Germany's Strategy Research Articles

Are graduates preferred to those completing initial vocational education and training? Case studies on company recruitment strategies in Germany, England and Switzerland

The German and Swiss economies value skilled work highly and initial vocational education and training (IVET) has been the predominant traditional pathway into such work. However, concerns about a more ‘knowledge-based society’ and the ‘academic shift in the labour market’ are starting to undermine the status associated with those who complete IVET pathways and these former trainees also face competition from graduates from the relatively new Bachelor programmes in Switzerland and Germany. An international project investigated whether these developments pose a threat to developed IVET systems and whether companies are changing their recruitment strategies and how they rate the status of IVET. The findings from Germany and Switzerland were compared with the situation in England, the home of two-phase HE structures along with a very different tradition of vocational training. The findings from individual case studies in England, Germany and Switzerland are presented here, with the focus on the expectations of companies towards applicants with experience of IVET or Bachelor’s degrees.

German Foreign Policy towards the Romanian Oil during 1938-1940

During the two world wars, oil had a vital role for belligerent states. During the inter-war period, oil became very important under the circumstances created by army motorization processes and by the spectacular increase of military troops. The strategic importance of oil reserves increased after 1938, under the increasing risk of yet another world war. The dependence of the great powers on oil imports forced them to elaborate supply strategies with this vital raw material for the war economy. Based on data from archives, memoirs and works about the role of oil during World War II, the study analyzes Germany's strategy to ensure the import of Romanian oil, which was needed in its war economy. At the same time, the study aims at bringing new information to answer a series of questions that are still debated on within the history of World War II. First: why did Germany not use military force to strategically exploit Romanian oil, as it did on other occasions? Second: how important was Hitler's Germany's loss of the possibility to import oil from the Middle East? Third: what are the lessons to be learned today from the asymmetrical dispute between Romanian and Germany over the control of the former's oil

Modularisation of vocational training in Germany, Austria and Switzerland: parallels and disparities in a modernisation process

This article considers the modularisation of initial vocational training (including apprenticeships) as a modernisation strategy in Germany, Austria and Switzerland. Training systems are similarly structured in these three countries with the apprenticeship system at their heart, and the three national philosophies of education and training are largely comparable. The approach in each country will be outlined and the three will then be compared in terms of the background to modularisation, key drivers and decision-making procedures, and forms and intensity of modularisation. The article concludes that in all three countries, technical and organisational change and greater labour market flexibility are driving the pressure to modularise. While the educational policy players and modalities differ, all three countries have adopted a form of modularisation that is limited in terms of its scope and how radical it is. The article proposes a concept that enables training to be modularised while leaving intact a country’s existing training philosophy and Berufskonzept, a German concept that embodies the extent to which workers internalise an occupational identity.

PCV92 Drug Approval Strategies in Germany

PCV92 Drug Approval Strategies in Germany

Trend of herbicide loads in the river Rhine and its tributaries

Many policies have been established and actions have been taken to reduce pesticide pollution of surface waters. However, the effectiveness of these initiatives was rarely tested on an empirical basis. This study suggests that evidence on the policy effects can be evaluated by analyzing the temporal changes in the loads rather than the concentrations of active ingredients in rivers. It is shown that the long-term change of pesticide emissions into surface waters can be tested statistically by the number of upward versus downward trends in river load. To evaluate the situation in Germany, 57 concentration time series of 14 herbicide substances at 7 river monitoring stations with a minimum of 24 analyses per year were assembled and annual substance river loads were calculated. The longest time course was 17 years (1990-2006). The significance of trends of data rows was analyzed by an univariate Mann-Kendall test that evaluates 27 (47.4%) of the 57 time series as statistically significant downward trended. It took a period of 10 years and longer before the high annual atrazine and simazine loads measured in the years 1990-1991 had been diminished to a drastically lowered level after ban of the herbicides. Data are available on the yearly consumption of 8 substances used in German agriculture. A total of 36 time series for this subset were tested with a partial Mann-Kendall test with the consumption as covariance factor, which reduces the number of significant trends in river load noticeably. Based on this test, only 7 (19.4% of 36) declining time series remain. As a result, the intended effect of measures to reduce surface water contamination by the use of pesticides seems to be only partially successful, however, the database to justify this statement is small. For the water monitoring strategies in Germany, it is recommend to enhance the sampling frequency at river stations. A minimum of a semimonthly sampling interval would facilitate the calculation of valuable annual river loads and would therefore allow a pronounced validation of the long-term change of pesticide emission into rivers.

Changes in the German Urban System—A Financial-Sector Perspective

Urban systems analysis and especially the seminal contributions of the Globalization and World Cities Research Network (GaWC) so far mainly rely on the analysis of national and international office geographies of advanced producer services firms. This paper shows how the geography of demand-supply relationships and associated knowledge flows adds important qualitative information to the office geographies of the Globalization and World Cities Research Network. It contributes to our understanding of intercity relations and networks—and thus of urban systems more generally. We illustrate our approach by looking at private equity firms and their knowledge management strategies in Germany. Empirically, we analyze private equity firms’ business relations and networks with external partners as well as their geographical organization. While private equity firms’ geographical organization in Germany is characterized by decentralized concentration with nodes in Frankfurt and regional financial centres, there is evidence that among the latter Munich plays a special role. Only in Munich has private equity—cross-fertilized by other local financial actors—initiated a self-supporting development which strengthens Munich as a financial centre. The paper illustrates how the dynamics of private equity and its knowledge management lead to Germany’s financial system having a more tiered structure and how qualitative network analysis can help deepen our understanding of urban systems development.

Falling Back on Old Habits? A Comparison of the Social and Unemployment Crisis Reactive Policy Strategies in Germany, the UK and Sweden

AbstractAlthough long‐term processes of welfare state development have been investigated frequently, there is a surprising gap in knowledge on short‐term reactions of states to sudden events. This article aims to fill this gap by examining the reactive policies, i.e. immediate policy responses to urgent social matters, of governments to the current economic crisis. We focus on social and unemployment policies of the three welfare regime ideal types of Esping‐Andersen's typology, namely Germany, the UK and Sweden. We apply long‐term policy development theories, most notably the convergence and path dependence theories, to understand the choices made in the different reactive policy strategies of these countries. In addition, we scrutinize whether we find similarities between the reactive policies and the converging structural welfare state developments. We use comparable data from various European and national data sources for the two years directly following the recent crisis, namely 2008 and 2009. Our analysis shows that, at least for the three countries under investigation, countries seem to have fallen back on ‘old habits’ by adopting social and unemployment reactive policies that can be identified based on their institutional legacies. This suggests that reactive policy strategies can be explained by different dynamics than the more structural long‐term policy developments, and in our case we find evidence in support for the path dependence theory.

Extension of platelet shelf life from 4 to 5 days by implementation of a new screening strategy in Germany

The Paul-Ehrlich-Institute analysed all fatalities due to bacterial infections between 1997 and 2007. Thereafter, the platelet shelf life was reduced to a maximum of 4 days after blood donation because the majority of all cases of severe transfusion-transmitted bacterial infections occurred with day 5 platelets. The current study compares the analytical sensitivity and the diagnostic specificity of four rapid bacterial detection procedures. Nine transfusion-relevant bacterial strains were spiked in pooled platelets or apheresis platelets at a low concentration (10 CFU/bag). Samples were collected after day 3, day 4 and day 5 and investigated by four rapid bacterial detection methods (modified BacT/ALERT, Bactiflow, FACS method and 16s DNA PCR methods). Seven out of nine bacterial strains were adequately detected by BacT/ALERT, Bactiflow and PCR in apheresis platelets and pooled platelets after sample collection at day 3, day 4 and day 5. For three bacterial strains, analytical sensitivity was reduced for the FACS method. Two bacterial strains did not grow under the storage conditions in either pooled or apheresis platelets. A late sample collection on day 3, day 4 or day 5 after blood donation in combination with a rapid bacterial detection method offers a new opportunity to improve blood safety and reduce errors due to sampling., BacT/ALERT, Bactiflow or 16s ID-NAT are feasible for late bacterial screening in platelets may provide data which support the extension of platelet shelf life in Germany to 5 days.

Cost-effectiveness of primary HPV screening for cervical cancer in Germany – a decision analysis

Objectives To systematically evaluate the long-term effectiveness and cost-effectiveness of HPV-based primary cervical cancer screening in the German health care context using a decision-analysis approach. Methods A Markov-model for HPV-infection and cervical cancer was developed for the German health care context, and applied to evaluate various screening strategies that differ by screening interval and test algorithms, including HPV-testing alone or in combination with cytology. German clinical, epidemiological, and economic data, and test accuracy data from international meta-analyses were used. Outcomes predicted included the reduction in cervical cancer cases and deaths, life expectancy and discounted incremental cost-effectiveness ratios (ICER). The analysis was performed from the perspective of the healthcare system adopting a 3% annual discount rate for costs and outcomes. Extensive sensitivity analyses were performed. Results HPV-based screening is more effective than cytology alone. It results in a 71–97% reduction in cervical cancer cases as compared to 53–93% for cytology alone. The ICER range from 2600 Euro/LYG (cytology, 5-year-interval) to 155,500 Euro/LYG (annual HPV-testing starting at age 30 years, cytology age 20–29 years). Annual cytology alone, the current recommended screening strategy in Germany, is dominated by HPV-strategies. Increasing the age at screening initiation from 20 to 25 years does not result in a relevant loss in effectiveness but results in lower costs. Conclusions Based on our analyses, HPV-based cervical cancer screening is more effective than cytology alone and could be cost-effective if performed at intervals of two years or longer. In the German context, an optimal screening strategy may be biennial HPV screening starting at age 30 years preceded by biennial cytology for women aged 25–29 years. Longer screening intervals may be considered in low-risk women with good screening adherence and in populations with low HPV-incidence.

Decision-analytic modeling to evaluate the long-term effectiveness and cost-effectiveness of HPV-DNA testing in primary cervical cancer screening in Germany.

BackgroundPersistent infections with high-risk types of human papillomavirus (HPV) are associated with the development of cervical neoplasia. Compared to cytology HPV testing is more sensitive in detecting high-grade cervical cancer precursors, but with lower specificity. HPV based primary screening for cervical cancer is currently discussed in Germany. Decisions should be based on a systematic evaluation of the long-term effectiveness and cost-effectiveness of HPV based primary screening.Research questionsWhat is the long-term clinical effectiveness (reduction in lifetime risk of cervical cancer and death due to cervical cancer, life years gained) of HPV testing and what is the cost-effectiveness in Euro per life year gained (LYG) of including HPV testing in primary cervical cancer screening in the German health care context? How can the screening program be improved with respect to test combination, age at start and end of screening and screening interval and which recommendations should be made for the German health care context?MethodsA previously published and validated decision-analytic model for the German health care context was extended and adapted to the natural history of HPV infection and cervical cancer in order to evaluate different screening strategies that differ by screening interval, and tests, including cytology alone, HPV testing alone or in combination with cytology, and HPV testing with cytology triage for HPV-positive women. German clinical, epidemiological and economic data were used. In the absence of individual data, screening adherence was modelled independently from screening history. Test accuracy data were retrieved from international meta-analyses. Predicted outcomes included reduction in lifetime-risk for cervical cancer cases and deaths, life expectancy, lifetime costs, and discounted incremental cost-effectiveness ratios (ICER). The perspective of the third party payer and 3% annual discount rate were adopted. Extensive sensitivity analyses were performed in order to evaluate the robustness of results and identify areas of future research.ResultsIn the base case analysis screening resulted in a 53% to 97% risk reduction for cervical cancer with a discounted ICER between 2,600 Euro/LYG (cytology alone every five years) and 155,500 Euro/LYG (Annual cytology age 20 to 29 years, and annual HPV age 30 years and older). Annual cytology, the current recommended screening strategy in Germany, was dominated. In sensitivity analyses variation in the relative increase in the sensitivity of HPV testing as compared to cytology, HPV test costs, screening adherence, HPV incidence, and annual discount rate influenced the ICER results. Variation in the screening start age also influenced the ICER. All cytology strategies were dominated by HPV screening strategies, when relative sensitivity increase by HPV testing compared to cytology was higher (scenario analysis with data for test accuracy from German studies). HPV testing every one, two or three years was more effective than annual cytology. With increased screening adherence a longer screening interval and with low screening adherence a shorter interval would be more cost-effective. With a reduction in HPV incidence of more than 70% triennial HPV screening in women aged 30 years and older (and biennial Pap screening in women aged 20 to 29 years) is cost-effective. The discounted ICER increases with increasing annual discount rate. Increasing screening start age to 25 years had no relevant loss in effectiveness but resulted in lower costs. An optimal strategy may be biennial HPV testing age 30 years and older with biennial cytology at age 25 to 29 years (ICER of 23,400 Euro/LYG).ConclusionsBased on these results, HPV-based cervical cancer screening is more effective than cytology and could be cost-effective if performed at intervals of two years or greater. Increasing the age at screening start to 25 years causes no relevant loss in effectiveness but saves resources. In the German context an optimal screening strategy could be biennial HPV testing at age 30 years and older with biennial cytology at the age of 25 to 29 years. An extension to a three-yearly screening interval requires substantially improved screening adherence or a higher relative increase in the sensitivity of HPV testing as compared to cytology. The implementation of an organised screening program for quality-controlled introduction of HPV-screening and -vaccination with continued systematic outcome evaluation is recommended.

An integrated digital research environment: DFG perspectives

PurposeThe purpose of this paper is to focus on the vision that the Deutsche Forschungsgemeinschaft (German Research Foundation (DFG)) pursues with its funding programmes in the field of digital information provision.Design/methodology/approachThe first section of the paper sketches out the strategic decisions which determine the funding policy of the DFG in the field of digital information, while the second section describes in more detail the central funding schemes of the DFG in the field of digital information.FindingsThe funding policy of the DFG seeks to build an integrated digital research environment that includes scholarly publications and primary research data as well as new forms of communication in virtual research and work environments. But it will be only by the common effort of scholars, libraries and providers of scholarly information, funders, publishers and fee‐collecting agencies that the vision of an integrated digital research environment will come true.Originality/valueThe outline of the funding programmes of the DFG in the area of digital information provision will be of interest to librarians and information professionals seeking information about library‐funding policies and strategies in Germany.

The transformation of Japan Post into a global player

The privatisation of Japan Post has been a cornerstone of recent Japanese government reform policy. However, little scholarly attention has been given to the expansion of Japan Post into the global express delivery market. This study compares the privatisation and internationalisation of Japan Post with Deutsche Post to 2007. Similarities and differences in the strategies in Germany and Japan both with respect to the privatisation process as well as to international expansion strategies are examined and discussed. Special focus is placed on the activities of Japan Post and DHL in China and the Asia-Pacific region.

Tuberkulose im Gesundheitswesen

Perception and knowledge of the TB-infection risk in healthcare workers (HCWs) changed profoundly in Germany during the past few years. Molecular-epidemiological studies and a comprehensive review of the existing evidence concerning the infection risk for HCWs lead to the conclusion that TB in HCWs is often caused by infection at the workplace. In the Hamburg Fingerprint Study, 80 % of the TB cases in HCWs were caused by infections at the workplace. In a similar Dutch study 43 % of all cases were work-related. Besides of the well-known risks in TB wards and laboratories, an increased risk for infection should be assumed for paramedics, in emergency rooms, for HCWs caring for the elderly or for workers with close contact to high-risk groups (homeless people, i. v. drug users, migrants from high-incidence countries). TB in a HCW working in these fields can be recognised as an occupational disease (OD) without identifying a particular source of infection. For all other HCWs, the German occupational disease law requires the identification of a source case before TB in an HCW can be accepted as an OD. Even though the proportion of work-related TB in HCWs is higher than was assumed before previously, the prevalence of latent TB infection (LTBI) is lower than expected. In an ongoing evaluation study of the interferon-gamma release assay (IGRA) LTBI prevalence in HCWs is 10 %. Prevention strategies in Germany should be reconsidered in the light of these new findings.

Nanotechnology in Germany: from forecasting to technological assessment to sustainability studies

The issues of innovations and sustainability are discussed more or less separately, so that risks and potentials of new technologies for a sustainable development often fail to be detected as early as possible. This article analyses this relationship in light of the development of the nanotechnology funding strategy in Germany which was guided by an integrated approach of technology management activities. This led from technological forecasting activities, the definition of application fields and market surveys to early technological assessment activities and sustainability studies combined with communication measures. The importance of sustainability aspects grew steadily throughout this process, and the integrated approach facilitated the early detection of relevant sustainability issues to be dealt with in the future. This underlines the importance of integrating innovation measures in research funding with work on systematically assessing the sustainability potential of the new technologies.

Laryngotracheale Stenosen im Kindesalter

Stenoses of the larynx and upper trachea in the pediatric population require a multidisciplinary approach and center-based treatment. Patterns of care and treatment strategies in Germany were evaluated using a standardized questionnaire. A questionnaire was transmitted by telefax to 141 departments of Otorhinolaryngology (ORL) and to 214 pediatric (PED) departments. Using primarily multiple-choice questions variables regarding caseload, surgical techniques, cooperating institutions, criteria for surgical indications and subjective assessment of success rates were investigated. The response rate was 55% (ORL) and 46% (PED), respectively, 34% of the replying ORL departments were offering tracheal surgery in children, with most of them using advanced surgical techniques. In 12 ORL departments 1-3 cases per year were operated, in 6 ORL departments more than 6 cases per year and 3 ORL departments were perceived as specialized centers for pediatric airway surgery by their peers. However, 41% of the PED departments were unable to identify a center for pediatric airway surgery. In Germany, surgery for pediatric airway stenoses is not primarily focused on treatment centers. There is a significant information gap among German pediatricians regarding success rates of reconstructive airway surgery and available centers offering surgical therapy for this population. Several factors offer potential to be optimized in the care for children with a compromised airway and improving communication between otolaryngologists and pediatricians should be a primary goal in the future.

Stellenwert von Endoprothetik und Umstellungsosteotomie bei Gonarthrose - Ergebnisse einer Umfrage an Unfallchirurgischen und Orthopädischen Kliniken

Die endoprothetische Versorgung der primären und sekundären Gonarthrose hat sich weltweit innerhalb der letzten Jahrzehnte zu einer erfolgreichen und zuverlässigen Behandlung etabliert [[1]]. In großen Erhebungen konnte am Beispiel des schwedischen Knieprothesenregisters eine hohe Patientenzufriedenheit in über 80 Prozent der behandelten Patienten ermittelt werden [[2]].

Framing political public relations: Measuring success of political communication strategies in Germany

The main goal of political public relations is the use of media outlets to communicate specific political interpretations of issues in the hope of garnering public support for political policies. This study elaborates on the question how successful political PR is at bringing its specific perspectives into the media. It uses the ‘framing’ concept to analyse the meanings and contexts of media coverage and political PR during the national debate on immigration in Germany between May 2000 and March 2002. The results show a high level of correlation between the preferred thematic and position frames of the political players and those in the press coverage. Yet, the media examined clearly did not have a passive relationship to PR. The findings indicate that journalists tend to use their power to alter PR messages when the communications from political players do not have a distinct focus and/or when the PR focuses were not among the (mainstream) aspects dominating the general political debate.

Laryngotracheale Stenosen im Kindesalter: Versorgungsstrukturen in Deutschland

Background. Stenoses of the larynx and upper trachea in the pediatric population require a multidisciplinary approach and center-based treatment. Patterns of care and treatment strategies in Germany were evaluated using a standardized questionnaire. Material and methods. A questionnaire was transmitted by telefax to 141 departments of Otorhinolaryngology (ORL) and to 214 pediatric (PED) departments. Using primarily multiple-choice questions variables regarding caseload, surgical techniques, cooperating institutions, criteria for surgical indications and subjective assessment of success rates were investigated. Results. The response rate was 55% (ORL) and 46% (PED), respectively, 34% of the replying ORL departments were offering tracheal surgery in children, with most of them using advanced surgical techniques, In 12 ORL departments 1-3 cases per year were operated, in 6 ORL departments more than 6 cases per year and 3 ORL departments were perceived as specialized centers for pediatric airway surgery by their peers. However, 41% of the FED departments were unable to identify a center for pediatric airway surgery. Conclusion. In Germany, surgery for pediatric airway stenoses is not primarily focused on treatment centers. There is a significant information gap among German pediatricians regarding success rates of reconstructive airway surgery and available centers offering surgical therapy for this population. Several factors offer potential to be optimized in the care for children with a compromised airway and improving communication between oto laryngologists and pediatricians should be a primary goal in the future.

Cyclosporine-Based Immunosuppressive Strategies for Kidney Recipients: Interim Analysis of German Data From the Multinational Observational Study (MOST)

Introduction We collected data from kidney recipients with a functioning graft at German kidney transplant centers in order to analyze the efficacy of various cyclosporine (CsA)-based immunosuppressive strategies, the effects of different perioperative and maintenance regimens, and the impact of donor source on clinical outcome. Methods As part of the ongoing prospective Multinational Observational Study in Transplantation (MOST), data for both prospective and retrospective analysis were collected from kidney recipients over 18 years bearing a functioning graft that was transplanted at 21 German kidney transplant centers between 1987 and 2002. Results Data from 1223 renal graft recipients, including their CsA-based immunosuppressive regimens, were stratified as: 402 de novo patients (median 6.8 months posttransplant) and 821 patients on maintenance therapy (median 71 months posttransplant). Triple regimens with CsA + mycophenolate mofetil (MMF) + steroids (Ste) currently comprise the major perioperative immunosuppressive strategies in Germany (de novo 65%). IL-2 receptor antagonist (IL-2Ra) use is increasing (de novo 18%, maintenance 4%), while mono and dual regimen use de novo is declining (de novo 4%, maintenance 20%). Among 689 patients transplanted between 1987 and 2002 with outcome data, the mean incidence of acute rejection during the first posttransplant year was 21.6%. Rejection rates on initial therapy with CsA + MMF + Ste ± antibodies ( n = 517) averaged 17.8%. Conclusions Between 1987 and 2002, CsA-based immunosuppression combined with MMF and Ste became the most commonly used strategy for both initial and maintenance therapy after kidney transplantation in Germany, yielding the low acute rejection rates particularly when combined with IL-2Ra.

Stellenwert von Endoprothetik und Umstellungsosteotomie bei Gonarthrose - Ergebnisse einer Umfrage an Unfallchirurgischen und Orthopädischen Kliniken

Knee arthroplasties, both total (TKA) and unicondylar, as well as high tibial osteotomy (HTO) represent the main treatment options in severe osteoarthritis of the knee. The aim of this study was to collect detailed information regarding the current treatment strategies in Germany. 220 departments of orthopaedic surgery and 250 departments of trauma surgery were asked about their treatment strategies in an anonymous nation-wide survey regarding the different operative procedures in HTO, TKA, revision TKA and related issues. Univariate analyses were performed and means, medians and rates were calculated. Questionnaire forms were answered by 54 % of the departments. The survey represents 31 138 TKA for the year 2002. In the mean 137 TKA were performed in each department. Posterior cruciate ligament retaining components were used in 67 %, resurfacing of the patella was performed in 19 % of cases. The incidence of revision TKA is about 10 % compared to the primary TKA cases. In comparison to a different survey from the year 1995, the absolute number of primary and revision TKA has increased by a factor of nearly three. Compared to the number of TKA, the proportion of HTO has declined to 12 % and the number of unicondylar knee arthroplasties represents 7 % of all cases. In the surgical treatment of severe osteoarthritis, TKA shows a highly increasing number, whereas HTO is decreasing. An increasing number of revision TKA can be observed. There is trend towards the cemented implantation technique. Patella resurfacing is not performed routinely in most German hospitals.