The illness perceptions of patients with percutaneous coronary intervention compared to patients with no percutaneous intervention, for acute myocardial infarction, in cardiac rehabilitation.

Purpose: Patients who receive percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) have been found to have low attendance at cardiac rehabilitation (CR). It has been suggested that this is because PCI patients have a benign perception of their coronary disease; however, this has never been quantitatively investigated. The aim of this prospective study was to evaluate the illness perceptions (IP) of patients with AMI treated with PCI.

No place for routine use of modified-release opioids in postoperative pain management.

Modified-release opioid tablets were introduced into surgical practice in the belief that they provided superior pain relief and reduced nursing workload, and they rapidly became embedded into many perioperative pathways. Although national and international guidelines for the management of postoperative pain now advise against the use of modified-release opioids, they continue to be prescribed in many centres. Recognition that modified-release opioids show lack of benefit and increased risk of harm compared with immediate-release opioids in the acute, postoperative setting has become clear.

Current Issues in the Use of Opioids for the Management of Postoperative Pain: A Review.

Importance: Uncontrolled and indiscriminate prescribing of opioids has led to an opioid crisis that started in North America and spread throughout high-income countries. The aim of this narrative review was to explore some of the current issues surrounding the use of opioids in the perioperative period, focusing on drivers that led to escalation of use, patient harms, the move away from using self-reported pain scores alone to assess adequacy of analgesia, concerns about the routine use of controlled-release opioids for the management of acute pain, opioid-free anesthesia and analgesia, and prescription of opioids on discharge from hospital.

Observations: The origins of the opioid crisis are multifactorial and may include good intentions to keep patients pain free in the postoperative period.

The opioid epidemic from the acute care hospital front line.

Prescription opioid use has risen steeply for over two decades, driven primarily by advocacy for better management of chronic non-cancer pain, but also by poor opioid stewardship in the management of acute pain. Inappropriate prescribing, among other things, contributed to the opioid 'epidemic' and striking increases in patient harm. It has also seen a greater proportion of opioid-tolerant patients presenting to acute care hospitals.

Australian experience with total pancreatectomy with islet autotransplantation to treat chronic pancreatitis.

Background: This study aimed to describe the clinical outcomes of total pancreatectomy with islet autotransplantation (TP-IAT) in Australia.

Methods: Individuals selected for TP-IAT surgery according to the Minnesota Criteria (Appendix) without evidence of diabetes were evaluated including time to transplantation from pancreatectomy, islet numbers infused and post-transplantation HbA1c, C-peptide, total daily insulin and analgesic requirement.

Results: Sixteen individuals underwent TP-IAT from Australia and New Zealand between 2010 and 2020.

An international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients.

This international multidisciplinary consensus statement was developed to provide balanced guidance on the safe peri-operative use of opioids in adults. An international panel of healthcare professionals evaluated the literature relating to postoperative opioid-related harm, including persistent postoperative opioid use; opioid-induced ventilatory impairment; non-medical opioid use; opioid diversion and dependence; and driving under the influence of prescription opioids. Recommended strategies to reduce harm include pre-operative assessment of the risk of persistent postoperative opioid use; use of an assessment of patient function rather than unidimensional pain scores alone to guide adequacy of analgesia; avoidance of long-acting (modified-release and transdermal patches) opioid formulations and combination analgesics; limiting the number of tablets prescribed at discharge; providing deprescribing advice; avoidance of automatic prescription refills; safe disposal of unused medicines; reducing the risk of opioid diversion; and better education of healthcare professionals, patients and carers.

Contracting Students for the Reduction of Foreign Language Classroom Anxiety: An Approach Nurturing Positive Mindsets and Behaviors.

The quasi-experimental study reported in this paper investigated whether contracting students' speaking in the foreign language (FL) classroom could effectively mitigate their FL classroom anxiety. It also explored the working mechanisms of this approach to the reduction of classroom anxiety and examined the attitudes FL students had toward it. To these ends, 42 Chinese-as-the-first-language university students learning English as a foreign language (EFL) were recruited and placed into the experimental ( = 20) and comparison groups ( = 22).

Management of Opioid-Tolerant Patients with Acute Pain: Approaching the Challenges.

For over two decades, dramatic increases in opioid prescriptions in the developed world, especially for long-term management of chronic noncancer pain, were accompanied by increases in patient harm. In recent years in the USA, opioid-related deaths rates have continued to increase despite falls in prescribing rates and deaths associated with prescription opioids. In large part, this is attributed to the growing availability of illicitly manufactured fentanyl.

A Meta-analysis of L2 Willingness to Communicate and Its Three High-Evidence Correlates.

Willingness to communicate (WTC) has been considered an important part of the language learning and communication process, playing a pivotal role in the development of language learners' communicative competence. Many studies have been conducted on the relationship between WTC and related variables in learning English as a foreign language. However, there is a lack of a comprehensive meta-analysis concerning the effect sizes of these studies.

Impact of ecological redundancy on the performance of machine learning classifiers in vegetation mapping.

Vegetation maps are models of the real vegetation patterns and are considered important tools in conservation and management planning. Maps created through traditional methods can be expensive and time-consuming, thus, new more efficient approaches are needed. The prediction of vegetation patterns using machine learning shows promise, but many factors may impact on its performance.

An observational study of perioperative risk associated with aortic stenosis in non-cardiac surgery.

This prospective multicentre observational study investigated the risk of non-cardiac surgery in patients with moderate or severe aortic stenosis (AS). Patients with AS undergoing non-cardiac surgery in five New Zealand hospitals between August 2011 and September 2015 were studied. Preoperative variables were analysed for a significant association with postoperative major adverse cardiac events (MACE) and 30-day mortality.

A retrospective observational study of patients with dilated cardiomyopathy undergoing non-cardiac surgery.

The perioperative risks and factors associated with adverse cardiac outcomes in patients with dilated cardiomyopathy undergoing non-cardiac surgery are unknown. Interrogation of the Nelson Hospital transthoracic echocardiogram database identified 127 patients with dilated cardiomyopathy who satisfied the study criteria and underwent non-cardiac surgery between June 1999 and July 2013. Demographic and clinical data along with postoperative death within 30 days or a major adverse cardiac event were retrieved and analysed.

A randomized controlled trial of postoperative analgesia following total knee replacement: transdermal Fentanyl patches versus patient controlled analgesia (PCA).

Background: This randomized controlled trial compared a standard patient controlled analgesic (PCA) regime with a transdermal and oral Fentanyl regime for post-operative pain management in patients undergoing total knee replacement.

Methods: One hundred and ninety-six patients undergoing total knee replacement were recruited. Pre- and post-operatively Visual Analogue Score (VAS), Oxford Knee Score, Health Anxiety and Depression Score and Brief Pain Inventory Score were completed.

Costs and consequences: a review of discharge opioid prescribing for ongoing management of acute pain.

Over recent years there has been a growing need for patients to be sent home from hospital with prescribed opioids for ongoing management of their acute pain. Increasingly complex surgery is being performed on a day-stay or 23-hour-stay basis and inpatients after major surgery and trauma are now discharged at a much earlier stage than in the past. However, prescription of opioids to be self-administered at home is not without risk.