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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.

Hats aid in reducing exposure to both direct and diffuse ultraviolet light, but hats are of mixed styles and the resultant sun-protection value is variable. Adult male patients have higher rates of skin cancer, especially of the head and neck, than other subgroups. The UK and Australia have set standards for what constitutes a sunhat, whereas no such standard exists in Ireland. We explored adult male sunhats for sale during the summer in a single urban region in the west of Ireland. All the hats available were compared with the UK standard, BS 8466:2006. Almost 90% of the hats available did not meet this standard and thus did not offer adequate sun protection. Ireland requires legislation on what constitutes a sun-hat and more availability and visibility of such hats for men to encourage the use of hats for photoprotection.

Background Members of racial and ethnic minority groups have been disproportionately impacted by coronavirus-2019 (COVID-19). The objective of the study is to describe associations between race and ethnicity on clinical outcomes such as need for mechanical ventilation and mortality. Methods Retrospective cohort study of patients with severe COVID-19 infection admitted within a large, not-for-profit healthcare system in the mid-Atlantic region between March and July, 2020. Patient demographic data and clinical outcomes were abstracted from the electronic health record. Logistic regressions were performed to estimate associations between race and ethnicity and the clinical outcomes. Results The study population (N = 2931) was stratified into 1 of 3 subgroups: non-Hispanic White (n = 466), non-Hispanic Black (n = 1611), and Hispanic (n = 654). The average age of White, Black, and Hispanic patients was 69 ± 17.06, 64 ± 15.9, and 50 ± 15.53 years old, respectively ( P Conclusion Our analysis demonstrated that Hispanic patients were more likely require mechanical ventilation but had lower mortality when compared to White patients, with lower average age likely mediating this association. These findings emphasize the importance of outreach efforts to communities of color to increase prevention measures and vaccination uptake to reduce infection with COVID-19.

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.

This case report describes a women in her 50s with obesity, end-stage kidney disease, and type 2 diabetes who presented with severe painful, erythematous nonhealing ulcerated skin lesions with necrotic eschars on the right lower abdomen.

We examined the sun-protection practices of 61 men attending a dermatology department in the west of Ireland. Most worked outdoors, either currently or in the past. Although most wore hats as a sun-protection measure, the majority wore baseball caps, with smaller numbers wearing other types of hats that do not offer protection to the head and neck. Use of SPF products was widespread, but often not used habitually.

Problem/Background Perinatal death has far reaching emotional effects for all involved in this devastating event. The opportunity for learning as a result of this catastrophe, however, remains unexplored. Aim To explore midwives’ experiences of caring through, and learning from, perinatal death, to better inform the effective planning and delivery of education that optimises both midwifery and self-care. Methods A naturalistic interpretive multiple case study design. Seventeen midwives, located in Australia, participated in an online group activity hosted as a blog, followed by telephonic focus groups and in-depth email interviews. Findings Thematic data analysis revealed seven major themes: Grappling with the reality of perinatal death; Struggling with personal and professional heartache; Seeking the space to grieve as a professional; Being with the woman and her family; Finding a new purpose; Strengthened through support; and Developing the courage to care. Discussion The initial turmoil and impact of loss reflected the catastrophic nature of perinatal death. Midwives uncovered a journey to acceptance and learning, realising a determination to enhance expertise and discovering value in experiential knowledge. Insecurity regarding competence and confidence to manage perinatal death and bereavement care was highlighted. However, sharing their stories revealed professional fulfilment, personal strength, and solidarity amongst midwives who have endured similar experiences. Conclusion A coordinated approach to support and the dissemination of experiential knowledge and learning could be developed within an online model of narrative sharing and discussion. Debriefing, support and sharing of expertise in this way may foster engagement within and beyond the workplace.

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.

Compounds of formula (I), or a pharmaceutically acceptable salts or solvates thereof : wherein -X- represents a group of formula (a), (b), (c), (d), (e), (f) or (g) : Being selective inhibitors of human MEK (MAPKK) enzymes, are accordingly of benefit in medicine, for example in the treatment of inflammatory, autoimmune, cardiovascular, proliferative (including oncological) and nociceptive

In the era of open abdomen management, the complication of enterocutaneous fistula (ECF) seems to be increasing in frequency. In nontrauma patients, reported mortality rates are 7% to 20%, and spontaneous closure rates are approximately 25%. This study is the largest series of ECFs reported exclusively caused by trauma and examines the characteristics unique to this population.Trauma patients with an ECF at a single regional trauma center over a 10-year period were reviewed. Parameters studied included fistula output, site, nutritional status, operative history, and fistula resolution (spontaneous vs. operative).Approximately 2,224 patients received a trauma laparotomy and survived longer than 4 days. Of these, 43 patients (1.9%) had ECF. The rate of ECF in men was 2.22% and 0.74% in women. Patients with open abdomen had a higher ECF incidence (8% vs. 0.5%) and lower rate of spontaneous closure (37% vs. 45%). Spontaneous closure occurred in 31% with high-output fistulas, 13% with medium output, and 55% with low output. The mortality rate of ECF was 14% after an average stay of 59 days in the intensive care unit.With damage-control laparotomies, the traumatic ECF rate is increasing and is a different entity than nontraumatic ECF. Although the two populations have similar mortality rates, the trauma cohort demonstrates higher spontaneous closure rates and a curiously higher rate of development in men. Fistula output was not predictive of spontaneous closure.