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The increasing speed of societal, environmental, technological, and workplace changes brings into sharper focus the question of how people shape and learn from transitions, such as so-called 'skilled migration'. Taking a doing transitions and doing migration perspective, I assert that transitions and migration do not simply exist but are constituted relationally through social practices and accompanied by learning processes. This paper reports findings from qualitative research into the question of how people learn and transform their understandings of (life)time when moving to a new country and seeking entry into the labour market. The study used the documentary method to analyse data from 20 biographical-narrative interviews with people who moved to Canada as adults. Findings indicate different modes of dealing with shifts in temporal contexts during migration as decompressing lifetime, losing time, and going with the flow. These modes are associated with positive transformative learning, negative transformative learning, and learning through participation in practices. This study has implications for theorising learning during life course transitions as a socially embedded process. It also points to the need for differentiated support as individuals seek to enter new labour markets or make career changes in the context of migration. [ABSTRACT FROM AUTHOR]

Party system institutionalization (PSI) is regarded as a critical underpinning of democracies, but its role in non‐democratic systems has been understudied. In this paper, we evaluate whether the concept has meaningful and perhaps unique implications for the durability of competitive authoritarian regimes. We argue that a modified version of electoral volatility – the most common measure of PSI in democracies – conveys useful information about PSI in competitive authoritarian contexts by signalling the ability of the ruling party to manage the opposition. To this end, we construct an original data set that disaggregates electoral volatility into ruling party seat change and opposition party seat volatility and further divides opposition party volatility into Type‐A and Type‐B volatility. We find robust results that democratization becomes more likely when decreases in the ruling party's seat share coincide with an increase in opposition party Type‐B volatility. This paper demonstrates that the concept of PSI has utility for understanding regime dynamics in competitive authoritarian contexts. [ABSTRACT FROM AUTHOR]

The solute drag effect of phosphorus (P) in the single-phase austenite (γ-Fe) region was studied under isothermal annealing conditions at temperatures of 1050 °C, 1150 °C, 1250 °C and 1350 °C. High-temperature laser scanning confocal microscopy (HT-LSCM) was used to observe and quantify in situ grain growth on the surface of three different samples containing 0.026 wt.-% P, 0.044 wt.-% P and 0.102 wt.-% P. The dependence of the arithmetic mean grain sizes on time and temperature were modeled mathematically using a simple ordinary differential equation (ODE) according to normal grain growth (NGG) theory. As no other major effects, i.e., Zener-pinning by precipitates, occurred under the selected experimental conditions, grain growth interference was only considered by grain boundary (GB) segregation of P. Thus, the total grain boundary mobility (M) was directly determined depending on the P content and isothermal annealing temperature. The fitted GB mobility values enabled the determination of an average binding energy value between impurity P atoms and grain boundaries (E 0 = -1.1 - -0.6 eV) in the system. Finally, the GB segregation of P in γ-Fe was derived from the observed grain growth kinetics. The results showed reasonable agreement with calculations using segregation enthalpies from the literature. [Display omitted] [ABSTRACT FROM AUTHOR]

In the course of the decarbonization of steel production, electric steel production will continue to gain importance. The processing of low‐quality scrap will also play an important role, which may lead to an increase in the content of so‐called tramp elements in steel production and further processing. This article examines the effect of the elements Cu, Sn, and Ni on the formation of surface cracks under the conditions of the continuous casting process. Results of an in situ bending test are compared with the results of the experimental simulation of high‐temperature oxidation and thermodynamic analysis based on the CALculation of PHase Diagrams (CALPHAD) approach. For a temperature of 900 °C, an equivalent Cu content of 0.20 wt% must be considered as the critical upper limit. The presumable reason is the existence of Cu‐ and Sn‐rich liquid phases at the austenite grain boundaries. The results clearly show the effect of the investigated elements but also point to the importance of the gas atmosphere and cooling conditions on the results. This can be a groundbreaking result for extending the process window for casting steels with increased tramp element contents. [ABSTRACT FROM AUTHOR]

Patients often present to emergency departments after potential or confirmed exposure to human immunodeficiency virus (HIV) asking for recommendations concerning the initiation of post-exposure prophylaxis (PEP). These presentations may occur after occupational as well as non-occupational exposure. PEP entails taking a triple antiretroviral therapy for 28–30 days. If taken early (ideally within 2 h, but no later than 72 h) and as indicated, HIV infection can be prevented with a high level of probability. Since these presentations occur around the clock, they require basic expertise on the part of the emergency department staff regarding its indication and its side effects as well as standardized procedures in the emergency department to not delay initiation. Patients should present to an infectious disease outpatient clinic or practice specialized in HIV in order to have the indication reviewed by a specialist and, if necessary, adapted to complex cases with the aim of making individual case decisions. This review article aims to summarize core statements of the 2022 German–Austrian guideline on HIV post-exposure prophylaxis and to give emergency department staff necessary knowledge to safely and correctly begin PEP. [ABSTRACT FROM AUTHOR]

Background: The establishment of a resuscitation room management for nontraumatic critically ill children appears to make sense. This study collected data of pediatric patients suffering from nontraumatic critically ill conditions treated in a resuscitation room. Methods: The retrospective OBSERvE-DUS-PED study (November 2019–October 2022) recorded pediatric patients (age < 18 years) who were admitted to the emergency department (ED) for resuscitation room care. The routinely documented data on treatment were taken from the hospital information system MEDICO® and the patient data management system COPRA® in accordance with the OBSERvE dataset. The study was approved by the Ethics Committee of the Medical Faculty of the Heinrich Heine University (2023-2377). Results: The study included 52 pediatric resuscitation room patients. Adolescents aged 14–17 years were the most frequent in the cohort representing 37% of the total and neonates/infants (0–1 year) were lowest at 8%. The most common symptoms categorized according to ABCDE problems were disturbance of consciousness (D) at 61%, cardiovascular failure (C) at 25%, respiratory insufficiency (B) at 6%, airway obstruction (A) and exposure/environment (E) problems each at 4%. The out-of-hospital and in-hospital emergency procedures were performed with the following frequencies: venous (58% vs. 65%), intraosseous (14% vs. 2%) and central venous access (0% vs. 12%), invasive airway management (35% vs. 8%), cardiopulmonary resuscitation (21% vs. 10%), vasopressors (15% vs. 17%), and intra-arterial pressure measurement (0% vs. 17%). The mean duration of resuscitation room management was 70 ± 43 min. The 30-day mortality was 17%. Conclusion: The OBSERvE-DUS-PED study demonstrates the major challenges in the care of critically ill nontraumatic pediatric patients, both in out-of-hospital and in-hospital management. The variety and complexity of the referral diagnoses as well as the immediate vital threat to the patients make it appear sensible to treat such patients primarily in a resuscitation room of the ED due to the available material, infrastructural and personnel resources. [ABSTRACT FROM AUTHOR]

Introduction: Penetrating injuries are a rare but recurring emergency situation in the out-of-hospital and in-hospital emergency settings. The purpose of this study was to determine the incidence and characteristics of injuries associated with penetrating violence across a German metropolitan region over a 5-year period. Material and methods: In the retrospective study, a database query of the control center of the Düsseldorf rescue service area was used to identify and descriptively analyze all rescue service operations with penetrating violence-associated injuries in the years 2015, 2017, and 2019. For those patients who were transferred to the major trauma center, a further analysis of the in-hospital course was performed. Results: In the 3 years 2015, 2017 and 2019 a total of 266 patients (age: 33 ± 14 years, male: 79%) could be recorded (2015 vs. 2017 vs. 2019: n = 81 vs. n = 93 vs. n = 92, respectively). The most common age group involved had an age range of 15–34 years. A particularly higher frequency of emergency calls was found for the areas of Old Town, City Center, and one other district (Oberbilk). A high frequency of rescue missions was found in the nights from Saturday to Sunday between 20.00 p.m. and 04.00 a.m. Rescue missions with emergency physicians on board increased over the years (2015 vs. 2019: 27 vs. 42%, p = 0.04). The primary weapons used were knives (56%), broken glass bottles (18%) and broken glasses (6%). Out of all patients 71 (27%, injury severity score 11 ± 14) were admitted to the major trauma center. Among these patients, the proportion of immediate surgical care (2015 vs. 2019: 20% vs. 35%, p < 0.05) and positive alcohol detection increased over the years (2015 vs. 2019: 10% vs. 43%, p < 0.05). The 30-day mortality in the 3 years studied was 1.1% (n = 3). Conclusion: Penetrating injuries associated with violence are relevant but rare rescue missions. Future care strategies should focus on deployment of rescue resources close to the scene of the incident ("old town guard", central station), and prevention strategies should focus on weapon prohibition zones. A control of alcohol consumption should be discussed. [ABSTRACT FROM AUTHOR]

Introduction of accredited Cardiac Arrest Centers. Patients after OHCA who were transferred to one of three university hospitals before and after CAC accreditation were analyzed retrospectively concerning treatment and outcome variables. Created with https://www.biorender.com/ [Display omitted] Out-of-hospital cardiac arrest (OHCA) remains a frequent medical emergency with low survival rates even after a return of spontaneous circulation (ROSC). Growing evidence supports formation of dedicated teams in scenarios like cardiogenic shock to improve prognosis. Thus, the European Resuscitation Council (ERC) recommended introduction of Cardiac Arrest Centers (CAC) in their 2015 guidelines. Here, we aimed to elucidate the effects of newly introduced CACs in Germany regarding survival rate and neurological outcome. A multicenter retrospective observational cohort study was performed at three university hospitals and outcomes after OHCA were compared before and after CAC accreditation. Primary outcomes were survival until discharge and favorable neurological status (CPC 1 or 2) at discharge. In total 784 patients (368 before and 416 after CAC accreditation) were analyzed. Rates of immediate percutaneous coronary intervention (40 vs. 52%, p = 0.01) and implementation of extracorporeal CPR (8 vs. 13%, p < 0.05) increased after CAC accreditation. Likelihood of favorable neurological status at discharge was higher after CAC accreditation (71 vs. 87%, p < 0.01), whereas overall survival remained similar (35 vs. 35%, p > 0.99). CAC accreditation is linked to higher rates of favorable neurological outcome and unchanged overall survival. [ABSTRACT FROM AUTHOR]