Rise Of Germany Research Articles

Importance and prevalence of multidrug-resistant gram-negative bacteria in Germany

Infections with multidrug-resistant gram-negative bacterial species are a great concern in clinics in Germany. By limiting therapeutic options dramatically, these bacteria pose a significant threat to patient health and cause extensive pressure on hygiene systems and patient management. In Germany, the recommendations on how to deal with these bacteria are called MRGN classification, using the terms 3MRGN and 4MRGN for bacteria resistant to three or four major classes of antibiotics. To be resistant to this large number of antibiotics and become classified as 3MRGN or 4MRGN, bacterial strains need to acquire multiple resistance mechanisms with beta-lactamases, especially carbapenemases, being the most important ones. According to established surveillance systems like national reporting systems, KISS or the National Reference Centre, multidrug-resistant bacteria are constantly on the rise in Germany. Although several novel therapeutic options have been approved recently, these bacteria represent a constant challenge and it may be necessary to discuss if the present hygiene recommendations need an update for an efficient and targeted prevention of transmission.

Analysing micrologistics initiatives in rural areas – Approaches to typologise and assess complex logistics solutions in regional supply networks

While demand for regional products increases and societal expectations towards a regionalisation of production are on the rise in Germany, little attention is given to the logistical challenges of local producers. At the same time, rural areas are confronted with declining supply options for goods of daily needs. Logistical challenges in rural areas are primarily caused by a scarcity of actors, low or fluctuating quantities of goods and long transport distances. A lack of economies of scale makes supply and logistics very costly. Given the rising interest and new possibilities created by digitisation, numerous private and public initiatives are developing solutions for sustainable regional logistics to secure and improve supply in rural areas - so called micrologistics solution. However, a meta-analysis of such regional logistics solutions is missing that identifies similarities and differences and indicates which characteristics are essential for the development of long-term viable regional logistics solutions.This article therefore aims at providing a general overview and at systematising current micrologistics solutions in rural regions, introducing a typology which is based on a meta-analysis of approximately 80 micrologistics initiatives in Germany and beyond. Referring to two case studies – Smart Village St. Wendel and UCKER Warentakt - we then focus analysis on solutions aiming at providing goods of daily need to the population in rural areas. We share lessons learnt on their characteristics, challenges and factors of success. This is done using a specifically developed morphological box, a viability and impact-oriented assessment framework for micrologistics initiatives as well as results of interviews with initiators and operators of such initiatives. We conclude on the usefulness of the analytical approaches developed for this new research field as well as further research needs.

The landscape of current trends and procedures in plastic surgery practices across the D-A-CH region: An in-depth analysis of 511 websites

BackgroundRecent data shows a 139.9% global increase in aesthetic procedures since 2011, with a notable 190.5% rise in Germany. This study analyzes the current landscape of plastic surgery in German-speaking European countries, focusing on the range of procedures offered in plastic surgery practices in Germany, Austria and Switzerland.We aimed to provide an overview of the current trends and procedures of plastic surgery in the practice setting in Germany, Austria, and Switzerland.MethodsThe information sampled from the websites of n = 511 plastic surgery practices (314 German, 113 Austrian, 84 Swiss) were analyzed with regards to general information, as well as procedures offered on the websites. A set of different procedures, belonging to each pillar of plastic surgery (i.e., Aesthetic, Reconstructive, Hand, Burn surgery) as well as non-surgical aesthetic procedures was analyzed.ResultsAesthetic surgical procedures were offered most often with 98.8% (506) of all websites analyzed, followed by Hand surgery at 29.7% (152), Reconstructive surgery at 27.8% (142) and Burn surgery at 5.7% (29). Reconstructive and Hand surgery were statistically significantly most commonly offered on Austrian plastic surgery websites, with p = 0.011 and p < 0.001, respectively. Among aesthetic surgical procedures, statistically significant regional differences were found for head and neck, body and breast procedures most commonly offered on Swiss plastic surgery with p = 0.041, p = 0.010 and p = 0.003, respectively, while the procedures of the intimate region were most commonly offered on German websites with p = 0.007.ConclusionsPlastic surgery websites in German-speaking European countries predominantly advertise aesthetic surgical procedures, with other domains of plastic surgery such as reconstructive, hand, and burn surgery being less prominent, suggesting an underrepresentation. Regional differences between the countries investigated are evident, underscoring the need for a more balanced approach in plastic surgery care in the practice setting. Level of Evidence: Not gradable

Thomas Fleischman. Communist Pigs. An Animal History of East Germany's Rise and Fall. University of Washington Press, Seattle (WA) 2020. xviii, 268 pp. Ill. $40.00.

Thomas Fleischman. Communist Pigs. An Animal History of East Germany's Rise and Fall. University of Washington Press, Seattle (WA) 2020. xviii, 268 pp. Ill. $40.00.

Japan and the Regional Security Complex in the Asia-Pacific region 1931-1945

This paper aims to analyse the Regional Security Complex (RSC) in the Asia-Pacific region from 1931-1945, from the perspective of the Empire of Japan. Along with the rise of Germany, the rise of Imperial Japan in the Asia-Pacific region is crucial to international relations. The challenge that Imperial Japan posed to the Status Quo in the region has had lasting effects that molded the current RSC. The RSC of the Asia-Pacific has risen to be critically important to the International System at large. With so many eyes peering in its direction, the importance of examining its past challenges is of utmost importance to orient present and future decision making. After all, the past is not dead, it’s not even past. The hipothesis of this paper is that internal factors (such as faulty institutions struggling to adapt to new social conditions, militarism, extremist politics and a lack of responsible leadership) were as important to the destabilisaton of the RSC in the Asia-Pacific region as the general disruption to the balance of power. The analyzes stresses out the importance of adopting a regional perspective and focusing not only on states but also on other security actors. Data will be used interpretatively; meaning that the focus will be on understanding events in a comprehensive/holistic way. Keywords: Regional Security Complex Theory, balance of power, soft power, international relations, foreign policy.

Informelle Pflege und Berufstätigkeit: Einflussfaktoren auf die Bereitschaft

IntroductionThe proportion of people in need of care will continue to rise in Germany. In 2019, the majority of people in need of care was cared for at home. Reconciling caregiving and work poses a heavy burden for many caregivers. Therefore, a monetary compensation for care is being discussed politically in order to facilitate the reconciliation of work and care. The aim of this study was to investigate whether and under which circumstances a sample of the German population is willing to care for a close relative. A particular focus was placed on the willingness to reduce working hours, the importance of the expected period of caregiving, and monetary compensation. MethodsA primary data collection was conducted in two modes using a questionnaire. A self-completion postal survey was sent out via the AOK Lower Saxony and complemented with an online survey. Data was analysed descriptively and using logistic regression. Results543 participants were included. 90% of the sample surveyed was willing to provide care for a close relative, with the majority stating that their willingness depended on various factors: both the health status and the person of the family member needing care had the greatest influence. 34% of the employed respondents were not willing to reduce their working hours, mostly for financial reasons. Discussion and conclusionMany older adults want to stay in their homes for as long as possible. Thus, the willingness to provide and take over the role of informal caregiver is and will remain a central pillar of the German care system. Negotiating between informal caregiving and professional activities often creates a substantial burden. For people from lower income households monetary compensation might enhance their willingness to provide informal care. However, in order to increase the willingness to engage in informal care of people from different backgrounds and life stages, flexible approaches are needed that go beyond monetary compensation.

The rise of contemporary china and Wilhelmine Germany: Challanges of productive analogy

The rise of a land power that is trying to develop its maritime forces has been viewed as an important conflict instigator among great powers. Great Britain shared similar concerns with the rise of Germany at the beginning of the 20th century. Power relations among states in East Asia, during last two decades, share many similarities with those of pre-World War I Europe. This historical analogy provides abundant information regarding the behavior of land and maritime states. On the other hand, the analogy is often used without reference to other great powers in the system and how these states influenced the overall balance of power. In other words, we get the notion that the conflict between land and maritime power is inevitable regardless of other actors and their position in the system. In our work we shall focus our attention on the two processes that are balance of power and balance of threat; and try to understand how these mechanisms affected the politics of key actors in Europe before the Great War and how they affect the politics of contemporary states in East Asia. Since we are discussing the balance of power concept the article follows ideas set forth by authors of realism. Comparing different approaches of great powers to balancing in the years before the Great War and what balancing looks like in contemporary East Asia we shall try to point out to some strategic misconceptions regarding this historical analogy.

Singing Like Germans: Black Musicians in the Land of Bach, Beethoven, and Brahms, by Kira Thurman

<i>Singing Like Germans: Black Musicians in the Land of Bach, Beethoven, and Brahms</i>, by Kira Thurman

The Fault in Our Stars? Korea's Strategy for Survival and Germany's Rise, 1876–1910

Observers often attribute the disappearance of Korea in 1910 to the failure of Korean elites to modernize the country. Yet, this explanation overlooks both Korea's foreign policy and the international power shift ongoing during the early twentieth century. Accordingly, this study uses international relations theory to shed new light on the Japanese annexation of Korea. First, it shows that the international strategy of Joseon and the Korean Empire corresponds to buck-passing, a cost-effective strategy for weak states. Second, it argues that the rise of German power during the 1900s forced the great powers to focus their attention on Europe. In doing so, they left Korea with no one to catch its buck and vulnerable to a Japanese takeover. Therefore, this article enriches both Korean historiography and the understanding of the strategies of small states.

Communist Pigs: An Animal History of East Germany's Rise and Fall by Thomas Fleischman

Reviewed by: Communist Pigs: An Animal History of East Germany's Rise and Fall by Thomas Fleischman Tatsuya Mitsuda (bio) Communist Pigs: An Animal History of East Germany's Rise and Fall By Thomas Fleischman. Seattle: University of Washington Press, 2020. Pp. 296. In recent years, scholars of science and technology have noted the emergence of what have been variously conceptualized since the 1970s as "bioeconomics," "biocapital," or "biovalue." Such concepts are generally understood as describing the intensified union between the life sciences and profit-driven enterprises. Academics deploy these concepts as heuristic devices to make sense of a significant shift in modern capitalism whereby increasingly small biological materials such as cells, molecules, genomes, and genes, are being exploited for commercial use. Much of the literature analyzing the biopolitical economy also considers how non-human creatures have been drawn into this capitalization of life. Even though the overt financialization of the bioeconomy—creating "assets" as opposed to "products"—signals an original departure, Thomas Fleischman's ambitious new book, Communist Pigs, is a timely reminder about the roots of the bioeconomy: they can be traced back further in time, and observed not just in the capitalist West, but also in the communist East. Drawing on an abundant array of sources, including public documents from state archives, Fleischman's main aim is to revise the image of the German Democratic Republic (GDR) as a political, ideological, and economic basket case. To do so, he presents a nuanced analysis of the complex and contradictory factors that made it possible for three types of swine—industrial, garden, and wild—to thrive under socialism. The author skillfully places events and actors (pigs included) within a global framework. This allows him to draw arresting parallels between East and West and to reconstruct the flows of both capital and technology that transcended national and ideological boundaries in the construction of factory farms. The book's main argument is that since the capital underwriting mass hog [End Page 525] production came from Western creditors, the GDR was forced to continue exporting cheap pork at all cost to service its debts. This policy not only resulted in pork-deprived East Germans raising pigs on their small plots of land. Wild boars multiplied as the shift to industrial farming disrupted the ecosystem, leading to the kinds of protests that ultimately brought down the communist regime. For the readers of this journal, the most rewarding part of the book is its close analysis of how the industrial pig evolved, facilitated by technological knowledge that came from the United States to Europe via Yugoslavia. Ever since Antony Sutton's three-volume Western Technology and Soviet Economic Development, published between 1968 and 1973, a significant body of work has built up showing how the Communist Bloc avidly studied industrial agriculture. Fleischman richly details how events played out in the GDR. At the massive slaughterhouse-cum-meat-processing facility in Eberswalde, porcine bodies were remade, retrofitted, and standardized to align with the dictates of modern industrial factory farming. As the author aptly notes, these industrial pigs were "technology made flesh" (p. 91). Fat, numerous, unhealthy, and environmentally damaging, these pigs were the result of deliberate scientific and technological interventions that reorganized their biological constitution and turned them into machines capable of efficiently converting grain into meat. Building on the recent "animal turn," Fleischman demonstrates how communist pigs could become actors entangled in social, political, and ecological change. Because of their innate biological trait to thrive in any kind of environment, the pigs—be they in the factory, the garden, or the wild—could easily frustrate humans' plans for them. Despite his stated focus on the three types of pigs, Fleischman at times veers off course, referencing other animals, chemicals, crops, or vegetables without necessarily clarifying their relevance to the main topic. Similarly, in his enthusiasm for emphasizing the role of international politics and global capitalism, Fleischman is prone to delving into details about other countries, once again without clarifying either their impact on communist pigs or drawing on comparisons to illustrate national differences and similarities. Putting such small quibbles aside, the book is packed with original insights. It represents a significant contribution to the...

Stillbirths in Germany: On the rise, but no additional increases during the first COVID-19 lockdown.

ObjectiveTo examine possible changes in the rate of stillbirths in Germany during the first COVID‐19 lockdown.MethodsPopulation‐level data of live births and stillbirths occurring between January 1995 and July 2020 were used and negative binomial regression was applied to estimate the rate of stillbirths in this period. The actual rate was compared to the expected figure for 2020.ResultsA steady increase in stillbirths was detected in Germany since 2013. The stillbirth rate for January to July 2020 (4.148) was slightly lower than that of the same period in 2019 (4.242). Furthermore, all monthly rates of stillbirths during the first half of 2020 lie inside the 95% prediction interval of expected stillbirth rates for this period.ConclusionA growing body of studies on the indirect effect of the COVID‐19 pandemic on stillbirths shows mixed and context‐dependent evidence. In contrast to other European countries, stillbirth rates have been on the rise in Germany in the last decade. However, stillbirth rates during the first half of 2020 were not higher than expected. The results suggest that stillbirth rates have not changed during the first‐wave COVID‐19 lockdown in this high‐income setting. However, further studies on the causes of the increasing trend in stillbirths in Germany are needed.

Pneumococcal vaccine uptake and vaccine effectiveness in older adults with invasive pneumococcal disease in Germany: A retrospective cohort study.

BackgroundInvasive pneumococcal disease (IPD) in people ≥60 years old is on the rise in Germany. There has been a recommendation for pneumococcal vaccination in this age group since 1998.MethodsWe determined the vaccination status of people ≥60 years old with IPD in Germany. We assessed vaccine effectiveness (VE) of the recommended 23-valent polysaccharide vaccine (PPV23) against IPD using the indirect cohort method.ResultsThe rate of pneumococcal vaccination in older adults with IPD is low, 26%, with only 16% of people receiving a pneumococcal vaccine within five years of the IPD episode. Age- and gender- adjusted vaccine effectiveness (VE) for PPV23 was 37% (95% confidence interval 12% - 55%). For people vaccinated with PPV23 less than two years prior to IPD, VE was -20% (-131% - 34%), between two and four years prior to IPD, VE was 56% (20% - 76%), and 47% (17% - 63%) for those vaccinated ≥5 five years ago. Excluding serotype 3, overall VE for the remaining serotypes in PPV23 was 63% (49% - 74%). For people receiving PPV23 within the past two years, VE against all serotypes except 3 was 49% (12% - 71%); for people vaccinated between two and four years prior to IPD 66% (37% - 82%); for those vaccinated ≥five years ago, 69% (50% - 81%). VE of PPV23 against serotype 3 IPD only was -110% (-198% - -47%).ConclusionsTo reduce IPD in older adults in Germany, we must increase the rate of pneumococcal vaccine uptake. For 22/23 serotypes, PPV23 was effective. Serotype 3 remains a major problem.FundingThis work was supported by an investigator-initiated research grant from Pfizer.

Vietnamese Studies in Germany

From modest beginnings in the 1950s and 1960s, Vietnamese studies experienced a slow but consistent rise in Germany. In the GDR, the rise was connected first with close relations between the two communist states. Second, the area studies’ concept favored Vietnamese studies as a subject of Southeast Asian studies, rather than as a side subject of sinology as it had been before. In both parts of Germany, the interest in Vietnam has grown, especially after its reunification in 1975. Since 1990, at least one place is continuing to teach the subject in the framework of the Southeast Asian Languages and Cultures Program. In this way, one of the two professorships could be preserved.

Europa en de opkomst van Duitsland, 1830-1871

Abstract Europe and the rise of Germany, 1830-1871. The German Question in European perspective A century and a half ago Bismarck’s Reichgründung fundamentally changed Europe’s states system. It marked the end of a quest for German unity that, since the 1830s, had been a central theme of European politics. This era has so far received little attention, and only a few historians appreciate that the rise of Germany in the nineteenth century triggered not only anxiety and fear among its neighbours, but feelings of sympathy and hope as well. This article aims to chart the whole range of reactions and to reintroduce openness to this historical process. It analyses a variety of conceptions of a new European states system in order to understand how Polish, Italian, French, and British politicians and activists anticipated and tried to influence the emergence of a strong and powerful German nation state in Europe’s centre. The conditionality of their support stresses the influence of these neighbouring nations on European-German relations then and now.

Cosmopolitanizing Colonial Memories in Germany

Cosmopolitanizing Colonial Memories in Germany

Attack of the clones: whole genome-based characterization of two closely related enterohemorrhagic Escherichia coli O26 epidemic lineages

BackgroundEnterohemorrhagic Escherichia coli (EHEC) O26:H11/H−, the most common non-O157 serotype causing hemolytic uremic syndrome worldwide, are evolutionarily highly dynamic with new pathogenic clones emerging rapidly. Here, we investigated the population structure of EHEC O26 isolated from patients in several European countries using whole genome sequencing, with emphasis on a detailed analysis of strains of the highly virulent new European clone (nEC) which has spread since 1990s.ResultsGenome-wide single nucleotide polymorphism (SNP)-based analysis of 32 EHEC O26 isolated in the Czech Republic, Germany, Austria and Italy demonstrated a split of the nEC (ST29C2 clonal group) into two distinct lineages, which we termed, based on their temporal emergence, as “early” nEC and “late” nEC. The evolutionary divergence of the early nEC and late nEC is marked by the presence of 59 and 70 lineage-specific SNPs (synapomorphic mutations) in the genomes of the respective lineages. In silico analyses of publicly available E. coli O26 genomic sequences identified the late nEC lineage worldwide. Using a PCR designed to target the late nEC synapomorphic mutation in the sen/ent gene, we identified the early nEC decline accompanied by the late nEC rise in Germany and the Czech Republic since 2004 and 2013, respectively. Most of the late nEC strains harbor one of two major types of Shiga toxin 2a (Stx2a)-encoding prophages. The type I stx2a-phage is virtually identical to stx2a-phage of EHEC O104:H4 outbreak strain, whereas the type II stx2a-phage is a hybrid of EHEC O104:H4 and EHEC O157:H7 stx2a-phages and carries a novel mutation in Stx2a. Strains harboring these two phage types do not differ by the amounts and biological activities of Stx2a produced.ConclusionsUsing SNP-level analyses, we provide the evidence of the evolutionary split of EHEC O26:H11/H− nEC into two distinct lineages, and a recent replacement of the early nEC by the late nEC in Germany and the Czech Republic. PCR targeting the late nEC synapomorphic mutation in ent/sen enables the discrimination of early nEC strains and late nEC strains in clinical and environmental samples, thereby facilitating further investigations of their geographic distribution, prevalence, clinical significance and epidemiology.

Partners in Leadership? American Views of the New German Role

The German–American relationship has become the pivot in the larger transatlantic partnership. This is the result of both the rise of Germany as a foreign policy actor due to an increase of its power as well as the decline of France and Britain as European powers. As American policy makers reassess the role of Europe in their broader foreign policy, Germany will be seen as a key partner both in Europe and on broader global issues. However there are limits to this partnership and it is likely to be an uneven one.

Reasons for Emergency Department Visits: Results of a Patient Survey

The number of patients visiting emergency departments (ED) is steadily increasing. The cause for this rise in Germany is unclear and less examined. This study aimed to assess the reasons of walk-in patients to visit EDs by using a direct survey. During a period of 4 weeks, 2 010 walk-in patients were anonymously surveyed in 2 major Berlin hospitals using a standardized questionnaire. Descriptive statistics were used for data analysis. More than 90% of patients assessed themselves as an emergency and three-quarters of patients reported pain. The majority of patients (57%) tried to contact statutory health insurance (SHI) office-based physicians in advance and 59% of patients said they would make use of ambulatory emergency facilities if they were available and well established. However, 55% of patients were unaware of the emergency service of the association of SHI physicians. The results indicate that centralized ambulatory emergency facilities should be available 24/7 at hospitals with EDs. Therefore, future planning of emergency services should integrate providers of ambulatory and inpatient sector. International experience suggests that different instruments aiming at better coordination of care, such as integrated call centers, extended ambulatory services and facilities for less urgent cases located in or nearby hospitals with EDs should also be implemented in Germany.

The rise of Germany, 1939-1941

The rise of Germany, 1939-1941

The Crowe Memorandum, the Rebalance to Asia, and Sino-US Relations

ABSTRACTMany contemporary academics and policy analysts have revisited the Anglo-German rivalry before 1914 to predict what may await China and the United States in the twenty-first century. However, few, if indeed any, have specified in what sense this comparison can be made. This paper attempts to fill this gap with a detailed analysis of the strategic parallels between the Anglo-German rivalry then and the China–US competition now through the lens of the Crowe Memorandum. The author argues that the basic parallel between the rise of Germany and the rise of China lies in the challenges they posed or pose to the dominant maritime power and system leader – Great Britain then and the United States today. This parallel also explains the similarity between the Triple Entente initiated by Great Britain prior to 1914 and the Rebalance to Asia launched by the United States in 2011. Furthermore, as in the case of the Anglo-German rivalry before 1914, the most crucial problem underlying the mounting China–US competition in recent years has been America’s deepening apprehension about the development of China’s anti-access/area-denial (A2/AD) and naval capabilities. This development, from the US perspective, is threatening to deprive the US of its most crucial instrument to influence the strategic equilibrium on the East Asian littorals. Based on the lessons of the Anglo-German rivalry prior to 1914, the essay also examines the potential for mitigating, if not eliminating, the mounting competition and misgivings between China and the United States.