3,144 research outputs found
Place Bonding in Children's Hospice Care- a qualitative study
The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Background
Limited knowledge exists of parentsā perceptions and experiences of childrenās hospices and how these contribute to the varied access and uptake of services.
Aim
This study aimed to explore parentsā perspectives and experiences of a hospice, to
understand the barriers and/or facilitators to accessing a hospice, and what characteristics
parents wanted from hospice provision.
Methods
A two-phase qualitative study underpinned by a constructivist grounded theory
methodology was employed. Phase 1 used focus groups to collect data from parents of children already accessing the hospice (n=24). Phase 2 used in-depth semi-structured interviews with parents of children who did not use the hospice (n=7) and with parents who had previous experience of using a hospice (n=7).
Results
A grounded theory of place bonding was developed which illustrates the cognitive
journey taken by parents of children with life-limiting conditions considering/receiving hospice care for their child.
Conclusions
Finding a place where they belonged and felt at āhomeā made the decision to accept help in caring for their child with a life-limiting condition more acceptable. The theory
of place bonding offers childrenās hospices a new perspective from which to view how parents access, accept and build relationships at the hospice
Editorial introduction: geographies of education and aspiration
Editorial introduction: geographies of education and aspiratio
10 of the best books of 2019 recommended by LSE blog editors
Many of the LSE blogs regularly feature book reviews of the latest publications emerging across the social sciences. But which books have LSE blog editors been enjoying in 2019? In this list, five LSE blog editors recommend their favourite reads of the year
Ten of the best books of 2019 recommended by LSE blog editors
Many of the LSE blogs regularly feature book reviews of the latest publications emerging across the social sciences. But which books have LSE blog editors been enjoying in 2019? In this list, five LSE blog editors recommend their favourite reads of the year
BabblePlay : An app for infants, controlled by infants, to improve early language outcomes
This project set out to develop an app for infants under one year of age that responds in real time to language-like infant utterances with attractive images on an iPad screen. Language-like vocalisations were defined as voiced utterances which were not high pitched squeals, nor shouts. The app, BabblePlay, was intended for use in psycholinguistic research to investigate the possible causal relationship between early canonical babble and early onset of word production. It is also designed for a clinical setting, (1) to illustrate the importance of feedback as a way to encourage infant vocalisations, and (2) to provide consonant production practice for infant populations that do not vocalise enough or who vocalise in an atypical way, specifically, autistic infants (once they have begun to produce consonants). This paper describes the development and testing of BabblePlay, which responds to an infantās vocalisations with colourful moving shapes on the screen that are analogous to some features of the infantās vocalization including loudness and duration. Validation testing showed high correlation between the app and two human judges in identifying vocalisations in 200 minutes of BabblePlay recordings, and a feasibility study conducted with 60 infants indicates that they can learn the contingency between their vocalisations and the appearance of shapes on the screen in one five minute BabblePlay session. BabblePlay meets the specification of being a simple and easy- to-use app. It has been shown to be a promising tool for research on infant language development that could lead to its use in home and professional environments to demonstrate the importance of immediate reward for vocal utterances to increase vocalisations in infants
Contextual factors that impact the implementation of patient portals with a focus on older people in acute care hospitals: a scoping review
Background:
Older people are the highest users of health services but are less likely to use a patient portal than younger people.
Objective:
This scoping review aimed to identify and synthesize the literature on contextual factors that impact the implementation of patient portals in acute care hospitals and among older people.
Methods:
A scoping review was conducted according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. The following databases were searched from 2010 to June 2020: MEDLINE and Embase via the Ovid platform, CINAHL and PsycINFO via the EBSCO platform, and the Cochrane Library. Eligible reviews were published in English; focused on the implementation of tethered patient portals; included patients, health care professionals, managers, and budget holders; and aimed at identifying the contextual factors (ie, barriers and facilitators) that impact the implementation of patient portals. Review titles and abstracts and full-text publications were screened in duplicate. The study characteristics were charted by one author and checked for accuracy by a second author. The NASSS (Non-adoption, Abandonment, Scale-up, Spread, and Sustainability) framework was used to synthesize the findings.
Results:
In total, 10 systematic reviews published between 2015 and 2020 were included in the study. Of these, 3 (30%) reviews addressed patient portals in acute care hospitals, and 2 (20%) reviews addressed the implementation of patient portals among older people in multiple settings (including acute care hospitals). To maximize the inclusion of the literature on patient portal implementation, we also included 5 reviews of systematic reviews that examined patient portals in multiple care settings (including acute care hospitals). Contextual factors influencing patient portal implementation tended to cluster in specific NASSS domains, namely the condition, technology, and value proposition. Certain aspects within these domains received more coverage than others, such as sociocultural factors and comorbidities, the usability and functionality aspects of the technology, and the demand-side value. There are gaps in the literature pertinent to the consideration of the provision of patient portals for older people in acute care hospitals, including the lack of consideration of the diversity of older adults and their needs, the question of interoperability between systems (likely to be important where care involves multiple services), the involvement of lay caregivers, and looking beyond short-term implementation to ways in which portal use can be sustained.
Conclusions:
We identified important contextual factors that impact patient portal implementation and key gaps in the literature. Future research should focus on evaluating strategies that address disparities in use and promote engagement with patient portals among older people in acute care settings
Changes in the secretome of tri-dimensional spheroid-cultured human mesenchymal stem cells in vitro by interleukin-1 priming
Funding The work was supported with funds from the Stroke Association and from EPSRC, MRC Centre for Doctoral Training in Regenerative Medicine studentship grant EP/L014904/1, and the Manchester Regenerative Medicine Network (MaRM). Availability of data and materials The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.Peer reviewedPublisher PD
Islands of linkage in an ocean of pervasive recombination reveals two-speed evolution of human cytomegalovirus genomes
Human cytomegalovirus (HCMV) infects most of the population worldwide, persisting throughout the host's life in a latent state with periodic episodes of reactivation. While typically asymptomatic, HCMV can cause fatal disease among congenitally infected infants and immunocompromised patients. These clinical issues are compounded by the emergence of antiviral resistance and the absence of an effective vaccine, the development of which is likely complicated by the numerous immune evasins encoded by HCMV to counter the host's adaptive immune responses, a feature that facilitates frequent super-infections. Understanding the evolutionary dynamics of HCMV is essential for the development of effective new drugs and vaccines. By comparing viral genomes from uncultivated or low-passaged clinical samples of diverse origins, we observe evidence of frequent homologous recombination events, both recent and ancient, and no structure of HCMV genetic diversity at the whole-genome scale. Analysis of individual gene-scale loci reveals a striking dichotomy: while most of the genome is highly conserved, recombines essentially freely and has evolved under purifying selection, 21 genes display extreme diversity, structured into distinct genotypes that do not recombine with each other. Most of these hyper-variable genes encode glycoproteins involved in cell entry or escape of host immunity. Evidence that half of them have diverged through episodes of intense positive selection suggests that rapid evolution of hyper-variable loci is likely driven by interactions with host immunity. It appears that this process is enabled by recombination unlinking hyper-variable loci from strongly constrained neighboring sites. It is conceivable that viral mechanisms facilitating super-infection have evolved to promote recombination between diverged genotypes, allowing the virus to continuously diversify at key loci to escape immune detection, while maintaining a genome optimally adapted to its asymptomatic infectious lifecycle
Potential Utility of Foveal Morphology in Preterm Infants Measured using Hand-Held Optical Coherence Tomography in Retinopathy of Prematurity Screening
Financial Support: Medical Research Council, London, UK (grant number: MR/N004566/1 and MR/J004189/1), Ulverscroft Foundation, Leicester, UK, Nystagmus Network UK. Acknowledgements: The authors acknowledge the assistance of Deputy Sister Hima Thanki in assisting with the acquisition of HH-OCT images and the Staff of the University Hospitals of Leicester Neonatal Service in supporting the infants during the imaging sessions.Peer reviewedPublisher PD
A Conserved Ribosomal Protein Has Entirely Dissimilar Structures in Different Organisms
\ua9 The Author(s) 2023. Published by Oxford University Press on behalf of Society for Molecular Biology and Evolution. Ribosomes from different species can markedly differ in their composition by including dozens of ribosomal proteins that are unique to specific lineages but absent in others. However, it remains unknown how ribosomes acquire new proteins throughout evolution. Here, to help answer this question, we describe the evolution of the ribosomal protein msL1/msL2 that was recently found in ribosomes from the parasitic microorganism clade, microsporidia. We show that this protein has a conserved location in the ribosome but entirely dissimilar structures in different organisms: in each of the analyzed species, msL1/msL2 exhibits an altered secondary structure, an inverted orientation of the N-termini and C-termini on the ribosomal binding surface, and a completely transformed 3D fold. We then show that this fold switching is likely caused by changes in the ribosomal msL1/msL2-binding site, specifically, by variations in rRNA. These observations allow us to infer an evolutionary scenario in which a small, positively charged, de novo-born unfolded protein was first captured by rRNA to become part of the ribosome and subsequently underwent complete fold switching to optimize its binding to its evolving ribosomal binding site. Overall, our work provides a striking example of how a protein can switch its fold in the context of a complex biological assembly, while retaining its specificity for its molecular partner. This finding will help us better understand the origin and evolution of new protein components of complex molecular assemblies-thereby enhancing our ability to engineer biological molecules, identify protein homologs, and peer into the history of life on Earth
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