Merkur, Mars, Minerva und Co. - Zur Frage nach dem Einfluss der römischen Religion im germanischen Barbaricum

Jenseits vom Rhein und den Provinzgrenzen der Germania inferior (Niedergermanien) und Germania superior (Obergermanien) lag der von den Römern als Germania magna oder Barbaricum bezeichnete Raum, dessen Funde im Mittelpunkt dieser Arbeit stehen. Römische Waren machten an den Grenzen des Imperiums nicht Halt. Denkbare Transferwege zu den germanischen Kulturgruppen sind Handel, Beutegut, Auszeichnung für militärische Dienste oder diplomatische Geschenke. Ein großer Teil von römischen Objekten aus der archäologischen Sachkultur, welche im germanischen Barbaricum gefunden wurden, tragen Darstellungen von Szenen, die eindeutig der römisch-griechischen Mythologie entstammen oder religiöse Szenen aus dem römischen Kult veranschaulichen. Es handelt sich u.a. um Objekte, die zum Ess- und Trinkservice gehörten, um verzierte Terra Sigillata, um Götterstatuetten oder um verzierte Bestandteile militärischer Ausrüstung wie Schwertscheiden oder-klingen und Gürtelbeschläge. Der Gedanke ist nicht abwegig, dass der „barbarische“ Besitzer oder Betrachter dieser römischen Waren von den religiösen Darstellungen in irgendeiner Form kognitiv beeinflusst wurde. Die vorliegende Dissertation spürt dieser Frage im Spiegel der archäologischen Funde nach. Teil I beschreibt sowohl die archäologisch- als auch die schriftlich überlieferte Ausgangssituation. Teil II legt das bis dato bekannte bzw. von der Autorin recherchierbare römische Fundmaterial im germanischen Barbaricum mit der Darstellung von religiösen oder kultischen Motiven in Katalogform vor, Teil III analog dazu das einheimische, germanische Fundmaterial, welches römische religiöse oder kultische Motive imitiert bzw. rezipiert. In Teil IV wird anhand ausgewählter Beispiele ein direkter Vergleich zwischen dem Bildschatz auf dem Fundmaterial aus dem Barbaricum mit den römischen Motiven gezogen. Teil V enthält die Zusammenfassung aller vorigen Teile und eine Einschätzung der Frage nach der Beeinflussung der germanischen Glaubensvorstellungen durch die Rezeption der römischen Götterwelt.Mercury, Mars, Minerva & Co - On the question of the influence of Roman religion in Germanic BarbaricumBeyond the Rhine and the provincial borders of Germania inferior (Lower Germania) and Germania superior (Upper Germania) was the area known by the Romans as Germania magna or Barbaricum whose findings are focused in this work. Roman goods did not stop at the borders of the Empire. Conceivable routes of transfer to the Germanic cultural groups are trade, booty, awards for military services or diplomatic gifts. A large part of Roman objects from the archeological material culture, which were found in Germanic Barbaricum, bear representations of scenes that clearly come from Roman-Greek mythology or illustrate religious scenes from the Roman cult. It concerns objects that belonged to the dining and drinking service, ornate terra sigillata, statuettes of gods or ornate components of military equipment such as sword scabbards or blades and belt fittings. It is not unreasonable to think that the “barbaric” owner or observer of these Roman goods was cognitively influenced in some way by the religious representations. This dissertation traces that question in the mirror of the archaeological finds. Part I describes the archaeological as well as the historical written sources. Part II presents the Roman found material known to date or researchable by the author in Germanic Barbaricum with the representation of religious or cult motifs in catalogue style, Part III analogously presents the indigenous, Germanic findings that imitate or adopt Roman religious or cult motifs. In Part IV, using selected examples, a direct comparison is made between the motifs on the found objects from Barbaricum and the Roman motifs. Part V contains the summary of all previous parts and an assessment of the question of how the Germanic beliefs were influenced by the reception of the Roman world of gods

How does Germany's health sector contribute to the economy?

Health matters. The health sector is an important and innovative industry, as well as a source of stable employment for many people. Health systems support active and productive populations, reduce inequities and poverty and promote social cohesion. A strong health system makes good economic sense and underpins the overall sustainable development agenda Countries around the world are grappling with the health, economic and fiscal implications of the COVID-19 pandemic. As they begin to recover from the crisis, difficult decisions will need to be made about how to allocate scarce resources. These snapshots share valuable evidence for policy-makers on how investing in health sectors and health systems helps to achieve national economic objectives

Pilotierung einer systematischen Messung der Leistungsfähigkeit und Effizienz des deutschen Gesundheitssystems (Health System Performance Assessment - HSPA): Manual zur dauerhaften und kontinuierlichen Durchführung eines HSPA in Deutschland - überarbeitete Fassung, Stand Januar 2024

Das Modul 3 stellt das abschließende Modul des Projektes und einen weiteren Schritt in Richtung Verstetigung der bisherigen Ergebnisse dar. Das darin entwickelte vorliegende Manual zur kontinuierlichen, möglichst automatisierten Durchführung eines HSPA im Regelbetrieb beschreibt Voraussetzungen und Rahmenbedingungen für eine dauerhafte Implementierung. Weiterhin wird die Verfügbarkeit der Datenquellen dargestellt, unter anderem des Alterssurveys, und Vorschläge werden formuliert, wie die Datenverfügbarkeit verbessert oder Datenlücken geschlossen werden könnten

Pilotierung einer systematischen Messung der Leistungsfähigkeit und Effizienz des deutschen Gesundheitssystems (Health System Performance Assessment - HSPA): Zweiter Bericht - überarbeitete Fassung; Stand Januar 2024

Wie leistungsfähig ist das deutsche Gesundheitssystem? Und wie kann man das messen? Das sind die Leitfragen des vorliegenden Forschungsprojekts. Health System Performance Assessments (HSPA) beschreibt die systematische und kontinuierliche Messung der Leistungsfähigkeit von Gesundheitssystemen. Es dient gemäß Weltgesundheitsorganisation (WHO) dem Monitoring und der Bewertung von Gesundheitssystemen anhand ihrer übergeordneten Ziele und generiert so Evidenz für Politik, Wissenschaft und die Bevölkerung. Seit dem World Health Report 2000 der WHO haben viele Länder sowie internationale Organisationen (z.B. OECD) das Thema aufgegriffen und eigene HSPA initiiert. Das Forschungsprojekt verfolgte das Ziel über einen Zeitraum von drei Jahren erstmals ein HSPA für Deutschland zu pilotieren. Basierend auf einem konzeptuellen Gerüst des Gesundheitssystems bestehend aus fünf Performanz-Dimensionen (Zugang, Qualität, Bevölkerungsgesundheit, Responsiveness und Effizienz) sowie fünf kontextuellen Dimensionen wurden mehr als 100 Indikatoren identifiziert und anhand von regelmäßig verfügbaren Daten für Deutschland, unter anderem anhand von DEAS-Daten, und acht Vergleichsländer über mehrere Jahre analysiert. Neben dem Gesamtbild der Leistungsfähigkeit ermöglichen die Ergebnisse der einzelnen Indikatoren einen detaillierten Blick auf Stärken und Herausforderungen des deutschen Gesundheitssystems. Nach einem ersten Durchlauf wurde das Vorgehen angepasst, die Analysen erweitert und die Ergebnisse in einem finalen HSPA-Bericht festgehalten. Das Projekt wird im Auftrag des Bundesministeriums für Gesundheit (BMG) durchgeführt und hat eine Laufzeit von Oktober 2020 bis September 2023

Exploring Health System Responsiveness in Ambulatory Care and Disease Management and its Relation to Other Dimensions of Health System Performance (RAC) – Study Design and Methodology

Background: The responsiveness of a health system is considered to be an intrinsic goal of health systems and an essential aspect in performance assessment. Numerous studies have analysed health system responsiveness and related concepts, especially across different countries and health systems. However, fewer studies have applied the concept for the evaluation of specific healthcare delivery structures and thoroughly analysed its determinants within one country. The aims of this study are to assess the level of perceived health system responsiveness to patients with chronic diseases in ambulatory care in Germany and to analyse the determinants of health system responsiveness as well as its distribution across different population groups. Methods and Analysis: The target population consists of chronically ill people in Germany, with a focus on patients suffering from type 2 diabetes and/or from coronary heart disease (CHD). Data comes from two different sources: ( i ) cross-sectional survey data from a postal survey and ( ii ) claims data from a German sickness fund. Data from both sources will be linked at an individual-level. The postal survey has the purpose of measuring perceived health system responsiveness, health related quality of life, experiences with disease management programmes (DMPs) and (subjective) socioeconomic background. The claims data consists of information on (co)morbidities, service utilization, enrolment within a DMP and sociodemographic characteristics, including the type of residential area. Discussion: RAC is one of the first projects linking survey data on health system responsiveness at individual level with claims data. With this unique database, it will be possible to comprehensively analyse determinants of health system responsiveness and its relation to other aspects of health system performance assessment. The results of the project will allow German health system decision-makers to assess the performance of nonclinical aspects of healthcare delivery and their determinants in two important areas of health policy: in ambulatory and chronic disease care

Cultivation of Phaffia rhodozyma (Xanthophyllomyces dendrorhous) yeast in discontinuous system to obtain astaxanthin

A levedura Phaffia rhodozyma, produtora de astaxantina, pigmento carotenóide largamente empregado na aqüicultura de peixes e crustáceos, pode ser eficientemente cultivada num meio de cultura de baixo custo, à base de caldo de cana diluído 1:10 e uréia a 1 g/L. No entanto, a produção de biomassa e a formação do carotenóide sofrem a inibição pelo substrato (efeito "Crabtree"), limitando desta forma a utilização do caldo de cana com concentrações da fonte de carbono superiores a 20 g/L, importante consideração na produção industrial de astaxantina. No presente trabalho, o cultivo da levedura P. rhodozyma foi realizado em processo descontínuo alimentado, no qual se obteve produtividade volumétrica de 0,024 mg astaxantina/L.h. em relação aos 0,013 mg astaxantina/L.h. obtidos no cultivo controle, que não sofreu alimentação da fonte de carbono.The yeast Phaffia rhodozyma produces astaxanthin, a carotenoid pigment widely applied in fish and crustaceous cultivation. This yeast can be efficiently cultured in a low cost medium, sugar cane broth diluted 1:10 and supplemented with 1 g/L urea. However, the biomass and astaxanthin production undergo inhibition by the substrate (Crabtree effect), limiting the utilization of sugar cane broth up to 20 g/L total sugar concentration. Therefore, this effect must be considered during the industrial production of astaxanthin. In the present work, using fed batch system to cultivate P. rhodozyma we were able to obtain 0.024 mg astaxanthin/l.h compared to 0.013 mg astaxanthin/l.h obtained by the discontinuous cultivation system

Mapping variability in allocation of Long-Term Care funds across payer agencies in OECD countries

Introduction: Long-term care (LTC) is organized in a fragmented manner. Payer agencies (PA) receive LTC funds from the agency collecting funds, and commission services. Yet, distributional equity (DE) across PAs, a precondition to geographical equity of access to LTC, has received limited attention. We conceptualize that LTC systems promote DE when they are designed to set eligibility criteria nationally (vs. locally); and to distribute funds among PAs based on needs-formula (vs. past-budgets or government decisions). Objectives: This cross-country study highlights to what extent different LTC systems are designed to promote DE across PAs, and the parameters used in allocation formulae. Methods: Qualitative data were collected through a questionnaire filled by experts from 17 OECD countries. Results: 11 out of 25 LTC systems analyzed, fully meet DE as we defined. 5 systems which give high autonomy to PAs have designs with low levels of DE; while nine systems partially promote DE. Allocation formulae vary in their complexity as some systems use simple demographic parameters while others apply socio-economic status, disability, and LTC cost variations. Discussion and conclusions: A minority of LTC systems fully meet DE, which is only one of the criteria in allocation of LTC resources. Some systems prefer local priority-setting and governance over DE. Countries that value DE should harmonize the eligibility criteria at the national level and allocate funds according to needs across regions

On the traces of tcf12: Investigation of the gene expression pattern during development and cranial suture patterning in zebrafish (Danio rerio)

The transcription factor 12 (tcf12) is a basic Helix-Loop-Helix protein (bHLH) of the E-protein family, proven to play an important role in developmental processes like neurogenesis, mesoderm formation, and cranial vault development. In humans, mutations in TCF12 lead to craniosynostosis, a congenital birth disorder characterized by the premature fusion of one or several of the cranial sutures. Current research has been primarily focused on functional studies of TCF12, hence the cellular expression profile of this gene during embryonic development and early stages of ossification remains poorly understood. Here we present the establishment and detailed analysis of two transgenic tcf12:EGFP fluorescent zebrafish (Danio rerio) reporter lines. Using these transgenic lines, we analyzed the general spatiotemporal expression pattern of tcf12 during different developmental stages and put emphasis on skeletal development and cranial suture patterning. We identified robust tcf12 promoter-driven EGFP expression in the central nervous system (CNS), the heart, the pronephros, and the somites of zebrafish embryos. Additionally, expression was observed inside the muscles and bones of the viscerocranium in juvenile and adult fish. During cranial vault development, the transgenic fish show a high amount of tcf12 expressing cells at the growth fronts of the ossifying frontal and parietal bones and inside the emerging cranial sutures. Subsequently, we tested the transcriptional activity of three evolutionary conserved non-coding elements (CNEs) located in the tcf12 locus by transient transgenic assays and compared their in vivo activity to the expression pattern determined in the transgenic tcf12:EGFP lines. We could validate two of them as tcf12 enhancer elements driving specific gene expression in the CNS during embryogenesis. Our newly established transgenic lines enhance the understanding of tcf12 gene regulation and open up the possibilities for further functional investigation of these novel tcf12 enhancer elements in zebrafish

Selective enrollment in Disease Management Programs for coronary heart disease in Germany – An analysis based on cross-sectional survey and administrative claims data

Abstract Background In 2002, Disease Management Programs (DMPs) were introduced within the German healthcare system with the aim to increase the quality of chronic disease care. Due to the enrollment procedures, it can be assumed a) that only certain patients actively decide to enroll in a DMP and/or b) that only certain patients get the recommendation for DMP enrollment from their physician. How strong this assumed effect of self- and/or professional selection is, is still unclear. Methods We used data from a cross-sectional postal-survey linked on individual level with administrative claims data from a German sickness fund. The sample consisted of individuals suffering from coronary heart disease (CHD) who i) were either enrolled in the respective DMP or ii) fulfilled the disease related criteria for enrollment but were not enrolled. We applied multivariate logistic regression analyses to assess factors on patient level associated with DMP enrollment. Results We included 7070 individuals in our analyses. Male sex, higher age and receiving old age pension, a higher Charlson Score and a diagnosis of type 2 diabetes increased the odds for DMP-CHD enrollment significantly. Individuals with a diagnosed myocardial infarction (MI) were also more likely to be enrolled in the DMP-CHD. We found a significant interaction effect for MI and sex, indicating that the association between MI and DMP enrollment is stronger for women than for men. Conclusion DMP-enrollees and non-enrollees differ in various factors. Studies analyzing the effectiveness of DMP-CHD should carefully take into account these group differences. Furthermore, the results suggest that the DMP-CHD assessed reaches men better than women