Die Schuldenkrise und die Unterstützung der Europäischen Union

Die Unterstützung der EU durch ihre Bürger ist spätestens seit dem Vertrag von Maastricht Gegenstand einer Vielzahl von Beiträgen in der Einstellungsforschung. Eine zentrale Annahme der bisherigen Forschung war die große Distanz der EU zur Alltagswirklichkeit der Bürger. Nach dieser werden Einstellungen zur EU nur aufwendig oder mit Rückgriff auf Einstellungen zum Nationalstaat gebildet. Mit der Euro-Schuldenkrise, deren wirtschaftlichen Auswirkungen für die Bürger und einer Vielzahl von EU-Krisengipfeln erfuhr die europäische Politik seit 2010 eine enorme Aufmerksamkeit in der Öffentlichkeit. In dieser Arbeit wird die Entwicklung der EU-Unterstützung vergleichend in Deutschland und Griechenland vor und während der Schuldenkrise untersucht: 1) Zunächst wird diskutiert, inwieweit die Schuldenkrise mit den etablierten Determinanten der Unterstützungsforschung theoretisch zusammenhängt. Im Mittelpunkt stehen wirtschaftliche und demokratische Performanz, europäische und nationale Identität sowie Heuristiken zum Nationalstaat. 2) Der Fokus auf Deutschland und Griechenland ermöglicht einen Vergleich der Determinanten vor und während der Krise, da beide Länder substanziell völlig unterschiedlich, jedoch gleichzeitig betroffen waren. Während die Bürger in Griechenland spürbare Wohlstandsverluste erleiden, stellt sich in Deutschland die Frage nach der Solidarität mit den europäischen Nachbarn. 3) Die empirische Analyse zeigt, dass die etablierten Determinanten in der Schuldenkrise ihre Relevanz behalten. Das individuelle wirtschaftliche Schicksal ist in Griechenland ein stärkerer Einflussfaktor als vor der Krise. Es bestätigt sich die Erwartung, dass die größere Präsenz der EU in der Krise mit einer geringeren Bedeutung der Einstellungen zum Nationalstaat einhergeht.

Tempering the EU? NGO Advocacy in the Area of Freedom, Security, and Justice

The European Union’s (EU) area of Freedom, Security and Justice (AFSJ) portfolio comprises policy areas such as immigration and asylum, and police and judicial cooperation. Steps were taken to bring this field into the mandate of the EU first by the Maastricht Treaty, followed by changes implemented by the Amsterdam and Lisbon Treaties, the last one ‘normalizing’ the EU’s erstwhile Third Pillar. As the emergent EU regime continues to consolidate in this field, NGOs of various kinds continue to seek to influence policy-making and implementation, with varying success. This article seeks to establish the context in which NGOs carry out their work and argues that the EU-NGO interface is impacted both by the institutional realities of the European Union and the capacities of EU-oriented NGOs to seize and expand opportunities for access and input into the policy cycle. Using EU instruments representing three different policy bundles in AFSJ (immigration, asylum and judicial cooperation in criminal matters), the article seeks to map out NGO strategies in engaging and oftentimes resisting European Union policy instruments.

Heart rate recovery after exercise in chronic heart failure: Role of vital exhaustion and type D personality

OBJECTIVE: Vital exhaustion and type D personality previously predicted mortality and cardiac events in patients with chronic heart failure (CHF). Reduced heart rate recovery (HRR) also predicts morbidity and mortality in CHF. We hypothesized that elevated levels of vital exhaustion and type D personality are both associated with decreased HRR. METHODS: Fifty-one patients with CHF (mean age 58+/-12 years, 82% men) and left ventricular ejection fraction (LVEF) derwent standard exercise testing before receiving outpatient cardiac rehabilitation. They completed the 9-item short form of the Maastricht Vital Exhaustion Questionnaire and the 14-item type D questionnaire asking about negative affectivity and social inhibition. HRR was calculated as the difference between heart rate at the end of exercise and 1min after abrupt cessation of exercise (HRR-1). Regression analyses were adjusted for gender, age, LVEF, and maximum exercise capacity. RESULTS: Vital exhaustion explained 8.4% of the variance in continuous HRR-1 (p=0.045). For each point increase on the vital exhaustion score (range 0-18) there was a mean+/-SEM decrease of 0.54+/-0.26bpm in HRR-1. Type D personality showed a trend toward statistical significance for being associated with lower levels of HRR-1 explaining 6.5% of the variance (p<0.08). The likelihood of having HRR-1dependently associated with reduced HRR-1. The findings provide a hitherto not explored psychobiological explanation for poor cardiac outcome in patients with CHF.

Independent association of sleep quality, fatigue, and vital exhaustion with platelet count in patients with a previous venous thromboembolic event

Elevated platelet count might reflect increased inflammation as an etiological factor for venous thromboembolism (VTE). Poor sleep, fatigue, and exhaustion are all associated with inflammation and are also common sequelae of chronic psychological stress that previously predicted increased risk of VTE. We hypothesized that platelet count would be high in patients with VTE who sleep poorly and who are fatigued and exhausted. We investigated 205 patients scheduled for thrombophilia work-up > or =3 months after an objectively diagnosed venous thromboembolic event. They completed the Jenkins Sleep Questionnaire to rate subjective sleep quality and the short forms of the Multidimensional Fatigue Symptom Inventory and Maastricht Vital Exhaustion Questionnaire. Platelet count was determined by a mechanical Coulter counter. Analyses controlled for age, sex, body mass index, time since the index event, and medication. After taking into account these covariates, poorer sleep quality (p = 0.001; DeltaR(2)= 0.046), high fatigue (p = 0.008; DeltaR(2)= 0.032), and vital exhaustion (p = 0.050; DeltaR(2)= 0.017) were all associated with elevated platelet count. In addition, high level of fatigue mediated the relationship between poor sleep quality and elevated platelet count (p = 0.046). Poor sleep quality, high levels of fatigue, and vital exhaustion were identified as correlates of an elevated platelet count in patients with a previous episode of VTE. Given the emerging role of inflammatory processes in VTE, the findings suggest a mechanism through which behavioral and chronic psychological stressors might contribute to incident and recurrent venous thrombotic events.

Association of vital exhaustion and depressive symptoms with changes in fibrin D-dimer to acute psychosocial stress

OBJECTIVE: Vital exhaustion and depression are psychosocial risk factors of coronary artery disease. A hypercoagulable state in response to acute psychosocial stress contributes to atherothrombotic events. We aimed to investigate the hypothesis that vital exhaustion and depression correlate with stress-induced changes in the hypercoagulability marker D-dimer. METHODS: Thirty-eight healthy and nonsmoking school teachers (mean age 50+/-8 years, 55% women) completed the nine-item Maastricht Vital Exhaustion Questionnaire and the seven-item depression subscale of the Hospital Anxiety and Depression Scale. Within 1 week, subjects twice underwent the Trier Social Stress Test (i.e., preparation phase, mock job interview, and mental arithmetic that totaled 13 min). Plasma D-dimer levels were determined at five time points during the protocol. RESULTS: Vital exhaustion (P=.022; eta(2)=.080) and depressive symptoms (P=.011; eta(2)=.090) were associated with stress-induced changes in D-dimer levels over time controlling for sex and age. Elevated levels of vital exhaustion (r=-.46, P=.005) and of depression (r=-.51, P=.002) correlated with reduced D-dimer increase from pre-stress to immediately post-stress. Also, elevated vital exhaustion (r=.34, P=.044) and depression (r=.41, P=.013) were associated with increase (i.e., attenuated recovery) of D-dimer levels between 20 and 45 min post-stress. Controlling for stress hormone and blood pressure reactivity did not substantially alter these results. CONCLUSION: The findings suggest an attenuated immediate D-dimer stress response and delayed recovery of D-dimer levels post-stress with elevated vital exhaustion and depressive symptoms. In particular, the prolonged hypercoagulability after stress cessation might contribute to the atherothrombotic risk previously observed with vital exhaustion and depression, even at subclinical levels.

Die Wurzeln der Judenfrage : Christen und Juden, zunächst den Studenten Deutschlands dargelegt

von Gottlieb August Schüler

Approaches to Ensure Quality Standards for Standardized/ Simulated Patient Performance in High Stakes Objective Structured Clinical Exams (OSCEs)

Introduction To meet the quality standards for high-stakes OSCEs, it is necessary to ensure high quality standardized performance of the SPs involved.[1] One of the ways this can be assured is through the assessment of the quality of SPs` performance in training and during the assessment. There is some literature concerning validated instruments that have been used to assess SP performance in formative contexts but very little related to high stakes contexts.[2], [3], [4]. Content and structure During this workshop different approaches to quality control for SPs` performance, developed in medicine, pharmacy and nursing OSCEs, will be introduced. Participants will have the opportunity to use these approaches in simulated interactions. Advantages and disadvantages of these approaches will be discussed. Anticipated outcomes By the end of this session, participants will be able to discuss the rationale for quality control of SPs` performance in high stakes OSCEs, outline key factors in creating strategies for quality control, identify various strategies for assuring quality control, and reflect on applications to their own practice. Who should attend The workshop is designed for those interested in quality assurance of SP performance in high stakes OSCEs. Level All levels are welcome. References Adamo G. 2003. Simulated and standardized patients in OSCEs: achievements and challenges:1992-2003. Med Teach. 25(3), 262- 270. Wind LA, Van Dalen J, Muijtjens AM, Rethans JJ. Assessing simulated patients in an educational setting: the MaSP (Maastricht Assessment of Simulated Patients). Med Educ 2004, 38(1):39-44. Bouter S, van Weel-Baumgarten E, Bolhuis S. Construction and validation of the Nijmegen Evaluation of the Simulated Patient (NESP): Assessing Simulated Patients' ability to role-play and provide feedback to students. Acad Med: Journal of the Association of American Medical Colleges 2012. May W, Fisher D, Souder D: Development of an instrument to measure the quality of standardized/simulated patient verbal feedback. Med Educ 2012, 2(1).

Pollen record in the area of Niederrheinische Bucht, Germany

Die Niederrheinische Bucht, ein altes tektonisches Senkungsgebiet, dessen Ausdehnung durch die Orte Aachen, Bonn, Duüsseldorf und Duisburg bestimmt ist, bildete während des jüngeren Tertiärs eine Meeresbucht am Südrande des Nordseebeckens. Noch zu Beginn des Pleistocäns erstreckte sich die Nordsee bis in den Raum von Nijmegen, und im Pliocän verlief die Kuüste etwa auf der Linie Maastricht-Kleve. Im Mittelmiocän reichte die Nordsee bis in die nördliche Niederrheinische Bucht. Marines Oberoligocän mit reicher Fauna findet sich noch in der Gegend von Köln. In Verbindung mit den marinen Transgressionen kam es in den inneren Teilen der Niederrheinischen Bucht zu mehr oder weniger ausgedehnten Vermoorungen, die zur Bildung von Braunkohlenflözen führten, unter denen das miocäne Hauptbraunkohlenflöz nordwestlich von Köln eine Mächtigkeit von mehr als 90 m erreicht. Nach NW spaltet sich das Hauptflöz in drei Teilflöze auf, die von oben nach unten als Flöz Garzweiler, Flöz Frimmersdorf und Flöz Morken bezeichnet werden. Diese Flöze können, wie neue Untersuchungen ergaben, eindeutig mit dem marinen Mittelmiocän in Verbindung gebracht werden.