Opioid prescribing trends in postpartum women: a multicenter study.

BACKGROUND: The postpartum period can be a particularly vulnerable time for exposure to opioid medications, and there are currently no consensus guidelines for physicians to follow regarding opioid prescribing during this period. OBJECTIVE: The purpose of this study was to evaluate inter- and intrahospital variability in opioid prescribing patterns in postpartum women and better understand the role of clinical variables in prescribing. STUDY DESIGN: Data were extracted from electronic medical records on 4248 patients who delivered at 6 hospitals across the United States from January 2016 through March 2016. The primary outcome of the study was postpartum opioid prescription at the time of hospital discharge. Age, parity, route of delivery, and hospital were analyzed individually and with multivariate analyses to minimize confounding factors. Statistical methods included χ RESULTS: The percentage of women prescribed postpartum opioids varied significantly by hospital, ranging from 27.6% to 70.9% (P CONCLUSION: Postpartum opioid prescription rates vary widely among hospitals, but providers within the same hospital tend to follow similar prescribing trends. The variation in prescribing found in our study illustrates the need for clear consensus guidelines for postpartum pain management

Activity and behaviour of lactating echidnas (Tachyglossus aculeatus multiaculeatus) from hatching of egg to weaning of young

Throughout their Australia-wide distribution, short-beaked echidnas breed during the winter months, i.e. June through early September. Actual duration of the female reproductive cycle, from attracting males and mating until weaning the young, can vary from 7 to 9 months depending on geographic location. Much of this variation is due to length of courtship and age of weaning the young. This paper presents data about the behaviour of free-ranging female echidnas on Kangaroo Island from egg laying through to weaning and compares it with findings from other areas. On Kangaroo Island, behaviour of lactating echidnas falls into two distinct phases: (1) while carrying the young in the pouch; and (2) after the young is placed in a nursery burrow. Females significantly increased both the number of hours active each day as well as the size of area utilised after the young was in the nursery. Although types of nursery burrows are similar throughout Australia, duration of use and frequency visited varies between geographic locations. A major difference is that Kangaroo Island echidnas are often active while carrying either the egg or the young in the pouch and echidnas in other regions remain in a burrow for extended periods.Peggy D. Rismiller and Michael W. McKelve