Office Of Germany Research Articles

National implementation of the Regulation establishing the European Public Prosecutor’s Office in Germany

The text tackles the European Public Prosecutor's Office (EPPO), which is a European body responsible for investigating, prosecuting, and bringing to justice the perpetrators of crimes detrimental to the Union's financial interests. While the EPPO has been established only by way of enhanced cooperation, involving originally 20 – and soon thereafter 22 – Member States, the fight against crimes affecting the financial interests of the Union is a common effort of all Member States of the European Union. Mostly international nature of the crimes against the Union’s interests makes necessary to create, develop and uphold such a supranational structure, as a most effective one.The EPPO relies on existing structures and human resources in participating Member States. Notwithstanding that the EPPO Regulation is directly applicable in the Member States, there is still a need to adjust the domestic legal framework to ensure that it is able to effectively carry out its tasks of investigating and prosecuting. The following contribution intends to provide an overview of the organizational and legislative measures that have been taken in Germany to this end.

Social workers as politicians. A quantitative study on social workers holding elected office in Germany

ABSTRACT There is a reciprocal relationship between social work and (social) policy: (i) social workers act on the basis of social policy guidelines, and (ii) they should contribute to changing these frameworks in the interest of their profession and of service users. Previous studies have outlined different routes for social workers to influence policy: One of these is referred to as ‘holding elected office’. This paper provides a descriptive analysis of social workers with political mandates in Germany. My first step is to compile a comprehensive dataset of current members of parliament to identify social workers. I then conduct an online survey among this group to learn more about their political socialisation processes, their political career paths, and their current political work. My results show that social workers accept mandates at all political levels, with their share being lowest at the national level. The decision of social workers to become directly involved in politics is closely linked to the experiences that they have gained in their professional practice. The process of politicisation tends to run parallel to their professional careers.

Times Out of Joint: The Spy Who Came in from the Cold

Abstract John le Carré’s The Spy Who Came in from the Cold (1963), the literary breakthrough of one of the most successful novelists of our time, is a Cold War classic that changed the direction of spy fiction, and has gone far to redefining it. The story is compelling, bleak and without heroes: that causes are betrayed is no surprise, but here institutions betray their own men. Reviewers took the novel to be credible and realistic, qualities assumed even by some recent political and cultural studies of the Cold War; the author had, after all, served the British Foreign Office in Germany, and though he denied it for decades, he was from the first suspected to have been a spy. The novel’s authenticity grew with le Carré’s denials, reinforced by his published story of how he wrote it: it was an immediate and intensely personal reaction to seeing the Berlin Wall being built, written in a great rush within five or six weeks. The novel itself, however, tells a different story, which no competent intelligence officer could ever have believed. Its chronologies are variously impossible, both internally and in their historical anchorage. It assumes the existence of the Wall from the outset, but parts must have been composed before the Wall was built: as will appear, the story is composite, and it marches to contradictory calendars. The textual archaeology thus indicated is confirmed by some of le Carré’s own correspondence.

Impact of the COVID pandemic on major abdominal cancer resections in Germany: a retrospective population-based cohort study.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is estimated to have claimed more than 6 million lives globally since it started in 2019. Germany was exposed to two waves of coronavirus disease 2019 in 2020, one starting in April and the other in October. To ensure sufficient capacity for coronavirus disease 2019 patients in intensive care units, elective medical procedures were postponed. The fraction of major abdominal cancer resections affected by these measures remains unknown, and the most affected patient cohort has yet to be identified. This is a register-based, retrospective, nationwide cohort study of anonymized 'diagnosis-related group' billing data provided by the Federal Statistical Office in Germany. Cases were identified using diagnostic and procedural codes for major cancer resections. Population-adjusted cancer resection rates as the primary endpoint were compared at baseline (2012-2019) to those in 2020. A change in resection rates for all analyzed entities (esophageal, gastric, liver, pancreatic, colon, rectum, and lung cancer) was observed from baseline to 2020. Total monthly oncological resections dropped by 7.4% (8.7% normalized to the annual German population, P =0.011). Changes ranged from +3.7% for pancreatic resections ( P =0.277) to -19.4% for rectal resections ( P <0.001). Reductions were higher during lockdown periods. During the first lockdown period (April-June), the overall drop was 14.3% (8.58 per 100 000 vs. 7.35 per 100 000, P <0.001). There was no catch-up effect during the summer months except for pancreatic cancer resections. In the second lockdown period, there was an overall drop of 17.3%. In subgroup analyses, the elderly were most affected by the reduction in resection rates. There was a significant negative correlation between regional SARS-CoV-2 incidences and resections rates. This correlation was strongest for rectal cancer resections (Spearman's r : -0.425, P <0.001). The pandemic lockdowns had a major impact on the oncological surgical caseload in Germany in 2020. The elderly were most affected by the reduction. There was a clear correlation between SARS-CoV-2 incidences regionally and the reduction of surgical resection rates. In future pandemic circumstances, oncological surgery has to be prioritized with an extra focus on the most vulnerable patients.

Location Factors Impact the Career Choice of German Dental Practitioners - An Empirical Analytical Approach to Multi-Criteria Decision-Making.

In light of the increasing number of employed dentists and the decreasing rate of self-employed dentists, the factors that impact the decision to set up a dental office in Germany were investigated. Central to this approach is the provision of comprehensive dental care. Using a pairwise comparison technique, the analytic hierarchy process (AHP), location factors identified as relevant in a systematic literature review and then prioritized by the professionals were weighted and ranked. According to this, five factors generally dominate the decision to open a dental office. These are, in descending order: environment for the family, quality of life in the private environment, real income, perception of location, and good infrastructure. The strongest impact on the rank order of the influencing factors is the socio-demographic characteristic of gender. For female dentists, the family environment is in the first place (p = .3196/C.R. = 0.1502). For male colleagues, this influence ranks third (p = .1550/C.R. = 0.1468) and real income receives the first place (p = .244/C.R. = 0.1468). For female dentists, the influence of income ranks fifth (p = .076/C.R. = 0.1502). Female and male dentists who grew up in rural areas were less likely to prefer employment (13.6%) than subjects of urban origin (40.2%). The method of AHP is a way to map a priority list of all relevant factors. It can successfully show variations related to specific personal attributes. Obviously, there are factors that are of greater importance for the decision-making process to set up a dental office.

Temporal Trends in Stroke Hospitalizations, Treatment Modalities, and Mortality

Stroke remains a leading cause of morbidity and is the second leading cause of death globally1 despite advances in treatment and prevention over the past decade. In this issue of Neurology ®, Kelly et al.2 use administrative data on acute stroke hospitalizations among adults aged 18 years or older in Germany between 2014 and 2019 to describe updated trends in stroke admissions, treatment modalities, and mortality nationally. Using population-level data from the Federal Statistics Office in Germany, study authors calculated frequencies of hospitalizations for acute stroke over a 6-year period. Study authors then evaluated demographic and clinical characteristics of stroke cases and evaluated trends in the utilization of interventions such as carotid stenting, systemic thrombolysis, and thrombectomy. They also calculated proportions of stroke cases in which in-hospital death occurred, followed by logistic regression models to investigate predictors of in-hospital mortality.

Estimation of R0 for the spread of SARS-CoV-2 in Germany from excess mortality

For SARS-CoV-2, R0 calculations in the range of 2–3 dominate the literature, but much higher estimates have also been published. Because capacity for RT-PCR testing increased greatly in the early phase of the Covid-19 pandemic, R0 determinations based on these incidence values are subject to strong bias. We propose to use Covid-19-induced excess mortality to determine R0 regardless of RT-PCR testing capacity. We used data from the Robert Koch Institute (RKI) on the incidence of Covid cases, Covid-related deaths, number of RT-PCR tests performed, and excess mortality calculated from data from the Federal Statistical Office in Germany. We determined R0 using exponential growth estimates with a serial interval of 4.7 days. We used only datasets that were not yet under the influence of policy measures (e.g., lockdowns or school closures). The uncorrected R0 value for the spread of SARS-CoV-2 based on RT-PCR incidence data was 2.56 (95% CI 2.52–2.60) for Covid-19 cases and 2.03 (95% CI 1.96–2.10) for Covid-19-related deaths. However, because the number of RT-PCR tests increased by a growth factor of 1.381 during the same period, these R0 values must be corrected accordingly (R0corrected = R0uncorrected/1.381), yielding 1.86 for Covid-19 cases and 1.47 for Covid-19 deaths. The R0 value based on excess deaths was calculated to be 1.34 (95% CI 1.32–1.37). A sine-function-based adjustment for seasonal effects of 40% corresponds to a maximum value of R0January = 1.68 and a minimum value of R0July = 1.01. Our calculations show an R0 that is much lower than previously thought. This relatively low range of R0 fits very well with the observed seasonal pattern of infection across Europe in 2020 and 2021, including the emergence of more contagious escape variants such as delta or omicron. In general, our study shows that excess mortality can be used as a reliable surrogate to determine the R0 in pandemic situations.

Beyond the Horizon

Beyond the Horizon

Termination of Criminal Prosecution followed by the Imposition of Duties and Regulations on the Accused as an Alternative Way to Resolve a Criminal Law Conflict in the German Criminal Procedure

Given the Russian tendency to expand the scope of non-rehabilitating grounds for termination of criminal prosecution/case, the paper examines the legal regulation and law enforcement practice of termination of criminal prosecution with the imposition of various duties and regulations to the accused as one of the alternative ways to resolve a criminal conflict within the framework of the German criminal procedure. The German criminal procedure has a lot in common with the Russian one; both are formed on the principle of lawfulness, or legality. At present, both Russian and German legislators are looking for alternative ways, in addition to procedural coercion or the threat of its use, to resolve the conflict in the process, which contribute to the humanization of criminal legislation, reducing the number of convicts, procedural economy. One of such alternatives in the German criminal procedure is the termination of criminal prosecution followed by the imposition of duties and regulations on the accused. The possibility of termination of criminal prosecution on this basis is provided not only in the Criminal Procedure Code of the Federal Republic of Germany, but also in various sectoral laws, for example, the German Narcotics Law, the German Youth Court Law. An analysis of the statistical data of the Federal Statistical Office in Germany from 2016 to 2020 on the termination of criminal prosecution followed by the imposition of certain duties and regulations to the accused shows the priorities of the German law enforcement officer in terms of choosing individual duties assigned to the accused and, if properly performed, entailing the termination of criminal prosecution. Despite the wide choice of duties and regulations, the law enforcement officer mainly uses the few duties imposed on the accused in order to terminate criminal prosecution. However, the very possibility of a wide choice of potentially possible duties and regulations indicates an individualized approach to the participants of the criminal law conflict in the German criminal procedure, which makes it possible to take into account the interests of all parties to the conflict.

Increased aortic repair in Germany correlates with reduction of death caused by aortic aneurysms but not aortic dissections.

We asked if there is a significant correlation between the increasing trend in aortic repair (AR) and decreasing aortic aneurysm (AA) and aortic dissection (AD) mortality? Therefore, we retrospectively analyzed all aortic repairs in patients with AA and AD and its correlation with disease-specific death rates and hospitalizations for ruptured AA and AD in Germany. We retrieved the number of cases hospitalized for AA and AD as well as the procedures in these cases from the Federal Bureau of Statistics (DRG statistics) and death rates from the national mortality statistic published by the Federal Statistical Office in Germany for the years 2006-2017. From 2006 to 2017, the total number of hospitalized cases admitted with principal diagnosis of AA increased by 25.8% and that of AD by 56.7%. That of cases with the principal diagnosis of ruptured AA (rAA) remained unchanged (-2.5%) and that with rAD increased by 54.6%. The number of (open and endovascular) procedures in cases hospitalized for AA increased by 39.4% and for AD by 126.4%. The age-adjusted death rates in Germany for AA decreased from 4.0 to 2.9 per 100,000 inhabitants and that for AD increased from 1.0 to 1.4. The decrease in death attributed to AA cases can be described by linear regression as y = -0.0003*y + 6.7076 (p < 0.0001). Accepting this association between increased elective procedures and reduced AA mortality, each/all 1000 procedures save 0.3 lives per 100,000 inhabitants. Despite increasing numbers of AR for AA and AD, only the mortality rate for all AAs decreased, while we did not observe a decrease in overall mortality of AD in Germany.

Impact of western sanctions on Russia's foreign trade indicators based on the developed exports efficiency criterion

In the framework of this scientific article the author of the criterion of efficiency of the country’s exports, developed on the basis of export performance indicator used by the Federal Statistical Office of Germany. The advantage of the proposed criterion of the author is that he became a multiparameter using a number of indicators such as the exporting country and the importing country. This criterion can be used to calculate the export potential of the country in the period of instability of the world economy, since under the proposed criteria can be considered not only the annual interval but also quarterly and monthly.

Recent trends in revision knee arthroplasty in Germany

We aimed to answer the following questions: (1) How did numbers of revision knee arthroplasty procedures develop in Germany over the last decade compared to primary TKA? (2) How high was the percentage of septic interventions in knee prosthesis revisions? (3) Which treatment strategy was chosen for surgical treatment of knee PJI? Revision arthroplasty rates as a function of age, gender, infection and type of prosthesis were quantified based on Operation and Procedure Classification System codes using revision knee arthroplasty data from 2008 to 2018, provided by the Federal Statistical Office of Germany (Destatis). In 2018, a total number 23,812 revision knee arthroplasties were performed in Germany, yielding an overall increase of 20.76% between 2008 and 2018. In comparison, primary TKA procedures increased by 23.8% from 152,551 performed procedures in 2008 to 188,866 procedures in 2018. Hence, 12.6% of knee arthroplasties required a revision in 2018. Septic interventions increased by 51.7% for all revisions. A trend towards higher numbers in younger patients was observed. Compared to 2008, 17.41% less DAIR procedures were performed, whereby single-stage and two- or multi-stage change increased by 38.76% and 42.76% in 2018, respectively. The increasing number of revision knee arthroplasty in Germany, especially in younger patients and due to infection, underlines the need for future efforts to improve treatment strategies to delay primary arthroplasty and avoid periprosthetic joint infection.

MIGRATIONS - JOURNEYS OF THE BROKERS - IN THE CONTEXT OF CONTEMPORARY AND FUTURE THREATS TO THE SECURITY OF 21ST CENTURY EUROPE

Contemporary and future threats to Europe in the 21st century constitute an important element of the European Union's security policy. Ongoing wars, terrorism, religious fanaticism and extreme poverty in third world countries led to a drastic wave of refugees that flooded Europe. The article presents the problem of threats related to the increasing migration, as well as the activities of the European Union aimed at preventing the migration crisis. The issue of Syrian refugees fleeing in desperation to Europe, a Europe that does not necessarily welcome them with open arms, was raised. The aim of the presented study is to analyze the situation of contemporary Europe in the context of threats related to the phenomenon of migration. Statistical data published by the most important institutions of the EU Member States, including data related to crimes committed by citizens who are not indigenous people of Europe, were thoroughly analyzed. Eurostat research, data disseminated by the Federal Criminal Police Office in Germany or statistics published by the Italian Istat were used. The conclusions from the above research allowed to verify the hypothesis that the migration crisis is a factor in the multifaceted destabilization of contemporary Europe, and the phenomenon of migration should be considered in this context. Due to the limited volume of the article, the author of the publication presented the most important legal bases regulating legal and illegal immigration, which will facilitate the understanding of the European Union's operation on the issue of interest to us.

What is the burden of osteomyelitis in Germany? An analysis of inpatient data from 2008 through 2018

BackgroundThe epidemiology of osteomyelitis in Germany is unknown, which makes it difficult to estimate future demands. Therefore, we aimed to analyse how the numbers of cases have developed over the last decade as a function of osteomyelitis subtype, age group, gender, and anatomical localization.MethodsOsteomyelitis rates were quantified based on annual ICD-10 diagnosis codes from German medical institutions between 2008 through 2018, provided by the Federal Statistical Office of Germany (Destatis).ResultsOverall osteomyelitis prevalence increased by 10.44% from 15.5 to 16.7 cases per 100,000 inhabitants between 2008 through 2018. Out of 11,340 cases in 2018, 47.6% were diagnosed as chronic, 33.2% as acute and 19.2% as unspecified osteomyelitis. Men were often affected than women with 63.4% of all cases compared to 36.6%. The largest proportion of patients comprised the age group 60–69 years (22.1%), followed by 70–79 years (21.7%). A trend towards more osteomyelitis diagnoses in older patients was observed. Lower extremities were most frequently infected with 73.8% of all cases in 2018 (+ 10.8% change).ConclusionsOsteomyelitis remains a serious problem for orthopedic and trauma surgery. Prevention methods and interdisciplinary approaches are strongly required.

A retrospective analysis of trends in primary knee arthroplasty in Germany from 2008 to 2018

Unicompartimental and total knee arthroplasty is one of the most successful and most performed operations worldwide. In the last years the number of primary knee arthroplasty increased constantly. The aim of this study is to analyze the rising numbers of primary knee arthroplasty and to see how it is used in Germany. In this retrospective study data, provided by the Federal Statistical Office of Germany from 2008 to 2018 was analyzed, using operation codes from the German procedure classification system and characteristics like age, sex and type of the prosthesis. We found a slight increase of unicompartimental and total knee arthroplasty over the investigated 10 years from 150.504 in 2008 up to 168.479 procedures in 2018, with a maximum of 169.334 in 2017. Most patients were female and over 65 years old. Interestingly, there was an obvious decrease of regular TKA in the year 2013, with a relevant impact on the total number of procedures. In the following years the number rised again reaching the former level in 2015 and is still increasing. The highest increase was found in partial knee arthroplasty, with a constant rise every year, starting with 7988 in 2008 up to 21.072 in 2018. In contrast, we found a relevant reduction of constrained prosthesis in primary TKA, whereas the number of semi-constrained prosthesis in primary TKA is again rising after a decrease in 2015. We found that the number of bicondylar TKA and especially UKA increased from 2008 to 2018. Regarding an aging population, we can expect a rising number for Primary knee arthroplasty and in consequence a rising number of revision arthroplasty in the future. This will be a challenging cost factor for the healthcare system in Germany.

Estimation of the export demand function (for example, Russia’s trade with Germany

The authors of this scientific article propose an approach that allows to describe the dependence of the export dynamics of the studied exporting country on the socio-economic state of the importing countries, followed by modeling and forecasting the export development of the studied country, taking into account the analysis of various scenario conditions for the development of the world economy. Within the framework of this scientific article, we also provide our own methodological development of a criterion for the eff ectiveness of a country’s export, based on the formula used by the Federal Statistical Office of Germany for assessing the eff ectiveness (productivity) of a country’s export using our hypothesis about the relationship between the socio-economic state of importing countries and the dynamics of the country’s export volumes — exporter.

Insight into ECMO, Mortality and ARDS: A Nationwide Analysis of 45,647 ECMO Runs

Background: Extracorporeal life support (ECLS) has become an integral part of modern intensive therapy. The choice of support mode depends largely on the indication. Patients with respiratory failure are predominantly treated with a venovenous (VV) approach. Methods: Inpatient data from Germany from 2007 to 2018 provided by the Federal Statistical Office of Germany were analysed. The ICD and OPS codes for extracorporeal membrane oxygenation (ECMO) types, acute respiratory distress syndrome (ARDS) and hospital mortality were used. Findings: A total of 45,647 hospitalized patients treated with ECLS were analysed. Overall hospital mortality remains higher than predicted in comparison to the values reported in the literature. The number of VV-ECMO cases increased by 236% percent from 825 in 2005 to 2,768 in 2018. ARDS was the main indication for VV-ECMO in only 33% of the patients in the past, but that proportion increased to 60% in 2018. VA-ECMO support is of minor importance in the treatment of ARDS in Germany. The age distribution of patients undergoing ECLS has shifted towards an older population. Interpretation: ARDS is a severe disease with a high mortality rate despite ECLS therapy. The mortality rate differs widely in studies such as the CESAR trial and the EOLIA trial and the ELSO Registry in Germany. Funding Statement: This study was supported by internal institutional research funds from the Department of Anaesthesiology, Intensive Care and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt Germany. Declaration of Interests: Dr. Mutlak received lecture fees from GETINGE and conducted workshops for GETINGE. Dr. Friedrichson, Dr. Piekarski and Prof. Zacharowski have no conflicts of interest regarding the article.

Data protection and competition law: non-compliance as abuse of dominant position

The Federal Cartel Office in Germany has prohibited Facebook from combining data from its internal and external services with each user's account, on the grounds that such processing infringes the GDPR and, as a result, the social network was abusing its dominant position. The dominant position of the company is used to exclude any legal ground justifying a particular type of processing, whereas the dominant position should not be relevant for assessing compliance with the GDPR. The decision is part of a trend to abandon the competition law criteria related to the impact on the market, without providing any added value in terms of data protection.

Correction: Trends in Total Hip Arthroplasty in Germany from 2007 to 2016: What Has Changed and Where Are We Now?

Background The number of total hip arthroplasties (THA) is rising in many industrialized nations. At the same time, the evidence regarding different types of prostheses and fixation techniques is constantly evolving. Therefore, this study aimed to analyze changes in THA by these advancements during the last decade. Methods A retrospective analysis of data provided by the Federal Statistical Office of Germany from 2007 to 2016 was conducted using codes from the German procedure classification system and associated International Statistical Classification of Diseases and Related Health Problems codes. THA procedures were evaluated according to diagnoses, sex, and age of patients, along with the distribution of different prosthesis types. Additionally, changes in these parameters over time were analyzed. Results From 2007 to 2016 a total of 2 157 041 primary THA procedures were performed in Germany, with an increase of 14.4% over this period. Overall, cementless standard THA (STHA) was used most frequently (50.0%), followed by hybrid variants (18.8%), hemiarthroplasties (15.9%), cemented standard THA (cSTHA; 9.2%), cementless short-stem THA (ssTHA; 4.8%), and hip resurfacing (HR; 0.9%) techniques. During the study period, the number of cSTHA and HR decreased significantly, whereas the use of STHA and ssTHA rose substantially, with a significantly higher application of these procedures in the elderly population. While osteoarthritis of the hip joint was the main indication for THA, several procedure-specific differences were identified. Conclusion The present data clearly demonstrate an increase in the use of cementless fixation for THA in Germany during the last decade and document a rise in ssTHA in recent years with, in contrast, the use of HR decreasing to a minimum.

Extracorporeal liver support: trending epidemiology and mortality - a nationwide database analysis 2007\u20132015

BackgroundExtracorporeal liver support therapies (ELS) are technical options (for bridge-to-recovery as well as bridge-to-transplant) in patients with acute liver dysfunction (e.g. acute liver failure (ALF), acute-on chronic liver failure (AoCLF) or decompensated chronic liver disease (decomp. CLD)) to reduce effects of failing hepatic detoxification functions. The present study investigates the real-life utilization of ELS (annual incidences), mortality rates as well as data regarding specific populations of liver transplantation in Germany.MethodsData on patient cases receiving extracorporeal liver support therapy were identified in a nationwide data set from the Federal statistical Office of Germany from 1 January 2007 through 31 December 2015 and analyzed regarding in-hospital mortality, age- and sex-specific distribution and use of ELS in the context of liver transplantation. Mortality rates in patients with primary acute liver dysfunction and secondary acute liver dysfunction (in the context of cardiothoracic surgery) were evaluated.ResultsAnnual incidences of ELS use remained stable between 0.39/100.000 in 2007 and 0.47/100.000 ELS in 2015. In-hospital mortality rate was 51.49% in the 2886 evaluated patient cases. Mortality was higher in men (56.04%) than in women (43.70) in the observed time period between 2007 and 2015. ELS utilization and case-related liver transplantation rates were low (12.47%). Since 2012, the annual numbers for ELS therapy in cardiosurgical patients exceeded the frequency of ELS utilization in cases of primary liver dysfunction (mortality rates: 68.39% versus 40.63%).ConclusionsELS utilization remained stable between 2007 and 2015. Mortality rates are high in this patient population of acute liver dysfunction, especially in combination with case-related cardiothoracic surgery. ELS is rarely used in the setting of liver transplantation. In 2015, more than 50% of all ELS cases in Germany were performed in the context of cardiothoracic surgery.