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

Psychometric properties of the Temporal Satisfaction with Life Scale among Turkish people

OBJECTIVES: The determinants of subjective well-being have been largely investigated in recent years. According to Pavot and Diener who have developed TSWL (Temporal Satisfaction with Life Scale), to assess the life satisfaction level of an individual according to temporal factors, subjective well-being is composed of two constructs: an emotional or affective component (i.e. positive and negative affects) and a conceptual or cognitive component (i.e. satisfaction with life, marriage, work, and leisure). The aim of this study was to adapt the Temporal Satisfaction with Life Scale into Turkish (TSWLS-T) and examine the reliability and validity of this new Turkish version. METHODS: The study was conducted in four phases with randomly chosen 236 participants (113 females, 123 males) and the mean age of sample was 38.6 ± 12.5 years. Cultural adaptation was implemented according to the internationally suggested method and a pre-test was administered to examine the language equivalence. Since the scale had high levels of language equivalence, validity and reliability studies were conducted. For construct validity, confirmatory factor analysis was employed. The Satisfaction with Life Scale (SWLS) was used in order to evaluate the validity of TSWLS-T, since internal consistency (Cronbach’s alpha and intra-class coefficients) and test–retest analysis were employed to estimate instrument reliability. RESULTS: The TSWLS-T demonstrated acceptable internal consistency, with a Cronbach’s alpha of 0.87 for the total scale and ranging between 0.76 and 0.88 for the subscales. The test–retest reliability was also satisfactory, with intra-class correlation coefficients of 0.81 for the total scale and ranging between 0.61 and 0.74 for the subscales (p < 0.01). Fit indices of the model supported the factor structure. However, the 1st, 5th, and 11th items in scale (past, present, and future) showed a series of problems. With these items excluded, the 12-item model provided a better fit to the data than the 15-item model while the factor structure remained almost unchanged. The author recommends that the 12-item TSWLS be used to measure temporal life satisfaction. CONCLUSIONS: The TSWLS-T is a valid and reliable measure to assess life satisfaction in Turkish

Investigation of Validity, Reliability and Acceptability of the Turkish Version of the 15D Questionnaire Health-Related Quality of Life on the People with Visual Impairment

Objective: This study aims to establish the validity and reliability of the Turkish version of the 15D questionnaire in a population of visually-impaired subjects. Material and Methods: Fifty-seven people (mean age: 36.6 +/- 12.3 years) who have a visual impairment and 63 sighted people (mean age: 54.4 +/- 11.6 years) participated in this study. A background questionnaire, 15D questionnaire, the Family Affluence Scale (FAS), and the Beck Depression Inventory (BDI) were used. Results: Among socio-demographic variables studied, the age (r=-0.41; 95% CI:-0.61 to-0.17; p<0.05), having an additional chronic health problem (r=-0.46; 95% CI:-0.64 to -0.23) and BDI score (r=-0.63; 95% CI: -0.61 to- 0.17; p<0.05) were significantly correlated with 15 D index score. Reliability was assessed for subjects who participated both in the first and second interviews (N=52). Cronbach's alpha for the 15D questionnaire was 0.75 at Time 1 and 0.78 at Time 2, which was obtained after removal of two dimensions (dimensions # 6 and 7) from the index because of zero variance. ICC for the 15D index was 0.95. Conclusion: It was concluded that the Turkish version of the generic 15D questionnaire was an acceptable, valid and reliable measure of health related quality of life for people with visually-impairment.WoSScopu

Long noncoding RNA ERICD interacts with ARID3A via E2F1 and regulates migration and proliferation of osteosarcoma cells

Long noncoding RNA (lncRNA) dysregulation is known to be taking part in majority of cancers, including osteosarcoma. In one of our previous studies, we showed that lncRNA MEG3 is being regulated by microRNA-664a (miR-664a) suppresses the migratory potential of osteosarcoma cells (U-2OS). We now report a novel lncRNA, namely, ERICD, which is linked to the transcription factor AT-rich interaction domain 3A (ARID3A) in U-2OS cells. We show that ARID3A binds to ERICD and indirectly interacts with each other via the E2F transcription factor 1 (E2F1). Furthermore, small interfering RNA (siRNA)-mediated knockdown of ERICD inhibited cell migration, formation of colonies, and proliferation in U-2OS cells. Overexpression of ARID3A inhibited cell migration, colony formation, and proliferation, whereas siRNA-mediated knockdown of ARID3A promoted cell migration, colony formation, and proliferation. Our findings indicate that ARID3A and lncRNA ERICD have plausible tumor suppressive and oncogenic functions, respectively, in osteosarcoma. Our data demonstrate the converse interaction between ARID3A and lncRNA ERICD that target DNA-binding proteins and dysregulation of their expression through E2F1 augments osteosarcoma progression. The cell rescue experiment also indicated E2F1 to be involved in the regulation of ARID3A and ERICD