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Introduction Acute respiratory infections (ARI) are the most common cause of paediatric hospitalisation. There is an urgent need to address ongoing critical knowledge gaps in ARI management. The Pragmatic Adaptive Trial for Respiratory Infections in Children (PATRIC) Clinical Registry will evaluate current treatments and outcomes for ARI in a variety of paediatric patient groups. The registry will provide a platform and data to inform a number of PATRIC clinical trials, testing various interventions in ARI treatment and management to optimise paediatric ARI care.Methods and analysis The PATRIC Clinical Registry is a single-centre, prospective observational registry recruiting from a tertiary paediatric Emergency Department in Western Australia. Through characterising demographic, clinical, treatment and outcome data, the PATRIC Clinical Registry will improve our understanding of antibiotic utilisation and ARI outcomes in children.Ethics and dissemination The PATRIC Clinical Registry is conducted in accordance with the Declaration of Helsinki, and the International Council for Harmonisation (ICH) Guidelines for Good Clinical Practice (CPMP/ICH/13595) July 1996. Approval is provided by the Child and Adolescent Health Service Human Research Ethics Committee (HREC). Study results will be communicated by presentation and publication (HREC: RGS0000003078.)Trial registration number Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000903189. UTN: U1111-1231-3365.

Timely, accurate and clear communication is essential in crisis response. Given the multilingual and multicultural nature of many parts of today’s populated world, it should be evident that translation is key to enabling crisis communication. Although receiving little attention previously, the COVID-19 pandemic has highlighted the important role of translation in responding to crises. Nevertheless, how prepared are jurisdictions for crisis translation? One way of measuring this is to use a maturity model assessment. In this article, we apply the Organisational Maturity for Disaster Preparedness (OMDP) model Mohamed & Qu, (2018) to the Republic of Ireland, assessing the level of response through documentary and interview-based evidence. All considered, we place the response between June and November 2020 at Level 2 on the OMDP. Recommendations for moving up in the maturity model are provided and could be applied to many more jurisdictions.

Abstract Background Bronchiolitis is the most common reason for hospitalisation in infants. All international bronchiolitis guidelines recommend supportive care, yet considerable variation in practice continues with infants receiving non-evidence based therapies. We developed six targeted, theory-informed interventions; clinical leads, stakeholder meeting, train-the-trainer, education delivery, other educational materials, and audit and feedback. A cluster randomised controlled trial (cRCT) found the interventions to be effective in reducing use of five non-evidence based therapies in infants with bronchiolitis. This process evaluation paper aims to determine whether the interventions were implemented as planned (fidelity), explore end-users’ perceptions of the interventions and evaluate cRCT outcome data with intervention fidelity data. Methods A pre-specified mixed-methods process evaluation was conducted alongside the cRCT, guided by frameworks for process evaluation of cRCTs and complex interventions. Quantitative data on the fidelity, dose and reach of interventions were collected from the 13 intervention hospitals during the study and analysed using descriptive statistics. Qualitative data identifying perception and acceptability of interventions were collected from 42 intervention hospital clinical leads on study completion and analysed using thematic analysis. Results The cRCT found targeted, theory-informed interventions improved bronchiolitis management by 14.1%. The process evaluation data found variability in how the intervention was delivered at the cluster and individual level. Total fidelity scores ranged from 55 to 98% across intervention hospitals (mean = 78%; SD = 13%). Fidelity scores were highest for use of clinical leads (mean = 98%; SD = 7%), and lowest for use of other educational materials (mean = 65%; SD = 19%) and audit and feedback (mean = 65%; SD = 20%). Clinical leads reflected positively about the interventions, with time constraints being the greatest barrier to their use. Conclusion Our targeted, theory-informed interventions were delivered with moderate fidelity, and were well received by clinical leads. Despite clinical leads experiencing challenges of time constraints, the level of fidelity had a positive effect on successfully de-implementing non-evidence-based care in infants with bronchiolitis. These findings will inform widespread rollout of our bronchiolitis interventions, and guide future practice change in acute care settings. Trial registration Australian and New Zealand Clinical Trials Registry: ACTRN12616001567415 .

Abstract Background Despite international guidelines providing evidence-based recommendations on appropriate management of infants with bronchiolitis, wide variation in practice occurs. This results in infants receiving care of no benefit, with associated cost and is potentially harmful. Theoretical frameworks are increasingly used to develop interventions, utilising behaviour change techniques specifically chosen to target factors contributing to practice variation, with de-implementation often viewed as harder than implementing. This paper describes the stepped process using the Theoretical Domains Framework (TDF) to develop targeted, theory-informed interventions which subsequently successfully improved management of infants with bronchiolitis by de-implementing ineffective therapies. Explicit description of the process and rationale used in developing de-implementation interventions is critical to dissemination of these practices into real world clinical practice. Methods A stepped approach was used: (1) Identify evidence-based recommendations and practice variation as targets for change, (2) Identify factors influencing practice change (barriers and enablers) to be addressed, and (3) Identification and development of interventions (behaviour change techniques and methods of delivery) addressing influencing factors, considering evidence of effectiveness, feasibility, local relevance and acceptability. The mode of delivery for the intervention components was informed by evidence from implementation science systematic reviews, and setting specific feasibility and practicality. Results Five robust evidence-based management recommendations, targeting the main variation in bronchiolitis management were identified: namely, no use of chest x-ray, salbutamol, glucocorticoids, antibiotics, and adrenaline. Interventions developed to target recommendations addressed seven TDF domains (identified following qualitative clinician interviews (n = 20)) with 23 behaviour change techniques chosen to address these domains. Final interventions included: (1) Local stakeholder meetings, (2) Identification of medical and nursing clinical leads, (3) Train-the-trainer workshop for all clinical leads, (4) Local educational materials for delivery by clinical leads, (5) Provision of tools and materials targeting influencing factors, and prompting recommended behaviours, and (6) Audit and feedback. Conclusion A stepped approach based on theory, evidence and issues of feasibility, local relevance and acceptability, was successfully used to develop interventions to improve management of infants with bronchiolitis. The rationale and content of interventions has been explicitly described allowing others to de-implement unnecessary bronchiolitis management, thereby improving care.

Language and its translation are important operational concerns in humanitarian crisis response. Information sharing, coordination, collaboration and relationship-building all revolve around the ability to communicate effectively. However, doing so is hampered in many humanitarian crises by linguistic differences and a lack of access to adequate translation. Various innovative practices and products are being developed and deployed with the goal of addressing these concerns. In this theoretical paper, we critically appraise the ethical terrain of crisis translation and humanitarian innovation. We identify ethical issues related to three broad themes. First, we foreground questions of justice in access to translation and its prioritisation in contexts of widespread and pressing needs. Second, we consider the relationship between humanitarian ethics and the ethics of crisis translation. We argue for the importance of attending to epistemic justice in humanitarian crisis response, and consider how Ricoeur’s conception of linguistic hospitality provides insights into how relationships in humanitarian settings can be understood through the lens of an ethics of exchange while also acknowledging the steep asymmetries that often exist in these contexts. Finally, we identify issues related to how translation innovations intersect with humanitarian values and humanitarians’ ethical commitments.

Abstract Background Bronchiolitis is the most common reason for admission to hospital for infants less than one year of age. Although management is well defined, there is substantial variation in practice, with infants receiving ineffective therapies or management. This study will test the effectiveness of tailored, theory informed knowledge translation (KT) interventions to decrease the use of five clinical therapies or management processes known to be of no benefit, compared to usual dissemination practices in infants with bronchiolitis. The primary objective is to establish whether the KT interventions are effective in increasing compliance to five evidence based recommendations in the first 24 h following presentation to hospital. The five recommendations are that infants do not receive; salbutamol, antibiotics, glucocorticoids, adrenaline, or a chest x-ray. Methods/design This study is designed as a cluster randomised controlled trial. We will recruit 24 hospitals in Australia and New Zealand, stratified by country and provision of tertiary or secondary paediatric care. Hospitals will be randomised to either control or intervention groups. Control hospitals will receive a copy of the recent Australasian Bronchiolitis Guideline. Intervention hospitals will receive KT interventions informed by a qualitative analysis of factors influencing clinician care of infants with bronchiolitis. Key interventions include, local stakeholder meetings, identifying medical and nursing clinical leads in both emergency departments and paediatric inpatient areas who will attend a single education train-the-trainer day to then deliver standardised staff education with the training materials provided and coordinate audit and feedback reports locally over the study period. Data will be extracted retrospectively for three years prior to the study intervention year, and for seven months of the study intervention year bronchiolitis season following intervention delivery to determine compliance with the five evidence-based recommendations. Data will be collected to assess fidelity to the implementation strategies and to facilitate an economic evaluation. Discussion This study will contribute to the body of knowledge to determine the effectiveness of tailored, theory informed interventions in acute care paediatric settings, with the aim of reducing the evidence to practice gaps in the care of infants with bronchiolitis. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12616001567415 (retrospectively registered on 14 November 2016).

Abstract Background Bronchiolitis is the commonest respiratory infection in children less than 12 months and cause of hospitalisation in infants under 6 months of age in Australasia. Unfortunately there is substantial variation in management, despite high levels of supporting evidence. This paper reports on the process, strengths and challenges of the hybrid approach used to develop the first Australasian management guideline relevant to the local population. Method An adaption of the nine steps recommended by the National Health and Medical Research Council (NHMRC) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology were utilised. Following establishment of the Guideline Development Committee (GDC), we identified the population, intervention, comparator, outcomes and time of interest (PICOt) questions, undertook a systematic literature search and graded the evidence and recommendations using the NHMRC and GRADE processes. Using Nominal Group Techniques (NGT), consensus was sought in formulating the clinical practice recommendations and practice points. Key health professional bodies were consulted to ensure relevance in the Australasian emergency and ward settings. Results From 33 PICOT questions, clinical recommendations for practice that were deemed relevant to the Australasian population were identified. Specific considerations for the management of Australian and New Zealand indigenous infants in relation to the use of azithromycin and risk factors for more serious illness are included. Using NGT, consensus demonstrated by a median Likert score > 8 for all recommendations was achieved. The guideline presents clinical guidance, followed by the key recommendations and evidence review behind each recommendation. Conclusion Developing evidence-based clinical guidelines is a complex process with considerable challenges. Challenges included having committee members located over two countries and five time zones, large volume of literature and variation of member’s knowledge of grading of evidence and recommendations. The GRADE and NHMRC processes provided a systematic and transparent approach ensuring a final structure including bedside interface, and a descriptive summary of the evidence base and tables for each key statement. Involvement of stakeholders who will ultimately be end-users as members of the GDC provided valuable knowledge. Lessons learnt during this guideline development process provide valuable insight for those planning development of evidence-based guidelines.

CAT tools have become a fixture of professional translation over the last two decades yet are still treated with suspicion or disinterest by many freelancers. Acknowledged to contribute to consistency and speed, they can constrain and otherwise negatively affect the translation process in various ways. Surveys of professional translators and observations at the workplace suggest that there is a degree of frustration associated with the use of CAT tools and room for improvement in their usability. A recent large-scale survey of professional translators included specific items for CAT tool users about whether any features of their tools were irritating or missing. Many reported that there were and also availed themselves of the opportunity to provide detailed comments about them. More than half of the CAT tool users said that they found some features irritating, and a quantitative and qualitative analysis of their comments revealed that the most common issues concerned the complexity of the user interface and segmentation. There were some differences in the responses between freelance, institutional and commercial translators but almost none across age groups. The comments about missing features also tended to be about making the tools easier to use. The focus in the survey reported here was on identifying negative aspects of tools with a view to mitigating them and tailoring the tools more to translators’ needs. However, there is also room for research exploring the positive aspects of tools in the interests of optimising their usability and reducing cognitive friction

Kanjingo is a post-editing application for iOS devices developed at the ADAPT Centre (formerly CNGL) at Dublin City University (DCU). The first stage of user testing was conducted in 2014 (reported in O’Brien, Moorkens & Vreeke, 2014), and improvements were made based on the initial feedback. This abstract describes further exploratory testing based on the second iteration of the Kanjingo application. The new tests were designed with several aims: (1) testing Kanjingo for post-editing using the phone’s keyboard (2) testing Kanjingo for post-editing with voice input; (3) testing Kanjingo for revision of post-edited texts; (4) testing Kanjingo general usability; and (5) testing Kanjingo interface design. This paper presents the results of the various tests, issues identified, and ideas for improvements. For example, the use of Kanjingo for post-editing with voice input, one of the most innovative forms of interaction with MT in the test, worked much better than participants expected, and this mode of input was preferred for translating from scratch when MT quality was very poor, whereas post-editing short words or phrases was found to be faster with the iPhone keyboard. In addition, we present some reflections on the strengths and weaknesses of the testing methods employed.

This paper describes the development of the mobile post-editing application Kanjingo, and the developers’ intentions for the tool. There have, to date, been two rounds of usability testing of Kanjingo, with good responses from participants. Despite this, it remains difficult to make a commercial case for mobile post-editing.

This study explored the influence of situational factors on aggressive driving from within the framework of a frustration-aggression model of aggressive driving. Through the use of driving scenarios, a number of situational characteristics were manipulated to examine their effect on the level of anger reported by participants and their likely behavioural response. The situational characteristics examined included the age, gender and anonymity of the offending driver, and the sense of time pressure as well as the gender of the participants. The results confirmed that the situational characteristics of a potentially frustrating road event can influence both the anger reported by participating drivers and their likely behavioural response.

This article presents the view of three professionals and researchers in the translation field about the post-editing task with a view to examining what it is known about this relatively new task both in the localization industry and in the academic arena, as well as highlighting what should be investigated further in order to shed light on different aspects of post-editing and the use of machine translation.