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

Awareness about production technology

Not AvailableThe findings regarding the level of awareness of the farmers about recommended cotton production technology, the majority of the respondent who were found in high awareness category, like field preparation (63.20%), time of sowing practices (49.60%) and method of sowing (64%), whereas medium awareness were found in practices like irrigation management (55.20%) and method of weed control (41.60%) while awareness were found in practices like improved varieties (58.40%), seed rate (54.40), seed treatment (69.40), recommended dose of the chemical fertilizer (55.20%) , and plant production (46.40%). Regarding the adoption of the farmers about recommended cotton production technology, the majority of the respondent who were found in high adoption category, like field preparation (55.20%), time of sowing practices (48.80%) and method of sowing (58.40%), whereas medium adoption were found in practices like irrigation management (53.60%) and method of weed control (40%) while adoption were found in practices like improved varieties (52%), seed rate (48.80%), seed treatment(64.80%), recommended dose of the chemical fertilizer (55.20%) and plant production (46.40%).Not Availabl

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Not AvailableThe present study was carried out in the purposively selected arid region of Rajasthan. A multistage stratified random sampling design was used to select the districts, blocks, villages and sample households. A sample of 240 households was selected for the present study. Data were collected personally through a well structured and pre-tested interview schedule. It was found that majority of the households (66.25%) were initially providing self medication using traditional practices and in cases of severity of disease/ailment, village quack was consulted. Vaccination of goat was followed in only 48.75 % of the selected households. In addition, only 36 households (31.25%) the sick animals were isolated from the flock. A variety of traditional practices were observed being followed for treatment of various ailments and diseases of the goat with the use of locally available material, herbs, etc.Not Availabl

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Not AvailableInformation sources and channels are the essence of extension, which provides knowledge and information for rural people to modify behaviour in ways that provide sustainable benefit to them and to society in general. These communication technologies serve both as direct information channels to farmers and as indirect channels improving extension agents, agribusinesses and other intermediaries access to information resources. The study was conducted by interviewing randomly selected 120 farmers of the Sumerpur panchayat samiti were having highest contact to development departments. It was found that the sources which were most utilized by the farmers were neighbours (3.20 MS), private agencies (2.78 MS), friends (1.97 MS), agriculture supervisors (1.90 MS) and progressive farmers (1.69 MS), whereas the least utilized sources by the farmers were agriculture graduates (0.0.57 MS), ATIC (0.77 MS) and NGOs (0.33 MS). It was further found that the channels which were most utilized by the farmers were group discussion (3.43 MS), group meetings (2.80 MS), television (2.44 MS), radio (2.10 MS), news paper (1.90 MS) and farmer's training (1.79 MS), whereas the least utilized channels by the farmers were literature (1.11 MS), posters/charts/circulars (0.90 MS) and field day/field visit (0.66 MS).Not Availabl

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Not AvailableThe study in total 40 frontline demonstrations were conducted on farmers’ fields in villages viz., Kishanagar, Bedkallan, Boyal, Kushalpura and Balara of Pali district during 2015, 2016 and 2017, to demonstrate production potential and economic benefit of improved technologies comprising sowing method, nutrient management and chemical weed control and adoption of whole package of practices for the crop. After sowing application (within two days of sowing) of weedicide Pendimethalin at 1.0 kg/ha in 500 liters of water used for effective control of the weeds during kharif season in rainfed condition. The findings of the study revealed that improved technology recorded a mean yield of 982 kg/ha which was 35.5% higher than obtained with farmers’ practice (755 kg/ha). Higher mean net income of Rs. 46030/ha with a Benefit: Cost ratio of 4.3 was obtained with improved technologies in comparison to farmers’ practices (Rs. 38775/ha). The frontline demonstrations conducted on greengram at the farmers’ field revealed that the adoption of improved technologies significantly increased the yield as well as yield attributing traits of crop and also the net returns to the farmers. So, there is a need to disseminate the improved technologies among the farmers with effective extension methods like training and demonstrations. The farmers’ should be encouraged to adopt the recommended package of practices realizing for higher returns.Not Availabl

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Not AvailableAgriculture can be an important engine of growth and poverty reduction. Women’s contribution to the farming sector in respect of participation and decision making has largely been ignored. Though women performed more than four-fifth of agriculture work, their decision were accepted only less than one-third of the case. The present study was attempted to ascertain the extent of participation and decision making pattern of farm women in agricultural activities. The present study was carried out in villages of Pali district of Rajasthan by selecting 120 Farm women. The findings of the study revealed that more number of farm women found to have high level of participation in agricultural operation 53.57 per cent followed by the medium participation (33.73%) and low participation (15.20%) in agricultural operations, respectively. The study also revealed that the higher number of farm women (57.11%) were observed in low category of decision making which was followed by 27.74 per cent and 15.15 per cent, respectively in case of medium and high decision making process. Study further revealed that age, education, size of family, size of land holding, social participation, extension participation, information seeking behaviour, cosmoploteness, economic motivation, exposure to training and management orientation factors had significantly influenced the participation and decision making pattern of farm women. The study also revealed that the socio-economic factors found to influence the agriculture operation and decision making of farm women positively and significantly.Not Availabl

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Not AvailableThere was significant difference in adoption levels between different categories of respondents with regard to breeds and breeding, feeding and management practices of goat rearing. The overall extent of adoption in general was found to be highest in large flock owners followed by medium and small flock owners.Not Availabl

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Not AvailableWomen play a vital role in advancing agricultural development, food security and nutritional outcomes. They participate in all aspects of rural life, including paid employment, trade and marketing, as well as raising crops and animals, collecting water and wood for fuel and caring for family members. But women face multiple constraints in many of the activities they pursue that limit their productivity. Relative to men, women tend to own less land, have limited ability to hire labour and have impeded access to credit, extension and other training services. They started to work in almost all fields like men and are equal to men. Inspite of the various measures taken up by the government after independence women haven't been fully empowered. The ground reality is deprivation and exploitation of women specially women from rural areas and those belonging to deprived sectors of the society. The study was conducted in Pali district. For this study, 160 rural women were selected and gathered information through structured interview schedule. The results of the study revealed that, majority of the women participated regularly in activities like sowing operations, weeding and intercultural operations, harvesting and post harvesting operations and animal husbandry activities. Major per cent of them participated in training demonstrations on vermiculture training and dairy training. Majority of the women perceived that losses at storage (due to storage pests attack), pests and diseases attack are the major causes for food grain losses. Empowerment of women in agriculture field is one of the major strategies for achieving food security. Hence, there is a need for empowerment of women in terms of social, cultural, economical and educational dimensions to play an important role in the overall development of the country. There is a need for empowerment of farm women to take care of food production and post harvest production losses for global food security through extension strategies.Not Availabl

Ethnoveterinary medicines used by goat keepers in Marwar region of Rajasthan, India

454-460The present study was carried out in the purposively selected arid region of Rajasthan. A multistage stratified random sampling design was used to select the districts, blocks, villages and sample households. A sample of 240 households was selected for the present study. Data were collected personally through a well structured and pre-tested interview schedule. It was found that majority of the households (66.25%) were initially providing self medication using traditional practices and in cases of severity of disease/ailment, village quack was consulted. Vaccination of goat was followed in only 48.75 % of the selected households. In addition, only 36 households (31.25%) the sick animals were isolated from the flock. A variety of traditional practices were observed being followed for treatment of various ailments and diseases of the goat with the use of locally available material, herbs, etc

MEDICINAL PLANTS USED IN POSTNATAL CARE

Not AvailablePali district of Rajasthan has powerful traditional practices in which plants play a key role. The present study endeavour to investigate and document the various medicinal plants used as traditional method of postnatal care of mother and children. A total of 120 rural women from randomly selected villages within the age group of 27 to 45 years were interviewed. The investigation revealed that 27 species of ethno medicinal plants were recorded belonging to 20 families used by the rural people of Pali district, Rajasthan for postnatal care practices. These medicinal plants were used as nutritious and medicinal preparations for postnatal care in the form of powder, decoction, laddu or haluwa etc. The mixture of different plant parts were also used for preparations. Most of the rural women (70 to 95%) used ethno medicinal preparation that is, dried ginger (Zingiber officinale) mixture, carom seed (Trachyspermum ammi), laddu, haluwa, edible gum (Allium sativum) laddu, harrira, fenugreek (Trigonella foenum-graecum) seed laddu just after delivery. Some of the popular formulations of carom, turmeric (Curcuma longa), nutmeg (Myristica fragrans), cloves (Syzygium aromaticum), garlic (Allium sativum) and asafoetida (Ferula assafoetida) were used by ninety percent rural women to give comfort to the baby from digestive disorders and cold and cough. These practices if unified with modern healthcare system could promote the health status of thousands of women and their neonateNot Availabl