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

Centre A | International Speaker, Hammad Nasar, Head of Research and Programmes, Asia Art Archives

Hammad Nasar, Head of Research and Programmes at the Asia Art Archive (AAA), Hong Kong, spoke on questions of geography, region and nation with insights into developments in contemporary art from West Asia or the “Middle East”, and with relation to the current exhibition at Centre A, “Minutes from a Second Story” by Hajra Waheed

Gardening the Archive: A Conversation between David Alesworth and Hammad Nasar

DOI For a contemporary artist, David Alesworth (b. 1957) has an unusual relationship with the landscape. For more than twenty-five years, he has maintained parallel professional lives: as an artist and art teacher; and as a landscape designer and horticultural consultant. Returning to live and work in the UK in 2015, after more than three decades in Karachi and Lahore, his geographic, artistic, horticultural, and biographical entanglements are directly reflected in a heterogonous and wide-ranging body of work featured in the Paul Mellon Centre’s Landscape Now conference (2017). In our cover collaboration with Alesworth for this special issue of British Art Studies, we feature five details from his recent projects that suggest the range of different questions we may pose to landscapes, now

When the Sixties Didn't Swing

The thriving 1960s and 70s London art scene was arguably less receptive to artists from beyond Europe and the US. Panelists Rachel Garfield, Amna Malik, Hammad Nasar and Niru Ratnam discuss the impact on artists and art history. In association with Green Cardamom and Aicon Gallery. accessed 12/10/10 http://www.whitechapelgallery.org/shop/product/category_id/22/product_id/712?session_id=12869177789914d3c2bf512e91eae324080249b6a

Where Three Dreams Cross: 150 Years of Photography from India, Pakistan and Bangladesh

Exhibition catalogue produced to accompany the landmark exhibition at the Whitechapel Gallery: Where Three Dreams Cross. Co-published with Fotomuseum Winterthur and Steild, this publication gives an inside view of how modern India, Pakistan and Bangladesh have been shaped through the lens of their photographers. Like the exhibition, the catalogue is arranged over five themes with works selected from the last 150 years. 'The Portrait' shows the evolution of self-representation; 'The Family' explores close bonds and relationships through early hand-painted and contemporary portraits; 'The Body Politic' charts political moments, movements and campaigns; 'The Performance' focuses on the golden age of Bollywood, circus performers and artistic practices that engage with masquerade; while 'The Street' looks at the built environment, social documentary and street photography. Over 70 photographers including Pushpamala N., Rashid Rana, Dayanita Singh, Raghubir Singh, Umrao Singh Sher-Gil, Rashid Talukder, Ayesha Vellani and Munem Wasif are represented in the catalogue, with works drawn from important collections of historic photography, including the influential Alkazi Collection, Delhi and the Drik Archive, Dhaka. They join many previously unseen images from private family archives, galleries, individuals and works by leading contemporary artists. ISBN: 978-0-85488-179-6, softback, 288 pages, colour illustrations. Co-published by the Whitechapel Gallery, Fotomuseum Winterthur, and Steidl, 2010

Modelling and Mapping of Soil Erosion Susceptibility of Murree, Sub-Himalayas Using GIS and RS-Based Models

Soil erosion is one of Pakistan’s most serious environmental threats. This study used geospatial modelling to identify the distinct zones susceptible to soil erosion in Murree, Pakistan. Using a machine learning technique in the Google Earth engine (GEE) and Google Earth, we identified 1250 soil erosion events. The inventory (dependent variable) was separated into two datasets, one for training (70%) and one for testing (30%). Elevation, slope, aspect, curvature, stream, precipitation, LULC, lithology, soil, NDVI, and distance to road were prepared in ArcGIS and considered as independent variables in the current research. GIS and RS-based models such as WOE, FR, and IV were used to assess the relationship between both variables and produce soil erosion susceptibility maps. Finally, the Area Under Curve (AUC) approach was used to confirm the research results. According to the validation data, the SRC for WOE, FR, and IV were 88%, 91%, and 87%, respectively. The present study’s validation results show that the PRC for WOE, FR, and IV are 92%, 94%, and 90%, respectively. Based on the AUC validation approach, we determined that the FR model had the highest accuracy when compared to the other two techniques, the WOE and IV models. The current analysis and final susceptibility maps of soil erosion could be useful for decision-makers in the future to prevent soil erosion and its negative repercussions

Modelling and Mapping of Soil Erosion Susceptibility of Murree, Sub-Himalayas Using GIS and RS-Based Models

Soil erosion is one of Pakistan’s most serious environmental threats. This study used geospatial modelling to identify the distinct zones susceptible to soil erosion in Murree, Pakistan. Using a machine learning technique in the Google Earth engine (GEE) and Google Earth, we identified 1250 soil erosion events. The inventory (dependent variable) was separated into two datasets, one for training (70%) and one for testing (30%). Elevation, slope, aspect, curvature, stream, precipitation, LULC, lithology, soil, NDVI, and distance to road were prepared in ArcGIS and considered as independent variables in the current research. GIS and RS-based models such as WOE, FR, and IV were used to assess the relationship between both variables and produce soil erosion susceptibility maps. Finally, the Area Under Curve (AUC) approach was used to confirm the research results. According to the validation data, the SRC for WOE, FR, and IV were 88%, 91%, and 87%, respectively. The present study’s validation results show that the PRC for WOE, FR, and IV are 92%, 94%, and 90%, respectively. Based on the AUC validation approach, we determined that the FR model had the highest accuracy when compared to the other two techniques, the WOE and IV models. The current analysis and final susceptibility maps of soil erosion could be useful for decision-makers in the future to prevent soil erosion and its negative repercussions

Fantasies of the Library

"Fantasies of the Library lets readers experience the library anew. The book imagines, and enacts, the library as both keeper of books and curator of ideas--as a platform of the future. One essay occupies the right-hand page of a two-page spread while interviews scrolls independently on the left. Bibliophilic artworks intersect both throughout the book-as-exhibition. A photo essay, “Reading Rooms Reading Machines” further interrupts the book in order to display images of libraries (old and new, real and imagined), and readers (human and machine) and features work by artists including Kader Atta, Wafaa Bilal, Mark Dion, Rodney Graham, Katie Paterson, Veronika Spierenburg, and others." -- Publisher's website

Production and characterization of CuNiZnFe2O4 dispersed transformer and kerosene oil based magnetic nanofluids for heat transfer applications

This study produced nanofluids via a two-step method by dispersing copper–nickel–zinc (CuNiZnFe2O4) ferrite nanocomposites in transformer and kerosene oils. A sol–gel auto-combustion approach was adopted to synthesize ferrite nanoparticles. The prepared nanoparticles were analyzed through scanning electron microscopy, photoluminescence spectroscopy, and x-ray diffraction. The measured crystallite size varied between 11 and 13 nm. The SEM images show that the structures of the developed CuNiZn nanoparticles are irregular. The photoluminescence results give a bandgap of 1.91 eV and the emission lines of the nanoparticles. Transient hot wire analysis was performed to determine the thermal conductivity of the base fluid and the prepared nanofluids. It is observed that nanoparticles in the nanofluid enhance the heat transfer rate. It has been proven that CuNiZn/kerosene-based nanofluids have greater thermal conductivity than CuNiZn/transformer oil-based nanofluids. The viscosity of transformer oil-based nanofluids at room temperature is 12.53 mm2 s−1, which decreases to 12.49 mm2 s−1 at 40 °C. Similarly, the viscosity of kerosene-based nanofluids is 1.49 mm2 s−1 at room temperature and 1.16 mm2 s−1 at 40 °C. The sedimentation method revealed that CuNiZn/transformer oil-based nanofluids have greater stability than CuNiZn/kerosene-based nanofluids