What is the experience of being readmitted to hospital for people 65 years and over? A review of the literature

© 2018 Informa UK Limited, trading as Taylor & Francis Group. Aim: To explore the experience of readmissions to hospital from the perspective of older adults. Methods: A systematic review with an interpretative approach was conducted. CINAHL, Embase, and Medline were consulted in October 2016. Results: Six studies with data collection between 2004 and 2013 fit the relevant criteria and included a total of 68 older adults. Two overarching themes were developed with relevant subthemes: Experience during initial hospital stay distinguished by exclusion (Feeling powerless; Feeling disregarded; Perception of readiness for discharge); Patients experience uncertainty following discharge (Perception that community-based services are not available or adequate; Perception that hospital is the only safe place; Difficulty in adapting to a “new normal”). Conclusions: A cycle of exclusion exists during the initial hospital stay and beyond. The experience of being readmitted to hospital is challenging, mostly perceived as negative, and, existential, emotional and psychological well-being is not satisfactorily addressed by healthcare professionals

Memory in narratives and stories: implications for nursing research

©2019 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers. BACKGROUND: Memory, as a concept, is rarely discussed or described in qualitative research. However, memories are central to the stories people tell about their experiences of health and illness, which are often the focus of nursing enquiry. Memories also have the potential to be sensitive or traumatic. AIM: To consider the implications of memory for qualitative research by exploring the following issues: What is memory? What are the implications for using it in research? How can research participants and researchers best be supported in qualitative research when sensitive or traumatic memories are involved? DISCUSSION: Memory is imperfect, complex and dependent on context. Memories are connected to meaning and are central to identity. Qualitative research should appreciate the complexities of memory. Nurses undertaking qualitative research should be mindful of the potentially sensitive or traumatic nature of memories. Both participants and researchers can be affected and care should be taken during the research. CONCLUSION: Memory should not be taken for granted. The meanings underpinning memories are central to qualitative enquiry and are to be valued. IMPLICATIONS FOR PRACTICE: The strategies described in this paper can support researchers and participants when dealing with traumatic or sensitive memories

Inferring behavior from partial social information plays little or no role in the cultural transmission of adaptive traits

This project has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program under grant agreement No. 648841 RATCHETCOG ERC‐2014‐CoG.Many human cultural traits become increasingly beneficial as they are repeatedly transmitted, thanks to an accumulation of modifications made by successive generations. But how do later generations typically avoid modifications which revert traits to less beneficial forms already sampled and rejected by earlier generations? And how can later generations do so without direct exposure to their predecessors' behavior? One possibility is that learners are sensitive to cues of non‐random production in others' behavior, and that particular variants (e.g., those containing structural regularities unlikely to occur spontaneously) have been produced deliberately and with some effort. If this non‐random behavior is attributed to an informed strategy, then the learner may infer that apparent avoidance of certain possibilities indicates that these have already been sampled and rejected. This could potentially prevent performance plateaus resulting from learners modifying inherited behaviors randomly. We test this hypothesis in four experiments in which participants, either individually or in interacting dyads, attempt to locate rewards in a search grid, guided by partial information about another individual's experience of the task. We find that in some contexts, valid inferences about another's behavior can be made from partial information, and these inferences can be used in a way which facilitates trait adaptation. However, the benefit of these inferences appears to be limited, and in many contexts—including some which have the potential to make inferring the experience of another individual easier—there appears to be no benefit at all. We suggest that inferring previous behavior from partial social information plays a minimal role in the adaptation of cultural traits.Publisher PDFPeer reviewe

Energy consumption and capacity utilization of galvanizing furnaces

An explicit equation leading to a method for improving furnace efficiency is presented. This equation is dimensionless and can be applied to furnaces of any size and fuel type for the purposes of comparison. The implications for current furnace design are discussed. Currently the technique most commonly used to reduce energy consumption in galvanizing furnaces is to increase burner turndown. This is shown by the analysis presented here actually to worsen the thermal efficiency of the furnace, particularly at low levels of capacity utilization. Galvanizing furnaces are different to many furnaces used within industry, as a quantity of material (in this case zinc) is kept molten within the furnace at all times, even outside production periods. The dimensionless analysis can, however, be applied to furnaces with the same operational function as a galvanizing furnace, such as some furnaces utilized within the glass industry. © IMechE 2004

Developing Distinctively Human Cumulative Culture: Age-Related Changes in Social Information Use

This thesis investigated the distinctiveness of human cumulative culture by examining the developmental trajectory of reasoning-based social learning strategies, which have been proposed to be what sets human learning apart from non-humans. Specifically, the studies reported in this thesis were concerned with differentiating cases in which social information use was driven by reasoned understanding and cases which could be explained by implicit adaptive heuristics. This was achieved by looking for age-related changes in children’s reasoning about, and use of, social information. More effective social information use was proposed to reflect learners’ reasoned understanding of its relevance and potential value to themselves. Each study examined a particular cognitive challenge identified as potentially relevant for social information use in the context of real world cases of cumulative culture. Chapter two explored the development of children’s ability to account for others’ conflicting goals in their use of the available social information as a means to achieve their own goal. Chapters three and four investigated children’s ability to seek out appropriate sources of social information. Chapter three looked at children’s recognition of what information they required to solve a problem and who could provide that information. While chapter four examined children’s ability to consider potential informants’ mental states when determining ‘who knows’. Overall, the developmental trajectory indicated relatively late childhood development of effective social information use driven by reasoned understanding. This late development is consistent with proposals suggesting that this may be a cognitive mechanism that is only available to humans. The flexibility afforded by the ability to recognise the value, to oneself, of others’ potential to provide useful and relevant information, on account of their experience or knowledge, appears to offer the significant advantage in social information use that may drive human cumulative culture beyond the capabilities of non-humans

Integrating physical activity promotion into UK medical school curricula: testing the feasibility of an educational tool developed by the Faculty of Sports and Exercise Medicine.

Background: At present education on exercise medicine and physical activity (PA) promotion does not feature heavily within the medical curriculum. Objectives: The purpose of this study was to test the feasibility of a self-directed educational tool (Faculty of Sports and Exercise Medicine (FSEM) exercise prescription booklet) on medical students' understanding of PA in disease management. Methods: Students from 22 UK medical schools were invited to complete a brief online questionnaire before and after being provided access to the FSEM exercise prescription booklet. Results: A total of 205 students responded to the open invitation to participate. At baseline 59% of students agreed that PA promotion was an important part of a doctor's job with 86% agreeing that PA was important in the prevention of disease. However, confidence to prescribe PA and knowledge of chief medical officer's adult PA guidelines was low. Following use of the FSEM booklet students' (n=53) knowledge of PA guidelines and confidence to advise patients about PA significantly improved (p<0.05). Correct response answers to case scenarios covering PA in disease management (specifically osteoarthritis and cancer) also improved (32% and 44% increase, respectively, p<0.01). Conclusion: Self-guided educational tools have the potential to improve the exercise prescription skills of undergraduate medical students. Future research should compare different methods of delivering education on PA within medical schools to determine the most effective means of integrating PA into the curriculum

Use of electronic medical records and biomarkers to manage risk and resource efficiencies

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