Unsichtbare Care-Arbeit. Transnationale Sorgenketten für Schweizer Senior*innen

Mit der Osterweiterung der EU und der damit einhergehenden Personenfreizügigkeit ist in der Schweiz ein neuer Markt entstanden: Spezialisierte Agenturen vermitteln und verleihen osteuropäische Arbeitskräfte an Privathaushalte, wo diese rund um die Uhr betagte Menschen betreuen. Care-Arbeit wird so an meist weibliche Arbeitskräfte aus Ländern mit tieferem Einkommensniveau ausgelagert. Aus einer feministisch-geographischen Perspektive erforschen wir die Funktionsweise und Implikationen dieser global care chains und wollen dazu beitragen, dieses feminisierte und grösstenteils unsichtbare Segment des Arbeitsmarktes zum Gegenstand öffentlicher Debatten zu machen

«Meine Liebe für die Schweiz wurde enttäuscht.» Live-in-Betreuerinnen in Schweizer Privathaushalten

Was bedeutet es, während der Covid-19-Pandemie als Betreuerin in einem Schweizer Privathaushalt für eine ältere Person zu sorgen? Und was passiert, wenn der Job ganz plötzlich wegfällt? Die Geschichten von zwei Frauen aus Polen und Rumänien als Beispiel für migrantische Arbeitskräfte, deren Arbeit auch während der Pandemie unentbehrlich ist und die trotzdem durch die Maschen der Rettungsschirme fallen

Treatment of ruptured intracranial aneurysms yesterday and now

Objective This prospective study is designed to detect changes in the treatment of ruptured intracranial aneurysms over a period of 17 years. Methods We compared 361 treated cases of aneurysm occlusion after subarachnoid hemorrhage from 1997 to 2003 with 281 cases from 2006 to 2014. Specialists of neuroradiology and vascular neurosurgery decided over the modality assignment. We established a prospective data acquisition in both groups to detect significant differences within a follow-up time of one year. With this setting we evaluated the treatment methods over time and compared endovascular with microsurgical treatment. Results When compared to the earlier group, microsurgical treatment was less frequently chosen in the more recent collective because of neck-configuration. Endovascular treatment was chosen more frequently over time (31.9% versus 48.8%). Occurrence of initial symptomatic ischemic stroke was significantly lower in the clipping group compared to the endovascular group and remained stable over time. The number of reinterventions due to refilled treated aneurysms significantly decreased in the endovascular group at one-year follow-up, but the significantly better occlusion- and reintervention-rate of the microsurgical group persisted. The rebleeding rate in the endovascular group at one year follow-up decreased from 6.1% to 2.2% and showed no statistically significant difference to the microsurgical group, anymore (endovascular 2.2% versus microsurgical 0.0%, p = 0.11). Conclusion Microsurgical clipping still has some advantages, however endovascular treatment is improving rapidly

Exclusion criteria for endovascular treatment.

<p>Fisher-exact tests and chi-square tests examine the 0-Hypothesis H₀ that there is no difference regarding the exclusion criteria of endovascular treatment between the two chronological groups (1997 to 2003 versus 2006 to 2009 and 2012 to 2014). Special configurations of the aneurysms and clinical factors affected the specialists’ decision of the choice of treatment and have been documented as "no specified reasons."</p

Characteristics of the included early patient collective (1997 to 2003).

<p>ACA: Anterior communicating artery, Anterior cerebral artery; ICA: Internal carotid artery; MCA: Middle cerebral artery; VA: Vertebral artery; BA: Basilar artery. Fisher-exact tests and Chi-Square tests examine the 0-Hypothesis H₀ that there is no difference between the intervention modalities (endovascular group versus microsurgical group) regarding the ratios of the specific patient characteristics (e. g. ratio “WFNS°I-II” to “not WFNS°I-II” in the endovascular group versus ratio “WFNS°I-II” to “not WFNS°I-II” in the microsurgical group).</p

Comparison of the efficacy and safety of the chronological groups (1997–2003 versus 2006 to 2009 and 2012 to 2014) regarding the endovascular procedure.

<p>Chi-Square tests examine the 0-Hypothesis H₀ that there is no difference regarding the rate of endovascular cases (n = 115) in the comprehensive group of 1997–2003 (n = 361) compared to the rate of endovascular cases (n = 137) in the comprehensive recent coiling group (n = 281) (coiling 2006–2009 and 2012–2014). Moreover Fisher-exact tests and Chi-Square tests examine the 0-Hypothesis H₀ that there is no difference regarding the rates of symptomatic ischemic stroke, occlusion rate, rebleeding, direct mortality and reinterventions between the two chronological groups (“Endovascular 1997–2003” versus “Endovascular 2006–2009 and 2012–2014”).</p

Efficacy and safety of the treatment modalities from 1997 to 2003.

<p>Fisher-exact tests and Chi-Square tests examine the 0-Hypothesis H₀ that there is no difference regarding the rates of symptomatic ischemic stroke, occlusion rate, rebleeding, direct mortality and reinterventions between the two treatment modalities (endovascular group versus microsurgical group).</p

Microscope-based indocyanine green video angiography supporting the microsurgical occlusion of a ruptured middle cerebral artery aneurysm, which has been tested but is not used as a routine intraoperative device so far.

<p>(A): Intraoperative illustration of the middle cerebral artery aneurysm (arrows). (B): Video angiography showing the perfusion of the untreated aneurysm (arrows). (C): After clipping no perfusion of the aneurysm is detectable any more (arrows).</p

Characteristics of the included recent patient data (2006 to 2009 and 2012 to 2014).

<p>ACA: Anterior communicating artery, Anterior cerebral artery; ICA: Internal carotid artery; MCA: Middle cerebral artery; VA: Vertebral artery; BA: Basilar artery. Fisher-exact tests and Chi-Square tests examine the 0-Hypothesis H₀ that there is no difference between the intervention modalities (endovascular treatment group versus microsurgical treatment group) regarding the ratios of the specific patient characteristics (e. g. ratio “WFNS°I-II” to “not WFNS°I-II” in the endovascular group versus ratio “WFNS°I-II” to “not WFNS°I-II” in the microsurgical group).</p

Comparison of the efficacy and safety of the chronological groups (1997–2003 versus 2006 to 2009 and 2012 to 2014) regarding the microsurgical procedure.

<p>Chi-Square tests examine the 0-Hypothesis H₀ that there is no difference regarding the rate of clipped cases (n = 246) in the comprehensive group of 1997–2003 (n = 361) compared to the rate of clipped cases (n = 144) in the comprehensive recent microsurgical clipping group (n = 281) (microsurgical 2006–2009 and 2012–2014). Moreover Fisher-exact tests and Chi-Square tests examine the 0-Hypothesis H₀ that there is no difference regarding the rates of symptomatic ischemic stroke, occlusion rate, rebleeding, direct mortality and reinterventions between the two chronological groups (“Microsurgical 1997–2003” versus “Microsurgical 2006–2009 and 2012–2014”).</p