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Purpose Twenty percent of children may develop chronic post-surgical pain (CPSP), but studies investigating pediatric CPSP are limited in scope. In an exploratory patient survey, we sought to assess CPSP prevalence among children of all ages, across a wide range of surgeries, and over an extended period of time after surgery. Methods We conducted a survey study, including patients < 19 years of age at the time of their surgery at a single-center, quaternary care academic pediatric hospital. Pediatric patients who underwent surgery from May 2014 to August 2019 were included. Via electronic survey, patients/caregivers were asked whether the child had any pain related to their last surgery at the pediatric hospital. Patients/caregivers who answered yes were asked 11 additional questions about the child's pain and pain-related quality of life. The primary outcome was CPSP prevalence; secondary outcomes were pain scores, quality-of-life scores, and the associations of CPSP with time since surgery, preoperative pain, and patient age. Results The response rate of completed surveys was 4.0%. 30% of respondents reported CPSP; the median pain score was 4.0 on an 11 point scale (0 to 10). Responses to quality of life questions indicated CPSP negatively impacted many children's lives. Preoperative pain was associated with an odds ratio for CPSP of 1.09 [95% confidence interval (CI): 0.58, 2.04], each year after surgery with an odds ratio of 0.94 (95% CI 0.80, 1.10), and each year of age at surgery with an odds ratio of 1.07 (95% CI 1.02, 1.12). Conclusion While limited by a low response rate, results from this exploratory survey suggest that CPSP is a considerable problem for children who undergo surgery across many specialties, with marked effects on patient well-being even years after surgery., Author(s): Micaela Q. Dugan [sup.1], Jorge R. Delgado [sup.3], Elizabeth De Souza [sup.2], T. Anthony Anderson [sup.2] Author Affiliations: (1) grid.168010.e, 0000000419368956, Department of History, Stanford University, , Stanford, CA, [...]

The article focuses on honest services fraud which is a 28-word sentence of 18 U.S.C. section 1346 stating that the term scheme or artifice to defraud includes a scheme or artifice to deprive another of the intangible right of honest services. It reflects that consolidating the circuit courts of the U.S. would have defined the limitations of honest services fraud and discusses the U.S. Supreme Court decision in McNally v. United States which regarding mail fraud.