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BackgroundCentenarians are a rapidly growing demographic group worldwide, yet their health and social care needs are seldom considered. This study aims to examine trends in place of death and associations for centenarians in England over 10 years to consider policy implications of extreme longevity.Methods and findingsThis is a population-based observational study using death registration data linked with area-level indices of multiple deprivations for people aged ≥100 years who died 2001 to 2010 in England, compared with those dying at ages 80-99. We used linear regression to examine the time trends in number of deaths and place of death, and Poisson regression to evaluate factors associated with centenarians' place of death. The cohort totalled 35,867 people with a median age at death of 101 years (range: 100-115 years). Centenarian deaths increased 56% (95% CI 53.8%-57.4%) in 10 years. Most died in a care home with (26.7%, 95% CI 26.3%-27.2%) or without nursing (34.5%, 95% CI 34.0%-35.0%) or in hospital (27.2%, 95% CI 26.7%-27.6%). The proportion of deaths in nursing homes decreased over 10 years (-0.36% annually, 95% CI -0.63% to -0.09%, p = 0.014), while hospital deaths changed little (0.25% annually, 95% CI -0.06% to 0.57%, p = 0.09). Dying with frailty was common with "old age" stated in 75.6% of death certifications. Centenarians were more likely to die of pneumonia (e.g., 17.7% [95% CI 17.3%-18.1%] versus 6.0% [5.9%-6.0%] for those aged 80-84 years) and old age/frailty (28.1% [27.6%-28.5%] versus 0.9% [0.9%-0.9%] for those aged 80-84 years) and less likely to die of cancer (4.4% [4.2%-4.6%] versus 24.5% [24.6%-25.4%] for those aged 80-84 years) and ischemic heart disease (8.6% [8.3%-8.9%] versus 19.0% [18.9%-19.0%] for those aged 80-84 years) than were younger elderly patients. More care home beds available per 1,000 population were associated with fewer deaths in hospital (PR 0.98, 95% CI 0.98-0.99, pConclusionsCentenarians are more likely to have causes of death certified as pneumonia and frailty and less likely to have causes of death of cancer or ischemic heart disease, compared with younger elderly patients. To reduce reliance on hospital care at the end of life requires recognition of centenarians' increased likelihood to "acute" decline, notably from pneumonia, and wider provision of anticipatory care to enable people to remain in their usual residence, and increasing care home bed capacity.

The recent advancements in low-dimensional material-based photodetectors have provided valuable insights into the fundamental properties of these materials, the design of their device architectures, and the strategic engineering approaches that have facilitated their remarkable progress. This review work consolidates and provides a comprehensive review of the recent progress in group-10 two-dimensional (2D) palladium diselenide (PdSe2)-based photodetectors. This work first offers a general overview of the various types of PdSe2 photodetectors, including their operating mechanisms and key performance metrics. A detailed examination is then conducted on the physical properties of 2D PdSe2 material and how these metrics, such as structural characteristics, optical anisotropy, carrier mobility, and bandgap, influence photodetector device performance and potential avenues for enhancement. Furthermore, the study delves into the current methods for synthesizing PdSe2 material and constructing the corresponding photodetector devices. The documented device performances and application prospects are thoroughly discussed. Finally, this review speculates on the existing trends and future research opportunities in the field of 2D PdSe2 photodetectors. Potential directions for continued advancement of these optoelectronic devices are proposed and forecasted.

Lithium-ion batteries (LIBs) and lithium-sulfur (Li–S) batteries are two types of energy storage systems with significance in both scientific research and commercialization. Nevertheless, the rational design of electrode materials for overcoming the bottlenecks of LIBs and Li–S batteries (such as low diffusion rates in LIBs and low sulfur utilization in Li–S batteries) remain the greatest challenge, while two-dimensional (2D) electrodes materials provide a solution because of their unique structural and electrochemical properties. In this article, from the perspective of ab-initio simulations, we review the design of 2D electrode materials for LIBs and Li–S batteries. We first propose the theoretical design principles for 2D electrodes, including stability, electronic properties, capacity, and ion diffusion descriptors. Next, classified examples of promising 2D electrodes designed by theoretical simulations are given, covering graphene, phosphorene, MXene, transition metal sulfides, and so on. Finally, common challenges and a future perspective are provided. This review paves the way for rational design of 2D electrode materials for LIBs and Li–S battery applications and may provide a guide for future experiments.

It is estimated that by the year 2030, the cumulative of Electric Vehicles (EVs) will reach 85 million. Once EV batteries degraded to 70–80% of their initial capacity, EV owners will have to replace the EV’s batteries as the residual capacity becomes insufficient for automotive use. As a result, more batteries will be discarded from EVs. These batteries could be re-purposed in other applications, where they are known as the EV Second Life Batteries (SLB). In this paper, several projects and research works are reviewed to understand the up-to-date state-of-the-art related to SLB. The technical feasibility, economics, and environmental impact of using SLB are investigated. Different applications of SLB, as well as the assessment and testing required before re-purposing EV batteries, are presented. Some of the existing projects related to SLB, such as the studies done in many countries, batteries' types, applications, and scope of the study, have been summarised. It was found that utilising SLB addresses not only an environmental concern with regards to the discarded batteries but also provides an excellent opportunity to generate revenue if assessed and used optimally. Nevertheless, some challenges do exist, such as the lack of standardised assessment and lack of reliable information due to the low number of studies related to SLB. Further studies of SLB, which could help understand the feasibility and economics of using them and standardising their assessment, are recommended.

Abstract The photovoltaic performance of perovskite solar cells (PSCs) can be improved by utilizing efficient front contact. However, it has always been a significant challenge for fabricating high-quality, scalable, controllable, and cost-effective front contact. This study proposes a realistic multi-layer front contact design to realize efficient single-junction PSCs and perovskite/perovskite tandem solar cells (TSCs). As a critical part of the front contact, we prepared a highly compact titanium oxide (TiO2) film by industrially viable Spray Pyrolysis Deposition (SPD), which acts as a potential electron transport layer (ETL) for the fabrication of PSCs. Optimization and reproducibility of the TiO2 ETL were discreetly investigated while fabricating a set of planar PSCs. As the front contact has a significant influence on the optoelectronic properties of PSCs, hence, we investigated the optics and electrical effects of PSCs by three-dimensional (3D) finite-difference time-domain (FDTD) and finite element method (FEM) rigorous simulations. The investigation allows us to compare experimental results with the outcome from simulations. Furthermore, an optimized single-junction PSC is designed to enhance the energy conversion efficiency (ECE) by > 30% compared to the planar reference PSC. Finally, the study has been progressed to the realization of all-perovskite TSC that can reach the ECE, exceeding 30%. Detailed guidance for the completion of high-performance PSCs is provided.

Abstract Two-dimensional (2D) layered Platinum Ditelluride (PtTe2), a novel candidate of group 10 transition-metal dichalcogenides (TMDs), which provides enormous potential for pulsed laser applications due to its highly stable and strong nonlinear optical absorption (NOA) properties. PtTe2 saturable absorber (SA) is successfully fabricated with firstly demonstrated the passively Q-switched laser operation within a Yb-doped fiber laser cavity at 1066 nm. Few layered PtTe2 is produced by uncomplicated and cost-efficient ultrasonic liquid exfoliation and follow by incorporating into polyvinyl alcohol (PVA) polymer to form a PtTe2-PVA composite thin film saturable absorber. The highest achieved single pulse energy is 74.0 nJ corresponding to pulse duration, repetition rate and average output power of 5.2 μs, 33.5 kHz and 2.48 mW, respectively. This work has further exploited the immeasurable utilization potential of the air stable and broadband group 10 TMDs for ultrafast photonic applications.

Abstract Energy conversion efficiency losses and limits of perovskite/silicon tandem solar cells are investigated by detailed balance calculations and photon management. An extended Shockley–Queisser model is used to identify fundamental loss mechanisms and link the losses to the optics of solar cells. Photon management is used to minimize losses and maximize the energy conversion efficiency. The influence of photon management on the solar cell parameters of a perovskite single-junction solar cell and a perovskite/silicon solar cell is discussed in greater details. An optimized solar cell design of a perovskite/silicon tandem solar cell is presented, which allows for the realization of solar cells with energy conversion efficiencies exceeding 32%.

Abstract Methods and mechanisms for improvement of photocatalytic activity, are important and popular research topics for renewable energy production and waste water treatment. Here, we demonstrate a facile laser drilling method for engineering well-aligned pore arrays on magnetron-sputtered WS2 nanofilms with increased active edge sites; the proposed method promotes partial oxidation to fabricate WS2/WO3 heterojunctions that enhance the separation of photogenerated electron-hole pairs. The WS2 film after one, two, and three treatments exhibited photocurrent density of 3.9, 6.2, and 8 μA/cm2, respectively, reaching up to 31 times larger than that of pristine WS2 film along with greatly improved charge recombination kinetics. The unprecedented combinational roles of laser drilling revealed in this study in regards to geometric tailoring, chemical transformation, and heterojunction positioning for WS2-based composite nanomaterials create a foundation for further enhancing the performance of other 2D transition metal dichalcogenides in photocatalysis via laser treatment.

Abstract Group‐10 transition metal dichalcogenides (TMDs) with distinct optical and tunable electrical properties have exhibited great potential for various optoelectronic applications. Herein, a self‐powered photodetector is developed with broadband response ranging from deep ultraviolet to near‐infrared by combining FA1−xCsxPbI3 perovskite with PdSe2 layer, a newly discovered TMDs material. Optoelectronic characterization reveals that the as‐assembled PdSe2/perovskite Schottky junction is sensitive to light illumination ranging from 200 to 1550 nm, with the highest sensitivity centered at ≈800 nm. The device also shows a large on/off ratio of ≈104, a high responsivity (R) of 313 mA W−1, a decent specific detectivity (D*) of ≈1013 Jones, and a rapid response speed of 3.5/4 µs. These figures of merit are comparable with or much better than most of the previously reported perovskite detectors. In addition, the PdSe2/perovskite device exhibits obvious sensitivity to polarized light, with a polarization sensitivity of 6.04. Finally, the PdSe2/perovskite detector can readily record five “P,” “O,” “L,” “Y,” and “U” images sequentially produced by 808 nm. These results suggest that the present PdSe2/perovskite Schottky junction photodetectors may be useful for assembly of optoelectronic system applications in near future.

Hydrogenated amorphous silicon (a-Si:H) has been effectively utilized as photoactive and doped layers for quite a while in thin-film solar applications but its energy conversion efficiency is limited due to thinner absorbing layer and light degradation issue. To overcome such confinements, it is expected to adjust better comprehension of device structure, material properties, and qualities since a little enhancement in the photocurrent significantly impacts on the conversion efficiency. Herein, some numerical simulations were performed to characterize and optimize different configuration of amorphous silicon-based thin-film solar cells. For the optical simulation, two-dimensional finite-difference time-domain (FDTD) technique was used to analyze the superstrate (p-i-n) planar amorphous silicon solar cells. Besides, the front transparent contact layer was also inquired by using SnO2:F and ZnO:Al materials to improve the photon absorption in the photoactive layer. The cell was studied for open-circuit voltage, external quantum efficiency, and short-circuit current density, which are building blocks for solar cell conversion efficiency. The optical simulations permit investigating optical losses at the individual layers. The enhancement in both short-circuit current density and open-circuit voltage prompts accomplishing more prominent power conversion efficiency. A maximum short-circuit current density of 15.32 mA/cm2 and an energy conversion efficiency of 11.3% were obtained for the optically optimized cell which is the best in class amorphous solar cell. Keywords: Superstrate p-i-n, Power loss, Quantum efficiency, Short circuit current, FDTD

Two-dimensional (2D) transition metal dichalcogenide (TMD) materials have exceptional optoelectronic and structural properties, which allow them to be utilized in several significant applications in energy, catalyst, and high-performance optoelectronic devices. Among other properties, the nonlinear optical properties are gaining much attention in the research field. In this work, a unique pentagonal TMD material, palladium disulfide (PdS2), is employed as a saturable absorber (SA) in an ytterbium-doped fiber (YDF) laser cavity and mode-locked laser pulse is generated. At first, liquid phase exfoliation is performed to prepare PdS2 nanoflakes. Afterward, the PdS2-nanoflakes solution was incorporated in the side-polished fiber (SPF) to form SPF-based PdS2-SA. By utilizing this SA, a highly stable mode-locked laser pulse is realized at pump power of 160 mW, which has a center wavelength of 1033 nm and a 3-dB spectral bandwidth of 3.7 nm. Moreover, the pulse duration, maximum power output and corresponding single-pulse energy were determined as 375 ps, 15.7 mW and 0.64 nJ, respectively. During the experiment, the mode-locked pulse remained stable till the pump power reached a value of 400 mW and, for the regulation of power, the slope efficiency is calculated at about 4.99%. These results indicate that PdS2 material is a promising nonlinear optical material for ultrafast optical applications in the near-infrared (NIR) region.

Abstract Women in higher education are in critical positions for preparing future healthcare professionals to support the health of people and the planet. However, women’s leadership remains an under-explored area in education for planetary health (EPH) literature. This article articulates, through a review of empirical and theoretical literature, that it is vital to highlight women’s perspectives as leaders of EPH. We argue that women are well positioned for developing and delivering EPH, and that exploring women’s leadership in EPH will nuance understandings of the gendered challenges that leaders in this field face. We propose that women’s leadership in EPH can be enhanced through celebrating role models as well as improving access to partnership, funding, and research opportunities. This article adds women to the agenda of the diverse voices that need to be heard for advancing EPH, inspiring others to join the growing collective of educators partnering for the health of people and the planet.

Objectives This study aims to determine the usage pattern, effectiveness and safety of oral tramadol 75 mg and dexketoprofen trometamol 25 mg fixed-dose combination (TRAM/DKP FDC) in the short-term treatment of moderate-to-severe acute pain in real-world clinical practice in Asia.Design Real-world, prospective, multicentre, observational, phase IV study.Setting 13 tertiary-care hospital sites across the Philippines, Thailand, Malaysia and Singapore.Participants Adult patients aged 18–80 years prescribed TRAM/DKP FDC for the short-term (up to 5 days) treatment of moderate-to-severe acute pain.Main outcome measures Primary endpoints were the proportion of patients prescribed TRAM/DKP FDC with different types of postsurgical and non-surgical treatments, and the average dosing frequency and duration of TRAM/DKP FDC treatment. Secondary endpoints were the proportion of patients achieving ≥30% pain reduction at 8 hours post the first dose (pain severity was assessed using the 11-point Numeric Pain Rating Scale); patient satisfaction at the end of treatment (based on a 5-point Patient Global Evaluation Scale (PGE)) and safety including the incidence of adverse drug reactions (ADRs).Results Among 599 patients (median age 44 years, 61.3% female) enrolled in this study, 68.61% (n=411) were postsurgical and 31.39% (n=188) were non-surgical patients. TRAM/DKP FDC was prescribed in a diverse group of postsurgical patients (eg, orthopaedic, general and cancer surgery) as well as in non-surgical conditions (eg, lower back pain and musculoskeletal pain). In the majority of patients, TRAM/DKP FDC was prescribed every 8 hours (65.94%) and for 5 days (78.80%). There was a significant reduction in pain intensity throughout the study and 65% of patients achieved ≥30% pain reduction from baseline at 8 hours post the first dose of TRAM/DKP FDC on day 1. 95.69% of patients were satisfied with the treatment (rated good, very good and excellent on the PGE scale). Overall, 13.9% of patients reported ADRs; most were mild to moderate in severity. The most common ADRs were nausea, vomiting and dizziness.Conclusion This study showed that TRAM/DKP FDC was used in diverse types of postsurgical and non-surgical patients in the real-world setting in Asia. It effectively reduced pain and was well tolerated with a high level of patient satisfaction.

Abstract Organic photovoltaic cells using Y6 non-fullerene acceptors have recently achieved high efficiency, and it was suggested to be attributed to the charge-transfer (CT) nature of the excitations in Y6 aggregates. Here, by combining electroabsorption spectroscopy measurements and electronic-structure calculations, we find that the charge-transfer character already exists in isolated Y6 molecules but is strongly increased when there is molecular aggregation. Surprisingly, it is found that the large enhanced charge transfer in clustered Y6 molecules is not due to an increase in excited-state dipole moment, Δμ, as observed in other organic systems, but due to a reduced polarizability change, Δp. It is proposed that such a strong charge-transfer character is promoted by the stabilization of the charge-transfer energy upon aggregation, as deduced from density functional theory and four-state model calculations. This work provides insight into the correlation between molecular electronic properties and charge-transfer characteristics in organic electronic materials.

Introduction Satisfactory management of acute pain remains a major medical challenge despite the availability of multiple therapeutic options including the fixed-dose combination (FDC) drugs. Tramadol and dexketoprofen trometamol (TRAM/DKP) 75/25 mg FDC was launched in 2018 in Asia and is widely used in the management of moderate to severe acute pain. There are limited data on its effectiveness and safety in Asian patients, and therefore, a need to better understand its usage patterns in clinical practice. We aim to understand the usage pattern of TRAM/DKP FDC, its effectiveness and tolerability in patients with moderate to severe acute pain in Asia.Methods and analysis REKOVER is a phase-IV, multicountry, multicentre, prospective, real-world observational study. A total of 750 postsurgical and non-surgical patients (male and female, aged 18–80 years) will be recruited from 13 tertiary-care hospitals (15 sites) in Singapore, Thailand, the Philippines and Malaysia. All patients prescribed with TRAM/DKP FDC and willing to participate in the study will be enrolled. The recruitment duration for each site will be 6 months. The severity of pain will be collected using Numeric Pain Rating Scale through the treatment period from day 1 to day 5, while satisfaction with the treatment will be evaluated using Patient Global Evaluation Scale at the end of treatment. Any adverse event reported during the study duration will be recorded for safety analysis (up to day 6). The study data will be entered into the ClaimIt portal and mobile application (app) (ObvioHealth, USA). All the inpatient data will be entered into the portal by the study site and for outpatient it will be done by patients through an app.Ethics and dissemination The study has been approved by the local ethics committee from each study sites in Singapore, Thailand, the Philippines and Malaysia. Findings will be disseminated through local and global conference presentations, publications in peer-reviewed scientific journals and continuing medical education.

Abstract Background Suicidal behaviour and deliberate self harm are common among adolescents. Limited evidence exists regarding interventions that can reduce risk; however research indicates that maintaining contact either via letter or postcard with at-risk adults following discharge from services can reduce risk. The aim of the study is to test a postcard intervention among people aged 15-24 who presented to mental health services but are not accepted, yet are at risk of suicide. Methods/design The study is a 3-year randomised controlled trial conducted at Orygen Youth Health Research Centre in Melbourne Australia. Participants are young help-seekers aged 15-24 who are at risk of suicide. Participants will be recruited over a 12 month period. The intervention comprises a regular postcard to be sent monthly for 12 months. The postcard enquires after their well being and includes information regarding individual sources of help and evidence-based self help strategies. Participants are assessed at baseline, 12 and 18 months. Discussion This paper describes the development of a study which aims to reduce suicide risk in a sample of young help-seekers. If effective, this intervention could have significant clinical and research implications for a population who can be hard to treat and difficult to research. Trial Registration The study was registered with the Australian Clinical Trials Registry; number: ACTRN012606000274572.

Abstract Background Although deliberate self-harm is prevalent among young people, many who engage in deliberate self-harm receive sub-optimal care. Although schools are a well placed setting to support young people who engage in self-harm there are no specific training packages designed to assist school welfare staff to support these young people. The current study aimed to design, deliver and evaluate a training course specifically for school staff. Methods The study employed a longitudinal design. Two hundred and thirteen people participated in the training and evaluation. A questionnaire was administered at baseline, immediately after the training and at 6-month follow-up in order to determine if the training led to improvements in confidence when working with young people who self-harm, perceived skill, knowledge of, and attitudes towards people who self harm. Results Prior to the course, the majority of participants demonstrated relatively high levels of confidence, perceived skill and knowledge of self-harm and endorsed relatively positive attitudes towards people who engage in self-harm. Despite this, significant improvements were observed in terms of increased confidence, increased perceptions of skill along with increased knowledge of deliberate self-harm. These improvements were sustained over the follow-up period. Conclusion The results demonstrated that the provision of specifically designed training can help school welfare staff to feel better equipped to support young people who are engaging in deliberate self-harm.

Internet-of-thing (IoT) is an assembly of devices that collect and share data with other devices and communicate via the internet. This massive network of devices, generates and communicates data and is the key to the value in IoT, allowing access to raw information, gaining insight, and making an intelligent decisions. Today, there are billions of IoT devices such as sensors and actuators deployed. Many of these applications are easy to connect, but those tucked away in hard-to-access spots will need to harvest ambient energy. Therefore, the aim is to create devices that are self-report in real-time. Efforts are underway to install a self-powered unit in IoT devices that can generate sufficient power from environmental conditions such as light, vibration , and heat . In this review paper, we discuss the recent progress made in materials and device development in power- and, storage units, and power management relevant for IoT applications. This review paper will give a comprehensive overview for new researchers entering the field of IoT and a collection of challenges as well as perspectives for people already working in this field.

Abstract Introduction Optimal pain management is crucial to the postoperative recovery process. We aimed to evaluate the efficacy and safety of intravenous oxycodone with intravenous fentanyl, morphine, sufentanil, pethidine, and hydromorphone for acute postoperative pain. Methods A systematic literature search of PubMed, Cochrane Library, and EMBASE databases was performed for randomized controlled trials published from 2008 through 2017 (inclusive) that evaluated the acute postoperative analgesic efficacy of intravenous oxycodone against fentanyl, morphine, sufentanil, pethidine, and hydromorphone in adult patients (age ≥ 18 years). Outcomes examined included analgesic consumption, pain intensity levels, side effects, and patient satisfaction. Results Eleven studies were included in the review; six compared oxycodone with fentanyl, two compared oxycodone with morphine, and three compared oxycodone with sufentanil. There were no eligible studies comparing oxycodone with pethidine or hydromorphone. Overall, analgesic consumption was lower with oxycodone than with fentanyl or sufentanil. Oxycodone exhibited better analgesic efficacy than fentanyl and sufentanil, and comparable analgesic efficacy to morphine. In terms of safety, there was a tendency towards more side effects with oxycodone than with fentanyl, but the incidence of side effects with oxycodone was comparable to morphine and sufentanil. Where patient satisfaction was evaluated, higher satisfaction levels were observed with oxycodone than with sufentanil and comparable satisfaction was noted when comparing oxycodone with fentanyl. Patient satisfaction was not evaluated in the studies comparing oxycodone with morphine. Conclusions Our findings suggest that intravenous oxycodone provides better analgesic efficacy than fentanyl and sufentanil, and comparable efficacy to morphine with less adverse events such as sedation. No studies comparing intravenous oxycodone with pethidine or hydromorphone were identified in this review. Better alignment of study methodologies for future research in this area is recommended to provide the best evidence base for a meta-analysis. Funding Mundipharma Singapore Holding Pte Ltd, Singapore.

Dessy R Emril1 Kok-Yuen Ho21Neurology Department, Syiah Kuala University/Dr Zainoel Abidin Hospital, Banda Aceh, Indonesia; 2Pain Management Centre, Raffles Hospital, SingaporeAbstract: Trigeminal neuralgia (TN) is a neuropathic pain condition affecting the face. It has a significant impact on the quality of life and physical function of patients. Evidence suggests that the likely etiology is vascular compression of the trigeminal nerve leading to focal demyelination and aberrant neural discharge. Secondary causes such as multiple sclerosis or brain tumors can also produce symptomatic TN. Treatment must be individualized to each patient. Carbamazepine remains the drug of choice in the first-line treatment of TN. Minimally invasive interventional pain therapies and surgery are possible options when drug therapy fails. Younger patients may benefit from microvascular decompression. Elderly patients with poor surgical risk may be more suitable for percutaneous trigeminal nerve rhizolysis. The technique of radiofrequency rhizolysis of the trigeminal nerve is described in detail in this review.Keywords: interventional treatment, minimally invasive, pain management, radiofrequency rhizolysis, trigeminal neuralgia

Introduction: The purpose of this trial was to determine the efficacy of a Nurse Controlled Analgesia (NCA) protocol in reducing the time taken to achieve a satisfactory postoperative pain score. The safety aspects of the NCA protocol were also evaluated. Method: 120 patients undergoing major surgery were randomised into 2 groups – NCA group and the doctor administered analgesia group (DRA). Nurses in the Post Anaesthestic Care Area (PACU) administered analgesia based on a protocol whereas analgesia was titrated at the discretion of the doctor in the DRA group. Effective pain control was measured by the time taken to obtain first dose of analgesia and the time taken to achieve either a pain score of less than 4/10 or if the patient refused further analgesia. Results: Patients received their first dose of morphine faster in the NCA group compared to DRA group, 6.7 minutes versus 9.5 minutes respectively (p= 0.037). Time taken to achieve a pain score of less than 4 was shorter in the doctor group although this was not significant. Complication rates were not different in both groups. Conclusion: Nurse administered analgesia based on a protocol can provide pain relief for patients in the postoperative period as effectively and safely as doctor administered analgesia.

Introduction: Failed back surgery syndrome (FBSS) is a debilitating chronic neuropathic pain condition, affecting approximately 10–40% of patients after lumbosacral spine surgery. Treatment of FBSS is challenging as conservative therapies and repeat surgery often fail in providing adequate pain relief. Spinal cord stimulation (SCS) has been proven to be a successful therapeutic option in FBSS patients. Case Report: A 23 year-old male presented with persistent low back pain and bilateral radicular pain after spinal surgery. He was also wheelchair-bound because of his severe pain. Conservative treatment with oral analgesics and interventional pain procedures were unsuccessful in improving his pain. Subsequently, we performed a permanent implantation of epidural leads for SCS after a successful trial of SCS. He reported good coverage of pain without complications after the procedure. Three months after surgery, and after intensive physiotherapy and rehabilitation, he could walk and return to work. Conclusion: We describe our first successful case of treating intractable pain from FBSS in a patient after implantation of SCS leads in our institution.