Learning to 'understand backwards' in time: children's temporal cognition and the primary history curriculum

This study examines children’s temporal ways of knowing and it highlights the centrality of temporal cognition in the development of children’s historical understanding. It explores how young children conceptualise time and it examines the provision for temporal cognition at the levels of the intended, enacted and received history curriculum in the Irish primary school context. Positioning temporality as a prerequisite second-order concept, the study recognises the essential role of both first-order and additional second-order concepts in historical understanding. While the former can be defined as the basic, substantive content to be taught, the latter refers to a number of additional key concepts that are deemed fundamental to children's capacity to make meaningful sense of history. The study argues for due recognition to be given to temporality, in the belief that both sets of knowledge, the content and skills, are required to develop historical thinking (Lévesque, 2011). The study addresses a number of key research questions, using a mixed methods research design, comprising an analysis of history textbooks, a survey among final year student teachers about their teaching of history, and school-based interviews with primary school children: What opportunities are available for children to develop temporal ways of knowing? How do student teachers experience being apprenticed into the available culture for teaching history and understanding temporality at primary level? What insights do the cognitive-developmental and sociocultural perspectives on learning provide for understanding the dynamics of children’s temporal ways of knowing? The study argues that the skill of developing a deeper understanding of time is a key prerequisite in connecting with, and constructing, understandings and frameworks of the past. The study advances a view of temporality as complex, multi-faceted and developmental. The findings have a potential contribution to make in influencing policy and pedagogy in establishing an elaborated and well-defined curriculum framework for developing temporal cognition at both national and international levels.

Early detection of delirium in older medical inpatients: prodrome, predictors and motor subtyping

Background Delirium is highly prevalent, especially in older patients. It independently leads to adverse outcomes, but remains under-detected, particularly hypoactive forms. Although early identification and intervention is important, delirium prevention is key to improving outcomes. The delirium prodrome concept has been mooted for decades, but remains poorly characterised. Greater understanding of this prodrome would promote prompt identification of delirium-prone patients, and facilitate improved strategies for delirium prevention and management. Methods Medical inpatients of ≥70 years were screened for prevalent delirium using the Revised Delirium Rating Scale (DRS--‐R98). Those without prevalent delirium were assessed daily for delirium development, prodromal features and motor subtype. Survival analysis models identified which prodromal features predicted the emergence of incident delirium in the cohort in the first week of admission. The Delirium Motor Subtype Scale-4 was used to ascertain motor subtype. Results Of 555 patients approached, 191 patients were included in the prospective study. The median age was 80 (IQR 10) and 101 (52.9%) were male. Sixty-one patients developed incident delirium within a week of admission. Several prodromal features predicted delirium emergence in the cohort. Firstly, using a novel Prodromal Checklist based on the existing literature, and controlling for confounders, seven predictive behavioural features were identified in the prodromal period (for example, increasing confusion; and being easily distractible). Additionally, using serial cognitive tests and the DRS-R98 daily, multiple cognitive and other core delirium features were detected in the prodrome (for example inattention; and sleep-wake cycle disturbance). Examining longitudinal motor subtypes in delirium cases, subtypes were found to be predominantly stable over time, the most prevalent being hypoactive subtype (62.3%). Discussion This thesis explored multiple aspects of delirium in older medical inpatients, with particular focus on the characterisation of the delirium prodrome. These findings should help to inform future delirium educational programmes, and detection and prevention strategies.

Learning curves: analysing pace and challenge in four successful puzzle games

The pace at which challenges are introduced in a game has long been identified as a key determinant of both the enjoyment and difficulty experienced by game players, and their ability to learn from game play. In order to understand how to best pace challenges in games, there is great value in analysing games already demonstrated as highly engaging. Play-through videos of four puzzle games (Portal, Portal 2 Co-operative mode, Braid and Lemmings), were observed and analysed using metrics derived from a behavioural psychology understanding of how people solve problems. Findings suggest that; 1) the main skills learned in each game are introduced separately, 2) through simple puzzles that require only basic performance of that skill, 3) the player has the opportunity to practice and integrate that skill with previously learned skills, and 4) puzzles increase in complexity until the next new skill is introduced. These data provide practical guidance for designers, support contemporary thinking on the design of learning structures in games, and suggest future directions for empirical research.