Introduction. Increased rates of surgery, combined with concerns about high-risk pain medications, have highlighted the need for improved methods of meaningfully assessing pain. In response to lack of medical context and functional data in existing scales, the Activity-Based Checks (ABCs) was developed. Methods. This prospective, cohort study was deployed at a single-institution, academic center. The primary outcome was to correlate the ABCs to the 0-10 numeric rating scale (NRS) in postoperative general surgery patients. Secondary outcomes included assessing the impact of patient factors and prescribing patterns on opioid consumption, in milligrams of morphine equivalents (MME) after discharge. Results. The function that correlated most to the NRS at discharge was “Out of Bed to Chair”. Indicators of better mental health were inversely correlated with MME consumption. Interestingly, the largest predictor of MME taken was MME prescribed. Over 40% of prescribed opioids goes unused. Conclusions. Functional pain scales, like the ABCs, may be useful adjuncts to evaluate pain. Individual functions, e.g., “Out of Bed to Chair” may be of particular importance. Clinicians must be aware that the strongest predictor of MMEs taken by patients was MMEs prescribed, highlighting the importance of better pain assessments and opioid stewardship.

Introduction. Understanding parental attitudes and adherence of recommended childhood vaccination schedules adopts a new level of importance in the era of the Sars-CoV-2019 (COVID-19) pandemic. With hopes for release of a safe and effective COVID-19 vaccine within the near future, understanding parental perception of vaccines is important to design successful vaccination interventions. Methods. A cross-sectional survey was administered to approximately 900 parents in the state of Kansas in May, 2020. Pearson chi square and Mann-Whitney U tests were utilized to analyze the assess the attitudes of Kansas parents towards a potential addition of the influenza vaccine to the required list for K-12 students and furthermore, their general perception of vaccinations, and the impact of COVID-19 on those beliefs. Results. 179 responded. 51% (n=92) were in favor of adding the influenza vaccine to the mandatory list (Pro-Addition). Anti-Addition parents had significantly higher levels of distrust (2.1, p<0.001) and were significantly more concerned about vaccine adverse effects. When presented with a hypothetical situation in which a “safe and effective” COVID-19 vaccine was available, these parents were significantly less likely to indicate they would receive the vaccine or obtain it for their children (53 people, p<0.001).   Conclusions. Pro-Addition and Anti-Addition parents are markedly split on their attitudes towards the addition and the effects of the pandemic. Follow-up qualitative studies of Anti-Addition parents are critical for successful vaccine distribution and coverage in the communities.

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Objectives: There is a paucity of literature on what contributes to 30-day readmission rates from the patient’s perspective in head and neck cancer patients. Post-operatively, these patients are often discharged with multiple surgical sites and home equipment requiring education and a large responsibility upon arriving home. Patients have a unique understanding of the discharge process and rationale behind presenting for care following initial discharge. Understanding the experience of the readmitted patient may be critical in finding effective methods to prevent unnecessary readmissions. Methods: Through key-informant interviews, we assessed factors that impact readmission rates from the patient perspective. Patients were eligible if they were discharged within the last 30 days and subsequently readmitted following an admission for a head and neck cancer surgery. Inductive coding was used to analyze interview transcripts and develop themes. Results: Thirteen respondents were interviewed. 46% (n = 6) did not feel ready for discharge after the index admission. Out of these 6 patients, 83% (n = 5) felt their readmission could have been avoided. Patients often encountered unexpected events after returning home from the index admission and felt their readmissions were potentially avoidable with more information regarding what to expect at home, prior to discharge. Although medically stable upon discharge, these findings indicate some patients might be discharged sooner than they should be due to factors outside of medical indications. Conclusions: To address the various biopsychosocial components of patient care in addition to medical aspects, an otolaryngology-specific, prior-to-discharge checklist could aid in lowering 30-day readmissions. Since the amount of education each patient requires to feel competent managing their health at home varies, more work is needed to craft post-education assessments of patient/caregiver competencies for home equipment, prior to discharge to reduce avoidable readmissions.