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- All Subjects: Learning
The main effects of shader fidelity and polygon fidelity were both non- significant for both learning and all presence subscales inside the VLE. In addition, there was no significant interaction between shader fidelity and model fidelity. However, there were two significant results on the supplementary variables. First, gender was found to have a significant main effect on all the presence subscales. Females reported higher average levels of presence than their male counterparts. Second, gameplay hours, or the number of hours a participant played computer games per week, also had a significant main effect on participant score on the learning measure. The participants who reported playing 15+ hours of computer games per week, the highest amount of time in the variable, had the highest score as a group on the mercury learning measure while those participants that played 1-5 hours per week had the lowest scores.
Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually, transitional care should be time-sensitive, patient-centered services intended to ensure continuity of care and an efficient transition between health care settings or home. A patient centered transitional care program was implemented at an outpatient primary care facility to reduce readmission rates. Institutional Review Board approval was obtained.
Twenty adult patients with chronic diseases discharged from an acute setting were identified. A follow up phone call and/or a home visit within 24-72 hours post discharge was employed. The Care Transitions Measure (CTM®) and Medication Discrepancy Tool (MDT®) were utilized to identify quality of care of transition and medication discrepancies. A chart audit collected data on the age of participant, diagnosis for initial hospitalization, CTM score, home visit, and ED visits or re-hospitalizations after 30 days of discharge. The outcome indicated that transitional care within primary care utilizing evidence-based practices is beneficial in reducing readmission rates. A logistic regression showed model significance, p = .002, suggesting that the CTM score was effective for both telephone support (TS) and home visit (HV).
A correlation analysis showed that as age of participants increased, the CTM score decreased, indicating that older adults required more support. A significance p <.001, of a proportional test indicated that readmission rates after the intervention was lower. It is evident that providing a timely and effective transitional care intervention in a primary care setting can reduce hospital readmissions, improve symptom management and quality of life of adult patients with chronic diseases.