Background: the ageing demographic means that increasing numbers of older people will be attending emergency departments (EDs). Little previous research has focused on the needs of older people in ED and there have been no evaluations of comprehensive geriatric assessment (CGA) embedded within the ED setting.Methods: a pre-post cohort study of the impact of embedding CGA within a large ED in the East Midlands, UK. The primary outcome was admission avoidance from the ED, with readmissions, length of stay and bed-day use as secondary outcomes.Results: attendances to ED increased in older people over the study period, whereas the ED conversion rate fell from 69.6 to 61.2% in people aged 85+, and readmission rates in this group fell from 26.0% at 90 days to 19.9%. In-patient bed-day use increased slightly, as did the mean length of stay.Discussion: it is possible to embed CGA within EDs, which is associated with improvements in operational outcomes.

Fiction, whether in the form of storytelling or plays, has a particular attraction for us: we repeatedly return to it and are willing to invest money and time in doing so. Why this is so is an evolutionary enigma that has been surprisingly underexplored. We hypothesize that emotionally arousing drama, in particular, triggers the same neurobiological mechanism (the endorphin system, reflected in increased pain thresholds) that underpins anthropoid primate and human social bonding. We show that, compared to subjects who watch an emotionally neutral film, subjects who watch an emotionally arousing film have increased pain thresholds and an increased sense of group bonding.

Marketers, filmmakers, and cinema-goers assume that genre has a large effect on how the audience responds to and engages with a film. However, trait measures such as transportability suggest that, in some cases, individual differences may shape audience engagement more than genre does. To investigate this disparity, we compared viewers’ enjoyment, identification with characters, and story world absorption (including three subscales: Transportation, Attention, and Emotional Engagement) for film clips from two very different genres (an emotional family film vs. an action chase scene) in a within-subjects design. Across two studies—an exploratory study and a preregistered replication—we found that participants’ feelings of being transported into the narrative (a dimension of story world absorption) were more highly correlated across films than other measures were and tended to be less related to genre preference than the other audience response measures were. This pattern of results suggests that feelings of transportation may be more dependent on individual differences, and less sensitive to genre, than other forms of audience response. An exploratory analysis of a short scale measuring trait transportability suggested this measure was not the basis of the individual differences theorized to underlie transportation. Our results further highlight the importance of examining viewer engagement with narrative as a multidimensional, rather than unitary, concept.

Transportation, the experience of feeling "transported" into a fictional world, differs widely across individuals. We examined transportation in 3 studies. Study 1 investigated links between individual differences in various measures of audience response, whereas the latter 2 studies examined links between trait measures (independent variables) and audience response (dependent variables). Study 1 found that individual differences in self-reported transportation to a film explained variation in virtually all other dependent measures, such as identification with characters, emotion, and attribution of blame for the protagonist's struggles. Group bonding after watching the film was non-linearly related to endorphin response (as measured by pain threshold), and transportation related to these variables as well (although more weakly). Study 2 found that individual differences in celebrity worship predicted transportation, as well as tendency to identify with the characters and approve of their behavior. Study 3 demonstrated that individual differences in trait measures of sensation seeking and empathy independently predicted viewers' transportation in two very different film genres. Transportation measures for both films were highly correlated, suggesting that tendency to be transported may be less genrespecific than other dependent measures. Altogether, these results illustrate the usefulness of individual differences approaches in the psychological study of fiction.