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This chapter focuses on the national level and studies interlinkages, institutional integration and policy coherence in the context of the 2030 Agenda for Sustainable Development and the Sustainable Development Goals. After defining key terms, the chapter reviews how perspectives on interlinkages have shaped a new discourse, followed by an analysis of the steering effects of the global goals on institutional integration and policy coherence. The chapter finds that some measures have been taken by national governments to advance institutional integration through coordination by central agencies and inter-ministerial exchanges. Growing policy coherence, however, is not clearly observable. Existing barriers in political-administrative systems preventing institutional integration and policy coherence have not vanished with the adoption of the Sustainable Development Goals. Although recent studies have considerably enhanced knowledge on the conceptual understanding of interlinkages, integration and coherence, empirical data about how these concepts play out in practice at national level is still very limited.
It remains unknown whether coronavirus disease 2019 (COVID-19) patients with bipolar disorders (BDs) are at an increased risk of mortality. We aimed to establish whether health outcomes and care differed between patients infected with COVID-19 with BD and patients without a diagnosis of severe mental illness.
We conducted a population-based cohort study of all patients with identified COVID-19 and respiratory symptoms who were hospitalized in France between February and June 2020. The outcomes were in-hospital mortality and intensive care unit (ICU) admission. We used propensity score matching to control for confounding factors.
In total, 50 407 patients were included, of whom 480 were patients with BD. Patients with BD were 2 years older, more frequently women and had more comorbidities than controls without a diagnosis of severe mental illness. Patients with BD had an increased in-hospital mortality rate (26.6% v. 21.9%; p = 0.034) and similar ICU admission rate (27.9% v. 28.4%, p = 0.799), as confirmed by propensity analysis [odds ratio, 95% confidence interval (OR, 95% CI) for mortality: 1.30 (1.16–1.45), p < 0.0001]. Significant interactions between BD and age and between BD and social deprivation were found, highlighting that the most important inequalities in mortality were observed in the youngest [OR, 95% CI 2.28 (1.18–4.41), p = 0.0015] and most deprived patients with BD [OR, 95% CI 1.60 (1.33–1.92), p < 0.001].
COVID-19 patients with BD were at an increased risk of mortality, which was exacerbated in the youngest and most deprived patients with BD. Patients with BD should thus be targeted as a high-risk population for severe forms of COVID-19, requiring enhanced preventive and disease management strategies.
We describe a novel dietary assessment strategy to estimate usual food intake in the ongoing large-scale multi-center German National Cohort (GNC). The dietary assessment is based on three 24 h food lists (24h-FL) and a food frequency questionnaire (FFQ) enriched by information from the representative German National Nutrition Survey II (NVS II). The novelty of this dietary assessment strategy is based on separating the probability of food intake from daily consumption amounts. The probability of consumption is estimated from 24h-FLs used in the GNC. To estimate daily consumption amounts, the already collected data of the NVS II are used. The 24h-FL simplifies the question on food consumption for all foods asked to consumption or not and so the questionnaire can be completed in about 10 minutes, reducing the burden on study participants. As proof of concept, we applied the assessment strategy to pretest data collected in 2012 to 2013 to assess the feasibility of the instruments. In brief, the novel dietary assessment strategy comprises three steps. First, the individuals’ consumption probability is estimated by three 24h-FLs and one FFQ applying a logistic linear mixed model adjusted for characteristics of the participants. Second, person-specific daily consumption amounts are estimated from the NVS II applying a linear mixed model taking the characteristics of the participants into account. Third, usual food intake is estimated by the consumption probability multiplied by person-specific daily amounts. Usual intake of 41 food groups in 318 men and 377 women were estimated. Of those participants who completed the first 24h-FL, 84.4, and 68.5% completed the second and third 24h-FL, respectively. No associations were observed between probability to participate and lifestyle factors. The estimated usual food intake distributions were in a plausible range as shown by comparing the estimated energy intake to the energy needs approximated by estimated total energy expenditure. Total energy was estimated to be 2,707 kcal/day for men and 2,103 kcal/day for women. With a few exceptions, the estimated food-based consumption probabilities did not differ considerably between men and women. The differences in energy intake between men and women were mainly due to their differences in the estimated person-specific daily amounts. As a conclusion, plausible but not validated values for usual food intake were derived in the pretest study, so that the combination of three repeated 24h-FLs, an FFQ and person-specific daily amounts from an external source is a feasible strategy for dietary assessment.
Care of children affected by AIDS in Swaziland is predominately provided by families, with support from ‘community-based responses’. This approach is consistent with United Nations International Children’s Fund’s (UNICEF) framework for the protection, care and support of children affected by AIDS. However, the framework relies heavily on voluntary caregiving which is highly gendered. It pays limited attention to caregivers’ well-being or sustainable community development which enables more effective caregiving. As a result, the framework is incompatible with the social justice principles of primary health care, and the sustainable development goals (SDGs).
Our aim was to examine the effects and gender dimensions of providing voluntary, community-based, care-related labour for children affected by AIDS.
We conducted multiple-methods research involving an ethnography and participatory health research, in a rural Swazi community. We analysed data related to community-based responses using an abductive, mixed-methods technique, informed by the capabilities approach to human development and a gender analysis framework.
Two community-based responses, ‘neighbourhood care points’ (facilities that provide children meals) and the ‘lihlombe lekukhalela’ (child protector) program were being implemented. The unpaid women workers at neighbourhood care points reported working in challenging conditions (eg, lacking labour-saving technologies), insufficient and diminishing material support (eg, no food), and receiving limited support from the broader community. Child protectors indicated their effectiveness was limited by lack of social power, relative to the perpetrators of child abuse. The results indicate that support for community-based responses will be enhanced by acknowledging and addressing the highly gendered nature of care-related labour and social power, and that increasing access to material resources including food, caregiver stipends and labour-saving technologies, is essential. These strategies will simultaneously contribute to the social and economic development of communities central to primary health care, and achieving the poverty, hunger, gender and work-related SDGs.
To describe dietary patterns by applying cluster analysis and to describe the cluster memberships of European children over time and their association with body composition changes.
The analyses included k-means clustering based on the similarities between the relative frequencies of consumption of forty-three food items and regression models were fitted to assess the association between dietary patterns and body composition changes.
Primary schools and pre-schools of selected regions in Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain.
Participants (n 8341) in the baseline (2–9 years old) and follow-up (4–11 years old) surveys of the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) study.
Three persistent clusters were obtained at baseline and follow-up. Children consistently allocated to the ‘processed’ cluster presented increased BMI (β=0·050; 95 % CI 0·006, 0·093), increased waist circumference (β=0·071; 95 % CI 0·001, 0·141) and increased fat mass gain (β=0·052; 95 % CI 0·014, 0·090) over time v. children allocated to the ‘healthy’ cluster. Being in the ‘processed’–‘sweet’ cluster combination was also linked to increased BMI (β=0·079; 95 % CI 0·015, 0·143), increased waist circumference (β=0·172; 95 % CI 0·069, 0·275) and increased fat mass gain (β=0·076; 95 % CI 0·019, 0·133) over time v. the ‘healthy’ cluster.
Children consistently showing a processed dietary pattern or changing from a processed pattern to a sweet pattern presented the most unfavourable changes in fat mass and abdominal fat. These findings support the need to promote overall healthy dietary habits in obesity prevention and health promotion programmes targeting children.
Glacier surface mass-balance measurements on Greenland started more than a century ago, but no compilation exists of the observations from the ablation area of the ice sheet and local glaciers. Such data could be used in the evaluation of modelled surface mass balance, or to document changes in glacier melt independently from model output. Here, we present a comprehensive database of Greenland glacier surface mass-balance observations from the ablation area of the ice sheet and local glaciers. The database spans the 123 a from 1892 to 2015, contains a total of ~3000 measurements from 46 sites, and is openly accessible through the PROMICE web portal (http://www.promice.dk). For each measurement we provide X, Y and Z coordinates, starting and ending dates as well as quality flags. We give sources for each entry and for all metadata. Two thirds of the data were collected from grey literature and unpublished archive documents. Roughly 60% of the measurements were performed by the Geological Survey of Denmark and Greenland (GEUS, previously GGU). The data cover all regions of Greenland except for the southernmost part of the east coast, but also emphasize the importance of long-term time series of which there are only two exceeding 20 a. We use the data to analyse uncertainties in point measurements of surface mass balance, as well as to estimate surface mass-balance profiles for most regions of Greenland.
Research indicates that fundraising is not an impediment to women candidates because women raise just as much money as men after accounting for seat status. However, previous research focuses solely on general election candidates. By examining both primary and general election candidates, we find both gender and partisan differences in fundraising. While incumbency, competitiveness, and candidate quality predict fundraising in the general election, we show that Democratic women raise more money than their male counterparts in the primary election. However, Republican women do not enjoy greater fundraising success compared with their male counterparts, and in limited cases, being a Republican woman can be an obstacle to fundraising in the primary election.
The fall of the Berlin Wall in 1989 and the unification of Germany in 1990 allowed East Germans to finally travel freely to western countries. This new freedom to travel to the West not only impacted the worldview of many former GDR citizens, but also found its way into the writings of East German authors throughout the 1990s and into the present. In her study on contemporary German literature around the turn of the twenty-first century, the literary critic Christine Cosentino examines several tendencies by which contemporary German authors deal with America in their texts. One tendency she describes is “die Reise in die USA als Topos für die Suche nach Identität, die den politischen Hintergrund weitgehend ausspart” (the journey to the USA as a symbol for the search for identity, which largely leaves out the political background). This tendency—finding one's identity by traveling to America—is noticeable in literature by East German authors from the 1990s, one of whom is Angela Krauß. In many of her works, particularly in her novels Die Überfliegerin (1995) and Milliarden neuer Sterne (1999), travel to America is a catalyst for the narrator experiencing her own identity in relation to past experiences, specifically her life in East German society. The exploration of the new world manifests itself in these texts as a discovery of the narrator's inner self.
Sophie von La Roche's America novel, Erscheinungen am See Oneida (Phenomena at Lake Oneida, 1798), centers on a French aristocratic couple from Flanders who go to live on a remote island in upstate New York. Carl and Emilie von Wattines have fled to the United States from the French revolutionary Terror, in which several of their relatives lost their lives. On advice from a Quaker friend in Philadelphia, they find their way to an island in Oneida Lake. There they live without contact with other Europeans for four years, producing two children and making a modest life for themselves, before moving to a new town founded by Dutch and German settlers on the lakeshore. A narrator traveling in the region pieces their story together from what he learns from them and their friends. At the crux of the tale is how the Wattineses, Crusoe-like, manage to survive in their isolation.
Three factors play a role. First, in spite of being aristocrats, they possess a bourgeois ethic, demonstrating qualities like modesty, hard work, and resourcefulness that help them to thrive. Second, they have brought a whole library of reference books with them, including the entire Encyclopédie and Buffon's Histoire naturelle, to which they frequently refer for how-to information. Finally and most interestingly, Emilie Wattines decides to reach out and make contact with the local indigenous people, the Oneidas, when she is about to give birth.
In recent years, the works by the German-Jewish poet Gertrud Kolmar (1894–1943) have found renewed interest among scholars. Raised in the upper middle class of Berlin and fully acculturated in the German cultural heritage, Gertrud Kolmar was persecuted, under the pressure of the National Socialist regime, because of her Jewish roots. Unlike many of her contemporaries, she chose to remain in Nazi Berlin and continued to write until her death in Auschwitz in 1943. Even though her published work spanned the innovative period between 1917 and 1937, Kolmar's poetic oeuvre from the years 1927 to 1937 has received the most attention. Though neglected by scholars, Kolmar's earlier work is fascinating precisely because it gives prescient insight into her poetic adaptations of questions concerning place, power, and gender at the end of the First World War.
My essay investigates an early poem in Kolmar's work: “Die Aztekin” (The Aztec Woman), written around 1920 and published in Früher Zyklus I. In memoriam 1918. Kolmar's “Aztekin” illustrates a testing ground for colonial fantasies and gendered mappings in its imaginary space of a poetic “Aztec empire.” The poem responds not only to preestablished writings on gendered conquests in the New World but also, more specifically, rewrites them in the perceived context of an imperial apocalypse in and after 1918, between megalomaniacal power struggles and the collapse of the Wilhelmine empire.
Swiss photojournalist and author Annemarie Schwarzenbach was born in 1908 into the family of the wealthy Swiss silk manufacturer Alfred Schwarzenbach and his wife Renée Schwarzenbach-Wille and died under tragic circumstances in 1942. Schwarzenbach's life was marked by her travels to the United States, the Orient, Africa, and through Europe. In this context, during her lifetime Schwarzenbach gained recognition for her travel writing and journalism within Switzerland. For example, her work was regularly published in Zürcher Illustrierte, National-Zeitung, Luzerner Tagblatt, Thurgauer Zeitung, and the journal ABC. As recent scholarship has emphasized, “her travel writings consist of a wide range of genres: from journalistic reportages and feuilletons to stories, novels, and also poems. In addition to her journalistic and travel writing, Schwarzenbach also produced several novels and novellas that thematize same-sex relationships as well as the blurring of gender lines, such as Eine Frau zu sehen (written in 1929, published in 2008), Pariser Novelle (written in 1929, published in 2003), Freunde um Bernhard (1931), and Tod in Persien (1936), among others. This last work also reflects her travels to the Near East. Schwarzenbach's androgynous and striking physical beauty, her homosexuality, travels, and drug abuse, as well as her encounters, friendships, and liaisons with famous contemporaries, made her in public and scholarly discourses into something of an icon. This icon status and the “clear autobiographical dimension” in her work fueled biographical scholarly approaches to Schwarzenbach's oeuvre after its rediscovery in 1987 (Schwelle, 404) after “her name [had] faded into obscurity” following her death.
November 5, 1853. Ida Pfeiffer, an Austrian traveler, is on her way to a village north of Crescent City in California, and the main purpose of her visit to this region is, as she claims, to see Indians. What she finds instead are ethnically hybrid Native Americans:
Nichts erschien mir komischer als die sonderbaren Anzüge, denn auch hier lasen sie alle von den Weißen weggeworfenen Kleidungsstücke auf. So sah ich einen Indianer, welcher ein Beinkleid, eine sehr schadhafte Mantille und einen zerknitterten Frauenhut trug. Ein anderer hatte weiter nichts als einen Frack an, den er nach eigenem Geschmacke auf der Rückseite ganz mit Glasperlen benäht hatte. Ein dritter trug wieder nur eine Weste, dazu einen Männerhut, in welchen er oben ein Loch geschnitten und viele Vogelfedern aufgesteckt hatte. Ebenso geschmackvoll waren die Weiber gekleidet.
[Nothing seemed more comical to me than their strange outfits, for here too they collected all the garments discarded by the whites. I saw an Indian wearing a pair of breeches, a very ragged mantilla, and a crumpled lady's hat. Another one wore nothing but a frock coat, the back of which he had adorned with glass beads according to his own taste. A third one wore only a waistcoat and a man's hat to go with it. On its top he had cut a hole and stuck many feathers into it. The women were dressed in equally good taste.]