Involving service users in the qualitative analysis of patient narratives to support healthcare quality improvement

Economic and Social Research Council (ES/L01338X/1). Locock, L., Kirkpatrick, S., Brading, L. et al. Response to “comments on: involving service users in the qualitative analysis of patient narratives to support healthcare quality improvement. Res Involv Engagem 5, 26 (2019). https://doi.org/10.1186/s40900-019-0158-yPeer reviewedPublisher PD

Spanish and Latin American women writers in the literary canon: a paratextual study of anthologies of fantastic literature (1946-2016)

While it is evident that there are outstanding women authors of the fantastic in Spain and Latin America since the nineteenth century, it is not as clear whether these writers are fairly represented in the corpus available to readers. To what extent are women authors part of the fantastic canon? Are there female reference points for new generations of women writers? To explore processes of canon formation in the literature of the fantastic from a feminist perspective, this article gathers paratexts from 110 anthologies. Employing a quantitative approach with regard to indexed authors, the first section addresses specific questions related to gender and the fantastic in the Hispanic context by analysing statistical data. The empirical study is complemented by an analysis of how the female author is presented and constructed through the discourse in introductions, forewords and other paratextual materials of these anthologies

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