Reconnecting Youth to Nature: A Camp on Campus Model

Day camps are a powerful context for youth development. The American Camp Association and Leave No Trace have been integral in supporting youth development by identifying outcomes associated with participation in outdoor recreation. Recreation majors in the programming class used the camp as a service-learning component of the class that offered them valuable hands-on experience in program design, program facilitation, working with youth, and program evaluation. Therefore, this study evaluated the impact of camp on identified youth outcomes. The outdoor recreation camp was a partnership from a private school and local university. The Youth Outcomes Battery provided measures that focus on common outcomes (e.g., affinity for nature). Thirty-one of the 32 campers completed the retrospective questionnaire. The sample was 61% female, with an average age of 9 years. On a scale of 1 to 10, campers scored a 9.32 on Level of Enjoyment. Findings show that over 50% of the campers learned “a little” or “a lot” about the desired outcomes (e.g., affinity for nature). This work provides an example of an evidence-based nature camp.

Comparison of a Daily Smartphone App and Retrospective Questionnaire Measures of Adherence to Nicotine Replacement Therapy within Pregnant Women (Preprint)

BACKGROUND Few studies have investigated how to best measure adherence to smoking cessation medications, but continuous usage measures are recommended. OBJECTIVE In this first study of its kind, we compared methods for measuring adherence to nicotine replacement therapy (NRT), investigating the completeness and validity of data collected from daily assessments using a smartphone app versus data collected from retrospective questionnaires. METHODS Women aged ≥16, who were daily smokers <25 weeks pregnant, were offered cessation counselling and encouraged to use NRT. Women set quit dates (QD) and, for 28 days afterwards, were asked to report NRT use daily to a smartphone app and to questionnaires administered in-person or remotely at 7 and 28 days. For both data collection methods, we provided up to £25 in compensation for time taken providing research data. Data completeness and NRT use reported to app and questionnaires were compared. For each method, we also correlated mean daily nicotine doses reported within 7 days of QD with Day 7 saliva cotinine concentrations. RESULTS Of 438 women assessed for eligibility, 40 participated and 35 accepted NRT. More participants (31/35) submitted NRT usage data to the app by Day 28 (median days submitted=25 [IQR 11]) than completed the Day 28 questionnaire (24/35). Data submitted to the app showed a lower reported duration of NRT use compared to the questionnaire (median days NRT for app=24 [IQR 10.25]; questionnaire=28 [4.75], P=.007), and there appeared to be specific cases of overreporting to the questionnaire. Mean daily nicotine doses (mg) between QD and Day 7 were lower when calculated using app data (median mg for app=40 [52.1]; questionnaire=40 [63.1], P=.001), and some large outliers were evident for the questionnaire. Mean daily nicotine doses, adjusted for cigarettes smoked, were not associated with cotinine concentrations for either method (app r=0.184, P=.55; questionnaire r=0.031, P=.92). CONCLUSIONS Daily assessment of NRT use via a smartphone app facilitated more complete data (a higher response rate) than questionnaires, and reporting rates over 28 days were encouraging among pregnant women. Although data from neither method was significantly associated with cotinine concentrations, app data had better face validity; retrospective questionnaires appeared to overestimate NRT use for some.

Independent Retailer Restocking Choices in Urban Goods Movement and Interaction Effects with Traditional Markets

Traditional markets play a key role in local supply chains in many countries, often influencing retailer decisions due to their inherent attractiveness. In contrast to restocking choices for retailers as part of large chains, choices of independent retailers driven by local traditional markets have not been widely researched and are not well understood. This paper analyses the factors influencing independent retailer restocking choices and investigates the interplay between the presence of traditional markets and retailer choices. Bandung city in Indonesia is chosen for the study where independent retailers are prevalent, and where a number of traditional markets are thriving. A retrospective questionnaire was used to capture independent retailer restocking behaviour and generation models were calibrated to arrive at the trip propensity. Discrete choice models were estimated to explain the retailer preferences for supplier location and transport service choice. Results indicate that trips generated by independent retailers are explained by the presence of traditional markets and retailers’ vehicle ownership, in addition to the standard variables such as number of persons employed, weekly goods demand and average shipment weight. As for restocking location choice, retailers are more likely to choose suppliers within a traditional market where the number of wholesaler units is larger. Furthermore, the choice of traditional markets has a positive influence on whether retailers choose to use their own vehicle to restock their shops.

EP.WE.324Variation Between Observed and Perceived Volume of Antireflux Operations Completed by Upper-Gastrointestinal Surgeons at a University Teaching Hospital

Aims Increased institutional volume and surgeon experience with antireflux surgery has been shown to improve patient outcomes. We have sought to illustrate the discrepancy between the perceived (self-reported) and observed annual volume of anti-reflux operations completed by each surgeon. Method A retrospective questionnaire was delivered to all upper-gastrointestinal (UGI) surgeons performing antireflux surgeries (ARS) at a University Teaching Hospital. Surgeons were asked to estimate the quantity of NHS antireflux cases completed annually. Objective, anonymised data was retrieved from the Surgical Workload Outcomes Audit Database (SWORD) from 2017 to 2020 for comparison. Results 127 ARS were completed by 6 UGI consultants between January 2018 and December 2020. The median number of ARS completed per surgeon was 5 (2-10) in 2018, 9 (4-11) in 2019 and 10 (1-11) in 2020. Conversely, the median number of self-reported annual procedures per surgeon was 20 (12-35). On average, participants overestimated the number of NHS ARS completed by 14.5 (4-27) cases or a factor of 2.08. No surgeon correctly or underestimated the number of ARS performed. Conclusion We conclude that self-reported operation volume should not be relied upon for the purposes of assessment or audit. Estimations of annual ARS procedures could be up to triple that suggested by objective data. Our data supports the importance of local or national data sets like SWORD to give an accurate reflection of practice and to allow individuals to compare their performance against their peers.

788 Variation Between Observed and Perceived Volume of Antireflux Operations Completed by Upper-Gastrointestinal Surgeons at a University Teaching Hospital

Aim Increased institutional volume and surgeon experience with antireflux surgery has been shown to improve patient outcomes. We have sought to illustrate the discrepancy between the perceived (self-reported) and observed annual volume of anti-reflux operations completed by each surgeon. Method A retrospective questionnaire was delivered to all upper-gastrointestinal (UGI) surgeons performing antireflux surgeries (ARS) at a University Teaching Hospital. Surgeons were asked to estimate the quantity of NHS antireflux cases completed annually. Objective, anonymised data was retrieved from the Surgical Workload Outcomes Audit Database (SWORD) from 2017 to 2020 for comparison. Results 127 ARS were completed by 6 UGI consultants between January 2018 and December 2020. The average number of ARS completed per surgeon was 5.8 (2-10) in 2018, 8.7 (4-11) in 2019 and 6.7 (1-11) in 2020. Conversely, the average number of self-reported annual procedures per surgeon was 22.4 (12-35). On average, participants overestimated the number of NHS ARS completed by 14.5 (4-27) cases or a factor of 2.08. No surgeon correctly or underestimated the number of ARS performed. Conclusions We conclude that self-reported operation volume should not be relied upon for the purposes of assessment or audit. Estimations of annual ARS procedures could be up to triple that suggested by objective data. We recommend that all surgeons maintain a database of ARS for the purpose of self-assessment and audit.

A Survey on Knowledge of Medical Emergencies and Its Management among the Under-Graduate (UG) Clinical Students of a Dental College in Pondicherry, India

Introduction: Dentist can encounter a medical emergency during any phase of the dental treatment. It isessential for the clinician to accurately identify and manage a life threatening situation in patients undergoingdental treatment. The aim of the present study is to assess the knowledge on medical emergencies and itsmanagement among dental clinical students of a dental college in Pondicherry.Materials and Methods: A retrospective questionnaire study was conducted among 135 under-graduate(UG) students to assess their knowledge on various medical emergency conditions and its management fromtheir level of perception in clinical postings.Results: The overall knowledge regarding identification and management of medical emergencies amongthe study population was found to be inadequate.Conclusion: Every dentist must be prepared for an emergency and believing it can be a real possibilityis of paramount importance. It cannot be completely prevented but efficiently managed with appropriateknowledge of signs, symptoms and management techniques.

Factors Predicting Chronic Opioid Use after Orthopedic Surgical Procedures

BACKGROUND: Opioid abuse has been an increasing problem since the 1990s. With over 47,000 opioid related deaths recorded in 2017 alone, concerns have been raised regarding the dangers of introducing opioids perioperatively to patients undergoing major surgeries. OBJECTIVES: The present study proposes to examine the frequency, amount, and trends in post-operative opioid consumption in patients undergoing orthopedic surgical procedures. STUDY DESIGN: This was a randomized, retrospective questionnaire-based study. SETTING: Patients who underwent any type of orthopedic surgery at the University of Pennsylvania Presbyterian Hospital from 1/1/2018 to 3/12/2019 were randomly selected and called during the summer of 2019. METHODS: In this retrospective questionnaire-based study, 828 patients were called by telephone in the summer of 2019. These patients were asked a variety of questions involving opioid consumption behavior post-surgery. The study ended after receiving responses from 200 patients. RESULTS: Nineteen (9.5%) patients reported positively for experiencing euphoria while taking opioids post-surgery. Of the 200 patients contacted, 6 patients (3%) reported switching to marijuana instead of opioids. Thirty-eight (19%) patients preferred to take no opioids at all post-surgery, and one patient was found to have given their prescription to a family member or friend. Twenty-one patients (10.5%) were found to have been taking opioids for non-severe pain. Blacks and whites were the most common racial demographics, making up 84 and 109 of the totals, respectively. The odds ratios for all of the predictors showed that the relative risk for opioid misuse was higher for black patients than white patients (OR = 3.034). There was no relationship between the intra- and post-operative opioid administration and long-term opioid misuse. LIMITATIONS: Patients are self-selected and had the option to opt out of the study when contacted. Some patients may not have been available to answer the phone when our study was being conducted. This study was only conducted for orthopedic patients and for patients who received surgery at the University of Pennsylvania Presbyterian Hospital, thus affecting the demographics for our research. CONCLUSIONS: Prescription opioid misuse is more common among the black population. The total opioid consumption is frequently lower than the quantity prescribed. Patients frequently use opioids even though they feel that pain is insufficient to deserve such an intervention. Euphoria is experienced by a significant number of patients taking prescription opioids Often patients do not take any opioids, although they had prescriptions. KEY WORDS: Opioids, post-operative pain, misuse, abuse