Politics and Administration in Germany

Although German bureaucracy is typically categorised as Weberian, a clear distinction between politics and administration has never been a defining characteristic of the German political-administrative system. Many close interrelations and interactions between elected politicians and appointed civil servants can be observed at all levels of administration. Higher-ranking civil servants in Germany are used to and generally appreciate the functional politicisation of their jobs, that is their close involvement in all stages of the policy process, from policy formation, goal definition, negotiation within and outside government to the implementation and evaluation of policies. For top positions, therefore, a class of ‘political civil servants’ is a special feature of the German system, and obtaining ‘political craft’ has become an important part of the learning and job experience of higher-ranking civil servants.

Sustainable Civil Justice through Open Enforcement: The Ukrainian Experience

Ukraine, which is a member of the Council of Europe and is firmly on the path to European integration, develops legislation and legal doctrine with the aim of the implementing European standards. The Association Agreement signed in 2014 set out to put into effect, in particular, the approximation of legislation, the strengthening of judicial cooperation etc. The comprehensive reforms taking place cover various areas of legal regulation, specifically, legal proceedings and the enforcement of judgments. This new legislation in the field of the judicial system was approved in Ukraine in 2015-2017. The low level of trust in the judiciary, inside as well as outside of Ukraine, causes economical relations to suffer increasingly. It impacts inter alia the circulation of judicial decisions between EU Member States and Ukraine, which is not unencumbered by this and may be described as uncertain at best. Regarding all of these, the first part of this paper is about the goal of civil justice definition and defining the enforcement part throughout the process of judicial rights protection in Ukraine. In the second part we are investigating the transitional issues of the creation of an open enforcement system in Ukraine, the challenges and ways to resolve them within the most current trends of sustainable development and inclusive justice. In the conclusion, some theoretical approaches are criticized due to the lack of attention to the very ideas of sustainable justice and a peaceful and strong institutions promotion, which elude the attention of the legislators. The way of its fruition of an open and peaceful judicial enforcement creation through proper goal definition were proposed.

Experiences of the Initial Phase Implementation of the STAMINA-Model in Perioperative Context Addressing Environmental Issues Systematically—A Qualitative Study

(1) Background: Challenges in perioperative settings put demands on staff working with systematic work environment management. A support model, STAMINA (Structured and Time-effective Approach through Methods for an Inclusive and Active working life), was implemented in a hospital in Sweden, to help staff address environmental issues systematically. The aim was to describe the experiences of the initial phase of implementation of the adapted STAMINA model in perioperative context. (2) Methods: Qualitative individual interviews were held with 14 managers and employees (three men and 11 women). Data were analysed by systematic text condensation. (3) Results: Five themes were identified: Limited knowledge of the model and the implementation process; scepticism, lack of confidence in the model and a passive attitude; the model offered increased participation; the culture in the organization—to understand one’s role as employees and managers; and endurance and feedback are key factors for success in the implementation process. (4) Conclusions: Scepticism turned to positive attitude by recognising that the STAMINA model offered increased participation. In order to have successful implementation, the organisational culture must be taken into consideration by giving the employees increased responsibilities and timely feedbacks. Role description, goal definition, feedback, and sticking to one model are key factors for success.

Electricity Generation in LCA of Electric Vehicles: A Review

: Life Cycle assessments (LCAs) on electric mobility are providing a plethora of diverging results. 44 articles, published from 2008 to 2018 have been investigated in this review, in order to find the extent and the reason behind this deviation. The first hurdle can be found in the goal definition, followed by the modelling choice, as both are generally incomplete and inconsistent. These gaps influence the choices made in the Life Cycle Inventory (LCI) stage, particularly in regards to the selection of the electricity mix. A statistical regression is made with results available in the literature. It emerges that, despite the wide-ranging scopes and the numerous variables present in the assessments, the electricity mix’s carbon intensity can explain 70% of the variability of the results. This encourages a shared framework to drive practitioners in the execution of the assessment and policy makers in the interpretation of the results.

User Participation in Coproduction of Health Innovation: Proposal for a Synergy Project (Preprint)

BACKGROUND This project concerns advancing knowledge, methods, and logic for user participation in coproduction of health innovations. Such advancement is vital for several reasons. From a user perspective, participation in coproduction provides an opportunity to gain real influence over goal definition, design, and implementation of health innovations, ensuring that the solution developed solves real problems in right ways. From a societal perspective, it’s a mean to improve the efficiency of health care and the implementation of the Patient Act. As for industry, frameworks and knowledge of coproduction offer tools to operate in a complex sector, with great potential for innovation of services and products. OBJECTIVE The fundamental objective of this project is to advance knowledge and methods of how user participation in the coproduction of health innovations can be applied in order to benefit users, industry, and public sector. METHODS This project is a synergy project, which means that the objective will be accomplished through collaboration and meta-analysis between three subprojects that address different user groups, apply different strategies to promote human health, and relate to different parts of the health sector. Furthermore, subprojects focus on distinctive stages in the spectrum of innovation, with the objective to generate knowledge of the innovation process as a whole. The project is organized around three work packages related to three challenges—coproduction, positioning, and realization. Each subproject is designed such that it has its own field of study with clearly identified objectives but also targets work packages to contribute to the project as a whole. The work on the work packages will use case methodology for data collection and analysis based on the subprojects as data sources. More concretely, logic of multiple case studies will be applied with each subproject representing a separate case which is similar to each other in its attention to user participation in coproduction, but different regarding, for example, context and target groups. At the synergy level, the framework methodology will be used to handle and analyze the vast amount of information generated within the subprojects. RESULTS The project period is from July 1, 2018 to June 30, 2022. CONCLUSIONS By addressing the objective of this project, we will create new knowledge on how to manage challenges to health innovation associated with the coproduction process, the positioning of solutions, and realization.

PERSONAL FACTORS AND THEIR PERSPECTIVE IN SOCIAL MEDICINE AND REHABILITATION

Motivation / Background: A broad and common understanding of the nature of Personal Factors is deemed to be necessary to gain and assess a comprehensive perspective regarding an individual’s health condition and accurately allocate social and medical benefits and interventions. Personal Factors have an impact on the functioning of individuals as facilitators or barriers. They play an essential role in the International Classification of Functioning, Disability and Health (ICF). To date, the World Health Organisation has not classified Personal Factors for global use. Method: A consensus group representing a broad spectrum of medical and social security professionals, research societies together with representatives of self-help organisations developed and published a proposal to classify relevant Personal Factors. Results: To face ongoing discussions misunderstandings are addressed, critics and suggestions balanced and positions created with pointed explanations and supplemented literature. Core messages summarise each position in a condensed form. Conclusions: Personal Factors may exert a powerful influence on the goal definition, goal achievement and type, complexity and length of necessary medical, social or rehabilitation benefits. Transparency, explicitness, fairness (standardisation) and the possibility for well-founded claims comprise additional arguments for reporting Personal Factors. They may be crucial to reach the goal of the highest degree of participation considering individual resources.

What is stable pain control? A prospective longitudinal study to assess the clinical value of a personalized pain goal

Background: A universal consensus regarding standardized pain outcomes does not exist. The personalized pain goal has been suggested as a clinically relevant outcome measure. Aim: To assess the feasibility of obtaining a personalized pain goal and to compare a clinically based personalized pain goal definition versus a research-based study definition for stable pain. Design: Prospective longitudinal descriptive study. Measures: The attending physician completed routine assessments, including a personalized pain goal and the Edmonton Classification System for Cancer Pain, and followed patients daily until stable pain control, death, or discharge. Stable pain for cognitively intact patients was defined as pain intensity less than or equal to desired pain intensity goal (personalized pain goal definition) or pain intensity ⩽3 (Edmonton Classification System for Cancer Pain study definition) for three consecutive days with <3 breakthroughs per day. Setting/participants: A total of 300 consecutive advanced cancer patients were recruited from two acute care hospitals and a tertiary palliative care unit. Results: In all, 231/300 patients (77%) had a pain syndrome; 169/231 (73%) provided a personalized pain goal, with 113/169 (67%) reporting a personalized pain goal ⩽3 (median = 3, range = 0–10). Using the personalized pain goal definition as the gold standard, sensitivity and specificity of the Edmonton Classification System for Cancer Pain definition were 71.3% and 98.5%, respectively. For mild (0–3), moderate (4–6), and severe (7–10) pain, the highest sensitivity was for moderate pain (90.5%), with high specificity across all three categories (95%–100%). Conclusion: The personalized pain goal is a feasible outcome measure for cognitively intact patients. The Edmonton Classification System for Cancer Pain definition closely resembles patient-reported personalized pain goals for stable pain and would be appropriate for research purposes. For clinical pain management, it would be important to include the personalized pain goal as standard practice.