How To Hospital: barriers to developing a patient ‘Hospital Survival Guide’ to support information transfer during ward-rounds on the patient journey from admission to hospital to discharge

Clinicians can enable patients to actively participate in their care but communication with patients is often poor and highly variable. The aim of this study was to explore patients’ understanding of their current illness while in hospital and using a codesign process to create prototype tools to facilitate better communication during ward rounds.A mixed-methods, multistep design with step 1: Application of a questionnaire addressing domains of care in the acute medical unit; step 2: Development of communication aids that were codesigned with active help of patients, students and a specialist in user centric design to address patient needs and step 3: Evaluation of tools with patients in four Plan–Do–Study–Act cycles.In the initial survey of 30 patients 12 (40%) patients did not know what their diagnosis was and 5 (17%) did not know the results of recent key tests. 20 (67%) patients felt that staff communication and coordination could be improved.An intervention was prototyped with four variations: (1) An A6 ward-round summary sheet completed by doctors during ward rounds. The system worked well but was highly person dependent. (2) An A4 patient-owned diary (‘How to Hospital’) that contained information about key processes in hospital and space to document conversations from rounds and prompts for questions. 10 patients read the diary and commented favourably but did not complete any pages. (3) ‘Diary-cards’: a basic set of information cards was given to patients on admission to hospital. (4) Patient specific ‘diary-cards’ were completed by clinicians—10 forms were piloted during rounds and improved subsequent day information retention of diagnosis to 80%.Our study identified interventions that were feasible but remained person-dependent. The patients’ ownership of information in relation to their care might facilitate retention and satisfaction but the optimal format for these interventions for enhancing communication remains unclear.

Results of a pre-implementation analysis of Ethiopia’s National Pediatric Cancer Registry

In Ethiopia, cancer accounts for about 5.8% of total national mortality, with an estimated annual incidence of cancer of approximately 60,960 cases and an annual mortality of over 44,000 persons. This is likely an underestimation. Survival rates for pediatric malignancies are likewise suboptimal although exact figures are unknown since a national cancer registry is unavailable. The World Health Organization (WHO) provides recommendations for the creation of cancer registries to track such data. Here we describe our pharmacist-led, pre-implementation assessment of introducing an enhanced national pediatric cancer registry in Ethiopia. Our assessment project had three specific aims around which the methods were designed: 1) characterization of the current spreadsheet-based tool across participating sites, including which variables were being collected, how these variables compared to standards set by the WHO, and a description of how the data were entered and its completeness; 2) assessment of the perceptions of an enhanced registry from hospital staff; and 3) evaluation of workflow gaps regarding documentation. The hospital staff and leadership have generally positive perceptions of an enhanced pediatric cancer registry, which were further improved by our interactions. The workflow assessment revealed several gaps, which were addressed systematically using a three-phase implementation science approach. The assessment also demonstrated that the existing spreadsheet-based tool was missing WHO-recommended variables and had inconsistent completion due to the workflow gaps. A pediatric oncology summary sheet will be implemented in upcoming trips in patient charts to better summarize the patients’ journey starting from diagnosis. This document will be used by the data clerks in an enhanced-spreadsheet to have a more complete data set.

Sistema de evaluación del desempeño técnico-táctico en voleibol, una propuesta sencilla (Evaluation system of the technical-tactical performance in volleyball, a simple proposal)

El propósito de esta investigación fue construir un instrumento de evaluación del desempeño técnico-táctico de los jugadores de vóleibol, que posibilite la toma de decisión por parte del entrenador. Las variables de estudio fueron la evaluación del desempeño técnico de los jugadores de vóleibol y la evaluación del desempeño táctico de un equipo de vóleibol, a través del programa Microsoft Office Excel®, que permitió registrar y acceder en tiempo real a la información durante el desarrollo de un partido. La evaluación de desempeño técnico abarcó fundamentos técnicos, con su respectiva categorización de valores. La evaluación de desempeño táctico del equipo se compuso por la organización de la levantada, el porcentaje de eficiencia técnica del ataque en k1 y k2, y el análisis de distribución de levantada y eficiencia de ataque por rotación. El programa consiste en 6 libros de Excel® que trabajan de manera interrelacionada. Los primeros cinco corresponden a los sets jugados y el sexto, al resumen de toda la información ingresada. Las hojas se dividen en: Activas (Hoja final, hoja general, hoja diferencia, hoja atqefi, hoja análisis atqk2 y hoja resumen por jugador), Intermedias (Datos y ATAQRSM), y Pasivas (Tablas). El instrumento de evaluación desempeño técnico-táctico aporta y desarrolla en el ámbito de la evaluación objetiva de los rendimientos técnicos-tácticos. Este instrumento presenta características de bajo costo y fácil operación constituyen fortalezas que beneficiarán a todos aquellos entrenadores que lo utilicen. Abstract. The purpose of this study was to build an instrument for evaluating the technical-tactical performance of the volleyball players, which enables a decision making by the coach. The study variables were the evaluation of the technical performance of the volleyball players and the evaluation of the tactical performance of a volleyball team. A computer tool for evaluating the technical-tactical performance of volleyball players was developed. Through a computer program established in Microsoft Office Excel, which allowed registering and immediately accessing the necessary information during the development of a game. The variable of technical performance evaluation covers the following technical foundations, with their respective categorization of values. The tactical performance evaluation variable of the team was composed by the distribution of the raised, the technical efficiency percentage of the attack in k1 and k2, and the analysis of raised distribution and efficiency of attack by rotation. The program consists of 6 Excel books that work in an interrelated manner. The first five correspond to the sets played and the sixth corresponds to the summary of all the information entered. The match data were entered in the story sheet, to codify the technical-tactical situations of the game full. The sheets are divided into: Active (Final sheet, general sheet, difference sheet, atqefi sheet, atqk2 analysis sheet and summary sheet per player), Intermediate (Data and ATAQRSM), and Passive (Tables). The instrument of statistical evaluation of the technical-tactical performance of volleyball players serves as a contribution to the entire national volleyball environment, for its development in the field of objective evaluation of technical performances. This instrument its low cost and easy operation are strengths that will benefit all those coaches that use it.

Supplemental Material: A sub-centennial-scale optically stimulated luminescence chronostratigraphy and late Holocene flood history from a temperate river confluence

S1–S16; Figures S1 (sediment accumulation rate modeled by OxCal and Bacon) and S2 (relative moisture values between OSL and LOI analytical methods); Table S1 (OSL procedure from the Rivers Severn-Teme confluence at Powick, UK); and Data Sets S1 (raw data for the modeled calendric dates, sediment accumulation rate, and sedimentological analyses), S2 (raw and log normalized data for ITRAX XRF analysis and key elements Zr, Rb, Fe, Mn, and heavy metals illustrated in Fig. 2), S3 (individual raw data sets for each 5 cm pOSL run alongside a background sediment sample and a summary sheet of all data and replicates), S4 (raw data, log normalized data, and statistical analysis used in the agglomerative hierarchical cluster analysis illustrated in Fig, 2), S5 (calculated log data of sedimentary analyses by 50 yr period and the statistical analysis used in the principal component analysis illustrated in Fig. 3), and S6 (20 yr grouping for the sediment deposition models for the Severn-Teme confluence at Powick, Broadwas, and Buildwas and climatic datasets illustrated in Fig. 4)<br>

Supplemental Material: A sub-centennial-scale optically stimulated luminescence chronostratigraphy and late Holocene flood history from a temperate river confluence

S1–S16; Figures S1 (sediment accumulation rate modeled by OxCal and Bacon) and S2 (relative moisture values between OSL and LOI analytical methods); Table S1 (OSL procedure from the Rivers Severn-Teme confluence at Powick, UK); and Data Sets S1 (raw data for the modeled calendric dates, sediment accumulation rate, and sedimentological analyses), S2 (raw and log normalized data for ITRAX XRF analysis and key elements Zr, Rb, Fe, Mn, and heavy metals illustrated in Fig. 2), S3 (individual raw data sets for each 5 cm pOSL run alongside a background sediment sample and a summary sheet of all data and replicates), S4 (raw data, log normalized data, and statistical analysis used in the agglomerative hierarchical cluster analysis illustrated in Fig, 2), S5 (calculated log data of sedimentary analyses by 50 yr period and the statistical analysis used in the principal component analysis illustrated in Fig. 3), and S6 (20 yr grouping for the sediment deposition models for the Severn-Teme confluence at Powick, Broadwas, and Buildwas and climatic datasets illustrated in Fig. 4)<br>

Supplemental Material: A sub-centennial-scale optically stimulated luminescence chronostratigraphy and late Holocene flood history from a temperate river confluence

S1–S16; Figures S1 (sediment accumulation rate modeled by OxCal and Bacon) and S2 (relative moisture values between OSL and LOI analytical methods); Table S1 (OSL procedure from the Rivers Severn-Teme confluence at Powick, UK); and Data Sets S1 (raw data for the modeled calendric dates, sediment accumulation rate, and sedimentological analyses), S2 (raw and log normalized data for ITRAX XRF analysis and key elements Zr, Rb, Fe, Mn, and heavy metals illustrated in Fig. 2), S3 (individual raw data sets for each 5 cm pOSL run alongside a background sediment sample and a summary sheet of all data and replicates), S4 (raw data, log normalized data, and statistical analysis used in the agglomerative hierarchical cluster analysis illustrated in Fig, 2), S5 (calculated log data of sedimentary analyses by 50 yr period and the statistical analysis used in the principal component analysis illustrated in Fig. 3), and S6 (20 yr grouping for the sediment deposition models for the Severn-Teme confluence at Powick, Broadwas, and Buildwas and climatic datasets illustrated in Fig. 4)<br>