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Summary: Background: Mucositis is a common and highly impactful side effect of conventional and emerging cancer therapy and thus the subject of intense investigation. Although common practice, mucositis assessment is heterogeneously adopted and poorly guided, impacting evidence synthesis and translation. The Multinational Association of Supportive Care in Cancer (MASCC) Mucositis Study Group (MSG) therefore aimed to establish expert recommendations for how existing mucositis assessment tools should be used, in clinical care and trials contexts, to improve the consistency of mucositis assessment. Methods: This study was conducted over two stages (January 2022–July 2023). The first phase involved a survey to MASCC-MSG members (January 2022–May 2022), capturing current practices, challenges and preferences. These then informed the second phase, in which a set of initial recommendations were prepared and refined using the Delphi method (February 2023–May 2023). Consensus was defined as agreement on a parameter by >80% of respondents. Findings: Seventy-two MASCC-MSG members completed the first phase of the study (37 females, 34 males, mainly oral care specialists). High variability was noted in the use of mucositis assessment tools, with a high reliance on clinician assessment compared to patient reported outcome measures (PROMs, 47% vs 3%, 37% used a combination). The World Health Organization (WHO) and Common Terminology Criteria for Adverse Events (CTCAE) scales were most commonly used to assess mucositis across multiple settings. Initial recommendations were reviewed by experienced MSG members and following two rounds of Delphi survey consensus was achieved in 91 of 100 recommendations. For example, in patients receiving chemotherapy, the recommended tool for clinician assessment in clinical practice is WHO for oral mucositis (89.5% consensus), and WHO or CTCAE for gastrointestinal mucositis (85.7% consensus). The recommended PROM in clinical trials is OMD/WQ for oral mucositis (93.3% consensus), and PRO-CTCAE for gastrointestinal mucositis (83.3% consensus). Interpretation: These new recommendations provide much needed guidance on mucositis assessment and may be applied in both clinical practice and research to streamline comparison and synthesis of global data sets, thus accelerating translation of new knowledge into clinical practice. Funding: No funding was received.

Background: Failure in performing pre-analytical procedures correctly is recognized as the main reason for erroneous laboratory results. The aim of this study was to determine how medical staff at physician’s offices are trained in pre-analytical laboratory processes and to understand learning cultures in these workplaces. Method: Employees at three Norwegian medical centers, including a center accredited for taking patient samples, were interviewed in groups. The interviews were qualitative in nature and were recorded on a Dictaphone. Following transcription, the text was abstracted, structured, and categorized. Results and conclusions: Group interviews of the staff at physician’s offices indicates that information and guidelines regarding preanalytical recommendations are not always implemented in the routines. This may cause random informal learning and a strong culture of continuing as before. There is also a culture of not correcting others if one observes that a colleague doesn’t follow recommendations. Furthermore, the survey indicates that a center accredited for taking patient samples has more rigorous requirements for the use of procedures than staff in a physician’s office. This demonstrates the importance of critical and reflective thinking in informal learning settings, and how important the use of procedures can be to ensure correct performance, since informal learning can be random and inadequate.

Heidi Hansen describes how people create meaning through stories. An event or episode does not carry any meaning in itself but is assigned meaning through its constructed relations to other events and the way it is put into words. Stories create memory as well as oblivion and thus influence the identity of the organization as well as the identity of its members. Therefore it is a central management discipline to try to influence the dominant stories told in the organization.

In June 2021, over 200 stakeholders, advocates, and visionaries gathered to launch the Healthy Hawai'i Strategic Plan 2030 (HHSP), a 10-year strategic plan for improving the health of Hawai'i residents by preventing and reducing chronic disease and advancing health equity. The HHSP is a guide to enable coordination across common risk factors, program areas, interventions, and strategies for chronic disease prevention and control. Developed during the COVID-19 pandemic, which revealed major areas of susceptibility in our health system infrastructure and magnified existing disparities, the HHSP prioritizes health equity and strives to create sustainable change to transform communities, schools, health care and worksites to support the health of the people of Hawai'i. The HHSP is a living document and partners -- present and future -- are invited to work together to achieve a healthier future for the people of Hawai'i. [ABSTRACT FROM AUTHOR]

The article discusses the importance of policy, systems, and environmental changes in addressing the growing obesity and chronic disease rates in Hawai'i. Topics discussed include the creation of Obesity Prevention Task Force law, the physical activity policy recommendations, and the symposium Weight of the State: Solving the Chronic Disease Crisis through Innovative Policy Change held on November 20, 2015.

In 2011, a small pilot bike share program was established in the town core of Kailua, Hawai'i, with funding from the Hawai'i State Department of Health. The Kailua system consisted of two stations with 12 bicycles, and the goal was to secure additional funding to expand the station network in the future. Community feedback consistently indicated support for the bike share program. However, system metrics showed low levels of usage, averaging 41.5 rides per month (2011-2014). From observational data, users were primarily tourists. With minimal local staff, the bike share program had limited resources for promotion and education, which may have hindered potential use by local residents. Management of station operations and bike maintenance were additional, ongoing barriers to success. Despite the challenges, the pilot bike share program was valuable in several ways. It introduced the bike share concept to Hawai'i, thereby helping to build awareness and connect an initial network of stakeholders. Furthermore, the pilot bike share program informed the development of a larger bike share program for urban Honolulu. As limited information exists in the literature about the experiences of smaller bike share programs and their unique considerations, this article shares lessons learned for other communities interested in starting similar bike share programs. [ABSTRACT FROM AUTHOR]

The article discusses the impact of built environment on the overall community health and physical activity in Hawaii. It explores the built environment efforts to promote health in the state, which covered policy change, systems evaluation, and environmental improvements. Other topics include the prevalence of unhealthy behaviors, the concept of Complete Streets as an aspect of built environment, and the effort of Department of Health, Chronic Disease Prevention and Health Promotion Division.

In 2011, a small pilot bike share program was established in the town core of Kailua, Hawai'i, with funding from the Hawai'i State Department of Health. The Kailua system consisted of two stations with 12 bicycles, and the goal was to secure additional funding to expand the station network in the future. Community feedback consistently indicated support for the bike share program. However, system metrics showed low levels of usage, averaging 41.5 rides per month (2011-2014). From observational data, users were primarily tourists. With minimal local staff, the bike share program had limited resources for promotion and education, which may have hindered potential use by local residents. Management of station operations and bike maintenance were additional, ongoing barriers to success. Despite the challenges, the pilot bike share program was valuable in several ways. It introduced the bike share concept to Hawai'i, thereby helping to build awareness and connect an initial network of stakeholders. Furthermore, the pilot bike share program informed the development of a larger bike share program for urban Honolulu. As limited information exists in the literature about the experiences of smaller bike share programs and their unique considerations, this article shares lessons learned for other communities interested in starting similar bike share programs.