-Lactamase-Producing E. coli and Vancomycin-Resistant Enterococci in the Northern Dutch–German Cross-Border Region

    Directory of Open Access Journals (Sweden)

    Xuewei Zhou

    2017-10-01

    Full Text Available Objectives: To reveal the prevalence and epidemiology of extended-spectrum β-lactamase (ESBL- and/or plasmid AmpC (pAmpC- and carbapenemase (CP producing Enterobacteriaceae and vancomycin-resistant enterococci (VRE across the Northern Dutch–German border region.Methods: A point-prevalence study on ESBL/pAmpC/CP producing Enterobacteriaceae and VRE was carried out in hospitalized patients in the Northern Netherlands (n = 445, 2012–2013 and Germany (n = 242, 2012. Healthy individuals from the Dutch community (n = 400, 2010–2012 were also screened. In addition, a genome-wide gene-by-gene approach was applied to study the epidemiology of ESBL-Escherichia coli and VRE.Results: A total of 34 isolates from 27 patients (6.1% admitted to Dutch hospitals were ESBL/pAmpC positive and 29 ESBL-E. coli, three pAmpC-E. coli, one ESBL-Enterobacter cloacae, and one pAmpC-Proteus mirabilis were found. In the German hospital, 18 isolates (16 E. coli and 2 Klebsiella pneumoniae from 17 patients (7.7% were ESBL positive. In isolates from the hospitalized patients CTX-M-15 was the most frequently detected ESBL-gene. In the Dutch community, 11 individuals (2.75% were ESBL/pAmpC positive: 10 ESBL-E. coli (CTX-M-1 being the most prevalent gene and one pAmpC E. coli. Six Dutch (1.3% and four German (3.9% hospitalized patients were colonized with VRE. Genetic relatedness by core genome multi-locus sequence typing (cgMLST was found between two ESBL-E. coli isolates from Dutch and German cross-border hospitals and between VRE isolates from different hospitals within the same region.Conclusion: The prevalence of ESBL/pAmpC-Enterobacteriaceae was similar in hospitalized patients across the Dutch–German border region, whereas VRE prevalence was slightly higher on the German side. The overall prevalence of the studied pathogens was lower in the community than in hospitals in the Northern Netherlands. Cross-border transmission of ESBL-E. coli and VRE seems unlikely

  14. [Consistency and Reliability of MDK Expertise Examining the Encoding in the German DRG System].

    Science.gov (United States)

    Gaertner, T; Lehr, F; Blum, B; van Essen, J

    2015-09-01

    Hospital inpatient stays are reimbursed on the basis of German diagnosis-related groups (G-DRG). The G-DRG classification system is based on complex coding guidelines. The Medical Review Board of the Statutory Health Insurance Funds (MDK) examines the encoding by hospitals and delivers individual expertises on behalf of the German statutory health insurance companies in cases in which irregularities are suspected. A study was conducted on the inter-rater reliability of the MDK expertises regarding the scope of the assessment. A representative sample of 212 MDK expertises was taken from a selected pool of 1 392 MDK expertises in May 2013. This representative sample underwent a double-examination by 2 independent MDK experts using a special software based on the 3MTM G-DRG Grouper 2013 of 3M Medica, Germany. The following items encoded by the hospitals were examined: DRG, principal diagnosis, secondary diagnoses, procedures and additional payments. It was analysed whether the results of MDK expertises were consistent, reliable and correct. 202 expertises were eligible for evaluation, containing a total of 254 questions regarding one or more of the 5 items encoded by hospitals. The double-examination by 2 independent MDK experts showed matching results in 187 questions (73.6%) meaning they had been examined consistently and correctly. 59 questions (23.2%) did not show matching results, nevertheless they had been examined correctly regarding the scope of the assessment. None of the principal diagnoses was significantly affected by inconsistent or wrong judgment. A representative sample of MDK expertises examining the DRG encoding by hospitals showed a very high percentage of correct examination by the MDK experts. Identical MDK expertises cannot be achieved in all cases due to the scope of the assessment. Further improvement and simplification of codes and coding guidelines are required to reduce the scope of assessment with regard to correct DRG encoding and its

  15. Career intentions of female surgeons in German liver transplant centers considering family and lifestyle priorities.

    Science.gov (United States)

    Radunz, Sonia; Hoyer, Dieter P; Kaiser, Gernot M; Paul, Andreas; Schulze, Maren

    2017-02-01

    Women represent up to 60 % of students entering the medical profession in many countries in the world. However, the proportion of women to men is not accordingly balanced among surgical residents and especially in leadership positions in surgery. Therefore, we investigated the career goals as well as family and lifestyle priorities of female surgeons in German liver transplant centers. A standardized questionnaire was developed using the web-based survey tool SurveyMonkey®. Questionnaires were distributed electronically to 180 female surgeons in 24 German liver transplant centers. A total of 81 completed questionnaires were analyzed. Female surgeons in German liver transplant centers are eager to assume leadership positions and do not wish to follow traditional role models. After finishing training, most female surgeons plan to continue working at a university hospital. About 80 % of the respondents intend to continue working full time and wish to combine career and family. This is the first survey on career intentions of female surgeons in Germany. In the face of gender changes in the medical profession, we were able to demonstrate that female surgeons are willing to fill leadership positions. Individual and institutional creative modifications are necessary if the advancement of women in surgery is to be promoted.

  16. Neurogenetic evidence in the courtroom: a randomised controlled trial with German judges.

    Science.gov (United States)

    Fuss, Johannes; Dressing, Harald; Briken, Peer

    2015-11-01

    Prominent court decisions and recent research suggest that introduction of neurogenetic evidence, for example, monoamine oxidase A alleles, may reduce the sentence of convicted psychopaths. Here, we are aiming to demonstrate that judges' response to neurogenetic evidence is highly influenced by the legal system in which they operate. Participating German judges (n=372) received a hypothetical case vignette of aggravated battery, and were randomly assigned to expert testimonies that either involved a neurogenetic explanation of the offender's psychopathy or only a psychiatric diagnosis of psychopathy. Testimonies were presented either by the prosecution or defence. Neurogenetic evidence significantly reduced judges' estimation of legal responsibility of the convict. Nevertheless, the average prison sentence was not affected in the German legal system. Most interestingly, analysis of judges' reasoning revealed that neurogenetic arguments presented by the prosecution significantly increased the number of judges (23% compared with ∼ 6%) ordering an involuntary commitment in a forensic psychiatric hospital. Such an involuntary commitment due to diminished or absent legal responsibility may last much longer than a prison sentence in the German legal system. Our data, thus, demonstrate the socially contingent nature of legal responses to neurogenetic evidence in criminal cases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Evaluation of Five Local Formulated Insecticides against German Cockroach (Blattella germanica L. in Southern Iran

    Directory of Open Access Journals (Sweden)

    M Shahi

    2008-06-01

    Full Text Available Background: The German cockroach, Blattella germanica L., is a serious household and public health pest worldwide. Con­trol of this species has been very difficult to achieve. Toxicity of cypermethrin EC10%, deltamethrin EC5%, diazi­non EC0.5%, lambda-cyhalothrin EC5% and Negon® (permethrin+propoxur oil liquid1% commercial for­mula­tions were investigated against adult males of German cockroaches collected from four hospitals of Bandar Abbas City, southern Iran, during 2006. These insecticides have been used for cockroach con­trol in this city.Methods: The tests were carried out only on males by the glass jar contact method recommended by the WHO.Results: Maximum mortality rates of 20, 35, 90, and 100% were obtained after one hour contact to label-recom­mended doses of cypermethrin, deltamethrin, lambad-cyhalothrin, diazinon and permethrin+propoxur insecti­cides, respectively. KT50 results were different from 5.68 min for permethrin+propoxur mixture to 240.37 min for cyper­methrin. German cockroach showed < 80 per cent mortality using three pyrethroid insecticides.Conclusion: It seems that the label-recommended concentrations of these insecticides were wrong and lower than WHO advised for cockroach control. For monitoring of resistance it is recommended to do more tests using the pure ac­tive ingredient of these insecticides.

  18. [Meeting the needs of the European working time directive in german medical profession].

    Science.gov (United States)

    Friedrich, M; Popov, A F; Schmitto, J D; Bireta, C; Emmert, A; Tirilomis, T

    2011-06-01

    The legal obligation of the European Working Time Directive with its implementation into a German Working Hours Act requires German hospitals to give up old structures and requires the implementation of new working time models. The failure of the revision of the European Working Time Directive in April 2009 prevented that any changes of status quo might happen in the near future. Fundamental terms of the working law for the medical area have been elucidated and have been implemented into concrete calculation formulas. The planned working time has been clearly determined. Particularly, on-call duties and a signed "OptOut-declaration" have huge effects on the upper limit of the working time that is to be determined. Shift duty leads to the greatest limitations of the upper limit of the working time. The Working Hours Act defines the maximal, available, individual working time budget and thus the working time budget of a hospital and it limits the maximal availability of the service providers of a hospital as well as defining the maximal personnel costs. Transparency in this area lays the foundation for an effective time management and the creation of new working time models in accordance with the European Working Time Directive as well as the Working Hours Act and the "TVÄ" (labour contract for doctors at municipal hospitals). It is possible, with the knowledge of the maximal working time budget and the thereof resulting personnel costs, to calculate the economical revenues better. The reallocation of the working time of doctors enables efficiency enhancement. It is necessary to demand a clear definition of the tasks of doctors with the consequential discharge of tasks that should not/do not belong to the responsibilities of a doctor. This would lead to a more attractive working environment for doctors at hospitals and thus to an improvement of the care of the patients. The implementation of the European Time Directive is not to be seen as unrealizable, as has been

  19. A simple route to synthesize manganese germanate nanorods

    International Nuclear Information System (INIS)

    Pei, L.Z.; Yang, Y.; Yuan, C.Z.; Duan Taike; Zhang Qianfeng

    2011-01-01

    Manganese germanate nanorods have been synthesized by a simple route using germanium dioxide and manganese acetate as the source materials. X-ray diffraction observation shows that the nanorods are composed of orthorhombic and monoclinic manganese germanate phases. Scanning electron microscopy and transmission electron microscopy observations display that the manganese germanate nanorods have flat tips with the length of longer than 10 micrometers and diameter of 60-350 nm, respectively. The role of the growth conditions on the formation of the manganese germanate nanorods shows that the proper selection and combination of the growth conditions are the key factor for controlling the formation of the manganese germanate nanorods. The photoluminescence spectrum of the manganese germanate nanorods exhibits four fluorescence emission peaks centered at 422 nm, 472 nm, 487 nm and 530 nm showing the application potential for the optical devices. - Research Highlights: → Manganese germanate nanorods have been synthesized by simple hydrothermal process. → The formation of manganese germanate nanorods can be controlled by growth conditions. → Manganese germanate nanorods exhibit good PL emission ability for optical device.

  20. Availability Improvement of German Nuclear Power Plants

    International Nuclear Information System (INIS)

    Wilhelm, Oliver

    2008-01-01

    High availability is important for the safety and economical performance of Nuclear Power Plants (NPP). The strategy for availability improvement in a typical German PWR shall be discussed here. Key parameters for strategy development are plant design, availability of safety systems, component reliability, preventive maintenance and outage organization. Plant design, availability of safety systems and component reliability are to a greater extent given parameters that can hardly be influenced after the construction of the plant. But they set the frame for maintenance and outage organisation which have shown to have a large influence on the availability of the plant. (author)

  1. [Poet-physicians in German literature].

    Science.gov (United States)

    Perels, C

    1991-12-17

    Starting with standards arising from the relationship between medicine and art in classical antiquity, biblical tradition and teutonic-pagan antiquity, this article roams through german literature from the Middle Ages up to the 20th century, from Hildegard of Bingen to Gottfried Benn and Alfred Döblin, guided by the question, how strongly medical knowledge and medical practise are reflected in the poetry of writing physicians. Individual dispositions and epoque-specific features are discussed. Special attention is given to Paul Fleming and Angelus Silesius, Albrecht von Haller and Friedrich Schiller, romanticism and Georg Büchner.

  2. Radiation exposure in German nuclear power plants

    International Nuclear Information System (INIS)

    Mueller, W.

    1981-01-01

    The individual and collective doses in German nuclear power stations have decreased remarkably since the beginning of the commercial nuclear power production. The paper discusses the influencing factors, that have caused this development and points out areas where improvements are possible in the future. Moreover the interaction between radiation protection practice and the relevant legal regulations is considered. Usually the recording of job related doses is regarded as the most direct access to possible improvements. Concluding, it is therefore demonstrated by some examples how the evaluation of such information has taken effect in practice. (orig.) [de

  3. Heisenberg and the German atomic project

    International Nuclear Information System (INIS)

    Hermann, A.

    1988-01-01

    The discovery of nuclear fusion 50 years ago, man's entry into the new atomic age, occurred in a fateful era, marked by the Munich Agreement shortly before and the outbreak of World War II shortly afterwards. Werner Heisenberg, Germany's Number One Physicist, was, on the one hand, respected as a competent and 'useful' theoretician, but on the other, was reviled as a 'white Jew, the spirit of Einstein's spirit'. He plays a key role in answering the question of whether research at that time could have resulted in a German atomic bomb. (orig.) [de

  4. Germans don’t make Jokes?

    DEFF Research Database (Denmark)

    Gravier, Magali

    This paper presents early results of a study on the uses of humour by members of the European Parliament. The paper is based on semi-structured interviews done with French, German and Romanian MEPS. The interviews reveal how humour is used by MEPS as well the constraints the interviewees perceive...... develop political strategies which are adapted to the particularities of the political and institutional game at play in an atypical parliament like the EP. On the other hand, they reveal cultural and language borders between MEPs who may have a harder time than expected evolving in a multicultural...

  5. Fifth French-German Conference on Optimization

    CERN Document Server

    1989-01-01

    The 2-yearly French-German Conferences on Optimization review the state-of-the-art and the trends in the field. The proceedings of the Fifth Conference include papers on projective methods in linear programming (special session at the conference), nonsmooth optimization, two-level optimization, multiobjective optimization, partial inverse method, variational convergence, Newton type algorithms and flows and on practical applications of optimization. A. Ioffe and J.-Ph. Vial have contributed survey papers on, respectively second order optimality conditions and projective methods in linear programming.

  6. German-Egyptian seminar on environmental research

    International Nuclear Information System (INIS)

    Aly, H.F.; Nentwich, D.

    1994-01-01

    Industrial development and scientific advancement have opened new frontiers of interest and challenges. Anthropogenic activities are increasingly upsetting the natural environmental balance and are at the same time shifting from local impact to global importance. Science is confronted with the challenge to answer the question of what are the consequences of anthropogenic changes to the environment and to help politics formulate countermeasures for the sake of a sustainable future. Protect results achieved within the Egyptian-German cooperation were presented to the scientific community and to the interested public and discussions on future lines of actions took place. (orig./KW)

  7. The German Environmentalist Party - The Greens

    International Nuclear Information System (INIS)

    Mettke, J.R.

    1982-01-01

    The Greens are winning supporters throughout the FRG, quite a few of them are already members of the parliament of various lands. Will they cooperate with the established political parties in Bonn. Will they take over from the Free Democrats the role of holding the balance of power. In this book, Spiegel editors present their analyses of the changing concepts of the new political movement. The most outstanding members of the Environmentalist Party - the so-called Greens - define their position and state their opinions on the problems of coalition forming, and prominent members of the parties of the German Bundestag answer these statements. (orig.) [de

  8. The German energy landscape in 2015

    International Nuclear Information System (INIS)

    Lauer, Hartmut

    2016-01-01

    This article proposes a brief overview of the German energy sector: stagnation of primary energy consumption, shares of the different energy sources (renewable, coal, lignite, oil, gas, nuclear), shares of the different electric power production sources and their recent evolution. It evokes issues related to the objectives defined for energy transition, the high level of renewable energy production and the high level of power exports. It outlines that consumption must be reduced to reach the objectives defined for 2020. It notices a stagnation of the energy system de-carbonation, and comments the evolution of electricity prices

  9. Energy report of the Federal German Government

    International Nuclear Information System (INIS)

    1986-01-01

    In its governmental declaration of May 4th, 1983, the Federal German Government has pointed out how it will safeguard the continuous, economical, and non-polluting supply of energy to the Federal Republic of Germany. By that report the Federal Government strikes a balance of its policy and defines its position with regard to topical questions, especially the peaceful use of nuclear energy. The report comprises four chapters: 1. peaceful use of nuclear energy in the Federal Republic of Germany, 2. Summary statement on energy policy, 3. Current situation in the energy market and long-term perspectives, 4. Points of main emphasis of future energy policy. (orig./UA) [de

  10. German contributions to the CMS computing infrastructure

    International Nuclear Information System (INIS)

    Scheurer, A

    2010-01-01

    The CMS computing model anticipates various hierarchically linked tier centres to counter the challenges provided by the enormous amounts of data which will be collected by the CMS detector at the Large Hadron Collider, LHC, at CERN. During the past years, various computing exercises were performed to test the readiness of the computing infrastructure, the Grid middleware and the experiment's software for the startup of the LHC which took place in September 2008. In Germany, several tier sites are set up to allow for an efficient and reliable way to simulate possible physics processes as well as to reprocess, analyse and interpret the numerous stored collision events of the experiment. It will be shown that the German computing sites played an important role during the experiment's preparation phase and during data-taking of CMS and, therefore, scientific groups in Germany will be ready to compete for discoveries in this new era of particle physics. This presentation focuses on the German Tier-1 centre GridKa, located at Forschungszentrum Karlsruhe, the German CMS Tier-2 federation DESY/RWTH with installations at the University of Aachen and the research centre DESY. In addition, various local computing resources in Aachen, Hamburg and Karlsruhe are briefly introduced as well. It will be shown that an excellent cooperation between the different German institutions and physicists led to well established computing sites which cover all parts of the CMS computing model. Therefore, the following topics are discussed and the achieved goals and the gained knowledge are depicted: data management and distribution among the different tier sites, Grid-based Monte Carlo production at the Tier-2 as well as Grid-based and locally submitted inhomogeneous user analyses at the Tier-3s. Another important task is to ensure a proper and reliable operation 24 hours a day, especially during the time of data-taking. For this purpose, the meta-monitoring tool 'HappyFace', which was

  11. Ageing management in German nuclear power plants

    International Nuclear Information System (INIS)

    Becker, D.E.; Reiner, M.

    1998-01-01

    In Germany, the term 'ageing management' comprises several aspects. A demand for a special ageing monitoring programme is not explicitly contained in the regulations. However, from the Atomic Energy Act and its regulations results the operator's obligation to perform extensive measures to maintain the quality of the plant and the operating personnel working in the plant. From this point of view, comprehensive ageing management in German nuclear power plants has taken place right from the start under the generic term of quality assurance. (author)

  12. German radionuclide exports and imports 1990

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    The statistics compiled by the German Federal Office for Trade and Industry (Bundesamt fuer Wirtschaft) for the Federal Ministry for the Environment, Conservation of Nature, and Reactor Protection of imports and exports of radionuclides, irradiation samples and sealed emitters above 1850 GBq show a slight decline by 11.8%, on the basis of activity, in imports and a somewhat higher rise by 21.6% in exports in 1990. Imports returned to the level of 1988 after having experienced an extraordinary rise in 1989. Exports were slightly better than in the previous year, but still considerably below the average of the past five years. (orig.) [de

  13. Skin care practice in German nursing homes: a German-wide cross-sectional study.

    Science.gov (United States)

    Kottner, Jan; Rahn, Yasmin; Blume-Peytavi, Ulrike; Lahmann, Nils

    2013-04-01

    Due to anatomical and physiological changes in the course of aging and due to increased vulnerability, there are special skin care needs in elderly and care-dependent persons. Little is known about skin care practice in German long-term care facilities. The aim of the study was to gather epidemiological data about skin care practice in German nursing homes. In spring 2012 a German-wide cross sectional study was conducted in 47 nursing homes. Based on standardized data collection sheets. demographics and variables about methods and frequencies of skin cleansing and application of skin care products for 3 552 nursing home residents were collected and analyzed. The variables age, gender and level of care dependency was representative for the group of all German nursing home residents. More than 90% of investigated nursing home residents required skin care assistance. Washing body parts or the whole body were conducted most frequently (89.1%, 95% CI 88.0- 90.1). Skin care leave-on products were used in 91.7% (95% CI 90.7-92.6), whereas there were large variations between individuals. In total, more than 100 brands were used. Skin care practice in multimorbid care dependent persons shows large variations. How skin care products meet the special requirements of aged skin and whether they enhance the skin barrier function and prevent cuteneous skin damage is unknown. © The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.

  14. Germans or Jews? German-Speaking Jews in Post-War Europe: An Introduction

    Czech Academy of Sciences Publication Activity Database

    Čapková, Kateřina; Rechter, D.

    2017-01-01

    Roč. 62, November (2017), s. 69-74 ISSN 0075-8744 Institutional support: RVO:68378114 Keywords : Jews * Germans * post- war period Subject RIV: AB - History OBOR OECD: History (history of science and technology to be 6.3, history of specific sciences to be under the respective headings) https://academic.oup.com/leobaeck/issue/volume/62?browseBy=volume

  15. [Competition between hospitals--from a legal perspective].

    Science.gov (United States)

    Bohle, Thomas

    2009-01-01

    Competition between hospitals exists in many different fields. In legal terms this competition is shaped by disputes over the status of "hospitals forming part of the Hospital Plan" (Plankrankenhaus). The German Federal Constitutional Court's ruling of January 14, 2004 granted hospital authorities the right of action for unfair competition. According to the Federal Administrative Court's ruling of September 25, 2008, however, third-party protection is limited to cases where the hospital filing the suit has itself unsuccessfully applied for inclusion in the state-level hospitals plan for the market segment served by the accepted hospital. In contrast, action that merely challenges an unfair preference of a competitor will remain inadmissible. Third-party protection between hospitals is also under way in the field of "Integrated Healthcare" (Integrierte Versorgung) (Sect. 140a et seqq. Book V of the German Social Security Code-SGB V): in the case of ECJ C-300/07 on December 16, 2008 (Oymanns/AOK Rheinland & Hamburg) the Advocate General in his final submissions not only expressed the opinion that the statutory health insurance funds are contract-placing authorities, but also argued that integration contracts are public orders. If the European Court of Justice (ECJ) takes the Advocate General's view, future integration contracts will become subject to the regulations governing public orders and thus also subject to the relevant verification procedure.

  16. Academic Hospitality

    Science.gov (United States)

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  17. [Commentary by the German Society for Thoracic and Cardiovascular Surgery on the positions statement by the German Cardiology Society on quality criteria for transcatheter aortic valve implantation (TAVI)].

    Science.gov (United States)

    Cremer, Jochen; Heinemann, Markus K; Mohr, Friedrich Wilhelm; Diegeler, Anno; Beyersdorf, Friedhelm; Niehaus, Heidi; Ensminger, Stephan; Schlensak, Christian; Reichenspurner, Hermann; Rastan, Ardawan; Trummer, Georg; Walther, Thomas; Lange, Rüdiger; Falk, Volkmar; Beckmann, Andreas; Welz, Armin

    2014-12-01

    Surgical aortic valve replacement is still considered the first-line treatment for patients suffering from severe aortic valve stenosis. In recent years, transcatheter aortic valve implantation (TAVI) has emerged as an alternative for selected high-risk patients. According to the latest results of the German external quality assurance program, mandatory by law, the initially very high mortality and procedural morbidity have now decreased to approximately 6 and 12%, respectively. Especially in Germany, the number of patients treated by TAVI has increased exponentially. In 2013, a total of 10.602 TAVI procedures were performed. TAVI is claimed to be minimally invasive. This is true concerning the access, but it does not describe the genuine complexity of the procedure, defined by the close neighborhood of the aortic valve to delicate intracardiac structures. Hence, significant numbers of life-threatening complications may occur and have been reported. Owing to the complexity of TAVI, there is a unanimous concordance between cardiologists and cardiac surgeons in the Western world demanding a close heart team approach for patient selection, intervention, handling of complications, and pre- as well as postprocedural care, respectively. The prerequisite is that TAVI should not be performed in centers with no cardiac surgery on site. This is emphasized in all international joint guidelines and expert consensus statements. Today, a small number of patients undergo TAVI procedures in German hospitals without a department of cardiac surgery on site. To be noted, most of these hospitals perform less than 20 cases per year. Recently, the German Cardiac Society (DGK) published a position paper supporting this practice pattern. Contrary to this statement and concerned about the safety of patients treated this way, the German Society for Thoracic and Cardiovascular Surgery (DGTHG) still fully endorses the European (ESC/EACTS) and other actual international guidelines and

  18. The German-German history of the nuclear power plant Greifswald. Nuclear power between east and west. 2. ed.

    International Nuclear Information System (INIS)

    Hoegselius, Per

    2015-01-01

    The historical study covers the chapters The nuclear power plant Greifswald; Lubmin shortly before the ''Wende'' 1989; the German ''Wende''; from the last vote for the ''Volkskammer (parliament of the German Democratic Republic) to the German reunification; Lubmin in reunified Germany; conclusions and perspectives. In the attachment technical data about the reactors WWER-440/W-230 are summarized, including a list of WWERs in the former eastern bloc countries.

  19. Control beliefs and health locus of control in Ugandan, German and migrated sub-Saharan African HIV infected individuals.

    Science.gov (United States)

    Milz, Ruth U; Husstedt, Ingo-W; Reichelt, Doris; Evers, Stefan

    2016-04-01

    Little is known about the influence of control beliefs on antiretroviral drug adherence in patients who migrated from sub-Saharan Africa to Europe. The aim of this study was to explore the differences in health locus of control and control beliefs between HIV infected patients from sub-Saharan Africa with and without a lifetime experience of migration. A sample of 62 HIV infected consecutive patients referred to the HIV clinics at the University Hospital of Münster (Germany) and at the Rubaga Hospital Kampala (Uganda) were enrolled into this study. We compared three groups of patients: sub-Saharan African migrants, German patients, and local Ugandan patients. We used the German health and illness related control beliefs questionnaire (KKG), the Competence and control beliefs questionnaire (FKK), and the Powe Fatalism Inventory-HIV/AIDS-Version (PFI-HIV/AIDS-Version) and translated these scales into English and Luganda. In addition, the patients' sociodemographic, acculturation, clinical, and immunological data were registered. Significant results were shown in HIV related external locus of control between migrated sub-Saharan African and local Ugandan patients compared to German patients. General control beliefs showed no significant differences. In the PFI-HIV-Version, there was a significant difference between migrated sub-Saharan African and Ugandan patients compared to German patients. Our data suggest that the experience of migration does not influence the locus of control. Compared to German HIV patients, African patients in general showed a significantly higher external health locus of control which might have implications for drug adherence. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Hospitality and hostility in hospitals

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Aanestad, Margunn

    2007-01-01

    The purpose of this paper is to discuss the adoption of healthcare information systems (HIS) from a user perspective. Our case study concerns how a group of orthopaedic surgeons experienced and reacted to the adoption and mandatory use of an Electronic Patient Record system in a Danish hospital. We...... propose to use the concepts of hospitality and hostility to turn our attention to the interaction between the host (the surgeons) and the guest (the information system) and consider how the boundaries between them evolved in the everyday work practices. As an alternative to previous studies on technology...

  1. German concept and status of the disposal of spent fuel elements from German research reactors

    International Nuclear Information System (INIS)

    Komorowski, K.; Storch, S.; Thamm, G.

    1995-01-01

    Eight research reactors with a power ≥ 100 kW are currently being operated in the Federal Republic of Germany. These comprise three TRIGA-type reactors (power 100 kW to 250 kW), four swimming-pool reactors (power 1 MW to 10 MW) and one DIDO type reactor (power 23 MW). The German research reactors are used for neutron scattering for basic research in the field of solid state research, neutron metrology, for the fabrication of isotopes and for neutron activation analysis for medicine and biology, for investigating the influence of radiation on materials and for nuclear fuel behavior. It will be vital to continue current investigations in the future. Further operation of the German research reactors is therefore indispensable. Safe, regular disposal of the irradiated fuel elements arising now and in future operation is of primary importance. Furthermore, there are several plants with considerable quantities of spent fuel, the safe disposal of which is a matter of urgency. These include above all the VKTA facilities in Rossendorf and also the TRIGA reactors, where disposal will only be necessary upon decommissioning. The present paper report is concerned with the disposal of fuel from the German research reactors. It briefly deals with the situation in the USA since the end of 1988, describes interim solutions for current disposal requirements and then mainly concentrates on the German disposal concept currently being prepared. This concept initially envisages the long-term (25--50 years) dry interim storage of fuel elements in special containers in a central German interim store with subsequent direct final disposal without reprocessing of the irradiated fuel

  2. [Hospital financing in 2016. Relevant changes for rheumatology].

    Science.gov (United States)

    Fiori, W; Bunzemeier, H; Lakomek, H-J; Buscham, K; Lehmann, H; Fuchs, A-K; Bessler, F; Roeder, N

    2016-03-01

    Hospital financing 2016 will be influenced by the prospects of the approaching considerable changes. It is assumed that the following years will lead to a considerable reallocation of financial resources between hospitals. While not directly targeted by new regulations, reallocations always also affect specialties like rheumatology. Compared to the alterations in the legislative framework the financial effects of the yearly adaptation of the German diagnosis-related groups system are subordinate. Only by comprehensive consideration of current and expected changes a forward-looking and sustainable strategy can be developed. The following article presents the relevant changes and discusses the consequences for hospitals specialized in rheumatology.

  3. Hospital innovation portfolios: Key determinants of size and innovativeness

    DEFF Research Database (Denmark)

    Schultz, Carsten; Zippel-Schultz, Bettina; Salomo, Søren

    2012-01-01

    and reward systems) organizational mechanisms. Methodology: To develop hypotheses, we integrated the innovation management literature into the hospital context. Detailed information about the innovation portfolio of 87 German hospitals was generated and combined with multirespondent survey data using ratings....... Reward systems did not have direct effects on the composition of innovation portfolios. However, they adjusted bottom-up employee and top-down strategic initiatives to match with the existing organization, thereby decreasing the degree of innovativeness and enforcing exploitation. Practice Implications......: Hospitals should intertwine employee encouragement, analytical approaches, and formal reward systems depending on organizational goals....

  4. Evolution of the German energy policy

    International Nuclear Information System (INIS)

    Audigier, Pierre

    2013-01-01

    The author first recalls the main events and decisions regarding the German policy from 1998 to 2011, and notably the decisions related to nuclear energy. He gives the main data of the German energy system (production capacity, production of the different primary sources) and indicates the main characteristics and assumptions of the 2011 turnaround (decision of shutting down 17 nuclear plants by 2022, objectives in terms of renewable energy production and share, of electricity consumption, and of greenhouse gas emission). The author then presents how the law on renewable energies (EEG) operates, indicates energy prices in Germany for individuals and industries and CO 2 emissions per electric sector, and compares them with the French ones. He outlines the need of construction of new energy transport lines, and identifies and comments other implications of the intermittent character of renewable energies in terms of electricity market organisation, of construction of combustion-based thermal plants, and of flexibility requirements. He discusses successes and difficulties of this evolution of energy policy, and the implication of this new policy for the European Union and for border countries

  5. Impulsiveness and venturesomeness in German smokers.

    Science.gov (United States)

    Bernow, Nina; Kruck, Bernadette; Pfeifer, Philippe; Lieb, Klaus; Tüscher, Oliver; Fehr, Christoph

    2011-08-01

    Cigarette smoking is a behavior, which is influenced by genetic, demographic, and psychological factors. A large body of research has examined the association of cigarette smoking variables with individual differences in personality traits. The aim of the current study was to replicate the findings of higher self-reported impulsivity in smokers compared with never-smokers in a German sample using Eysenck´s construct of impulsivity. Furthermore, it was intended to further the knowledge about associations between different self-reported impulsivity components and different smoking variables. We used the Impulsiveness-Venturesomeness-Empathy questionnaire (I7) to measure self-reported impulsiveness and venturesomeness and the Temperament and Character Inventory (TCI) to measure novelty seeking (NS) in a sample of 82 nicotine-dependent smokers and 119 never-smokers. Smokers scored higher on impulsiveness, venturesomeness, and NS than never-smokers independent of age, gender, and years of education. We found a significant association between venturesomeness, impulsiveness and smoking status in daily smokers. In summary, this study provides evidence that impulsiveness and venturesomeness as well as the novelty-seeking subscale extravagance are significantly associated with smoking status in a German sample of female and male smokers compared with never-smokers.

  6. Apitherapy: Usage and Experience in German Beekeepers

    Directory of Open Access Journals (Sweden)

    Markus Hellner

    2008-01-01

    Full Text Available This study aimed to investigate the practice of apitherapy - using bee products such as honey, pollen, propolis, royal jelly and bee venom to prevent or treat illness and promote healing - among German beekeepers and to evaluate their experiences with these therapies. A questionnaire incorporating two instruments on beekeepers’ physical and mental health and working practice was included in three German beekeeping journals and readers were asked to complete it. The instrument included questions on the use of apitherapy. Simple descriptive methods, bivariate correlation, cross-tabulation and one-way ANOVA were used to analyze the data. Altogether 1059 completed questionnaires were received. The beekeepers reported the most effective and favorable therapeutic effects with honey, followed by propolis, pollen and royal jelly. The factors associated with successful experiences were: age, number of hives tended, health consciousness, positive experiences with one product and self-administration of treatment. Beekeepers were asked for which condition they would employ propolis and pollen. They reported that they used propolis most frequently to treat colds, wounds and burns, sore throats, gum disorders and also as a general prophylactic, while pollen was most commonly used as a general prophylactic and, less frequently, in treating prostate diseases. No adverse experiences were reported. The potential benefit of bee products is supported by the positive experiences of a large group of beekeepers who use some of these products to treat a wide range of conditions. The indications and treatments given here may be important in selecting bee products and designing future trials.

  7. The German Debate on Tactical Nuclear Weapons

    International Nuclear Information System (INIS)

    Meier, Olivier

    2008-01-01

    This report analyses the debate in Germany about tactical nuclear weapons deployments in Europe. It is mainly based on interviews conducted with senior officials from the German Federal Foreign Ministry, the Federal Ministry of Defence, senior members of Parliament as well as experts from research institutes and think-tanks. The interviews focused on the more recent past in the German debate as well as the future of tactical nuclear weapon deployments in Germany and Europe. The report concludes that while a change of Germany's position on tactical nuclear weapons is unlikely to change in the short-term, several developments will make it unlikely that the continued involvement of Germany in NATO nuclear sharing will have to be debated in the medium term. Should the next Parliamentary elections, which will take place in 2009 at the latest, result in a Social Democrat-led government, a push for a reduction of Germany's involvement in NATO nuclear sharing appears possible. A conservative-led government is likely to maintain the nuclear status quo within NATO

  8. Life extension for German nuclear power plants

    International Nuclear Information System (INIS)

    Heller, W.

    2005-01-01

    The Federation of German Industries (BDI) commissioned a study of the ''Economic Effects of Alternative Lifetimes of Nuclear Power Plants in Germany.'' The expert organizations invited as authors were the Power Economy Institute of the University of Cologne (EWI) and Energy Environment Forecast Analysis GmbH (EEFA), Berlin. The reasons for commissioning the Study include the changed framework conditions (deregulation, CO 2 emission certificate trading, worldwide competition for resources), which have altered the energy supply situation in Europe. The findings of the Study were presented to the public by the BDI on October 26, 2005. The study deals with two scenarios of extended lifetimes for German nuclear power plants of 40 and 60 years as against the existing regulations with plant lifetimes limited to approx. 32 years. The longer service lives of plants are reflected in reduced electricity generation costs and thus may have a positive influence on electricity prices. Moreover, there would be additional growth of production together with additional jobs, all of which would add up to nearly 42,000 persons for all sectors of the economy as compared to the basic scenario. Also, CO 2 emissions could be curbed by up to 50 million tons of carbon dioxide. The Study offers ample and valid reasons in favor of extending the lifetimes of nuclear power plants. In the interest of general welfare, politics would be well advised to relax the restrictions on plant life in the course of this legislative term. (orig.)

  9. [German neurology and neurologists during the Third Reich: Preconditions and general framework before and after 1933].

    Science.gov (United States)

    Martin, M; Karenberg, A; Fangerau, H

    2016-08-01

    This article focuses on the institutional development of neurology in Germany up to the rise to power of the National Socialists and the radical sociopolitical changes after 1933. A wide range of scattered secondary literature was assessed and evaluated. Additionally, some original sources are literally quoted and interpreted according to the context. Since the end of the nineteenth century a complicated process of separation from internal medicine and psychiatry led to the formation of a self-conscious discipline of neurology. The first generation of German neurologists succeeded in founding the German Journal for Neurology ("Deutsche Zeitschrift für Nervenheilkunde") in 1890 and their own neurological association, the Society of German Neurologists ("Gesellschaft Deutscher Nervenärzte", GDN) in 1907. On an international scale, however, the institutional implementation of neurology with only a small number of chairs and few neurology departments remained more than modest. The ambitions for autonomy ended 2 years after the change of power in 1933. Regulatory interventions by the government and psychiatric interests led to the fusion of the GDN with the psychiatric specialist society, the new association being called the Society of German Neurologists and Psychiatrists ("Gesellschaft Deutscher Neurologen und Psychiater", GDNP) in 1935. In this group psychiatrists dominated the discourse. The expulsion, imprisonment and murder of physicians declared as non-Aryan or Jewish along with the forced consolidation ("Gleichschaltung") at the universities prompted profound changes in medical and academic life. It remains an ongoing challenge of neurological historical research to measure the impact of this upheaval on the few neurology departments in hospitals and private practices.

  10. Ideology and ethics. The perversion of German psychiatrists' ethics by the ideology of national socialism.

    Science.gov (United States)

    Singer, L

    1998-01-01

    As soon as Adolf Hitler came to into power in 1933, four laws on racial segregation and race protection were edicted between 1934 and 1935. Schizophrenia, manic-depressive psychoses, epilepsy and alcoholism were regarded as hereditary mental illnesses. These laws were responsible for the sterilisation of 350,000 individuals who were thought to be at the source of the propagation of hereditary illnesses which might endanger the health and the future of the Aryan Germans. On September 1, 1939, Action T4 was launched: it required that all the mentally ill be exterminated. This action, which was run by the highest level of the Reich's chancellery with the help of psychiatrists coming from all backgrounds including university professors, was supposed to grant a serene death to all the mentally ill considered as untreatable. The death sentences were carried out by the medical staff in psychiatric hospitals specially equipped with gas chambers. Following protests, Action T4 was officially stopped on August 24, 1941, but, in reality, continued until the end of the war. The death sentences were carried out using either lethal doses of medication or food deprivation. One hundred and fifty thousand individuals fell victim to that therapeutic extermination which played an economic role as important as the one deemed to social protection. Many German academics, researchers, psychiatrists, geneticians and anthropologists played and active part in these murders which were carried out in the name of Nazi ideology based upon the supremacy of the Northern Germanic race and the necessity to protect it from miscegenation, especially from Jews. In the final part of this paper, the author gives an explanation of the perversion of ethics carried out by German psychiatrists.

  11. [The challenge of adequate reimbursement for the seriously injured patient in the German DRG system].

    Science.gov (United States)

    Franz, D; Lefering, R; Siebert, H; Windolf, J; Roeder, N; Mahlke, L

    2013-02-01

    Critically injured patients are a very heterogeneous group, medically and economically. Their treatment is a major challenge for both the medical care and the appropriate financial reimbursement. Systematic underfunding can have a significant impact on the quality of patient care. In 2009 the German Trauma Society and the DRG-Research Group of the University Hospital Muenster initialised a DRG evaluation project to analyse the validity of case allocation of critically injured patients within the German DRG system versions 2008 and 2011 with additional consideration of clinical data from the trauma registry of the German Trauma Society. Severe deficits within the G-DRG structure were identified and specific solutions were designed and realised. A retrospective analysis was undertaken of standardised G-DRG data (§ 21 KHEntgG) including case-related cost data from 3 362 critically injured patients in the periods 2007 and 2008 from 10 university hospitals and 7 large municipal hospitals. For 1 241 cases of the sample, complementary detailed information was available from the trauma registry of the German Trauma Society to monitor the case allocation of critically injured patients within the G-DRG system. Analyses of coding and grouping, performance of case allocation, and the homogeneity of costs in the G-DRG versions 2008 and 2011 were done. The following situations were found: (i) systematic underfunding of trauma patients in the G-DRG-Version 2008, especially trauma patients with acute paraplegia; (ii) participation in the official G-DRG development for 2011 with 13 proposals which were largely realised; (ii) the majority of cases with cost-covering in the G-DRG version 2011; (iv) significant improvements in the quality of statistical criteria; (v) overfunded trauma patients with high intensive care costs; (vi) underfunding for clinically relevant critically injured patients not identified in the G-DRG system. The quality of the G-DRG system is measured by the

  12. Hospital Malnutrition

    OpenAIRE

    Asumadu-Sarkodie, Samuel

    2012-01-01

    Malnutrition seen in hospitals usually occurs as some form of protein-energy malnutrition (PEM). Primary PEM results from an acute or chronic deficiency of both protein and calories. Secondary PEM, or cachexia, results from a disease or medical condition such as cancer or gastrointestinal disease that alters requirements or impairs utilization of nutrients. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

  13. Normabweichungen im Zeitungsdeutsch Ostbelgiens (Deviations from the Standard in the Newspaper German of East Belgium)

    Science.gov (United States)

    Nelde, Peter H.

    1974-01-01

    Concludes that the German used in the east Belgium newspaper differs fr om standard High German. Proceeds to list these differences in the areas of lexicology, semantics and stylistics, morphology and syntax, orthography e tc. (Text is in German.) (DS)

  14. Creating a German–Basque Electronic Dictionary for German ...

    African Journals Online (AJOL)

    user

    For German as a foreign language, the first text book written in German ..... In GFL production, it is often not the meaning but the syntactic properties ..... Hacia la creación de un corpus digitalizado, paralelo, trilingüe (alemán–español– uuskera) ...

  15. 75 FR 62453 - German-American Day, 2010

    Science.gov (United States)

    2010-10-12

    ... a better life. The German men and women who braved numerous perils to cross the Atlantic long ago... influenced our country in all walks of life, and their resolve lives on in the men, women, and families of... not only the countless achievements and rich heritage of German Americans, but also the strong ties...

  16. German Television in the U.S. and Abroad

    Science.gov (United States)

    Ecke, Peter

    2008-01-01

    In this article, I review the options that teachers and students have to obtain German TV in the U.S.: through satellite and cable networks and by streaming, downloading, or recording TV programs through the internet. I also address how one can access TV programs over the air in the German-speaking countries by using a notebook PC and TV card.

  17. German Television in the United States and Abroad

    Science.gov (United States)

    Ecke, Peter

    2008-01-01

    In this article, I review the options that teachers and students have to obtain German TV in the U.S.: through satellite and cable networks and by streaming, downloading, or recording TV programs through the internet. I also address how one can access TV programs over the air in the German-speaking countries by using a notebook PC and TV card.

  18. Stuttering Characteristics of German-English Bilingual Speakers

    Science.gov (United States)

    Schafer, Martina; Robb, Michael P.

    2012-01-01

    The purpose of this study was to examine stuttering behavior in German-English bilingual people who stutter (PWS), with particular reference to the frequency of stuttering on content and function words. Fifteen bilingual PWS were sampled who spoke German as the first language (L1) and English as a second language (L2). Conversational speech was…

  19. German Machine Building: A New Benchmark before World War I

    NARCIS (Netherlands)

    Fremdling, Rainer

    2009-01-01

    The figure most commonly used as benchmark for the output of machinery before WW I is based on an estimate by the Association of German Machinery Producers (VDMA). It estimated that all German firms in total had sold machines worth 2800 million Marks in 1913.Using a recently detected detailed

  20. The 3 C's for College German: Communication, Culture, and Commerce.

    Science.gov (United States)

    Livingston, Kreimhilde I. R.

    The existing German curriculum should be updated to include career-oriented, career-related language courses, especially in German commercial language, since West Germany is one of the world's most important trading countries and the United States is a major trading partner. Language fluency alone is not sufficient for employment in international…

  1. German for Professional Purposes at the University of NSW.

    Science.gov (United States)

    Fischer, Gerhard

    1992-01-01

    A professionally oriented language course at the University of New South Wales (Australia) is described that is designed for students who have studied German in high school and wish to continue studying it to enhance their employment prospects. Both linguistic proficiency and German business culture are emphasized. (LB)

  2. Business Interests and the Development of the German Welfare State

    DEFF Research Database (Denmark)

    Paster, Thomas

    2016-01-01

    the core of the model of the ‘Bismarckian welfare state’, for which Germany became the prototype. After giving a brief overview of the main characteristics of the German welfare state and its historical origins, the chapter analyses the attitudes of German employers towards the adoption of these four...

  3. Latest German-English Terminology in CADCAM and Robotics

    International Nuclear Information System (INIS)

    Hussain, S M

    2014-01-01

    As a technical translator who speaks German fluently, the author would like to study and display the latest bilingual technical terminology in German being used in hardware, software and process technology involved in CADCAM and ROBOTICS. This will greatly help technical translators to correctly translate difficult texts from this area of technology

  4. The German energy market: chronicle of a promised liberalization

    International Nuclear Information System (INIS)

    Heuraux, Ch.

    2002-01-01

    This book treats of: the German energy sector, its historical evolution since its creation during the second industrial revolution, the German energy market, the nuclear energy policy and its debate in the public opinion, and the present day trend towards the development of renewable energy sources. (J.S.)

  5. Artificial Intelligence in a German Adventure Game: Spion in PROLOG.

    Science.gov (United States)

    Molla, Steven R.; And Others

    1988-01-01

    Spion, an adventure game for intermediate and advanced college German students, requires players to communicate with a fictitious agent in complete, correct German sentences. The spy game was written in PROLOG, runs on an IBM-PC, and is available at no cost for noncommercial purposes. (Author/CB)

  6. Univariate characterization of the German business cycle 1955-1994

    OpenAIRE

    Weihs, Claus; Garczarek, Ursula

    2002-01-01

    We present a descriptive analysis of stylized facts for the German business cycle. We demonstrate that simple ad-hoc instructions for identifying univariate rules characterizing the German business cycle 1955-1994 lead to an error rate comparable to standard multivariate methods.

  7. German financial media's responsiveness to Deutsche Bank's cultural change

    NARCIS (Netherlands)

    Strauß, N.

    2015-01-01

    Based on first-order and second-order agenda building theory, this study analyzes the responsiveness of German financial media to frames of the "cultural change" proclaimed in the banking industry, exemplified by Deutsche Bank. Findings suggest a difference between the two major German financial

  8. Dutch between German and English : in honor of Josef Bayer

    NARCIS (Netherlands)

    Zwart, Jan-Wouter; Brandner, Ellen; Czypionka, Anna; Freitag, Konstantin; Trotzke, Andreas

    2015-01-01

    This squib revisits the arguments from Bayer's 2000 article 'Basic order: a significant difference between English VO and German OV' (relating certain opacity phenomena to the VO vs. OV basic order distinction), and shows that Dutch, being OV like German, nevertheless sides with English on most

  9. Political Education in the Former German Democratic Republic.

    Science.gov (United States)

    Dumas, Wayne; Dumas, Alesia

    1996-01-01

    Investigates civic education curricular reform in the former German Democratic Republic (GDR). Discusses the problems inherent in reforming an entire educational system, from textbooks to teachers, originally designed for Marxist-Leninist purposes. Examines the German state educational structure and the role that the main political parties play in…

  10. Integrative Teaching Techniques and Improvement of German Speaking Learning Skills

    Science.gov (United States)

    Litualy, Samuel Jusuf

    2016-01-01

    This research ist a Quasi-Experimental research which only applied to one group without comparison group. It aims to prove whether the implementation of integrative teaching technique has influenced the speaking skill of the students in German Education Study Program of FKIP, Pattimura University. The research was held in the German Education…

  11. An empirical analysis of the German interest rate

    NARCIS (Netherlands)

    den Butter, F.A.G.; Jansen, P.W.

    2004-01-01

    The short run and long run influences of the main determinants of the German long-term interest rate are estimated using quarterly data for the period 1982-2001. A major reason for the focus on the German interest rate is that this rate, and hence its determinants, will be dominant in explaining the

  12. Analysis of High School German Textbooks through Rasch Measurement Model

    Science.gov (United States)

    Batdi, Veli; Elaldi, Senel

    2016-01-01

    The purpose of the present study is to analyze German teacher trainers' views on high school German textbooks through the Rasch measurement model. A survey research design was employed and study group consisted of a total of 21 teacher trainers, three from each region and selected randomly from provinces which are located in seven regions and…

  13. The Social Stratification of the German VET System

    Science.gov (United States)

    Protsch, Paula; Solga, Heike

    2016-01-01

    Germany is widely known for its vocational education and training (VET) system and its dual apprenticeship system in particular. What is often overlooked, however, is the vertical stratification within the German VET system. This is the focus of this study. Our analysis shows that the VET system, like the German school system, is highly…

  14. Acquisition of German Pluralization Rules in Monolingual and Multilingual Children

    Science.gov (United States)

    Zaretsky, Eugen; Lange, Benjamin P.; Euler, Harald A.; Neumann, Katrin

    2013-01-01

    Existing studies on plural acquisition in German have relied on small samples and thus hardly deliver generalizable and differentiated results. Here, overgeneralizations of certain plural allomorphs and other tendencies in the acquisition of German plural markers are described on the basis of test data from 7,394 3- to 5-year-old monolingual…

  15. Generational Aspects of German National Socialism, 1919-33.

    Science.gov (United States)

    Madden, Paul

    1982-01-01

    Examines the theory that pre-Hitler Nazism was part of a generational revolt. Research shows that, among new recruits to the National Socialist German Workers Party in that period, there were more than twice as many who were under 30 years old. Socioeconomic and historical factors which made Nazism attractive to German youth are discussed. (AM)

  16. 'Good Hunting': German submarine offensives and South African ...

    African Journals Online (AJOL)

    By the latter half of 1942, the High Command of the German U-boats (BdU) realised that the 'sinking results' of the North Atlantic had decreased immensely. The successes of the Allied anti-submarine operations in the North Atlantic precluded the successful employment of the German submarines in said waters.

  17. German Culture and Civilization, Foreign Language: 7536.14.

    Science.gov (United States)

    Dade County Public Schools, Miami, FL.

    This is a guide to a realization and appreciation of the German culture, gained through the use of oral and written German. Four areas of language instruction are emphasized: (1) listening, (2) speaking, (3) reading, and (4) writing. The guide is divided into five sections: (1) broad goals and performance objectives, which include a breakdown of…

  18. The Use of Film in Teaching German Culture

    Science.gov (United States)

    Figge, Richard C.

    1977-01-01

    Some of the possibilities of teaching German culture through the medium of the fictional film are suggested. Brief descriptions are provided of German films found useful in communicating some aspect or problem of twentieth-century culture. A select bibliography of works containing extensive analyses and interpretations is provided. (SW)

  19. [Hospitals failing minimum volumes in 2004: reasons and consequences].

    Science.gov (United States)

    Geraedts, M; Kühnen, C; Cruppé, W de; Blum, K; Ohmann, C

    2008-02-01

    In 2004 Germany introduced annual minimum volumes nationwide on five surgical procedures: kidney, liver, stem cell transplantation, complex oesophageal, and pancreatic interventions. Hospitals that fail to reach the minimum volumes are no longer allowed to perform the respective procedures unless they raise one of eight legally accepted exceptions. The goal of our study was to investigate how many hospitals fell short of the minimum volumes in 2004, whether and how this was justified, and whether hospitals that failed the requirements experienced any consequences. We analysed data on meeting the minimum volume requirements in 2004 that all German hospitals were obliged to publish as part of their biannual structured quality reports. We performed telephone interviews: a) with all hospitals not achieving the minimum volumes for complex oesophageal, and pancreatic interventions, and b) with the national umbrella organisations of all German sickness funds. In 2004, one quarter of all German acute care hospitals (N=485) performed 23,128 procedures where minimum volumes applied. 197 hospitals (41%) did not meet at least one of the minimum volumes. These hospitals performed N=715 procedures (3.1%) where the minimum volumes were not met. In 43% of these cases the hospitals raised legally accepted exceptions. In 33% of the cases the hospitals argued using reasons that were not legally acknowledged. 69% of those hospitals that failed to achieve the minimum volumes for complex oesophageal and pancreatic interventions did not experience any consequences from the sickness funds. However, one third of those hospitals reported that the sickness funds addressed the issue and partially announced consequences for the future. The sickness funds' umbrella organisations stated that there were only sparse activities related to the minimum volumes and that neither uniform registrations nor uniform proceedings in case of infringements of the standards had been agreed upon. In spite of the

  20. Translation and validation of the German version of the Mother-Generated Index and its application during the postnatal period.

    Science.gov (United States)

    Grylka-Baeschlin, Susanne; van Teijlingen, Edwin; Stoll, Kathrin; Gross, Mechthild M

    2015-01-01

    the Mother-Generated Index (MGI) is a validated tool to assess postnatal quality of life. It is usually administered several weeks or months after birth and correlates with indices of post partum mood states and physical complaints. The instrument had not been translated into German before or validated for use among German-speaking women, nor have the results of the tool been assessed specifically for the administration directly after birth. This paper aims to describe the systematic translation process of the MGI into German and to assess the convergent validity of the German version of the instrument directly after birth and seven weeks post partum. prospective two-stage survey. two rural hospitals in the south of Germany and in the north of Switzerland. all women giving birth between 1st October and 15th December 2012 with sufficient knowledge of German and whose babies were not referred to a neonatal care unit; 226 women were eligible to participate. two questionnaires including questions relating to socio-demographic factors and perinatal care, and incorporating the MGI, the Hospital Anxiety and Depression Scale (HADS) and the Postnatal Morbidity Index (PMI). All instruments were subjected to forward and back translation and pilot-tested; the first questionnaire was then administered in the first two days after birth and the second six weeks post partum. Parametric and non-parametric tests were computed using SPSS. 129 surveys were returned an average of three days after birth and 83 after seven weeks. Higher postnatal quality of life showed a significant correlation with a lower anxiety and depression score (pGerman version of the MGI is a valid indicator of physical and emotional post partum well-being. the German version of the MGI can be used in the post partum period to identify women whose quality of life is impaired during the first days after birth, in order to initiate extended midwifery care and referral if necessary. Copyright © 2014 The Authors

  1. [Private charity - public health service. Comparison between British and German birthing centers of the 18th century].

    Science.gov (United States)

    Schlumbohm, Jürgen

    In the eighteenth century, lying-in hospitals were founded in many European towns and cities. The way in which these institutions were financed differed greatly across Europe. In the UK, most of them were "charities" and relied on donations from wealthy benefactors, whereas on the continent they were usually funded by "public" money, be it from the state or local communities. The paper focuses on British charities and German hospitals, and explores the corollaries of the mode of financing. In the eighteenth century, a market emerged in Britain where numerous charities with different aims competed for donations from the well-to-do. For attracting benefactors, a charity had to convince potential donors that its clientele and purpose were particularly deserving, and that it used the money donated in a cost-efficient way. In Germany, it was mainly bureaucrats and governments who had to be persuaded, but public opinion did matter as well. In British lying-in charities, the main donors acted as governors, and benefactors could recommend persons for being admitted. In publicly funded German hospitals, the medical directors had much more power. In the competitive market, in which British charities acted, out-patient dispensaries (policlinics) became increasingly important, since they could argue that they were more cost-efficient and had lower mortality. In Germany, however, hospitals remained the dominant type of assistance in this field, in spite of the criticism they received. The different sources of finance appear to have been one of the reasons for this divergence. Teaching was the main purpose of most German lying-in hospitals. They either trained medical students or midwife apprentices or both. Since the patients served as teaching objects, all women were welcomed, and in fact most patients were single mothers. By contrast, most of the British institutions admitted only married women, because donors did not wish to encourage immorality. The charities staged the

  2. Revitalization of ethnic identity among the Germans in Sremski Karlovci

    Directory of Open Access Journals (Sweden)

    Krel Aleksandar

    2009-01-01

    Full Text Available During the 1990's, many members of the German national minority have awaken from the several decades long sleep in 'ethnic hibernation'. Several associations have been founded at that time, with an aim to gather and encourage ethnic feelings of the Germans living in Vojvodina. These associations work toward revitalization and reconstruction of the German ethnic and cultural identity. There are quite a few of such institutions today, and one of them is German association promoting good neighbor relations Karlowitz, Sremski Karlovci. This paper will discuss transformation of an ethnic identity strategy among the Germans in Sremski Karlovci; in addition, I will analyze modus operandi by which this local association aims at keeping and encouraging certain elements of the ethnic and cultural particulars. The results of the research point out how a relatively small group, without social power, can define and redefine its own identity, in regards to historical, social and economic conditions.

  3. Data from the German Chest Pain Unit Registry: The well known gap between knowledge and practice.

    Science.gov (United States)

    Fernández-Bergés, Daniel

    2017-11-01

    In-hospital mortality of acute myocardial infarction with ST segment elevation remains high and is influenced by many factors, some of which are modifiable such as time to treatment initiation and modality of treatment. It is well established that reperfusion therapy is the gold-standard in the management of ST-elevation acute myocardial infarction. Despite recent developments and clear, comprehensible guidelines recommendations, it remains difficult to disseminate this knowledge to medical practitioners. The German Chest Pain Unit shows that the best door-to-balloon time is reached when patients contact the Emergency Medical Systems (EMS) directly, rather than when referred by the general practitioner (GP), or are transferred from another hospital, or present as a self-referral. In order to improve mortality in ST-elevation acute myocardial infarction, patients must be able to recognize symptoms and call the EMS as soon as possible, in addition to having an ECG within ten minutes and direct access to reperfusion therapy (PPCI preferred). The German Registry has highlighted the importance of training both patients and doctors. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. [Reimbursement of intensive care services in the German DRG system : Current problems and possible solutions].

    Science.gov (United States)

    Riessen, R; Hermes, C; Bodmann, K-F; Janssens, U; Markewitz, A

    2018-02-01

    The reimbursement of intensive care and nursing services in the German health system is based on the diagnosis-related groups (G-DRG) system. Due to the lack of a central hospital planning, the G‑DRG system has become the most important influence on the development of the German health system. Compared to other countries, intensive care in Germany is characterized by a high number of intensive care beds, a low nurse-to-patient ratio, no official definition of the level of care, and a minimal available data set from intensive care units (ICUs). Under the given circumstances, a shortage of qualified intensive care nurses and physicians is currently the largest threat for intensive care in Germany. To address these deficiencies, we suggest the following measures: (1) Integration of ICUs into the levels of care which are currently developed for emergency centers at hospitals. (2) Mandatory collection of structured data sets from all ICUs including quality criteria. (3) A reform of intensive care and nursing reimbursement under consideration of adequate staffing in the individual ICU. (4) Actions to improve ICU staffing and qualification.

  5. German Grammar in the Students' Words: The "Essentialization" of German Grammar by American College-Level Learners

    Science.gov (United States)

    Chavez, Monika

    2011-01-01

    This study of 134 college-level learners of German, enrolled in four years of instruction, showed them to "essentialize" German grammar when asked to describe it to a hypothetical friend. Kubota defined the term essentialization to capture learners' views of the target culture. Its main characteristic is the presupposition of "essential, stable,…

  6. Deutsch im Louvre (oder: Deutsch als tote Sprache) (German in the Louvre [or, German as a Dead Language])

    Science.gov (United States)

    Markwald, Sabine

    1976-01-01

    Describes a German course for archeologists and art historians, given in the Louvre by the Paris Goethe Institute. Reliance is placed on the students' visual memory, with schematic presentation of pronoun and article declension. This approach sometimes fosters errors and misunderstandings. The verb system is emphasized. (Text is in German.)…

  7. German standard and German X-ray guide lines as a guide for quality assurance in X-ray diagnosis

    International Nuclear Information System (INIS)

    Pychlau, P.

    1985-01-01

    The German standard DIN 6868 (in preparation) and parts of the German X-ray Ordinance of 1973 deal with quality assurance in X-ray diagnosis. It is shown that both documents support each other and are a guidance for daily work. (author)

  8. Reforms in German Higher Education: Implementing and Adapting Anglo-American Organizational and Management Structures at German Universities

    Science.gov (United States)

    Liefner, Ingo; Schatzl, Ludwig; Schroder, Thomas

    2004-01-01

    Currently, the German higher education system is undergoing drastic reform. Competitive structures and funding mechanisms are being introduced that are already successfully used in other countries. However, critics state that cultural differences prevent the effective application, in German universities, of funding mechanisms and incentives…

  9. Dietary iron intake and iron status of German female vegans: results of the German vegan study.

    Science.gov (United States)

    Waldmann, Annika; Koschizke, Jochen W; Leitzmann, Claus; Hahn, Andreas

    2004-01-01

    As shown in previous studies vegetarians and especially vegans are at risk for iron deficiency. Our study evaluated the iron status of German female vegans. In this cross-sectional study, the dietary intakes of 75 vegan women were assessed by two 9-day food frequency questionnaires. The iron status was analyzed on the basis of blood parameters. Mean daily iron intake was higher than recommended by the German Nutrition Society. Still 42% of the female vegans or = 50 years (old women, OW). In all, 40% (tri-index model (TIM) 20%) of the YW and 12% (TIM 12%) of the OW were considered iron-deficient based on either serum ferritin levels of vegan diet should have their iron status monitored and should consider taking iron supplements in case of a marginal status. Copyright 2004 S. Karger AG, Basel

  10. Long memory in German energy price indices

    Energy Technology Data Exchange (ETDEWEB)

    Barros, Carlos P. [Lisbon Univ. (Portugal). Inst. Superior de Economia e Gestao; Caporale, Guglielmo Maria [Brunel Univ., London (United Kingdom). Centre for Empirical Finance; Gil-Alana, Luis A. [Navarra Univ., Pamplona (Spain). Faculty of Economics and Business Administration

    2012-09-15

    This study examines the long-memory properties of German energy price indices (specifically, import and export prices, as well as producer and consumer prices) for hard coal, lignite, mineral oil and natural gas adopting a fractional integration modelling framework. The analysis is undertaken using monthly data from January 2000 to August 2011. The results suggest nonstationary long memory in the series (with orders of integration equal to or higher than 1) when breaks are not allowed for. However, endogenous break tests indicate a single break in all series except for producer prices for lignite for which two breaks are detected. When such breaks are taken into account, and with autocorrelated disturbances, evidence of mean reversion is found in practically all cases.

  11. Great nuclear debate: German--American disagreements

    International Nuclear Information System (INIS)

    Kaiser, K.

    1978-01-01

    The post-war international consensus on nuclear nonproliferation has been eroding because of the debate over actions taken by some countries and because of the U.S. response with a unilateral change in nuclear policy. The chronology of developments is traced, noting that the 1973--74 oil crisis, India's nuclear explosion in 1974, and the exchange of Brazilian uranium for German technology all had a major role in the policy controversy. New nonproliferation proposals by the Carter administration, by precipitating debate between those wanting tighter export controls and those with nuclear commercial interests, also introduced several foreign-relations problems because of the emphasis on international agreements and a technological approach. The U.S. is credited with taking a constructive step to correct the inadequacies of the present policies and exerting pressure for global involvement in reassessing the rules on armaments and proliferation. Significant U.S. leadership could also take the form of lower energy consumption

  12. Enteric methane emissions from German pigs

    DEFF Research Database (Denmark)

    Dämmgen, Ulrich; Schulz, Joachim; Klausing, Heinrich Kleine

    2012-01-01

    Methane emissions from enteric fermentation of pigs are object of emission reporting. Hitherto they were treated as part of the energy balance of pigs, in accordance with IPCC guidance documents. They were calculated from the gross energy intake rate and a constant methane conversion ratio....... Meanwhile numerous experimental data on methane emissions from enteric fermentation is available in Germany and abroad; the results are compiled in this work. These results also allow for a description of transformation processes in the hind gut and a subsequent establishment of models that relate emissions...... to feed and performance data. The model by Kirchgeßner et al. (1995) is based on German experimental data and reflects typical national diet compositions. It is used to quantify typical emissions and methane conversion ratios. The results agree with other experimental findings at home and abroad...

  13. Market cloudiness, a German national polemics

    International Nuclear Information System (INIS)

    Luginsland, M.

    2004-01-01

    While theoretically liberalized, the German electricity market remains the most opaque of all European electricity markets. Strong price increases (up to 25%) are announced for 2005, while Brussels and Berlin want to put an end to the lack of regulation authority and transparency. Since the implementation of market deregulation, Germany has come back to its former situation: the 4 main producers are equivalent to an oligopoly which controls more than 80% of the market and respects the boundaries of their respective ex-monopolies. Other factors influence the electricity price: the eco-taxes, the subsidies for renewable energies development, the abandonment of nuclear energy and the excessive tariffs of the power transportation network. (J.S.)

  14. SPOKEN BAHASA INDONESIA BY GERMAN STUDENTS

    Directory of Open Access Journals (Sweden)

    I Nengah Sudipa

    2014-11-01

    Full Text Available This article investigates the spoken ability for German students using Bahasa Indonesia (BI. They have studied it for six weeks in IBSN Program at Udayana University, Bali-Indonesia. The data was collected at the time the students sat for the mid-term oral test and was further analyzed with reference to the standard usage of BI. The result suggests that most students managed to express several concepts related to (1 LOCATION; (2 TIME; (3 TRANSPORT; (4 PURPOSE; (5 TRANSACTION; (6 IMPRESSION; (7 REASON; (8 FOOD AND BEVERAGE, and (9 NUMBER AND PERSON. The only problem few students might encounter is due to the influence from their own language system called interference, especially in word order.

  15. German nuclear fuel exports and imports 1991

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    The statistics compiled by the German Federal Office for Trade and Industry (Bundesamt fuer Wirtschaft) for the Federal Ministry for the Environment, Conservation of Nature, and Reactor Safety of imports and exports of nuclear fuels and source materials in 1991 show a major drop by 33.8% in imports and a pronounced rise by 191.5% in exports, compared to the levels in the previous year. Source material for the purposes of these statistics refers only to uranium concentrate. Quantitatively, the biggest import items are source materials, depleted uranium, and uranium enriched up to 3%. Exports of unirradiated material quantitatively comprise mainly depleted uranium, source material, and uranium enriched up to 10%. (orig.) [de

  16. A glance on the German energy policy

    International Nuclear Information System (INIS)

    Audigier, Pierre

    2012-01-01

    As Germany has decided to phase out nuclear by 2022 while aiming at ambitious objectives in terms of energy savings and reduction of greenhouse gas emissions, this report first highlights the interest of such an energy transition. It discusses the immediate consequences of the shutting down of the first eight reactors. It gives an overview of the German energy mix and discusses the objectives and challenges of the energy policy, and how this policy is implemented (by restructuring the electric grid, by building flame-based thermal power stations, by searching for a solution for electricity mass storage, by creating the conditions of an efficient energy saving policy). It discusses the consequences of this policy for the European and French energy policy

  17. Protection of the German coal industry

    Energy Technology Data Exchange (ETDEWEB)

    Jones, S; Savage, E

    1989-06-01

    Within Germany, subsidies to the domestic coal industry are raising taxes, increasing electricity prices, constraining industry competitiveness and causing distortions to resource allocation decisions. Coal assistance policies raise the costs of German industry, particularly those which use coal and electricity. In the case of assistance to steaming coal production, subsidies are less explicit, making the direct cost of continued support to the industry less obvious. If Germany deregulated its coal industry, it would become a major coal importer, conceivably importing as much as 60 Mt a year. Such an increase in import demand would raise world coal trade volume significantly. The impact of liberalisation on world coal prices would depend on the extent and timing of liberalisation and the responsiveness of suppliers to the increased import demand. 13 refs., 5 figs., 2 tabs.

  18. The revised German radiation protection ordinance

    International Nuclear Information System (INIS)

    Palm, M.

    2002-01-01

    Since August 2001, German radiation protection law is governed by a new Radiation Protection Ordinance, implementing two new Euratom Directives and taking into account new scientific developments, which provides a comprehensive basis for the protection of man and the environment. The Ordinance has been completely restructured; however, it is still a very complex piece of legislation comprising 118 provisions and 14 annexes, some of them highly technical. Reduced dose limits for occupationally exposed persons and members of the public, a detailed provision on clearance of radioactive substances, a new part aiming at the protection of man and the environment against ionising radiation emanating from natural sources, and regulations dealing with the protection of consumers in connection with the addition of radioactive substances to consumer goods are some of the centre pieces of the new legislation which shall contribute significantly to the further prevention or at least minimisation of the adverse effects of radiation exposure. (orig.) [de

  19. Electricity market liberalisation - the German model

    International Nuclear Information System (INIS)

    Mueller, W.

    2002-01-01

    This article discusses the experience gained as a result of the opening of the German electricity market - not only from the national but also from European and international points of view. The history of electricity market liberalisation in Germany is described and the market's structure is compared with that of Switzerland. Both the advantages and disadvantages that have been brought about by liberalisation are discussed as well as the role of state regulation. Certain problem areas still to be tackled are discussed, such those in the areas of cartels, possibilities of supplier-change and tariffs. Also, liberalisation in the context of the European Union's efforts in this area are discussed, especially with respect to the consideration of differing structures in the various member countries of the Union

  20. Meeting the nutritional requirements of hospitalized patients: an interdisciplinary approach to hospital catering.

    Science.gov (United States)

    Iff, S; Leuenberger, M; Rösch, S; Knecht, G; Tanner, B; Stanga, Z

    2008-12-01

    The study served to assure the quality of our catering, to locate problems, and to define further optimization measures at the Bern University Hospital. The main objective was to investigate whether the macronutrient and energy content of the hospital food complies with the nutritional value calculated from recipes as well as with the recommendations issued by the German Nutrition Society (DGE). Prospective, randomized, single-center quality study. Complete standard meals were analyzed over seven consecutive days for each seasonal menu plan in one year. The quantitative and qualitative chemical content of a randomly chosen menu was determined by an external laboratory. Sixty meals were analyzed. The amount of food served and the ratio of macronutrients contained in the food satisfactorily reflected all recipes. Not surprisingly, the energy and carbohydrate content of our meals was lower than in the German recommendations, because the report of the DGE is based on the sum of meals, snacks and beverages consumed over the whole day and not only on the main meals, as we analyzed. Periodic quality control is essential in order to meet recommendations and patients' expectations in hospital catering. Members of the catering service should undergo regularly repeated skills training, and continuous efforts should be made to ensure portion size for all delivered meals. Food provision in the hospital setting needs to be tailored to meet the demands of the different patient groups, to optimize nutritional support, and to minimize food waste.

  1. Germans or Jews? German-Speaking Jews in Post-War Europe: An Introduction

    Czech Academy of Sciences Publication Activity Database

    Čapková, Kateřina; Rechter, D.

    2017-01-01

    Roč. 62, November (2017), s. 69-74 ISSN 0075-8744 Institutional support: RVO:68378114 Keywords : Jews * Germans * post-war period Subject RIV: AB - History OBOR OECD: History (history of science and technology to be 6.3, history of specific sciences to be under the respective headings) https://academic.oup.com/leobaeck/issue/volume/62?browseBy=volume

  2. Adaptation and initial validation of the german version of the Students’ Life Satisfaction Scale (German SLSS)

    OpenAIRE

    Weber, Marco; Ruch, Willibald; Huebner, E Scott

    2013-01-01

    The present research describes the adaptation and initial validation of a brief measure of global life satisfaction, the Students’ Life Satisfactions Scale (SLSS), for German-speaking children and adolescents aged 10–17 years. Study 1 investigated the responses of 286 Swiss students (aged 12–17 years) administered paper-pencil questionnaires (e.g., Junior Eysenck Personality Questionnaire) during class on two occasions (interval 4 months). Study 2 investigated the responses of a heterogeneous...

  3. German Foreign and Security Policy: Determinants of German Military Engagement in Africa Since 2011

    Science.gov (United States)

    2015-06-01

    and in Bosnia- Herzegovina 2004 (EUFOR Althea as successor of SFOR). The affirmation of Germany’s unlimited “political and moral solidarity”165...and reliable multilateral partner. Relativizing the initially harsh domestic criticism aimed at the federal government due to Germany’s isolation...the UNSC and the support of the Arab League, the political, legal, and moral preconditions for a German military engagement in Libya were even more

  4. Environmental medicine disaster. Pt. 1; Umweltmedizinische Katastrophen. T. 1. Die Minamata-Krankheit

    Energy Technology Data Exchange (ETDEWEB)

    Seidel, H.J.; Krefeldt, T. [Ulm Univ. (Germany). Inst. fuer Arbeits-, Sozial- und Umweltmedizin

    1998-07-01

    The list of environmental disasters after World War II includes events which were detected by an epidemy of adverse health effects and others with an acute event as a starting point. Their analysis should contribute to knowledge in human toxicology and also to the formulation of regulatory toxicology. The present study shows to what extent this has been performed, beginning with the description of the Minamata Disease. During the 50ies, neurological symptoms were discovered in people living at the shore of a Japanese lake, especially the Minamata bay which contained industrial effluents from a chemical plant. After years, methyl-mercury was identified as the toxic agent. The substance had found its way into the food chain, especially via contaminated fish. Besides man, cats were also affected to a high degree. The long-lasting process of scientific analysis, including official reactions, is described. Regulatory toxicology concerning organic mercury now makes use of the data from this event and another one in Iraq. (orig.) [Deutsch] Die Liste der grossen umweltmedizinischen Katastrophen seit dem II. Weltkrieg umfasst z.T. Schadensereignisse, auf die man wegen der Haeufung von Gesundheitsstoerungen aufmerksam wurde und solche, bei denen ein akutes Ereignis am Anfang stand. Aus der systematischen wissenschaftlichen Analyse sollten sich Erkenntnisse zur Humantoxikologie und zur Gestaltung von Regelwerken ergeben. Inwieweit dies getan wurde, wird hiermit aufgrund einer Literaturanalyse dargestellt, beginnend mit der Minamata-Erkrankung. In den 50er Jahren fielen bei Anwohnern eines japanischen Sees, in der Bucht von Minamata, in die Abwaesser aus einer chemischen Fabrik gleitet wurden, neurologische Erkrankungen auf, die erst nach Jahren eindeutig als Intoxikation mit Methylquecksilber identifiziert wurden. Methylquecksilber war in die Nahrungskette, und hier insbesondere ueber kontaminierten Fisch, gelangt. Ausser dem Menschen waren auffaelligerweise Katzen betroffen. Der lange Prozess der wissenschaftlichen Abklaerung wird mitsamt den behoerdlichen Reaktionen dargestellt. Die heutigen Regelwerke zu organischem Quecksilber stuetzen sich auf die Erkenntnisse aus dieser Katastrophe - und einer weiteren Methylquecksilberintoxikation im Irak. (orig.)

  5. Efficiency, ownership, and financing of hospitals: the case of Austria.

    Science.gov (United States)

    Czypionka, Thomas; Kraus, Markus; Mayer, Susanne; Röhrling, Gerald

    2014-12-01

    While standard economic theory posits that privately owned hospitals are more efficient than their public counterparts, no clear conclusion can yet be drawn for Austria in this regard. As previous Austrian efficiency studies rely on data from the 1990s only and are based on small hospital samples, the generalizability of these results is questionable. To examine the impact of ownership type on efficiency, we apply a Data Envelopment Analysis which extends the existing literature in two respects: first, it evaluates the efficiency of the Austrian acute care sector, using data on 128 public and private non-profit hospitals from the year 2010; second, it additionally focusses on the inpatient sector alone, thus increasing the comparability between hospitals. Overall, the results show that in Austria, private non-profit hospitals outperform public hospitals in terms of technical efficiency. A multiple regression analysis confirms the significant association between efficiency and ownership type. This conclusive result contrasts some international evidence and can most likely be attributed to differences in financial incentives for public and private non-profit hospitals in Austria. Therefore, by drawing on the example of the Austrian acute care hospital sector and existing literature on the German acute care hospital sector, we also discuss the impact of hospital financing systems and their incentives on efficiency. This paper thus also aims at providing a proof of principle, pointing out the importance of the respective market conditions when internationally comparing hospital efficiency by ownership type.

  6. TOWARDS A GERMAN LANGUAGE FRAMEWORK FOR MALAYSIABASED MULTINATIONAL COMPANIES (MNCS

    Directory of Open Access Journals (Sweden)

    Siti Waltraud Brigitte Mayr

    2016-08-01

    Full Text Available Purpose - The aim of this study is to introduce an approach to managing business communication based on the German language needs of employees in multinational companies in Malaysia and the expectations of employers in the teaching of German in their companies. As additional variables, training for sustainable development (ESD and for maximizing the mutual understanding in personal interactions is included. Design / methodology / approach – This paper is reflecting on the spectrum of ideas about the teaching of German in German companies in Malaysia that was obtained through the author’s earlier target situation analysis in MNCs in Malaysia. In addition to a variety of methods that is incorporated to engage students in the learning process, a ‘meaning negotiation’ approach is applied in order to deal with the intercultural communication practices. Results - The paper outlines a set of topics and strategies that can assist employees in intercultural interaction contexts in a German Malaysia-based company. It draws them together into a conceptual framework of required skills in a German beginner class. Originality / Benefits - This study contributes to the current issues concerning the German mediation requirements in the management field.

  7. Stop and Fricative Devoicing in European Portuguese, Italian and German.

    Science.gov (United States)

    Pape, Daniel; Jesus, Luis M T

    2015-06-01

    This paper describes a cross-linguistic production study of devoicing for European Portuguese (EP), Italian, and German. We recorded all stops and fricatives in four vowel contexts and two word positions. We computed the devoicing of the time-varying patterns throughout the stop and fricative duration. Our results show that regarding devoicing behaviour, EP is more similar to German than Italian. While Italian shows almost no devoicing of all phonologically voiced consonants, both EP and German show strong and consistent devoicing through the entire consonant. Differences in consonant position showed no effect for EP and Italian, but were significantly different for German. The height of the vowel context had an effect for German and EP. For EP, we showed that a more posterior place of articulation and low vowel context lead to significantly more devoicing. However, in contrast to German, we could not find an influence of consonant position on devoicing. The high devoicing for all phonologically voiced stops and fricatives and the vowel context influence are a surprising new result. With respect to voicing maintenance, EP is more like German than other Romance languages.

  8. Public Awareness and Use of German Physician Ratings Websites: Cross-Sectional Survey of Four North German Cities.

    Science.gov (United States)

    McLennan, Stuart; Strech, Daniel; Meyer, Andrea; Kahrass, Hannes

    2017-11-09

    Physician rating websites (PRWs) allow patients to rate, comment, and discuss physicians' quality. The ability of PRWs to influence patient decision making and health care quality is dependent, in part, on sufficient awareness and usage of PRWs. However, previous studies have found relatively low levels of awareness and usage of PRWs, which has raised concerns about the representativeness and validity of information on PRWs. The objectives of this study were to examine (1) participants' awareness, use, and contribution of ratings on PRWs and how this compares with other rating websites; (2) factors that predict awareness, use, and contribution of ratings on PRWs; and (3) participants' attitudes toward PRWs in relation to selecting a physician. A mailed cross-sectional survey was sent to a random sample (N=1542) from four North German cities (Nordhorn, Hildesheim, Bremen, and Hamburg) between April and July 2016. Survey questions explored respondents' awareness, use, and contribution of ratings on rating websites for service (physicians, hospitals, and hotels and restaurants) and products (media and technical) in general and the role of PRWs when searching for a new physician. A total of 280 completed surveys were returned (280/1542, 18.16% response rate), with the following findings: (1) Overall, 72.5% (200/276) of respondents were aware of PRWs. Of the respondents who were aware of PRWs, 43.6% (86/197) had used PRWs. Of the respondents who had used PRWs, 23% (19/83) had rated physicians at least once. Awareness, use, and contribution of ratings on PRWs were significantly lower in comparison with all other rating websites, except for hospital rating websites. (2) Except for the impact of responders' gender and marital status on the awareness of PRWs and responders' age on the use of PRWs, no other predictors had a relevant impact. (3) Whereas 31.8% (85/267) of the respondents reported that PRWs were a very important or somewhat important information source when

  9. [The German guideline "legal evaluation after closed head injury"].

    Science.gov (United States)

    Wallesch, C W; Fries, W; Marx, P; du Mesnil de Rochemont, R; Roschmann, R; Schmidt, R; Schwerdtfeger, K; Tegenthoff, M; Widder, B

    2013-09-01

    In 2005, the "Deutsche Gesellschaft für Neurowissenschaftliche Begutachtung" (German Society for Neuroscientific Legal Evaluation) together with other Societies published a guideline for the legal evaluation of patients with closed head injuries. Meanwhile, not only scientific progress in imaging techniques but also in other fields such as neuropsychology has necessitated a revision, which is presented here. In the mean time, the handling of guidelines has been systematised in Germany so that a registration with the Cooperation of German Medical Learned Societies is applied for and publication in the German Guideline Registry is expected. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Psychohistory before Hitler: early military analyses of German national psychology.

    Science.gov (United States)

    Bendersky, J W

    1988-04-01

    As part of a grandiose post-World War I psychological project to predict the behavior of nations, the U.S. Military Intelligence Division (MID) utilized racial and social psychological theories to explain an alleged problematic German national character. Though unsuccessful, this project has major significance in the history of psychohistory. For the newly discovered MID files reveal that ideas, attitudes, and biases many psychohistorians subsequently identified as manifestations of a peculiar German national character had previously been held by American officers and reputable psychologists. What American analysts would, in 1940, view as symptoms of a maladjusted German mind, their predecessors had, in 1920, considered valid scientific concepts.

  11. German power options: Lack of clarity will be costly

    International Nuclear Information System (INIS)

    Schuelke, Christian

    2010-01-01

    The German environment minister Norbert Roettgen (CDU) revived the German debate about the future of nuclear power in February when he argued for a limited lifetime extension of Germany's nuclear plants. His statements created much dissent in his own party and with the coalition partner FDP. The government will not take a formal decision before the autumn, but the contradicting messages from inside the government send highly ambiguous signals to electricity utilities with investment plans in Germany. What does the German government want the companies to do?

  12. 'Combating' tropical diseases in the German colonial press.

    Science.gov (United States)

    Correa, Sílvio Marcus de Souza

    2013-03-01

    This article shows how much certain German language newspapers were a vehicule for reporting to the lay public on 'combating' tropical diseases. Through the press, immigrants and their descendents in Brazil were informed not only about the diseases which afflicted German colonists in Africa, but also about measures concerning sanitation, prophylaxis and experiments with tropical medicine, etc. Based on hemerographic sources, it shows how successful the overseas German communities were in sharing their experiences regarding health in tropical and/or sub-tropical regions.

  13. Psychometric properties of the Hospital Survey on Patient Safety Culture for hospital management (HSOPS_M

    Directory of Open Access Journals (Sweden)

    Pfeiffer Yvonne

    2011-07-01

    Full Text Available Abstract Background From a management perspective, it is necessary to examine how a hospital's top management assess the patient safety culture in their organisation. This study examines whether the Hospital Survey on Patient Safety Culture for hospital management (HSOPS_M has the same psychometric properties as the HSOPS for hospital employees does. Methods In 2008, a questionnaire survey including the HSOPS_M was conducted with 1,224 medical directors from German hospitals. When assessing the psychometric properties, we performed a confirmatory factor analysis (CFA. Additionally, we proved construct validity and internal consistency. Results A total of 551 medical directors returned the questionnaire. The results of the CFA suggested a satisfactory global data fit. The indices of local fit indicated a good, but not satisfactory convergent validity. Analyses of construct validity indicated that not all safety culture dimensions were readily distinguishable. However, Cronbach's alpha indicated that the dimensions had an acceptable level of reliability. Conclusion The analyses of the psychometric properties of the HSOPS_M resulted in reasonably good levels of property values. Although the set of dimensions within the HSOPS_M needs further scale refinement, the questionnaire covers a broad range of sub-dimensions and supplies important information on safety culture. The HSOPS_M, therefore, is eligible to measure safety culture from the hospital management's points of view and could be used in nationwide hospital surveys to make inter-organisational comparisons.

  14. Radiation therapy and internet - what can patients expect? homepage analysis of german radiotherapy institutions.

    Science.gov (United States)

    Janssen, Stefan; Meyer, Andreas; Vordermark, Dirk; Steinmann, Diana

    2010-12-01

    the internet as a source of medical information has emerged during the last years. There is a confusing amount of medical websites with a great diversity of quality. Websites of radiotherapy institutions could offer a safe and an easy-to-control way to assist patients' requests. 205 internet appearances of German radiotherapy institutions were analyzed in June 2009 (nonuniversity hospitals n = 108, medical practices n = 62, university hospitals n = 35). For the evaluation of each homepage verifiable criteria concerning basic information, service and medical issues were used. the quality of information published via internet by different radiotherapy institutions showed a large variety. Basic information like telephone numbers, operating hours, and direction guidance were provided in 96.7%, 40%, and 50.7%, respectively. 85% of the websites introduced the staff, 50.2% supplied photos and 14% further information on the attending physicians. The mean amount of continuative links to other websites was 5.4, the mean amount of articles supplying medical information for patients summed up to 4.6. Medical practices and university hospitals had statistically significant more informative articles and links to other websites than nonuniversity hospitals. No statistically significant differences could be found in most other categories like service issues and basic information. internet presences of radiotherapy institutions hold the chance to supply patients with professional and individualized medical information. While some websites are already using this opportunity, others show a lack of basic information or of user-friendliness.

  15. SYNONYMS IN GERMAN ONLINE MONOLINGUAL DICTIONARIES

    Directory of Open Access Journals (Sweden)

    Paloma Sánchez Hernández

    2017-03-01

    Full Text Available This study includes both theoretical and qualitative research and falls within the framework of semantics and lexicography. It is based on work conducted as a part of the COMBIDIGILEX research project: MINECO-FEDER FFI2015-64476-P. The lexicographical description proposed in the COMBIDIGILEX project is based on the foundations of bilingual lexicography from an onomasiological perspective, including paradigmatic information and syntagmatic analysis, which is useful to users creating texts for students at an advanced level. The project analyses verbal lexemes in German and Spanish based on a paradigmatic, syntagmatic, orthographic and morphological perspective (among others. Subsequently, a contrastive analysis was conducted between both languages. In this contribution, we first analyse what paradigmatic information is, including its relevance to a dictionary. Paradigmatic information includes not only synonyms and antonyms but also hyperonyms and hyponyms, which often complete the lexicographical article in a general dictionary. Paradigmatic relations can be observed in light of semantic definitions or may independently become part of the lexical entry. Forming the paradigmatic information of an entry in an independent manner is known as “intentionelle Paradigmatik”, and it constitutes a series of advantages in the dictionary (Hausmann 1991b: 2794. This type of information aids the processes of production and expands vocabulary. Next, we examine the appearance of synonyms in three German online monolingual dictionaries – DWDS, WORTSCHATZLEXIKON and DUDEN ONLINE – from the semantic perspective of cognition verbs. The primary objective of the study is to demonstrate the relevance of this type of information as well as the needs it covers from a user’s perspective. Offering the user a series of lexical elements along with information on semantic relations of a paradigmatic nature thus addresses the issue of users having an array of

  16. The German competence network on nuclear technology

    International Nuclear Information System (INIS)

    Kuczera, B.; Fritz, P.

    2004-01-01

    Full text: The present German energy policy is based on the phase-out of nuclear electricity generation, which means that the last of the currently operating eighteen German nuclear power plants will run until about 2022. While the plants will be shut down one after the other, decommissioning will start together with interim storage of the radioactive waste. The safe waste disposal in a final repository is planned to start around 2030 and may take another two decades, i.e., in Germany nuclear competence is further needed, at least until the mid of this century. Against this background, a high-ranking commission under the direction of the Federal Ministry of Economy and Technology evaluated the publicly funded nuclear safety related research and development (R and D) activities in Germany. One of the recommendations made by the commission was the foundation of a Competence Network on Nuclear Technology for an optimum coordination of the remaining nuclear activities including aspects of future human resources in this area. This Network was established in March 2000 with the following member institutions: Research Centre Juelich, Research Centre Karlsruhe, Research Centre Rossendorf and the Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS) in Munich and their neighbouring Technical Universities. The strategic objectives of the Competence Network include: Trend investigations on job development and on university education capacities in the nuclear technology sector; Enhanced cooperation of the Research Centres with universities in the nuclear field and support of international education initiatives (e.g. ENEN, WNU); Coordination and bundling of the activities in publicly funded reactor safety and waste management R and D programmes; Support of qualified young scientists and engineers (pre-doctoral students) - also by third-party funds; Participation in and collaboration with international projects and activities for advancements of international nuclear safety

  17. Cultural differences in postnatal quality of life among German-speaking women - a prospective survey in two countries.

    Science.gov (United States)

    Grylka-Baeschlin, Susanne; van Teijlingen, Edwin; Gross, Mechthild M

    2014-08-15

    Assessment of quality of life after childbirth is an important health-outcome measurement for new mothers and is of special interest in midwifery. The Mother-Generated Index (MGI) is a validated instrument to assess postnatal quality of life. The tool has not been applied for making a cross-cultural comparison before. This study investigated (a) responses to the MGI in German-speaking women in Germany and Switzerland; and (b) associations between MGI scores on the one hand and maternity and midwifery care on the other. A two-stage survey was conducted in two rural hospitals 10 km apart, on opposite sides of the German-Swiss border. The questionnaires included the MGI and questions on socio-demographics, physical and mental health and maternity care, and were distributed during the first days after birth and six weeks postpartum. Parametric and non-parametric tests were computed with the statistical programme SPSS. A total of 129 questionnaires were returned an average of three days after birth and 83 in the follow-up after seven weeks. There were no statistically significant differences in the MGI scores between the German and the Swiss women (p = 0.22). Significantly more favourable MGI scores were found associated with more adequate information during pregnancy (p = 0.02), a more satisfactory birth experience (p German-speaking women were higher than those in other studies reported previously. Thus the tool may be able to detect differences in postnatal quality of life among women with substantially divergent cultural backgrounds. Shortcomings in maternity and midwifery care were detected, as for example the inadequate provision of information during pregnancy, a lack of individualised postpartum care during the hospital stay and insufficient support for exclusively breastfeeding mothers. The MGI is an appropriate instrument for maternity care outcome measurement in cross-cultural comparison research.

  18. Surgical strategies in polytraumatized patients with femoral shaft fractures - comparing a German and an Australian level I trauma centre.

    Science.gov (United States)

    Andruszkow, Hagen; Dowrick, Adam S; Frink, Michael; Zeckey, Christian; Krettek, Christian; Hildebrand, Frank; Edwards, Elton R; Mommsen, Philipp

    2013-08-01

    Femoral shaft fractures are one of the most common injuries in multiple trauma patients. Due to their prognostic relevance, there is an ongoing controversial discussion as to the optimal treatment strategy in terms of Damage Control Orthopaedics (DCO) and Early Total Care (ETC). We aimed to describe the differences in fracture management and clinical outcome of multiple trauma patients with concomitant femoral shaft fractures treated at a German and an Australian level I trauma centre using the same inclusion criteria. Polytraumatized patients (ISS ≥ 16) with a femoral shaft fracture aged ≥ 16 years treated at a German and an Australian trauma centre between 2003 and 2007 were included. According to ETC and DCO management principles, we evaluated demographic parameters as well as posttraumatic complications and clinical outcome. Seventy-three patients were treated at the German and 134 patients at the Australian trauma centre. DCO was performed in case of increased injury severity in both hospitals. Prolonged mechanical ventilation time, and length of ICU and hospital stay were demonstrated in DCO treatment regardless of the trauma centre. No differences concerning posttraumatic complications and survival were found between both centres. Survival of patients after DCO was similar to those managed using ETC despite a greater severity of injury and lower probability of survival. There was no difference in the incidence of ARDS. DCO was, however, associated with a greatly increased length of time on mechanical ventilation and length of stay in the ICU. We found no differences concerning patient demographics or clinical outcomes in terms of incidence of ARDS, MODS, or mortality. As such, we propose that comparability between German and Australian trauma populations is justified. Despite a higher ISS in the DCO group, there were no differences in posttraumatic complications and survival depending on ETC or DCO treatment. Further research is required to confirm

  19. Is Whole-Body Computed Tomography the Standard Work-up for Severely-Injured Children? Results of a Survey among German Trauma Centers.

    Science.gov (United States)

    Bayer, J; Reising, K; Kuminack, K; Südkamp, N P; Strohm, P C

    2015-01-01

    Whole-body computed tomography is accepted as the standard procedure in the primary diagnostic of polytraumatised adults in the emergency room. Up to now there is still controversial discussion about the same algorithm in the primary diagnostic of children. The aim of this study was to survey the participation of German trauma-centres in the care of polytraumatised children and the hospital dependant use of whole-body computed tomography for initial patient work-up. A questionnaire was mailed to every Department of Traumatology registered in the DGU (German Trauma Society) databank. We received 60,32% of the initially sent questionnaires and after applying exclusion criteria 269 (53,91%) were applicable to statistical analysis. In the three-tiered German hospital system no statistical difference was seen in the general participation of children polytrauma care between hospitals of different tiers (p = 0.315). Even at the lowest hospital level 69,47% of hospitals stated to participate in polytrauma care for children, at the intermediate and highest level hospitals 91,89% and 95,24% stated to be involved in children polytrauma care, respectively. Children suspicious of multiple injuries or polytrauma received significantly fewer primary whole-body CTs in lowest level compared to intermediate level hospitals (36,07% vs. 56,57%; p = 0.015) and lowest level compared to highest level hospitals (36,07% vs. 68,42%; p = 0.001). Comparing the use of whole-body CT in intermediate to highest level hospitals a not significant increase in its use could be seen in highest level hospitals (56,57% vs. 68,42%; p = 0.174). According to our survey, taking care of polytraumatised children in Germany is not limited to specialised hospitals or a defined hospital level-of-care. Additionally, there is no established radiologic standard in work-up of the polytraumatised child. However, in higher hospital care -levels a higher percentage of hospitals employs whole-body CTs for primary

  20. Testing Language, Testing Ethnicity? Policies and Practices Surrounding the Ethnic German "Aussiedler"

    Science.gov (United States)

    Schupbach, Doris

    2009-01-01

    "Aussiedler" are ethnic Germans from the former Soviet Union and other Eastern European countries who are granted the right to resettle in the Federal Republic of Germany (FRG) if they can provide evidence of German ancestry, attachment to the German language and culture, and ongoing assertion of German ethnicity. This article outlines…

  1. Cross-Linguistic Differences in Prosodic Cues to Syntactic Disambiguation in German and English

    Science.gov (United States)

    O'Brien, Mary Grantham; Jackson, Carrie N.; Gardner, Christine E.

    2014-01-01

    This study examined whether late-learning English-German second language (L2) learners and late-learning German-English L2 learners use prosodic cues to disambiguate temporarily ambiguous first language and L2 sentences during speech production. Experiments 1a and 1b showed that English-German L2 learners and German-English L2 learners used a…

  2. Effective Outpatient Care in the Community: One German Way ...

    African Journals Online (AJOL)

    indicators of the chronicity and severity of psychiatric disorder, the psychiatric first diagnosis, the age of onset of disease and duration since onset of disease) at the first ... Key Words: Community Psychiatry, German Model, Effectiveness.

  3. Possibilities of professional career in the German coal mining industry

    Energy Technology Data Exchange (ETDEWEB)

    Gierhardt, H; Mader, S

    1977-06-01

    Development and age structure of the labor force. Possibilities and courses of professional training in the German coal mining industry. Choice of profession and possibilities of promotion. More advertising campaigns necessary to obtain recruits for mining work.

  4. On Quality Intensification Expression Means in German And Lithuanian

    Directory of Open Access Journals (Sweden)

    Ernesta Račienė

    2013-12-01

    Full Text Available The paper presents the analysis of German Adjectives’ derivational means, which intensify the meaning of quality, and which are compared with functional equivalents in Lithuanian. The intensification of quality is treated as the functional semantic category, implemented in various language levels. This semantics may be expressed morphologically, by lexical and syntactic means, as well as by stress and intonation. The German language has many first components of compound adjectives, representing the intensification of quality, such as: stock-, blitz-, hoch-, brand-, grund-, etc. The rendering function of this semantics is typical of German adjectives prefixes erz-, ur- as well as prefixes of foreign origin super-, ultra-, extra-, mega-, hyper-, top-. In the Lithuanian language, the intensifying meaning of quality is realized by syntactic com-pounds, while on the morphological level it can be conveyed by diminutive suffixes. The paper presents the comparison of German and Lithuanian quality intensification expression means in order to highlight typological similarities and differences.

  5. Rubella (German Measles, Three-Day Measles) Photos

    Science.gov (United States)

    ... Controls Cancel Submit Search The CDC Rubella (German Measles, Three-Day Measles) Note: Javascript is disabled or is not supported ... child's back. Distribution is similar to that of measles, but the lesions are less intensely red. This ...

  6. Mutual incomprehension: U.S.- German value gaps beyond Iraq

    OpenAIRE

    Larres, Klaus

    2003-01-01

    Differences over Iraq policy have revealed deep U.S.- German value gaps over multilateralism, nationalism, and the role of force in international relations. Cooperation in four areas of mutual importance can help compensate for them.

  7. Fifth German-American Frontiers of Engineering Symposium

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2002-05-01

    The agenda book for the Fifth German-American Frontiers of Engineering Symposium contains abstracts of the 16 presentations as well as information on the program, bios of the speakers, contact information for all attendees, and background on the activity.

  8. 76 FR 63531 - German-American Day, 2011

    Science.gov (United States)

    2011-10-12

    ... Atlantic to seize the promise of the American dream. The same spirit that guided intrepid settlers to help... society, generations of German Americans have helped make America what it is today. The bonds of...

  9. Safety and safeguards aspects on retrievability: A German study

    International Nuclear Information System (INIS)

    Biurrun, E.; Engelmann, H.-J.; Brennecke, P.; Kranz, H.

    2000-01-01

    The article refers shortly to the definition of the term 'retrievability' and shows two different possibilities of retrieval scenarios, their advantages and detriments. The second part lists the Safeguards aspects of retrievability, gives a short outlook on the present German Safeguards Reference Concept in the post-closure phase of a repository in a salt dome and about the results of German studies concerning some proposed Safeguards methods. Furthermore, Planned investigations on Safeguards in the post-closure phase of a repository are mentioned. The third and main part finally describes the results of the German Retrievability Study, which was elaborated in the middle of the nineties by DBE on behalf of the German Federal Ministry of Education, Science, Research and Technology, BMBF, under an R and D contract. (author)

  10. On the contrast between Germanic and Romance negated quantifiers

    Directory of Open Access Journals (Sweden)

    Robert Cirillo

    2009-01-01

    Full Text Available Universal quantifiers can be stranded in the manner described by Sportiche (1988, Giusti (1990 and Shlonsky (1991 in both the Romance and Germanic languages, but a negated universal quantifier can only be stranded in the Germanic languages. The goal of this paper is to show that this contrast between the Romance and the Germanic languages can be explained if one adapts the theory of sentential negation in Zeijlstra (2004 to constituent (quantifier negation. According to Zeijlstra’s theory, a negation marker in the Romance languages is the head of a NegP that dominates vP, whereas in the Germanic languages a negation marker is a maximal projection that occupies the specifier position of a verbal phrase. I will show that the non-occurrence of stranded negated quantifiers in the Romance languages follows from the fact that negation markers in the Romance languages are highly positioned syntactic heads.

  11. Main results of the German nuclear power plant risk study

    International Nuclear Information System (INIS)

    Danzmann, H.J.

    1981-01-01

    The subject is discussed under the headings: introduction; purpose and task of the German risk study; approach; results of investigations (analyses of engineered plant features; determination of accident consequences); emergency response model; protective actions and countermeasures; evaluation. (U.K.)

  12. German Antarctic Receiving Station (GARS) O'Higgins

    Science.gov (United States)

    Neidhardt, Alexander; Ploetz, Christian; Kluegel, Thomas

    2013-01-01

    In 2012, the German Antarctic Receiving Station (GARS) O'Higgins contributed to the IVS observing program with four observation sessions. Maintenance and upgrades were made, and a new replacement dewar is under construction in the observatory at Yebes, Spain.

  13. A RE-ASSESSMENT OF THE GERMAN ARMAMENTS ...

    African Journals Online (AJOL)

    Steenkamp Fonseca R

    The German armaments production during World War II (1939-1945) is a ... assistance of captured material and industrial power of occupied Europe) but failed .... designs (types) of trucks decreased from 151 in 1939 to 23 in 1942; and of.

  14. Creating a German–Basque electronic dictionary for German learners

    African Journals Online (AJOL)

    , and propose a first iteration of the online user interface and publishing process. Keywords: Bilingual lexicography, electronic dictionaries, Basque language, German as foreign language, parallel corpora, user interface, wiktionary.

  15. Speech Act Classification of German Advertising Texts

    Directory of Open Access Journals (Sweden)

    Артур Нарманович Мамедов

    2015-12-01

    Full Text Available This paper uses the theory of speech acts and the underlying concept of pragmalinguistics to determine the types of speech acts and their classification in the German advertising printed texts. We ascertain that the advertising of cars and accessories, household appliances and computer equipment, watches, fancy goods, food, pharmaceuticals, and financial, insurance, legal services and also airline advertising is dominated by a pragmatic principle, which is based on demonstrating information about the benefits of a product / service. This influences the frequent usage of certain speech acts. The dominant form of exposure is to inform the recipient-user about the characteristics of the advertised product. This information is fore-grounded by means of stylistic and syntactic constructions specific to the advertisement (participial constructions, appositional constructions which contribute to emphasize certain notional components within the framework of the advertising text. Stylistic and syntactic devices of reduction (parceling constructions convey the author's idea. Other means like repetitions, enumerations etc are used by the advertiser to strengthen his selling power. The advertiser focuses the attention of the consumer on the characteristics of the product seeking to convince him of the utility of the product and to influence his/ her buying behavior.

  16. The German Chernobyl project: Lessons learned

    International Nuclear Information System (INIS)

    Hill, P.; Hille, R.

    1999-01-01

    This report presents results and lessons learned by one of the so far largest assessments of a post-accidental situation. Funded by the Federal Republic of Germany the German Chernobyl Project investigated in the years 1991-1993 the radiological situation in contaminated regions of the Russian Federation, Belarus and Ukraine. Measurements included a mass screening of the population in order to determine the Cesium body burdens of 250,000+ individuals in more than 240 settlements as well as the evaluation of external doses in selected settlements with soil contaminations varying from less than 74 kBq/m 2 to about 3700 kBq/m 2 including some, where decontamination measures had previously been taken. Also in many settlements environmental monitoring was undertaken. For most individuals doses did not exceed the international annual limits set for the general population. Open and comprehensive communication of results was favourably accepted by the public. In a few settlements the radiological situation has been followed up till to date. (author)

  17. Are LMFBR permits unconstitutional. [German Feferal Republic

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, H; Ziegler, E

    1977-12-01

    The August 18, 1977 decision by the Muenster Higher Administrative Court to have the Federal Constitutional Court investigate the constitutionality of permits granted for fast breeder power plants has aroused much attention, both in the FRG and in other countries. This is the first time that the German Atomic Energy Act is being questioned with respect to the separation of powers between legislative and executive authorities and also with respect to the principle of a constitutional state. As a result of their analysis of the first information available about the court decision the authors have some doubts as to whether the views held by the court about the consequences of the development of fast breeder reactors and of the permit granted for the SNR 300 demonstration nuclear power station are essentially correct. In view of the wording of and the official comments on the incriminated Section 7 of the Atomic Energy Act and the large number of subsequent leading decisions by the Federal Diet about fast breeder reactors also the concern about the constitutionality of that reactor line appears to be unfounded.

  18. Early German plans for southern observatories

    Science.gov (United States)

    Wolfschmidt, G.

    2002-07-01

    As early as the 18th and 19th centuries, French and English observers were active in South Africa. Around the beginning of the 20th century, Heidelberg and Potsdam astronomers proposed a southern observatory. Then Göttingen astronomers suggested building an observatory in Windhoek for photographing the sky and measuring the solar constant. In 1910 Karl Schwarzschild (1873-1916), after a visit to observatories in the United States, pointed out the usefulness of an observatory in South West Africa, in a climate superior to that in Germany, giving German astronomers access to the southern sky. Seeing tests were begun in 1910 by Potsdam astronomers, but WW I stopped the plans. In 1928 Erwin Finlay-Freundlich (1885-1964), inspired by the Hamburg astronomer Walter Baade (1893-1960), worked out a detailed plan for a southern observatory with a reflecting telescope, spectrographs and an astrograph with an objective prism. Paul Guthnick (1879-1947), director of the Berlin observatory, in cooperation with APO Potsdam and Hamburg, made a site survey to Africa in 1929 and found the conditions in Windhoek to be ideal. Observations were started in the 1930s by Berlin and Breslau astronomers, but were stopped by WW II. In the 1950s, astronomers from Hamburg and The Netherlands renewed the discussion in the framework of European cooperation, and this led to the founding of ESO in 1963.

  19. The Litvinenko 210polonium case. German experiences

    International Nuclear Information System (INIS)

    Kroeger, Emily Alice

    2009-01-01

    The high scientific standards of the BfS were necessary in order to characterize and evaluate the low activities of 210 Po found during the deployment in Hamburg. The evaluation of the measurements enabled the BfS to offer effective radiation protection advice and to assist the police investigation. The majority of the 210 Po traces were found in places that had been in skin contact with Kovtun, leading to the conclusion that Kovtun had most probably incorporated 210 Po before his visit to Hamburg in October 2006. As yet, no formal charges have been brought by the German authorities against Kovtun and the costs of the operation remain under discussion. Strategies to improve the internal and external deployment communication of the ZUB are being developed and implemented to deal with both the real and the perceived threats that occur during such an incident. Open communication from the onset of a deployment is essential, both between the institutions involved and between deployment leaders and the press. This will save precious time and resources, lower anxiety in the public and emergency workers and could, in a culture of trust where radiation protection advice is listened to and followed, ultimately save lives. (orig.)

  20. Evaluation of German and international operating experience

    International Nuclear Information System (INIS)

    Stueck, Reinhard; Verstegen, Claus

    2014-01-01

    The systematic analysis of safety-relevant events in nuclear power plants and their causes is a key driver for the further development of nuclear safety. The findings obtained from the evaluation of operating experience in this respect form the basis for both technical and organisational improvements in the plants as well as for adaptations of technical rules and standards. In its role as Technical Safety Organisation advising the German federal government, Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS) has been concerned with the detection and analysis of failure mechanisms that underlie events in nuclear power plants at home and abroad since its foundation in 1977. This article provides an overview of the different objectives which are pursued in this context by order of or funded by the Federal Environment Ministry. Here, the focus is on the evaluation of reportable events for the preparation of so-called Information Notices and generic reports as well as for the acquisition of data that can be used for in-depth probabilistic analyses.

  1. Einstein's Cosmos (German Title: Einsteins Kosmos)

    Science.gov (United States)

    Duerbeck, Hilmar W.; Dick, Wolfgang R.

    The different contributions of the present volume illuminate the interaction between Einstein and his colleagues when the foundations of modern cosmology were laid: First, the relativistic effects in the solar system, the gravitational redshift in the solar spectrum, and Einstein's relations with Freundlich and Eddington. Second, the cosmological models of Einstein, de Sitter, Friedmann, and Lemaître, which were discussed controversely till the end of the 1920s. Other scientists have also widened or critically questioned Einstein's insight and knowledge: Schwarzschild, Selety, Silberstein, and Mandl, whose life and work is discussed in separate articles. In those days, politics more than ever in history had influenced the lifes of scientists. Therefore, some comments on the ``political cosmos'' that has influenced decisively Einstein's life are also given. A special role in popularizing Einstein's world view was played by Archenhold Observatory in Berlin. A list of Einstein memorial places and a bibliographic list conclude the present book. All papers are written in German, and have English abstracts.

  2. Profitability of Management Systems on German Fenlands

    Directory of Open Access Journals (Sweden)

    Marco Rebhann

    2016-10-01

    Full Text Available Fens are organic sites that require drainage for agricultural use. Lowering the groundwater level leads to trade-offs between economic benefits and environmental impacts (i.e., CO2 and nutrient emissions. To identify management options that are both environmentally and economically sustainable, a propaedeutic systematic analysis of the costs, income and profit of different land use and management systems on fenlands is necessary. This study provides an overview of the profitability, labor demand and comparative advantages of feasible management systems on German fenlands. Twenty management practices in four land use systems are analyzed. The results indicate that most management systems are profitable only with subsidies and payments for ecosystem services. In addition to sales revenue, these payments are indispensable to promote peat-saving agricultural practices on fenlands. Regarding the labor aspect, intensive management systems caused an increase in working hours per hectare, which may positively affect employment in rural areas. The calculations obtained in this study can be used as a basis for estimations of greenhouse gas (GHG mitigation costs when management systems are associated with GHG emission values.

  3. German risk study, phase (DRS-B)

    International Nuclear Information System (INIS)

    Werner, W.

    1992-01-01

    The first risk investigations were primarily intended to estimate the risk of accidents in nuclear power plants and to compare it with other natural risk and civilization risks. The American reactor safety study WASH 1400 and the German risk study phase A (DRS-A) gave a detailed analyses of the offsite consequences of accidents, especially the magnitude and frequency of health damage for the population. Risk investigations today are primarily used to examine the design of safety systems and to further develop the entire safety concept. Safety investigations have shown that nuclear power plants still possess safety reserves if safety systems do not operate as planned. These safety reserves can be exploited in the sense of a further development of safety by plant internal emergency measures. One purpose of risk analyses is to identify such measures and to evaluate their feasibility and effectiveness. The most important goals of the investigations in DRS-B were: Identification of vulnerabilities and possible safety improvements; determination of safety reserves during accident sequences exceeding the design limits; evaluation of plant internal emergency measures. Thus, goals in phase B compared with phase A have changed from investigations of the magnitude of damage to detailed analysis of the plant systems response under accident conditions. The magnitude of possible fission product releases is also determined in phase B. However, no new accident consequence calculations are performed. Figs and tabs

  4. Subsurface urban heat islands in German cities.

    Science.gov (United States)

    Menberg, Kathrin; Bayer, Peter; Zosseder, Kai; Rumohr, Sven; Blum, Philipp

    2013-01-01

    Little is known about the intensity and extension of subsurface urban heat islands (UHI), and the individual role of the driving factors has not been revealed either. In this study, we compare groundwater temperatures in shallow aquifers beneath six German cities of different size (Berlin, Munich, Cologne, Frankfurt, Karlsruhe and Darmstadt). It is revealed that hotspots of up to +20K often exist, which stem from very local heat sources, such as insufficiently insulated power plants, landfills or open geothermal systems. When visualizing the regional conditions in isotherm maps, mostly a concentric picture is found with the highest temperatures in the city centers. This reflects the long-term accumulation of thermal energy over several centuries and the interplay of various factors, particularly in heat loss from basements, elevated ground surface temperatures (GST) and subsurface infrastructure. As a primary indicator to quantify and compare large-scale UHI intensity the 10-90%-quantile range UHII(10-90) of the temperature distribution is introduced. The latter reveals, in comparison to annual atmospheric UHI intensities, an even more pronounced heating of the shallow subsurface. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Gender - an Issue for German Welfare Organisation

    Directory of Open Access Journals (Sweden)

    2003-11-01

    Full Text Available During the last months and years the English expression 'gender' has become a well-known word all over Germany, often with the annex 'mainstreaming'. Gender mainstreaming was initiated as a political strategy by the Women's World Conference in Beijing in 1995 and adopted by the European Union in 1997 (COM(9676 final. It basically means that all actions and initiatives planned have to be tested as to their effects on women and men and should not be taken if they disadvantage either one. But gender is also a category in the discussion about democratic features. Gender democracy means that males and females should be represented equally in the public, political, cultural, social and economic sphere of a society. On this background, this paper traces the gender issue in the field of organizations in the social sector of Germany, in particular the 'welfare organizations'. In this article, 'welfare organizations' is used as a translation of the German word 'Wohlfahrtsverbände'. The reason for this choice is the endeavor to indicate their difference from for instance English 'charitable associations' or French 'associations sociale et sanitaire', because social organizations in the EU-member states differ considerably in regard to their history, function, self-image , financing, political power etc.. The terms 'social non-governmental organizations' (NGOs or 'social nonprofit organizations' (NPOs are used synonymously.

  6. ["Lean management" in hospitals: potentials and limitations].

    Science.gov (United States)

    Glossmann, J P; Schliebusch, O; Diehl, V; Walshe, R

    2000-08-15

    Little attention has yet been payed on establishing modern and competitive organizational structures in German hospitals. In this paper, we attempt to apply elements of lean management to the work of physicians working in an inpatient setting. Traditional ways of communication and their disadvantages are discussed. These include loss of motivation, bureaucratic structures and a lack of interdisciplinary cooperation. Using Maslow's theory of motivation, possible improvements are discussed, such as the reduction of restrictive job characteristics, an increase of physicians' spheres of competence and the use of their innovative potentials. These suggestions are explained using practical examples. The aim of the study is to contribute to quality management in hospitals by increasing personal responsibilities according to lean management.

  7. The French-German initiative for Chernobyl: Overview of the French-German initiative

    Energy Technology Data Exchange (ETDEWEB)

    Biesold, H.; Friederichs, H.G.; Pretzsch, G. [Gesellschaft fuer Anlagen- und Reaktorsicherheit mbH (GRS), Dept. International Programmes, Berlin (Germany); Deville-Cavelin, G.; Lhomme, V.; Rutschkowsky, N.; Tirmarche, M. [Institut de Radioprotection et de Surete Nucleaire (IRSN), Dept. International Relations, 92 - Clamart (France); Bazyka, D.; Chabanyuk, V.; Seleznev, A. [Chornobyl Center (CC), Kiev regoin (Ukraine); Kellerer, A.M. [Munchen Univ., Strahlenbiologisches Institut (Germany)

    2006-07-01

    - Purpose: The main purpose of the French-German Initiative is to assist in the collection and validation of the existing data in Ukraine, Belarus and Russia for developing a reliable and objective basis useful for the planning of counter-measures, for information of the public, and for future work. - Coordination: GRS (Gesellschaft fuer Anlagen- und Reaktorsicherheit), supported in programme 3 by SBI (Strahlenbiologisches Institut der Universitaet Muenchen) and IRSN (Institut de radioprotection et de surete nucleaire) are coordinating the projects on the Western side. The CC (Chernobyl Center for Nuclear Safety, Radioactive Waste and Radioecology) as Eastern coordinator is also the beneficiary. German Support by Bundesministerium fuer Umwelt, Naturschutz und Reaktorsicherheit (BMU), Vereinigung Deutscher Elektrizitaetswerke (VDEW) e.V.; French Support by Institut de radioprotection et de surete nucleaire (IRSN), Electricite de France (EdF). - Programmes: Three scientific and technical co-operation programmes are financed with a total budget of about 6 million Euro within the frame work of the French- German Initiative: Programme 1: SARCOPHAGUS: Safety of the Chernobyl 'Sarcophagus', Programme 2: RADIOECOLOGY: Study of the radioecological consequences of the accident,Programme 3: HEALTH: Study of health effects. - Background: At the IAEA conference in Vienna in April 1996 - 10 years after the Chernobyl accident - the French and German Environment Ministers jointly announced their co-operation initiative with the Ukraine, Belarus and Russia over scientific programmes concerning the aftermath of the Chernobyl disaster. Numerous scientific studies have been conducted in the affected republics of the former USSR with and without the participation of international organisations, but largely with insufficient real co-ordination. For some of the studies, results have never been publicly documented. There are still incoherent or even contradictory reports on the

  8. OPPOSITIVE METAPHORICAL MODELS IN THE GERMAN POLITICAL DISCOURSE

    Directory of Open Access Journals (Sweden)

    Tameryan, T.Yu.

    2016-06-01

    Full Text Available The paper deals with the analysis of German Chancellor Angela Merkel’s metaphoric image in the German press. As a result of analysis 8 binary metaphorical constructions, verbalized by two components, one of which is positively marked (PM, the other one have been negatively (NM identified. Statistical analysis of the linguistic material allowed to conclude that the assessment of Merkel is ambivalently with a slight predominance of positive estimation.

  9. Higher prices, higher quality? Evidence from German nursing homes

    OpenAIRE

    Herr, Annika; Hottenrott, Hanna

    2016-01-01

    Objectives: This study investigates the relationship between prices and quality of 7,400 German nursing homes controlling for income, nursing home density, demographics, labour market characteristics, and infrastructure at the regional level. Method: We use a cross section of public quality reports for all German nursing homes, which had been evaluated between 2010 and 2013 by external institutions. Our analysis is based on multivariate regressions in a two stage least squares framework, wher...

  10. Germanic heritage languages in North America: Acquisition, attrition and change

    OpenAIRE

    Johannessen, Janne Bondi; Salmons, Joseph C.; Westergaard, Marit; Anderssen, Merete; Arnbjörnsdóttir, Birna; Allen, Brent; Pierce, Marc; Boas, Hans C.; Roesch, Karen; Brown, Joshua R.; Putnam, Michael; Åfarli, Tor A.; Newman, Zelda Kahan; Annear, Lucas; Speth, Kristin

    2015-01-01

    This book presents new empirical findings about Germanic heritage varieties spoken in North America: Dutch, German, Pennsylvania Dutch, Icelandic, Norwegian, Swedish, West Frisian and Yiddish, and varieties of English spoken both by heritage speakers and in communities after language shift. The volume focuses on three critical issues underlying the notion of ‘heritage language’: acquisition, attrition and change. The book offers theoretically-informed discussions of heritage language processe...

  11. Great Britain and German-Polish Relations, 1929–1931

    Directory of Open Access Journals (Sweden)

    Zotova Ekaterina

    2014-12-01

    Full Text Available The article deals with the study of British-German relations during the period of exacerbation of territorial disputes between Germany and Poland in 1929-1931. Germany was making plans for revising the eastern borders. It sought to enlist the support of the new Labour government. Britain didn’t only approve of Germany's intention to carry out revision of the Treaty of Versailles (reparation issue, the evacuation of the Rhineland and the change in the German-Polish border, but also supported the strengthening of the political and economic situation in Germany as a whole. Assistance to Germany was advantageous for Britain. Firstly, the British support helped to improve the capacity of the purchasing power of the German market as one of the traditional markets of the English sale. Secondly, the strengthening of the position of the German cabinet meant failure of the French policy in Europe at this stage. The defeat of France in a dispute on the issue of early evacuation of the Rhineland would seriously devalue the foreign policy initiatives of Paris. Thirdly, the British government hoped that Germany will go into orbit of British political influence. The identity of the positions of the German and the British cabinets were considered as the components of British policy success not only in relations with France and Italy, but also with Czechoslovakia and Poland. Since the formation of the MacDonald’s cabinet, anti-Polish moods increased in the British course for the settlement of German-Polish relations. However, the threat of an attack on Poland by Germany was regarded by the government of Britain as unacceptable way of resolving the German-Polish conflict. Britain tried to follow the traditional foreign policy concept of “balance of power”, but the inefficiency of British policy “mediation” in European affairs was clearly shown in times of growing financial and economic crisis. The issue of the German-Polish border remained unsolved.

  12. Comparisons between Japanese and Korean Learners of German

    OpenAIRE

    吉満, たか子

    2009-01-01

    This article reports on differences and similarities between Japanese and Korean learners of German at a summer course of the University of Hamburg. A survey was conducted with the intention of gaining insights into the profiles, motivation, and difficulties which Japanese and Koreans possess when learning German and language-learning strategies. A questionnaire was administered to 15 Japanese students and 14 Korean students who participated in the summer course held at the University of ...

  13. Media Bias and Advertising: Evidence from German Car Magazines

    OpenAIRE

    Dewenter, Ralf; Heimeshoff, Ulrich

    2011-01-01

    This paper investigates the existence of a possible media bias by analyzing the impact of automobile manufactures' advertisements on automobile reviews in German car magazines. By accounting for both endogeneity and sample selection we find a positive impact of advertising volumes on test scores. Moreover, also a home bias in terms of higher scores for German cars is observable. We account these results as some evidence for a media bias, induced by the two-sidedness of the markets.

  14. D-1 report: The first German spacelab mission

    Science.gov (United States)

    1985-01-01

    Introduction of a new popular magazine on the DI mission, the first West German Space mission. The DI project office publishes the magazine. The German sponsored astronauts are to study the gravitational effects of reduced gravity on the human generated processes of the environment. Other areas of concern are boundary surface and transport phenomena, physical chemisty and process engineering, metals and composite materials, and single crystals.

  15. HIGHER CHOREOGRAPHIC EDUCATION: THE EXPERIENCE OF GERMAN-SPEAKING COUNTRIES

    Directory of Open Access Journals (Sweden)

    Iryna Tkachenko

    2017-03-01

    Full Text Available The current state of higher choreographic education and features of professional training of choreographers in the German-speaking countries, in particular Austria, Germany and Switzerland were analyzed. It is found that most of the German-speaking countries are Germany, Austria and Switzerland, which became the object of study. The considered the structure of higher choreographic education in the German-speaking countries. Universities, higher dance schools and higher art schools are functioning in Germany. Universities and academies are functioning in Austria and Switzerland. The institutions of theatre sciences, faculty of pedagogy and psychology, departments of performing arts are the structural units of the universities. The institutions of higher education have both private and state ownership. It is found out that the main areas for which training is future choreographers in the German-speaking countries there is a "Dance", "Dance pedagogy", "Modern dance", "Science of dance", "Choreography". German-speaking countries recognized by the training of specialists in the specialty choreography of Modern dance that has no analogues in Ukraine. The term of study is four (bachelor and two (master years. Higher choreographic education in these countries has a different approach and aims at mastering a separate specialty that provides future dance instructors completely and thoroughly master the basic knowledge and skills in this specialty. Specific conditions and rules of admission to the higher educational institutions of German-speaking countries.

  16. Verb Movement Variation in Germanic and Optimality Theory

    DEFF Research Database (Denmark)

    Vikner, Sten

    2001-01-01

    This habilitation dissertation falls into two parts. In the first part, "Establishing the typology: Verb Movement in the Germanic VO- and OV-languages", I continue the work in Vikner (1995a, 1997) on the movement of finite verbs across the Germanic languages. Chapter 1 argues that rich finite inf...... data are treated: constructions with auxiliaries, negation and/or do-insertion, and chapter 7 accounts for the differences in distribution between the V2 word order and the non-V2 word order between the languages.......This habilitation dissertation falls into two parts. In the first part, "Establishing the typology: Verb Movement in the Germanic VO- and OV-languages", I continue the work in Vikner (1995a, 1997) on the movement of finite verbs across the Germanic languages. Chapter 1 argues that rich finite...... inflection triggers V°-to-I° movement in the Germanic (and Romance) VO-languages, chapter 2 supports the claim that Yiddish is an OV-language, and chapter 3 defends the view that all Germanic OV-languages except Yiddish do not have V°-to-I° movement. Where Part I tries to establish facts and arguments which...

  17. USING EDUCATIONAL MARBLE GAMES IN GERMAN LANGUAGE TEACHING

    Directory of Open Access Journals (Sweden)

    HASAN COŞKUN

    2015-09-01

    Full Text Available The aim of this article is to show how German students can be motivated by learning games. Apart from the development and didacticisation of the learning game “Marbles”, the attitude of Turkish families and language teaching educational establishments and the support of the DaF lessons by German mediating institutions in Turkey will be considered. The attitude of Turkish families to learning foreign languages is mostly positive. Turkish educational authorities and those responsible for education take various measures to expand foreign language teaching availability in the schools. German institutions which provide teachers (Goethe-Institut, ZfA, DAAD promote the improvement of German teaching in Turkey. Nevertheless, the quality of German teaching is not satisfactory mostly because the available teachers are not adequately qualified, teacher training is remote from practice, the quality of text books and teaching materials, the traditions of learning, the excessively large classes, inadequate learning environment (language cabinets and equipment, the nature and method of central examinations (multiple choice and their significance in the Turkish educational system. In the long-term, this leads to frustration in both teachers and students. The Turkish educational authorities initially took measures to expand the availability of language teaching in the course of harmonisation of the Turkish educational system to that of the EU e.g. the introduction of a second foreign language. German mediating institutions ensure reasonable further training for teachers locally and in Germany and support the creation of teaching materials etc.

  18. Interviewing German scientists on climate change. A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Ungar, S. [GKSS-Forschungszentrum Geesthacht GmbH (Germany). Inst. fuer Kuestenforschung; Toronto Univ., Scarborough (Canada)

    2004-07-01

    This study is based on in-depth interviews with 25 German scientists at the Coastal Research Institute of the GKSS-Forschungszentrum. It takes as its context the differential rhetoric and planning on climate change found in Germany and North America. The interviews try to throw light on the early German decision to address climate change, and to assess the current attitudes, beliefs and experiences of these German scientists. The results reveal a degree of complacency among these scientists, including a sense that Germany is not particularly threatened by climate change and has the capacity to adapt to it. The scientists are critical of inaction among the German population, but themselves uphold a ''light version'' of the precautionary principle. They have great difficulty translating the idea of climate change into popular metaphors that can be grasped by children. They strongly reject any link between German leadership on the issue as a result of a sense of guilt about the German past. (orig.)

  19. German validation of Quality of Life after Brain Injury (QOLIBRI) assessment and associated factors.

    Science.gov (United States)

    von Steinbüchel, Nicole; Real, Ruben G L; Sasse, Nadine; Wilson, Lindsay; Otto, Christiane; Mullins, Ryan; Behr, Robert; Deinsberger, Wolfgang; Martinez-Olivera, Ramon; Puschendorf, Wolfgang; Petereit, Werner; Rohde, Veit; Schmidt, Holger; Sehmisch, Stephan; Stürmer, Klaus Michael; von Wild, Klaus; Gibbons, Henning

    2017-01-01

    The consequences of traumatic brain injury (TBI) for health-related quality of life (HRQoL) are still poorly understood, and no TBI-specific instrument has hitherto been available. This paper describes in detail the psychometrics and validity of the German version of an internationally developed, self-rated HRQoL tool after TBI-the QOLIBRI (Quality of Life after Brain Injury). Factors associated with HRQoL, such as the impact of cognitive status and awareness, are specifically reported. One-hundred seventy-two participants after TBI were recruited from the records of acute clinics, most of whom having a Glasgow Coma Scale (GCS) 24-hour worst score and a Glasgow Outcome Scale (GOSE) score. Participants had severe (24%), moderate (11%) and mild (56%) injuries as assessed on the GCS, 3 months to 15 years post-injury. The QOLIBRI uses 37 items to measure "satisfaction" in the areas of "Cognition", "Self", "Daily Life and Autonomy", and "Social Relationships", and "feeling bothered" by "Emotions"and "Physical Problems". The scales meet standard psychometric criteria (α = .84 to .96; intra-class correlation-ICC = .72 to .91). ICCs (0.68 to 0.90) and αs (.83 to .96) were also good in a subgroup of participants with lower cognitive performance. The six-subscale structure of the international sample was reproduced for the German version using confirmatory factor analyses and Rasch analysis. Scale validity was supported by systematic relationships observed between the QOLIBRI and the GOSE, Patient Competency Rating Scale for Neurorehabilitation (PCRS-NR), Hospital Anxiety and Depression Scale (HADS), Profile of Mood States (POMS), Short Form 36 (SF-36), and Satisfaction with Life Scale (SWLS). The German QOLIBRI contains novel information not provided by other currently available measures and has good psychometric criteria. It is potentially useful for clinicians and researchers, in post-acute and rehabilitation studies, on a group and individual level.

  20. German validation of Quality of Life after Brain Injury (QOLIBRI assessment and associated factors.

    Directory of Open Access Journals (Sweden)

    Nicole von Steinbüchel

    Full Text Available The consequences of traumatic brain injury (TBI for health-related quality of life (HRQoL are still poorly understood, and no TBI-specific instrument has hitherto been available. This paper describes in detail the psychometrics and validity of the German version of an internationally developed, self-rated HRQoL tool after TBI-the QOLIBRI (Quality of Life after Brain Injury. Factors associated with HRQoL, such as the impact of cognitive status and awareness, are specifically reported. One-hundred seventy-two participants after TBI were recruited from the records of acute clinics, most of whom having a Glasgow Coma Scale (GCS 24-hour worst score and a Glasgow Outcome Scale (GOSE score. Participants had severe (24%, moderate (11% and mild (56% injuries as assessed on the GCS, 3 months to 15 years post-injury. The QOLIBRI uses 37 items to measure "satisfaction" in the areas of "Cognition", "Self", "Daily Life and Autonomy", and "Social Relationships", and "feeling bothered" by "Emotions"and "Physical Problems". The scales meet standard psychometric criteria (α = .84 to .96; intra-class correlation-ICC = .72 to .91. ICCs (0.68 to 0.90 and αs (.83 to .96 were also good in a subgroup of participants with lower cognitive performance. The six-subscale structure of the international sample was reproduced for the German version using confirmatory factor analyses and Rasch analysis. Scale validity was supported by systematic relationships observed between the QOLIBRI and the GOSE, Patient Competency Rating Scale for Neurorehabilitation (PCRS-NR, Hospital Anxiety and Depression Scale (HADS, Profile of Mood States (POMS, Short Form 36 (SF-36, and Satisfaction with Life Scale (SWLS. The German QOLIBRI contains novel information not provided by other currently available measures and has good psychometric criteria. It is potentially useful for clinicians and researchers, in post-acute and rehabilitation studies, on a group and individual level.

  1. A 'German world' shared among doctors: a history of the relationship between Japanese and German psychiatry before World War II.

    Science.gov (United States)

    Hashimoto, Akira

    2013-06-01

    This article deals with the critical history of German and Japanese psychiatrists who dreamed of a 'German world' that would cross borders. It analyses their discourse, not only by looking at their biographical backgrounds, but also by examining them in a wider context linked to German academic predominance and cultural propaganda before World War II. By focusing on Wilhelm Stieda, Wilhelm Weygandt and Kure Shuzo, the article shows that the positive evaluation of Japanese psychiatry by the two Germans encouraged Kure, who was eager to modernize the treatment of and institutions for the mentally ill in Japan. Their statements on Japanese psychiatry reflect their ideological and historical framework, with reference to national/ethnic identity, academic position, and the relationship between Germany and Japan.

  2. "deutsche Sprache, gute Sprache...": Minorities in Germany and Their German-Language Literature for Upper-Division German.

    Science.gov (United States)

    Veteto-Conrad, Marilya

    1997-01-01

    Describes how the topic of minorities and minority literature can be integrated into an upper-division German course. Presents materials and approaches used in a recent fourth-year model minicourse. (28 references) (Author/CK)

  3. Europeanization of the Hospital Markets - Opportunities and Risks for German Hospitals (Europaeisierung des Krankenhausmarkets - Chancen und Risiken fuer deutsche Krankenhaeuser)

    Science.gov (United States)

    2004-07-06

    Information Services Institut (3M HIS Institut) hat u.a. mit der Entwicklung eines Werkzeugs zur Pflege und Weiterentwicklung des deutschen DRG-Systems ftir... Pflege (Krankenhauspflege) a. die Kosten wachsen schneller als allgerneine Inflation b. praktisch stabile Krankenversicherungsentnahme c. es existieren 9...Krankenkassen d. die Pflege ist von der Krankenversicherung voll (theoretisch) vergUltet e. Missverhlitnis zwischen Versicherungsentnuhrne und

  4. The German Quality Network Sepsis: study protocol for the evaluation of a quality collaborative on decreasing sepsis-related mortality in a quasi-experimental difference-in-differences design.

    Science.gov (United States)

    Schwarzkopf, Daniel; Rüddel, Hendrik; Gründling, Matthias; Putensen, Christian; Reinhart, Konrad

    2018-01-18

    While sepsis-related mortality decreased substantially in other developed countries, mortality of severe sepsis remained as high as 44% in Germany. A recent German cluster randomized trial was not able to improve guideline adherence and decrease sepsis-related mortality within the participating hospitals, partly based on lacking support by hospital management and lacking resources for documentation of prospective data. Thus, more pragmatic approaches are needed to improve quality of sepsis care in Germany. The primary objective of the study is to decrease sepsis-related hospital mortality within a quality collaborative relying on claims data. The German Quality Network Sepsis (GQNS) is a quality collaborative involving 75 hospitals. This study protocol describes the conduction and evaluation of the start-up period of the GQNS running from March 2016 to August 2018. Democratic structures assure participatory action, a study coordination bureau provides central support and resources, and local interdisciplinary quality improvement teams implement changes within the participating hospitals. Quarterly quality reports focusing on risk-adjusted hospital mortality in cases with sepsis based on claims data are provided. Hospitals committed to publish their individual risk-adjusted mortality compared to the German average. A complex risk-model is used to control for differences in patient-related risk factors. Hospitals are encouraged to implement a bundle of interventions, e.g., interdisciplinary case analyses, external peer-reviews, hospital-wide staff education, and implementation of rapid response teams. The effectiveness of the GQNS is evaluated in a quasi-experimental difference-in-differences design by comparing the change of hospital mortality of cases with sepsis with organ dysfunction from a retrospective baseline period (January 2014 to December 2015) and the intervention period (April 2016 to March 2018) between the participating hospitals and all other German

  5. Dictionary of control technology. Pneumatics, hydraulics, electronics. English-German, German-English. Woerterbuch der Steuerungstechnik. Pneumatik, Hydraulik, Elektronik. Deutsch-Englisch, Englisch-Deutsch

    Energy Technology Data Exchange (ETDEWEB)

    Budd, F

    1988-01-01

    The English-German/German-English dictionary covers the complete field of control technology present in industry today. The subjects represent appropriate terms from hydraulics, pneumatics, electrical engineering, electronics, data processing, administration, and training. (DG).

  6. The German model of capitalism and the persistence of outward foreign direct investment: evidence from German manufacturing industries

    Directory of Open Access Journals (Sweden)

    Martin T Bohl

    2011-06-01

    Full Text Available Against the backdrop of critique on the German model of capitalism in general, and German public policy in particular as to the ability to successfully adjust to rapid change and exogenous shocks in wake of economic globalisation, this paper investigates the degree of shock persistence in foreign direct investment (FDI of ten German manufacturing industries for the period 1976 to 2003. Theory on exports and non-FDI investment suggests that FDI should exhibit a considerable degree of shock persistence because they are subject to high sunk costs because of high entry and exit costs associated with the high level of asset specificity that is normally connected to FDI. Persistence in foreign direct investment time series data is established by applying various unit root tests. The results are robust to the potential presence of structural breaks in the data. The empirical analysis shows that German outward FDI in mature manufacturing industries, with one exception, exhibits a high degree of shock persistence. The results suggest, at least for mature German industries, that the sunk costs view on shock persistency is confirmed for outward FDI. The results furnish evidence for a tentative assessment of the relationship between German public policy and FDI strategies of multinational firms.

  7. [Evaluating the effectiveness of a disease management program diabetes in the German Statutory Health Insurance: first results and methodological considerations].

    Science.gov (United States)

    Drabik, Anna; Graf, Christian; Büscher, Guido; Stock, Stephanie

    2012-01-01

    Disease management programs (DMPs) were implemented in the German Statutory Health Insurance (SHI) in a nationwide rollout in 2002. The explicit goal of the programs is to improve coordination and quality of care for the chronically ill (Sect. 137f, SGB V). To reach this goal extensive quality assurance measures in the programs are mandatory, enrolment and coordination of care rests with the primary care or DMP physician, treatment is based on evidence-based care guidelines, and patients are offered diabetes education classes to support self-management. The present study evaluates the DMP diabetes mellitus type II, a nationwide program offered by the BARMER, a German health insurance company. To minimize selection bias we formed a control group of administrative data using a propensity score matching approach. In comparison to the control group DMP participants have a significantly lower mortality rate, and their average drug and hospital costs are reduced. Enrolled patients also had a lower mean number of hospital stays and shorter hospital stays. These results indicate that the programs meet the initial goal of improving the quality of care for the chronically ill. Copyright © 2011. Published by Elsevier GmbH.

  8. German research reactor back-end provisions

    International Nuclear Information System (INIS)

    Koester, Siegfried; Gruber, Gerhard

    2002-01-01

    Germany has several types of Research Reactors in operation. These reactors use fuel containing uranium of U.S. origin. Basically all the fuel which will be spent until May 2006 will be returned to the U.S. under existing contracts with the U.S. Department of Energy. The contracts are based on the U.S. FRR SNF (Foreign Research Reactor Spent Nuclear Fuel) Program which started in May 1996 and which will last for 10 years. In 1990, the German Federal Government started a program to long-term store (approx. 40 years) and finally dispose of spent fuel in Germany after the so-called U.S. fuel return window will be closed. In order to long-term store the fuel, a special container was designed which covers all different types of spent fuel from the Research Reactors. The container called 'CASTOR MTR 2' is basically licensed and is already in use for the spent fuel of Russian origin from the 'Research Reactor Rossendorf' in the eastern part of Germany. All that fuel is expected to be stored in the existing intermediate storage facility, the so-called BZA (Brennelemente Zwischenlager Ahaus). BZA already accomodates spent fuel from the former THTR-300 high temperature reactor. A final repository does not yet exist in Germany. Alternative provisions to close the back-end of the Research Reactor fuel cycle are reprocessing at COGEMA (France) or in Russian facilities, perspectively. Waste return in a form to be agreed will be mandatory, at least in France. (author)

  9. RISK MANAGEMENT OF GERMAN FRUIT PRODUCERS

    Directory of Open Access Journals (Sweden)

    Annkatrin PORSCH

    2018-03-01

    Full Text Available Horticultural farms in Germany face substantial business risks. However, fruit farms often struggle to implement appropriate risk management processes, and the risk management literature widely has ignored this farm type. The aim of the study was to improve the assessment of risks by farmers and the choice of suitable risk management instruments. Therefore, a risk management process based on subjective probabilities and suitable for small and medium-sized farms was developed, considering the specific needs of family run businesses. An online survey was conducted to achieve a comprehensive view of the risk perception and risk management practices of German fruit producers. Price and production risks are the most relevant risk categories for fruit farmers. However, among single risk sources, those in the people risk category were seen as the most important. Results show significant interactions among risk categories and a significant correlation between loss experience and the rating of risk categories. The assumption that risk averse farmers generally rate risks higher than risk neutral or risk seeking farmers cannot be confirmed. Diversification seems to be the most important risk management instrument for many fruit producers, especially diversification of marketing channels, farm income, and production activities. Further research should focus on the apparent inconsistency between the satisfaction with instruments reported by farmers and the actual implementation of many of them (e.g., hail insurance and anti-hail net. Furthermore, there is a need for research, to develop decision models considering the interactions of risks and risk management instruments, loss experience and risk seeking attitudes.

  10. The Myth of Apolitical Volunteering for Refugees: German Welcome Culture and a New Dispositif of Helping

    Directory of Open Access Journals (Sweden)

    Larissa Fleischmann

    2017-09-01

    Full Text Available During the so-called “refugee crisis”, the notion of an unparalleled German hospitality toward asylum seekers circulated within the (international public sphere, often encapsulated by the blurry buzzword “Welcome Culture”. In this article, we scrutinize these developments and suggest that the image of the so-called “crisis” has activated an unprecedented number of German citizens to engage in practices of “apolitical” helping. We argue that this trend has contributed to the emergence of what we term a new dispositif of helping, which embeds refugee solidarity in humanitarian parameters and often avoids an explicit political, spatial, and historical contextualization. This shift has activated individuals from the socio-political centre of society, well beyond the previously committed radical-left, antiracist, and faith-based groups. However, we aim to unmask forms of “apolitical” volunteering for refugees as a powerful myth: the new dispositif of helping comes with ambivalent and contradictory effects that range from forms of antipolitics to transformative political possibilities within the European border regime.

  11. Improving patient-level costing in the English and the German 'DRG' system.

    Science.gov (United States)

    Vogl, Matthias

    2013-03-01

    The purpose of this paper is to develop ways to improve patient-level cost apportioning (PLCA) in the English and German inpatient 'DRG' cost accounting systems, to support regulators in improving costing schemes, and to give clinicians and hospital management sophisticated tools to measure and link their management. The paper analyzes and evaluates the PLCA step in the cost accounting schemes of both countries according to the impact on the key aspects of DRG introduction: transparency and efficiency. The goal is to generate a best available PLCA standard with enhanced accuracy and managerial relevance, the main requirements of cost accounting. A best available PLCA standard in 'DRG' cost accounting uses: (1) the cost-matrix from the German system; (2) a third axis in this matrix, representing service-lines or clinical pathways; (3) a scoring system for key cost drivers with the long-term objective of time-driven activity-based costing and (4) a point of delivery separation. Both systems have elements that the other system can learn from. By combining their strengths, regulators are supported in enhancing PLCA systems, improving the accuracy of national reimbursement and the managerial relevance of inpatient cost accounting systems, in order to reduce costs in health care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  12. Hospital Outpatient PPS Partial Hospitalization Program LDS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...

  13. Can hospitals compete on quality? Hospital competition.

    Science.gov (United States)

    Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W

    2015-09-01

    In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples.

  14. German 450: Introduction to Business Operations in Germany. Initiating the Integration Process into the International Business Environment for German Majors at the Undergraduate and Graduate Levels.

    Science.gov (United States)

    Becker, Claudia A.

    The redesign of a course on German business, taught at the University of Illinois at Chicago, is described. The course, intended for both undergraduate and graduate German majors, initially described and defined German institutions and common business practices and explored differences in historical and cultural backgrounds. Course revision…

  15. Beginning German in Grade Three: MLA Teacher's Guide. A Course of Study Including Methods, Materials, and Aids for Teaching Conversational German to Third-Grade Children.

    Science.gov (United States)

    Wittman, Nora E.; And Others

    This guide is planned to help the FLES teacher develop pleasurable language learning experiences in spoken German for children at the third-grade level. Experiences included in this guide present German in life situations, as well as insight into German culture. The guide offers suggestions for classroom procedures, and detailed directions are…

  16. Hospital ownership, decisions on supervisory board characteristics, and financial performance.

    Science.gov (United States)

    Kuntz, Ludwig; Pulm, Jannis; Wittland, Michael

    2016-01-01

    Dynamic and complex transformations in the hospital market increase the relevance of good corporate governance. However, hospital performance and the characteristics of supervisory boards differ depending on ownership. The question therefore arises whether hospital owners can influence performance by addressing supervisory board characteristics. The objective of this study is to explain differences in the financial performance of hospitals with regard to ownership by studying the size and composition of supervisory boards. The AMADEUS database was used to collect information on hospital financial performance in 2009 and 2010. Business and quality reports, hospital websites, and data from health insurer were used to obtain information on hospital and board characteristics. The resulting sample consisted of 175 German hospital corporations. We utilized ANOVA and regression analysis to test a mediation hypothesis that investigated whether decisions regarding board size and composition were associated with financial performance and could explain performance differences. Financial performance and board size and composition depend on ownership. An increase in board size and greater politician participation were negatively associated with all five tested measures of financial performance. Furthermore, an increase in physician participation was positively associated with one dimension of financial performance, whereas one negative relationship was identified for nurse and economist participation. For clerics, no associations were found. Decisions concerning board size and composition are important as they relate to hospital financial performance. We contribute to existing research by showing that, in addition to board size and physician participation, the participation of other professionals can also influence financial performance.

  17. [The hospital at Hillersleben Germany, April 1945].

    Science.gov (United States)

    Weisskopf, Varda

    2014-01-01

    On 6th April 1945, nine days before the liberation of the Bergen Belsen Concentration Camp, about 2,500 Jewish prisoners were ordered to prepare to leave the camp on the next day. On 7th April, the prisoners left through the gates of the camp and began to walk about 10 kilometers to the train station near the city of Celle. There they were ordered to board a train that would take them to the Theresienstadt Concentration Camp. After six days of travel, the train stopped near the village of Farsleben, Germany, where it was liberated by the 743rd Tank Battalion of the 30th Infantry Division, of the U.S. 9th Army, on 13th April 1945. The 105th Medical Battalion of the same Division was the primary care provider for the survivors, who were then taken in vehicles available from the 30th Infantry Division, and organized into a convoy by the Division's Liaison Officer, Lt. Frank W. Towers, to the town of Hillersleben. A former German Air Force Base was located at Hillersleben with a small hospital that could not provide medical attention to all the survivors. On 21st April, Company C of the 95th Medical Battalion, received an order to go to Hillersleben. Colonel Dr. William W. Hurteau, the Commanding Officer of this Battalion, determined that the biggest task given to the Battalion during World War II, was establishing another hospital in the town of Hillersleben and providing additional beds in the existing hospital, which was a structure that had served as a boarding school. Furthermore, they needed to acquire hospital equipment which was obtained from German equipment and supplies that had been captured by the U.S. MiLitary. Also, they took care of obtaining food supplies from German warehouses, and meat and milk from local dairy farms. The lives of the prisoners on this train were saved by the heroism and dedicated work of those brave soldiers of the 30th Infantry Division and the 95th Medical Battalion.

  18. [German validation of the Acute Cystitis Symptom Score].

    Science.gov (United States)

    Alidjanov, J F; Pilatz, A; Abdufattaev, U A; Wiltink, J; Weidner, W; Naber, K G; Wagenlehner, F

    2015-09-01

    The Uzbek version of the Acute Cystitis Symptom Score (ACSS) was developed as a simple self-reporting questionnaire to improve diagnosis and therapy of women with acute cystitis (AC). The purpose of this work was to validate the ACSS in the German language. The ACSS consists of 18 questions in four subscales: (1) typical symptoms, (2) differential diagnosis, (3) quality of life, and (4) additional circumstances. Translation of the ACSS into German was performed according to international guidelines. For the validation process 36 German-speaking women (age: 18-90 years), with and without symptoms of AC, were included in the study. Classification of participants into two groups (patients or controls) was based on the presence or absence of typical symptoms and significant bacteriuria (≥ 10(3) CFU/ml). Statistical evaluations of reliability, validity, and predictive ability were performed. ROC curve analysis was performed to assess sensitivity and specificity of ACSS and its subscales. The Mann-Whitney's U test and t-test were used to compare the scores of the groups. Of the 36 German-speaking women (age: 40 ± 19 years), 19 were diagnosed with AC (patient group), while 17 women served as controls. Cronbach's α for the German ACSS total scale was 0.87. A threshold score of ≥ 6 points in category 1 (typical symptoms) significantly predicted AC (sensitivity 94.7%, specificity 82.4%). There were no significant differences in ACSS scores in patients and controls compared to the original Uzbek version of the ACSS. The German version of the ACSS showed a high reliability and validity. Therefore, the German version of the ACSS can be reliably used in clinical practice and research for diagnosis and therapeutic monitoring of patients suffering from AC.

  19. 95. German Roentgen congress and 7. joint congress of the DRG and OeRG. Program with abstracts

    International Nuclear Information System (INIS)

    Diederich, Stefan; Lammer, Johannes

    2014-01-01

    The volume contains the program and the abstracts of the 95th German Roentgen congress and the 7th joint congress of the DRG and OeRG. The radiological focal points of the congress were thorax radiology (pneumology: lung fibrosis, emphysema); oncological radiology: skeletal carcinoma, lung carcinoma, kidneys, lung metastases, primary liver carcinoma, liver metastases. Further topics included radiology in hospitals and medical centers, tele-radiology, ambulant health care, legal issues, financial accounting and management issues. Several courses an specific radiological issues and radiological techniques were offered, including radiation protection and legal aspects.

  20. Albrecht Scholz (1940-2013): German dermatologist and historian of dermatology.

    Science.gov (United States)

    Grzybowski, Andrzej; Parish, Lawrence Charles; Plewig, Gerd

    2014-01-01

    Albrecht Scholz (Figure 1) was born in Görlitz (now Zgorzelec, a city located at the Polish-German border, covering both sides of the River Nysa) on September 6, 1940, the youngest of three children. His father was a laryngologist, specializing in voice and hearing impairment. Scholz attended school in his hometown and in 1958 passed his Matura examination, after which he studied medicine at both Humboldt University in Berlin and the “Carl Gustav Carus” Medical Academy in Dresden. Following successful completion of the state examination in 1964 and an internship at the Reichenbach Hospital the following year, he was granted the right to practice medicine. His 1964 doctoral dissertation was titled, “Evaluation of Astrand's Steps in Elderly Patients.”