Careful Description Research Articles

EXAMINING AGE BIAS IN CHATGPT RESPONSES TO USER QUESTIONS ABOUT DECISION-MAKING IN ADVANCED CANCER

Abstract ChatGPT is an online, AI-powered chat application that provides human-like responses to user input. There is concern about bias in ChatGPT responses based on user demographics, yet no existing research has examined age bias in ChatGPT responses to questions about decision making (DM) in advanced cancer. The current study examined the content of ChatGPT responses to a hypothetical patient question about DM in advanced cancer. Replicating Nastasi and colleagues’ (2023) approach, we posed a medical-advice-seeking vignette to ChatGPT with variations on four hypothetical patient characteristics: age (45/65/85 years), race (Black/White), ethnicity (Hispanic/Non-Hispanic), and insurance status (Insured/Not Insured). Each vignette ended with: “Should I look for other treatments or focus on my quality of life?” Three coders categorized responses (ICC=.95) for mentions of nine topics relevant to DM in advanced cancer (e.g., consideration of clinical trials, suggestion to pursue second opinions, descriptions of hospice and palliative care, and encouragement to talk to providers for DM support). ChatGPT responses more frequently mentioned consideration of clinical trials to patients who were 45 compared to patients who were 65 and 85 years old (X2(2,N=96)=8.6, p=.01). There was a non-significant trend toward ChatGPT responses suggesting pursuit of second opinions more frequently for younger patients (X2(2,N=96)=3.0 p=.22). There were no age differences in mentions of hospice care (p>.50), palliative care (p>.30), or talking to providers for DM support (p>.30). Findings indicate that ChatGPT responses to questions about advanced cancer DM may contain age bias. Future research should address how ChatGPT users navigate bias in responses.

The CareVirtue Digital Journal for Family and Friend Caregivers of People Living With Alzheimer Disease and Related Dementias: Exploratory Topic Modeling and User Engagement Study.

As Alzheimer disease (AD) and AD-related dementias (ADRD) progress, individuals increasingly require assistance from unpaid, informal caregivers to support them in activities of daily living. These caregivers may experience high levels of financial, mental, and physical strain associated with providing care. CareVirtue is a web-based tool created to connect and support multiple individuals across a care network to coordinate care activities and share important information, thereby reducing care burden. This study aims to use a computational informatics approach to thematically analyze open text written by AD/ADRD caregivers in the CareVirtue platform. We then explore relationships between identified themes and use patterns. We analyzed journal posts (n=1555 posts; 170,212 words) generated by 51 unique users of the CareVirtue platform. Latent themes were identified using a neural network approach to topic modeling. We calculated a sentiment score for each post using the Valence Aware Dictionary and Sentiment Reasoner. We then examined relationships between identified topics; semantic sentiment; and use-related data, including post word count and self-reported mood. We identified 5 primary topics in users' journal posts, including descriptions of specific events, professional and medical care, routine daily activities, nighttime symptoms, and bathroom/toileting issues. This 5-topic model demonstrated adequate fit to the data, having the highest coherence score (0.41) among those tested. We observed group differences across these topics in both word count and semantic sentiment. Further, posts made in the evening were both longer and more semantically positive than other times of the day. Users of the CareVirtue platform journaled about a variety of different topics, including generalized experiences and specific behavioral symptomology of AD/ADRD, suggesting a desire to record and share broadly across the care network. Posts were the most positive in the early evening when the tool was used habitually, rather than when writing about acute events or symptomology. We discuss the value of embedding informatics-based tools into digital interventions to facilitate real-time content delivery.

Mixed and undifferentiated autoimmune connective tissue diseases.

Dr. Irwin M. Braverman has advanced our understanding of cutaneous manifestations of autoimmune connective tissue diseases (AI-CTD). Prior to the era of molecular diagnostics, Dr. Braverman's careful clinical observations and detailed descriptions of patients with AI-CTD in his textbook Skin Signs of Systemic Disease provided insights into disease characterization, progression, and evolution. Patients from Dr. Braverman's career who did not fulfill criteria for a single clinical entity, but rather were diagnosed with undifferentiated connective tissue disease or mixed connective tissue disease, are discussed. In addition, key observations of Dr. Braverman into the cutaneous manifestations of Sjögren syndrome and the systemic complications of urticarial vasculitis are highlighted.

THE CHALLENGES FACED BY PRODUCERS IN THE PRODUCTION OF AMAZONIAN ROBUSTA COFFEE IN TANGARÁ DA SERRA – MT

Coffee production is one of the main activities in the world, generating around 100 million jobs directly and indirectly. In 2022, an estimated 17.97 thousand bags of Amazonian Robusta coffee were produced in Brazil. Given the considerable importance of coffee cultivation for the country as well as for the municipality of Tangará da Serra - MT, it is relevant to identify the main challenges faced by Tangará producers in the production of this type of coffee. In order to provide solutions to the problems exposed, the proposal was to characterize the producers of Amazonian Robusta coffee in Tangará da Serra - MT, identify the difficulties that interfere in production and compare them to those recorded in 2019 with those faced in 2023. For the study, a qualitative methodological approach was used, which enables a given perception of reality, with an exploratory research strategy for greater familiarity with this topic little explored in the municipality. The careful description sought to identify the obstacles faced by local coffee producers, and nineteen semi-structured interviews were conducted with these workers to collect data. The results showed that they face various challenges in the production of Amazonian robusta coffee, since they worked individually, without any ties to coffee associations or cooperatives, a factor that limits the representativeness of the crop, such as the lack of adaptation to the regime that manages water resources when the irrigation method is used for the crop, and the succession for the coffee activity, which appears as an obstacle to be overcome, since it is the transfer of power to the next manager of the business. It is evident that this production in Tangara tends to grow, since there are new entrants in the crop with crops in formation.

Chaplain care for health care colleagues: a scoping review

In addition to supporting patients and their loved ones at critical times, chaplains have long understood that caring for their health care colleagues is an important part of their practice. The Covid-19 pandemic prompted conversations among chaplains about how best to address the stress they were observing in health care workers. Our team conducted a scoping review in PubMed and CINAHL of peer reviewed literature describing chaplaincy care for health care workers. We started with 364 unique articles and found 59 that met criteria for the review. Five themes surfaced in analysis of these articles, with two themes emerging as most important: (1) descriptions of care for staff as part of the chaplain’s role, especially when staff are making difficult decisions and (2) reports of the effects of chaplain care for staff, both indirect and direct. We discovered that research was limited, and more research is needed regarding chaplain care for health care colleagues.

Coherence resonance in a memristive map neuron and adaptive energy regulation

Involvement of memristive term and additive physical variables including magnetic flux and charge can enhance the physical description of the biophysical neurons. Neural circuits coupled with memristors can be built and tamed to mimic the intrinsic biophysical characteristics and dynamical properties of biological neurons, and these memristive oscillator models are effective in predicting the mode transition in neural activities and self-organization in collective electric behaviors of neural networks. Any proposal of memristive map neurons requires reliable physical description. For example, the energy definition and self-adaptive working mechanism are crucial to verify the reliability of memristive maps. A capacitive variable is useful to describe the membrane potential, while the complexity of ion channels requires careful evaluation and description by using inductive variables relative to the electromagnetic field. In this work, a charge-controlled memristor is connected to an inductor in series for building a hybrid ion channel, and then a capacitor and a nonlinear resistor are combined to couple the ion channel. As a result, a simple memristive neural circuit is designed to discern the inner effect of electric field and magnetic field synchronously. The energy function is defined and verified with theoretical proof. Furthermore, a linear transformation is applied to convert this memristive neuron into a memristive map with an exact energy description, in which its dynamics and mode transition will be controlled by an adaptive law when its energy is beyond the threshold. Additive noise is imposed to induce coherence resonance, which can be detected by using the statistical analysis and average value for Hamilton energy function during changes in noise intensity. This scheme provides guidance for energy definition in memristive maps and the intrinsic energy regulation mechanism in neural activities is explained from physical and dynamical aspects.

En analyse av sakkyndigvurderinger i foreldretvister

Aim: Expert assessments in parental disputes are used to help the court make decisions “in the best interests of the child”. Our aim was to explore the understandings of parenthood, parental care, and child development embedded in such assessments. Methods: The article is based on a qualitative analysis of 20 expert assessments from the Oslo District Court. Analytical questions, such as how each parent’s contribution to parental care was described and evaluated, were posed to each assessment. The answers were then summarised across the cases. Results: Emotional aspects of the parent–child relationship, isolated episodes and statistical risk factors dominated the descriptions of parental care. The child’s everyday life and the parents’ care practices around the clock and over time received little attention. Moreover, the mothers seemed to be held to higher standards of parenting than were the fathers. This made it difficult to get a clear picture of the child’s life situation and made violence seem a less significant aspect of parenthood. Implications: Given that care and development are rooted in the practices of everyday life, the child’s daily life and the way in which the parents organise it must receive more attention. Furthermore, the occurrence of parental violence must be integrated into assessments of the child’s overall care situation. Keywords: family law, child custody evaluation, parenthood, developmental psychology, gender

CARING NURSES IN THE PREVENTION OF FALL RISK PATIENTS IN THE INPATIENT ROOM

The inpatient treatment room is a room that has the potential to have a risk of falling in patients with heart, lung and nerve diseases such as strokes who experience decreased consciousness, muscle weakness and impaired mobility which are at risk of falling from bed or when going to the bathroom. Nurses who are not Caring for patients can result in the risk of falling for patients. The inability of nurses to carry out fall risk assessments will be detrimental to patients during hospitalization. The purpose of this study was to explore the description of caring for nurses in preventing patients at risk of falling in the inpatient room of Permata Medika Ngaliyan Hospital, Semarang City. The research method uses a qualitative research design with a phenomenological approach. Research informants are implementing nurses. Determination of the sample using purposive sampling. Collecting data by in-depth interviews with informants using a voice recorder. The results of the study identified several themes related to the research objectives, namely the caring behavior of nurses when providing nursing care to patients, the impact of caring for patients on patients, the implementation of patient fall risk assessments in hospitals, and the efforts of nurses to prevent the risk of falling in patients. Conclusion: Nurses' caring behavior is a dynamic approach, where nurses work to increase their concern for patients, especially patients at risk of falling as an effort to prevent unexpected events in maintaining the quality of nursing care services.

End of life care in a level IV outborn neonatal intensive care unit.

Describe care surrounding the end of life (EOL) in the neonatal intensive care unit (NICU). Retrospective chart review of 208 infants who died in a level IV referral-only NICU over 5 years. A goals of care (GOC) conversation was documented before the day of death for 63% of infants. 73% died following withdrawal of life-sustaining treatment (WD); 13% died in a code. The median age at death was 17.5 days. 72% were held by a parent at EOL. 94% of families desired formal memory-making. We identified associations with mode of death and parental holding at death, including: WD was associated with palliative care consultation, early GOC conversations, and increased unit-specific length of stay. Holding was associated with chaplain visits, memory-making, and increased home-to-hospital distance. We present a detailed description of EOL care in an outborn NICU, including novel data on parental holding and memory-making.

Understanding person-centered care within a complex social context: A qualitative study of Saudi Arabian acute care nursing.

Policy reforms implemented in Saudi Arabia in recent years aim to modernize the culture and infrastructure of healthcare delivery and are expected to integrate person- and patient-centered care principles throughout the national healthcare system. However, in a complex multicultural environment where most nurses are international migrant workers, unique challenges emerge that frame the delivery of care. Better understanding is needed about what nurses perceive to be high-quality, person-centered care in Saudi Arabia and how they manage to enact it in practice. Semi-structured interviews were conducted with 21 nurses working in two tertiary hospitals in Riyadh, the capital city. Participants included Saudi citizens (n = 9) and expatriates (n = 12) who were asked to describe their perceptions of quality nursing care and explain the obstacles that they encounter in providing such care. Nurses reported extensive efforts to achieve individualized, empathetic, developmentally appropriate care. Their descriptions of care aligned with principles of patient-centeredness in care but were not separable from challenges at the patient, organizational, and regional levels, including staffing and supplies shortages, gaps in regional care coordination, inadequate language translation services, variability in cultural beliefs about healthcare communication, and overt discrimination against expatriate workers. Nurses reported creative strategies to achieve professional nursing values while navigating a dynamic landscape of constraints. The findings add to literature suggesting that person-centeredness in care cannot be understood outside the social and organizational conditions that shape it.

Understanding health service utilisation patterns for care home residents during the COVID-19 pandemic using routinely collected healthcare data

BackgroundHealthcare in care homes during the COVID-19 pandemic required a balance, providing treatment while minimising exposure risk. Policy for how residents should receive care changed rapidly throughout the pandemic. A lack of accessible data on care home residents over this time meant policy decisions were difficult to make and verify. This study investigates common patterns of healthcare utilisation for care home residents in relation to COVID-19 testing events, and associations between utilisation patterns and resident characteristics.MethodsDatasets from County Durham and Darlington NHS Foundation Trust including secondary care, community care and a care home telehealth app are linked by NHS number used to define daily healthcare utilisation sequences for care home residents. We derive four 10-day sets of sequences related to Pillar 1 COVID-19 testing; before [1] and after [2] a resident’s first positive test and before [3] and after [4] a resident’s first test. These sequences are clustered, grouping residents with similar healthcare patterns in each set. Association of individual characteristics (e.g. health conditions such as diabetes and dementia) with healthcare patterns are investigated.ResultsWe demonstrate how routinely collected health data can be used to produce longitudinal descriptions of patient care. Clustered sequences [1,2,3,4] are produced for 3,471 care home residents tested between 01/03/2020–01/09/2021. Clusters characterised by higher levels of utilisation were significantly associated with higher prevalence of diabetes. Dementia is associated with higher levels of care after a testing event and appears to be correlated with a hospital discharge after a first test. Residents discharged from inpatient care within 10 days of their first test had the same mortality rate as those who stayed in hospital.ConclusionWe provide longitudinal, resident-level data on care home resident healthcare during the COVID-19 pandemic. We find that vulnerable residents were associated with higher levels of healthcare usage despite the additional risks. Implications of findings are limited by the challenges of routinely collected data. However, this study demonstrates the potential for further research into healthcare pathways using linked, routinely collected datasets.

Analysis of the quality of description of usual care interventions in clinical trials involving exercise for knee osteoarthritis: a systematic review protocol

Introduction: Treatment for Osteoarthritis (OA) includes exercises, educational and self-management programs, with new therapeutic interventions often compared to “Usual Care”. Objectives: To investigate the quality of description of Usual Care as a comparator group in randomized clinical trials (RCTs) using exercise in the treatment of knee OA through a Systematic Review (SR). Methods: A search will be conducted in the MEDLINE, Embase, Cochrane Central, PEDro, CINAHL, and SPORTDiscus databases to identify RCTs that used Usual Care as a comparator in the treatment of knee OA with exercise. After selection, eligible studies will be assessed by a pair of trained researchers. The PEDro scale will be used to evaluate the risk of bias, with each study classified as “poor,” “fair,” “good,” or “excellent,” and intervention description will be assessed using the TIDieR checklist. The quality of the intervention descriptions in each RCT will be classified as “High” if the score is equal to or greater than 50% of the total score, or “Low” if it is lower. Unpaired t-tests and the chi-square test will be used for the evaluation of numerical and categorical variables, respectively. Expected Results: The results of this review are expected to summarize the quality of intervention description in RCTs in OA that are often inadequately described, especially concerning the control group, making replication in RCTs and comparison between tested therapies challenging. A well-constructed SR protocol is necessary to help clarify uncertainties about interventions generically referred to as Usual Care. Key-Words: knee osteoarthritis; patient care; exercise.

PHONEME- GRAPHEME CORRESPONDENCE IN READING SKILLS OF GRADE SEVEN STUDENTS: A THEMATIC ANALYSIS

PHONEME- GRAPHEME CORRESPONDENCE IN READING SKILLS OF GRADE SEVEN STUDENTS: A THEMATIC ANALYSIS

Watch Me Play!: protocol for a feasibility study of a remotely delivered intervention to promote mental health resilience for children (ages 0–8) across UK early years and children’s services

BackgroundHalf of mental health problems are established by the age of 14 years and 75% by 24 years. Early intervention and prevention of mental ill health are therefore vitally important. However, increased demand over recent years has meant that access to child mental health services is often restricted to those in severest need. Watch Me Play! (WMP) is an early intervention designed to support caregiver attunement and attention to the child to promote social-emotional well-being and thereby mental health resilience. Originally developed in the context of a local authority mental health service for children in care, it is now also delivered online as a low intensity, scalable, preventative intervention. Although WMP shows promise and is already used in some services, we do not yet know whether it is effective.MethodsA non-randomised single group feasibility study with embedded process evaluation. We propose to recruit up to 40 parents/carers of children aged 0–8 years who have been referred to early years and children’s services in the UK. WMP involves a parent watching the child play and talking to their child about their play (or for babies, observing and following signals) for up to 20 min per session. Some sessions are facilitated by a trained practitioner who provides prompts where necessary, gives feedback, and discusses the child’s play with the caregiver. Services will offer five facilitated sessions, and parents will be asked to do at least 10 additional sessions on their own with their child in a 5-week period. Feasibility outcomes examined are as follows: (i) recruitment, (ii) retention, (iii) adherence, (iv) fidelity of delivery, (v) barriers and facilitators of participation, (vi) intervention acceptability, (vii) description of usual care, and (viii) data collection procedures. Intervention mechanisms will be examined through qualitative interview data. Economic evaluation will be conducted estimating cost of the intervention and cost of service use for child and parents/carers quality-adjusted life years.DiscussionThis study will address feasibility questions associated with progression to a future randomised trial of WMP.Trial registrationISRCTN13644899. Registered on 14th April 2023.

Modelling non-local cell-cell adhesion: a multiscale approach

Cell-cell adhesion plays a vital role in the development and maintenance of multicellular organisms. One of its functions is regulation of cell migration, such as occurs, e.g. during embryogenesis or in cancer. In this work, we develop a versatile multiscale approach to modelling a moving self-adhesive cell population that combines a careful microscopic description of a deterministic adhesion-driven motion component with an efficient mesoscopic representation of a stochastic velocity-jump process. This approach gives rise to mesoscopic models in the form of kinetic transport equations featuring multiple non-localities. Subsequent parabolic and hyperbolic scalings produce general classes of equations with non-local adhesion and myopic diffusion, a special case being the classical macroscopic model proposed in Armstrong et al. (J Theoret Biol 243(1): 98–113, 2006). Our simulations show how the combination of the two motion effects can unfold. Cell-cell adhesion relies on the subcellular cell adhesion molecule binding. Our approach lends itself conveniently to capturing this microscopic effect. On the macroscale, this results in an additional non-linear integral equation of a novel type that is coupled to the cell density equation.

Rural home care nurses’ experiences with continuing nursing education

Purpose: Rural home care nurses require access to continuing nursing education to address the increasing complexity of client care needs. There is currently limited literature on continuing nursing education for rural home care nurses. The purpose of this study was to explore the continuing nursing education experiences of rural home care nurses. Sample: Purposive and snowball sampling were used to recruit registered nurses who worked in publicly funded rural home care in one western Canadian province, in communities with a population of less than 10,000 people. Twenty rural home care nurses participated in semi-structured telephone interviews. Methods: This study used interpretive description as its method of inquiry and analysis. Data was collected between December 2020 and May 2021 and the analysis was supported using NVivo 12 software. Findings: Key findings from this study contribute to the description of western Canadian rural home care nursing roles and the degree of autonomy required to provide expert care in the home environment. Rural home care nurses’ experiences with continuing education are impacted by external factors including (1) Chameleonic Practice (One-Person Show, Professional Intersection, Becoming their Person), (2) Foundational Instability (Roadblocks to Learning, Stretched Thin, Rural Repatriation) and (3) Learning Leadership (Filling the Learning Bucket, Finding a Way, Learning Reciprocity). Conclusions: The findings of this study suggest that the continuing nursing education experiences of rural home care nurses is dependent on many factors. Significant policy changes and updated standards of practice are required to support safe client care through the delivery of evidence-informed continuing nursing education.

Description Of Diabetic Wound Treatment With Hydrogel In Pedis Care Malang City

The hydrogel's optimum hydration ability can lyse slough and necrotic tissue (autolytic debridement ability). This study aims to determine the description of diabetic wound care using hydrogel as a modern dressing in the development of BWAT scores. The research design uses a case study method and consisting of 2 samples with grade II-III diabetic ulcers at Pedis Care Malang. The results of the study on subject I obtained the BWAT score on the first treatment was 33 and on the sixth day of treatment was 26, in subject II the first treatment was 37 and on the sixth day of treatment was 25, showed a decrease in the BWAT score, which means that diabetic ulcer healing progressed. The healing process of diabetic ulcer wounds is also influenced by the nutrients that enter the body, one of which is protein which plays a role in cell formation. The researcher's advice for both subjects is that they are expected to be able to maintain wound moisture with sustainable modern dressings until the wound is declared healed and increase nutrition as a supporting factor for wound healing.

How to Care for Adolescent Patients With Orthostatic Intolerance in the Primary Care Office.

Orthostatic intolerance (and its subtype postural orthostatic tachycardia syndrome [POTS]) is an increasingly common complaint among adolescents associated with significant decrease in quality of life and frequent visits to primary care offices. As orthostatic intolerance becomes increasingly discussed online and through social media, we have observed that family angst and anxiety only heighten, often leading to requests for specialist referral to manage the symptoms. This often leads to delay in diagnosis, which further exacerbates the situation. In truth, however, a pragmatic approach applied by the primary care provider, including a ready explanation for the experienced symptoms, not only provides the bedrock for patient improvement, but also eases the anxiety of having a seemingly nebulous diagnosis. As physicians caring for these patients, we have seen success with treatment and seek to share this blueprint. Key points that will be covered include how to make an accurate diagnosis (using the "dizziness rule"), how to counsel about treatment, and clinic pitfalls to avoid. The description of care that follows is not based on systematic review and instead is exactly what is used in our office and what we hope will be successful in yours as well.

Scientific applicability in day-to-day practice on Granthokta Sutika Paricharya

Being a mother is most challenging and most rewarding position a woman ever holds, so motherhood is wonderful at the same time its hardest phase for woman. Giving birth to a new life is a beautiful moment a women will cherish forever. But after the delivery, mothers body encounters many physical and psychological changes which may lead to the generalized weakness and backache etc., if proper postnatal care is not taken. Mother needs to recover and heal from the physical and emotional distress experienced during the delivery. So, proper care in postnatal period is essential. Ayurveda classics emphasize on both prenatal and postnatal care of the mother. There is detailed description of postnatal period and care known as Sutika Kala and Paricharaya respectively. After the childbirth when placenta is expelled out then women is termed as Sutika[1] and Paricharya means following the diet, regimen and medicines (Aahara, Vihara and Aushadha) during the Sutika Kala (postnatal period). According to Acharyas, Mithyaachrana during Sutika Kala may result in incurable disease, so extreme care must be taken during this period.[2] The main prospective of the Sutika Paricharya is to retrieve the strength and vitality of the mother’s body same as non-pregnant state along with stabilization of the physiological and psychological health. It also improves the quality and quantity of breast milk of mother. In present time due to changing lifestyles and food habits Sutika Paricharya can be a solution to many problems faced due to Mithyaachrana during the Sutika Kala.

One catastrophic flood every millennium: Synchronicity of extreme floods and global warm periods in the multi-archive record of the Roman theatre of Guadix (Granada, SE Spain)

Past global changes are typically registered in both natural (e.g., geologic-geomorphological, atmospheric-climatic, hydrologic-glacial and biological) and cultural records (e.g., archaeological, historical and documentary sources). Nevertheless, there are few sites in the world where sedimentary and archaeological evidence combine to provide information about two or more past millennial climate changes. In this regard, the Roman city of Guadix (Granada, SE Spain) represents a singular location, whose Roman theatre (1st century CE), recently discovered in 2007, contains palaeo-flood evidences that can be related to the two latest global warm periods: the Roman and Medieval epochs.In this research, detailed geological analyses are carried out. These analyses consisted in careful descriptions of vertical stratigraphic sections (lithology, structures…) and lateral correlation panels; as well as fluvial facies models to interpret the sedimentary environments for each sequence. This sedimentological information was combined with the study of archaeological remains, radiocarbon dating and optically stimulated luminescence, and three major flood events have been identified: two of them dating back to the beginning of the 1st century CE (period of the Pax Romana Empire); and the other occurring at the end of the 12th century (Islamic Almohad period). Such extreme hydrological events were synchronous with two warm periods: the Roman Climatic Optimum and the Medieval Warm Period. This seems to suggest that the meteorological fluctuations associated to climate changes during warming periods (such as the current one associated with present-day climate change) very likely produce such extraordinary or extreme events, which can mobilise large amounts of solid load (sands, silts and clays) and trigger sudden changes in the configuration of the river system (channel avulsions, meander cut-offs and captures among tributaries) and alluvial fans (at tributary mouths).We believe that the documented observations provide an analogy for the current warming period. In this regard, flood risk management in the current city of Guadix, whose hazard and risk maps were drawn up according to the criteria of the European Flood Directive, should take into account: (i) the millennial recurrent character of catastrophic floods in Guadix, well above the 500-year return period officially considered; (ii) the importance of the mobilisation of solid load in flood hazard and risk, which can obstruct drains and reduce the capacity of channels and bridges; (iii) the geomorphological dynamics, capable of modifying the position of the channels and thus the delimitation of hazard and risk zones; (iv) the role of non-permanent tributaries of the Guadix River during storms and heavy rain, related to quasi-stationary convective cells. Only in this way, will flood hazard and risk maps be useful in territorial and urban planning, civil protection during emergencies and the reduction of damage from future catastrophic floods. The present study highlights how geoarchaeological and palaeo-environmental records can be a highly valuable source of data for the improvement of flood hazard assessments in the 21st Century.