Family, marriage and social change in some Libyan villages.

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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

Bulk Heterojunction Tandem Photoelectric Cell Based on p-Si and Phthalocyanine

An organic-inorganic (p-Si and phthalocyanine) hybrid tandem heterojunction Ag/p-Si/AlPc:H2Pc/ITO photoelectric cell was fabricated by pressing technology using preliminary vapor deposited heterojunction films of mixed aluminum-phthalocyanine (AlPc) and metal free phthalocyanine (H2Pc) on p-Si substrate and on ITO coated plastic substrate. By keeping organic films face to face both substrates were pressed and fixed together by adhesive at elevated temperature. Total thickness of the AlPc and H2Pc films were equal to 300 nm. On the back side of p-Si substrate the Ag film was deposited. The device architecture was the following: Ag/p-Si/AlPc:H2Pc/ITO. The morphology of the organic semiconductors film was investigated by AFM. The optical properties of the AlPc:H2Pc film were studied by UV-visible spectroscope. Current-Voltage characteristics were measured in dark and also illumination conditions. Under illumination of 296 W/m(2) the values of V-oc, I-SC, FF and efficiency were equal to 0.5 V, 4 mA, 0.45 and 0.61 %, respectively. The I-V and P-V characteristics of the solar cell were simulated by using Shockley equation and its Newton Raphson solution, respectively for dark and illumination conditions. The obtained simulated results were in good agreement with the experimental results