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BACKGROUND: In Oman, there is a lack of data on utilisation, needs and women's satisfaction with care and information provided during postnatal follow-up period. AIM: To investigate postnatal follow-up care utilisation and women's needs; level of postnatal information received and satisfaction with services. METHODS: A purposive sample of women (n = 500), recruited in the immediate postnatal period at one metropolitan and one regional birthing hospital in Oman. An electronic survey link was sent to participants at 6-8 weeks postnatally. Quantitative variables were analysed as frequencies and chi-squared test. RESULTS: A total of 328 completed surveys were received; a response rate of 66 %. Most respondents were located in the metropolitan area (n = 250) and between 20 and 39 years (n = 308). Utilisation was low as women reported no need or no benefit in attending. Women's information needs were not sufficiently met by HCPs, requiring women to seek information from family and the internet to meet their needs. Satisfaction with services was mostly neither satisfied nor dissatisfied (30 %) or satisfied (30 %). CONCLUSION: Postnatal follow-up care utilisation in both metropolitan and regional areas is less than optimal and not utilised as there was no advice to attend or no appointment date/time given, no benefit experienced previously, no need and information needed sourced from family or the internet. The information provided by postnatal follow-up care consumers can be used to enhance service delivery, inform future updates to the national maternity care guidelines, and provides a baseline for future evaluation and research.

The UK government has committed to reducing its carbon emissions to net-zero by 2050. Higher education institutions (HEIs) are high energy users, with the largest proportion of their energy demand for space heating; an area still dominated by carbon-intensive fuels. This research addresses the UK HEI space temperature policy landscape, making direct links between space temperature policy and carbon management, advocating the development of evidence-based policies as a critical tool for reducing carbon emissions within the sector. Sixty-six space temperature policies were reviewed, and five experienced energy managers were interviewed to understand the range, development and use of space temperature policies in UK HEIs. The research identified a lack of consistency across these policies, leading to missed opportunities for making energy and carbon savings. The research highlights gaps in the available data and literature needed to connect policy to its effectiveness, and identifies the use of policy as a defensive tool against complaints rather than an active driver of energy reduction. A series of recommendations are proposed for national and institutional policymakers, suggesting areas for improvement and future research to facilitate effective development and practice in space temperature policy towards net-zero.

The UK government has committed to reducing its carbon emissions to net-zero by 2050. Higher education institutions (HEIs) are high energy users, with the largest proportion of their energy demand for space heating; an area still dominated by carbon-intensive fuels. This research addresses the UK HEI space temperature policy landscape, making direct links between space temperature policy and carbon management, advocating the development of evidence-based policies as a critical tool for reducing carbon emissions within the sector. Sixty-six space temperature policies were reviewed, and five experienced energy managers were interviewed to understand the range, development and use of space temperature policies in UK HEIs. The research identified a lack of consistency across these policies, leading to missed opportunities for making energy and carbon savings. The research highlights gaps in the available data and literature needed to connect policy to its effectiveness, and identifies the use of policy as a defensive tool against complaints rather than an active driver of energy reduction. A series of recommendations are proposed for national and institutional policymakers, suggesting areas for improvement and future research to facilitate effective development and practice in space temperature policy towards net-zero.

Background: In clinical trials, hepatitis C virus (HCV) salvage treatment with sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) achieved an SVR12 rate of >95% in NS5A-experienced participants. Lower SVR12 rates have been reported in real-world studies, particularly for genotype (GT)3 infection and cirrhosis. We determined the efficacy and safety of SOF/VEL/VOX in a large real-world cohort. Method(s): We assessed the efficacy of salvage SOF/VEL/VOX for HCV infection in NS5A-inhibitor experienced participants with cirrhosis and portal hypertension, prior liver transplantation (LT) or severe extra-hepatic manifestations. SOF/VEL/VOX was available via an early access program. The primary outcome was SVR12. Secondary outcome was frequency of adverse events (AE). Finding(s): Ninety-seven participants were included. Median age was 58, 82% were male, 78% had cirrhosis, most with portal hypertension (61%, n=46/76), and 18% had prior-LT. Of the cirrhotic participants, 96% were Child-Turcotte-Pugh class A, and 4% were class B. Of the 72% with GT3, 76% were also cirrhotic. By intention-to-treat analysis, SVR12 rate was 85% (n=82/97). Per protocol, the SVR12 rate was 90%, including 91% in GT1 (GT1a n=18/18, GT1b n=2/4), 89% in GT3 (n=59/66) and 100% in GT6 (n=3/3). SVR12 in participants with GT3 and cirrhosis was 90%. No predictors of non-SVR12 were identified. There were 4 serious AEs including 1 death and 3 hepatic decompensation events. NS5A resistance-associated substitutions detected at baseline did not affect SVR12. Conclusion(s): This real-world study confirms high efficacy of SOF/VEL/VOX for the treatment of difficult-to-cure NS5A-inhibitor experienced patients, including those with GT3 and cirrhosis. Treatment was well tolerated in most; however, serious AEs can occur in those with advanced liver disease.Copyright © 2020 The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail

Background and Aims: In clinical trials, salvage therapy including Sofosbuvir/Velpatasvir/Voxilaprevir (SOF/VEL/VOX) achieved an SVR12 rate of 96% in NS5A-experienced participants. An extended access program (EAP) for SOF/VEL/VOX was sponsored by Gilead Pharmaceuticals for Australian patients with advanced liver disease or prior liver transplantation (LT), who had relapsed. We determined the real-world efficacy and safety of this regimen in this cohort with advanced liver disease. Method(s): In this Australian multicentre EAP study, adult patients with chronic HCV infection genotype(GT)1-6 with prior failure on a DAA NS5A inhibitor containing regimen were eligible to access 12 weeks of SOF/VEL/VOX 400 mg/100 mg/100 mg. Other eligibility criteria included compensated liver disease with at least one of the following i) Child Pugh (CP)A cirrhosis with clinically significant portal hypertension or platelets <100 x 109/L, ii) prior LT, or iii) severe extra hepatic manifestations. Hospitals with >1 EAP recipient were invited to participate. Clinical characteristics and treatment outcomes were recorded at baseline, end-of-treatment (EOT) and SVR12. HCV NS5A RAS testing was performed prior to retreatment, where serum was available. The primary outcomes was SVR12 rate. Result(s): To date, baseline data is available for 89 patients from 24 participating hospitals. 85 have reached end-of-treatment (EOT), and 80 have SVR12 data available for analysis. Four patients have incomplete data due to early discontinuation of therapy (n = 2), loss to follow up (n = 1) and death (n = 1). 74 (83%) were male and the median age was 53. GT3 was the most common (n = 64), then GT1a (n = 18), GT1b (n = 4), GT6 (n = 2) and GT4 (n = 1). The median platelet count was 127. 68 (75%) had cirrhosis and of these, 35 (51%) had portal hypertension. 14 (16%) had prior hepatoma and 15 (17%) prior LT. All participants were NS5A-experienced and 8 (9%) had received?>1 DAA course (1-4). Three participants were

Abstract Background In clinical trials, hepatitis C virus (HCV) salvage treatment with sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) achieved an SVR12 rate of >95% in NS5A-experienced participants. Lower SVR12 rates have been reported in real-world studies, particularly for genotype (GT)3 infection and cirrhosis. We determined the efficacy and safety of SOF/VEL/VOX in a large real-world cohort. Methods We assessed the efficacy of salvage SOF/VEL/VOX for HCV infection in NS5A-inhibitor experienced participants with cirrhosis and portal hypertension, prior liver transplantation (LT) or severe extra-hepatic manifestations. SOF/VEL/VOX was available via an early access program. The primary outcome was SVR12. Secondary outcome was frequency of adverse events (AE). Findings Ninety-seven participants were included. Median age was 58, 82% were male, 78% had cirrhosis, most with portal hypertension (61%, n = 46/76), and 18% had prior-LT. Of the cirrhotic participants, 96% were Child-Turcotte-Pugh class A, and 4% were class B. Of the 72% with GT3, 76% were also cirrhotic. By intention-to-treat analysis, SVR12 rate was 85% (n = 82/97). Per protocol, the SVR12 rate was 90%, including 91% in GT1 (GT1a n = 18/18, GT1b n = 2/4), 89% in GT3 (n = 59/66) and 100% in GT6 (n = 3/3). SVR12 in participants with GT3 and cirrhosis was 90%. No predictors of non-SVR12 were identified. There were 4 serious AEs including 1 death and 3 hepatic decompensation events. NS5A resistance-associated substitutions detected at baseline did not affect SVR12. Conclusions This real-world study confirms high efficacy of SOF/VEL/VOX for the treatment of difficult-to-cure NS5A-inhibitor experienced patients, including those with GT3 and ci

BACKGROUND: In clinical trials, HCV salvage treatment with Sofosbuvir/Velpatasvir/Voxilaprevir (SOF/VEL/VOX) achieved an SVR12 rate of >95% in NS5A-experienced participants. Lower SVR12 rates have been reported in real-world studies, particularly for genotype (GT)3 infection and cirrhosis. We determined the efficacy and safety of SOF/VEL/VOX in a large real-world cohort. METHOD(S): We assessed the efficacy of salvage SOF/VEL/VOX for HCV infection in NS5A-inhibitor experienced participants with cirrhosis and portal hypertension, prior liver transplantation (LT) or severe extra-hepatic manifestations. SOF/VEL/VOX was available via an early access program. The primary outcome was SVR12. Secondary outcome was frequency of adverse events (AE). FINDINGS: Ninety-seven participants were included. Median age was 58, 82% were male, 78% had cirrhosis, most with portal hypertension (61%, n=46/76), and 18% had prior-LT. Of the cirrhotic participants, 96% were Child-Turcotte-Pugh class A and 4% were class B. Of the 72% with GT3, 76% were also cirrhotic. By intention-to-treat analysis, SVR12 rate was 85% (n=82/97). Per protocol, the SVR12 rate was 90%, including 91% in GT1 (GT1a n=18/18, GT1b n=2/4), 89% in GT3 (n=59/66) and 100% in GT6 (n=3/3). SVR12 in participants with GT3 and cirrhosis was 90%. No predictors of non-SVR12 were identified. There were four serious AEs including one death and three hepatic decompensation events. NS5A resistance-associated substitutions detected at baseline did not affect SVR12. CONCLUSION(S): This real-world study confirms high efficacy of SOF/VEL/VOX for the treatment of difficult-to-cure NS5A-inhibitor experienced patients, including those with GT3 and cirrhosis. Treatment was well tolerated in most however serious AEs can occur in those with advanced liver disease.Copyright © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions

Maintaining a consistent indoor temperature causes one of the largest energy demands in UK. UK buildings are famously poorly insulated and expensive to heat and cool. This is set to become ever more challenging in a warming and rapidly changing climate. What if we allowed ourselves to be more uncomfortable and took more charge of our thermal comfort? Wouldn’t we then be healthier, more thermally delighted, more productive? Would we not also save energy and related carbon emissions? We offer this provocation, and set the challenge to identify how this should change the role of future ubiquitous environments.

Background and Aim: The introduction of highly effective direct-acting antiviral (DAA) therapy has revolutionized hepatitis C virus (HCV) treatment. However, some patients, most often those with genotype (Gt) 3 infection and cirrhosis, do not respond to first-line DAA therapy. In clinical trials, salvage therapy including sofosbuvir-velpatasvir- voxilaprevir (SOF/VEL/VOX) achieved a rate of sustained virological response at 12 weeks (SVR12) of 96% in NS5A-experienced participants. An extended access program (EAP) for SOF/VEL/VOX was sponsored by Gilead Pharmaceuticals for Australian patients with advanced liver disease or prior liver transplantation who had relapsed. We determined the real-world efficacy and safety of this regimen in this cohort. Method(s): In this Australian multicenter EAP study, adult patients with chronic HCV infection Gt1-6 with prior failure on a DAA NS5A inhibitor-containing regimen were eligible to access 12 weeks of SOF/VEL/VOX 400 mg/100 mg/100 mg. Other eligibility criteria included estimated glomerular filtration rate of > 30 mL/min/1.73 m2 and compensated liver disease with at least one of the following: Child-Pugh (CP) A cirrhosis with clinically significant portal hypertension or platelets of < 100 x 109/L; prior liver transplantation; or severe extrahepatic manifestations. Hospitals with more than one EAP recipient were invited to participate. Clinical characteristics and treatment outcomes were recorded at baseline, end of treatment (EOT), and SVR12. HCV NS5A resistanceassociated substitution testing was performed before retreatment, where serum was available. The primary outcome was SVR12 rate. Secondary outcomes included frequency of adverse events. Result(s): A total of 114 patients have been identified as eligible. Data collection is ongoing. To date, baseline data have been collected for 56 participants, 44 have reached EOT, and 31 have reached the SVR12 time point. The median age is 60 years. Gt3 infection was most common (42

Reducing carbon emissions is a key priority across the globe, and in the UK, schools have been identified as the second largest users of non-domestic energy. In this paper, we present an IoT solution for schools that aims to unite senior leadership, teachers, and pupils in the goal of reducing or shifting their energy consumption and carbon emissions. We achieve this by prompting behavioural change through instrumenting schools with sensors, visual displays, and a variety of educational resources which use the BBC micro:bit to interact with the data produced by these sensors, enabling pupils to engage in educational activities to solve real world problems. By increasing the visibility, availability, and interactivity of data, we enable a new space for dialogue between facilities managers and building users. We summarise some of the challenges and lessons learned so far, with preliminary results indicating our approach is effective in raising the profile of energy management and shifting demand. Future monitoring and evaluation will provide more detail on the effectiveness of our IoT solution. © 2019 Institution of Engineering and Technology. All rights reserved.

Maintaining a consistent indoor temperature causes one of the largest energy demands in UK. UK buildings are famously poorly insulated and expensive to heat and cool. This is set to become ever more challenging in a warming and rapidly changing climate. What if we allowed ourselves to be more uncomfortable and took more charge of our thermal comfort? Wouldn’t we then be healthier, more thermally delighted, more productive? Would we not also save energy and related carbon emissions? We offer this provocation, and set the challenge to identify how this should change the role of future ubiquitous environments.

Since the 1980’s, concerns have been raised about the extent of water-based tourism targeting spinner dolphins (Stenella longirostris) in their resting habitat off Big Island of Hawai’i. In 2010, spinner dolphins associated with the Big Island were defined as a unique stock and were also identified as one of the most vulnerable to anthropogenic disturbance. The National Oceanic and Atmospheric Administration is currently considering a management intervention to reduce the number and intensity of human-dolphin interactions by implement time-area closures in critical habitat. To measure the effectiveness of this mitigation approach a Before-After-Control-Impact (BACI) design is being employed to asses the local abundance, distribution and behaviour of spinner dolphins in four resting bays before and after the implementation of time-area closures. Systematic boat-based photographic identification surveys have been carried out continuously over the past year following Pollock’s Robust Design (Primary period: each month; Secondary Period: 2-4 consecutive days in each of the four bays). Of the 96 surveys undertaken over 850 hours, spinner dolphins were observed on 43 (45%) occasions with group sizes ranging from 6 to approximately 250 dolphins. Preliminary abundance estimates over five primary periods ranged between 205 (SE ± 18; 95% CI = 176 – 249) and 446 (SE ± 73; 95% CI=329 – 621) spinner dolphins frequenting the study area. The precision of these preliminary abundance estimates will be tested over the next 3 to 5 years of continued data collection. In addition, passive acoustic loggers have been deployed in each bay, recording 30 seconds every 4 minutes with data collected continuously. These acoustic data allow for cross-validation with photographic survey records, and the method of deployment will provide an index of the regularity of dolphin presence in each bay before and after the implementation of time-area closures.