German Regions Research Articles

Textbooks, hunger, and humanitarian narratives: representations of U.S. food policies to Germany on a regional scale (1949–89)

AbstractThis article investigates the significance of United States (U.S.) post-WWII food aid to Germany in West German textbooks from a regional angle during the Cold War period. Previous studies have predominantly focused on interpreting the significance of U.S. aid in West Germany from a national standpoint, overlooking regional variations in humanitarian narratives. This study challenges the national scale as the exclusive basis of collective meaning. By exploring educational materials from three different German regions—Berlin, Bavaria and North Rhine-Westphalia, it examines the different afterlives of U.S. aid in West German humanitarian narratives. Further attention for nuances in reconstructing humanitarian narratives not only does justice to the distinct regional histories and memory cultures, but also gives scope to reassessments of dominant narratives.

Developing a trustworthy national health data space: public needs and policy implications

Abstract Background The ongoing development of a national health data space in Switzerland presents an opportunity to transform health delivery and care by enabling large-scale secondary health research. Central to this development is the Health2030 strategy, which calls for the establishment of public trust in the reliability and security of data collection, storage, and exchange. Methods We conducted four focus groups across the German, French and Italian-speaking regions of Switzerland to inform the development of the Swiss health data space that fosters public trust. To inform Swiss policy, we held a panel discussion with patient experts and healthcare professionals to translate the focus group findings into governance and public communication requirements. We synthesized our findings using a thematic analysis approach and proposed a guiding health policy strategy. Results Citizens perceive the health data space as trustworthy conditional on the delivery of its promised higher levels of transparency, security, and lower risk compared to other data sharing initiatives. To ensure its trustworthiness, citizens call for the provision of value-based consent to control data access based on the actors involved and research purposes, alongside implementing accountability measures for data misuse. Governance framework requirements entail establishing an advisory group for the health data space with sufficient representation of the Swiss population, including members of the public, patient advisory groups, and researchers. Public communication requirements call for ongoing monitoring of public opinion on health data space, alongside establishing public engagement initiatives, such as public fora, to inform ongoing progress. Conclusions Policy efforts should prioritize the meaningful involvement of relevant stakeholders throughout all stages of the health data space development to foster trust. Central to these efforts is balancing public expectations with their practical implementation. Key messages • For the health data space to be trustworthy, citizens require transparency on their data use and the security measures taken, value-based consent for data access, and accountability measures. • Diverse representation in governance and continuous public involvement are key policy measures to build public trust in the development of national health data spaces.

Public views on open data health research in Switzerland: Implications for research and policy

Abstract Background The increasing volume of publicly available data offers health researchers opportunities to explore public sentiment through open data research on issues such as vaccination hesitancy and fake news propagation. To ensure ethical conduct and maintain public trust, assessing public perceptions of open data research in healthcare is crucial. Methods We conducted 10 focus groups across the German, French, and Italian-speaking regions of Switzerland. We presented participants with real-world examples of open data research in healthcare and guided discussions using a semi-structured format. The topic areas were: (1) using Twitter data to assess public opinion on gene-editing technology, (2) assessment of health policy documents, (3) using Twitter data to predict individual health status and (4) using YouTube data to assess public sentiment on health policies. We assessed our findings using a thematic analysis approach. Results Gathering insights from 75 citizens, four major themes emerged: (1) Expectations towards actors and open data research, such as using research findings for societal benefit, and ensuring transparency in data use through informed consent; (2) Supportive measures including communication strategies to raise awareness and inform the public about the use of publicly available data for health research; (3) Concerns about data reuse for purposes beyond the study’s objectives, especially for financial gain, and about data validity and privacy, particularly for sensitive health data; and (4) Mitigative measures to minimize harm, such as through the involvement of external oversight committees. Conclusions Our findings indicate public support for open data research in healthcare, provided that specific expectations are met. Developing a guiding framework for legitimate open data research in healthcare is a valuable next step, with a focus on enhancing public awareness through communication campaigns and providing oversight measures to foster public trust. Key messages • Open data research in healthcare relies on public data use without explicit consent, which can disconnect the research community from society. • We found that public support for open data research in healthcare is generally present, however it is also conditional on communication and policy efforts addressing their concerns.

Reversing fortunes of German regions, 1926–2019: Boon and bane of early industrialization?

Reversing fortunes of German regions, 1926–2019: Boon and bane of early industrialization?

Digitalization and the Emergence of E-Mobility Technology in German Regions

Digitalization and the Emergence of E-Mobility Technology in German Regions

Different impacts of similar crises? The financial and COVID-19 crisis in border and non-border regions

ABSTRACT The last two decades have seen an increase in the number and intensity of shocks and crises. The financial crisis of 2008/2009 and the COVID-19 crisis of 2020/2021 have led to economic recessions. During the COVID-19 crisis, national borders and the impact of crises in border regions were often the subject of political debate and media coverage. Border-regional resilience has only been discussed in the academic discourse for the last few years. This article uses a diverse set of socio-economic indicators to examine the (border)–regional resilience of German regions in the wake of the financial crisis and the COVID-19 crisis. A distinction is made between border and non-border regions, urban and rural regions, and regions in the old and new German federal states. The results show, first, that the COVID-19 crisis had a stronger socio-economic impact than the financial crisis. Second, border regions tended to be more affected by the financial crisis than non-border regions. Surprisingly, this was not the case for the border-specific COVID-19 crisis. Moreover, the study shows that it is not so much the border location that determines regional resilience, but rather the socio-economic level, the degree of urbanization and the associated embeddedness in global networks.

교육과정의 교과 편제와 내용조직 비교 연구: 독일의 교과 편제와 역사 교육과정을 중심으로

This study aims to discuss the subject organization and time allocation by linking them to the contents of subject curriculum. To this end, this study compares the subject organization and time allocation of the secondary school curriculum and contents of learning of history subject curriculum by grade using the cases of three German regions (North Rhine-Westphalia, Bavaria, and Baden- Württemberg), in juxtaposition with the grade-specific learning topics in the current history curriculum of South Korea. In Germany, history is allocated a constant two hours per week for six years in grades 5 through 10. The scope of study is dominated by the history of Western Europe and Germany, and is organized to cover ancient, medieval, and modern times in chronological order only one time over the six years. This differs significantly from the curriculum of Korea, where Korean history is taught three times in chronological order for one semester or one year each in elementary, middle, and high school. World history taught once for one year covering all eras in middle school. This study argues the following two points. First, the Secondary Stufe I curriculum in Germany, based on the school system of grades 5-10, covers the content of a subject curriculum in a continuous manner without poses between school levels and grades, and this organization and allocation of time provides a foundation for depth of learning. Second, the Korean history curriculum, which covers the entire chronological period in a single semester or year, needs to be changed to lay the foundation for in-depth learning. In terms of individual students' learning experience and growth, the organization of subject and its content should be discussed beyond the distinction between school levels.

Rooftop PV Potential Determined by Backward Ray Tracing: A Case Study for the German Regions of Berlin, Cologne, and Hanover

ABSTRACTPhotovoltaics (PV) on building rooftops is a major contributor to the decarbonization of energy systems. We simulate the PV energy yield potential for 2.5 million individual roofs in three German regions. We cumulate the results for each single roof to calculate the cost‐potential curves for the three cities Berlin, Cologne, and Hanover. These curves give the amount of electricity that can be generated at less than a given cost per kWh. We find that these curves have the shape of a hockey stick. Neglecting the dependence of PV investment on building size and thus on the system sizes causes largely different cost‐potential curves that differ by 11%–18% for flat roofs due to their heterogeneous building size distribution. The cost‐potential curves of the three cities are very similar when appropriately normalized, for example, by the local solar irradiation and the settlement area of the city, despite substantial variations in population density. This allows for an extrapolation of our results. For Germany, we reveal an upper limit for the total electricity generation from rooftop PV of 762 TWh/a with cost as low as 6.9 ct/kWh without accounting for area losses due to chimneys, air conditioning systems, and so forth. We estimate the actual potential to be at least half of that figure.

Proton Pump Inhibitor Prescription in Nursing Home Residents: Prevalence, Appropriateness, and Associated Factors-A Secondary Data Analysis from Three German Regions and the Impact of Guideline Recommendations.

Despite reliable evidence of adverse drug effects, the substantially increased prescription rates of proton pump inhibitors (PPIs) remain at a high level. This study analyzed the appropriateness of PPI prescriptions among residents of nursing homes in three regions of Germany. Baseline data of a cluster-randomized controlled trial were used to determine the prevalence of PPI prescriptions, the validity of indications, and the adequacy of the prescribed dosages according to 1. their drug approvals and 2. valid recommendation guidelines. Regression analyses were conducted to assess associated factors. A total of 437 residents in 37 nursing homes were included (mean age 83 ± 9.2 years, 72% women). The PPI prescription prevalence was 44% (n = 193). In 52/193 (27%) there was no adequate indication, and in 54 (39%) of 138 indicated PPI prescriptions it was overdosed. Yet, in only less than one-third (28%) of "adequate" prescriptions, the indication was according to the PPI approvals, whereas the majority (72%) were off-label indications in line with valid guideline recommendations. Non-indicated PPI prescription was associated with the total number of prescribed drugs (OR 1.32; 95% CI 1.18-1.62; p = 0.013). There were no associations with age, level of care dependency, cognitive impairment, prescription of psychotropic drugs, number of chronic diseases, number of physicians' consultations, or study region. To conclude, in 55%, the high prescription prevalence among residents was either not indicated or overdosed. In total, only 20% (39/193) of cases of PPI use complied with the approved indications. There is a need for quality control of 1. PPI administration in German nursing homes, and 2. of guideline recommendations expanding the off-label PPI use by 72% within the indication scale, predominantly from wide prescription for low-dose ASA.

Assessment of Psychosocial Stress and Mental Health Disorders in Parents and Their Children in Early Childhood: Cross-Sectional Results from the SKKIPPI Cohort Study.

Early childhood can be a stressful period for families with a significant impact on parents' mental health, the child's healthy development, and the development of a secure mother-child attachment. The goal of the cross-sectional study part of SKKIPPI was to assess the occurrence of psychosocial stress and mental health disorders in parents as well as in their offspring in early childhood in three German regions. Based on random samples from three residents' registration offices, parents with infants aged up to 12 months were invited to participate. An online screening questionnaire was developed in four languages to assess common psychosocial stressors and mental health problems of parents with small children. The study enrolled 4984 mothers and 962 fathers. The most common potential psychosocial stressors were professional problems (mothers 22%, fathers 33%), lack of social support (20%, 14%), and severe, negative experiences in childhood (22%, 16%). Obsessive-compulsive thoughts (21%, 16%) and depressive (9%, 9%) and anxiety symptoms (11%, 7%) were the most frequently reported mental health problems by both parents. Regulatory problems of the child were reported by between 1.5% and 5.1% of parents. The study showed that a substantial proportion of parents are burdened by psychosocial problems and suffer from mental health problems in the first years after the birth of their children. Early preventive and low-threshold support measures should be available in the health and social care system. Low-threshold questionnaires, which cover a wide range of possible stress factors, should be further developed for the practical healthcare of this group of people.

Impact of the COVID-19 Pandemic on Tumor Stage and Pathohistological Parameters of Vulvar Cancer.

Background/Objectives: Vulvar cancer (VC) comprises a small fraction of female neoplasms with notable high-incidence clusters among German regions. Despite a proposed impact of nationwide lockdowns in response to the COVID-19 pandemic on oncological diseases, the effect on VC staging and tumor characteristics remains yet to be resolved; therefore, analyzing pathological data from patients with squamous cell VC pre-, during, and post-COVID in a high-incidence region may offer insights into potential epidemiological and clinical trends. Methods: We identified a total of 90 patients who were diagnosed at the Institute of Pathology, University Hospital Saarland, between 2018 and 2023, and defined three distinct cohorts: a pre-COVID cohort (2018-2019), a COVID cohort (2020-2021), and a post-COVID cohort (2022-2023). Histomorphological data were collected from the individual patient reports and statistically analyzed using Fisher's exact test or the Kruskal-Wallis test. Results: Although we found no statistically significant differences in age, T-stage, perineural infiltration, blood vessel infiltration, resection status, grading, or resection margin between our three cohorts, surprisingly, we determined a greater extent of lymphovascular infiltration (Fisher's exact test; p = 0.041), as well as deeper tumor infiltration depth (Kruskal-Wallis test; p < 0.001) before the COVID-19 pandemic. Furthermore, we did not identify any soft indications of abnormalities in patient care within our center (unchanged status of the resection margins across all three cohorts). Conclusions: Our results clearly do not support a negative affection of clinical or pathobiological characteristics of VC during or after the pandemic. However, final assessments regarding the pandemic's effect on VC require additional study approaches in various regions, preferably with future extended timeframes of a longer follow-up.

Rodenticide contamination of cormorants and mergansers feeding on wild fish

AbstractExposure of wildlife to anticoagulant rodenticides from sewer baiting and bait application is poorly understood. We analyzed residues of eight anticoagulant rodenticides in liver samples of 96 great cormorants, 29 common mergansers, various fish species, and coypu, in different German regions. Results show that hepatic residues of anticoagulant rodenticides were found in almost half of the investigated cormorants and mergansers due to the uptake of contaminated fish from effluent-receiving surface waters. By contrast, exposure of coypu to rodenticides via aquatic emissions was not observed. The maximum total hepatic anticoagulant rodenticide concentration measured in waterfowl specimens was 35 ng per g based on liver wet weight. Second-generation anticoagulant rodenticide active ingredients brodifacoum, difenacoum, and bromadiolone were detected almost exclusively, reflecting their estimated market share in Germany and their continuing release into the aquatic compartment. Overall, our findings reveal that second-generation anticoagulant rodenticides accumulating in wild fish are transferred to piscivorous predators via the aquatic food chain.

IV. Das Einlager. Forderungsdurchsetzung in der Frühen Neuzeit zwischen Autonomie und Heteronomie

Summary In medieval and early modern Germany, the Einlager (lat. obstagium) was a widespread practice of private debt enforcement. Parties stipulated that in case the debtor defaulted, contractually agreed on persons, usually the debtor and/or sureties along with members of their retinue, would confine themselves to given premises, usually a public house, for as long as the debt was left unpaid. During that time, all costs for boarding and lodging were to be borne by the debtor. This legal institution was meant to increase the economic pressure on the debtor and keep him from pursuing his usual private and professional life. Voluntarily agreeing to the Einlager, publicly committing to a debt as well as submitting to slander should the debtor not turn himself in all hinged on contemporary codes of honour – the debtor vouched his personal honour when he took on him the possibility of the Einlager. At the same time, the Einlager itself was perceived to leave personal honour intact. This meant that it was popular in cases in which distraint for debt proved difficult; particularly noble debtors and cities found it to be acceptable. However, increasing economic pressure on an already defaulting debtor had always been viewed sceptically. During the course of the 16th century, criticism of the Einlager grew more intensive and new facets were added to it. Prolonged stays in pubs, sometimes in excess of a year, were now deemed detrimental to public as well as private morality. More importantly, the Einlager as a means of private, autonomous debt enforcement that used personal honour as a leverage point was increasingly perceived as a challenge to early modern concepts of territorial lordship, as it ignored governmental jurisdiction. Early modern German legislation addressing the issue introduced a new argument: It criticized that those employing the Einlager made themselves judges in their own causes. Assailed on all sides, the Einlager thus quickly fell into disuse around 1600. Only in a few northern German regions it was moderated by legislation and employed well into the 19th century.

An innovative visual approach to the simultaneous study of two dimensions of progress in longevity: an application to French and German regions

BackgroundBoth enhancing life expectancy and decreasing inequalities in lifespan between social groups are significant goals for public policy. To date, however, methodological tools to study progress in both dimensions simultaneously have been lacking. There is also a consensus that absolute and relative inequalities in lifespan must be studied together.MethodsWe introduce a novel graphical representation that combines national mortality rates with both absolute and relative measures of social inequality in mortality. To illustrate our approach, we analyze French and German data stratified by place of residence.ResultsFor all-age mortality, in France we find a steady pace of decline in both mortality and in regional inequalities in mortality over recent decades. In Germany, substantial progress was made in the 1990s, mostly driven by convergence between eastern and western Germany, followed by a period of slower progress. Age-specific analyses for Germany reveal a worrying divergence in regional trends at ages 35–74 in recent years, which is particularly pronounced among women.ConclusionOur novel visual approach offers a way to simultaneously examine two dimensions of progress in longevity, and facilitates meaningful comparisons between populations, even when their current mortality rates differ. The applied methods can be easily reproduced in any country for which long-term mortality series stratified by region, or any relevant socioeconomic characteristic, are available. It is useful for both scientific analysis and policy advice.

Urban density versus regional dispersion: On the risks in high-density conurbations in Germany during COVID-19

Significant research has been devoted to understanding how environmental factors affect the COVID-19 risks local populations face. Urban density has been identified as a critical factor, posing a particular threat in densely populated countries like Germany, one of Europe's most crowded nations. Furthermore, the high degree of interconnectivity between German regions increases the risk of virus transmission from infection hotspots through regional dispersion. Our research uses linear and non-linear regression models, enhanced with longitude and latitude, to assess the relative impact of population density and regional dispersion of COVID-19 mortality across German counties. Our findings, adjusted for health-related variables, indicate that locational factors have a three times greater impact on mortality than density does. This highlights that pandemic mortality risk is shaped not only by our individual responses but also by the actions of our neighbours. Consequently, our research suggests that, given the increasing global interdependence, regional sprawl cannot be the dominant strategy for planners to avoid the consequences of a pandemic. Instead, the priority should be efficient information management to identify and mitigate interdependence with infection hotspots, which requires enhanced international cooperation.

Alleinerziehende in der Betreuungsplatzvergabe: Status quo und Handlungsempfehlungen

Abstract Single parents and their children benefit particularly from early childhood education and childcare programmes. Nevertheless, almost a third of single parents in Germany who need childcare for their children under the age of three are unable to find it. Although around 70 % of day care providers claim to take the single-parent criterion into account when allocating slots, the prevailing allocation procedures cannot guarantee that this is implemented. This article shows how transparent allocation criteria can be designed nationwide and how their implementation can be realised through suitable, centralised, municipal allocation systems. Particularly in (western) German regions with a high unmet demand for institutional childcare, single-parent status should be considered as an independent criterion in addition to other factors such as employment and child age.

Personality and regional innovativeness: An empirical analysis of German patent data

This paper brings together the literature on regional variability in innovation activity with studies on the role of personality for regional innovativeness. Building on regionally aggregated levels of individual Big Five personality traits obtained from the German Socio-Economic Panel and the Big Five Project, we find that only extraversion has a positive effect on patenting in German regions. This effect is particularly strong in the case of lagging regions. We interpret this finding as an indication of the compensatory role of collaboration for the innovativeness of lagging regions characterized by low levels of business research and development (R&D) and a dominance of small and medium-sized enterprises (SMEs), which demonstrates the need for place-sensitive policies that consider different modes of innovation and emphasize interregional and intraregional learning.

What hampers research collaboration in a region?

Research collaboration is an important instrument for innovation and knowledge transfer. In this respect, barriers that prevent or impede research collaboration between research institutions and companies are of particular importance. In this paper, we elaborate on the importance of research collaboration barriers by conducting and analysing 77 expert interviews from ten German regions. We go beyond the existing literature by examining differences in the perception of different kinds of experts and by comparing different types of regions classified according to the presence of important actors, namely research institutions and large companies. Our results show that research collaboration barriers are perceived as very significant barriers to innovation across all region types. We find differences in the perception of research collaboration barriers between the experts. On the regional level, the presence of research institutions shifts the relevance from missing partners to other research collaboration barriers, while all research collaboration barriers are not perceived as significantly less important.

The contribution of knowledge-intensive firms to employment growth: a Granger causality approach for German regions

ABSTRACT Academic discussions have frequently examined the interrelation between regional employment growth and firm locations. Two growth patterns emerge: employment growth induced through new firm locations or vice versa, where firms locate in areas experiencing employment supply growth. The specific causal relationship responsible for regional employment growth in Germany remains uncertain. In the German context, however, more research is needed to identify contributors to employment growth, as most existing studies rely on highly aggregated data or focus on specific case studies. This paper aims to approach this subject by using a uniquely matched dataset of firm locations and the individual employment of 480 multi-locational firms in the knowledge economy and comparing it to total employment in Germany. We assume that a change in knowledge-intensive firms’ employment may affect regional employment growth. The study uses longitudinal historical employment data at the functional urban area (FUA) level from 1999 to 2019, aggregated to knowledge-intensive high-tech and advanced producer services (APS) sectors. The analysis employs aggregated and individual Granger causality tests, evaluating the relationship between employment in knowledge-intensive sectors and overall employment change. Results are spatialised using GIS to provide evidence of where the Granger causalities occur at the FUA level in Germany. Findings indicate that, in general, knowledge-intensive employment growth Granger causes total employment growth in a few economically more active FUAs. In contrast, for a greater number of FUAs, total employment Granger causes knowledge-intensive employment.

Depression and fatigue six months post-COVID-19 disease are associated with overlapping symptom constellations: A prospective, multi-center, population-based cohort study

BackgroundDepression and fatigue are commonly observed sequelae following viral diseases such as COVID-19. Identifying symptom constellations that differentially classify post-COVID depression and fatigue may be helpful to individualize treatment strategies. Here, we investigated whether self-reported post-COVID depression and post-COVID fatigue are associated with the same or different symptom constellations. MethodsTo address this question, we used data from COVIDOM, a population-based cohort study conducted as part of the NAPKON-POP platform. Data were collected in three different German regions (Kiel, Berlin, Würzburg). We analyzed data from >2000 individuals at least six months past a PCR-confirmed COVID-19 disease, using elastic net regression and cluster analysis. The regression model was developed in the Kiel data set, and externally validated using data sets from Berlin and Würzburg. ResultsOur results revealed that post-COVID depression and fatigue are associated with overlapping symptom constellations consisting of difficulties with daily activities, perceived health-related quality of life, chronic exhaustion, unrestful sleep, and impaired concentration. Confirming the overlap in symptom constellations, a follow-up cluster analysis could categorize individuals as scoring high or low on depression and fatigue but could not differentiate between both dimensions. LimitationsThe data presented are cross-sectional, consisting primarily of self-reported questionnaire or medical records rather than biometric data. ConclusionsIn summary, our results suggest a strong link between post-COVID depression and fatigue, highlighting the need for integrative treatment approaches.