Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19

In this editorial, we provide some first insights into this willingness to be vaccinated, based on a multi-country European study

Trends in incidence and outcomes of revision total hip arthroplasty in Spain: A population based study

<p>Abstract</p> <p>Background</p> <p>To analyze changes in incidence and outcomes of patients undergoing revision total hip arthroplasty (RTHA) over an 8-year study period in Spain.</p> <p>Methods</p> <p>We selected all surgical admissions in individuals aged ≥ 40 years who underwent RTHA (ICD-9-CM procedure code 81.53) between 2001 and 2008 from the Spanish National Hospital Discharge Database. Age- and sex-specific incidence rates, Charlson co-morbidity index, length of stay (LOS), costs and in-hospital mortality (IHM) were estimated for each year. Multivariate analyses were conducted to asses time trends.</p> <p>Results</p> <p>32, 280 discharges of patients (13, 391 men/18, 889 women) having undergone RTHA were identified. Overall crude incidence showed a small but significant increase from 20.2 to 21.8 RTHA per 100, 000 inhabitants from 2001 to 2008 (p < 0.01).</p> <p>The incidence increased for men (17.7 to 19.8 in 2008) but did not vary for women (22.3 in 2001 and 22.2 in 2008). Greater increments were observed in patients older than 84 years and in the age group 75-84. In 2001, 19% of RTHA patients had a Charlson Index ≥ 1 and this proportion rose to 24.6% in 2008 (p < 0.001). The ratio RTHA/THA remained stable and around 20% in Spain along the entire period</p> <p>The crude overall in-hospital mortality (IHM) increased from 1.16% in 2001 to 1.77% (p = 0.025) in 2008. For both sexes the risk of death was higher with age, with the highest mortality rates found among those aged 85 or over. After multivariate analysis no change was observed in IHM over time. The mean inflation adjusted cost per patient increased by 78.3%, from 9, 375 to 16, 715 Euros from 2001 to 2008.</p> <p>After controlling for possible confounders using Poisson regression models, we observed that the incidence of RTHA hospitalizations significantly increased for men and women over the period 2001 to 2008 (IRR 1.10, 95% CI 1.03-1.18 and 1.08, 95% CI 1.02-1.14 respectively).</p> <p>Conclusions</p> <p>The crude incidence of RTHA in Spain showed a small but significant increase from 2001 to 2008 with concomitant reductions in LOS, significant increase in co-morbidities and cost per patient.</p

The Troubled Patriot: German Innerlichkeit in World War II

How German society responded to the Holocaust, military defeat, Allied bombing and the mass flights from the Eastern territories in 1945 needs to be seen in relation to the larger question of morale and attitudes towards the continuation of the war per se. Any attempt to assess German morale inevitably involves psychological and emotional analyses, and this article explores how these issues operated at the level of individual subjectivity. It focuses on the personal diary of August Töpperwien, a German Protestant, who was not a Nazi and yet maintained a loyal patriotism to the end. In so doing, it probes the troubled conscience of someone whose conflicting senses of personal duty and political obligation found their vent in pages of silent self-reflection, and so reveal with an unusual clarity the underlying frames of moral reference, which so often remain implicit and unargued in the short-hand and commonsense of other diaries and family letters, let alone macro-level surveys of popular opinion. Many historians have followed the lead of Martin Broszat and accepted that, after the Battle of Stalingrad, German society was increasingly alienated not only by the demands of the Nazi regime but by the war itself, and retreated into privacy. Careful reading of a diary such as this one reveals that support for the Nazi regime and for the war were not the same thing, and questions how much interiority remained untouched by the emotional and moral claims of war. © The Author 2010. Published by Oxford University Press on behalf of the German History Society. All rights reserved