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Der Prozess der europäischen Integration wirkt zunehmend auf die Gestaltung der Gesundheitssysteme der Mitgliedstaaten ein. Die von der Kommission und dem EuGH vorangetriebene Anwendung des europäischen Binnenmarkt- und Wettbewerbsrechts auf die Gesundheitspolitik hat zur Folge, dass marktlichen Steuerungsprinzipien ein Primat gegenüber staatlicher und korporatistischer Regulierung eingeräumt wird. Die gesundheitspolitische Gestaltungskompetenz liegt bei den Mitgliedstaaten, diese haben jedoch die „vier Freiheiten“ bzw. das europäische Wettbewerbsrecht zu beachten. Das Prinzip der Solidarität spielt in den europäischen Verträgen dagegen nur eine untergeordnete Rolle. Solidarität erscheint im europäischen Diskurs als ein Wert, der für die Europäische Union einen wichtigen Bezugspunkt darstellt, ohne dass er eine rechtlich verbindliche Form erhalten hat. Im Resultat entscheidet daher die Auslegung des Solidaritätsprinzips durch den Gerichtshof darüber, ob solidarische Elemente in der nationalen Gesundheitspolitik mit dem europäischen Recht vereinbar sind. Dieser Mechanismus beruht nicht auf demokratisch organisierten Meinungs- und Willensbildungsprozessen, sondern ist Gegenstand schwer prognostizierbarer richterlicher Interpretationskunst.
Die Privatisierung von Krankheitskosten durch erhöhte Zuzahlungen, informelle Leistungsverweigerungen in der GKV sowie das Nebeneinander von gesetzlicher und privater Krankenversicherung bei einer wachsenden Kluft zwischen beiden Systemen haben die sozialen und die räumlich-zeitlichen Barrieren zur Inanspruchnahme von Gesundheitsleistungen für sozial schwache Gruppen erhöht. Damit wächst die Gefahr, dass die Krankenversorgungspolitik zu einer eigenständigen Ursache für die Verstärkung und Aufrechterhaltung gesundheitlicher Ungleichheit wird. Gleichzeitig werden die Möglichkeiten der gesetzlichen Krankenversicherung, durch verbesserte Prävention zu einer Verringerung gesundheitlicher Ungleichheit beizutragen, nur unzureichend genutzt. So liegt die Teilnahmequote von Personen mit niedrigem Sozialstatus an zahlreichen Maßnahmen der Krankheitsfrüherkennung, insbesondere bei der Krebsvorsorge, nach wie vor deutlich unter dem Durchschnitt. Mit der Novellierung des § 20 SGB V im Jahr 2000 hat zwar auch die Verminderung der sozialen Ungleichheit von Gesundheitschancen Eingang in das Zielsystem der GKV gefunden. Allerdings geht dieses Ziel nur teilweise in die Präventionspraxis der Krankenkassen ein. Nach wie vor existieren zahlreiche Hürden bei der Implementierung von Maßnahmen der kontextgestützten Verhältnisprävention.
Die politische Steuerung des Krankenhaussektors hat sich in den vergangenen anderthalb Jahrzehnten nachhaltig verändert. Das Gesundheitsstrukturgesetz von 1992 markiert einen gesundheitspolitischen Paradigmenwechsel, mit dem verstärkt wettbewerbliche Steuerungsinstrumente in das Gesundheitswesen eingeführt wurden. Auch im stationären Sektor ersetzen bzw. ergänzen wettbewerbliche Instrumente korporatistische Arrangements. Die Gegenüberstellung der politischen Steuerung des Krankenhaussektors vor 1992 mit der Situation nach der Gesundheitsreform 2007 verdeutlicht, dass auf den Feldern Leistungserbringung, Vergütung und Qualitätssicherung sukzessive ein neues Steuerungsmodell entstanden ist. Dieses zeichnet sich durch eine gewachsene Komplexität, eine Zunahme von Steuerungsaktivitäten und eine Neujustierung des Verhältnisses staatlicher bzw. korporatistischer Steuerung einerseits und wettbewerblicher Steuerung andererseits aus. Dort, wo es um allokative Entscheidungen geht, werden korporatistische Elemente durch wettbewerbliche ersetzt. Auf anderen Regulierungsfelder bleibt der Korporatismus dagegen erhalten. Der Staat als „architect of political order“ (Anderson) hat diese Transformation herbeigeführt, sieht sich allerdings zunehmend mit dem Widerspruch zwischen einer bedarfsorientierten Krankenhausplanung und Investitionsfinanzierung auf Landesebene und einer Leistungsverteilung über den Wettbewerb konfrontiert.
We study the responses of residential property and equity prices, inflation and economic activity to monetary policy shocks in 17 countries, using data spanning 1986-2006, using single-country VARs and panel VARs in which we distinguish between groups of countries depending on their financial systems. The effect of monetary policy on property prices is about three times as large as its impact on GDP. Using monetary policy to guard against financial instability by offsetting asset-price movements thus has sizable effects on economic activity. While the financial structure influences the impact of policy on asset prices, its importance appears limited.
This paper explores the role of trade integration—or openness—for monetary policy transmission in a medium-scale New Keynesian model. Allowing for strategic complementarities in price-setting, we highlight a new dimension of the exchange rate channel by which monetary policy directly impacts domestic inflation. Although the strength of this effect increases with economic openness, it also requires that import prices respond to exchange rate changes. In this case domestic producers find it optimal to adjust their prices to exchange rate changes which alter the domestic currency price of their foreign competitors. We pin down key parameters of the model by matching impulse responses obtained from a vector autoregression on U.S. time series relative to an aggregate of industrialized countries. While we find evidence for strong complementarities, exchange rate pass-through is limited. Openness has therefore little bearing on monetary transmission in the estimated model.
Bayesian learning provides the core concept of processing noisy information. In standard Bayesian frameworks, assessing the price impact of information requires perfect knowledge of news’ precision. In practice, however, precision is rarely dis- closed. Therefore, we extend standard Bayesian learning, suggesting traders infer news’ precision from magnitudes of surprises and from external sources. We show that interactions of the different precision signals may result in highly nonlinear price responses. Empirical tests based on intra-day T-bond futures price reactions to employment releases confirm the model’s predictions and show that the effects are statistically and economically significant.
The popular Nelson-Siegel (1987) yield curve is routinely fit to cross sections of intra-country bond yields, and Diebold and Li (2006) have recently proposed a dynamized version. In this paper we extend Diebold-Li to a global context, modeling a potentially large set of country yield curves in a framework that allows for both global and country-specific factors. In an empirical analysis of term structures of government bond yields for the Germany, Japan, the U.K. and the U.S., we find that global yield factors do indeed exist and are economically important, generally explaining significant fractions of country yield curve dynamics, with interesting differences across countries.
Measuring financial asset return and volatilty spillovers, with application to global equity markets
(2008)
We provide a simple and intuitive measure of interdependence of asset returns and/or volatilities. In particular, we formulate and examine precise and separate measures of return spillovers and volatility spillovers. Our framework facilitates study of both non-crisis and crisis episodes, including trends and bursts in spillovers, and both turn out to be empirically important. In particular, in an analysis of nineteen global equity markets from the early 1990s to the present, we find striking evidence of divergent behavior in the dynamics of return spillovers vs. volatility spillovers: Return spillovers display a gently increasing trend but no bursts, whereas volatility spillovers display no trend but clear bursts.
Research with Keynesian-style models has emphasized the importance of the output gap for policies aimed at controlling inflation while declaring monetary aggregates largely irrelevant. Critics, however, have argued that these models need to be modified to account for observed money growth and inflation trends, and that monetary trends may serve as a useful cross-check for monetary policy. We identify an important source of monetary trends in form of persistent central bank misperceptions regarding potential output. Simulations with historical output gap estimates indicate that such misperceptions may induce persistent errors in monetary policy and sustained trends in money growth and inflation. If interest rate prescriptions derived from Keynesian-style models are augmented with a cross-check against money-based estimates of trend inflation, inflation control is improved substantially.
In den grundlegenden Quellen des Islam, d.h. in Koran und Hadith, gibt es keine klar formulierten Verbote, die gegen das Engagement der Frauen in der Gesellschaft sprechen. Die Gründe für viele Interpretationen, die gegen das Engagement der Frauen in der Gesellschaft sprechen, müssen in den geschichtlichen und sozialen Gegebenheiten der betreffenden Region gesucht werden. Viele Verbote sind traditionell und nicht theologisch bedingt. Wenn diese Verbote auch heute ihre Gültigkeit behalten sollen, so verstossen wir damit gegen das Menschenverständnis des Korans. Wir müssen aber akzeptieren, dass die Probleme der Frauen in der islamischen Welt noch nicht ausreichend gelöst sind. In den frühesten Koranversen wird das Lesen und Lernen für alle Menschen befohlen, damit sich Kultur und Wissen in der Gesellschaft verbreiten können. Wenn diese Vorschrift auch unter den Frauen ausreichend beachtet wird, dann werden sie ihre soziale Identität wiederfinden und ihre Rechte noch stärker verteidigen. Viele Aufgaben und Funktionen, die in unserer Gesellschaft von Männern ausgefüllt werden, werden zunehmend auch von Frauen übernommen. Heute sehen wir, dass Frauen mit einer soliden Ausbildung ihre Rechte besser verteidigen können und mit den Männern weniger Probleme haben. Als Ergebnis können wir festhalten, dass die Probleme der Frauen nicht von den Vorschriften der Religion, hier dem Islam, hervorgerufen werden, sondern aus kulturellen und traditionellen Gegebenheiten heraus entstehen. Für die Lösung dieser Probleme müssen der Koran und andere wichtige Quellen der Religion den Bedürfnissen der heutigen modernen Gesellschaft entsprechend neu interpretiert werden.
Religious conversion has become a dangerous social and individual problem. In Latin America, a traditional Catholic area, Protestant sects are successfully con-verting more and more Catholics into their own communities. Therefore the Pope demands a strict control of these activities. In India e.g., the Catholic hierarchy is critizising the Indian governments which have forbidden conversion on non-spiritual reasons. Hindu organizations have started even very successfully to re-convert Indian Christians particularly of Dalit and tribal background. Buddhists are very successful in indirect and even direct conversion of many Westerners. Wah-habit missionaries spread their Neo-Islam in the Muslim societies and get more and more even non-Muslim converts. We should add the forcible and sometimes ex-tremely cruel conversions the atheistic states had executed since the last century. ...
In the course of the ME period, HAVE began to encroach on territory previously held by BE. According to Rydén and Brorström (1987); Kytö (1997), this occurred especially in iterative and durational contexts, in the perfect infinitive and modal constructions. In Early Modern English (henceforth EModE), BE was increasingly restricted to the most common intransitives come and go, before disappearing entirely in the 18th and 19th centuries. This development raises a number of questions, both historical and theoretical. First, why did HAVE start spreading at the expense of BE in the first place? Second, why was the change conditioned by the factors mentioned by Rydén and Brorström (1987) and Kytö (1997)? Third, why did the change take on the order of 800 years to go to completion? Fourth, what implications does the change have for general theories of auxiliary selection? In this paper we’ll try to answer the first question by focusing on one the earliest clearly identifiable advance of HAVE onto BE territory – its first appearance with the verb come, which for a number of reasons is an ideal verb to focus on. First, come is by far the most common intransitive verb, so we get large enough numbers for statistical analysis. Second, clauses containing the past participle of come with a form of BE are unambiguous perfects: they cannot be passives, and they did not continue into modern English with a stative reading like he is gone. Third, and perhaps most importantly, come selected BE categorically in the early stages of English, so the first examples we find with HAVE are clear evidence for innovation. We will present evidence from a corpus study showing that the first spread of HAVE was due to a ban on auxiliary BE in certain types of counterfactual perfects, and will propose an account for that ban in terms of Iatridou’s (2000) Exclusion theory of counterfactuals.
Verbs, nouns and affixation
(2008)
What explains the rich patterns of deverbal nominalization? Why do some nouns have argument structure, while others do not? We seek a solution in which properties of deverbal nouns are composed from properties of verbs, properties of nouns, and properties of the morphemes that relate them. The theory of each plus the theory of howthey combine, should give the explanation. In exploring this, we investigate properties of two theories of nominalization. In one, the verb-like properties of deverbal nouns result from verbal syntactic structure (a “structural model”). See, for example, van Hout & Roeper 1998, Fu, Roeper and Borer 1993, 2001, to appear, Alexiadou 2001, to appear). According to the structural hypothesis, some nouns contain VPs and/or verbal functional layers. In the other theory, the verbal properties of deverbal nouns result from the event structure and argument structure of the DPs that they head. By “event structure” we mean a representation of the elements and structure of a linguistic event, not a representation of the world. We refer to this view as the “event model”. According to the event model hypothesis, all derived nouns are represented with the same syntactic structure, the difference lying in argument structure – which in turn is critically related to event structure, in the way sketched in Grimshaw (1990), Siloni (1997) among others. In pursuing these lines of analysis, and at least to some extent disentangling their properties, we reach the conclusion that, with respect to a core set of phenomena, the two theories are remarkably similar – specifically, they achieve success with the same problems, and must resort to the same stipulations to address the remaining issues that we discuss (although the stipulations are couched in different forms).
Class features as probes
(2008)
In this article, we adress (i) the form and (ii) the function on inflection class features in minimalist grammar. The empirical evidence comes from noun inflection systems involving fusional markers in German, Greek, and Russian. As for (i), we argue (based on instances of transparadigmatic syncretism) that class features are not privative; rather, class information must be decomposed into more abstract, binary features. Concerning (ii), we propose that class features qualify as the very device that brings about fusional infection: They are uninterpretable in syntax and actas probes on stems, with matching inflection markers as goels, and thus trigger morphological Agree operations that merge stem and inflection marker before syntax is reached.
In meinem Vortrag habe ich mich mit den eher technischen Bestimmungen des Referentenentwurfs des Schuldverschreibungsgesetzes zu den Anforderungen an die Beschlüsse der Gläubigerversammlung und vor allem mit ihrer gerichtlichen Kontrolle zu befassen. Diese technischen Fragen lassen sich freilich nicht ganz von den Fragen trennen, die Gegenstand der Referate zu den Befugnissen der Gläubigerversammlung und zu den Anleihebedingungen sind. Ich werde mir also gewisse Grenzüberschreitungen insbesondere auf die Gebiete der zu diesen Themen speziell vorgesehenen Referate zuschulden kommen lassen und bitte hierfür schon jetzt um Nachsicht. Mit Anmerkungen versehene Fassung eines Vortrags auf dem Seminar des Deutschen Aktieninstituts „Die Novellierung des Schuldverschreibungsrechts“ am 16. 9. 2008. Die Vortragsform ist beibehalten.
Background: Polymorphisms within the insulin gene can influence insulin expression in the pancreas and especially in the thymus, where self-antigens are processed, shaping the T cell repertoire into selftolerance, a process that protects from ß-cell autoimmunity.
Methods: We investigated the role of the -2221Msp(C/T) and -23HphI(A/T) polymorphisms within the insulin gene in patients with a monoglandular autoimmune endocrine disease [patients with isolated type 1 diabetes (T1D, n = 317), Addison´s disease (AD, n = 107) or Hashimoto´s thyroiditis (HT, n = 61)], those with a polyglandular autoimmune syndrome type II (combination of T1D and/or AD with HT or GD, n = 62) as well as in healthy controls (HC, n = 275).
Results: T1D patients carried significantly more often the homozygous genotype "CC" -2221Msp(C/T) and "AA" -23HphI(A/T) polymorphisms than the HC (78.5% vs. 66.2%, p = 0.0027 and 75.4% vs. 52.4%, p = 3.7 × 10-8, respectively). The distribution of insulin gene polymorphisms did not show significant differences between patients with AD, HT, or APS-II and HC.
Conclusion: We demonstrate that the allele "C" of the -2221Msp(C/T) and "A" -23HphI(A/T) insulin gene polymorphisms confer susceptibility to T1D but not to isolated AD, HT or as a part of the APS-II.
Poster presentation A central problem in neuroscience is to bridge local synaptic plasticity and the global behavior of a system. It has been shown that Hebbian learning of connections in a feedforward network performs PCA on its inputs [1]. In recurrent Hopfield network with binary units, the Hebbian-learnt patterns form the attractors of the network [2]. Starting from a random recurrent network, Hebbian learning reduces system complexity from chaotic to fixed point [3]. In this paper, we investigate the effect of Hebbian plasticity on the attractors of a continuous dynamical system. In a Hopfield network with binary units, it can be shown that Hebbian learning of an attractor stabilizes it with deepened energy landscape and larger basin of attraction. We are interested in how these properties carry over to continuous dynamical systems. Consider system of the form Math(1) where xi is a real variable, and fi a nondecreasing nonlinear function with range [-1,1]. T is the synaptic matrix, which is assumed to have been learned from orthogonal binary ({1,-1}) patterns ξμ, by the Hebbian rule: Math. Similar to the continuous Hopfield network [4], ξμ are no longer attractors, unless the gains gi are big. Assume that the system settles down to an attractor X*, and undergoes Hebbian plasticity: T´ = T + εX*X*T, where ε > 0 is the learning rate. We study how the attractor dynamics change following this plasticity. We show that, in system (1) under certain general conditions, Hebbian plasticity makes the attractor move towards its corner of the hypercube. Linear stability analysis around the attractor shows that the maximum eigenvalue becomes more negative with learning, indicating a deeper landscape. This in a way improves the system´s ability to retrieve the corresponding stored binary pattern, although the attractor itself is no longer stabilized the way it does in binary Hopfield networks.
Introduction To investigate the predictive value of clinical and biological markers for a pathological complete remission after a preoperative dose-dense regimen of doxorubicin and docetaxel, with or without tamoxifen, in primary operable breast cancer. Methods Patients with a histologically confirmed diagnosis of previously untreated, operable, and measurable primary breast cancer (tumour (T), nodes (N) and metastases (M) score: T2-3(>= 3 cm) N0-2 M0) were treated in a prospectively randomised trial with four cycles of dose-dense (bi-weekly) doxorubicin and docetaxel (ddAT) chemotherapy, with or without tamoxifen, prior to surgery. Clinical and pathological parameters (menopausal status, clinical tumour size and nodal status, grade, and clinical response after two cycles) and a panel of biomarkers (oestrogen and progesterone receptors, Ki-67, human epidermal growth factor receptor 2 (HER2), p53, bcl-2, all detected by immunohistochemistry) were correlated with the detection of a pathological complete response (pCR). Results A pCR was observed in 9.7% in 248 patients randomised in the study and in 8.6% in the subset of 196 patients with available tumour tissue. Clinically negative axillary lymph nodes, poor tumour differentiation, negative oestrogen receptor status, negative progesterone receptor status, and loss of bcl-2 were significantly predictive for a pCR in a univariate logistic regression model, whereas in a multivariate analysis only the clinical nodal status and hormonal receptor status provided significantly independent information. Backward stepwise logistic regression revealed a response after two cycles, with hormone receptor status and lymph-node status as significant predictors. Patients with a low percentage of cells stained positive for Ki-67 showed a better response when treated with tamoxifen, whereas patients with a high percentage of Ki-67 positive cells did not have an additional benefit when treated with tamoxifen. Tumours overexpressing HER2 showed a similar response to that in HER2-negative patients when treated without tamoxifen, but when HER2-positive tumours were treated with tamoxifen, no pCR was observed. Conclusion Reliable prediction of a pathological complete response after preoperative chemotherapy is not possible with clinical and biological factors routinely determined before start of treatment. The response after two cycles of chemotherapy is a strong but dependent predictor. The only independent factor in this subset of patients was bcl-2. Trial registration number NCT00543829