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‘There was no preamble’: Comparing the Transition from Hospital to Home in Different Care Settings
- Marianne Saragosa, Lianne Jeffs, Shoshana Hahn-Goldberg, Howard Abrams, Christine Soong, Michelle Hart, Beverley Shea, Karen Okrainec
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- Journal:
- Canadian Journal on Aging / La Revue canadienne du vieillissement / Volume 40 / Issue 2 / June 2021
- Published online by Cambridge University Press:
- 16 November 2020, pp. 282-292
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Our qualitative descriptive study compared how older patients and their informal caregivers experienced the care transition from acute care or rehabilitation to home. We recruited patients 65 years of age or older, or their informal caregivers, from in-patient units within acute care hospitals and rehabilitation facilities to participate in semi-structured interviews. We identified emergent themes via thematic analysis. In all, 16 patients and four patient caregivers participated. Across all care settings, caregivers were integral in facilitating the transition as well as experiencing variable discharge preparation, health care providers’ optimizing transitions, and missed care and medication discrepancies at transition points. Orthopedic and rehabilitation patients more commonly voiced prior transition experiences in discharge preparation, including having to unexpectedly coordinate and wait for outpatient services. Differing responses between acute care and orthopedic settings suggest that transitional care practices and policies favor an individualized approach that considers patients’ previous experiences, needs, and care expectations.
Viewpoint: What the Marine Mollusc Aplysia Can Tell the Neurologist About Behavioral Neurophysiology
- Peter Ruben, Jeff Goldberg, Jon Edstrom, Karen Voshart, Ken Lukowiak
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 8 / Issue 4 / November 1981
- Published online by Cambridge University Press:
- 18 September 2015, pp. 275-280
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Only recently has man begun to regard himself as mundane and not divine. This conceptual liberation has allowed him to ask frank questions concerning the physical and chemical mechanisms which determine or affect his behavior. Unfortunately the answers to these questions have been slow in coming. The reasons for this are two-fold: Basic ethical considerations preclude the experiments necessary to investigate the neural substrates of human behavior in man. Further, man’s behavior and nervous system are both so enormously complex and subtle, it is therefore unlikely that much real fundamental knowledge could be gained from such experiments if performed. It is more expedient to study simple behavior in simpler organisms than man to understand how nervous systems operate in general and, it is hoped, to eventually gain a better understanding of the human in particular. This tactic is known as the “model systems” approach. By discovering the strategies adopted by less complex nervous systems to deal with simple situations one can devise a realistic model of the neural mechanisms that control more complex behavior in more advanced animals.
Many animals have served as valuable sources of model systems. Among them the marine gastropod mollusc Aplysia has received considerable attention. In comparison to the human nervous system with approximately 50 billion neurons, the Aplysia nervous system contains relatively few neurons — about 20,000. Furthermore the study of the Aplysia nervous system has several other advantageous characteristics. A number of forms of behavioral plasticity that are found in all higher metazoans including man are also found in the Aplysia. These simple but non-trivial types of behavioral plasticity include habituation, sensitization and associative learning as well as easily defined qualities of neural function which we choose to call “behavioral states”. In addition the nervous system is composed of neurons which are large and, in many cases, easily identified by anatomical and physiological criteria so that the “same” cell can be studied in more than one animal under more than one set of experimental conditions. The cell bodies of the neurons in Aplysia, from which electrical recordings can be fairly easily obtained, are electrically close to their dendrites so that changes in postsynaptic potentials occurring during modifications of behavior can be monitored.
Contributors
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- By Shamsuddin Akhtar, Greg Albert, Sidney Allison, Muhammad Anwar, Haruo Arita, Amanda Barker, Mary Hanna Bekhit, Jeanna Blitz, Tyson Bolinske, David Burbulys, Asokumar Buvanendran, Gregory Cain, Keith A. Candiotti, Daniel B. Carr, Derek Chalmers, John Charney, Rex Cheng, Roger Chou, Keun Sam Chung, Anna Clebone, Frederick Conlin, Susan Dabu-Bondoc, Tiffany Denepitiya-Balicki, Jeanette Derdemezi, Anahat Kaur Dhillon, Ho Dzung, Juan Jose Egas, Stephen M. Eskaros, Zhuang T. Fang, Claudia R. Fernandez Robles, Victor A. Filadora, Ellen Flanagan, Dan Froicu, Allison Gandey, Nehal Gatha, Boris Gelman, Christopher Gharibo, Muhammad K. Ghori, Brian Ginsberg, Michael E. Goldberg, Jeff Gudin, Thomas Halaszynski, Martin Hale, Dorothea Hall, Craig T. Hartrick, Justin Hata, Lars E. Helgeson, Joe C. Hong, Richard W. Hong, Balazs Horvath, Eric S. Hsu, Gabriel Jacobs, Jonathan S. Jahr, Rongjie Jaing, Inderjeet Singh Julka, Zeev N. Kain, Clinton Kakazu, Kianusch Kiai, Mary Keyes, Michael M. Kim, Peter G. Lacouture, Ryan Lanier, Vivian K. Lee, Mark J. Lema, Oscar A. de Leon-Casasola, Imanuel Lerman, Philip Levin, Steven Levin, JinLei Li, Eric C. Lin, Sharon Lin, David A. Lindley, Ana M. Lobo, Marisa Lomanto, Mirjana Lovrincevic, Brenda C. McClain, Tariq Malik, Jure Marijic, Joseph Marino, Laura Mechtler, Alan Miller, Carly Miller, Amit Mirchandani, Sukanya Mitra, Fleurise Montecillo, James M. Moore, Debra E. Morrison, Philip F. Morway, Carsten Nadjat-Haiem, Hamid Nourmand, Dana Oprea, Sunil J. Panchal, Edward J. Park, Kathleen Ji Park, Kellie Park, Parisa Partownavid, Akta Patel, Bijal Patel, Komal D. Patel, Neesa Patel, Swati Patel, Paul M. Peloso, Danielle Perret, Anthony DePlato, Marjorie Podraza Stiegler, Despina Psillides, Mamatha Punjala, Johan Raeder, Siamak Rahman, Aziz M. Razzuk, Maggy G. Riad, Kristin L. Richards, R. Todd Rinnier, Ian W. Rodger, Joseph Rosa, Abraham Rosenbaum, Alireza Sadoughi, Veena Salgar, Leslie Schechter, Michael Seneca, Yasser F. Shaheen, James H. Shull, Elizabeth Sinatra, Raymond S. Sinatra, Neil Singla, Neil Sinha, Denis V. Snegovskikh, Dmitri Souzdalnitski, Julie Sramcik, Zoreh Steffens, Alexander Timchenko, Vadim Tokhner, Marc C. Torjman, Co T. Truong, Nalini Vadivelu, Ashley Vaughn, Anjali Vira, Eugene R. Viscusi, Dajie Wang, Shu-ming Wang, J. Michael Watkins-Pitchford, Steven J. Weisman, Ira Whitten, Bryan S. Williams, Jeremy M. Wong, Thomas Wong, Christopher Wray, Yaw Wu, Anthony T. Yarussi, Laurie Yonemoto, Bita H. Zadeh, Jill Zafar, Martha Zegarra, Keren Ziv
- Edited by Raymond S. Sinatra, Jonathan S. Jahr, University of California, Los Angeles, School of Medicine, J. Michael Watkins-Pitchford
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- Book:
- The Essence of Analgesia and Analgesics
- Published online:
- 06 December 2010
- Print publication:
- 14 October 2010, pp xi-xviii
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