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Adressierung und Professionalität in der Erziehungsberatung:Eine qualitative Analyse habitualisierter Selbstverständnisse von Berater:innen in Teams der Erziehungsberatung
No full textDie Dissertation analysiert Fachkräfte in Erziehungsberatungsstellen (EB) und deren habitualisierte Selbstverständnisse. Die EB wird dabei als Handlungsfeld der Kinder- und Jugendhilfe verstanden, welches immer wieder in fachtheoretische Spannungsfelder verwickelt zu sein scheint (z.B. klinische vs. sozialpädagogische Einflüsse, Vorwürfe einer Mittelschichtsorientierung). Aus einer dezidierten - und bisher stark vernachlässigten - sozialpädagogischen Perspektive wird danach gefragt, wie Adressat:innen durch Fachkräfte der EB in Rückbezug auf deren Selbstverständnisse adressiert werden. Kurzum: Welche Bedeutung haben habitualisierte Denk-, Wahrnehmungs- und Einstellungsschemata von Fachkräften für die Adressierungspraxis und inwiefern können diese hilfreich sein, um Ein- und Ausschließungen zu erklären? Über eine qualitative Analyse konnte u.a. ermittelt werden, dass soziale Ausschlüsse meist implizit erfolgen und u.a. von der konzeptionellen Rahmung der Beratungsstellen abzuhängen scheinen. Über bilanzierende Thesen und Implikationen möchte die Arbeit helfen, die Praxis der EB zu reflektieren und adressat:innenorientiert im Sinne ausschlusssensibler Zugangsgerechtigkeit zu optimieren
Analysis of the Spinopelvic Parameters in Patients with Fragility Fractures of the Pelvis
No full textBackground: We investigated the spinopelvic parameters of lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS) in patients with fragility fractures of the pelvis (FFPs). We hypothesized that these parameters differ from asymptomatic patients. Methods: All patients treated for FFPs in a center of maximal care of the German Spine Society (DWG) between 2017 and 2021 were included. The inclusion criteria were age ≥ 60 years and the availability of a standing lateral radiograph of the spine and pelvis in which the spine from T12 to S1 and both femoral heads were visible. The baseline characteristics and study parameters were calculated and compared with databases of asymptomatic patients. The two-sample t-Test was performed with p < 0.05. Results: The study population (n = 57) consisted of 49 female patients. The mean age was 81.0 years. The mean LL was 47.9°, the mean PT was 29.4°, the mean SS was 34.2° and the mean PI was 64.4°. The mean value of LLI was 0.7. LL, LLI and SS were significantly reduced, and PI and PT were significantly increased compared to asymptomatic patients. Conclusions: The spinopelvic parameters in patients with FFPs differ significantly from asymptomatic patients. In patients with FFPs, LL, LLI and SS are significantly reduced, and PI and PT are significantly increased. The sagittal spinopelvic balance is abnormal in patients with FFPs
Biomechanical Comparisons between One- and Two-Compartment Devices for Reconstructing Vertebrae by Kyphoplasty
No full textBackground: This biomechanical in vitro study compared two kyphoplasty devices for the extent of height reconstruction, load-bearing capacity, cement volume, and adjacent fracture under cyclic loading. Methods: Multisegmental (T11–L3) specimens were mounted into a testing machine and subjected to compression, creating an incomplete burst fracture of L1. Kyphoplasty was performed using a one- or two-compartment device. Then, the testing machine was used for a cyclic loading test of load-bearing capacity to compare the two groups for the amount of applied load until failure and subsequent adjacent fracture. Results: Vertebral body height reconstruction was effective for both groups but not statistically significantly different. After cyclic loading, refracture of vertebrae that had undergone kyphoplasty was not observed in any specimen, but fractures were observed in adjacent vertebrae. The differences between the numbers of cycles and of loads were not statistically significant. An increase in cement volume was strongly correlated with increased risks of adjacent fractures. Conclusion: The two-compartment device was not substantially superior to the one-compartment device. The use of higher cement volume correlated with the occurrence of adjacent fractures
Biomechanical Stability of Third-Generation Adjustable Suture Loop Devices Versus Continuous Loop Button Device for Cortical Fixation of ACL Tendon Grafts
No full textBackground: Concerns regarding the primary stability of early adjustable loop button (ALB) devices for cortical fixation of tendon grafts in anterior cruciate ligament reconstruction (ACLR) have led to the development of new implant designs. Purpose: To evaluate biomechanical stability of recent ALB implants in comparison with a continuous loop button (CLB) device. Study Design: Controlled laboratory study. Methods: ACLR was performed in a porcine model (n = 40) using 2-strand porcine flexor tendons with a diameter of 8 mm. Three ALB devices (Infinity Button [ALB1 group]; Tightrope II RT [ALB2 group]; A-TACK [ALB3 group]) and 1 CLB device (FlippTack with polyethylene suture) were used for cortical tendon graft fixation. Cyclic loading (1000 cycles up to 250 N) with complete unloading were applied to the free end of the tendon graft using a uniaxial testing machine, followed by load to failure. Elongation, stiffness, yield load, and ultimate failure load were recorded and compared between the groups using a Kruskal-Wallis test with post hoc Dunn correction. Results: Elongation after 1000 cycles at 250 N was similar between groups (ALB1, 4.5 ± 0.7 mm; ALB2, 4.8 ± 0.8 mm; ALB3, 4.5 ± 0.6 mm; CLB, 4.5 ± 0.8 mm), as was load to failure (ALB1, 838 ± 109 N; ALB2, 930 ± 89 N; ALB3, 809 ± 103 N; CLB, 842 ± 80 N). Stiffness was significantly higher in the ALB1 group compared with the CLB group (262.3 ± 21.6 vs 229.3 ± 15.1 N/mm; P < .05). No significant difference was found between the 4 groups regarding yield load. Constructs failed either by rupture of the loop, breakage of the button, or rupture of the tendon. Conclusion: The tested third-generation ALB devices for cortical fixation in ACLR withstood cyclic loading with complete unloading without significant differences to a CLB device.
Clinical Relevance: The third-generation ALB devices tested in the present study provided biomechanical stability comparable with that of a CLB device. Furthermore, ultimate failure loads of all tested implants exceeded the loads expected to occur in the postoperative period after ACLR
Does Early Mobilization Following Resection of Spinal Intra-Dural Pathology Increase the Risk of Cerebrospinal Fluid Leaks?—A Dual-Center Comparative Effectiveness Research
No full textBackground and Objectives: Prolonged bed rest after the resection of spinal intradural tumors is postulated to mitigate the development of cerebrospinal fluid leaks (CSFLs), which is one of the feared postoperative complications. Nonetheless, the empirical evidence supporting this conjecture remains limited and requires further investigation. The goal of the study was to investigate whether prolonged bed rest lowers the risk of CSFL after the resection of spinal intradural tumors. The primary outcome was the rate of CSFL in each cohort. Materials and Methods: To validate this hypothesis, we conducted a comparative effectiveness research (CER) study at two distinct academic neurosurgical centers, wherein diverse postoperative treatment protocols were employed. Specifically, one center adopted a prolonged bed rest regimen lasting for three days, while the other implemented early postoperative mobilization. For statistical analysis, case–control matching was performed. Results: Out of an overall 451 cases, we matched 101 patients from each center. We analyzed clinical records and images from each case. In the bed rest center, two patients developed a CSFL (n = 2, 1.98%) compared to four patients (n = 4, 3.96%) in the early mobilization center (p = 0.683). Accordingly, CSFL development was not associated with early mobilization (OR 2.041, 95% CI 0.365–11.403; p = 0.416). Univariate and multivariate analysis identified expansion duraplasty as an independent risk factor for CSFL (OR 60.33, 95% CI: 0.015–0.447; p < 0.001). Conclusions: In this CER, we demonstrate that early mobilization following the resection of spinal intradural tumors does not confer an increased risk of the development of CSFL
Dunkle Zeiten:Das Bild des Nationalsozialismus in niederländischen Geschichtsschulbüchern für den Sekundarunterricht von 1946 bis 2010
No full textIm niederländischen Geschichtsunterricht und in den Schulbüchern von 1946 bis 2010 nimmt das Thema Nationalsozialismus eine dominante Stellung ein. Dadurch, so die These, habe der Unterricht zu einem negativen Deutschlandbild beigetragen. Die Dissertation geht daher der Frage nach, welche Aussagen die Autorentexte in den Schulbüchern zu den Ursachen und Bedingungen für den Aufstieg des Nationalsozialismus, zu seiner Etablierung in Deutschland und zu seinem Bild als Besatzungsmacht der Niederlande machen. Dazu werden inhaltliche Kontinuitäten und Veränderungen ermittelt, beschrieben und bewertet. Da Schulbücher die Ergebnisse der Fachwissenschaft aufnehmen, schlagen sich neue historische Fragestellungen, Erkenntnisse oder Paradigmenwechsel in den Schulbüchern nieder. Der Vergleich von Fachaussagen und Schulbuchtexten erlaubt ein Urteil über die historische Korrektheit der Schulbuchtexte wie auch über ihre Relevanz zur Erklärung politisch-sozialer Phänomene der Gegenwart
Efficiency of Plasma Activated Water on Planktonic Waterborne Microorganisms Occurring in Water Supply Systems and Dental Unit Waterlines
No full textSince high microbiological loads in water pipes of medical facilities and dental units pose a risk for human health, the establishment of bactericide agents should be advanced to minimize the contamination level. We focused on the efficacy of plasma-activated water (PAW) as a novel disinfectant against waterborne microorganisms being present in medical in-house and dental unit water-lines (DUWL), considering a dilution effect of PAW when flushing the water bearing systems. The efficiency of PAW, activated under defined conditions (90 W for 30 min) in a lab unit, was studied towards eight different waterborne species focusing on 'Pseudomonas aeruginosa, Acinetobacter' spp. and 'Legionella' spp. present in water-lines. PAW, presenting low pH at < 3.2 and high oxidation-reduction potential (763 mV) and conductivity (963 μS/cm) values, was applied in defined units to determine the minimum volume amount added to water for bacterial reduction. Six species failed in growth when exposed to the double PAW volume unit after 30 min incubation. A fivefold volume excess provided sufficient activity to inactivate the waterborne microorganisms while only 'Acinetobacter baumannii' required a tenfold PAW surplus substantially reduction. Microorganisms show a species-specific susceptibility to PAW and cell count reduction strikingly correlates with added PAW volumes. PAW needs to be used in excess to achieve adequate cell reduction in aqueous environments, considering that dilution effects always accompany the disinfection. Our results indicate that PAW is a suitable disinfecting agent in a watery environment applicable for microbiological reduction in DUWLs
