The strength of the Christian Democrats, the weakness of the opposition. Germany before the parliamentary elections. OSW Commentary No. 114, 12.09.2013

The political campaign before Germany’s parliamentary elections to be held on 22 September has in all its glory reflected the trends visible during the last four years of the government of Chancellor Angela Merkel – the strength of the Christian Democrats, the weakness of the opposition and the increasing marginalisation of the coalition partner, the FDP. The CDU/CSU remains the most popular political choice in Germany, largely because Angela Merkel has consistently remained the most popular German politician. Everything indicates that the CDU/CSU will win the election, even though it has been running a passive campaign and the Chancellor herself has been avoiding confrontation, presenting herself as a kind of cross-party representative of the interests of all social groups. The Christian Democrats’ main competitors, the Social Democrats, have been unable to play to their strengths and present themselves as a serious alternative to the CDU/CSU. The Christian Democrats, despite their difficult cooperation with the liberal FDP, have declared their willingness to continue doing so during the next parliamentary term. If the numbers make that impossible, and the Social Democrats and the Greens have too few votes to be able to form a government, a grand coalition of the Christian Democrats and the SPD will be formed in Germany.

Prise alimentaire: pas uniquement une question de volonté [Food intake: not only a question of will!]

During many years, we thought that food intake was only a question of will. Nevertheless, in the second part on the XXth century, we identified several hormones regulating food intake and energy expenditure. Furthermore, these hormones seem to be implicated in the pathogenesis of obesity and in weight loss following bariatric surgery. This short review highlights the main mechanisms implicated in food intake and energy expenditure and also their implication in obesity and bariatric surgery.

Compliance with preoperative oral nutritional supplements in patients at nutritional risk─only a question of will?

BACKGROUND/OBJECTIVES: Preoperative nutrition has been shown to reduce morbidity after major gastrointestinal (GI) surgery in selected patients at risk. In a randomized trial performed recently (NCT00512213), almost half of the patients, however, did not consume the recommended dose of nutritional intervention. The present study aimed to identify the risk factors for noncompliance. SUBJECTS/METHODS: Demographic (n=5) and nutritional (n=21) parameters for this retrospective analysis were obtained from a prospectively maintained database. The outcome of interest was compliance with the allocated intervention (ingestion of ⩾11/15 preoperative oral nutritional supplement units). Uni- and multivariate analyses of potential risk factors for noncompliance were performed. RESULTS: The final analysis included 141 patients with complete data sets for the purpose of the study. Fifty-nine patients (42%) were considered noncompliant. Univariate analysis identified low C-reactive protein levels (P=0.015), decreased recent food intake (P=0.032) and, as a trend, low hemoglobin (P=0.065) and low pre-albumin (P=0.056) levels as risk factors for decreased compliance. However, none of them was retained as an independent risk factor after multivariate analysis. Interestingly, 17 potential explanatory parameters, such as upper GI cancer, weight loss, reduced appetite or co-morbidities, did not show any significant correlation with reduced intake of nutritional supplements. CONCLUSIONS: Reduced compliance with preoperative nutritional interventions remains a major issue because the expected benefit depends on the actual intake. Seemingly, obvious reasons could not be retained as valid explanations. Compliance seems thus to be primarily a question of will and information; the importance of nutritional supplementation needs to be emphasized by specific patients' education.

Notice of Will - James Middough

Notice regarding the late James Middough that anything concerning his will is granted to William Woodruff and Richard Woodruff (merchants) executors of the will, August 3, 1839.

The process of accumulation and the weakness of the protagonists

Includes bibliography

Weakness of expiratory muscles and pulmonary complications in malnourished patients undergoing upper abdominal surgery

Background and objective: Malnutrition is prevalent in hospitalized patients and causes systemic damage including effects on the respiratory and immune systems, as well as predisposing to infection and increasing postoperative complications and mortality. This study aimed to assess the impact of malnutrition on the rate of postoperative pulmonary complications, respiratory muscle strength and chest wall expansion in patients undergoing elective upper abdominal surgery. Methods: Seventy-five consecutive candidates for upper abdominal surgery (39 in the malnourished group (MNG) and 36 in the control group (CG)) were enrolled in this prospective controlled cohort study. All patients were evaluated for nutritional status, respiratory muscle strength, chest wall expansion and lung function before surgery. Postoperative pulmonary complications (pneumonia, tracheobronchitis, atelectasis and acute respiratory failure) before discharge from hospital were also evaluated. Results: The MNG showed expiratory muscle weakness (MNG 65 +/- 24 vs CG 82 +/- 22 cm H2O; P < 0.001) and decreased chest wall expansion (P < 0.001), whereas inspiratory muscle strength and lung function were preserved (P > 0.05). The MNG also had a higher incidence of postoperative pulmonary complications compared with the CG (31% and 11%, respectively; P = 0.05). In addition, expiratory muscle weakness was correlated with BMI in the MNG (r = 0.43; P < 0.01). The association between malnutrition and expiratory muscle weakness increased the likelihood of postoperative pulmonary complications after upper abdominal surgery (P = 0.02). Conclusions: These results show that malnutrition is associated with weakness of the expiratory muscles, decreased chest wall expansion and increased incidence of pulmonary complications in patients undergoing elective upper abdominal surgery.

The Weakness of Post-Communist Civil Society Reassessed. CES Papers - Open Forum #11, 2012

During the last two decades, scholars from a variety of disciplines have argued that civil society is structurally deficient in post-communist countries. Yet why have the seemingly strong, active and mobilized civic movements of the transition period become so weak after democracy was established? And why have there been diverging political trajectories across the post-communist space if civil society structures were universally weak? This paper uses a wide range of data from various available sources to show that civil societies in Central and Eastern European countries are not as feeble as is commonly assumed. Some post-communist countries possess vigorous public spheres, and active civil society organizations strongly connected to transnational civic networks able to shape domestic policies. Following the calls by Anheier (2004) and Bernhard and Karakoç (2007) we adopt a multidimensional approach to the measurement of civil society. In a series of cross-section timeseries models, we show that our broader measures of civic and social institutions are able to predict the diverging transition paths among post-communist regimes, and in particular the growing gap between democratic East Central Europe and the increasingly authoritarian post-Soviet space.

Charter, extracts of will, officers and by-laws.

Mode of access: Internet.