Friendly Visiting Programs for Older People Experiencing Social Isolation: A Realist Review of what Works, for whom, and under what Conditions.

Many social interventions have been developed with the hopes of reducing and preventing social isolation among older people (e.g., recreation, arts-based programs and social prescription). Friendly visiting programs, also known as befriending schemes, have been a mainstay in this area for decades and are largely thought to be effective at reconnecting older people (≥ 60 years of age) experiencing isolation. Research and evaluations have yet to determine, however, how and why these programs may be most successful, and under what conditions. This article presents the findings of a realist synthesis aimed at identifying the critical mechanisms and contextual factors that lead to successful outcomes in friendly visiting programs. Seven studies are synthesized to inform a friendly visiting program theory accounting for key mechanisms (e.g., provision of informal support) and underlying contexts (e.g., training of volunteers) that can be used to inform future programs. Recommendations for future research are also presented.

Re-imagining world: From human health in the world to 'all-world health'.

This article explores the concept of 'world' as it frequently appears across health studies; specifically largely humanistic and phenomenological variations in use of 'the world' and 'lifeworld' are considered as they have helped cast knowledge on health and care. Looking forward, it is argued that world might be reimagined post-humanistically and post-phenomenologically as a vital emergent material entity and property. This is a reimagination that pays dividends by drawing attention to all-world processes and productions, hence to 'all-world health'. On one level, all-world health involves consideration of the healths of all the world's material and biological entities (all parts of the world). On another level, all-world health involves understanding what an entity gains from its total surround as it moves through life (all parts of its world). Together these levels provide a more processual, relational and holistic understanding of health than that provided by traditional notions of human health states, determinants or meanings, and even by some environmental (ist) ideas on health. All-world health arguably provides a vision of interrelatedness on which greater unity, cooperation and care might be built.

Living with embodied vibrations: Sensory experiences following a traumatic brain injury.

Based on autoethnography, this article adopts a (neuro)phenomenological lens to explore sensory experiences following a traumatic brain injury (TBI). Although focussing particularly on pain, vision, hearing, and somatic experiences connected with sleep, we also touch on how these are interwoven with other symptoms associated with TBIs. We use these experiences to enliven, and thereby enrich, clinical constructions and understandings of 'sensitivity' to light and to noise, as well as 'sleep disturbance'. We conclude with a discussion of how these sensory experiences can be understood in relation to embodied dynamics of vibration, oscillation, and (stochastic) resonance. The article closes with the suggestion that an embodied, sensorial, and phenomenologically informed analysis of the experiences of people with TBIs, particularly in relation, for example, to embodied sensations and perceptions of vibration, might provide novel insights for research and clinical practice.

'Whole onflow', the productive event: an articulation through health.

In this paper we develop an understanding of 'whole onflow'. Extending philosopher Ralph Pred's original descriptions in materialist directions consistent with posthumanist and non-representational theory, we treat whole onflow as the progressing moment ever-materializing; as a never-ending more-than-human event happening everywhere that is existed in, registered, malleable and productive. In particular, using examples in health, we describe whole onflow's core qualities that lend it, as a vital forceful becoming, its productive capacities. We argue that whole onflow offers compelling ways of understanding the processual origins of health and many productions besides in all their diversity. Moreover, we argue that it offers ways of understanding how humans figure as part of the Universe's becoming.

Matter beginning to matter: On posthumanist understandings of the vital emergence of health.

In recent years much health research across the social sciences and humanities has undergone a noticeable, albeit by no means cohesive or comprehensive, 'turn' towards a posthumanist theoretical orientation. This paper reviews the radical ideas about health's emergence that have accompanied this turn, noting the core processes that are understood to always be in play. In particular, while acknowledging that not all humanistic ideas have been rejected in this work, it describes how some have been reworked and extended in 'other-than-fully conscious' and 'more-than-human' terms. The paper assesses and synthesizes this diverse literature, emphasising the novel understandings of corporeality, materiality, assemblage, relationality, vitality and affect that have become distinctive features of it.

Spinning, hurting, still, afraid: Living life spaces with Type I Chiari Malformation.

Human geography's varied engagement with the brain has involved considerations of the way people know and respond to their environments, and their place-based experiences with emotions, mental illnesses and disorders, intellectual disabilities and particular neurological conditions. This paper argues however that this scholarship could be augmented by, and existing expertise be directed towards, considering physical brain abnormalities and injuries. As a case in point it considers the spatial experience of living with Type 1 Chiari Malformation. Through interviews with four sufferers, the research articulates three domains that they have had to re-negotiate - home space, social space and medical space - emphasizing supportive and challenging aspects of each, as well as meaningful and affective qualities to encounters. The paper concludes with some pointers towards the future study of physical brain abnormalities and injuries and the kinds of knowledge it might create to increase awareness and inform care.

'Hopeful adaptation' in health geographies: Seeking health and wellbeing in times of adversity.

Living with adversity can create wide-ranging challenges for people's health and wellbeing. This adversity may arise through personal embodied difference (e.g. acquiring a brain injury or losing mobility in older age) as well as wider structural relations that shape a person's capacity to adapt. A number of dichotomies have dominated our understanding of how people engage with health and wellbeing practices in their lives, from classifying behaviours as harmful/health-enabling, to understanding the self as being defined before/after illness. This paper critically interrogates a number of these dichotomies and proposes the concept of 'hopeful adaptation' to understand the myriad, often non-linear ways that people seek and find health and wellbeing in spite of adversity. We highlight the transformative potential in these adaptive practices, rather than solely focusing on how people persist and absorb adversity. The paper outlines an agenda for a health geography of hopeful adaptation, introducing a collection of papers that examine varied forms of adaptation in people's everyday struggles to find health and wellbeing whilst living with and challenging adversity.

Care Challenges in the Bathroom: The Views of Professional Care Providers Working in Clients' Homes.

In home care, bathroom activities-particularly bathing and toileting-present a unique set of challenges. In this focus group study, professional home care providers identified factors that increase the danger and difficulty of assisting their clients with bathing and toileting. These included small restrictive spaces, a poor fit between available equipment and the environment, a reliance on manual handling techniques (but insufficient space to use optimal body mechanics), attempts to maintain normalcy, and caring for unsteady and unpredictable clients. Specific elements of each activity that care providers found difficult included multitasking to support client stability while performing care below the waist (dressing/undressing, providing perineal care) and helping clients to lift their legs in and out of a bathtub. Participants did not feel that available assistive devices provided enough assistance to reduce the danger and difficulty of these activities.

Geographical thinking in nursing inquiry, part two: performance, possibility, and non-representational theory.

Part one in this two paper series reviewed the nature of geographical thinking in nursing research thus far. The current paper builds on it by looking forwards and providing a particular vision for future research. It argues that it is time to once again look to the parent discipline of human geography for inspiration, specifically to its turn towards non-representational theory, involving an emphasis on life that onflows prior to meaning, significance, and full cognition; on life's 'taking-place'. The paper introduces this way of viewing and animating the world. Some potential connections to nursing research and practice are suggested, as are some specific avenues for future inquiry. Explained is how, through non-representational theory, nursing might be re-imagined as something that reveals space-time.

Extending the field of play: Revealing the dynamics between sports, health and place.

Although the sub-discipline of sports geography has a long fifty-year history it has been, at best, a sporadic endeavor. Whilst clearly indicating the fundamental geographical qualities of sports, it has never really taking off to the extent that arguably it should have given sport's social profile and importance. In way of a solution this paper presents triple tracks, or ways forward, that might circumvent this academic shortfall and cover some of the missed ground. First, pursuing the health component of sport far more thoroughly and in its very broadest sense, including its public health adoption and specific wellbeing, fitness and aesthetic features. Second, defining sport broadly beyond elite forms to include a wide-range of physical and lifestyle activities that possess elements of personal or interpersonal competition. Third, complementing sports geography by developing 'spatial sports studies' as a more expansive interdisciplinary field of inquiry spanning the health and social sciences. Indeed, these tracks potentially unearth substantial new research capacity by together considering the dynamics between sports, health and place.

Geographical thinking in nursing inquiry, part one: locations, contents, meanings.

Spatial thought is undergoing somewhat of a renaissance in nursing. Building on a long disciplinary tradition of conceptualizing and studying 'nursing environment', the past twenty years has witnessing the establishment and refinement of explicitly geographical nursing research. This article - part one in a series of two - reviews the perspectives taken to date, ranging from historical precedent in classical nursing theory through to positivistic spatial science, political economy, and social constructivism in contemporary inquiry. This discussion sets up part two, which considers the potential of non-representational theory for framing future studies.

Co-creating health's lively, moving frontiers: brief observations on the facets and possibilities of non-representational theory.

This paper follows up a recent debate on the potential of non-representational theory in health geography (see Andrews et al 2014; Kearns 2014; Hanlon 2014; Andrews 2014c) by outlining, more broadly, some of its key facets and investigative possibilities. The intention is to provide a helpful introduction, and entry point, to this particular way of understanding the world and of going about research that might help scholars reverberate the 'taking place' of health and health care.

The 'taking place' of health and wellbeing: towards non-representational theory.

For the last two decades health geography has focused on the dynamics between health and place. Although the social constructivist perspective of much research has provided many insights into the meanings of health and health care arguably, mirroring progress in the parent discipline of human geography, there could be a far more serious engagement with non-representational theory and the 'taking place' of health and health care. To showcase the importance and potential of this broadly, the idea of wellbeing is re-approached. The paper reflects on the ways wellbeing has been treated in research primarily as a meaningful and relatively prescribed state of life, to the neglect of process. Based on this critique, a qualitative study then illustrates the most immediate and everyday ways wellbeing might arise through 'affect'; the pre-personal mobile energies and intensities that result from physical encounters within assemblages of bodies and objects. Indeed, theoretically the findings support the proposition that, at one level, wellbeing might not be taken from environment but instead might emerge as the affective environment. They certainly raise awareness of how much in health might originate at the surface, prior to meaning, within life's infinite spatial doings, and thus they launch some final thoughts on the wider challenges and opportunities for non-representational health geographies.

Two years post-tsunami in Thailand: who still needs assistance?

BACKGROUND: On 26 December 2004, 280 000 people lost their lives in the Asia-Pacific region. A massive earthquake struck Indonesia, triggering a tsunami that affected several countries, including Thailand. This tsunami had important implications for the health status of Thai citizens and health planning, and thus there is a need to study its long-term impact. METHODS: This cohort study identified determinants of health service utilization (outpatient services, inpatient services, home care, medications and informal care) 1 and 2 years post-tsunami in Thailand. A two-part model with a multivariate logistic regression for each part was used to identify determinants of the propensity and intensity of utilization. RESULTS: Of 1943 participants, 1889 (97.2%) participated at 1 year and 1814/1889 (96.0%) at 2 years. Common determinants of health service utilization in post-tsunami settings were age, marital status, education level, employment status, number of health conditions and (physical and mental) health status. CONCLUSIONS: Knowing the determinants of health service use, health providers may be able to establish programmes for, or to carefully monitor populations, who are more likely to use services. The study results may be used to inform requests for health resources or to assist the development of guidelines for long-term disaster recovery planning.

The transition from acute care to home: a review of issues in discharge teaching and a framework for better practice.

Patients are often sent home with complex discharge plans that can become overwhelming and difficult to follow. By contrast, implementing effective teaching at the time of discharge can lead to a decrease in the rate of hospital readmissions and mortality for patients post discharge (Koelling, Johnson, Cody, & Aaronson, 2005). Unfortunately, many of the discharge teaching practices and programs used in health care settings have been criticized as being ineffective. Ensuring that patients are prepared for the transition from hospital to home after a cardiac event will require a fundamental shift in how teaching is performed in acute care settings. In this paper, the authors identify and examine models and concepts relevant to improving the process of providing discharge education in acute care settings. This includes attention to adult education, self-management and patient-centred care. A practical framework was developed: Important Elements of Effective Discharge Teaching. This framework can be used by frontline staff to initiate realistic practice change and promote the use of evidence-based strategies related to discharge teaching in acute care settings. The Important Elements of Effective Discharge Teaching framework provides health care practitioners with a tool to evaluate and reflect on their current professional practice and provides examples of teaching strategies that are based on best evidence. Nurses can incorporate elements of this framework while providing health teaching to patients after a cardiac event.

'Creating the right therapy vibe': relational performances in holistic medicine.

This paper explores the relational constitution and performance of environments for holistic medicine. Informed by actor-network theory and the idea of 'affect', the findings of a combined observational and interview study of therapists are presented. These suggest how the mediation of care experiences involves influxes of humans, objects and ideas - some visualized, some physical, each providing relationalities to other places - that compose assemblages. These assemblages, in certain arrangements involving particular relationalities within them, create changing therapeutic vibes and possibilities. The paper closes by discussing the potential for conceptualizing place relationally beyond the current study across other forms of health care.

Mapping nurse mobility in Canada with GIS: career movements from two Canadian provinces.

Recent years have witnessed the publication of a growing number of studies of nursing which, from a disciplinary perspective, are geographical in their orientation. Conceptually, while the emphasis in much of this research has been focused at the micro scale on the dynamics between nursing and "place," curiously there has been scant attention to geometrical "space," and the basic yet important locational and distributive features of nursing at the macro scale. Noting this gap in the literature, the authors of this paper used a Geographical Information System (GIS) to map the movement of 199 nurses from two Canadian provinces where they were educated - Manitoba and Newfoundland - to the provinces where they currently live and work. While the findings show that nurses who move tend to move to nearby provinces, more generally they illustrate the effectiveness of GIS for managing data and representing findings from workforce studies.