Political parties and public policy in the German Länder:when parties matter

When Parties Matter looks at the extent to which political parties can make a difference to public policy, focusing on the regional level in Germany. Politicians of the left and the right sometimes have radically different views, but inevitably the combined forces of legal and financial constraints, bureaucracy, public expectations and the 'weight of history' restrict their ability to translate political disagreement into policy change. Giving a detailed examination of education policy, childcare and family policy, and labour market policy in three German regions between 1999 and 2006, this book provides insights into what politicians can and cannot achieve, in particular at the level below the nation-state.

A study of potential serum markers for a diagnosis of gram-positive and gram-negative bacterial sepsis

Sepsis continues to be a major cause of morbidity and mortality as it can readily lead tosevere sepsis, septic shock, multiple organ failure and death. The onset can be rapid and difficult to define clinically. Despite the numerous candidate markers proposed in the literature, to date a serum marker for sepsis has not been found. The aim of this study was to assay the serum of clinically diagnosed patients with eithera Gram-negative or Gram- positive bacterial sepsis for elevated levels of nine potentialmarkers of sepsis, using commercially produced enzyme linked immunosorbent assays(ELISA). The purpose was to find a test marker for sepsis that would be helpful toclinicians in cases of uncertain sepsis and consequently expose false positive BC'scaused by skin or environmental contaminants. Nine test markers were assayed including IL-6, IL-I 0, ILI2, TNF-α, lipopolysaccharide binding protein, procalcitonin, sE-selectin, sICAM -1 and a potential differential marker for Gram-positive sepsis- anti-lipid S antibody. A total of 445 patients were enrolled into this study from the Queen Elizabeth Hospital and Selly Oak Hospital (Birmingham). The results showed that all the markers were elevated in patients with sepsis and that patients with a Gram-negative sepsis consistently produced higher median/range serum levels than those with a Gram-positive sepsis. No single marker was able to identify all the septic patients. Combining two markers caused the sensitivities and specificities for a diagnosis of sepsis to increase to within a 90% to 100% range. By a process of elimination the markers that survived into the last phase were IL-6 with sICAM -1, and anti-lipid S IgG assays Defining cut-off levels for a diagnosis of sepsis became problematic and a semi-blind trial was devised to test the markers in the absence of both clinical details and positive blood cultures. Patients with pyrexia of unknown origin and negative BC were included in this phase (4). The results showed that IL-6 with sICAM-l are authentic markers of sepsis. There was 82% agreement between the test marker diagnosis and the clinical diagnosis for sepsis in patients with a Gram-positive BC and 78% agreement in cases of Gram-negative Be. In the PUO group the test markers identified 12 cases of sepsis and the clinical diagnosis 15. The markers were shown to differentiate between early sepsis and sepsis, inflammatory responses and infection. Anti-lipid S with IL-6 proved be a sensitive marker for Gram-positive infections/sepsis.

Dipeptidyl peptidase IV (DPP IV) and related molecules in type 2 diabetes

Dipeptidyl peptidase IV (DPP IV) is a widely distributed physiological enzyme that can be found solubilized in blood, or membrane-anchored in tissues. DPP IV and related dipeptidase enzymes cleave a wide range of physiological peptides and have been associated with several disease processes including Crohn's disease, chronic liver disease, osteoporosis, multiple sclerosis, eating disorders, rheumatoid arthritis, cancer, and of direct relevance to this review, type 2 diabetes. Here, we place particular emphasis on two peptide substrates of DPP IV with insulin-releasing and antidiabetic actions namely, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). The rationale for inhibiting DPP IV activity in type 2 diabetes is that it decreases peptide cleavage and thereby enhances endogenous incretin hormone activity. A multitude of novel DPP IV inhibitor compounds have now been developed and tested. Here we examine the information available on DPP IV and related enzymes, review recent preclinical and clinical data for DPP IV inhibitors, and assess their clinical significance.

Novel pH‐and temperature‐responsive methacrylamide microgels

A novel transition temperature in MeAM copolymer microgels is reported. Despite the fact that MeAM homopolymers do not show thermosensitive properties, a specific synthetic strategy leads to a thermo-responsive swelling behavior that could be potentially useful in medical and/or industrial applications. The pH and temperature-dependent swelling response of microgels of MeAM copolymerized with 2-aminomethylpyridine and ethylenediamine is reported. The changes in particle sizes, which depend on the nature of the surrounding environment, are recorded by QELS. The relation between copolymer structure and its novel behavior is analyzed by several techniques (1H NMR, TGA).

A high-efficiency solar rankine engine with isothermal expansion

Though the principle of the solar Rankine cycle is well known, with several examples reported in the literature, there is yet a scarcity of engines that could be efficiently applied in small-scale (<100 KW) applications. Hence, this paper presents a variant of the engine that uses an isothermal expansion to achieve a theoretical efficiency close to the Carnot limit. Generation of steam inside the power cylinder obviates the need for an external boiler. The device is suitable for slow-moving applications and is of particular interest for driving a batch-desalination process. Preliminary experiments have shown cycle efficiency of 16%, and a high work ratio of 0.997. ©The Author 2013. Published by Oxford University Press. All rights reserved.

A social role for churches and cultural demarcation:how German MEPs represent religion in the European Parliament

This study deals with the question of how German members of the European Parliament (MEPs) represent the German model of religion–state relations at the European level. Based on a survey and interviews with German MEPs as well as a content-analysis of German MEPs’ speeches, motions and parliamentary questions during the seventh term of the European Parliament (EP), our study demonstrates that this model is represented in three dimensions. First, German MEPs reflect the close cooperation between the churches and the state in Germany, primarily on social issues, through largely church- and religion-friendly attitudes and relatively frequent contacts with religious interest-groups. Second, by referring to religious freedoms and minorities primarily outside the EU and by placing Islam in considerably more critical contexts than Christianity, German MEPs create a cultural demarcation line between Islam and Christianity through their parliamentary activities, which is similar to, though less politicised than, cultural boundaries often produced in public debates in Germany. Third, our study illustrates similar patterns of religious affiliation and subjective religiosity among German parliamentarians in both the EP and the national Parliament, which to some degree also reflect societal trends in Germany. Yet our data also suggest that European political elites are more religious than the average German population. If the presence of religion in terms of religious interest-groups and arguments is included, the EP appears to be more secularist than the German Parliament.

Representation of people of South Asian origin in cardiovascular outcome trials of glucose-lowering therapies in Type 2 diabetes

Aims : Our aim was to investigate the proportional representation of people of South Asian origin in cardiovascular outcome trials of glucose-lowering drugs or strategies in Type 2 diabetes, noting that these are among the most significant pieces of evidence used to formulate the guidelines on which clinical practice is largely based. Methods : We searched for cardiovascular outcome trials in Type 2 diabetes published before January 2015, and extracted data on the ethnicity of participants. These were compared against expected values for proportional representation of South Asian individuals, based on population data from the USA, from the UK, and globally. Results : Twelve studies met our inclusion criteria and, of these, eight presented a sufficiently detailed breakdown of participant ethnicity to permit numerical analysis. In general, people of South Asian origin were found to be under-represented in trials compared with UK and global expectations and over-represented compared with US expectations. Among the eight trials for which South Asian representation could be reliably estimated, seven under-represented this group relative to the 11.2% of the UK diabetes population estimated to be South Asian, with the representation in these trials ranging from 0.0% to 10.0%. Conclusions : Clinicians should exercise caution when generalizing the results of trials to their own practice, with regard to the ethnicity of individuals. Efforts should be made to improve reporting of ethnicity and improve diversity in trial recruitment, although we acknowledge that there are challenges that must be overcome to make this a reality.