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The states have to use public funds. It is a fundamental problem how can a state acquire money for fulfilling its obligations and tasks and how can it spend these funds properly. Basically two sides can be separated and scrutinized: the expenditures and the revenues. During the historical development the monarchs had fundamentally the power to make decisions in fiscal questions: they could prescribe taxes (contributions) and spend money without any restriction, public finances and the private wealth (expenditures) of the ruler weren't separated. Later the orders and the parliaments vindicated different rights to restrict the power of the monarchs: they could offer the taxes and since than the rulers couldn't impose taxes without their contributions. These very important restrictions appeared in different fundamental laws (for example in the Magna Charta Libertatum in England). It was very essential that the expenditures should be controlled as well. The next huge step was accordint to that the acquisition of the right to make detailed prescriptions on the field of expenses. In constitutional democracies many legal resources regulate the field of budgets in modern states: different principles and detailed provisions prescribe the requirements of acquisition and the spending of funds. The current financial decisions appear in the annual detailed budgets which are accepted and their execution are controlled by the parliament on the base of publicity and transparency. This paper scrutinizes the development of the legal frames of the budgets. [ABSTRACT FROM AUTHOR]

This paper draws on the company history of London's Brompton Cemetery to show how burial practices and, more generally, the handling of dead bodies changed during the nineteenth century. We argue that new strategies of dealing with the dead emerged which, in the long run, replaced established patterns: by the mid-19th century burial places were managed according to prevailing notions of efficiency, elaborate marketing schemes were implemented, and administrators used an increasingly economic rationale. To take these developments into account, we propose using the term "economization". In more general terms, we highlight that cemeteries such as Brompton can serve as an indicator of how entrepreneurial action came to permeate new strata of British society. [ABSTRACT FROM AUTHOR]

While scholars working on high and late medieval England and France have long been emphasising the significance of kings and their chanceries as driving forces for the use of the written word in administrative matters, scholars dealing with the Empire have painted a different picture: pragmatic literacy was first deployed by the towns, then by the magnates and lastly by the kings. This view, however, created a blind spot for the impact kings might have had on the activities of princely chanceries. This article addresses this theme by focussing on the subject of princely rank. In so doing it investigates when kings started issuing charters concerning the promotions to princely rank or dealing with the hierarchy among the princes. It then looks at the representation of such documents in princely cartularies by analysing the earliest cartularies of the counts palatine of the Rhine and the counts / dukes of Jülich respectively. It can be shown that these charters occupied a central position and may even have been the reason for the creation of the cartularies; they were key to the manifestation of princely rank. As a result, the idea that princely rank derived from the king - an idea the king himself was eager to promote in his charters - was enshrined in and communicated by these princely cartularies. These cartularies, therefore, did not paint an image of autonomous princely authority, but on the contrary, they portray a hierarchically ordered community of king and princes. In such a way the cartularies made their own small contribution to creating and maintaining the long-lasting idea of the Empire as a political configuration represented by the king and the princes. [ABSTRACT FROM AUTHOR]

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Background: Climate neutrality is the major aim of our generation. In order to be able to achieve this a net zero emission should be strived for in operating theaters., Objective: What does zero emission implicate for the operative sector? Which structural approaches already exist? Can zero emission surgery be achieved?, Material and Methods: Evaluation of published studies, discussion of fundamental research and expert recommendations., Results: Studies in England and Germany show that by structural alterations and strict sustainability structures net zero emission surgery seems to be feasible. In Germany the attention and awareness of the topic are greatly increasing and the first projects and studies have been launched., Conclusion: To achieve the aim of net zero emission by 2050 we must rapidly and significantly increase our efforts., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Background: Studies from different countries have shown that a small number of insured persons (high-cost patients) are responsible for a large portion of health care spending. At the same time, it is assumed that some of these costs could be saved by a better management of this group of people. The aim of this article is to analyze the performance and cost profiles of high-cost patients, to put them in an international comparison, and to derive a better management approach., Methods: Retrospective observation study based on statutory health insurance data from two statutory health insurances for the year 2013., Study Population: top 5 %, as well as top 1 % of the most expensive insured persons. Identification of characteristics of high-cost patients and international comparison with the Netherlands, the USA, Canada, Spain, England and Japan., Results: 5 % of insured persons account for almost half of the total costs and the most expensive 1 % of 22 %. These high-cost patients in Germany are, on average, 20 years older than the general population. Almost every person of the high-cost population was prescribed at least one medication during the study period (99.2 %), and 85.8 % had at least one hospital stay. Hospital care accounts for the biggest part of total costs: 75 % together with drugs. The average per capita costs caused by one of the 5 % most expensive insured persons in the year under review are 20 times higher than that of the other 95 % of insured persons. High-cost patients are generally more multimorbid and have higher mortality rates. The most common diagnoses of these patients are hypertension, lipoprotein metabolism disorder and back pain., Conclusion: Similar to other developed countries, Germany faces the challenge to develop and implement adequate intervention approaches addressing the special requirements of high-cost insured persons. This paper provides a first basis. The analogies of high-cost patients in Germany and other countries illustrate the need for transnational research and intervention approaches on this specific issue. More in-depth work is needed to investigate the potentials of Predictive Modelling and integrated care approaches to the management of this group of insured persons., (Copyright © 2020. Published by Elsevier GmbH.)

This paper examines the history of hospital infections, the clinical introduction of antibiotics and the emergence of antibiotic resistant disease strains in English hospitals between 1930 and 1960. It argues that infection has been an almost constant problem for the modern, curative hospital. The arrival first of sulphonamides and later of antibiotics provided a cost-effective, readily available counter-measure which proved to be highly effective in the short term. The longer term consequence, however, was the emergence of antibiotic resistant strains. Calls for a rational use of antibiotics, voiced from 1952, remained unheard. The problem culminated in the crisis around Staph 80/81, a strain of Staphyloccocus Aureus resistant to all available antibiotics at the time. The development of methicillin and the implementation of stricter infection control regimes allowed the problem to recede around 1960 after an intense period of historical change from the end of the war onwards.

In the 1950's and 1960's Edith Jacobson and Herbert Rosenfeld commented critically on one another's work. Beginning with Jacobson's paper on psychotic identifications this controversial but very respectful dialogue continued for over twenty years. At the core of the controversy lay questions of technique. Although Rosenfeld and Jacobson agreed on the central importance of projective identification Jacobson regarded its interpretation in the clinical situation as a mistake. In contrast to Rosenfeld she emphasizes the defensive character of projective identification against psychosis whereas Rosenfeld always understands projective identification as a symptom and therefore considers its interpretation as essential for the modification of concretistic projections. In addition I understand this clinical dialogue as an implicit discussion of the rise and success of National Socialism and the power of destructive projection that flourished in the extermination of European Jewry.