Rechtstransfer im Fokus : Die Übertragung europäischen Rechts im Bereich der Gleichbehandlung von Frauen und Männern im Rahmen des Erweiterungsprozesses nach Bulgarien und Rumänien

Im Politikfeld Gleichstellung und Gleichbehandlung von Frauen und Männern begegnen sich bei der Erweiterung Ost zwei nahezu konträre Regulierungsansätze. Die EU-Strategie der Verrechtlichung der Gleichheit von Frauen und Männern setzt funktionierende Rechtsinstitutionen, als auch ein ausgeprägtes Rechtsbewußtsein von Behörden, ArbeitgeberInnen und ArbeitnehmerInnen voraus. Dahingegen war Gleichbehandlung und Gleichstellung von Frauen und Männern in sozialistischen Staaten ein gesellschaftspolitisches Konstrukt, ohne tatsächliche rechtliche Kodifizierung und mit durchaus zu hinterfragenden Zielsetzungen, die im Rahmen dieser Arbeit beleuchtet werden. Wie auch in anderen Politikfeldern waren Bulgarien und Rumänien im Erweiterungsprozess Rechts- und Politiktransfer von West nach Ost gezwungen, eine Rechtsangleichung an die rechtlichen Vorgaben der Europäischen Union zu erreichen. Dieser Prozess lief unter strengen Bedingungen seitens der Europäischen Kommission, aber auch mit administrativen und finanziellen Unterstützungsleistungen für die Bewerberstaaten, ab. Die Arbeit richtet mittels des Ansatzes des process tracing gleichzeitig ihren Blick auf die Anpassungsprozesse in beiden Staaten, und andererseits werden die theoretische Ansätze der Europäischen Integration und der Implementation von Politik aufgegriffen. Da aber nahezu alle ehemals staatssozialistischen Staaten, so auch Bulgarien und Rumänien, in ihrer Transformationsperiode auch die Annäherung an die Europäische Union suchten, werden zusätzlich transformationstheoretische sowie rechtsphilosophische und rechtstheoretische Ansätze in die Arbeit aufgenommen, um so die Anpassungsleistungen in beiden Staaten greifbar zu machen. Es wird der Verlauf der rechtlichen Annäherung im Politikfeld der Gleichbehandlung von Frauen und Männern untersucht, indem sowohl die offiziellen Berichte der Europäischen Kommission, als auch Berichte und ExpertInneneinschätzungen aus beiden Bewerberstaaten zusammengetragen wurden. Durch diese Herangehensweise werden unterschiedliche Wahrnehmungen des jeweiligen Anpassungsfortschritts sichtbar, was Fragen über die Funktionalität und Nachhaltig des durch die Europäische Kommission gesteuerten, in einem sehr engen Zeithorizont ablaufenden, Anpassungsprozesses aufwirft. Die Ergebnisse der Arbeit zeigen eine Diskrepanz der jährlichen Berichte und der Einschätzung von ExpertInnen. Rechtswirklichkeit, Rechtsbewusstsein und rechtliche Verankerung stehen in einem großen Miss- und Spannungsverhältnis, dass auf Jahre hinaus zum Problem für betroffene Frauen und Männer in Bulgarien und Rumänien werden kann. Wie die Arbeit zeigt, ist es der Prozess selbst, der zu wenig auf die Beobachtung der Implementation ausgelegtet ist, denn im Beitrittsprozess wurde eine Reihe von europäischen Regelungen nur unzureichend implementiert.The European enlargement towards East European countries started right after the fundamental changes, which took place in the beginning 1990s. Since then, Bulgaria and Romania as well as all former socialist states started to reform their political, economic and societal structures with focus to become a member state of the European Union. In order to follow these adjustments, the thesis expounds the problems in the policy field of opportunities and equal treatment of women and men. This policy field is most interesting, as one can speak of two different approaches towards the problem of inequality between women and men in West and East, which face each other in the process of adaption. Whereas especially the EU is mainly oriented towards legalistic approaches to deal with the problem, former socialist countries showed a more societal approach, almost without legal fundaments. Within the so called enlargement process the focus lies on the transfer of the European approach of legalization of equal treatment. Eastern European applicant countries had to download the European regulation and to develop legal construction and regulation in order to adapt to the laws coming from the EU s legal basis, the Acquis Communautaire. The whole enlargement process has been based on conditions by the European Commission and rewards to the applicant countries. The thesis uses the process tracing approach, to do two things in the same time: first of all to follow the development in Bulgaria and Romania in order to see what happened during almost 17 years of harmonization with western European regulations and policy approaches in the field of equal treatment, and, secondly, to take into account the different theoretical approaches. Beside the obvious focus on theoretical approaches of European integration and policy implementation, the circumstances of the radical political, economic and societal changes in the early nineties and the process of transition (transformation) of all eastern European countries necessitates to also use theories of transition in order to understand the adaption in those countries. Further on, it seems to be crucial to focus on literature of law transfer, as the process itself is based in transfer of western European legal approaches and regulation towards other countries. Adaptation and transfer have been closely monitored by the European Commission. In annual progress reports, the EC mainly focused on adaption, whereas the implementation almost didn t appear in the reports. In this thesis, indepth expert interviews were used to highlight the other side, the experienced reality of regulation and adaption on the ground in both countries. The differences between both perspectives are obvious and raise the question, whether the European Commission didn t track the implementation phase in order to evaluate progress and adaption. The findings highlight the misconception of the EC s monitoring, as the gap between adaptation and implementation remains large. The thesis also emphasizes the different and complex explanations for the developments in both countries. The results also provide some hints, why current and future applicant countries have a more difficult access to the EU: the EC is more careful in evaluating the progress of adaption than she was in the cases of Bulgaria and Romania

Germany and the United States: Reliable Allies. But Disagreement on Russia, Global Leadership and Trade

This Pew Research Center report, in association with Bertelsmann Foundation, examines American and German attitudes toward each other and their respective geopolitical roles. This report is based on telephone surveys in the United States and Germany. In the U.S., interviews were conducted February 26 to March 1, 2015 among a national sample of 1,003 persons, 18 years of age or older. In Germany, interviews were conducted February 24-25, 2015 among a national sample of 963 persons, 18 years of age or older. For more details, see survey methods and topline results

Effectiveness of a self-management intervention with personalised genetic and lifestyle-related risk information on coronary heart disease and diabetes-related risk in type 2 diabetes (CoRDia): study protocol for a randomised controlled trial

Background Many patients with type 2 diabetes fail to achieve good glycaemic control. Poor control is associated with complications including coronary heart disease (CHD). Effective self-management and engagement in health behaviours can reduce risks of complications. However, patients often struggle to adopt and maintain these behaviours. Self-management interventions have been found to be effective in improving glycaemic control. Recent developments in the field of genetics mean that patients can be given personalised information about genetic- and lifestyle-associated risk of developing CHD. Such information may increase patients’ motivation to engage in self-management. The Coronary Risk in Diabetes (CoRDia) trial will compare the effectiveness of a self-management intervention, with and without provision of personalised genetic- and lifestyle-associated risk information, with usual care, on clinical and behavioural outcomes, the cognitive predictors of behaviour, and psychological wellbeing. Methods/Design Participants will be adults aged 25–74 years registered with general practices in the East of England, diagnosed with type 2 diabetes, with no history of heart disease, and with a glycated haemoglobin level of ≥6.45 % (47 mmol/mol). Consenting participants will be randomised to one of three arms: usual care control, group self-management only, group self-management plus personalised genetic- and lifestyle-associated risk information. The self-management groups will receive four weekly 2-hour group sessions, focusing on knowledge and information sharing, problem solving, goal setting and action planning to promote medication adherence, healthy eating, and physical activity. Primary outcomes are glycaemic control and CHD risk. Clinical data will be collected from GP records, including HbA1c, weight, body mass index, blood pressure, and HDL and total cholesterol. Self-reported health behaviours, including medication adherence, healthy eating and physical activity, and cognitive outcomes will be assessed by questionnaire. Measures will be taken at baseline, 3 months (questionnaire only), 6 months and 12 months post-baseline. Discussion This study will determine whether the addition of personalised genetic- and lifestyle-associated CHD risk information to a group self-management intervention improves diabetes control and CHD risk compared with group self-management and usual care. Effectiveness of the combined intervention on health behaviours cognitions theorised to predict them, and psychological outcomes will also be investigated. Trial registration This study has been registered at ClinicalTrials.gov; registration identifier NCT01891786, registered 28 June 2013

The Neuropathology of Fatal Cerebral Malaria in Malawian Children

We examined the brains of 50 Malawian children who satisfied the clinical definition of cerebral malaria (CM) during life; 37 children had sequestration of infected red blood cells (iRBCs) and no other cause of death, and 13 had a nonmalarial cause of death with no cerebral sequestration. For comparison, 18 patients with coma and no parasitemia were included. We subdivided the 37 CM cases into two groups based on the cerebral microvasculature pathology: iRBC sequestration only (CM1) or sequestration with intravascular and perivascular pathology (CM2). We characterized and quantified the axonal and myelin damage, blood-brain barrier (BBB) disruption, and cellular immune responses and correlated these changes with iRBC sequestration and microvascular pathology. Axonal and myelin damage was associated with ring hemorrhages and vascular thrombosis in the cerebral and cerebellar white matter and brainstem of the CM2 cases. Diffuse axonal and myelin damage were present in CM1 and CM2 cases in areas of prominent iRBC sequestration. Disruption of the BBB was associated with ring hemorrhages and vascular thrombosis in CM2 cases and with sequestration in both CM1 and CM2 groups. Monocytes with phagocytosed hemozoin accumulated within microvessels containing iRBCs in CM2 cases but were not present in the adjacent neuropil. These findings are consistent with a link between iRBC sequestration and intravascular and perivascular pathology in fatal pediatric CM, resulting in myelin damage, axonal injury, and breakdown of the BBB

A randomised controlled trial comparing the effectiveness of Tai Chi alongside usual care with usual care alone on the postural balance of community-dwelling people with dementia: Protocol for The TACIT Trial (TAi ChI for people with dementia).

Background: Falls are a public health issue for the older adult population and more so for people with dementia (PWD). Compared with their cognitively intact peers, PWD are at higher risk of falls and injurious falls. This randomised controlled trial aims to test the clinical and cost effectiveness of Tai Chi to improve postural balance among community-dwelling PWD and to assess the feasibility of conducting a larger definitive trial to reduce the incidence of falls among PWD. Methods: A 3-centre parallel group randomised controlled trial with embedded process evaluation. One hundred and fifty community-dwelling dyads of a person with dementia and their informal carer will be recruited and assessed at baseline and at six-month follow-up. Dyads will be randomised in a 1:1 ratio to either usual care or usual care plus a Tai Chi intervention for 20 weeks. The Tai Chi intervention will consist of weekly classes (45 minutes’ Tai Chi plus up to 45 minutes for informal discussion, with up to 10 dyads per class) and home-based exercises (20 minutes per day to be facilitated by the carer). Home practice of Tai Chi will be supported by the use of behaviour change techniques with the Tai Chi instructor at a home visit in week 3-4 of the intervention (action planning, coping planning, self-monitoring, and alarm clock reminder) and at the end of each class (feedback on home practice). The primary outcome is dynamic balance measured using the Timed Up and Go test, coinciding with the end of the 20-week intervention phase for participants in the Tai Chi arm. Secondary outcomes for PWD include functional balance, static balance, fear of falling, global cognitive functioning, visual-spatial cognitive functioning, quality of life, and falls. Secondary outcomes for carers include dynamic balance, static balance, quality of life, costs, and carer burden. Discussion: This trial is the first in the UK to test the effectiveness of Tai Chi to improve balance among PWD. The trial will inform a future study that will be the first in the world to use Tai Chi in a trial to prevent falls among PWD. Trial registration: NCT02864056

The Transfer of European regulations on the equal treatment of women and men to Bulgaria and Romania.

Im Politikfeld Gleichstellung und Gleichbehandlung von Frauen und Männern begegnen sich bei der Erweiterung Ost zwei nahezu konträre Regulierungsansätze. Die EU-Strategie der Verrechtlichung der Gleichheit von Frauen und Männern setzt funktionierende Rechtsinstitutionen, als auch ein ausgeprägtes Rechtsbewußtsein von Behörden, ArbeitgeberInnen und ArbeitnehmerInnen voraus. Dahingegen war Gleichbehandlung und Gleichstellung von Frauen und Männern in sozialistischen Staaten ein gesellschaftspolitisches Konstrukt, ohne tatsächliche rechtliche Kodifizierung und mit durchaus zu hinterfragenden Zielsetzungen, die im Rahmen dieser Arbeit beleuchtet werden. Wie auch in anderen Politikfeldern waren Bulgarien und Rumänien im Erweiterungsprozess Rechts- und Politiktransfer von West nach Ost gezwungen, eine Rechtsangleichung an die rechtlichen Vorgaben der Europäischen Union zu erreichen. Dieser Prozess lief unter strengen Bedingungen seitens der Europäischen Kommission, aber auch mit administrativen und finanziellen Unterstützungsleistungen für die Bewerberstaaten, ab. Die Arbeit richtet mittels des Ansatzes des process tracing gleichzeitig ihren Blick auf die Anpassungsprozesse in beiden Staaten, und andererseits werden die theoretische Ansätze der Europäischen Integration und der Implementation von Politik aufgegriffen. Da aber nahezu alle ehemals staatssozialistischen Staaten, so auch Bulgarien und Rumänien, in ihrer Transformationsperiode auch die Annäherung an die Europäische Union suchten, werden zusätzlich transformationstheoretische sowie rechtsphilosophische und rechtstheoretische Ansätze in die Arbeit aufgenommen, um so die Anpassungsleistungen in beiden Staaten greifbar zu machen. Es wird der Verlauf der rechtlichen Annäherung im Politikfeld der Gleichbehandlung von Frauen und Männern untersucht, indem sowohl die offiziellen Berichte der Europäischen Kommission, als auch Berichte und ExpertInneneinschätzungen aus beiden Bewerberstaaten zusammengetragen wurden. Durch diese Herangehensweise werden unterschiedliche Wahrnehmungen des jeweiligen Anpassungsfortschritts sichtbar, was Fragen über die Funktionalität und Nachhaltig des durch die Europäische Kommission gesteuerten, in einem sehr engen Zeithorizont ablaufenden, Anpassungsprozesses aufwirft. Die Ergebnisse der Arbeit zeigen eine Diskrepanz der jährlichen Berichte und der Einschätzung von ExpertInnen. Rechtswirklichkeit, Rechtsbewusstsein und rechtliche Verankerung stehen in einem großen Miss- und Spannungsverhältnis, dass auf Jahre hinaus zum Problem für betroffene Frauen und Männer in Bulgarien und Rumänien werden kann. Wie die Arbeit zeigt, ist es der Prozess selbst, der zu wenig auf die Beobachtung der Implementation ausgelegtet ist, denn im Beitrittsprozess wurde eine Reihe von europäischen Regelungen nur unzureichend implementiert.The European enlargement towards East European countries started right after the fundamental changes, which took place in the beginning 1990s. Since then, Bulgaria and Romania as well as all former socialist states started to reform their political, economic and societal structures with focus to become a member state of the European Union. In order to follow these adjustments, the thesis expounds the problems in the policy field of opportunities and equal treatment of women and men. This policy field is most interesting, as one can speak of two different approaches towards the problem of inequality between women and men in West and East, which face each other in the process of adaption. Whereas especially the EU is mainly oriented towards legalistic approaches to deal with the problem, former socialist countries showed a more societal approach, almost without legal fundaments. Within the so called enlargement process the focus lies on the transfer of the European approach of legalization of equal treatment. Eastern European applicant countries had to download the European regulation and to develop legal construction and regulation in order to adapt to the laws coming from the EU s legal basis, the Acquis Communautaire. The whole enlargement process has been based on conditions by the European Commission and rewards to the applicant countries. The thesis uses the process tracing approach, to do two things in the same time: first of all to follow the development in Bulgaria and Romania in order to see what happened during almost 17 years of harmonization with western European regulations and policy approaches in the field of equal treatment, and, secondly, to take into account the different theoretical approaches. Beside the obvious focus on theoretical approaches of European integration and policy implementation, the circumstances of the radical political, economic and societal changes in the early nineties and the process of transition (transformation) of all eastern European countries necessitates to also use theories of transition in order to understand the adaption in those countries. Further on, it seems to be crucial to focus on literature of law transfer, as the process itself is based in transfer of western European legal approaches and regulation towards other countries. Adaptation and transfer have been closely monitored by the European Commission. In annual progress reports, the EC mainly focused on adaption, whereas the implementation almost didn t appear in the reports. In this thesis, indepth expert interviews were used to highlight the other side, the experienced reality of regulation and adaption on the ground in both countries. The differences between both perspectives are obvious and raise the question, whether the European Commission didn t track the implementation phase in order to evaluate progress and adaption. The findings highlight the misconception of the EC s monitoring, as the gap between adaptation and implementation remains large. The thesis also emphasizes the different and complex explanations for the developments in both countries. The results also provide some hints, why current and future applicant countries have a more difficult access to the EU: the EC is more careful in evaluating the progress of adaption than she was in the cases of Bulgaria and Romania

Extending the Comfort Zone: Building Resilience in Older People With Long-Term Conditions

This article examines how a 6-week mental health resilience course for people with long-term conditions (LTCs; diabetes, heart disease, and arthritis) increased perceived resilience of older participants. This article examines how peer support assisted participants to develop resilience, considers gender issues, examines the importance of course activities, and explores how resilience enhances quality of life. A mixed methods approach was used. A before-and-after questionnaire was administered 3 times, including 3-month follow-up. Interviews were held with 24 program participants, aged 45 to 80 years. Diaries were kept by participants over 3 months. Survey findings showed significant gains in perceived resilience, at the end of the course, with no significant drop-off after 3 months. Interview and diary narratives highlighted positive experiences around well-being, condition management, and social engagement. Peer support was key to effective processes. Challenges concern ongoing support in communities, and considering age and gender variables when researching what improved resilience means to older people with LTCs