Association of opioid exposure during intensive care unit stays with post-discharge opioid use: A retrospective study and literature review.

OBJECTIVE: To evaluate whether pain management strategies within intensive care unit (ICU) settings contribute to chronic opioid use upon hospital discharge in opioid-naive patients requiring invasive mechanical ventilation. DESIGN: A retrospective, observational study. SETTING: An 18-bed mixed ICU at a community teaching hospital located in Brooklyn, New York. PARTICIPANTS: This study included mechanically ventilated patients requiring continuous opioid infusion from April 25, 2017 to May 16, 2019. Patients were excluded if they received chronic opioid therapy at home or expired during this hospital admission. Eligible patients were identified using an electronic health record data query. MAIN OUTCOME MEASURE(S): The proportion of ICU patients who continued to require opioids upon ICU and hospital discharge. RESULTS: A total of 196 ICU patients were included in this study. Of these, 22 patients were transferred to a regular floor while receiving a fentanyl transdermal patch. However, the fentanyl patch treatment was continued only for three patients (2 percent) at hospital discharge. CONCLUSIONS: This retrospective study suggested that high-dose use of opioids in mechanically ventilated, opioid-naive ICU patients was not associated with continued opioid use upon hospital discharge.

The effects of green growth, environmental-related tax, and eco-innovation towards carbon neutrality target in the US economy.

This study aims to examine the nexus between green growth and carbon neutrality targets in the context of the USA while observing the role of ecological innovation, environmental taxes, and green energy. For this purpose, data were collected from 1970 to 2015 for all the variables of interest. This research utilized the quantile autoregressive distributed lag (QARDL) method due to its various benefits, such as depicting the causality patterns based on different quantiles for different variables like green growth, ecological innovation, environmental taxes, and renewable energy. The findings through the QARDL method showed that the error correction coefficient was significant and negative with the expected negative sign for the different quantiles. The findings showed a significant and negative impact of green growth, square of green growth, ecological innovation, and environmental taxes in determining the carbon dioxide (CO2) emissions for the USA's economy under the long-run estimation. Meanwhile, the outcome for the short-term estimation confirmed that the past and lagged values of CO2 emission were significantly and negatively linked with the current and lagged values of CO2 emission. On the other hand, it was found that green growth and square of green growth, ecological innovation, environmental taxes, and renewable energy played their vital role in reducing haze pollution like PM2.5. Besides, this research also covers the limitations and policy implications.

Impact of Perceived Severity of COVID-19 (SARS-COV-2) on Mental Health of University Students of Pakistan: The Mediating Role of Muslim Religiosity.

Background: Perceived severity of COVID-19 (SARS-COV-2) is known to be associated with mental health of people in general and health professionals in particular in Western societies. However, its association with the mental health of students in Pakistan, which is predominantly a Muslim society, remains unclear so far. Moreover, the role of Muslim religiosity for such an association has not yet been investigated. We aimed to examine the association and report findings on the impact of perceived severity on mental health with a sample of students from all five provinces of Pakistan. Methods: We did a cross-sectional online survey from 1,525 Pakistani students in March 2020 using standardized measurement tools. We then determined the prevalence of perceived severity among students and its impact on their mental health. The strength of associations between these variables was estimated using generalized linear models, with appropriate distribution and link functions. Structural equation modeling through SmartPLS (3.0) software was utilized to analyze the results. Findings: The perceived severity of COVID-19 is significantly associated with mental health of Pakistani students, whereas Muslim religiosity is a strong mediator between perceived severity and mental health of Pakistani students. Conclusions: Though the perceived severity of COVID-19 is associated with mental health, this relationship can be better explained by the role of Muslim religiosity. When tested individually, the perceived severity accounted for only 18% variance in mental health that increased up to 57% by the mediating role of Muslim religiosity. This difference clearly indicates the mediating role of Muslim religiosity in the association between perceived severity and mental health for Pakistani students.