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To identify how patient journey mapping is being undertaken and reported.A scoping review of the literature was undertaken using JBI guidance.Databases were searched in July 2021 (16th-21st), including Ovid's Medline, Embase, Emcare and PsycINFO; Scopus; Web of Science Core Collection, the Directory of Open Access Journals; Informit and; ProQuest Dissertations and Theses Global.Eligible articles included peer-reviewed literature documenting journey mapping methodologies and studies conducted in healthcare services. Reviewers used Covidence to screen titles and abstracts of located sources, and to screen full-text articles. A table was used to extract data and synthesize results.Eighty-one articles were included. An acceleration of patient journey mapping research was observed, with 76.5% (n = 62) of articles published since 2015. Diverse mapping approaches were identified. Reporting of studies was inconsistent and largely non-adherent with relevant, established reporting guidelines.Patient journey mapping is a relatively novel approach for understanding patient experiences and is increasingly being adopted. There is variation in process details reported. Considerations for improving reporting standards are provided.Patient journey mapping is a rapidly growing approach for better understanding how people enter, experience and exit health services. This type of methodology has significant potential to inform new, patient centred models of care and facilitate clinicians, patients and health professionals to better understand gaps and strategies in health services. The synthesised results of this review alert researchers to options available for journey mapping research and provide preliminary guidance for elevating reporting quality.

Objective This scoping review will assess the literature that documents or utilizes patient journey mapping methodologies in health care settings. It will also examine the reporting processes of studies that use this methodology. Introduction Health care systems are complex and can be challenging for patients to navigate. Using patient journey mapping as a research method promotes a deeper understanding of patient experiences when navigating these systems. Patient journey mapping provides valuable insights into where systems are working well, where gaps in care exist, and how the system could respond to these gaps. Inclusion criteria This review will consider peer-reviewed articles and publicly available academic literature documenting patient journey mapping methodologies. The review will also consider studies providing guidance and recommendations on how to report patient journey mapping studies in health care services and systems. Methods The proposed review will follow JBI guidance for scoping reviews. The following databases will be searched: MEDLINE, Embase, Emcare, PsycINFO, Scopus, Web of Science Core Collection, the Directory of Open Access Journals, Informit, and ProQuest Dissertations and Theses Global. The search will not be limited to year of publication but will be limited to studies reported in English. The PRISMA-ScR extension will be used to document the literature search. Two reviewers will screen titles, abstracts, and full-text articles. An extraction table will be used to extract relevant data from all included articles and to facilitate data analysis.

Published on 06 Feb 2022 The COVID-19 pandemic, and the resulting closure of daycare centers worldwide, led to unprecedented changes in children’s learning environments. This period of increased time at home with caregivers, with limited access to external sources (e.g., daycares) provides a unique opportunity to examine the associations between the caregiver-child activities and children’s language development. The vocabularies of 1742 children aged 8-36 months across 13 countries and 12 languages were evaluated at the beginning and end of the first lockdown period in their respective countries (from March to September 2020). Children who had less passive screen exposure and whose caregivers read more to them showed larger gains in vocabulary development during lockdown, after controlling for SES and other caregiver-child activities. Children also gained more words than expected (based on normative data) during lockdown; either caregivers were more aware of their child’s development, or vocabulary development benefited from intense caregiver-child interaction during lockdown, or both. We discuss these results in the context of the extraordinary circumstances of the COVID-19 pandemic and highlight limitations of the study. Funding for Polish sample: grant from National Science Center NCN (Poland), no 2018/31/B/HS6/03916. NK was partly supported by the Research Council of Norway through its Centres of Excellence funding scheme [project number 223265].

Renal transplant recipients (RTRs) are at increased risk of keratinocyte cancer (KC), especially cutaneous squamous cell carcinoma (cSCC). Previous studies identified a genetic variant of theWe sought to find further genetic variation inGenotyping of a combined RTR population (Polymorphism atWe report the association of a SNP in the

Background The Needs in Recovery Assessment (NiRA) is a newly developed needs assessment tool, designed to identify the needs of people recovering from mental illness. This tool has been evaluated outside of the clinical context for validity and reliability. The aim of this study is to introduce the NiRA into clinical practice and to evaluate the value of the NiRA as an adjunct to service delivery from the perspectives of stakeholders and to evaluate the barriers and facilitators of embedding the NiRA in a mental health service. Methods The establishment of the NiRA in a tertiary mental health unit over a 6-month period will be evaluated using a multi-methods approach. Quantitative data will be collected using the NiRA itself and the Recovery Self-Assessment (RSA). Face-to-face interviews with service users and clinicians will be conducted following the initial completion of the NiRA, with a follow-up interview for service users on discharge from the service. Regular informal follow-up with clinicians throughout the study will support the introduction of the NiRA. Descriptive statistics will be used to analyse quantitative data, and descriptive qualitative methods will be used to analyse data from interviews. Discussion Aligning mental health services with recovery-oriented frameworks of care is imperative. The NiRA is a tool that has been designed in accordance with recovery principles and may assist services to be more recovery-oriented. If the NiRA is able to achieve the aims and objectives of this project, a larger implementation study will be conducted. Trial registration Australian and New Zealand Clinical Trial Registry (ANZCTR), ACTRN12621000316808

Onomatopoeia are disproportionately high in number in infants’ early words compared to adult language. Studies of infant language perception have proposed an iconic advantage for onomatopoeia, which may make them easier for infants to learn. This study analyses infants’ early word production to show a phonological motivation for onomatopoeia in early acquisition. Cross-linguistic evidence from 16 infants demonstrates how these forms fit within a phonologically-systematic developing lexicon. We observe a predominance of consonant harmony and open cv syllables in infants’ early words—structures that are typical of onomatopoeia across languages. Infants’ acquisition of onomatopoeia is shown to be driven by a preference for structures that are easy to plan and produce. These data present an original perspective on onomatopoeia in early development, highlighting the role of production in language acquisition in general, and onomatopoeic words in particular.

Onomatopoeia appear in high quantities in many infants’ earliest words, yet there is minimal research in this area. Instead, findings from the wider iconicity literature are generalised to include onomatopoeia, leading to the assumption that their iconic status makes them inherently learnable, thereby prompting their early production. In this review we bring together the literature on onomatopoeia specifically and iconicity more generally to consider infants’ acquisition from three perspectives: perception, production, and interaction. We consider these findings in relation to Imai and Kita’s (2014) ‘sound symbolism bootstrapping hypothesis’ to determine whether their framework can account for onomatopoeia alongside other iconic forms.

Infants’ early babbling allows them to engage in proto-conversations with caretakers, well before clearly articulated, meaningful words are part of their productive lexicon. Moreover, the well-rehearsed sounds from babble serve as a perceptual ‘filter’, drawing infants’ attention towards words that match the sounds they can reliably produce. Using naturalistic home recordings of 44 10-11-month-olds (an age with high variability in early speech sound production), this study tests whether infants’ early consonant productions match words and objects in their environment. We find that infants’ babble matches the consonants produced in their caregivers’ speech. Infants with a well-established consonant repertoire also match their babble to objects in their environment. Our findings show that infants’ early consonant productions are shaped by their input: by 10 months, the sounds of babble match what infants see and hear.

Toxic epidermal necrolysis and Staphylococcal scalded skin syndrome (SSSS) are potentially life-threatening dermatological emergencies that present in a similar clinical fashion. Toxic epidermal necrolysis is typically triggered by anticonvulsant and other neurological medications and reports clindamycin inducing the disease is exceedingly rare. SSSS seldomly occurs in adult patients. We present the case of a 60-year-old male presenting with dermatological rash covering >80% his body surface. Diagnosis and therapy involved multidisciplinary contribution from medical physicians, dermatologists, microbiologists and histopathologists to provide a favourable outcome.

Soils are a nonrenewable resource that support a wide array of ecosystem functions. The scope of these functions depends on the nature and properties of the soil at a given location on the Earth. Demand for better soil information has been growing since the development of soil science in the nineteenth century. This recent interest is driven by an increasing recognition of the ecological, economic, and societal benefits of understanding soil properties and the value of that knowledge for realizing management objectives for agriculture, grazing, forestry, and other land uses. Soil surveys are one method for amassing soil data and mapping the extent of various soil types. The Federal Government has singularly been a long-term sponsor of soil surveys in the United States. The history of these surveys is richly documented and illustrated by Helms and others (2008). Soil surveys describe horizontal (e.g., soil series) and vertical (e.g., horizon depth) properties of soils. Soil mapping enhances assessments of spatial variability in the development and properties of soils as a function of geology, climate, topography, and vegetation. Extensive sampling of soils in concert with other attributes (e.g., forest or rangeland composition) can provide focused estimates and understanding of the linkages between soils and vegetation growth, mortality, and C stocks (O’Neill et al. 2005) (Box 9.1). Thus, soils are not independent of biogeophysical settings and climate, but rather are a result of these variables. Management interpretations of soil functions and processes such as erosion, potential vegetation growth, and hydrologic function integrate these factors and offer an index for land use limitations and opportunities.

There has been a shift from using the term sexually transmitted disease (STD) to sexually transmitted infection (STI), primarily based on conjecture that STI is less stigmatizing. However, there is a dearth of evidence regarding how the public actually perceives these terms.Students at a Midwestern university participated in an online survey and were randomized to the open-ended question "What comes to mind when you think of the term sexually transmitted disease (STD)?" (n = 205) or "What comes to mind when you think of the term sexually transmitted infection (STI)?" (n = 208). Conventional content analysis was conducted to identify response themes. Cross tabulations with the χ statistic determined the number of participants that endorsed each theme and any differences between the STD and STI responses.Almost all themes occurred in similar numbers across the STD and STI responses. Overarching themes for both terms were contracted through sex; specific STDs/STIs; severe; negative emotional affect; types of people who get STDs/STIs; physical symptoms; preventable; common; and treatable/curable. However, participants were more likely to mention that STDs were common (P = 0.030) and reported less negative emotional affect for STIs (P = 0.024). Two themes emerged only in the STI group: STDs (P = 0.001) and site of infection (P = 0.003).With some exceptions, late adolescents have overlapping conceptualizations of the terms STD and STI. The most commonly reported themes revealed likely areas of misinformation. Although language is an important aspect of health communication, more than a terminology change is needed to reduce the stigma associated with STDs/STIs.

Literature examining the effects of mothers' work status on infant language development is mixed, with little focus on varying work-schedules and early vocabulary. We use naturalistic data to analyze the productive vocabulary of 44 17-month-olds in relation to mothers' work status (Full-time, Part-time, Stay-at-home) at 6 and 18 months. Infants who experienced a combination of care from mothers and other caretakers had larger productive vocabularies than infants in solely full-time maternal or solely other-caretaker care. Our results draw from naturalistic data to suggest that this care combination may be particularly beneficial for early lexical development.

Background: Over 1000 horses are investigated annually for Hendra virus (HeV)-like illness, of which very few (

biomarkers. We also touch upon the changing biomarker environment, the increased focus on multigene testing, and how that might impact the development, commercialization and clinical practice of PM. Potential limiting factors for the adoption of genetic biomarkers

Cluster BE1 Streptomyces bacteriophages belong to the Siphoviridae, with genome sizes over 130 kbp, and they contain direct terminal repeats of approximately 11 kbp. Eight newly isolated closely related cluster BE1 phages contain 43 to 48 tRNAs, one transfer-messenger RNA (tmRNA), and 216 to 236 predicted open reading frames (ORFs), but few of their genes are shared with other phages, including those infecting Streptomyces species.

A perceptual advantage for iconic forms in infant language learning has been widely reported in the literature, termed the “sound symbolism bootstrapping hypothesis” by Imai and Kita (2014). However, empirical research in this area is limited mainly to sound symbolic forms, which are very common in languages such as Japanese but less so in Indo-European languages such as English. In this study, we extended this body of research to onomatopoeia—words that are thought to be present across most of the world’s languages and that are known to be dominant in infants’ early lexicons. In a picture-mapping task, 10- and 11-month-old infants showed a processing advantage for onomatopoeia (e.g., woof woof) over their conventional counterparts (e.g., doggie). However, further analysis suggests that the input may play a key role in infants’ experience and processing of these forms.

1. Wildlife managers often require estimates of abundance. Direct methods of estimation are often impractical, especially in closed-forest environments, so indirect methods such as dung or nest surveys are increasingly popular. 2. Dung and nest surveys typically have three elements: surveys to estimate abundance of the dung or nests; experiments to estimate the production (defecation or nest construction) rate; and experiments to estimate the decay or disappearance rate. The last of these is usually the most problematic, and was the subject of this study. 3. The design of experiments to allow robust estimation of mean time to decay was addressed. In most studies to date, dung or nests have been monitored until they disappear. Instead, we advocate that fresh dung or nests are located, with a single follow-up visit to establish whether the dung or nest is still present or has decayed. 4. Logistic regression was used to estimate probability of decay as a function of time, and possibly of other covariates. Mean time to decay was estimated from this function. 5. Synthesis and applications. Effective management of mammal populations usually requires reliable abundance estimates. The difficulty in estimating abundance of mammals in forest environments has increasingly led to the use of indirect survey methods, in which abundance of sign, usually dung (e.g. deer, antelope and elephants) or nests (e.g. apes), is estimated. Given estimated rates of sign production and decay, sign abundance estimates can be converted to estimates of animal abundance. Decay rates typically vary according to season, weather, habitat, diet and many other factors, making reliable estimation of mean time to decay of signs present at the time of the survey problematic. We emphasize the need for retrospective rather than prospective rates, propose a strategy for survey design, and provide analysis methods for estimating retrospective rates.

The influence of natural terrestrial disturbances on the limnology of northern lakes is little known, yet important for understanding the ecology of these remote ecosystems. The Riviere George Caribou Herd (RGCH) in northern Quebec has undergone a large population increase since the 1950s, which has been accompanied by pronounced impacts (i.e., degradation of vegetation cover, soil erosion) on terrestrial environments of the Riviere George region. The goal of our study was to evaluate if the increased caribou activity and resulting terrestrial impacts have been accompanied by impacts on adjacent aquatic ecosystems. We studied the recent diatom assemblages (i.e., about the last two centuries) preserved in six sediment cores taken from lakes located in the most heavily impacted region, and in one core from a lake showing little evidence of recent caribou activity in the catchment basin. Core chronologies based on 210Pb dating techniques indicated that average mass sedimentation rates in this subarctic region were very low (0.0039 to 0.012 g cm-2 yr-1). Perhaps surprisingly, diatom assemblages from all seven cores showed very little change, indicating remarkably stable limnological conditions throughout the past -200 yr. The lack of a signal from caribou activity is most likely due to (1) short-term impacts being too transitory to be registered in the sediment record, and (2) long-term impacts not representing a significant perturbation outside the natural variability of these aquatic ecosystems. In contrast to other arctic regions, the limnological stability of our study sites suggests that recent climatic change impacts have been negligible in this region of northern Quebec, which seems to confirm climate model predictions that northern Quebec and Labrador will remain climatically stable under global warming scenarios.

Incidence of breast cancer (BC) varies among ethnic groups, with higher rates in white than in African-American women. Until now, most epidemiological and genetic studies have been carried out in white women. To investigate whether interactions between genetic and reproductive risk factors may explain part of the ethnic disparity in BC incidence, a genetic epidemiology study was conducted, between 1989 and 1994, at the Howard University Cancer Center (Washington, DC), which led to the recruitment of 245 African-American families. Segregation analysis of BC was performed by use of the class D regressive logistic model that allows for censored data to account for a variable age of onset of disease, as implemented in the REGRESS program. Segregation analysis of BC was consistent with a putative dominant gene effect (P < 0.000001) and residual sister-dependence (P < 0.0001). This putative gene was found to interact significantly with age at menarche (P = 0.048), and an interaction with a history of spontaneous abortions was suggested (P = 0.08). A late age at menarche increased BC risk in gene carriers but had a protective effect in non-gene carriers. A history of spontaneous abortions had a protective effect in gene carriers and increased BC risk in non-gene carriers. Our findings agree partially with a similar analysis of French families showing a significant gene x parity interaction and a suggestive gene x age at menarche interaction. Investigating gene x risk factor interactions in different populations may have important implications for further biological investigations and for BC risk assessment.

The terrestrial condition assessment (TCA) evaluates effects of uncharacteristic stressors and disturbance agents on land-type associations (LTAs) to identify restoration opportunities on national forest system (NFS) lands in the United States. A team of agency scientists and managers, representing a broad array of natural resource disciplines, developed a logic structure for the TCA to identify appropriate data sources to support analyses. Primary national data sources included observed insect- and pathogen-induced mortality, key critical loads for soil and the atmosphere, long term seasonal departures in temperature and precipitation, road densities, uncharacteristic wildfires, historical fire regime departure, wildfire potential, insect and pathogen risk, and vegetation departure from natural range of variability. The TCA was implemented with the ecosystem management decision support (EMDS) system, a spatial decision support system for landscape analysis and planning. EMDS uses logic models to interpret data, synthesizes information over successive layers of logic topics, and draws inferences about the ecological integrity of LTAs as an initial step to identifying high priority LTAs for landscape restoration on NFS lands. Results from the analysis showed that about 74 percent of NFS lands had moderate or better overall ecological integrity. Major impacts to ecological integrity included risk of mortality due to insects and disease, extent of current mortality, extent of areas with high and very high wildfire hazard potential, uncharacteristically severe wildfire, and elevated temperatures. In the discussion, we consider implications for agency performance reporting on restoration activities, and subsequent possible steps, including strategic and tactical planning for restoration. The objective of the paper is to describe the TCA framework with results from a national scale application on NFS lands.

Limnological data (e.g., water chemistry, lakewater temperature, vegetation zone and degree of human impact) were collected from lakes spanning the Russian arctic treeline in three regions: on the Taimyr Peninsula and near the mouth of the Lena River, both in central arctic Siberia, and near the mouth of the Pechora River, western arctic Russia. Pearson correlation and canonical variates analyses revealed similar environmental gradients in all three regions. Variables expressing ionic composition of the water (i.e., cations, anions, dissolved inorganic carbon and conductivity) were highly intercorrelated, as were nutrients, chlorophyll a, particulate organic matter and metal (i.e., Fe and Mn) concentrations. Lakewater transparency was related to water colour (i.e., Fe, Mn and dissolved organic carbon) and productivity. Regional differences among the lakes were strong and appeared to reflect differences in geology, hydrology and human impact. For example, Na and Cl concentrations were related to proximity to the ocean in the Lena and Pechora River regions but not in the more inland Taimyr region. Extensive mining and smelting at Norilsk, on the Taimyr Peninsula, has apparently resulted in elevated major ion and metal concentrations in lakes closer to the city. Surface water temperatures, nutrients, and related variables were particularly useful for distinguishing lakes in different vegetation biomes. Forest lakes were typically warmer, with slightly elevated concentrations of dissolved organic carbon (DOC). Lakes in the forest–tundra zone often had higher concentrations of particulate organic matter, Fe and Mn. Tundra lakes were characterized by low nutrient and DOC concentrations. These data will facilitate the development of models that predict the outcome of future climatic change on arctic and subarctic aquatic ecosystems, as well as provide baseline data for future limnological studies in these remote regions.

The chemical speciation of zinc- and tin(II)-containing dentrifices and of the reaction between saliva and such toothpastes has been researched using computer simulation. Pivotal formulation variables have been identified (phosphates, fluorides, citrate, etc.) and optimised to suggest formulations having maximum availability, of antimicrobial metal salts Zn2+ (aq) and soluble tin(II) species. Although the concept of having a single dentifrice in which both the zinc and the soluble tin(II) species are maximised together is desirable, it is concluded that at a single pH value, there cannot be maximal availability for both species, but it is possible to achieve levels of antimicrobial metal salts superior to a dentifrice containing either ingredient alone.

Purpose To compare bleb survival and histology after implantation of the EX-PRESS™ glaucoma filtration device versus silicone tubes in a rabbit model of filtration surgery. Methods Glaucoma filtration surgery was performed on one eye each of twelve New Zealand white rabbits. Eyes were randomized to implantation with the EX-PRESS™ filtration device (n=6) or a silicone tube (n=6). Bleb vascularity was evaluated at three and six weeks using a standard scale. At 6 weeks, eyes were enucleated and a histologic analysis was performed. Bleb survival was also recorded for the two groups. Results Histologically, a thin capsule consisting of mild fibroblast proliferation associated with intercellular collagen was present around both implants. Both groups demonstrated a mild infiltration of plasma cells and polymorphonuclear leukocytes. Bleb vascularity was similar between both groups at three and six weeks post-operatively. Bleb survival between the two groups was not significantly different. Conclusions Similar outcomes were noted after glaucoma filtration surgery using either silicone tubes or the EX-PRESS™ glaucoma filtration device in this rabbit model. Both implants appear to be relatively inert with little difference in biocompatibility and bleb survival.

The RET (rearranged-during-transfection protein) protooncogene triggers multiple intracellular signaling cascades regulating cell cycle progression and cellular metabolism. We therefore hypothesized that metabolic imaging could allow noninvasive detection of response to the RET inhibitor vandetanib in vivo.The effects of vandetanib treatment on the full-genome expression and the metabolic profile were analyzed in the human medullary thyroid cancer cell line TT. In vitro, transcriptional changes of pathways regulating cell cycle progression and glucose, dopa, and thymidine metabolism were correlated to the results of cell cycle analysis and the uptake of (3)H-deoxyglucose, (3)H-3,4-dihydroxy-L-phenylalanine, and (3)H-thymidine under vandetanib treatment. In vivo, the tumor metabolism under vandetanib was monitored by small-animal PET of tumor-bearing mice.Vandetanib treatment resulted in the transcriptional downregulation of various effector pathways with consecutive downregulation of cyclin expression and a G(0)/G(1) arrest. In vitro, vandetanib treatment resulted in the decreased expression of genes regulating glucose, 3,4-dihydroxy-L-phenylalanine, and thymidine metabolism, with a subsequent reduction in the functional activity of the corresponding pathways. In vivo, metabolic imaging with PET was able to assess changes in the tumoral glucose metabolism profile as early as 3 d after initiation of vandetanib treatment.We describe a metabolic imaging approach for the noninvasive detection of successful vandetanib treatment. Our results suggest that PET may be useful for identifying patients who respond to vandetanib early in the course of treatment.

Cancer cells and immune cells modulate their metabolism according to specific needs during cancer progression and immune responses. The ability to measure cellular metabolic function in vivo would enable the evaluation of tumors and their response to therapy and also the effectiveness of cellular immune responses to cancer. Positron emission tomography (PET) is a highly sensitive clinical imaging modality that enables whole-body, quantitative measurements of tissue biochemical function. Here, we review work using PET probes for specific metabolic pathways to measure cell function in cancer and immunity. We focus on the use of probes for glycolysis and nucleoside salvage and then discuss the development of new metabolic probes that visualize distinct parameters of cell function during disease.

Previous results of the comparison of colors given by indicators in alkaline buffers and pure aqueous sodium hydroxide have been repeated and confirmed. The electrometric determinations show that the sodium hydroxide was pure and gave theoretical values for the concentration of hydroxyl ion. The slight but distinct neutralising effect of dilute solutions of alkali has been measured electrometrically and the allowances to be made are recorded graphically. It is found that whereas alizarin yellow G, tropæolin O and thymol violet may be used without appreciable error (in accordance with our previous communication) the grave discrepancies remain for phenolphthalein, o-cresol phthalein and thymol blue and phenol red which must be ascribed to salt error in the alkaline buffer itself.

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We performed a pilot study, looking at the COX-2 inhibitor celecoxib, on newly diagnosed prostate cancer patients in the neo-adjuvant setting using DNA microarray analysis.This was a single-blinded, randomized controlled phase II presurgical (radical prostatectomy) 28-day trial of celecoxib versus no drug in patients with localized T1-2 N0 M0 prostate cancer. cDNA microarray analysis was carried out on prostate cancer biopsies taken from freshly obtained radical prostatectomy samples. Results were confirmed by qPCR analysis of a selection of genes.Multiple genes were differentially expressed in response to celecoxib treatment. Statistical analysis of microarray data indicated 24 genes were up-regulated and 4 genes down-regulated as a consequence of celecoxib treatment. Gene changes e.g. survivin, SRP72kDa, were associated with promoting apoptotic cell death, enhancement of antioxidant processes and tumour suppressor function (p73 and cyclin B1 up-regulation).Celecoxib at 400 mg b.i.d. for 4 weeks perioperatively gave rise to changes in gene expression in prostate cancer tissue consistent with enhancement of apoptosis and tumour suppressor function. Given the short time interval for the duration of this study, the data are encouraging and provide a good rationale for conducting further trials of celecoxib in prostate cancer.