Background Preliminary empirical data indicates a substantial impact of the COVID-19 pandemic on well-being and mental health. Individuals with minoritized sexual and gender identities are at a ...higher risk of experiencing such negative changes in their well-being. The objective of this study was to compare levels of well-being among cis-heterosexual individuals and individuals with minoritized sexual and gender identities during the COVID-19 pandemic. Methods Using data obtained in a cross-sectional online survey between April 20 to July 20, 2020 (N = 2332), we compared levels of well-being (WHO-5) across subgroups (cis-individuals with minoritized sexual identities, individuals with minoritized gender identities and cis-heterosexual individuals) applying univariate (two-sample t-test) and multivariate analysis (multivariate linear regression). Results Results indicate overall lower levels of well-being as well as lower levels of well-being in minoritized sexual or gender identities compared to cis-heterosexual individuals. Further, multivariate analyses revealed that living in urban communities as well as being in a relationship were positively associated with higher levels of well-being. Furthermore, a moderation analysis showed that being in a relationship reduces the difference between groups in terms of well-being. Conclusion Access to mental healthcare for individuals with minoritized sexual and gender identities as well as access to gender-affirming resources should be strengthened during COVID-19 pandemic. Healthcare services with low barriers of access such as telehealth and online peer support groups should be made available, especially for vulnerable groups.
To explore health care professionals' (HCPs) perspectives, experiences and preferences towards digital technology use in routine palliative care delivery.
HCPs (n = 19) purposively selected from a ...sample of settings that reflect routine palliative care delivery (i.e. specialized outpatient palliative care, inpatient palliative care, inpatient hospice care in both rural and urban areas of the German states of Brandenburg and Berlin) participated in an explorative, qualitative study using semi-structured interviews. Interview data were analyzed using structured qualitative content analysis.
Digital technologies are widely used in routine palliative care and are well accepted by HCPs. Central functions of digital technologies as experienced in palliative care are coordination of work processes, patient-centered care, and communication. Especially in outpatient care, they facilitate overcoming spatial and temporal distances. HCPs attribute various benefits to digital technologies that contribute to better coordinated, faster, more responsive, and overall more effective palliative care. Simultaneously, participants preferred technology as an enhancement not replacement of care delivery. HCPs fear that digital technologies, if overused, will contribute to dehumanization and thus significantly reduce the quality of palliative care.
Digital technology is already an essential part of routine palliative care delivery. While generally perceived as useful by HCPs, digital technologies are considered as having limitations and carrying risks. Hence, their use and consequences must be carefully considered, as they should discreetly complement but not replace human interaction in palliative care delivery.
Dimensions of social location such as socioeconomic position or sex/gender are often associated with low response rates in epidemiological studies. We applied an intersectionality-informed approach ...to analyze non-response among population strata defined by combinations of multiple dimensions of social location and subjective health in a health survey in Germany.
We used data from the cross-sectional sample of the German Health Interview and Examination Survey for Adults (DEGS1) conducted between 2008 and 2011. Information about non-responders was available from a mailed non-responder questionnaire. Intersectional strata were constructed by combining all categories of age, sex/gender, marital status, and level of education in scenario 1. Subjective health was additionally used to construct intersectional strata in scenario 2. We applied multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to calculate measures of discriminatory accuracy, proportions of non-responders among intersectional strata, as well as stratum-specific total interaction effects (intersectional effects). Markov chain Monte Carlo methods were used to estimate multilevel logistic regression models.
Data was available for 6,534 individuals of whom 36% were non-responders. In scenario 2, we found weak discriminatory accuracy (variance partition coefficient = 3.6%) of intersectional strata, while predicted proportions of non-response ranged from 20.6% (95% credible interval (CI) 17.0%-24.9%) to 57.5% (95% CI 48.8%-66.5%) among intersectional strata. No evidence for intersectional effects was found. These results did not differ substantially between scenarios 1 and 2.
MAIHDA revealed that proportions of non-response varied widely between intersectional strata. However, poor discriminatory accuracy of intersectional strata and no evidence for intersectional effects indicate that there is no justification to exclusively target specific intersectional strata in order to increase response, but that a combination of targeted and population-based measures might be appropriate to achieve more equal representation.
What would it mean for a novel to turn us as we turn its pages? How are we not simply moved, but transformed—turned around —through the novel’s combination of gestural and affective structures? How ...might we think, in other words, about the correspondences between the novel’s technics and its tropes in its ability to assume meaning for us as a genre on a profound personal level? This essay explores the use of computational models to understand the novel’s relationship to the narration of profound change as a vehicle of readerly devotion. It aims to give us new techniques for thinking about the novel’s significance as a genre, a significance that depends less on forms of critical estrangement and more on felt experiences of pronounced transformation. In doing so, it outlines the potential impact that the practice of computational modeling might have on our own affective attachments as critical readers.
Realistic conceptions of genuinely fantastic literary or mythical characters, such as Theodor Fontane’s Melusine, represent what Umberto Eco refers to as “floating individuals.” These characters are ...transfictional as they are highly decontextualized from their narrative origin and thus a challenge for intertextuality and intermedia studies: the name implies a relationship with another text or medium but the representation does not offer any information about the relationship’s quality. To examine the range of (re-)presentation strategies and to shed some light on the transfictional background of the character as it is represented in Theodor Fontane’s novel
, I borrow ‘interfigurality’ as an umbrella term from Wolfgang G. Müller. Fontane’s myth-reflexive intermedia strategies come fully to the fore in contrast with the unknown novel
by Eufemia von Ballestrem on the one hand and in comparison with contemporary art on the other. The localization within an intermedia network reveals that the practice of the literary re-production of realistic characters as a “work on myth” (Blumenberg) is reflexive and critical or affirmative towards popular usage such as branding, labeling, or namedropping.
In many of his texts, Theodor Fontane 'reveals' his poetics of novel in a hidden manner. When reading his works, readers can receive implicit hints and references about their narrative methods, and ...get hints about the author's wish about how his texts should be interpreted. Take Fontane's Effi Briest for example. In this novel, following a traditional way, the author metaphorizes the text into a braided fabric. In view of this, we can decode the self-commentaries of the novelist about his own work. In order to convey his own poetics, Fontane also employs very different metaphorical references such as architectures, landscapes, gardens and geographical localities. By analyzing the exemplary scenarios in the novel Effi Briest, this paper tries to disclose Fontane's hidden poetic self-commentaries which is largely ignored in the recent Fontane researches.
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