Toward the Development of a Global Financial Safety Net or a Segmentation of the Global Financial Architecture?

This article examines the prospects for the development of a comprehensive global financial safety net (GFSN). It discusses the optimal layout of the GFSN, comprising the International Monetary Fund, regional financing arrangements (RFAs), as well as bilateral or multilateral central bank swap arrangements, and the relationship between these. It then briefly reviews and appraises the current structure and functioning of these different layers of the GFSN and discusses the need and scope for strengthening cooperation between RFAs and the IMF. It argues that the GFSN is still very patchy and there is little reason to expect significant progress in better collaboration between RFAs and the IMF as long as the latter’s governance structure is not significantly revamped. Indeed, risks are that the GFSN will become even more fragmented with the further development of the European Stability Mechanism and the emergence of the BRICS Contingent Reserve Arrangement. To prevent a further fragmentation of the GFSN, substantial governance reform of the IMF is urgently needed

Making up meanings in a capital city: power, memory and monuments in Berlin

Much contemporary writing on cities focuses on their position within wider global networks, so there is a risk of underplaying the significance of other aspects of the urban experience.This paper explores the particular role of Berlin as capital city in the making of the (new) Berliner Republic and the ways in which it is defined (and defines itself) within that Republic. Berlin is the (and often literally the building) site on which a new Germany is being constructed. The making up of the new Berlin is dominated by attempts to reinterpret and reimagine its history: it is a city of memorials and of deliberate absences; of remembering and forgetting, or trying to forget; of reshaping the past as well as trying to build a new future. The juxtapositions of urban experience, the layering of memories and the attempt to imagine a different future come together to define Berlin as a contemporary capital city

Growing old at home – A randomized controlled trial to investigate the effectiveness and cost-effectiveness of preventive home visits to reduce nursing home admissions: study protocol [NCT00644826]

<p>Abstract</p> <p>Background</p> <p>Regarding demographic changes in Germany it can be assumed that the number of elderly and the resulting need for long term care is increasing in the near future. It is not only an individual's interest but also of public concern to avoid a nursing home admission. Current evidence indicates that preventive home visits can be an effective way to reduce the admission rate in this way making it possible for elderly people to stay longer at home than without home visits. As the effectiveness and cost-effectiveness of preventive home visits strongly depends on existing services in the social and health system existing international results cannot be merely transferred to Germany. Therefore it is necessary to investigate the effectiveness and cost-effectiveness of such an intervention in Germany by a randomized controlled trial.</p> <p>Methods</p> <p>The trial is designed as a prospective multi-center randomized controlled trial in the cities of Halle and Leipzig. The trial includes an intervention and a control group. The control group receives usual care. The intervention group receives three additional home visits by non-physician health professionals (1) geriatric assessment, (2) consultation, (3) booster session.</p> <p>The nursing home admission rate after 18 months will be defined as the primary outcome. An absolute risk reduction from a 20% in the control-group to a 7% admission rate in the intervention group including an assumed drop out rate of 30% resulted in a required sample size of N = 320 (n = 160 vs. n = 160).</p> <p>Parallel to the clinical outcome measurement the intervention will be evaluated economically. The economic evaluation will be performed from a society perspective.</p> <p>Discussion</p> <p>To the authors' knowledge for the first time a trial will investigate the effectiveness and cost-effectiveness of preventive home visits for people aged 80 and over in Germany using the design of a randomized controlled trial. Thus, the trial will contribute to the existing evidence on preventive home visits especially in Germany.</p