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

Les Houches physics at TeV colliders 2005 beyond the standard model working group: Summary report

The work contained herein constitutes a report of the Beyond the Standard Model'' working group for the Workshop Physics at TeV Colliders, Les Houches, France, 2-20 May, 2005. We present reviews of current topics as well as original research carried out for the workshop. Supersymmetric and non-supersymmetric models are studied, as well as computational tools designed in order to facilitate their phenomenology

1st Workshop on CP Studies and Non-standard Higgs Physics

There are many possibilities for new physics beyond the Standard Model that feature non-standard Higgs sectors. These may introduce new sources of CP violation, and there may be mixing between multiple Higgs bosons or other new scalar bosons. Alternatively, the Higgs may be a composite state, or there may even be no Higgs at all. These non-standard Higgs scenarios have important implications for collider physics as well as for cosmology, and understanding their phenomenology is essential for a full comprehension of electroweak symmetry breaking. This report discusses the most relevant theories which go beyond the Standard Model and its minimal, CP-conserving supersymmetric extension: two-Higgs-doublet models and minimal supersymmetric models with CP violation, supersymmetric models with an extra singlet, models with extra gauge groups or Higgs triplets, Little Higgs models, models in extra dimensions, and models with technicolour or other new strong dynamics. For each of these scenarios, this report presents an introduction to the phenomenology, followed by contributions on more detailed theoretical aspects and studies of possible experimental signatures at the LHC and other colliders.There are many possibilities for new physics beyond the Standard Model that feature non-standard Higgs sectors. These may introduce new sources of CP violation, and there may be mixing between multiple Higgs bosons or other new scalar bosons. Alternatively, the Higgs may be a composite state, or there may even be no Higgs at all. These non-standard Higgs scenarios have important implications for collider physics as well as for cosmology, and understanding their phenomenology is essential for a full comprehension of electroweak symmetry breaking. This report discusses the most relevant theories which go beyond the Standard Model and its minimal, CP-conserving supersymmetric extension: two-Higgs-doublet models and minimal supersymmetric models with CP violation, supersymmetric models with an extra singlet, models with extra gauge groups or Higgs triplets, Little Higgs models, models in extra dimensions, and models with technicolour or other new strong dynamics. For each of these scenarios, this report presents an introduction to the phenomenology, followed by contributions on more detailed theoretical aspects and studies of possible experimental signatures at the LHC and other colliders

Call to restrict neonicotinoids

On 28 April 2018 the European Parliament voted for a complete and permanent ban on all outdoor uses of the three most commonly used neonicotinoid pesticides. With the partial exception of the state of Ontario, Canada, governments elsewhere have failed to take action. Below is a letter, signed by 232 scientists from around the world, urgently calling for global action by policy makers to address this issue