International Alliances – An Approach to a Trust-Based Management

Gegenstand der Arbeit ist die Entwicklung eines vertrauensbasierten Ansatzes für das Management internationaler Kooperationen. Es hat sich gezeigt, dass Kooperation als freiwillige Ziel-Mittel-Verflechtung beschrieben werden kann. Vertrauen als Koordinationsmechanismus dient dazu, diese freiwillige Einordnung der individuellen Nutzenorientierung in ein übergeordnetes Ganzes zu gestalten. Um Vertrauen in seiner Vielschichtigkeit richtig begreifen zu können, wird im Weiteren ein multidimensionales Modell zum Aufbau von Vertrauen entwickelt, in welches im Anschluss die internationale Dimension integriert wird. Basierend auf diesem mehrdimensionalen Modell werden Handlungsempfehlungen abgeleitet, welche den aktiven Aufbau von Vertrauen innerhalb internationaler Kooperationen fördern.The topic of the study is the development of a trust-based approach for the management of international alliances. It has been shown that an alliance can be described as a voluntary means-end-relation. Trust as a coordinating tool can be used to map the voluntary subordination of individual utility maximising to a greater whole. To understand trust as a complex phenomenon, a multidimensional model for the building of trust is developed, integrating the international dimension into the model in a next step. Based on this multidimensional model, rules of action are developed, which foster the active building of trust within international alliances

Women’s and Provider’s Moral Reasoning About the Permissibility of Coercion in Birth: A Descriptive Ethics Study

Evidence shows that during birth women frequently experience unconsented care, coercion, and a loss of autonomy. For many countries, this contradicts both the law and medical ethics guidelines, which emphasize that competent and fully informed women’s autonomy must always be respected. To better understand this discordance, we empirically describe perinatal maternity care providers’ and women’s moral deliberation surrounding coercive measures during birth. Data were obtained from 1-on-1 interviews with providers (N = 15) and women (N = 14), and a survey of women (N = 118). Analyses focused on an in-depth exploration of responses to a question on the permissibility of coercion in birth whose wording was borrowed from a Swiss medical-ethical guideline. Reasons for and against a principle permissibility of coercive measures in birth were grouped into clusters of reasons to build a coherent explanatory framework. Factors considered morally relevant when deliberating on coercion included women’s decisional capacity, beneficence/non-maleficence, authority through knowledge on the part of providers, flaws of the medical system, or the imperative to protect the most vulnerable. Also, we identified various misconceptions, such as the conviction that a pathological birth can justify coercion or that fetal rights can justifiably infringe on women’s autonomy. Information and education on the issue of coercion in birth are urgently needed to enable women to fully exercise their reproductive autonomy, to prevent long-term adverse health outcomes of women and children, and to reconcile the medical vigilance which has lead to a reduction of perinatal morbidity and mortality with women’s enfranchisement in their own care

Cost optimization for the 100% renewable electricity scenario for the Java-Bali grid

A 100% renewable electricity supply is no insurmountable technical problem anymore after the respective technologies to harvest the energy from multiple renewable energy sources have been developed and have reached a high level of maturity. A problem may rather be suspected to reside on the economic side of an exclusively renewable electricity supply. The present study examines the economic implications of a renewable energy scenario for the Java-Bali grid. Based on given energy supply scenarios, the costs of an electricity supply from renewable energy sources alone are determined. Economic optimum configurations are determined for which the annual system costs and accordingly the power generation costs are minimized. First the system running costs are considered, i.e. the operation and maintenance costs as well as the costs of the continuous renovation of system components, while capital costs are not taken into account. After this the capital costs are taken into consideration, and total system costs and power generation costs are determined. The main result is a specification of economic optimum system configurations. One important result is that a future electricity supply from renewable resources alone is not more expensive than the current power generation in developed countries. Another result is that the integration of special long-term storage into the Java-Bali grid, like for instance methane storages, besides pumped storages and batteries, is not economically favourable if further moderate battery cost reductions are reached. Article History: Received May 18th 2018; Received in revised form August 16th 2018; Accepted October 1st 2018; Available online How to Cite This Article: Günther, M., Eichinger, M., (2018) Cost Optimization for the 100% Renewable Electricity Scenario for the Java-Bali Grid, International Journal of Renewable Energi Development, 7(3), 269-276. https://doi.org/10.14710/ijred.7.3.269-27

Evaluating the Public Climate School, a multi-component school-based program to promote climate awareness and action in students: A cluster-controlled pilot study

Introduction: Despite the potential of school-based programs targeting climate awareness and action to support students in addressing the climate crisis and to improve their mental health and well-being, there is limited evidence for their effectiveness. In preparation for a cluster-randomized controlled trial, we assessed the feasibility of evaluating the Public Climate School (PCS), a one-week school program in Germany, and its effects on theory-based behavioral and psychological outcomes. Material and methods: We enrolled 158 students from 11 classes (grades 7–13) into a cluster-controlled pilot study. Four classes were allocated to the waitlist control group and 7 to the intervention group participating in the PCS in November 2021. Using online surveys, we assessed theory-based behavioral and psychological outcomes at baseline and follow-up. Two-level models were used to investigate changes in outcomes. Results: 125 students completed the baseline and follow-up survey (dropout rate: 21 %). For most outcomes we observed no between-group differences, except for pro-environmental communication and engagement (e.g., posting on social media; p=.040) and perceptions of environmental norms (p=.001) in the anticipated direction. Conclusion: This study confirmed the feasibility of evaluating the PCS and provides parameter estimates to guide sample size calculations and study design decisions for future research. Together with recent work on the association between collective action and mental health, the effect of the PCS on pro-environmental communication and engagement highlights the value of examining effects of education for sustainable development programs on student health and linking them to collective action in future work

Anxiety in response to the climate and environmental crises: validation of the Hogg Eco-Anxiety Scale in Germany

Background: As the climate and environmental crises unfold, eco-anxiety, defined as anxiety about the crises’ devastating consequences for life on earth, affects mental health worldwide. Despite its importance, research on eco-anxiety is currently limited by a lack of validated assessment instruments available in different languages. Recently, Hogg and colleagues proposed a multidimensional approach to assess eco-anxiety. Here, we aim to translate the original English Hogg Eco-Anxiety Scale (HEAS) into German and to assess its reliability and validity in a German sample. Methods: Following the TRAPD (translation, review, adjudication, pre-test, documentation) approach, we translated the original English scale into German. In total, 486 participants completed the German HEAS. We used Bayesian confirmatory factor analysis (CFA) to assess whether the four-factorial model of the original English version could be replicated in the German sample. Furthermore, associations with a variety of emotional reactions towards the climate crisis, general depression, anxiety, and stress were investigated. Results: The German HEAS was internally consistent (Cronbach’s alphas 0.71–0.86) and the Bayesian CFA showed that model fit was best for the four-factorial model, comparable to the factorial structure of the original English scale (affective symptoms, rumination, behavioral symptoms, anxiety about personal impact). Weak to moderate associations were found with negative emotional reactions towards the climate crisis and with general depression, anxiety, and stress. Discussion: Our results support the original four-factorial model of the scale and indicate that the German HEAS is a reliable and valid scale to assess eco-anxiety in German speaking populations

Anxiety in response to the climate and environmental crises: validation of the Hogg Eco-Anxiety Scale in Germany

Background: As the climate and environmental crises unfold, eco-anxiety, defined as anxiety about the crises’ devastating consequences for life on earth, affects mental health worldwide. Despite its importance, research on eco-anxiety is currently limited by a lack of validated assessment instruments available in different languages. Recently, Hogg and colleagues proposed a multidimensional approach to assess eco-anxiety. Here, we aim to translate the original English Hogg Eco-Anxiety Scale (HEAS) into German and to assess its reliability and validity in a German sample. Methods: Following the TRAPD (translation, review, adjudication, pre-test, documentation) approach, we translated the original English scale into German. In total, 486 participants completed the German HEAS. We used Bayesian confirmatory factor analysis (CFA) to assess whether the four-factorial model of the original English version could be replicated in the German sample. Furthermore, associations with a variety of emotional reactions towards the climate crisis, general depression, anxiety, and stress were investigated. Results: The German HEAS was internally consistent (Cronbach’s alphas 0.71–0.86) and the Bayesian CFA showed that model fit was best for the four-factorial model, comparable to the factorial structure of the original English scale (affective symptoms, rumination, behavioral symptoms, anxiety about personal impact). Weak to moderate associations were found with negative emotional reactions towards the climate crisis and with general depression, anxiety, and stress. Discussion: Our results support the original four-factorial model of the scale and indicate that the German HEAS is a reliable and valid scale to assess eco-anxiety in German speaking populations

Guidance for the treatment of deep vein thrombosis and pulmonary embolism

This guidance document focuses on the diagnosis and treatment of venous thromboembolism (VTE). Efficient, cost effective diagnosis of VTE is facilitated by combining medical history and physical examination with pre-test probability models, D dimer testing and selective use of confirmatory imaging. Clinical prediction rules, biomarkers and imaging can be used to tailor therapy to disease severity. Anticoagulation options for acute VTE include unfractionated heparin, low molecular weight heparin, fondaparinux and the direct oral anticoagulants (DOACs). DOACs are as effective as conventional therapy with LMWH and vitamin K antagonists. Thrombolytic therapy is reserved for massive pulmonary embolism (PE) or extensive deep vein thrombosis (DVT). Inferior vena cava filters are reserved for patients with acute VTE and contraindications to anticoagulation. Retrievable filters are strongly preferred. The possibility of thoracic outlet syndrome and May-Thurner syndrome should be considered in patients with subclavian/axillary and left common iliac vein DVT, respectively in absence of identifiable triggers. The optimal duration of therapy is dictated by the presence of modifiable thrombotic risk factors. Long term anticoagulation should be considered in patients with unprovoked VTE as well as persistent prothrombotic risk factors such as cancer. Short-term therapy is sufficient for most patients with VTE associated with transient situational triggers such as major surgery. Biomarkers such as D dimer and risk assessment models such the Vienna risk prediction model offer the potential to customize VTE therapy for the individual patient. Insufficient data exist to support the integration of bleeding risk models into duration of therapy planning

National Planetary Health learning objectives for Germany: A steppingstone for medical education to promote transformative change

Physicians play an important role in adapting to and mitigating the adverse health effects of the unfolding climate and ecological crises. To fully harness this potential, future physicians need to acquire knowledge, values, skills, and leadership attributes to care for patients presenting with environmental change-related conditions and to initiate and propel transformative change in healthcare and other sectors of society including, but not limited to, the decarbonization of healthcare systems, the transition to renewable energies and the transformation of transport and food systems. Despite the potential of Planetary Health Education (PHE) to support medical students in becoming agents of change, best-practice examples of mainstreaming PHE in medical curricula remain scarce both in Germany and internationally. The process of revising and updating the Medical Licensing Regulations and the National Competency-based Catalog of Learning Objectives for Medical Education in Germany provided a window of opportunity to address this implementation challenge. In this article, we describe the development and content of national Planetary Health learning objectives for Germany. We anticipate that the learning objectives will stimulate the development and implementation of innovative Planetary Health teaching, learning and exam formats in medical schools and inform similar initiatives in other health professions. The availability of Planetary Health learning objectives in other countries will provide opportunities for cross-country and interdisciplinary exchange of experiences and validation of content, thus supporting the consolidation of Planetary Health learning objectives and the improvement of PHE for all health professionals globally.</p