Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Perceived benefits of and barriers to Building Information Modelling (BIM) implementation in construction : the case of Hong Kong

202208 bcchSelf-funde

Critical success factors for building information modelling (BIM) implementation in Hong Kong

202208 bcchSelf-funde

The detrimental impacts of negative age stereotypes on the episodic memory of older adults : does social participation moderate the effects?

202101 bcrcVersion of RecordPublishe

Cross-generational Dialogue through Life Stories

Conference Theme: Aging as a Lifelong ProcessThis Free journal suppl. entitled: 2015 GSA Annual Scientific Meeting AbstractsSession 545 (Poster) - Family and Intergenerational Relations 1Young people nowadays have little opportunities to interact meaningfully with older people leading to possible ageism. Older people also find it difficult to understand the youth. This paper examines the impacts of the ‘Life Mentor Scheme’, an intergenerational learning activity between university students and the elders, on their attitude toward each other. Undergraduates were matched with elders on a 2: 1 basis. The elderly shared their life experiences, and the undergraduates constructed life stories of their elderly mentors in a book form. METHODS: A total of 140 undergraduates across different major studies from four universities in Hong Kong and 60 elders aged 60 or above participated in the Scheme from 2014 to 2015. The impacts of the Scheme were measured by a survey using A-B design, self-administered for student participants and interview-based for elders. Respondents’ attitude towards the other generation was assessed with the use of validated tools. RESULTS: For student participants, pair sample t test of the Kogan’s Attitude Towards Older People Scale showed significant increase in positive attitude and decrease in negative attitudes toward the older generation after joining the Scheme. Similarly, pair sample t test of Aging Semantic Differential Scale also showed significantly more positive attitude toward the elderly. However, no significant findings were found among the elderly participants. At the same time, positive qualitative comments on the Scheme were given by both samples. DISCUSSION: Similar intergenerational activities are recommended to strengthen empathetic understanding between the young and the old.link_to_OA_fulltex

Humor attenuates the awakening cortisol response in older men

Poster Session 3 - Board: III-078Sense of humor, as measured by an adaptation of the Coping Humor Scale, was found to be negatively associated with the mean level of cortisol in the post-awakening period in a group of 42 older men, with the effects of age, socioeconomic status and self-esteem statistically controlled

Humor attenuates the cortisol awakening response in healthy older men

This study examined the impact of an important factor contributing to successful aging, humor, on post-awakening cortisol levels among a group of 45 older men whose ages ranged from 64 years to 86 years (mean=73.6 years). Four saliva samples were collected from the participants for 2 days immediately after waking and every 15min thereafter for three times. Cortisol data of the 2 days were aggregated for analysis. Two separate indices of cortisol awakening response reflecting the mean level of secretion and the rise from immediately to 45min post-awakening, AUCG and AUCI, were computed using the trapezoid formula. The relation of these two indices to humor (operationalized as coping) was examined in a multiple regression analysis while controlling for the effect of age, socioeconomic status, and self-esteem. Results indicated that higher humor scores were associated with lower AUCG but had no relation with AUCI. Findings of the present study suggest that the hypothalamic-pituitary-adrenocortical axis is the major pathway whereby positive psychological dispositions, such as humor, exert their health effects in the aging population. Moreover, cortisol levels in the awakening period may be particularly sensitive to the influences of psychosocial factors. © 2010 Elsevier B.V.link_to_subscribed_fulltex

Reconceptualizing online experiential learning : case study of a tele-engineering project

202306 bcwwAccepted ManuscriptSelf-fundedPublishe