Dancing with death. A historical perspective on coping with covid-19

In this paper, we address the question on how societies coped with pandemic crises, how they tried to control or adapt to the disease, or even managed to overcome the death trap in history. On the basis of historical research, we describe how societies in the western world accommodated to or exited hardship and restrictive measures over the course of the last four centuries. In particular, we are interested in how historically embedded citizens' resources were directed towards living with and to a certain extent accepting the virus. Such an approach of “applied history” to the management of crises and public hazards, we believe, helps address today's pressing question of what adaptive strategies can be adopted to return to a normalized life, including living with socially acceptable medical, hygienic and other pandemic‐related measures

'Het belang en de welvaart van alle ingezetenen' : gezondheidszorg in de stad Groningen 1800-1870

In ‘Het belang en de welvaart van alle ingezetenen’ besteedt Minie Baron voor het eerst aandacht aan het hele gebied van de gezondheidszorg in een Nederlandse stad in de eerste zeventig jaren van de negentiende eeuw. Ze toont aan dat de bestrijding van de inheemse volksziekten in de periode 1800-1870 van grotere invloed was op het inrichten van de gezondheidszorg in de negentiende eeuw dan de bestrijding van de nieuwe ziekte cholera. De meeste ontwikkelingen in de gezondheidszorg in Groningen in de periode 1800-1870 kunnen worden gekoppeld aan de bestrijding van epidemieën en besmettelijke ziekten. Door de groeiende bevolking en toegenomen economische activiteiten verslechterden in de loop van de negentiende eeuw de hygiënische omstandigheden in de Nederlandse steden. Ziektes namen toe en epidemieën grepen steeds vaker om zich heen. Hoewel men de juiste oorzaak van de ziektes niet altijd kende, werden in de openbare gezondheidszorg en de medische hulpverlening verschillende maatregelen getroffen om de gevolgen van de vele volksziekten op te vangen. Al vroeg in de negentiende eeuw ontstonden nieuwe collectieve regelingen en voorzieningen. Naast de angst voor besmettelijke ziektes, speelden in de stad Groningen ook economische motieven en stadstrots een rol in de opbouw van de negentiende-eeuwse gezondheidszorg. http://www.vangorcum.nl

Income-related health inequalities: does perceived discrimination matter?

Because of their meritocratic ideology, Western countries might promote the belief that every individual is responsible for his or her socioeconomic position. These beliefs might enhance discrimination which, in turn, might affect health. Therefore, the aim of the study was to investigate the role of perceived discrimination within income-related health inequalities. Two-year follow-up data (2008-2010) from the Dutch Longitudinal Internet Studies for the Social sciences panel (N = 2,139) were used to examine the relation between income, perceived discrimination, and self-rated health and feeling hindered by health problems. Results showed that poor health was more prevalent in the low income and in the discriminated group. Participants from the low income group were also more likely to perceive discrimination (OR = 1.57, 95 % CI = 1.03-2.42). However, there was no substantial evidence for a mediating effect of perceived discrimination on the income-health association. The results emphasise the importance of a more in-depth study of discrimination in relation to socioeconomic health inequalities. Since ethnicity was a major confounder, it is recommended to take account of the complex interplay between discrimination and both the socioeconomic and ethnic background

Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients’ preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings Between June 16, 2014, and April 29, 2015, data from 22803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj –4·4%, 95% CI –5·5 to –3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj –2·6%, 95% CI –3·9 to –1·4) and the administration of reversal agents (1·23, 1·07–1·41; –1·9%, –3·2 to –0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj –0·3%, 95% CI –2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; –0·4%, –3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications