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BackgroundPatient understanding of their care, supported by physician involvement and consistent communication, is key to positive health outcomes. However, patient and care team characteristics can hinder this understanding.ObjectiveWe aimed to assess inpatients' understanding of their care and their perceived receipt of mixed messages, as well as the associated patient, care team, and hospitalization characteristics.DesignWe administered a 30-item survey to inpatients between February 2020 and November 2021 and incorporated other hospitalization data from patients' health records.ParticipantsRandomly selected inpatients at two urban academic hospitals in the USA who were (1) admitted to general medicine services and (2) on or past the third day of their hospitalization.Main measuresOutcome measures include (1) knowledge of main doctor and (2) frequency of mixed messages. Potential predictors included mean notes per day, number of consultants involved in the patient's care, number of unit transfers, number of attending physicians, length of stay, age, sex, insurance type, and primary race.Key resultsA total of 172 patients participated in our survey. Most patients were unaware of their main doctor, an issue related to more daily interactions with care team members. Twenty-three percent of patients reported receiving mixed messages at least sometimes, most often between doctors on the primary team and consulting doctors. However, the likelihood of receiving mixed messages decreased with more daily interactions with care team members.ConclusionsPatients were often unaware of their main doctor, and almost a quarter perceived receiving mixed messages about their care. Future research should examine patients' understanding of different aspects of their care, and the nature of interactions that might improve clarity around who's in charge while simultaneously reducing the receipt of mixed messages.

BackgroundThere are currently no evidence-based guidelines that provide standardized criteria for the discharge of COVID-19 patients from the hospital.ObjectiveTo address this gap in practice guidance, we reviewed published guidance and collected discharge protocols and procedures to identify and synthesize common practices.DesignRapid review of existing guidance from US and non-US public health organizations and professional societies and qualitative review using content analysis of discharge documents collected from a national sample of US academic medical centers with follow-up survey of hospital leaders SETTING AND PARTICIPANTS: We reviewed 65 websites for major professional societies and public health organizations and collected documents from 22 Academic Medical Centers (AMCs) in the US participating in the HOspital MEdicine Reengineering Network (HOMERuN).ResultsWe synthesized data regarding common practices around 5 major domains: (1) isolation and transmission mitigation; (2) criteria for discharge to non-home settings including skilled nursing, assisted living, or homeless; (3) clinical criteria for discharge including oxygenation levels, fever, and symptom improvement; (4) social support and ability to perform activities of daily living; (5) post-discharge instructions, monitoring, and follow-up.LimitationsWe used streamlined methods for rapid review of published guidance and collected discharge documents only in a focused sample of US academic medical centers.ConclusionAMCs studied showed strong consensus on discharge practices for COVID-19 patients related to post-discharge isolation and transmission mitigation for home and non-home settings. There was high concordance among AMCs that discharge practices should address COVID-19-specific factors in clinical, functional, and post-discharge monitoring domains although definitions and details varied.

Photocatalysts are developed in the pursuit of enabling more efficient chemical processes. Perovskites are uniquely situated for the role of a photocatalyst given their favorable optoelectronic properties and tailorable energetic features. While perovskites can be synthesized in a wide range of sizes, from quantum‐confined nanocrystals to bulk single crystals, research to date has primarily focused on perovskite nanocrystals. In this review, recent advancements in perovskite photocatalysts throughout various size regimes are outlined and emerging developments in the field are highlighted. Future directions for perovskite photocatalytic research, including a focus on larger dimensions, with more efficient photocatalysis enabled by the improvements discussed herein are proposed. [ABSTRACT FROM AUTHOR]

Photon upconversion, particularly via triplet–triplet annihilation (TTA), could prove beneficial in expanding the efficiencies and overall impacts of optoelectronic devices across a multitude of technologies. The recent development of bulk metal halide perovskites as triplet sensitizers is one potential step toward the industrialization of upconversion-enabled devices. Here, we investigate the impact of varying additions of bromide into a lead iodide perovskite thin film on the TTA upconversion process in the annihilator molecule rubrene. We find an interplay between the bromide content and the overall device efficiency. In particular, a higher bromide content results in higher internal upconversion efficiencies enabled by more efficient charge extraction at the interface likely due to a more favorable band alignment. However, the external upconversion efficiency decreases as the absorption cross section in the near infrared is reduced. The highest upconversion performance is found in our study for a bromide content of 5%. This result can be traced back to a high absorption cross section in the near infrared and higher photoluminescence quantum yield in comparison to the iodide-only perovskite and an increased driving force for charge transfer. [ABSTRACT FROM AUTHOR]

This article takes a multimodal social semiotic approach to analysing educational textbooks. We are interested in the ways in which educational textbooks contribute to designing our social futures by constructing both the student and the discipline in a particular manner. While a textbook's primary purpose is to provide the reader with knowledge content about a specific topic, it also serves to conventionalise and entrench certain discipline-specific practices and values. A textbook simultaneously competes in an economic environment where the reader has a choice of many textbooks. The text, therefore, takes on a hybrid form, where marketisation and conversationalisation co-exist in dialogue with academic discourse. The article analyses the discourses of Pharmacology as constructed in two widely used Pharmacology textbooks in South Africa. We take a systemic functional approach which views texts as realising meaning in three ways, namely the ideational, the interpersonal and the textual. The analysis shows how one of the textbooks tends to establish a more democratic relationship between authors and readers, while constructing Pharmacology within a scientific discourse of drugs. The other textbook constructs a more traditional and hierarchical relationship between author and reader, yet tends to reinforce a clinical, patient-centred approach to Pharmacology. We argue that this kind of analysis is important when interrogating curriculum, as textbooks are crucial sites of struggle over discourse, meaning and power.

Despite a proliferation of virtual partial hospital programs (PHP) during the COVID-19 pandemic, there is a dearth of research on such programs. In the current study, we compared treatment outcomes and patient satisfaction between an in-person and a virtual PHP. Further, we examined patients' qualitative feedback about the virtual PHP. Participants included 282 patients attending a virtual PHP during the COVID-19 pandemic and 470 patients attending an in-person PHP one year prior. Patients completed daily measures of symptom severity, and post-treatment measures of patient satisfaction and treatment outcomes. Patients in the virtual PHP provided feedback about virtual care. Quantitative data were analyzed using multilevel modeling, and qualitative data were analyzed using the principles of inductive analysis. Patients experienced a reduction in depression (b = -.28, p <.001) and anxiety symptoms (b = -.25, p <.001) over time and reported high satisfaction in both the in-person and virtual PHPs. There were no significant differences across programs. Virtual PHP patients identified unique advantages and disadvantages of virtual care. Our results suggest that virtual PHPs should be explored as an ongoing model of care that may help to systematically reduce barriers to accessing mental health services. [ABSTRACT FROM AUTHOR]