Opioid misuse is now considered a major public health epidemic in North America, with substantial social and financial consequences. As well as socio-economic and commercial drivers, modifiable risk-factors that have resulted in this crisis have been identified. The purpose of this study was to identify whether, within England, modifiable drivers for persistent postoperative opioid use were present. This was a retrospective cohort study of practice at 14 National Health Service hospitals across England. Data were collected retrospectively and validated for adult patients undergoing elective intermediate and major or complex major general surgical procedures between 1 and 31 March 2019. Of the 509 patients enrolled from 14 centres, 499 were included in the data analysis. In total, 31.5% (157/499) patients were in the intermediate surgery cohort and 68.5% (342/499) were in the major or complex major surgery cohort, with 21.0% (33/157) and 21.6% (74/342) discharged with opioid medicines to be taken at regular intervals, respectively. There were similar median oral morphine equivalent doses prescribed at discharge. Of patients prescribed regular opioid medicines, 76.6% (82/107) had a specified duration at discharge. However, 72.9% (78/107) had no written deprescribing advice on discharge. Similarly, of patients prescribed 'when required' opioids, 59.6% (93/156) had a specified duration of their prescription and 33.3% (52/156) were given written deprescribing advice. This study has identified a pattern of poor prescribing practices, a lack of guidance and formal training at individual institutions and highlights opportunities for improvement in opioid-prescribing practices within England. Labor induction rates are increasing and, in Finland today, one of three labors is induced. Group B streptococcus (GBS) is a bacterium found in 10%-30% of pregnant women and it can be transmitted to the neonate during vaginal delivery. Although GBS is rarely harmful in the general population, it is the leading cause of severe neonatal infections such as sepsis, pneumonia, and meningitis. In addition, GBS can cause maternal morbidity. Labor induction in GBS-positive women has not yet been investigated but concerns of infectious morbidity associated with balloon catheters have been raised. A historical cohort study of 1959 women undergoing labor induction by balloon catheter in Helsinki University Hospital, Finland, between January 1, 2014 and December 31, 2017. Women with viable singleton term pregnancy in cephalic presentation, unfavorable cervix (Bishop score <6), and intact amniotic membranes were included. GBS was screened by rapid qualitative in vitro test (XPert GBS) from vaginal and perineal cual intrapartum infection were associated with neonatal infection. Regarding maternal and neonatal infectious morbidity, labor induction with balloon catheter appears safe in women colonized with GBS when prophylactic antibiotics are administered at the onset of labor or at membrane rupture. Regarding maternal and neonatal infectious morbidity, labor induction with balloon catheter appears safe in women colonized with GBS when prophylactic antibiotics are administered at the onset of labor or at membrane rupture. School is an important place for physical activity (PA); however, little is known about how homeschool students' PA levels compare with public and private school students. This study estimated the national prevalence of PA levels of homeschool students compared to public and private school students. We used the 2017 National Household Travel Survey for school-aged participants (N=31,486) to compare weekly PA (not active, light or moderate activity, or vigorous activity) by school type (public/private or homeschool) and school level (elementary, middle, and high school). Unadjusted analyses found higher prevalence of physical inactivity for homeschool students, 14.2% (95% CI, 9.7-18.7%), compared to public/private school students, 8.0% (95% CI, 7.1-9.0%). For students who reported any PA, there was no difference in mean number of episodes for light or moderate PA [public/private 4.2 (95%, CI, 4.1-4.3), homeschool 4.3 (95% CI, 3.9-4.6)], or vigorous PA [public/private 5.6 (95% CI, 5.5-5.7); homeschool 5.5 (95% CI, 4.9-6.0)]. Results were comparable for covariate-adjusted analyses. A higher percentage of homeschool students report being physically inactive compared to public/private school students. However, data with more specific measures of PA intensity and duration are required to determine the potential magnitude of reported differences in behavior. A higher percentage of homeschool students report being physically inactive compared to public/private school students. However, data with more specific measures of PA intensity and duration are required to determine the potential magnitude of reported differences in behavior. In 2020, US schools closed due to SARS-CoV-2 but their role in transmission was unknown. In fall 2020, national guidance for reopening omitted testing or screening recommendations. We report the experience of 2 large independent K-12 schools (School-A and School-B) that implemented an array of SARS-CoV-2 mitigation strategies that included periodic universal testing. SARS-CoV-2 was identified through periodic universal PCR testing, self-reporting of tests conducted outside school, and contact tracing. Schools implemented behavioral and structural mitigation measures, including mandatory masks, classroom disinfecting, and social distancing. Over the fall semester, School-A identified 112 cases in 2320 students and staff; School-B identified 25 cases (2.0%) in 1400 students and staff. Most cases were asymptomatic and none required hospitalization. Of 69 traceable introductions, 63 (91%) were not associated with school-based transmission, 59 cases (54%) occurred in the 2 weeks post-thanksgiving. https://www.selleckchem.com/products/d-4476.html In 6/7 clued those measures and should be discouraged, perhaps with behavioral contracts, to ensure the safety of school communities. In addition, introduction risks were highest following extended school breaks. These risks may be mitigated with voluntary quarantines and surveillance testing prior to reopening.