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Wo stehen Geflüchtete fünf Jahre nach der Einreise hinsichtlich ihrer Arbeitsmarktintegration? Der vorliegende Beitrag nähert sich dieser Fragestellung aus einer biografischen und prozessorientierten Längsschnittperspektive. Die Geflüchteten sehen sich der denkbar großen Aufgabe gegenüber, in einer herausfordernden Lebensphase und ausgestattet mit knappen Ressourcen einen Platz in einem gänzlich unbekannten Umfeld zu finden. Auf Basis von zwei narrativ-biografischen Befragungswellen mit Geflüchteten aus Syrien wird gezeigt, dass sich bei diesen Suchprozessen vier typische Verlaufsmuster der Arbeitsmarktintegration herausbilden, die auf die Fluchtpunkte Exklusion, erwerbsbezogene Marginalisierung, Re-Normalisierung und Chancenorientierung zulaufen. Wir beleuchten Bedingungskonstellationen und Dynamiken, die den Arbeitsmarktintegrationsverläufen unterliegen und ihnen Dauerhaftigkeit verleihen. Refugees’ Labour Market Trajectories in Germany – A Typology of Conditions and Dynamics Where do refugees stand with regard to their labor market integration five years after immigration? This article addresses this question from a biographical and process-oriented longitudinal perspective. In a turbulent life phase, refu­gees confront the challenging task of finding their economic positioning in a new environment. Based on two waves of narrative-biographical Interviews with Syrian refugees, we identify four typical trajectories of labor market integration: exclusion, employment-related marginalization, re-normalization, and a focus on opportunity. The article highlights factors and dynamics that underlie and perpetuate these integration trajectories.

ZusammenfassungAufgrund ausgeprägter und residualer neurologischer Störungen bedürfen neurochirurgische Erkrankungen oftmals einer rehabilitativen Behandlung. Im vorliegenden Übersichtsartikel sollen die kraniellen neurochirurgischen Erkrankungen, die häufig zu einer rehabilitativen Behandlung führen, näher erläutert werden.

OBJECTIVEAcute subdural hematoma (ASDH) is a leading entity in brain injury. Rodent models mostly lack standard intensive care, while large animal models frequently are only short term. Therefore, the authors developed a long-term, resuscitated porcine model of ASDH-induced brain injury and report their findings.METHODSAnesthetized, mechanically ventilated, and instrumented pigs with human-like coagulation underwent subdural injection of 20 mL of autologous blood and subsequent observation for 54 hours. Continuous bilateral multimodal brain monitoring (intracranial pressure [ICP], cerebral perfusion pressure [CPP], partial pressure of oxygen in brain tissue [PbtO2], and brain temperature) was combined with intermittent neurological assessment (veterinary modified Glasgow Coma Scale [MGCS]), microdialysis, and measurement of plasma protein S100β, GFAP, neuron-specific enolase [NSE], nitrite+nitrate, and isoprostanes. Fluid resuscitation and continuous intravenous norepinephrine were targeted to maintain CPP at pre-ASDH levels. Immediately postmortem, the brains were taken for macroscopic and histological evaluation, immunohistochemical analysis for nitrotyrosine formation, albumin extravasation, NADPH oxidase 2 (NOX2) and GFAP expression, and quantification of tissue mitochondrial respiration.RESULTSNine of 11 pigs survived the complete observation period. While ICP significantly increased after ASDH induction, CPP, PbtO2, and the MGCS score remained unaffected. Blood S100β levels significantly fell over time, whereas GFAP, NSE, nitrite+nitrate, and isoprostane concentrations were unaltered. Immunohistochemistry showed nitrotyrosine formation, albumin extravasation, NOX2 expression, fibrillary astrogliosis, and microglial activation.CONCLUSIONSThe authors describe a clinically relevant, long-term, resuscitated porcine model of ASDH-induced brain injury. Despite the morphological injury, maintaining CPP and PbtO2 prevented serious neurological dysfunction. This model is suitable for studying therapeutic interventions during hemorrhage-induced acute brain injury with standard brain-targeted intensive care.

Der vorliegende Text will die disziplinäre Abschottung zwischen Bewegungsforschung und Theorie industrieller Beziehungen abbauen, indem er Theorieelemente der mobilization studies für die Analyse von Betriebsratsgründungsprozessen nutzt. Betriebsratsgründungen werden als interessenpolitische Mobilisierungsereignisse verstanden, deren Ergebnis davon abhängt, ob es innerbetrieblichen Kerngruppen gelingt, eine kollektive Umdeutung der hegemonialen politischen Kultur innerbetrieblicher Austauschbeziehungen zu erreichen. Die Analyse von zwei empirischen Fallbeispielen - einer gelungenen und einer gescheiterten Betriebsratsgründung - ermöglicht eine Evaluation zentraler Einflussfaktoren für den Erfolg von Betriebsratsgründungen. The present text seeks to dismantle the disciplinary barrier between movement research and theory of industrial relations by using elements of mobilization theory for analysing works council foundations. Initiatives for implementing a works council are interpreted as mobilization incidents in terms of political interest. It is crucial for the development whether core groups on the shop floor level succeed in re-framing the hegemonic political culture of relationships between management and labour. Analysing two examples of work council implementation - a successful case and a failed one - helps to identify relevant factors influencing the success of works council initiatives.

Die digitale Subtraktionsangiografie stellt den Goldstandard in der vaskularen Neurochirurgie dar. Durch die Anwendung einer intraoperativen Angiografie, welche durch den Hybridoperationssaal mit dem System Artis zeego moglich ist, kann diese Kontrolle noch wahrend der Operation, bei geoffnetem Schadel durchgefuhrt werden. Unterschiedliche 2-D- und 3-D-Darstellungsmoglichkeiten der akquirierten Bilddaten machen es dem Operateur moglich, die operative Strategie den daraus resultierenden Befunden ggf. anzupassen.

Decompressive craniectomy is an effective therapy to relieve intractable intracranial hypertension following acute brain injury. However, little is known about the optimal timing for cranioplasties in the sub-acute phase. The objective of the present study was to analyse the effect of cranioplasty timing on neurological outcomes.Single-centre observational study.One hundred and forty-seven consecutive patients with decompressive craniectomy and cranioplasty during the course of inpatient neurorehabilitation were identified by means of a retrospective hospital database search. This database contains the following prospectively-entered weekly scores: Barthel-Index (BI), Functional Independence Measure (FIM) and Coma Remission Scale (CRS). Additional clinical data were taken retrospectively from patient charts. Regression analysis was used to identify factors that influenced the end-of-rehabilitation outcome.Patients with shorter delays to cranioplasty (86 days) had a better functional outcome than patients with longer delays of85 days (60 ± 29.5 versus 25 ± 24.1 BI points; p 0.01, respectively). Age, pre-operative BI and CRS scores were additional independent outcome factors. Complication rates were not different between early and late cranioplasty groups.Patients with decompressive craniectomy for management of intracranial hypertension may benefit from early cranioplasty.

The primary objective of the study was to test whether there is a general downward trend in the number of head injuries in Europe. The research design of the study was a retrospective, explorative orientating analysis. A comparison of 27 European countries is presented. They have been sourced from the World Health Organization. The mean percentage of all hospital admissions for intracranial trauma in Europe is 0.855 % (±SD 0.550; range 0.03 to 2.82 %). The highest rates of treatments due to intracranial injuries are found in the Czech Republic, Latvia and Lithuania, whereas in the new member states of the European Union, such rates have been falling since entry, and there has been an increase in countries such as Germany, Finland and Cyprus. The mean length of in-hospital stay due to intracranial trauma in Europe is 6.79 days (±SD 2.95). There is no general decrease in the number of treated patients due to head injuries. There are serious regional differences and there is a need for preventive and informative action throughout Europe.

Primary objective The number of head injuries is not generally falling, but rather rising in some European countries. We want to certify the age and sex proportion in the number of head injuries in Europe.

Introduction. The secondary increase in the size of intracranial haematomas as a result of spontaneous haemorrhage or trauma is of particular relevance in the event of prior intake of platelet aggregation inhibitors. We describe the effect of desmopressin acetate as a means of temporarily stabilising the platelet function.Patients and Methods. The platelet function was analysed in 10 patients who had received single (N=4) or multiple (N=6) doses of acetylsalicylic acid and 3 patients (control group) who had not taken acetylsalicylic acid. All subjects had suffered intracranial haemorrhage. Analysis was performed before, half an hour and three hours after administration of desmopressin acetate. Statistical analysis was performed by applying a level of significance ofP≤0.05.Results. (1) Platelet function returned to normal 30 minutes after administration of desmopressin acetate. (2) The platelet function worsened again after three hours. (3) There were no complications related to electrolytes or fluid balance.Conclusion. Desmopressin acetate can stabilise the platelet function in neurosurgical patients who have received acetylsalicylic acid prior to surgery without causing transfusion-related side effects or a loss of time. The effect is, however, limited and influenced by the frequency of drug intake. Further controls are needed in neurosurgical patients.

Background Anatomical variants of the aortic arch and its branching patterns often appear as an incidental finding during routine computed tomography (CT) scanning. These variations can be of relevance when performing angiography or endovascular interventions and may cause symptoms such as dysphagia. Purpose To analyze common anatomical variations found within the arteries originating from the aortic arch in patients using contrast CT imaging techniques. Material and Methods A total of 2033 contrast CT scans were analyzed. To obtain a truly representative sample, cases were chosen from different hospital departments without previous knowledge of the patient history. Results The total percentage of variations within the analyzed patients was 13.3%. In 8.0% a truncus bicaroticus was found. 4.2% of the patients showed a left vertebral artery originating directly from the aortic arch, mostly proximal, and in 1 case distal to the left subclavian artery. In 1.0% we found an aberrant right subclavian artery. We also found a single case of a right descending aortic arch. Conclusion Variations of the aortic arch and its branching are frequently found, mostly as an incidental finding during routine diagnostic scanning. A contrast-enhanced CT scan is a good method with which to study the aortic arch and its associated branching pattern.