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BackgroundMask mandates for children during the COVID-19 pandemic varied in different locations. A risk-benefit analysis of this intervention has not yet been performed. In this study, we performed a systematic review to assess research on the effectiveness of mask wearing in children.MethodsWe performed database searches up to February 2023. The studies were screened by title and abstract, and included studies were further screened as full-text references. A risk-of-bias analysis was performed by two independent reviewers and adjudicated by a third reviewer.ResultsWe screened 597 studies and included 22 in the final analysis. There were no randomised controlled trials in children assessing the benefits of mask wearing to reduce SARS-CoV-2 infection or transmission. The six observational studies reporting an association between child masking and lower infection rate or antibody seropositivity had critical (n=5) or serious (n=1) risk of bias; all six were potentially confounded by important differences between masked and unmasked groups and two were shown to have non-significant results when reanalysed. Sixteen other observational studies found no association between mask wearing and infection or transmission.ConclusionsReal-world effectiveness of child mask mandates against SARS-CoV-2 transmission or infection has not been demonstrated with high-quality evidence. The current body of scientific data does not support masking children for protection against COVID-19.

Chronic hepatitis B (CHB) is endemic in the Aboriginal and Torres Strait Islander population of Australia's Northern Territory. Progression to liver disease can be prevented if holistic care is provided. Low health literacy amongst health professionals is a known barrier to caring for people living with CHB. We co-designed and delivered a culturally safe \"Managing hepatitis B\" training course for the Aboriginal health workforce. Here, we present an evaluation of the course. 1. To improve course participants CHB-related knowledge, attitudes, and clinical practice. 2. To evaluate the \"Managing hepatitis B\" training course. 3. To enable participants to have the skills and confidence to be part of the care team. We used participatory action research and culturally safe principles. We used purpose-built quantitative and qualitative evaluation tools to evaluate our \"Managing hepatitis B\" training course. We integrated the two forms of data, deductively analysing codes, grouped into categories, and assessed pedagogical outcomes against Kirkpatrick's training evaluation framework. Eight courses were delivered between 2019 and 2023, with 130 participants from 32 communities. Pre- and post-course questionnaires demonstrated statistically significant improvements in all domains, p<0.001 on 93 matched pairs. Thematic network analysis demonstrated high levels of course acceptability and significant knowledge acquisition. Other themes identified include cultural safety, shame, previous misinformation, and misconceptions about transmission. Observations demonstrate improvements in post-course engagement, a deep understanding of CHB as well as increased participation in clinical care teams. The \"Managing hepatitis B\" training course led to a sustained improvement in the knowledge and attitudes of the Aboriginal health workforce, resulting in improved care and treatment uptake for people living with CHB. Important non-clinical outcomes included strengthening teaching and leadership skills, and empowerment.

People who overdose on opioids when they are alone or unmonitored are at heightened risk of death as other people do not know they should provide an emergency response. Wearable technology provides an opportunity to continuously measure respiratory function and ultimately send an alert if respiratory depression occurs. This study evaluates the feasibility and acceptability of PneumoWave DC in UK homeless hostels or supported accommodation settings (equivalent to Housing First in the USA) for individuals at high risk of opioid overdose. The PneumoWave system consists of a wearable biosensor that is affixed to the chest and records chest motion and which, in future, could potentially provide early detection of respiratory depression and trigger overdose response. RESCU-2 is a non-randomised, observational trial conducted in supported accommodation facilities across the UK. 50 participants who currently use opioids and live in homeless hostels in England and Scotland will wear the PneumoWave biosensor for varying periods to collect data over 2,000 participant-days. The biosensor will be linked via Bluetooth to a hub for continuous respiratory data collection. Self-reported drug use during the trial will be measured using drug diaries. Quantitative acceptability data will be measured using structured satisfaction surveys, while qualitative acceptability data will be obtained from interviews and focus groups with both residents and staff. Statistical analysis will include descriptive evaluation of feasibility outcomes, while qualitative data will undergo thematic analysis. The primary objectives of the study are: 1) feasibility of the study protocol within the hostel setting; 2) acceptability and usability of the device among people who use opioids and live in hostels; 3) acceptability of the device among staff who work in hostels and respond to overdose events. Primary outcomes are recruitment, total hours of usable data collected and successful recording of key outcome measures, among others. Trial registration: ISRCTN12060022. Findings will inform the feasibility of future integration of chest biosensor technology into hostel settings, assessing participant adherence, usability, and acceptability among people who use substances and staff. Insights gained will support the design of future trials and further development of remote monitoring technologies for overdose prevention and response strategies.

IntroductionAccurate evaluation of respiratory rate and pattern is important in health and disease; however, it can be challenging in children and babies due to small size and poor tolerability of existing monitoring equipment. This protocol outlines a study evaluating the feasibility of collecting respiratory data using a chest-worn accelerometer-based motion sensor in paediatric patients at risk of apnoea, respiratory failure and sudden death.Methods and analysisThis is an observational feasibility study over a 2-year period. The biosensor is an accelerometer worn on an ECG electrode during standard care at the Royal Hospital for Children, Glasgow. We aim to recruit three groups of patients (75 patients to each group): (1) Children attending for overnight cardiorespiratory polygraphy (0 to ≤16 years), (2) neonatal inpatients (from 30 weeks gestation) and (3) children attending for video telemetry at the epilepsy monitoring unit (0 to ≤16 years). Measurements will include (1) chest and/or abdominal wall motion measured by the worn biosensors; (2) standard clinical monitoring data will be collected to support biosensor data interpretation and (3) acceptability will be measured by a feedback questionnaire completed by patients and their parents/guardians.Ethics and disseminationThis study protocol was reviewed and approved by Yorkshire and The Humber-Leeds East Research Ethics Committee, approval number 314 696. This study involves human participants; written informed consent and assent, when appropriate, will be obtained from participants (or their parent/legal guardian/next of kin) to participate in the study. The study will be carried out in accordance with the World Medical Association Declaration of Helsinki (1964) standard reporting. Study findings will be reported clearly and transparently with relevant stakeholders including researchers, practitioners and publicly available databases. Results from this study will be presented at national and international conferences and reported in peer-reviewed publications.Trial registration numberNCT06292299 pre-results stage.

Accidental opioid overdose and Sudden Unexpected Death in Epilepsy (SUDEP) represent major forms of preventable mortality, often involving sudden-onset catastrophic events that could be survivable with rapid detection and intervention. The current physiological monitoring technologies are potentially applicable, but face challenges, including complex setups, poor patient compliance, high costs, and uncertainty about community-based use. Paradoxically, simple clinical observation in supervised injection facilities has proven highly effective, suggesting observable changes in central body motion may be sufficient to detect life-threatening events. We describe a novel wearable biosensor for continuous central body motion monitoring, offering a potential early warning system for life-threatening events. The biosensor incorporates a low-power, triaxial MEMS accelerometer within a discreet, chest-worn device, enabling long-term monitoring with minimal user burden. Two system architectures are described: stored data for retrospective analysis/research, and an in-development system for real-time overdose detection and response. Early user research highlights the importance of accuracy, discretion, and trust for adoption among people who use opioids. The initial clinical data collection, including the OD-SEEN study, demonstrates feasibility for capturing motion data during real-world opioid use. This technology represents a promising advancement in non-invasive monitoring, with potential to improve the outcomes for at-risk populations with multiple health conditions.

BackgroundChildren with epilepsy are at increased risk of Sudden Unexpected Death (SUDEP). The pathophysiology of SUDEP remains unclear however ictal respiratory disturbances can be significant. The risk of SUDEP varies but is estimated to be 1.2/1,000 children with epilepsy per year. SUDEP most often occurs during sleep. PneumoWave is a small chest-worn accelerometer which measures changes in chest wall motion (figure 1). Using a wearable sensor alerting carers to apnoeas could save lives.Aims(1) Determine the feasibility of collecting chest motion data from a novel, accelerometer-based sensor, PneumoWave (PneumoWave Ltd, UK) in children attending for video telemetry (VT) at the Royal Hospital for Children, Glasgow. (2) Improve understanding of chest motion changes in peri-ictal period.MethodsAn observational feasibility study over a 2-year period. Measurements include (1) chest wall motion measured by the worn biosensor, (2) standard monitoring VT and oximetry data, (3) Parents/ carers and patient feedback questionnaires to assess experience and tolerability. Cardiorespiratory changes 15 minutes before and after events will be mapped. Algorithms are in development to allow for automated evaluation of motion metrics.Results18 VT patients [17 wearing the sensor] with a range of age (14 months to 16 years of age), weight (8.64kg to 94.6kg), epilepsy types and comorbidities were recruited. The sensor was well tolerated by all patients who wore it. 1,135 hours of biosensor has been collected and 19 epileptic seizures recorded with 3 post-ictal central apnoeas identified in addition to apnoeas during sleep and breath holding episodes (figure 2).ConclusionThis multidisciplinary study evaluates the feasibility of collecting chest motion data from children at risk of SUDEP using a novel biosensor. We examine the biosensor’s potential for real-time respiratory monitoring, providing insights into changes in respiratory pattern architecture during the peri-ictal period and supporting intervention strategies.Abstract O4 Figure 1PneumoWave data workflow. The PneumoWave sensor attaches to the patient’s chest using an ECG electrode. Accelerometery data is transferred via Bluetooth to a data capture mobile application (DCM). Data is processed in a cloud-based infrastructure and a combined waveform us generates (displayed on MATLAB for demonstration purposes). Algorithms are in development to identify respiratory metrics such as respiratory rate,pattern and central apnoeas. ECG, electrocardiogramAbstract O4 Figure 2(A) 15 years 7-month female, drug resistant focal epilepsy, DEPDC5 mutation, event at 02:36:25: A brief period, lasting 7 seconds of dystonic posturing of limbs is associated with lower amplitude background with fast/ muscle activity superimposed, muscle artefact is prominent particularly over the left hemisphere. (B) 15-years 7-month female, drug resistant focal epilepsy, DEPDC5 mutation, apnoeas during period of sleep. (C) 11-year 3-month female with Rett syndrome and epilepsy, VT to capture apnoeic events and time in relation to epileptic seizures. Eyes rolled back, then staring, stopped breathing, staring. Spike wave activity is seen on the EEG at the time of the event marker pressed (08:33:40), run of widespread delta activity. Green box, central apnoea: Red box oxygen desaturation ≥3%

In Echoes of Success, Ian Stuart Kelly uses new information about late Victorian Scottish Highland battalions to provide new insights into how groups identify themselves, and pass that sense on to successive generations of soldiers.Kelly applies concepts from organisational theory (the study of how organisations function) to demonstrate how soldiers' experiences create a 'blueprint' of expected behaviours and thought patterns that contribute to their battalion's continued success. This model manages the interplay between public perception and actual life experiences more effectively than current approaches to understanding identity. Also, Kelly's primary research offers a more certain description of soldiers' life, faith, education, and discipline than has previously been available.

Teacher professional learning is often disjointed and not aligned with the curricula teachers use in daily instruction. This lack of preparation has led to fragmented approaches to teaching young students to read, in part because initiatives lose momentum, teachers modify the instruction beyond recognition, and programs are soon eclipsed by newer curricula that face the same structural limitations. Schools have a long way to go in scaling effective reading instruction. Collaborative Classroom is a mission-driven nonprofit organization working to close that distance. Collaborative Classroom intentionally designs its curriculum materials to be educative; that is, teachers learn new skills and content as they teach student-facing lessons (Sawyer, n.d.; Ball & Cohen, 1996). But in recent years, especially during remote learning due to COVID-19, it was recognized that teachers need more intensive and personalized support, and Collaborate Classroom has been exploring ways to extend that support through coaching. In partnership with Javelin Learning, Collaborate Classroom developed Collaborative Coach, personalized coaching support for teachers to be paired with evidence-based curriculum. This combination has the potential to transform the way teachers support students.

[...]the teacher selects a coaching focus from a list of common problems of practice. The pilot teachers included 11 interventionists, two reading coaches, a district resource teacher, a classroom teacher, a reading specialist, and a special education teacher. Because of the asynchronous approach, the coach had to actively listen to the reflections of the teacher without interrupting. [...]the teachers directed their learning and made visible the new learnings, wonderings, and struggles.