Search

Purpose: In spine care, frailty is associated with poor outcomes. The aim of this study was to describe changes in frailty in spine care during the coronavirus disease 2019 (COVID-19) pandemic and their relation to surgical management and outcomes., Methods: Patients hospitalized for spine pathologies between January 1, 2019, and May 17, 2022, within a nationwide network of 76 hospitals in Germany were retrospectively included. Patient frailty, types of surgery, and in-hospital mortality rates were compared between pandemic and pre-pandemic periods., Results: Of the 223,418 included patients with spine pathologies, 151,766 were admitted during the pandemic and 71,652 during corresponding pre-pandemic periods in 2019. During the pandemic, the proportion of high-frailty patients increased from a range of 5.1-6.1% to 6.5-8.8% (p < 0.01), while the proportion of low frailty patients decreased from a range of 70.5-71.4% to 65.5-70.1% (p < 0.01). In most phases of the pandemic, the Elixhauser comorbidity index (ECI) showed larger increases among high compared to low frailty patients (by 0.2-1.8 vs. 0.2-0.8 [p < 0.01]). Changes in rates of spine surgery were associated with frailty, most clearly in rates of spine fusion, showing consistent increases among low frailty patients (by 2.2-2.5%) versus decreases (by 0.3-0.8%) among high-frailty patients (p < 0.02). Changes in rates of in-hospital mortality were not associated with frailty., Conclusions: During the COVID-19 pandemic, the proportion of high-frailty patients increased among those hospitalized for spine pathologies in Germany. Low frailty was associated with a rise in rates of spine surgery and high frailty with comparably larger increases in rates of comorbidities., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This article discusses the emergence of a discourse on 'political Islam' in the policy circles of European elites. It interprets this discourse on one hand as a manifestation of the further criminalization of Muslimness emanating from programs of countering 'extremism' and deradicalizing Muslim youth in the wake of the global war on terror. More specifically, the discourse on 'political Islam' is seen as an extension of countering violent extremism projects to counter an alleged non-violent 'extremism.' The article discusses three cases: Austria, Germany, and France to analyze what the fight against 'political Islam' (in Austria), 'legalistic Islamism' (in Germany), and 'Islamist separatism' (in France) respectively mean. These terminologies are analyzed as 'empty signifiers' and (Foucauldian) dispositifs that are used deliberately to legitimize state interventions to shape their respective societies. It is argued that the main shared idea is not that Muslims break the law or commit violence. Rather, the argument is that Muslims use the law to subvert their European nation-states. This aims at excluding Muslims from political life and not allowing them to shape the future of these countries. A simultaneous effort is the nurturing of an unpolitical, submissive Muslim that does not question hegemonial power structures, a project which is pursued by creating a domesticated or 'national Islam.' The article discusses these three terminologies' similarities and differences in the respective countries. In sum, the apparatus of 'political Islam' is interpreted as a means to 1) push back or exclude Muslims from the public sphere; 2) crackdown on organized Muslims; and 3) silence critical voices to these policies. [ABSTRACT FROM AUTHOR]