In this article, we examine the conceptual models that help us understand the development and sustainability of scholarly and professional communication forums on the Internet, such as conferences, pre-print servers, field-wide data sets, and collaboratories. We first present and document the information processing model that is implicitly advanced in most discussions about scholarly communications-the "Standard Model." Then we present an alternative model, one that considers information technologies as Socio-Technical Interaction Networks (STINs). STIN models provide a richer understanding of human behavior with online scholarly communications forums. They also help to further a more complete understanding of the conditions and activities that support the sustainability of these forums within a field than does the Standard Model. We illustrate the significance of STIN models with examples of scholarly communication forums drawn from the fields of high-energy physics, molecular biology, and information systems. The article also includes a method for modeling electronic forums as STINs.

Persistent postoperative opioid use is thought to contribute to the ongoing opioid epidemic in the United States. However, efforts to study and address the issue have been stymied by the lack of a standard definition, which has also hampered efforts to measure the incidence of and risk factors for persistent postoperative opioid use. The objective of this systematic review is to (1) determine a clinically relevant definition of persistent postoperative opioid use, and (2) characterize its incidence and risk factors for several common surgeries. Our approach leveraged a group of international experts from the Perioperative Quality Initiative-4, a consensus-building conference that included representation from anesthesiology, surgery, and nursing. A search of the medical literature yielded 46 articles addressing persistent postoperative opioid use in adults after arthroplasty, abdominopelvic surgery, spine surgery, thoracic surgery, mastectomy, and thoracic surgery. In opioid-naïve patients, the overall incidence ranged from 2% to 6% based on moderate-level evidence. However, patients who use opioids preoperatively had an incidence of >30%. Preoperative opioid use, depression, factors associated with the diagnosis of substance use disorder, preoperative pain, and tobacco use were reported risk factors. In addition, while anxiety, sex, and psychotropic prescription are associated with persistent postoperative opioid use, these reports are based on lower level evidence. While few articles addressed the health policy or prescriber characteristics that influence persistent postoperative opioid use, efforts to modify prescriber behaviors and health system characteristics are likely to have success in reducing persistent postoperative opioid use.

Therapeutic, III.