Examining Readiness for Patients and Their Companions to Transfer From Hospitals to Skilled Nursing Facilities in Saudi Arabia

Abstract Purpose/Aim: This study assessed the readiness of chronically ill patients in Saudi Arabia for transfer from hospitals to skilled nursing facilities (SNFs). It aimed to identify factors that influence this readiness and provide suggestions for making transitions easier. Background: Maintaining chronic patients\u27 ability to transition from hospitals to SNFs is critical for healthcare continuity and quality. However, patients\u27 preparedness for this transition may vary by various factors, including clinical status, caregiver support, and demographics. Conceptual Framework: This study is based on Meleis\u27s Transitional Theory, which highlights the significance of understanding the processes and factors that affect transitions in healthcare environments. This framework is especially pertinent for analyzing the transfer of patients with chronic illnesses from hospitals to SNFs in Saudi Arabia. Methods: A descriptive correlational cross-sectional design was employed. A convenience sample of 123 chronic patients and their companions (families) in hospitals was recruited and enrolled in Saudi Arabia hospitals. After providing informed consent, participants completed surveys that included standardized measures to assess chronic patients\u27 readiness to transition from hospitals to SNFs. The study utilized descriptive and inferential statistical analyses to evaluate variables such as sociodemographic characteristics, clinical profiles, caregiver support, and perceived barriers to transition. Findings: Education, income, chronic illness, self-rated health, and caregiver preparedness significantly predicted readiness to transfer patients from hospitals to SNFs in Saudi Arabia. Education level, income, and self-reported health predicted greater readiness; caregiver involvement positively influenced transition quality. Length of stay, age, and sex made no difference. The findings underscore the importance of interventions to improve caregiver training, financial support, health literacy, and standardizing discharge planning to improve patient transitions. Implications: Policy interventions are needed to help the patient transition from hospital to SNFs in Saudi Arabia. The most common recommendations addressed improving caregiver education, financial support resources, resource allocation using a standardized discharge planning process, and caregiver training programs promoting preparedness. In line with Saudi Arabia\u27s Vision 2030, these measures are intended to create patient-centered care, create fewer obstacles to readiness, and improve overall healthcare outcomes

The Mathematical Structure of the Law

Scientific “law” and human-made law (“social law”) are both “laws” in a general sense—scientific laws “govern” the workings of the material world and social laws govern the behavior of people. Beyond this superficial resemblance, do social laws partake of the same sorts of mathematical structures as scientific laws? Many theorists have proposed formal, deontic-oriented logical models of legal rights and other entitlements. Here, leveraging the typology of Wesley Hohfeld, this Article proposes a novel, mathematical model of legal entitlements. This model incorporates physical and mathematical properties—such as entropy, indeterminacy, temperature, and modularity—to measure quantitative properties of legal systems. Moreover, this Article proposes a post-classical approach to model ontological legal indeterminacy by adapting the formalism of quantum mechanics. These understandings have important implications for the nature of legal rules, legal AI, game theory and the law, and the ontology of rule-based systems. Of particular note, the formalism suggests a novel approach to the quantum measurement problem, proposing that measurement is a “second-order” physical process, which is fundamentally different from the “first-order” physical processes currently described by quantum mechanics

Educational Choice: The Legacy of \u3ci\u3eMeyer v. Nebraska\u3c/i\u3e and \u3ci\u3ePierce v. Society of Sisters\u3c/i\u3e: Introduction

One hundred years ago, in 1925, in a lawsuit brought by parochial and private schools, the U.S. Supreme Court unanimously struck down an Oregon state law requiring children to attend only public schools. Two years earlier, in 1923, the Court struck down a state law prohibiting the teaching of foreign languages to young children. Midway between the hundredth anniversaries of these two decisions—in March 2024—the Classical Liberal Institute at New York University School of Law sponsored a symposium in conjunction with this Journal on “Educational Choice: The Legacy of Meyer v. Nebraska and Pierce v. Society of Sisters”. This Introduction gives an overview of how and why growing numbers of American families now opt for alternatives to the public schools for their children. Longstanding concerns about educational quality have been compounded more recently by concerns about ideological bias and sexual politics in public school classrooms. The Meyer and Pierce decisions—so long as they last—ensure that educational alternatives, and parental choice about their children’s schooling, have a degree of constitutional protection. The symposium papers which follow explore the implications of these decisions for schooling policies in America today and in times to come

Famílias Indigenas Entre Mundos: Standing in Pachakuti, Living in Chi’xi Within the Constellation of Their Comunidad de Saberes

To be Indigenous is to be la luz del mundo, to stand in your light and spread your sunrays, no matter winds or clouds of colonization that strive to dim you. This qualitative study explored ways Indigenous Latine families negotiate a sense of place within onto-epistemological realities and their home culture of learning and Western education. This research is desire-based (Eve Tuck, 2009), creating our own project of modernity, grounded in one Indigenous family’s experience within their Andean community. Drawing from Critical Latine Indigeneities Framework (Blackwell et al., 2017) and Chicana Feminist Epistemologies (Bernal, 1998), using an Entre Mundos methodology, this study centers Indigenous Latine narraciones orales and testimonios through poetic inquiry to sit and learn within the constellation of Indigenous Latine families’ comunidad de saberes (Urrieta, 2013). Learnings emerging from this study sit in an understanding of No es Saber, es Sentir. To be Indigenous is to embody Watjimanta Kawsayninchista Uqharikapuy that is ancestral, spiritual, and relationship driven, living with, not over other beings. Contending colonial forces rooted in onto-epistemological conflicts is to be in a state of pachakuti, renewal, where Indigenous families find themselves in chi’xi (Cusicanqui, 2012), a powerful place of transformation and possibility; Nitaj Ancha Jatun, Nitaj Ancha Juchuy responds to the tension of chi’xi, grounding them in their ancestral knowings. Sitting in pockets of grandmothers, and stories of los abuelos, this study is about epistemic resistance, claims resurgence and offers more beauty to the world, on its own terms

Dissipation Physics and Absorption Features in Black Hole X-ray Binaries

As matter falls closer toward the center of the accretion disk it loses gravitational potential energy, part of which becomes radiation primarily in X-ray wavelengths. Accretion disk models often invoked to fit observed spectra predict relativistically smeared absorption features that are not present in data from black hole X-ray systems such as GX 339-4 and LMC-X3. Informed by recent local and global simulations, we conduct new disk structure and radiative transfer calculations with increased dissipation rates of gravitational potential energy into thermal energy in disk upper layers. We find a noticeable reduction of the absorption features compared to older models that did not incorporate simulation-based dissipation physics

Impact of temperature on larval mortality and performance of the acorn barnacle Chthamalus fissus in San Diego, CA

Rising ocean temperatures and increasingly frequent marine heatwaves threaten the physiological performance and survival of marine larvae. This study quantifies the thermal tolerance, respiration, and swimming behavior of Chthamalus fissus cyprid larvae to establish a baseline for understanding their vulnerability under future climate scenarios. Larvae were collected from the Scripps Pier in La Jolla, CA and exposed to a range of temperatures (12–50°C, dependent on the experiment) to assess oxygen consumption, mortality, and swimming speeds. Oxygen consumption rates increased significantly with temperature, peaking at 30°C, with cyprids exposed to temperatures above 26°C showing significantly higher respiration rates than those below this threshold. The median lethal temperature (LT₅₀) was 40.2°C, indicating high acute thermal tolerance. However, swimming behavior declined above 26°C, with cyprids at 40°C exhibiting slower mean swim speeds. These results suggest that while C. fissus cyprids can survive short-term thermal extremes, their performance and potential for successful settlement may be compromised under prolonged or sublethal warming conditions. Future work can observe long term exposure impact of temperature on larval performance, population-level differences, and sublethal stress indicators such as heat shock protein expression to better predict the ecological consequences of local warming scenarios on this foundation species