Tell Me A Story Assignment

This assignment sheet was designed for an English 102 course

Early discharge: What are the effects of programmes targeted at elderly orthopaedic patients?

Early discharge from hospital is rapidly becoming acceptable hospital policy with increasing financial pressures that confront health services. Formalised programmes of early discharge have been developed in the United States, the United Kingdom and also Australia to support patients leaving hospital early, mainly in the areas of orthopaedics and maternity. The reviewed literature demonstrates an overall trend to deinstitutionalise health services and identifies the general effect of early discharge on the health service, carers and patients. Elderly patients following orthopaedic trauma are more likely to be dependent on others for their care than general patients. The aim of this study was to identify experiences and perceptions of elderly orthopaedic patients who participated in a programme of early discharge. The study involved semi-structured, in-depth interviews with a sample of six men and women who had been orthopaedic patients at the Hornsby Ku-ring-gai Hospital. Broad areas for discussion included expectations of the programme, experiences following discharge including any difficulties or problems encountered, use of formal services reported capacity to attend activities of daily living and the main areas of satisfaction and dissatisfaction. The findings revealed that patients preferred early discharge with support from both the rehabilitation discharge team and family to staying in hospital until fully recovered. Whilst experiences of this small sample cannot be generalised to the larger population, they provide insight to individual perceptions that can be used as the basis for further study

Early discharge: What are the effects of programmes targeted at elderly orthopaedic patients?

Early discharge from hospital is rapidly becoming acceptable hospital policy with increasing financial pressures that confront health services. Formalised programmes of early discharge have been developed in the United States, the United Kingdom and also Australia to support patients leaving hospital early, mainly in the areas of orthopaedics and maternity. The reviewed literature demonstrates an overall trend to deinstitutionalise health services and identifies the general effect of early discharge on the health service, carers and patients. Elderly patients following orthopaedic trauma are more likely to be dependent on others for their care than general patients. The aim of this study was to identify experiences and perceptions of elderly orthopaedic patients who participated in a programme of early discharge. The study involved semi-structured, in-depth interviews with a sample of six men and women who had been orthopaedic patients at the Hornsby Ku-ring-gai Hospital. Broad areas for discussion included expectations of the programme, experiences following discharge including any difficulties or problems encountered, use of formal services reported capacity to attend activities of daily living and the main areas of satisfaction and dissatisfaction. The findings revealed that patients preferred early discharge with support from both the rehabilitation discharge team and family to staying in hospital until fully recovered. Whilst experiences of this small sample cannot be generalised to the larger population, they provide insight to individual perceptions that can be used as the basis for further study

The Application of Integrated Knowledge-based Systems for the Biomedical Risk Assessment Intelligent Network (BRAIN)

One of NASA's goals for long duration space flight is to maintain acceptable levels of crew health, safety, and performance. One way of meeting this goal is through the Biomedical Risk Assessment Intelligent Network (BRAIN), an integrated network of both human and computer elements. The BRAIN will function as an advisor to flight surgeons by assessing the risk of in-flight biomedical problems and recommending appropriate countermeasures. This paper describes the joint effort among various NASA elements to develop BRAIN and an Infectious Disease Risk Assessment (IDRA) prototype. The implementation of this effort addresses the technological aspects of the following: (1) knowledge acquisition; (2) integration of IDRA components; (3) use of expert systems to automate the biomedical prediction process; (4) development of a user-friendly interface; and (5) integration of the IDRA prototype and Exercise Countermeasures Intelligent System (ExerCISys). Because the C Language, CLIPS (the C Language Integrated Production System), and the X-Window System were portable and easily integrated, they were chosen as the tools for the initial IDRA prototype. The feasibility was tested by developing an IDRA prototype that predicts the individual risk of influenza. The application of knowledge-based systems to risk assessment is of great market value to the medical technology industry

Meanings of wellbriety and wellness among urban native peoples in Boston

Wellbriety is a multifaceted concept utilized in Native American communities that demonstrates meanings of health in Native-based discourse. Conceptually, wellbriety symbolizes strength through resilience. During this ethnographic study, I spent two years working within an Urban Indian Health Service facility where I used community-based participatory research methods. I examined complex intersections between meanings of urban native identities, colonization, and tribal sovereignty. Through deconstructing structural violence, I seek to place current urban native health status in a socially-informed context. This research explores how Native peoples define wellbriety and wellness through the lens of healthworld, which addresses how Native communities attempt to heal from traumas inflicted by the U.S. Federal Government. Additionally, I analyze dimensions of food sovereignty among Native community members by exploring how the act of consuming food shapes social and identity meanings which impact community members’ health

Written reflection in assessment and appraisal:GP and GP trainee views

BACKGROUND: In the UK, evidence of written reflection is part of licensing and revalidation for general practitioners (GPs). However, there is little evidence of specific benefits compared to other forms of reflective practice.AIM: To seek GPs' and general practice (GP) trainees' views on the role of written reflection in learning and assessment.DESIGN AND SETTING: An online survey of 1005 GPs and GP trainees (GPTs) in the UK.METHOD: An anonymous questionnaire containing 38 attitudinal items was administered. Descriptive statistics were used to analyse Likert scale responses, thematic analysis for free-text responses.RESULTS: In total 544 GPs and 461 GPTs completed the survey, with 842 (83.8%) agreeing they find verbal reflection with a colleague more useful than written reflection. Three quarters disagreed that written reflection is a way of identifying poorly performing GPs. Over 70% of respondents stated that summative, written reflection is a time-consuming, box-ticking exercise which distracts from other learning. They question its validity as part of assessment and state that its use may contribute to current difficulties with recruitment and retention to GP.CONCLUSIONS: For many GPs, written reflection is an onerous process rather than beneficial to their learning, indicating its continued use in assessment needs to be critically examined.</p

Medication decision making and patient outcomes in GP, nurse and pharmacist prescriber consultations

UNLABELLED: Aim The aims of this study were twofold: (a) to explore whether specific components of shared decision making were present in consultations involving nurse prescribers (NPs), pharmacist prescribers (PPs) and general practitioners (GPs) and (b) to relate these to self-reported patient outcomes including satisfaction, adherence and patient perceptions of practitioner empathy.BACKGROUND: There are a range of ways for defining and measuring the process of concordance, or shared decision making as it relates to decisions about medicines. As a result, demonstrating a convincing link between shared decision making and patient benefit is challenging. In the United Kingdom, nurses and pharmacists can now take on a prescribing role, engaging in shared decision making. Given the different professional backgrounds of GPs, NPs and PPs, this study sought to explore the process of shared decision making across these three prescriber groups.METHODS: Analysis of audio-recordings of consultations in primary care in South England between patients and GPs, NPs and PPs. Analysis of patient questionnaires completed post consultation. Findings A total of 532 consultations were audio-recorded with 20 GPs, 19 NPs and 12 PPs. Prescribing decisions occurred in 421 (79%). Patients were given treatment options in 21% (102/482) of decisions, the prescriber elicited the patient's treatment preference in 18% (88/482) and the patient expressed a treatment preference in 24% (118/482) of decisions. PPs were more likely to ask for the patient's preference about their treatment regimen (χ 2=6.6, P=0.036, Cramer's V=0.12) than either NPs or GPs. Of the 275 patient questionnaires, 192(70%) could be matched with a prescribing decision. NP patients had higher satisfaction levels than patients of GPs or PPs. More time describing treatment options was associated with increased satisfaction, adherence and greater perceived practitioner empathy. While defining, measuring and enabling the process of shared decision making remains challenging, it may have patient benefit