Spatial analysis of G.f.fuscipes abundance in Uganda using Poisson and Zero-Inflated Poisson regression models

What evidence is needed to inform postoperative opioid consumption guidelines? A cohort study of the Michigan Surgical Quality Collaborative

INTRODUCTION

To balance adequate pain management while minimizing opioid-related harms after surgery, opioid prescribing guidelines rely on patient-reported use after surgery. However, it is unclear how many patients are required to develop precise guidelines. We aimed to compare patterns of use, required sample size, and the precision for patient-reported opioid consumption after common surgical procedures.

METHODS

We analyzed procedure-specific 30-day opioid consumption data reported after discharge from 15 common surgical procedures between January 2018 and May 2019 across 65 hospitals in the Michigan Surgical Quality Collaborative. We calculated proportions of patients using no pills and the estimated number of pills meeting most patients' needs, defined as the 75th percentile of consumption. We compared several methods to model consumption patterns. Using the best method (Tweedie), we calculated sample sizes required to identify opioid consumption within a 5-pill interval and estimates of pills to meet most patients' needs by calculating the width of 95% CIs.

RESULTS

In a cohort of 10,688 patients, many patients did not consume any opioids after all types of procedures (range 20%-40%). Most patients' needs were met with 4 pills (thyroidectomy) to 13 pills (abdominal hysterectomy). Sample sizes required to estimate opioid consumption within a 5-pill wide 95% CI ranged from 48 for laparoscopic appendectomy to 188 for open colectomy. The 95% CI width for estimates ranged from 0.7 pills for laparoscopic cholecystectomy to 7.0 pills for ileostomy/colostomy.

CONCLUSIONS

This study demonstrates that profiles of opioid consumption share more similarities than differences for certain surgical procedures. Future investigations on patient-reported consumption are required for procedures not currently included in prescribing guidelines to ensure surgeons and perioperative providers can appropriately tailor recommendations to the postoperative needs of patients.

Intensity of adaptations to heat stress in poultry farms: A behavioural analysis of farmers in Ondo state, Nigeria

The detrimental consequences of heat stress due to high ambient temperatures, particularly in the poultry industry, have led to the invention of several adaptation strategies. However, there is still limited information on the intensity of adaptations and the likely behavioural factors that influence farmers' decisions. Thus, understanding the practical adaptation behaviours of poultry farmers would improve our knowledge of the fundamental mechanisms for developing effective interventions. To fill this void, using a count data model, the study empirically examines the farmers' behavioural factors and the intensity of heat stress adaptation strategies' adoption among poultry farmers in Ondo State, Nigeria. The data were drawn from a survey of 150 poultry farmers using a multistage sampling procedure. The empirical results show that the majority of the farmers perceived an increase in temperature, frequently experienced heat stress, and believed that heat stress is induced by climate change. An average of six adaptation strategies were simultaneously adopted to mitigate heat stress in the area. The results of the count regression model reveal that farm-level factors such as permanent water sources, the quantity of feed, and bird stock density exert a significant effect on the intensity of adaptations. Climate-related factors such as access to climate information, training participation, perceived increases in temperature, attitudes toward climate change, and motives for adoption have a significant behavioural effect on the intensity of adaptations. Likewise, variables such as poultry farming experience, educational status, and access to credit are accounted for as socioeconomic behavioural factors that influence the intensity of adopting heat stress adaptation strategies in the area. This concludes that behavioural factors are crucial in addressing heat stress adaptations and assisting in improving environmental management, which would form a key variable in the policy interventions.