Search Results (8)

Background/Objectives: While anterior lumbar interbody fusion (ALIF) is a well-established treatment for degenerative lumbar spine pathology, the timing and pace of postoperative recovery remain poorly defined. Understanding these temporal trends is clinically important for setting patient expectations and optimizing postoperative care. Methods: This retrospective single-institution study evaluated functional recovery in patients undergoing primary, single-level stand-alone (SA) ALIF, or with percutaneous posterior instrumentation (PI). Patient-reported outcome measures (PROMs), including the Oswestry Disability Index (ODI), the Visual Analog Scale (VAS) for back and leg pain, and the SF-12 Physical Component Score (PCS), were assessed preoperatively and at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, and 2 years postoperatively. Achievement of minimum clinically important difference (MCID), global rating change (GRC), and return-to-activity milestones were also analyzed. Results: A total of 143 patients were included (90 SA; 53 PI). PROMs showed significant improvement through 1 year. VAS-back improved by 2 weeks, while ODI and SF12 PCS initially worsened but improved after 6 weeks. By 6 months, over half of the cohort achieved MCID, with continued gains through 1 year. Most patients returned to driving and work, and over 90% discontinued narcotics. Recovery trajectories were comparable between groups, despite early delays in the instrumented cohort. Conclusions: These findings provide time-specific recovery benchmarks that can guide surgical decision-making, patient education, and expectations around functional milestones. Full article

Introduction: Novel psychoactive substances (NPSs) are substances not controlled by the United Nations’ 1961 Narcotic Drugs and 1971 Psychotropic Substances convention, which pose a threat to public health. The use of NPSs is growing among recreational drug users. NPSs mimic the effects of the existing illegal drugs; they are used as substitutes for the traditional drugs of use. NPSs are commonly marketed as safe substances. NPS abuse is especially risky among vulnerable individuals, such as children and adolescents. The Aim: This study aims to analyze the knowledge and attitudes of primary and high school students regarding NPSs, determining the frequency and patterns of NPS use, and examine motivational factors for their consumption. Methodology: The questionnaire was employed to primary and secondary school students of the city of Novi Sad in November 2024. The data were analyzed using the methods of descriptive and inferential statistics in the statistical software package JASP 0.18.1.0. Results: A total of 1095 participants took part in the survey (53.6% males and 46.4% females). The age range of participants was 11–18 years (mean age 14.637 years). The majority of pupils lived in the city (70.5%). The most numerous students were students with the highest overall grade. The proportion of students who were familiar with NPSs was 38.3%, while 61.7% of them were not aware of their existence. Living in cities correlated positively with the NPS knowledge. The NPS risk awareness was notably low. The proportion of students who tried one or more novel drugs was 1.918%. Conclusions: The abuse of novel psychoactive substances is a growing concern, particularly among young individuals, requiring increased awareness and education on their risks. Educational systems should provide accurate information to prevent false beliefs, while policymakers must legally regulate new drugs. A coordinated approach is crucial for effective prevention, involving education, media, and support from different organizations. Future studies should focus on the impact of education on attitudes towards NPSs. Full article

Background/Objectives: The objective of this study was to determine whether preoperative opioid education reduces opioid consumption after spine surgery and which educational methods are the most effective. Orthopedists are the most likely to prescribe opioids among all specialists. To alleviate the prescription opioid crisis, studies have identified ways to taper narcotic dosage and use following surgery. The role of preoperative education and its varying modalities on opioid consumption following spine surgery has yet to be reported in the literature. Methods: The study group received formal education describing the use of opioids, side effects, and alternatives to pain management. Patients were to choose their preferred modality of a 2 min narrated video and two handouts to be watched and read in their individual time, attending a small class led by a physician assistant where they watched the 2 min narrated video along with reading the two handouts or receiving a one-on-one session with the treating spine surgeon. Meanwhile, the control group received standard preoperative education. Refill prescriptions were collected from patients’ electronic medical record charts at the 2-week, 1-month, 3-month, and 6-month postoperative follow-ups. The primary outcome measure was morphine equivalents (MME) of prescription opioids at six months following spine surgery. Results: At 2 weeks postoperatively, there were no statistically significant differences between patients who received any formal narcotic education and those who did not. At 1 and 3 months postoperatively, the video education group (p-value < 0.001), class education group (p-value < 0.001), and the one-on-one education group (p-value < 0.05) all had significant reductions in opioid consumption. At 6 months postoperatively, only the video education group (p-value < 0.001) and the class education group (p-value < 0.01) had significant reductions in opioid consumption. Conclusions: A two-fold approach with a video and handouts significantly decreases the prescription dosage at six months postoperatively and allows for early opioid cessation after undergoing spine surgery. Full article

Inflaming public opinion about narcotics was the collective goal of anti-narcotics organizers who emerged from the battlefields of the war on alcohol. The most famous was Richmond P. Hobson, who used newspapers, radio, pamphlets, speaking tours, and networking with civic organizations to agitate for reform. This article draws on archival and newly accessible electronic sources to draw a picture of Hobson’s anti-narcotics propagandizing and put it in historical context. Full article

An uncomplicated appendectomy in children is common. Safely minimizing the post-operative length of stay is desirable from hospital, patient, and parent perspectives. In response to an overly long mean length of stay following uncomplicated appendectomies in children of 2.5 days, we developed clinical pathways with the goal of safely reducing this time to 2.0 or fewer days. The project was conducted in an urban, academic children’s hospital. The pathways emphasized the use of oral, non-narcotic pain medications; the education of parents and caregivers about expectations regarding pain control, oral food intake, and mobility; and the avoidance of routine post-operative antibiotic use. A convenience sample of 46 patients aged 3–16 years old was included to evaluate the safety and efficacy of the intervention. The mean post-operative length of stay was successfully reduced by 80% to 0.5 days without appreciable complications associated with earlier discharge. The hospital length of stay following an uncomplicated appendectomy in children may be successfully and safely reduced through the use of carefully devised, well-defined, well-disseminated clinical pathways. Full article

The purpose of this article is to provide a new understanding of the essence of inclusive educational spaces as a pedagogical phenomenon that presents different scientific approaches to the concept of educational space, and the importance of interpersonal interactions in educational spaces, and also presents the authors’ interpretations of their essence. The analytical basis is a literature review of various studies from the domains of symbolic interactionism, social constructivism, ethnomethodology, the sociology of knowledge, education, pedagogy and social pedagogy. Empirical sequences in the reviewed literature that exemplify inclusive educational spaces are derived from the organisational and practical work of compulsory and upper-secondary schools related to newly arrived students and students who use alcohol and narcotics, and from the context of the organisational and practical work of universities related to the education of future actors. The importance of recognizing the role of creative educational spaces as a leading requirement for the preparation of students for future communicative interactions in professional communication is revealed, and the structural characteristics of these spaces’ content and functional load are provided. Inclusive educational spaces and professionals’ inclusive approach demand that schools practically and collaboratively organise work with students in the educational space, show support for them and give them room to manoeuvre to ensure that professional actors in the school and university thrive in their practical work with students, both in relation to the expected normative right and deviant acting in the educational space and in relation to laws and governing documents that, to a certain extent, govern practical work in these educational spaces. The study contributes to the development of knowledge regarding (1) dealing with social interaction and inclusive educational spaces combining (a) the experiences of students in educational space, (b) the experiences of professional actors in educational space, and (c) the development of integration and social pedagogical recognition in educational space; (2) the significance of these social interactions and inclusive educational spaces in the creation and recreation of students’ and professionals’ identities; and (3) alternative social pedagogical approaches to analysing inclusive educational spaces in compulsory, upper-secondary and post-secondary education. Full article

Objective: The objectives of this study are to describe opioid stewardship practices in hospitals being implemented globally, in addition to investigating the attitudes and perceptions of health professionals regarding opioid stewardship in the hospital setting. Methods: A survey was developed by the research team to ask about participants’ attitudes and perceptions regarding opioid stewardship practices. The survey was piloted for performance by five independent third-party healthcare professionals prior to being made available online, being hosted using Research Electronic Data Capture software, with invitations distributed by the International Pharmaceutical Federation (FIP). Descriptive analyses were used to describe the features of the study, and responses obtained from the survey were further categorised into subgroups separating answers relating to attitudes and perceptions, and policies and regulations. Results: Overall, there were 50 respondents from 18 countries, representing an 8% response rate from the FIP hospital pharmacy section mailing list. In total, 33/50 (66%) participants agreed opioids are overused nationally, with 22/49 (45%) agreeing they are overused at their workplace. Furthermore, 32/50 (64%) agreed the opioid crisis is a significant problem nationally, and 44/50 (88%) agreed opioid stewardship would reduce problems associated with the opioid crisis. Policies to educate providers about safe opioid prescribing were uncommon, not exhibited in 26/46 (57%) of hospitals, with all EMR and SE Asia hospitals not displaying this policy. Policy for investigation of narcotic discrepancies was present in 34/46 (74%) of hospitals, and there was a policy for reporting discrepancies at 33/46 (72%) hospitals. Conclusion: In conclusion, healthcare professionals in the American region are more likely to perceive the opioid crisis as a problem, as opposed to those from the European region. Regardless of the presence or absence of a crisis, the implementation of further opioid education and stewardship practices are necessary globally and will contribute to safer prescribing and utilisation practices in hospitals. Full article

Pain is a challenge for orthopedic healthcare professionals (OHCP). However, pain studies examined the competencies of a single OHCP category, did not consider various pain management domains or barriers to optimal pain service, and are deficient across the Arabic Eastern Mediterranean region. We surveyed OHCP’s recognition and knowledge of pain and perceived barriers to optimal pain service (361 OHCP, five hospitals). Chi square compared doctors’ (n = 63) vs. nurses/physiotherapists’ (n = 187) views. In terms of pain recognition, more nurses had pain management training, confidently assessed pediatric/elderly pain, were aware of their departments’ pain protocols, and felt that their patients receive proper pain management. More doctors comfortably prescribed opiate medications and agreed that some nationalities were more sensitive to pain. For pain knowledge, more nurses felt patients are accurate in assessing their pain, vital signs are accurate in assessing children’s pain, children feel less pain because of nervous system immaturity, narcotics are not preferred due respiratory depression, and knew pre-emptive analgesia. As for barriers to optimal pain service, less nurses agreed about the lack of local policies/guidelines, knowledge, and skills; time to pre-medicate patients; knowledge about medications; complexity of the clinical environment; and physicians being not comfortable prescribing pain medication. We conclude that doctors required confidence in pain, especially pediatric and geriatric pain, using vital signs in assessing pain and narcotics use. Their most perceived barriers were lack of local policies/guidelines and skills. Nurses required more confidence in medications, caring for patients on narcotics, expressed fewer barriers than doctors, and the complexity of the clinical environment was their highest barrier. Educational programs with clinical application could improve OHCPs’ pain competencies/clinical practices in pain assessment and administration of analgesics. Full article