'Yes, the century is an ashen sun': poem and subject in the philosophy of Alain Badiou

This thesis examines the relation between philosophy, the poem and the subject in the mature philosophy of Alain Badiou. It investigates Badiou’s decisive contribution to these questions primarily by means of comparison, especially to Martin Heidegger, Philippe Lacoue-Labarthe and Theodor Adorno, as well as by analysing Badiou’s readings of poems and prose by Paul Celan and Samuel Beckett respectively as sites of potential dialogue with his immediate predecessors. The thesis stresses the importance of French philosophy’s German heritage, emphasising not only Badiou’s radical departure from Heidegger and his legacy, but also the former’s wholesale rejection of philosophies that would, in the wake of twentieth-century violence and beyond, proclaim their own end or completion. The thesis argues Badiou’s innovative readings of Celan and Beckett to be crucial to understanding this endeavour: for Badiou, both writers use the poem to affirm novel conceptions of subjectivity capable of transcending the historical conditions of their presentation. The title quotation from Badiou’s The Century, ‘Yes, the century is an ashen sun’, anticipates both the affirmative nature of these subjective figures, and their presience, beyond the bounds of a twentieth-century ‘ashen sun’ pervaded by melancholy, for the ‘new suns’ of the twenty-first. The thesis is in four chapters. The first chapter unfolds the central concepts of Badiou’s departure from Heidegger using Paul Celan’s poems to focus the enquiry. It is guided by two of Badiou’s most condensed declarations about the poem, that, firstly, ‘the modern poem harbours a central silence’, and secondly, that ‘Celan completes Heidegger’. The second chapter exposes the political implications of Heidegger’s writings on Friedrich Hölderlin and the role of the subject therein, offering at its close some thoughts about what Badiou calls, following Philippe Lacoue-Labarthe, the poem’s ‘becoming-prose’. It concludes by drawing the poem and politics into relation by way of the philosophical category of the subject. The third chapter reads Badiou’s concept of ‘anabasis’ against Heidegger’s ‘homecoming’ in order to think the possibility of a collective political subject’s formation in the wake of Auschwitz. The final chapter examines the imbrication of the Two of love and the ‘latent poem’ in Badiou’s reading of Samuel Beckett’s late prose, contrasting this ‘affirmative’ reading of Beckett to Theodor Adorno’s earlier emphases on negation. Following its investigations of subjectivity, poem and prose throughout, the thesis concludes by returning to the title quotation in order to unfold the particular relations between subject, affirmation and negation Badiou’s philosophy enacts, and to offer further routes forward for research regarding Badiou’s philosophy and aesthetic figuration.

'Don't stop': re-thinking the function of endings in narrative television

This thesis argues that the study of narrative television has been limited by an adherence to accepted and commonplace conceptions of endings as derived from literary theory, particularly a preoccupation with the terminus of the text as the ultimate site of cohesion, structure, and meaning. Such common conceptions of endings, this thesis argues, are largely incompatible with the realities of television’s production and reception, and as a result the study of endings in television needs to be re-thought to pay attention to the specificities of the medium. In this regard, this thesis proposes a model of intra-narrative endings, islands of cohesion, structure, and meaning located within television texts, as a possible solution to the problem of endings in television. These intra-narrative endings maintain the functionality of traditional endings, whilst also allowing for the specificities of television as a narrative medium. The first two chapters set out the theoretical groundwork, first by exploring the essential characteristics of narrative television (serialisation, fragmentation, duration, repetition, and accumulation), then by exploring the unique relationship between narrative television and the forces of contingency. These chapters also introduce the concept of intra-narrative endings as a possible solution to the problems of television’s narrative structure, and the medium’s relationship to contingency. Following on from this my three case studies examine forms of television which have either been traditionally defined as particularly resistant to closure (soap opera and the US sitcom) or which have received little analysis in terms of their narrative structure (sports coverage). Each of these case studies provides contextual material on these televisual forms, situating them in terms of their narrative structure, before moving on to analyse them in terms of my concept of intra-narrative endings. In the case of soap opera, the chapter focusses on the death of the long running character Pat Butcher in the British soap EastEnders (BBC, 1985-), while my chapter on the US sitcom focusses on the varying levels of closure that can be located within the US sitcom, using Friends (NBC, 1993-2004) as a particular example. Finally, my chapter on sports coverage analyses the BBC’s coverage of the 2012 London Olympics, and focusses on the narratives surrounding cyclists Chris Hoy and Victoria Pendleton. Each of these case studies identifies their chosen events as intra-narrative endings within larger, ongoing texts, and analyses the various ways in which they operate within those wider texts. This thesis is intended to make a contribution to the emerging field of endings studies within television by shifting the understanding of endings away from a dominant literary model which overwhelmingly focusses on the terminus of the text, to a more televisually specific model which pays attention to the particular contexts of the medium’s production and reception.

The Gospel of Something or Other / Critical mass

This thesis is comprised of two components: a creative work of fiction and a critical analysis of the fiction through a discussion of craft and creative influence. The creative section, the novel The Gospel of Something or Other, is a formally experimental work that explores authenticity - of both narrative and voice - authorial identity, the performativity of grief and sincerity, and the aesthetic function of narratalogical failure. The critical section of the thesis, Critical Mass, analyses the work of David Foster Wallace and James Wood in relation to the aforementioned fiction, discussing aspects of craft most relevant to the novel: the function of comedy and the function of manipulation. The critical piece investigates the extent to which influence can be identified in the creative process and the unstable relationship between critical interpretation and authorial intent.

The Wounded Me: a novel and critical essay on Hugo Simberg's oeuvre and the literary engagement with his painting The Wounded Angel

No abstract available.

Geometry and topography in James Joyce's Ulysses and Finnegans Wake

Following the development of non-Euclidean geometries from the mid-nineteenth century onwards, Euclid’s system had come to be re-conceived as a language for describing reality rather than a set of transcendental laws. As Henri Poincaré famously put it, ‘[i]f several geometries are possible, is it certain that our geometry [...] is true?’. By examining Joyce’s linguistic play and conceptual engagement with ground-breaking geometric constructs in Ulysses and Finnegans Wake, this thesis explores how his topographical writing of place encapsulates a common crisis between geometric and linguistic modes of representation within the context of modernity. More specifically, it investigates how Joyce presents Euclidean geometry and its topographical applications as languages, rather than ideally objective systems, for describing visual reality; and how, conversely, he employs language figuratively to emulate the systems by which the world is commonly visualised. With reference to his early readings of Giordano Bruno, Henri Poincaré and other critics of the Euclidean tradition, it investigates how Joyce’s obsession with measuring and mapping space throughout his works enters into his more developed reflections on the codification of visual signs in Finnegans Wake. In particular, this thesis sheds new light on Joyce’s developing fascination with the ‘geometry of language’ practised by Bruno, whose massive influence on Joyce is often assumed to exist in Joyce studies yet is rarely explored in any great detail.

The Scots in Ireland: culture, colonialism and memory, 1315-1826

This thesis examines three key moments in the intersecting histories of Scotland, Ireland and England, and their impact on literature. Chapter one Robert Bruce and the Last King of Ireland: Writing the Irish Invasion, 1315- 1826‘, is split into two parts. Part one, Barbour‘s (other) Bruce‘ focuses on John Barbour‘s The Bruce (1375) and its depiction of the Bruce‘s Irish campaign (1315-1318). It first examines the invasion material from the perspective of the existing Irish and Scottish relationship and their opposition to English authority. It highlights possible political and ideological motivations behind Barbour‘s negative portrait of Edward Bruce - whom Barbour presents as the catalyst for the invasion and the source of its carnage and ultimate failure - and his partisan comparison between Edward and his brother Robert I. It also probes the socio-polticial and ideological background to the Bruce and its depiction of the Irish campaign, in addition to Edward and Robert. It peers behind some of the Bruce‘s most lauded themes such as chivalry, heroism, loyalty, and patriotism, and exposes its militaristic feudal ideology, its propaganda rich rhetoric, and its illusions of freedom‘. Part one concludes with an examination of two of the Irish section‘s most marginalised figures, the Irish and a laundry woman. Part two, Cultural Memories of the Bruce Invasion of Ireland, 1375-1826‘, examines the cultural memory of the Bruce invasion in three literary works from the Medieval, Early Modern and Romantic periods. The first, and by far the most significant memorialisation of the invasion is Barbour‘s Bruce, which is positioned for the first time within the tradition of ars memoriae (art of memory) and present-day cultural memory theories. The Bruce is evaluated as a site of memory and Barbour‘s methods are compared with Icelandic literature of the same period. The recall of the invasion in late sixteenth century Anglo-Irish literature is then considered, specifically Edmund Spenser‘s A View of the State of Ireland, which is viewed in the context of contemporary Ulster politics. The final text to be considered is William Hamilton Drummond‘s Bruce’s Invasion of Ireland (1826). It is argued that Drummond‘s poem offers an alternative Irish version of the invasion; a counter-memory that responds to nineteenth-century British politics, in addition to the controversy surrounding the publication of the Ossian fragments. Chapter two, The Scots in Ulster: Policies, Proposals and Projects, 1551-1575‘, examines the struggle between Irish and Scottish Gaels and the English for dominance in north Ulster, and its impact on England‘s wider colonial ideology, strategy, literature and life writing. Part one entitled Noisy neighbours, 1551-1567‘ covers the deputyships of Sir James Croft, Sir Thomas Radcliffe, and Sir Henry Sidney, and examines English colonial writing during a crucial period when the Scots provoked an increase in militarisation in the region. Part two Devices, Advices, and Descriptions, 1567-1575‘, deals with the relationship between the Scots and Turlough O‘Neill, the influence of the 5th Earl of Argyll, and the rise of Sorley Boy MacDonnell. It proposes that a renewed Gaelic alliance hindered England‘s conquest of Ireland and generated numerous plantation proposals and projects for Ulster. Many of which exhibit a blurring‘ between the documentary and the literary; while all attest to the considerable impact of the Gaelic Scots in both motivating and frustrating various projects for that province, the most prominent of which were undertaken by Sir Thomas Smith in 1571 and Walter Devereux, 1st Earl of Essex in 1573.

From physics to metaphysics: philosophy and style in the critical writings of T. S. Eliot (1913-1935)

This thesis considers Eliot's critical writing from the late 1910s till the mid-1930s, in the light of his PhD thesis - Knowledge and Experience in the Philosophy of F. H. Bradley - and a range of unpublished material: T S. Eliot's Philosophical Essays and Notes (1913- 4) in the Hayward Bequest (King's College, Cambridge University); T. S. Eliot's Family Papers in the T. S. Eliot Collection at the Houghton Library (Harvard University); and items from the Harvard University Archives at the Pusey Library. 'Me thesis offers a comprehensive view of Eliot's critical development throughout this important period. It starts by considering The Sacred Wood's ambivalence towards the metaphysical philosophy of F. H. Bradley and Eliot's apparent adoption of a scientific method, under the influence of Bertrand Russell. It will be argued that Eliot uses rhetorical strategies which simultaneously subvert the method he is propounding, and which set the tone for an assessment of his criticism throughout the 1920s. His indecision, in this period, about the label 'Metaphysical' for some poets of the seventeenth century, reveals the persistence of the philosophical thought he apparently rejects in 1916, when he chooses not to pursue a career in philosophy in Harvard. This rhetorical tactic achieves its fulfilment in Dante (1929), where Eliot finds a model in the medieval allegorical method and 'philosophical' poetry. Allegory is also examined in connection with the evaluation of Eliot's critical writings themselves to determine, for instance, the figurative dimension of his early scientific vocabulary and uncover metaphysical residues he had explicitly disowned but would later embrace. Finally, it is suggested that, the hermeneutics of allegory are historical and it is used here to test the relationship between Eliot's early and later critical writings, that is the early physics and the later metaphysics.

Scrapbook

The poems in Scrapbook are rooted in memory and the act of remembering. While the poems explore different personas and landscapes, they continually return to the poet’s childhood home: a falling apart 50s rancher, where the domestic and mundane are always accompanied by the bizarre. While the mother tries to make order out of these experiences, the poet becomes the quiet observer, journaling and collecting memories her mother would prefer to silence. Influenced by Elizabeth Bishop, Patricia Smith and Shuntaro Tanikawa, these poems tell stories through colloquial language that understates the strange details of everyday life.

Making a home: the difficulty of dwelling in Genesis and its intertexts

Using an inter-disciplinary range of research on the home-space, home-making practices and the concept of ‘dwelling’, I achieve a new understanding of a central thematic concern in Genesis: its characters’ struggle to build stable, lasting homes upon the earth. Genesis starts with a lost home-space named Eden, before progressing towards other temporary dwellings such as the ark Noah builds, and Abraham’s tents. The biblical ‘home’ is constructed from a mix of materials: the birth of children, divine instructions and journeys, dreams, homemaking acts and so on. Alongside social scientific criticism, this thesis uses literary and midrashic intertexts as a way into re-imagining the ‘unhomely’ experiences of certain characters, or drawing out tensions in acts such as home-unmaking or homecomings. The investigation of the concept of ‘home’ in Genesis contributes to the study of this space more widely, as well as reinterpreting familiar biblical themes such as identity, family and community.

Sonic Movie Memories: Sound, Childhood, and American Cinema

Though the trend rarely receives attention, since the 1970s many American filmmakers have been taking sound and music tropes from children’s films, television shows, and other forms of media and incorporating those sounds into films intended for adult audiences. Initially, these references might seem like regressive attempts at targeting some nostalgic desire to relive childhood. However, this dissertation asserts that these children’s sounds are instead designed to reconnect audience members with the multi-faceted fantasies and coping mechanisms that once, through children’s media, helped these audience members manage life’s anxieties. Because sound is the sense that Western audiences most associate with emotion and memory, it offers audiences immediate connection with these barely conscious longings. The first chapter turns to children’s media itself and analyzes Disney’s 1950s forays into television. The chapter argues that by selectively repurposing the gentlest sonic devices from the studio’s films, television shows like Disneyland created the studio’s signature sentimental “Disney sound.” As a result, a generation of baby boomers like Steven Spielberg comes of age and longs to recreate that comforting sound world. The second chapter thus focuses on Spielberg, who incorporates Disney music in films like Close Encounters of the Third Kind (1977). Rather than recreate Disney’s sound world, Spielberg uses this music as a springboard into a new realm I refer to as “sublime refuge” - an acoustic haven that combines overpowering sublimity and soothing comfort into one fantastical experience. The second half of the dissertation pivots into more experimental children’s cartoons like Gerald McBoing-Boing (1951) - cartoons that embrace audio-visual dissonance in ways that soothe even as they create tension through a phenomenon I call “comfortable discord.” In the final chapter, director Wes Anderson reveals that these sonic tensions have just as much appeal to adults. In films like The Royal Tenenbaums (2001), Anderson demonstrates that comfortable discord can simultaneously provide a balm for anxiety and create an open-ended space that makes empathetic connections between characters possible. The dissertation closes with a call to rethink nostalgia, not as a romanticization of the past, but rather as a reconnection with forgotten affective channels.

Iris Murdoch's romantic platonism

Abstract available.

Adapting to change in contemporary Irish and Scottish culture: fiction to film

Abstract available: p. [ii]-[iii].

Beyond orientalism: 'The Stranger' and 'Colonial Cosmopolitanism' in the romantic period novel

Going beyond Orientalism in its examination of novels dealing with British colonisation in the West, as well as the East Indies, the postcolonial frame of my thesis develops recent theorisations of the Romantic ‘stranger’. Analysing a range of novels from the much anthologised Mansfield Park (1814), to less well-known narratives such as John Thelwall’s The Daughter of Adoption (1801) and Sir Walter Scott’s Saint Ronan’s Well (1823), my thesis seeks to account for a model of ‘colonial cosmopolitanism’ within fiction of the period. Considering the cosmopolitan dimensions of the transferential rhetoric of slavery, my thesis explores the ways in which, Jane Austen, Amelia Opie and Maria Edgeworth consider the position of women in domestic society through a West Indian frame. Demonstrating the need for reform both at home and abroad, such novels are representative of a fledgling cosmopolitanism that is often overlooked in current criticism. In seeking to account for ‘colonial cosmopolitanism’ as a new model for reading fiction composed during the Romantic period, my thesis attempts to add further nuance to current understandings of sympathetic exchange during the process of British colonisation. In chapters four and five I will develop my analysis of novels dealing with colonial expansion in the Caribbean to consider novels which deal with the Indian subcontinent. Although stopping short of questioning colonial expansion, discourses of ‘colonial cosmopolitanism’, as my thesis demonstrates, provided a foundation for humanitarian and cultural engagement which was mutually transformative for both the coloniser and the colonised.

Wondrous transformations: rereading and rewriting wonder in contemporary anglophone and francophone fairy tales

This thesis compares contemporary anglophone and francophone rewritings of traditional fairy tales for adults. Examining material dating from the 1990s to the present, including novels, novellas, short stories, comics, televisual and filmic adaptations, this thesis argues that while the revisions studied share similar themes and have comparable aims, the methods for inducing wonder (where wonder is defined as the effect produced by the text rather than simply its magical contents) are diametrically opposed, and it is this opposition that characterises the difference between the two types of rewriting. While they all engage with the hybridity of the fairy-tale genre, the anglophone works studied tend to question traditional narratives by keeping the fantasy setting, while francophone works debunk the tales not only in relation to questions of content, but also aesthetics. Through theoretical, historical, and cultural contextualisation, along with close readings of the texts, this thesis aims to demonstrate the existence of this francophone/anglophone divide and to explain how and why the authors in each tradition tend to adopt such different views while rewriting similar material. This division is the guiding thread of the thesis and also functions as a springboard to explore other concepts such as genre hybridity, reader-response, and feminism. The thesis is divided into two parts; the first three chapters work as an in-depth literature review: after examining, in chapters one and two, the historical and contemporary cultural field in which these works were created, chapter three examines theories of fantasy and genre hybridity. The second part of the thesis consists of textual studies and comparisons between francophone and anglophone material and is built on three different approaches. The first (chapter four) looks at selected texts in relation to questions of form, studying the process of world building and world creation enacted when authors combine and rewrite several fairy tales in a single narrative world. The second (chapter five) is a thematic approach which investigates the interactions between femininity, the monstrous, and the wondrous in contemporary tales of animal brides. Finally, chapter six compares rewritings of the tale of ‘Bluebeard’ with a comparison hinged on the representation of the forbidden room and its contents: Bluebeard’s cabinet of wonder is one that he holds sacred, one where he sublimates his wives’ corpses, and it is the catalyst of wonder, terror, and awe. The three contextual chapters and the three text-based studies work towards tracing the tangible existence of the division postulated between francophone and anglophone texts, but also the similarities that exist between the two cultural fields and their roles in the renewal of the fairy-tale genre.

Nichtmedikamentöse Sekundärprävention der koronaren Herzkrankheit (KHK)

Hintergrund: Die koronare Herzkrankheit (KHK) ist eine häufige und potenziell tödliche Erkrankung mit einer Lebenszeitprävalenz von über 20%. Allein in Deutschland wird die Zahl der durch die ischämische Herzerkrankung und des akuten Myokardinfarkts jährlich verursachten Todesfälle auf etwa 140.000 geschätzt. Ein Zusammenhang eng mit dem Lebensstil verbundener Risikofaktoren mit Auftreten und Prognose der KHK ist nachgewiesen. Durch Maßnahmen der nichtmedikamentösen Sekundärprävention wird versucht, diese Risikofaktoren positiv zu verändern sowie die KHK im Gegensatz zu palliativen interventionellen Therapiestrategien kausal zu behandeln. Zur Wirksamkeit der nichtmedikamentösen sekundärpräventiven Maßnahmen liegt eine ganze Reihe von Einzelstudien und -untersuchungen vor, eine systematische Analyse, die die Evidenz aller hauptsächlich angewandten Sekundärpräventionsstrategien zusammenfasst, fehlt unseres Wissens nach bislang jedoch. Auch eine Auswertung vorhandener Studien zur Kosten-Effektivität der Maßnahmen ist hierbei zu integieren. Fragestellung: Ziel dieses HTA-Berichts (HTA=Health Technology Assessment) ist die Erstellung einer umfassenden Übersicht der aktuellen Literatur zu nichtmedikamentösen Sekundärpräventionsmaßnahmen in der Behandlung der KHK, um diese Maßnahmen und deren Komponenten bezüglich ihrer medizinischen Wirksamkeit sowie Wirtschaftlichkeit zu beurteilen. Weiterhin sollen die ethischen, sozialen und rechtlichen Aspekte der nichtmedikamentösen Sekundärprävention und die Übertragbarkeit der Ergebnisse auf den deutschen Versorgungsalltag untersucht werden. Methodik: Relevante Publikationen werden über eine strukturierte und hochsensitive Datenbankrecherche sowie mittels Handrecherche identifiziert. Die Literaturrecherche wird in vier Einzelsuchen zu medizinischen, gesundheitsökonomischen, ethischen und juristischen Themen am 18.09.2008 durchgeführt und erstreckt sich über die vergangenen fünf Jahre. Die methodische Qualität der Publikationen wird von jeweils zwei unabhängigen Gutachtern unter Beachtung von Kriterien der evidenzbasierten Medizin (EbM) systematisch geprüft. Ergebnisse: Von insgesamt 9.074 Treffern erfüllen 43 medizinische Publikationen die Selektionskriterien, mit einem Nachbeobachtungszeitraum zwischen zwölf und 120 Monaten. Insgesamt ist die Studienqualität zufriedenstellend, allerdings berichtet nur ca. die Hälfte der Studien differenziert die Gesamtmortalität, während die übrigen Studien andere Outcomemaße verwenden. Die Wirksamkeit einzelner Sekundärpräventionsmaßnahmen stellt sich als sehr heterogen dar. Insgesamt kann langfristig eine Reduktion der kardialen sowie der Gesamtmortalität und der Häufigkeit kardialer Ereignisse sowie eine Erhöhung der Lebensqualität beobachtet werden. Vor allem für trainingsbasierte und multimodale Interventionen ist eine effektive Reduktion der Mortalität zu beobachten, während psychosoziale Interventionen besonders in Bezug auf eine Erhöhung der Lebensqualität effektiv zu sein scheinen. Für die ökonomischen Auswertungen werden 26 Publikationen identifiziert, die von ihrer Themenstellung und Studienart dem hier betrachteten Kontext zugeordnet werden können. Insgesamt kann festgestellt werden, dass sich die Studienlage zur multimodalen Rehabilitation sowohl bezüglich ihrer Menge als auch Qualität der Analysen besser darstellt, als dies für Evaluationen von Einzelmaßnahmen beobachtet werden kann. Die internationale Literatur bestätigt den multimodalen Ansätzen dabei zwar ein gutes Verhältnis von Kosten und Effektivität, untersucht jedoch nahezu ausschließlich ambulante oder häuslichbasierte Maßnahmen. Die Auswertung der Studien, die einzelne sich mit präventiven Maßnahmen in Hinblick auf ihre Kosten-Effektivität beschäftigen, ergibt lediglich positive Tendenzen für Interventionen der Raucherentwöhnung und des körperlichen Trainings. Im Hinblick auf psychosoziale Maßnahmen sowie auch die Ernährungsumstellung können aufgrund der unzureichenden Studienlage jedoch keine Aussagen über die Kosten-Effektivität getroffen werden. Insgesamt werden im Rahmen der Betrachtung sozialer Aspekte der nichtmedikamentösen Sekundärprävention elf Publikationen einbezogen. Die relativ neuen Studien bestätigen, dass Patienten mit niedrigem sozioökonomischen Status insgesamt schlechtere Ausgangsbedingungen und demnach einen spezifischen Bedarf an rehabilitativer Unterstützung haben. Gleichzeitig sind sich die Forscher jedoch uneinig, ob gerade diese Patientengruppe relativ häufiger oder seltener an den Rehabilitationsmaßnahmen teilnimmt. Bezüglich der Barrieren, die Patienten von der Teilnahme an den präventiven Maßnahmen abhalten, werden psychologische Faktoren, physische Einschränkungen aber auch gesellschaftliche und systemisch-orientierte Einflüsse genannt. Diskussion: Nichtmedikamentöse Sekundärpräventionsmaßnahmen sind sicher und in der Lage eine Reduktion der Mortalität sowie der Häufigkeit kardialer Ereignisse zu erzielen sowie die Lebensqualität zu erhöhen. Da nur wenige der methodisch verlässlichen Studien Teilnehmer über einen längeren Zeitraum von mindestens 60 Monaten nachverfolgen, müssen Aussagen über die Nachhaltigkeit als limitiert angesehen werden. Verlässliche Angaben in Bezug auf relevante Patientensubgruppen lassen sich nur sehr eingeschränkt machen ebenso wie im Hinblick auf die vergleichende Beurteilung verschiedener Maßnahmen der Sekundärprävention, da diese von eingeschlossenen Studien nur unzureichend erforscht wurden. Zukünftige methodisch verlässliche Studien sind notwendig, um diese Fragestellungen zu untersuchen und zu beantworten. Bezogen auf die Kosten-Effektivität nichtmedikamentöser sekundärpräventiver Maßnahmen kann aus den internationalen Studien eine insgesamt positive Aussage zusammengefasst werden. Einschränkungen dieser resultieren jedoch zum einen aus den Besonderheiten des deutschen Systems der stationären Rehabilitationsangebote, zum anderen aus den qualitativ mangelhaften Evaluationen der Einzelmaßnahmen. Studien mit dem Ziel der Bewertung der Kosten-Effektivität stationärer Rehabilitationsangebote sind ebenso erforderlich wie auch qualitativ hochwertige Untersuchungen einzeln erbrachter Präventionsmaßnahmen. Aus sozialer Perspektive sollte insbesondere untersucht werden, welche Patientengruppe aus welchen Gründen von einer Teilnahme an Rehabilitations- bzw. präventiven Maßnahmen absieht und wie diesen Argumenten begegnet werden könnte. Schlussfolgerung: Nichtmedikamentöse sekundärpräventive Maßnahmen sind in der Lage eine Reduktion der Mortalität und der Häufigkeit kardialer Ereignisse zu erzielen sowie die Lebensqualität zu erhöhen. Eine Stärkung des Stellenwerts nichtmedikamentöser Maßnahmen der Sekundärprävention erscheint vor diesem Hintergrund notwendig. Auch kann für einige Interventionen ein angemessenes Verhältnis von Effektivität und Kosten angenommen werden. Es besteht allerdings nach wie vor erheblicher Forschungsbedarf bezüglich der Wirksamkeitsbeurteilung nichtmedikamentöser Maßnahmen der Sekundärprävention in wichtigen Patientensubgruppen und der Effizienz zahlreicher angebotener Programme. Darüber hinaus ist weitere Forschung notwendig, um die Nachhaltigkeit der Maßnahmen und Gründe für die Nichtinanspruchnahme detailliert zu untersuchen. Vor allem gilt es jedoch den Versorgungsalltag in Deutschland, wie er sich für Ärzte, Patienten und weitere Akteure des Gesundheitswesens darstellt, zu untersuchen und den heutigen Stellenwert nichtmedikamentöser Maßnahmen aufzuzeigen.