Wandel und Reform des deutschen Sozialstaats aus Sicht der Bevölkerung

Der Beitrag untersucht anhand aktueller repräsentativer Umfragedaten die Einstellungen der Bürger zu wesentlichen Aspekten der Reformen des deutschen Sozialstaats. Es wird gefragt, ob der sich abzeichnende sozialpolitische Paradigmenwechsel hin zum "investiven Sozialstaat" in der Bevölkerung auf Zustimmung stößt. Im Einzelnen geht es dabei um grundsätzliche Gerechtigkeitsorientierungen, die gewachsene Bedeutung von Eigenverantwortung, die stärkere Akzentuierung investiver Sozialpolitikbereiche sowie Maßnahmen der aktivierenden Arbeitsmarktpolitik. Die Ergebnisse zeigen, dass eine Mehrheit der Bürger die jeweiligen Reformen zwar grundsätzlich unterstützt, jedoch erfolgt ihre Zustimmung weder vorbehaltlos noch ist sie frei von Ambivalenzen. Insbesondere Reformen, die mit hohen materiellen wie immateriellen Kosten für den Einzelnen verbunden sind, werden negativ beurteilt

Developing a Medical Institution Management System through Promoting Social Accountability

The paper regards the implementation of social accountability principles into the system of medical institution management as the target of research. The process of personnel management is viewed as its research subject. The paper aims to develop the system of incentives for medical institution personnel based on the principles of social accountability. The research methods and tools applied in the study are analysis of content and internal enterprise documentation, staff member interviews and statistical methods of data processing. The expected research outcome is the implementation phase of the social accountability management system resulted in the development of the Code of corporate conduct. The article advocates the view, that the Code of Conduct should be based on the diagnosis of the state of corporate culture and motivate employees of the organization. The management team of medical institution can set their own social and reasonable quality management system, which will enable it to promote and involve staff in the process of improvement

Fibrin gel - advantages of a new scaffold in cardiovascular tissue engineering

Objective: The field of tissue engineering deals with the creation of tissue structures based on patient cells. The scaffold plays a central role in the creation of 3-D structures in cardiovascular tissue engineering like small vessels or heart valve prosthesis. An ideal scaffold should have tissue-like mechanical properties and a complete immunologic integrity. As an alternative scaffold the use of fibrin gel was investigated. Methods: Preliminary, the degradation of the fibrin gel was controlled by the supplementation of aprotinin to the culture medium. To prevent tissue from shrinking a mechanical fixation of the gel with 3-D microstructure culture plates and a chemical fixation with poly-l-lysine in different fixation techniques were studied. The thickness of the gel layer was changed from 1 to 3 mm. The tissue development was analysed by light, transmission and scanning electron microscopy. Collagen production was detected by the measurement of hydroxyproline. Injection molding techniques were designed for the formation of complex 3-D tissue structures. Results: The best tissue development was observed at an aprotinin concentration of 20 μg per cc culture medium. The chemical border fixation of the gel by poly-l-lysine showed the best tissue development. Up to a thickness of 3 mm no nutrition problems were observed in the light and transmission electron microscopy. The molding of a simplified valve conduit was possible by the newly developed molding technique. Conclusion: Fibrin gel combines a number of important properties of an ideal scaffold. It can be produced as a complete autologous scaffold. It is moldable and degradation is controllable by the use of aprotini

The GOODSTEP project: General Object-Oriented Database for Software Engineering Processes

The goal of the GOODSTEP project is to enhance and improve the functionality of a fully object-oriented database management system to yield a platform suited for applications such as software development environments (SDEs). The baseline of the project is the O2 database management system (DBMS). The O2 DBMS already includes many of the features regulated by SDEs. The project has identified enhancements to O2 in order to make it a real software engineering DBMS. These enhancements are essentially upgrades of the existing O2 functionality, and hence require relatively easy extensions to the O2 system. They have been developed in the early stages of the project and are now exploited and validated by a number of software engineering tools built on top of the enhanced O2 DBMS. To ease tool construction, the GOODSTEP platform encompasses tool generation capabilities which allow for generation of integrated graphical and textual tools from high-level specifications. In addition, the GOODSTEP platform provides a software process toolset which enables modeling, analysis and enaction of software processes and is also built on top of the extended O2 database. The GOODSTEP platform is to be validated using two CASE studies carried out to develop an airline application and a business application

Wandering permanent pacemaker generators in children: a case series

<p>Abstract</p> <p>Introduction</p> <p>Epicardial permanent pacemaker generators are implanted some times in the abdominal wall in pediatric age groups.</p> <p>Case presentation</p> <p>Three permanent epicardial pacemakers that migrated in an unusual manner producing intraabdominal complications are reported.</p> <p>Conclusion</p> <p>The different clinical presentations of pacemaker migration in the pediatric age groups are highlighted and a few suggestions are made for avoiding such a complication.</p

Narrative review of Ebstein's anomaly beyond childhood: imaging, surgery, and future perspectives

Ebstein's anomaly is a rare congenital heart disease with malformation of the tricuspid valve and myopathy of the right ventricle. The septal and inferior leaflets adhere to the endocardium due to failure of delamination. This leads to apical displacement of their hinge points with a shift of the functional tricuspid valve annulus towards the right ventricular outflow tract with a possibly restrictive orifice. Frequently, a coaptation gap yields tricuspid valve regurgitation and over time the "atrialized" portion of the right ventricle may dilate. The highly variable anatomy determines the clinical presentation ranging from asymptomatic to very severe with need for early operation. Echocardiography and magnetic resonance imaging are the most important diagnostic modalities to assess the tricuspid valve as well as ventricular morphology and function. While medical management of asymptomatic patients can be effective for many years, surgical intervention is indicated before development of significant right ventricular dilatation or dysfunction. Onset of symptoms and arrhythmias are further indications for surgery. Modified cone reconstruction of the tricuspid valve is the state-of-the-art approach yielding the best results for most patients. Alternative procedures for select cases include tricuspid valve replacement and bidirectional cavopulmonary shunt depending on patient age and other individual characteristics. Long-term survival after surgery is favorable but rehospitalization and reoperation remain significant issues. Further studies are warranted to identify the optimal surgical strategy and timing before adverse right ventricular remodeling occurs. It is this article's objective to provide a comprehensive review of current literature and an overview on the management of Ebstein's Anomaly. It focuses on imaging, cardiac surgery, and outcome. Additionally, a brief insight into arrhythmias and their management is given. The "future perspectives" summarize open questions and fields of future research.Thoracic Surger

The Welfare State and Equality? Stratification Realities and Aspirations in Three Welfare Regimes

Welfare regimes differ in their impact on social inequality in important ways. While previous research has explored the shape of stratification across nations and citizens’ normative attitudes towards inequality, scant attention has been given to citizens’ perceptions of actual stratification across welfare regimes. Using the 1999 International Social Survey Programme, we compare perceptions of inequality in Germany, Sweden, and the United States. More specifically, we ask how the stratification reality in each country is assessed by its citizens, whether it meets their stratification aspirations, and whether these perceptions differ systematically both across and within welfare regimes. Our results show that perceptions vary in a clear and meaningful way across countries as well as between different social groups within a given welfare regime. For instance, Americans are more likely to view society as unequal, but only slightly more likely to prefer that extent of inequality. Conversely, the Swedish clearly view their society as more equal than citizens in the United States and Germany, yet not nearly as equal as they would like it to be. Our multivariate results reveal important similarities and differences as well, such as socio-economic cleavages in the United States, and cleavages between labour market insiders and outsiders in Germany