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BACKGROUND: The Pediatric Respiratory Syncytial Virus Electronic Severity and Outcome Rating System (PRESORS) was developed to assess the severity of respiratory syncytial virus (RSV) infection in children. Because young children cannot report how they feel or function, ratings are based on observations by the child's caregiver (Observer‐Reported Outcome questionnaire [ObsRO]) and clinician (Clinician‐Reported Outcome questionnaire [ClinRO]). This prospective study aimed to evaluate the psychometric properties of the PRESORS. METHODS: The PRESORS version 6 ObsRO and ClinRO were evaluated in children with RSV infection requiring hospitalization in centers in the United States, Argentina, and Chile. Assessments were performed from days 1 to 7 by the child's caregiver and clinician. To assess inter‐rater reliability, two clinicians independently performed the ClinRO near in time. RESULTS: A total of 124 children aged ≤36 months were enrolled (mean age, 8 months). Factor analysis demonstrated that RSV severity consists of two dimensions, respiratory signs and illness behavior, and that these dimensions were consistent over time. The inter‐rater reliability for the ClinRO was 0.66 (95% confidence interval [CI], 0.55–0.75) but improved to 0.79 (95% CI, 0.71–0.86) after removing one outlying site, suggesting that quantifying RSV severity is not trivial, even using qualified raters, but that an adequate inter‐rater reliability is achievable with the PRESORS through adequate training. ClinRO and ObsRO displayed acceptable internal consistency and acceptable convergent validity with the Respiratory Syncytial Virus Network Scale, global impression scores, and key hospital characteristics. CONCLUSIONS: The PRESORS is relevant and appropriate for assessing the severity of RSV infection in infants requiring hospitalization.

Fire retardancy for textiles is important to prevent the rapid spread of fire and minimize damage to property and harm to human life. To infer fire-resistance on textile materials such as cotton or nylon, chemical coatings are often used. These chemicals are usually toxic and economically and environmentally unsustainable, however, some naturally produced protein-based fire retardants could be an alternative. A biofilm protein from Bacillus subtilis (BslA) was identified and recombinantly expressed in Escherichia coli with a double cellulose binding domain. It was then applied to a range of natural and synthetic fabric materials. A flame retardancy test found that use of BslA reduced fire damage by up to 51% and would pass fire retardancy testing according to British standards. It is therefore a viable and sustainable alternative to current industrial fire-retardant coatings.

Living textiles are evolving at the interface of textiles and biology. This emerging field proposes methods to design with, by, and for the growth of microorganisms using textiles thinking, textile materials and textile process. Textiles transform the microscale of fibres and biosynthesised polymers into high performance, environmentally responsive systems that function at a macroscale through the hierarchical structuring of constituent materials. As biotechnology looks for scalable solutions for diverse applications in the built environment and beyond, textiles offer a variety of strategies for bio-assembly and bio-fabrication.

Matthew Ison,1,2 Jane Scott,3 John Apel,3 Andrew Apel1,3 1Princess Alexandra Hospital, Woolloongabba, QLD, 4102, Australia; 2University of Queensland, St Lucia, QLD, 4072, Australia; 3The Eye Health Centre, Brisbane, QLD, 4000, AustraliaCorrespondence: Matthew IsonPrincess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, AustraliaTel +61 434 946 264Email Matthew.Ison2@health.qld.gov.auPurpose: To report patient expectations, visual performance and satisfaction with AcrySof IQ PanOptix multifocal intraocular lens in a heterogeneous patient group. Additionally, determine if identifiable pre-operative characteristics can predict post-operative satisfaction.Methods: Data were prospectively collected for 67 consecutive patients (134 eyes) who underwent bilateral Panoptix implantation in a private ophthalmology clinic. A pre-operative questionnaire was completed regarding vision satisfaction, visual phenomena and expectations. Routine clinical parameters were collected 1 month and follow-up questionnaire administered 3 months post-operatively.Results: Post-operative unaided distance vision was 20/20 (0.01 ± 0.10) and binocular near vision 20/25-2 (N5; 0.14 ± 0.06). Patients satisfied with vision increased from 6% (n=4) unaided and 48% (n=32) aided pre-operatively to 94% (n=63) unaided post-operatively (p< 0.001). There was marked increase in frequency of halo from 14% (n=9) to 69% (n=46; p< 0.001) but no corresponding increase in how bothersome this symptom was (p=0.193) nor the frequency of other visual phenomena. Worse post-operative vision and fluctuating vision were associated with lower post-operative satisfaction. There was no difference in satisfaction or residual astigmatism in those implanted with toric lenses. A total of 96% (n=64) of patients were spectacle-free at 3-months and would recommend this procedure to others.Conclusion: This study supports the trend towards increased patient expectations of multifocal intraocular lenses, matched by excellent visual outcomes and satisfaction. Visual phenomena may be less troubling with new multifocal lenses than previously reported. A pre-operative questionnaire may be a useful education tool but could not isolate pre-operative characteristics that predict post-operative satisfaction.Keywords: multifocal, intraocular lens, cataract, refractive lens exchange, satisfaction

Christine de la Loge,1 Fatoumata Fofana,2 Paul Williams,1 Sarah Rusch,3 Marita Stevens,4 Jane Scott5 1Patient-Centered Outcomes, Mapi (an ICON Plc. company), Lyon, France; 2Patient-Centered Outcomes, Mapi (an ICON Plc. company), Leiden, the Netherlands; 3Statistical Decisions and Sciences, Janssen Biostatistics Research & Development, Beerse, B-2340, Belgium; 4Global Clinical Development Infectious Diseases, Janssen Research & Development, Beerse, B-2340, Belgium; 5Janssen Global Services LLC, High Wycombe, UKCorrespondence: Christine de la Loge Tel +33 7 85 61 78 59Email cdelaloge@outlook.frPurpose: PRESORS ClinRO completed by clinicians and ObsRO completed by caregivers were developed to characterize the clinical course of respiratory syncytial virus (RSV) infection. This study describes preliminary analysis of PRESORS’ measurement properties using clinical trial data.Patients and Methods: PRESORS ClinRO and ObsRO data were collected in a 28-day randomized, double-blind, Phase 1b trial of JNJ-53718678 or placebo in infants and children ≤ 24 months of age treated for RSV infection in hospitals. PRESORS data were scored and key psychometric properties of scores were evaluated, including ability to discriminate between known groups and to detect change over time. Time to resolution of RSV signs was explored using two responder definitions.Results: Daily completion rates for PRESORS ClinRO and ObsRO were high for the 44 children in the study (median: 100% and 93%, respectively). Large floor effects were observed at baseline for signs of severe RSV infection that were either absent (cyanosis, fever, apnea) or rarely reported (reduced urination/dehydration, vomiting). Implausible ObsRO ratings suggested some caregivers could not accurately measure heart rate. Known-group validity was confirmed: children in poor health based on baseline ClinRO had mean baseline composite scores that were significantly worse for both ObsRO (p=0.001) and ClinRO (p< 0.001) compared to those with better overall health. ObsRO (p=0.009) and ClinRO (p< 0.001) composite scores were responsive to change in overall health status from baseline to Day 3. Mean scores for RSV sign dimensions decreased rapidly from baseline to Day 7 except for coughing and sleep ratings by caregivers. Time to recovery varied greatly depending on definitions used.Conclusion: PRESORS ClinRO and ObsRO can inform endpoints and enable monitoring the clinical course of RSV in pediatric trials. Improved alignment between ClinRO and ObsRO and revisions ensuring caregivers can assess all signs will be addressed in revised PRESORS.Keywords: psychometric validation, clinician-reported outcomes, observer-reported outcomes, pediatrics, respiratory syncytial virus

Grasp classification using data gloves can enable therapists to monitor patients efficiently by providing concise information about the activities performed by these patients. Although, classical machine learning algorithms have been applied in grasp classification, they require manual feature extraction to achieve high accuracy. In contrast, convolutional neural networks (CNNs) have outperformed popular machine learning algorithms in several classification scenarios because of their ability to extract features automatically from raw data. However, they have not been implemented on grasp classification using a data glove. In this study, we apply a CNN in grasp classification using a piezoresistive textile data glove knitted from conductive yarn and an elastomeric yarn. The data glove was used to collect data from five participants who grasped thirty objects each following Schlesinger’s taxonomy. We investigate a CNN’s performance in two scenarios where the validation objects are known and unknown. Our results show that a simple CNN architecture outperformed k-nn, Gaussian SVM, and Decision Tree algorithms in both scenarios in terms of the classification accuracy.

PurposeThe purpose of this paper is to describe the design, creation and outcome of a pilot project to provide additional course reserve materials to students. The goals of the project include off-setting the rising costs of higher education and providing equitable access to materials.Design/methodology/approachThis case study describes the process of library staff co-creating a workflow to efficiently identify, order and process print and electronic books for 100 and 200 level courses at a small, private university. The project was influenced by an exploration of library services in the context of library ethics. The authors evaluate the impact of the project and determine continued need after a two-year pilot.FindingsThis paper demonstrates the usefulness of the course reserves service in providing accessible and cost-effective resources. Increased usage of course reserve materials by students, along with a reduction in money spent over time by the library to support the service, has resulted in a program that is deemed viable to continue and potentially expand.Social implicationsThis paper seeks to address the added challenges often placed on low-income college students in accessing, paying for and using assigned course materials. Libraries can use course reserves to enhance student success by providing them with an alternate to purchasing course materials.Originality/valueThe project addresses constraints of cost, staff time and cross-departmental workflows in managing a course reserves program at a small university and provides a template for other libraries to use.

ObjectiveThis study examined the association between family planning counselling receipt during the 12 months preceding the survey and postpartum modern contraceptive uptake in Ethiopia. We hypothesised that receiving family planning counselling either within the community setting by a field health worker or at a health facility by a healthcare attendant during the 12 months preceding the survey improves postpartum modern contraceptive uptake.DesignWe used a cross-sectional study of the Ethiopian Demographic and Health Survey conducted in 2016.SettingEthiopia.ParticipantsA total of 1650 women who gave birth during the 12 months and had contact with service delivery points during the 12 months preceding the survey.Primary outcomeA weighted modified Poisson regression model was used to estimate an adjusted relative risk (RR) of postpartum modern contraceptives.ResultsApproximately half (48%) of the women have missed the opportunity to receive family planning counselling at the health service contact points during the 12 months preceding the survey. The postpartum modern contraceptive uptake was 27%. Two hundred forty-two (30%) and 204 (24%) of the counselled and not counselled women used postpartum modern contraceptive methods, respectively. Compared with women who did not receive counselling for family planning, women who received counselling had higher contraceptive uptake (RR 1.32, 95% CI 1.04 to 1.67).ConclusionSignificant numbers of women have missed the opportunity of receiving family planning counselling during contact with health service delivery points. Modern contraceptive uptake among postpartum women was low in Ethiopia. Despite this, our findings revealed that family planning counselling was associated with improved postpartum modern contraceptive uptake.

Background The hospitalized acute respiratory tract infection (HARTI) study used the Respiratory Intensity and Impact Questionnaire (RiiQ™) Symptom Scale, derived from FluiiQ™, to assess and compare the burden of respiratory infection symptoms for patients with influenza, respiratory syncytial virus (RSV), and human metapneumovirus (hMPV) infection, with or without core risk factors (CRF) (age ≥65; chronic heart, renal, obstructive pulmonary disease; asthma). Methods This was a prospective cohort study in adult patients hospitalized with acute respiratory tract infection (40 centers, 12 countries) during two consecutive influenza/RSV/hMPV seasons (2017–2019). The RiiQ™ Symptom Scale and EuroQol 5‐Dimensions 5‐Levels (EQ‐5D‐5L) were assessed by interview at two timepoints during hospitalization and at 1, 2, and 3 months post‐discharge. Results Mean lower respiratory tract (LRT) symptom scores were higher for RSV and hMPV participants compared to influenza at 48 h after enrollment/early discharge (p = 0.001) and 3 months post‐discharge (p = 0.007). This was driven by LRT symptoms, including shortness of breath (SOB) (p

Compiled for language teachers and directors of instructional materials centers, this reference list contains mostly recent materials. Each listing includes price of the item, publisher or distributor, as well as a content annotation where necessary. Teaching aids and professional references make up the two largest sections. English as a foreign language, foreign language publications, linguistics, and textbooks are next in size. Briefer lists cover course outlines, cultural aids, evaluation and testing, international understanding, language laboratories, programed instruction, research, study abroad, and vocational opportunities. (AF)

Family planning counselling can help improve the postpartum modern contraceptive uptake. However, studies in Ethiopia indicate inconsistent effects of integrated family planning counselling on postpartum modern contraceptive uptake. This study aimed to determine the extent of family planning counselling and its role in improving postpartum contraceptive uptake among women in Ethiopia. We used the Performance Monitoring for Action (PMA) Ethiopia panel survey data, a community-based prospective cohort study. Randomly selected pregnant women were recruited at the baseline interview and followed by six weeks and six months postpartum. A weighted generalised linear model fitted with a Poisson distribution and a log link function was used to estimate the adjusted relative risk (aRR) and 95% Confidence Interval (CI) of modern contraceptive uptake. The coverages of family planning counselling provision during ANC, prior to discharge and child immunisation were 20%, 27% and 23%, respectively. The modern contraceptive uptakes by six weeks and six months postpartum were 18% and 36%, respectively. Family planning counselling prior to discharge from the facility was associated with increased modern contraceptive uptake by six weeks (aRR 1.25; 95% CI 0.94, 1.65) and six months postpartum periods (aRR 1.07; 95% CI 0.90, 1.27). Moreover, women who received family planning counselling during child immunisation were 35% more likely to use modern contraceptives by six months postpartum (aRR 1.35;95% CI 1.12, 1.62). However, counselling during ANC visits was not associated with modern contraceptive uptake by either six weeks or six months postpartum. A significant proportion of women had missed the opportunity, and the postpartum modern contraceptive uptake was low. Despite these, family planning counselling prior to discharge from the facility and during child immunisation improved the postpartum modern contraceptive uptake. However, our finding revealed insufficient evidence that family planning counselling during ANC is associated with postpartum modern contraceptive uptake.

Patient-reported outcomes (PROs) are used in clinical trials to provide valuable evidence on the impact of disease and treatment on patients' symptoms, function and quality of life. High-quality PRO data from trials can inform shared decision-making, regulatory and economic analyses and health policy. Recent evidence suggests the PRO content of past trial protocols was often incomplete or unclear, leading to research waste. To address this issue, international, consensus-based, PRO-specific guidelines were developed: the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT)-PRO Extension. The SPIRIT-PRO Extension is a 16-item checklist which aims to improve the content and quality of aspects of clinical trial protocols relating to PRO data collection to minimise research waste, and ultimately better inform patient-centred care. This SPIRIT-PRO explanation and elaboration (E&E) paper provides information to promote understanding and facilitate uptake of the recommended checklist items, including a comprehensive protocol template. For each SPIRIT-PRO item, we provide a detailed description, one or more examples from existing trial protocols and supporting empirical evidence of the item's importance. We recommend this paper and protocol template be used alongside the SPIRIT 2013 and SPIRIT-PRO Extension paper to optimise the transparent development and review of trial protocols with PROs. ispartof: BMJ OPEN vol:11 issue:6 ispartof: location:England status: published

**Background:** Hepatitis C virus (HCV) infection and its treatments are associated with significant symptoms, side effects and impact on patients functioning. The Hepatitis C Symptom and Impact Questionnaire version 4 (HCV-SIQv4) was developed according to FDA Patient Reported Outcomes (PRO) Guidance, for evaluating chronic HCV infection and its treatment. **Objectives:** This study evaluated the psychometric properties and clinically important change (CIC) thresholds of the measure. **Methods:** PRO data were pooled from three Phase IIb and III trials evaluating interferon-free simeprevircontaining regimens for treatment of chronic HCV infection. Scale range adequacy, reliability, validity, responsiveness and CIC thresholds were assessed incorporating knowledge of the appropriate measurement model. **Results:** Data from 437 patients were analyzed. Stage of liver disease was associated with symptom severity and functioning at baseline. Reliability was acceptable (test-retest ICC ≥0.7) for most scores except the Gastrointestinal and Integumentary domains. Convergent validity was observed between HCV-SIQv4 scores and concurrent measures of conceptual similarity. Greater symptom severity and worse impact scores were associated with liver cirrhosis, depression, severe fatigue and health limitations. Patients who achieved SVR12 had better outcomes than those failing to. HCV-SIQv4 symptom and domain scores were responsive to changes in health state (effect sizes ≥0.5). Exploratory thresholds for change in scores indicating a clinically important improvement and worsening were HCV-SIQv4 Overall Body System Score (BSS), 8 and 8; Constitutional BSS, 10 and 10; Gastrointestinal BSS, 5 and 5; Psychiatric BSS, 8 and 8; Neurocognitive BSS, 8 and 8; and Integumentary BSS, 5 and 5. **Conclusions:** The HCV-SIQv4 offers reliable, responsive assessments within HCV clinical development. CIC thresholds are now available to aid score interpretation.

In the fall of 2017, the Clark Library at the University of Portland undertook an investigation of ethics in academic libraries to understand ethical practices in the library’s day-to-day work. The...

This report outlines an exploratory study that investigated whether the "Never Events" system - first used in healthcare contexts to identify and investigate preventable incidents that cause serious harm or death as a result of human error - could be adapted in the context of UK multi-agency child protection. Using a sequential design, two online surveys were carried out that explored practitioners' (n = 46) views about the feasibility of adopting the Never Events model and what, if any, incidents or events could be investigated plausibly using such a model. Practitioners were drawn from a purposive sample. An inter-disciplinary panel of senior practitioners - drawn from nursing, public health, social work and child mental health services- discussed the surveys' findings and the list of proposed child protection Never Events. The findings indicate that the complex, judgment-based nature of child protection contributes to difficulties creating shared understandings about what constitutes harm and the extent to which multi-agency systems can share decision-making and responsibility for the way they identify and support families. Thinking through and discussing the relative strengths and limitations of the Never Events model may nevertheless be a valuable exercise in interprofessional training and the design of highly localized review and reporting systems.

Rehabilitation of stroke survivors can be expedited by employing an exoskeleton. The exercises are designed such that both hands move in synergy. In this regard, often, motion capture data from the healthy hand is used to derive control behavior for the exoskeleton. Therefore, data gloves can provide a low-cost solution for the motion capture of the joints in the hand. However, current data gloves are bulky, inaccurate, or inconsistent. These disadvantages are inherited because the conventional design of a glove involves an external attachment that degrades overtime and causes inaccuracies. This article presents a weft knit data glove whose sensors and support structure are manufactured in the same fabrication process, thus removing the need for an external attachment. The glove is made by knitting multifilament conductive yarn and an elastomeric yarn using WholeGarment technology. Furthermore, we present a detailed electromechanical model of the sensors alongside its experimental validation. In addition, the reliability of the glove is verified experimentally. Finally, machine learning algorithms are implemented for classifying the posture of hand on the basis of sensor data histograms.

Data gloves are the optimal data acquisition devices in hand-based gesture classification. Gesture classification involves the interpretation of the acquired raw data into defined gestures by applying machine learning techniques. Recently, the application of deep learning algorithms has improved the accuracy obtained in glove-based gesture classification. This chapter will review these deep learning approaches. In particular, we analyze their current performance, advantages over classical machine learning algorithms and limitations in certain classification scenarios. Furthermore, we present other deep learning approaches that may outperform current algorithms. This chapter will provide readers with an all-encompassing review that will enable a clear understanding of the current trends in glove-based gesture classification and provide new ideas for further research.

There are good theoretical and empirical grounds to suggest that personal practices (PPs; e.g., self-practice/self-reflection [SP/SR] programmes, meditation programmes and personal therapy) can have a positive impact on therapist skills and client outcomes. However, to date, a weakness in many PP studies is the lack of cohort control groups. The two pilot studies reported in this paper examined SP/SR programmes integrated into postgraduate psychology training and are the first to include cohort control groups. Study 1 compared outcomes of students assigned to either SP/SR (n = 17) or a cognitive behaviour therapy (CBT) book study group (n = 13) during their first clinical placement. Study 2 compared outcomes of students who completed the SP/SR programme as part of CBT training (n = 12) with participants who completed the same CBT training in the previous year without an SP/SR programme (n = 17). Significant improvements in therapist confidence for the SP/SR groups were found in both studies. Study 2 also showed significantly higher therapist self-awareness and lower burnout scores in the SP/SR group. These studies are limited by their small sample size and the lack of random allocation. Nevertheless, they provide preliminary empirical evidence demonstrating large effects of PP on trainees' personal and therapist selves and offer a basis for further research using randomized controlled designs with larger sample sizes.

Weft knitted conductive fabrics can act as excellent textile strain sensors for human motion capture. The loop architecture dictates the overall electrical properties of weft knit strain sensors. Therefore, research into loop architecture is relevant for comprehensively investigating the design space of e-textile sensors. There are three main types of knit stitches, Knitted loop stitch, Miss stitch, and Tuck stitch. Nevertheless, most of the research into weft knit strain sensors has largely focused on fabrics with only knitted loop stitches. Miss and tuck stitches will affect the contact points in the sensor and, consequently, its piezoresistivity. Therefore, this paper investigates the impact of incorporating miss and tuck stitches on the piezoresistivity of a weft knit sensor. Particularly, the electromechanical models of a miss stitch and a tuck stitch in a weft knit sensor are proposed. These models were used in order to develop loop configurations of sensors that consist of various percentages of miss or tuck stitches. Subsequently, the developed loop configurations were simulated while using LTspice and MATLAB software, and, verified experimentally through a tensile test. The experimental results closely agree with the simulated results. Furthermore, the results reveal that increases in the percentage of tuck or miss stitches in weft knit sensor decrease the initial and average resistance of the sensor. In addition, it was observed that, although the piezoresistivity of a sensor with tuck or miss stitches is best characterised as a quadratic polynomial, increases in the percentage of tuck stitches in the sensor increase the linearity of the sensor&rsquo, s piezoresistivity.

This study aims to explore association between maternal depressive symptoms and infant feeding practice at hospital discharge.Data were obtained from a birth cohort study based in Australia that linked to health administrative records. Maternal demographic data, mental health status derived from the Edinburgh Postnatal Depression Scale (EPDS), feeding practices of livebirths of at least 400 g or gestation periods of at least 20 weeks recorded during July-December 2015 were included (n = 14,658). Logistic regression models were performed to test association between presence of depressive symptoms and exclusive breast or formula feeding within 24 h prior to hospital discharge while adjusting for covariates known to be associated with breastfeeding.About 12% of women self-reported having depressive symptoms (EPDS score ≥ 10). Although only 7% of women (n = 1012) exclusively formula fed their babies, having depressive symptoms was associated with a 51% higher likelihood of exclusive formula feeding at hospital discharge. The association remains significant after adjustment for maternal age, gestational weeks, number of previous pregnancies, socioeconomic and partner status (p 0.001) and all other covariates (p = 0.009).Having depressive symptoms was associated with increased likelihood of exclusive formula feeding. Routine measurement post-delivery and early management of maternal depressive symptoms may influence infant feeding practice and reduce prevalence of exclusive formula feeding at hospital discharge.