Measuring pressure distribution under the seat cushion and dividing the pressure map in six regions might be beneficial for comfort studies of aircraft seats

Seat pressure maps are often used to evaluate comfort of the users. In this study, we explored the relationships between pressure maps and comfort/discomfort of users in aircraft seats with a focus on a new 6-division method on the pressure maps collected at the bottom of the cushions. An experiment was designed where three cushions with identical shapes but different stiffnesses were prepared. 33 subjects joined the experiment and after sitting on each cushion in 4 postures, they completed comfort questionnaires. Pressure maps on the top as well as the bottom of cushions were collected and analysed. Results indicated that measures on the proposed 6 divisions, especially on the distal posterior thigh regions and regions close to ischial tuberosity of the bottom pressure maps, had larger correlation values to comfort scores compared to other division methods. Practitioner summary: The relations between comfort/discomfort and seat pressure maps collected from the top/bottom of three cushions were studied with 33 subjects in four postures. The distal posterior thigh and ischial tuberosity regions in the proposed 6-division of the bottom pressure maps had larger correlation values to comfort/discomfort compared to other methods.

Dense 3D pressure discomfort threshold (PDT) map of the human head, face and neck: A new method for mapping human sensitivity

When designing wearables that interface with the human head, face and neck, designers and engineers consider human senses, ergonomics and comfort. A dense 3D pressure discomfort threshold map could be helpful, but does not exist yet. Differences in pressure discomfort threshold for areas of the head, neck and face were recorded, to create a 3D pressure discomfort threshold map. Between 126 and 146 landmarks were placed on the left side of the head, face and neck of twenty-eight healthy participants (gender balanced). The positions of the landmarks were specified using an EEG 10-20 system-based landmark-grid on the head and a self-developed grid on the face and neck. A 3D scan was made to capture the head geometry and landmark coordinates. In a randomised order, pressure was applied on each landmark with a force gauge until the participant indicated experiencing discomfort. By interpolating all collected pressure discomfort thresholds based on their corresponding 3D coordinates, a dense 3D pressure discomfort threshold map was made. A relatively low-pressure discomfort threshold was found in areas around the nose, neck front, mouth, chin-jaw, cheek and cheekbone, possibly due to the proximate or direct location of nerves, blood veins and soft (muscular) tissue. Medium pressure discomfort was found in the neck back, forehead and temple regions. High pressure discomfort threshold was found in the back of the head and scalp, where skin is relatively thin and closely supported by bone, making these regions interesting for mounting or resting head, face and neck related equipment upon.

Safety and efficacy of recombinant and live herpes zoster vaccines for prevention in at-risk adults with chronic diseases and immunocompromising conditions

Compared with the general population, older adults with immune senescence and individuals who are immunocompromised (IC) due to disease or immunosuppressive therapy are at increased risk for herpes zoster (HZ) and its associated complications, which can be debilitating and life-threatening. Vaccination can be an effective strategy against HZ and studies have shown that HZ vaccination in IC individuals can elicit immune responses and provide protection from infection. Recently, the first approvals have been granted in the United States and the European Union for the recombinant HZ vaccine (RZV) in adults ≥ 18 years of age at risk of HZ due to immunodeficiency or immunosuppression. Existing systematic reviews have highlighted the risks for HZ in limited immunocompromising conditions and have only examined clinical data for RZV. This review details the risks and burden of HZ in a broad range of clinically relevant IC populations and summarizes key efficacy and safety data for RZV and live HZ vaccine in these individuals. Research has shown IC individuals can benefit from HZ vaccination; however, these insights have yet to be fully incorporated into vaccination guidelines and clinical care. Clinicians should consider HZ vaccination in eligible at-risk populations to protect against HZ and its associated complications and thereby, reduce the burden that HZ poses on the healthcare system. Electronic health records and linked personal health records could be used to identify and contact patients eligible for HZ vaccination and provide clinical decision support-generated alerts for missing or delayed vaccinations. This review will help clinicians identify eligible IC individuals who may benefit from HZ vaccination. A video abstract linked to this article is available on Figshare https://doi.org/10.6084/m9.figshare.21517605.

Recruiting participants for ergonomic research using self-reported stature and body mass

BACKGROUND

A valid distribution of key anthropometric parameters among participants is often a perquisite of ergonomics research.

OBJECTIVE

In this paper, we investigated the accuracy of self-reported stature and body mass of the population in the Netherlands.

METHODS

Data from 4 experiments was synthesized where in each experiment, participants self-reported their stature and body mass prior to being measured, of which they were not notified before.

RESULTS

Statistical analysis of 249 records indicated that on average, participants overreported their stature by 1.31 cm and underreported their mass by 1.45 kg. This is especially true for people with a BMI≥25.

CONCLUSION

Two models were proposed to adjust the self-reported stature and body mass for ergonomic researchers in a survey or recruitment. Limitations in using the models are highlighted as well.

AB1072 HERPES ZOSTER IN INDIVIDUALS WITH AUTOIMMUNE DISEASES AND RECOMBINANT HERPES ZOSTER VACCINE AS A PREVENTATIVE STRATEGY

Background

Individuals with autoimmune diseases (AIDs) are particularly vulnerable to herpes zoster (HZ) and its related complications. Although the live attenuated HZ vaccine is contraindicated in many of these individuals, the two-dose non-live recombinant zoster vaccine (RZV) can be used in immunosuppressed individuals. Based on accumulating data from RZV studies within specific immunosuppressive conditions, recently updated guidelines recommend RZV not only in immunocompetent adults aged ≥50 years, but also in adults aged ≥18 years (EU)/≥19 years (USA) at risk of HZ due to immunodeficiency or immunosuppression.1–3

Objectives

To evaluate the burden of HZ in individuals with AIDs and the use of RZV as a preventative strategy.

Methods

We reviewed PubMed for available data on HZ incidence, summarised RZV data (effectiveness and safety) and the current recommendations for RZV in individuals with AIDs. The latest search was conducted in September 2021.

Results

HZ incidence in the general population is 4–7/1000 person-years (increases with age) and 8–15/1000 person-years in individuals with AIDs. Common immunosuppressive and immunomodulatory therapies can predispose individuals to HZ, as shown by large meta-analyses of interventional and observational studies. No published randomised controlled trial data of RZV in AID populations were found in our search. In two retrospective cohort studies in patients with inflammatory bowel disease (IBD), 4,5 RZV demonstrated high vaccine effectiveness (OR 0.64; 95% CI 0.44, 0.77).4 In a real-world observational study investigating RZV in beneficiaries of the Medicare national health insurance program in the USA, individuals with AIDs achieved vaccine effectiveness of 68.0% (95% CI 62.3%, 72.8%), which was similar to the overall population (70.1% [95% CI 68.6%, 71.5%]).6 In two single-centre, retrospective studies of RZV in individuals with AIDs, including rheumatoid arthritis (RA), adverse events after the first RZV dose were mild7,8. Disease flares were uncommon, mild and self-limiting, although a flare at the first RZV dose was significantly associated with an increased risk of a flare at the second dose (hazard ratio 3.9; P=0.0015)7. In addition, glucocorticoid use during vaccination was significantly associated with flares (odds ratio [OR] 2.31; P=0.004; Lenfant, 2021)7. In a study of individuals with IBD, receiving ≥1 RZV dose was associated with a low flare rate9. Current RZV guidelines vary by country and will be revised as new data emerge. Ongoing studies include phase 4 studies of individuals with RA and IBD receiving immunotherapies, and a study investigating the immunogenicity and safety of RZV in individuals with stable systemic lupus erythematosus.

Conclusion

Individuals with AIDs are at increased risk of HZ and its related complications, which may be due to either or both of their underlying condition and the treatment(s) they are receiving. The developing collective scientific evidence from the published literature on RZV in individuals with AIDs demonstrates a favourable benefit:risk profile for RZV in this population which contributed to the recent USA ACIP recommendation. Further studies are warranted to evaluate potential effects of individual conditions and immunotherapies on vaccine efficacy and methods to optimise vaccine use.

References

[1]Dooling KL, et al. MMWR Morb Mortal Wkly Rep, 2018

[2]GlaxoSmithKline, Press Release, 2021

[3]GlaxoSmithKline, RZV EU SmPC, 2021

[4]Kochhar GS, et al. Vaccine, 2021

[5]Khan N, et al. Clin Gastroenterol Hepatol, 2021

[6]Izurieta HS, et al. Clin Infect Dis, 2021

[7]Lenfant T, et al. Rheumatology, 2021

[8]Stevens E, et al. ACR Open Rheumatol, 2020

[9]Satyam VR, et al. Dig Dis Sci, 2020

Acknowledgements

This abstract was funded by GlaxoSmithKline Biologicals SA. Medical writing support in the preparation of this abstract was provided by Silvia Pregnolato of OPEN Health Communications, London, UK, with financial support from GlaxoSmithKline Biologicals SA.

Disclosure of Interests

Kevin Winthrop Consultant of: KLW has received consultancy fees from GlaxoSmithKline, Bristol Myers Squibb, Pfizer, AbbVie, Union Chimique Belge, Eli Lilly, Galapagos, Roche, Gilead, Sanofi, Regeneron, AstraZeneca and Novartis., Grant/research support from: KLW has received research grants from Bristol Myers Squibb and Pfizer., Francis A Farraye Consultant of: KMS has received consultancy fees from and been part of publication committees for GlaxoSmithKline., Keith M Sullivan Shareholder of: FAF is a stockholder in Innovation Pharmaceuticals., Paid instructor for: FAF sits on the data safety monitoring board for Eli Lilly and Theravance., Consultant of: FAF has received consultancy fees from Arena, Bristol Myers Squibb, Braintree Labs, GI reviewers, GlaxoSmithKline, Iterative Scopes, Janssen, Pfizer and Sebela., David O Willer Shareholder of: DOW holds restricted share stock ownership for GlaxoSmithKline., Employee of: DOW is employed by GlaxoSmithKline., Peter Vink Employee of: PV was an employee at GSK at the time this work was completed., Fernanda Tavares-Da-Silva Shareholder of: FTDS holds restricted share stock ownership for GlaxoSmithKline., Employee of: FTDS is employed by GlaxoSmithKline.

The Haptic Fidelity Framework: A Qualitative Overview and Categorization of Cutaneous-Based Haptic Technologies Through Fidelity

After decades of research and development, haptic feedback is increasingly appearing in consumer products. While the prevalence of haptic feedback is increasing, the integration rarely offers increased fidelity to previous generations. We argue this is because of the tremendous complexity of successful haptic design engineering, but critically, also because of information saturation. With novel cutaneous feedback technologies and companies emerging almost daily, the multi-disciplinary nature of haptics and the marketing-driven terminology used to stand out in a crowded market makes it challenging to select and integrate actuators correctly. To manage this complexity and facilitate the interdisciplinary exchange of user requirements and material affordances, we introduce a novel classification criterion for haptic actuators focused on the bandwidth and fidelity of potential effects. We introduce vocabulary for describing the precise experience the actuators and corresponding systems should deliver. Lastly, we summarize currently commercially available cutaneous-based haptic technology. In the nearby future, the same criterion and language can also prove valuable for steering technology development of new and improved actuators and enabling novice and experienced practitioners to understand and integrate cutaneous feedback in their products.

Identify dominant dimensions of 3D hand shapes using statistical shape model and deep neural network

Hand anthropometry is one of the fundamentals of ergonomic research and product design. Many studies have been conducted to analyze the hand dimensions among different populations, however, the definitions and the numbers of those dimensions were usually selected based on the experience of the researchers and the available equipment. Few studies explored the importance of each hand dimension regarding the 3D shape of the hand. In this paper, we aim to identify the dominant dimensions that influence the hand shape variability while considering the stability of the measurements in practice. A novel four-step research method was proposed where in the first step, based on literature study, we defined 58 landmarks and 53 dimensions for the exploration. In the second step, 80,000 virtual hand models, each had the associated 53 dimensions, were augmented by changing the weights of Principle Components (PCs) of a statistical shape model (SSM). Deep neural networks (DNNs) were used to establish the inverse relationships from the dimensions to the weight of each PC of the hand SSM. Using the structured sparsity learning method, we identified 21 dominant dimensions that represent 90% of the variance of the hand shape. In the third step, two different manual measuring methods were used to evaluate the stability of the measurements in practice. Finally, we selected 16 dominant dimensions with lower measurement variance by synthesizing the findings in Step 2 and 3. It was concluded that the recognized 21 dominant dimensions can be treated as the reference dimensions for anthropometric study and using the selected 16 dominant dimensions with lower measurement variance, ergonomists are able to generate a 3D hand model based on simple measurement tools with an accuracy of 5.9 mm. Though the accuracy is limited, the efforts are minimum, and the results can be used as an indicator in the early stage of research/design.

Immune responses to the adjuvanted recombinant zoster vaccine in immunocompromised adults: a comprehensive overview

Immunocompromised (IC) persons are at increased risk for herpes zoster (HZ) and its complications, mainly due to impairment of cell-mediated immunity (CMI). The adjuvanted recombinant zoster vaccine (RZV) demonstrated efficacy against HZ in autologous hematopoietic stem cell transplant (auto-HSCT) recipients and hematologic malignancy (HM) patients. We review immune responses to RZV in 5 adult IC populations, 4 of which were receiving multiple, concomitant immunosuppressive medications: auto-HSCT and renal transplant recipients, HM and solid tumor patients, and human immunodeficiency virus-infected adults. Although administered in most cases when immunosuppression was near its maximum, including concomitantly with chemotherapy cycles, RZV induced robust and persistent humoral and, more importantly, CMI responses in all 5 IC populations. Based on the overall clinical data generated in older adults and IC individuals, RZV is expected to provide benefit in a broad adult population at risk for HZ.

Desktop lighting for comfortable use of a computer screen

BACKGROUND:

The contrast between a bright computer screen and a dark ambient environment may influence comfort of the users, especially on their eyes.

OBJECTIVE:

The objective of this research is to identify the optimal desktop lighting for the comfortable use of the computer screen in a dark environment.

METHODS:

An experiment was designed where seven illumination setups were introduced for the users to perform their leisure tasks on a computer screen. Fifteen healthy subjects participated in the experiments. During each session, durations of the eye blinks, fixations and saccades of the user were recorded by an eye tracker. His/her neck and trunk movements were recorded by a motion tracking system as well. The comfort/discomfort questionnaire, localized postural discomfort questionnaire, NASA task load index and computer user questionnaire were used to record the overall comfort/discomfort, the local perceived physical discomfort, the cognitive workload, and general/eye health problems, respectively.

RESULTS:

Subjective and objective measurement results indicated that users felt more comfortable with high intensity warm lights using a computer screen. We also identified that the eye fixation durations, as well as the scores of two questions in the computer user questionnaire, have significant negative correlations with comfort. On the other side, the durations of blinks and the scores of three questions in the computer user questionnaire, were significantly correlated with discomfort.

CONCLUSION:

The warm (3000K) and high intensity (1500 lux) light reduced the visual and cognitive fatigue of the user and therefore improve the comfort of the user during the use of a computer screen.

Concept evaluation of a new aircraft passenger privacy bubble using virtual prototyping: A Human-Centered Design framework

BACKGROUND

The Human-Centered Design methodology advocates VR prototyping, as an effective tool to evaluate concepts in a cost-efficient, time-saving way. It is the question of whether it works in the development of a product intended to increase privacy while flying.

OBJECTIVE

The current study aims at the application of virtual reality on the evaluation of a new privacy bubble called PRIVA for the passenger cabin.

METHODS

An interactive VR was created and aligned with the HTC VIVE headset. 40 participants took part in the experiment as well as in the post-experiment survey.

RESULTS

The concept was in overall, desirable as it was perceived to be more private, comfortable, satisfactory, effective, and appealing to participants compared to the current seat experiences. It was also perceived as more satisfactory with regards to the activities.

CONCLUSIONS

The VR was effective, although there are limitations, the product seems promising and should be developed further.

Effect of scent on comfort of aircraft passengers

BACKGROUND:

Scents may influence the perceived comfort of an environment. There are only a few studies conducted on the relationship between scent and comfort in aircraft cabin.

OBJECTIVES:

The goal of this research is to explore whether relationships between scents and perceived comfort can be found for passengers in an aircraft cabin.

METHODS:

276 participants joined an experiment in a Boeing 737 fuselage. The participants were divided into nine groups and each joined a session for 60 minutes with the exposure to different scents. The effect of the odor was measured by a set of questionnaires at the beginning and at the end of the session. Results of questionnaires were analyzed regarding the effects on the completion time, of the type of scents, of the intensity of the scent and on gender.

RESULTS:

Significant differences were found at the beginning and at the end of the experiment regarding comfort and emotion, but sometimes no relations could be established. The influence of different scents on comfort/discomfort varied and changed over time. However, in all scenarios, participant’ scores on emotion decreased. Additionally, the added scents influenced the linearity between the changes in comfort and discomfort.

CONCLUSIONS:

Smell could influence the perceived comfort/discomfort of aircraft passengers over time, and different types of smells have different effects on passengers. The preferences on scents are diverse, which highlights the need for personalization in aircraft cabin design.

Developments in work-related upper limb disorders (WRULD) amongst Dutch university students from 2004 to 2014

BACKGROUND

Former studies on work-related upper limb disorders (WRULD) within university education report substantial prevalence rates. In this study, developments in WRULD amongst students in the period 2004-2014 were investigated. Our findings can be a benchmark for future studies, in particular when there are major societal changes as in the case of the COVID-19 pandemic.

OBJECTIVE

Differences in time (academic year), how long students have been studying (year of studying), relations with computer time and societal changes were points of interest.

METHODS

2254 students (average age 20.0 years) responded to a questionnaire on WRULD. Students experiencing complaints were further questioned about the severity of complaints and associated body locations.

RESULTS

The average percentage of students experiencing complaints was 57%. The highest prevalence rates and severity scores were found in the first and last recorded academic years. The neck, shoulder, back and wrist were most often indicated. The prevalence of complaints raised from the 1st (49%) to the 4th (75%) year of studying. Two seriousness measures showed highest scores in the 5th/6th/7th year of studying. Relations were found between both the prevalence and seriousness of complaints with reported computer time.

CONCLUSIONS

After an initial decreasing trend from the academic year 2006/2007 to 2010/2011 there was an increase in WRULD amongst students from 2010/2011 to 2013/2014. Limiting financial and study time factors may have played a role. Structural attention for WRULD prevention and risk factors seems to be effective in reducing prevalence and severity of WRULD. This seems to be even more necessary due to recent COVID-related changes in the students' lives.

Differences and similarities in comfort and discomfort experience in nine countries in Asia, the Americas and Europe

In order to investigate differences in comfort and discomfort experiences amongst different regions of the world (America, Asia and Europe), a cross cultural study was performed. A questionnaire was sent to participants out in nine countries (Brazil, Canada, the USA, China, Indonesia, Thailand, Germany, Italy and the Netherlands). In total 795 participants completed the questionnaires. All countries score the comfort of a luxurious bed higher than a simple bed, first-class seats higher than economy class and all countries rate the comfort lower when the duration of sitting increases. The study suggests that in the USA and Canada softer beds, hammocks, more luxurious seats and softer pillows are scored as more comfortable compared with the other countries. There are indications that China and Germany prefer a harder mattress than in the other countries. For pillows, the differences between countries are large, which might show that much is influenced by habitude or hesitation to use something new. The Asian countries score the comfort of a brace neck pillow higher, which might be because these participants better realise the benefits better or feel less concerned to wear something that might give the appearance of an orthotic device. Further studies are needed to confirm these suggestions. The study shows that obvious differences are seen in all countries, which makes the construct of comfort internationally comparable. Practitioner summary: In designing and manufacturing globally, it is important to know how different parts of the world experience (dis)comfort. This study did not show large cultural differences amongst nine countries. Some differences emerge regarding pillows, perhaps as differences in sleeping habits play a role. Abbreviations: MANOVA: multivariate analysis of variance; VDA: Vargha and Delaney's A statistic; USA: United States of America.

Implementing spring-foam technology to design a lightweight and comfortable aircraft seat-pan

This paper investigates whether spring-foam technology in an aircraft seat-pan can reduce weight and at the same time provide equal or better comfort. Firstly, through literature studies and using an iterative design process a prototype seat-pan was designed and developed using spring-foam technology. The (dis)comfort of this seat was compared with a standard aircraft seat-pan. Twenty two participants were asked to sit in each seat for 90 min, completing a questionnaire every 15 min. At the end of each seating session pressure map recordings were made of the seat-pans. The results showed that the prototype seat-pan has on average a significantly higher comfort for the first 30 min and at a 60 min recording than the standard seat-pan. The discomfort and long term comfort were not significantly influenced. The pressure distribution on the prototype seat-pan was significantly closer to an ideal pressure distribution than a conventional seat-pan. In addition, the prototype seat-pan had a significantly larger contact area and lower average pressure. The seat-cushion weighs 20% less than the conventional seat-cushion. The study indicates that a seat-pan design using spring-foam technology can be lighter and more comfortable than conventional foam cushion materials. It is recommended to optimize the prototype seat further and conduct long term (dis)comfort studies with a broader variation in subjects' age.

Immunogenicity and Safety of the Adjuvanted Recombinant Zoster Vaccine in Chronically Immunosuppressed Adults Following Renal Transplant: A Phase 3, Randomized Clinical Trial

Background

The incidence of herpes zoster is up to 9 times higher in immunosuppressed solid organ transplant recipients than in the general population. We investigated the immunogenicity and safety of an adjuvanted recombinant zoster vaccine (RZV) in renal transplant (RT) recipients ≥18 years of age receiving daily immunosuppressive therapy.

Methods

In this phase 3, randomized (1:1), observer-blind, multicenter trial, RT recipients were enrolled and received 2 doses of RZV or placebo 1–2 months (M) apart 4–18M posttransplant. Anti–glycoprotein E (gE) antibody concentrations, gE-specific CD4 T-cell frequencies, and vaccine response rates were assessed at 1M post–dose 1, and 1M and 12M post–dose 2. Solicited and unsolicited adverse events (AEs) were recorded for 7 and 30 days after each dose, respectively. Solicited general symptoms and unsolicited AEs were also collected 7 days before first vaccination. Serious AEs (including biopsy-proven allograft rejections) and potential immune-mediated diseases (pIMDs) were recorded up to 12M post–dose 2.

Results

Two hundred sixty-four participants (RZV: 132; placebo: 132) were enrolled between March 2014 and April 2017. gE-specific humoral and cell-mediated immune responses were higher in RZV than placebo recipients across postvaccination time points and persisted above prevaccination baseline 12M post–dose 2. Local AEs were reported more frequently by RZV than placebo recipients. Overall occurrences of renal function changes, rejections, unsolicited AEs, serious AEs, and pIMDs were similar between groups.

Conclusions

RZV was immunogenic in chronically immunosuppressed RT recipients. Immunogenicity persisted through 12M postvaccination. No safety concerns arose.

Clinical Trials Registration

NCT02058589.

Introduction to the special issue on comfort: A review of 26 papers from the International Comfort Congress 2019

Various aspects related to comfort are described in this special issue. Some papers are focused on the environment, like smell, temperature, light, acoustics, space and some on an artefact touching the human, like the floor angle, the seat, a bed and light. However, in this special issue also topics like modelling and behavior get more attention.

4. Immunogenicity of the Adjuvanted Recombinant Zoster Vaccine in Immunocompromised Adults

Background

Immunocompromised (IC) populations are at increased risk of developing herpes zoster (HZ) due to disease- and/or therapy-induced immunosuppression. The adjuvanted recombinant zoster vaccine (RZV) has demonstrated 68.2% efficacy in preventing HZ in autologous hematopoietic stem cell transplant (HSCT) recipients and 87.2% efficacy in a post-hoc analysis in hematologic malignancy (HM) patients ≥ 18 years of age (YOA). Here we present the immunogenicity of RZV in representative IC populations.

Methods

Our analysis includes five phase I/II/III clinical trials conducted worldwide between 2010–2017 (Table 1) in IC populations (autologous HSCT, human immunodeficiency virus [HIV]-infected, HM, solid tumor [ST] on chemotherapy and renal transplant [RT] patients) ≥ 18 YOA. Anti-glycoprotein E (gE) antibody geometric mean concentrations (GMCs) and gE-specific CD4 T cell frequencies were descriptively evaluated by age group (18–49 YOA and ≥ 50 YOA) and overall at 1 month (M) and 12M post-last RZV dose.

Table 1. Clinical studies with immunocompromised populations included in our analysis

Results

The according-to-protocol cohorts for immunogenicity from the included trials are presented in Table 1. At 1M post-last RZV dose, anti-gE GMCs and median CD4 T-cell frequencies increased in all IC populations compared to pre-vaccination and persisted above baseline up to 12M post-last RZV dose (Figures 1 and 2). No meaningful differences were seen between age groups in terms of humoral (except a slight trend for stronger responses in the 18–49 YOA RT and HM patients compared to their corresponding ≥ 50 YOA group) and gE-specific CD4 T-cell responses in any of the IC populations.

Figure 1. Humoral immune responses to RZV in immunocompromised populations (adapted ATP cohort for humoral immunogenicity)

Figure 2. Cell-mediated immune responses to RZV in immunocompromised populations (adapted ATP cohort for cell-mediated immunogenicity)

Conclusion

RZV induced robust and persistent humoral and cell-mediated immune (CMI) responses that lasted up to at least 12M post-last vaccination in all evaluated IC populations. Humoral responses in the IC populations were robust although not as strong as in the non-IC adults ≥ 50 YOA. CMI responses were mostly similar across IC populations and adults ≥ 50 YOA, with a potent response occurring even in ST patients undergoing chemotherapy. This data shows that RZV is immunogenic even in severely IC adults.

Funding: GlaxoSmithKline Biologicals SA

Acknowledgment: M Maior/S Hulsmans (Modis c/o GSK) provided writing/editorial support

Disclosures

Alemnew F. Dagnew, MD, MSc, GSK group of companies (Employee, Shareholder) Peter Vink, MD, GSK group of companies (Employee, Shareholder) Mamadou Drame, MSc, GSK group of companies (Employee) David Willer, PhD, GSK group of companies (Employee, Shareholder) Bruno Salaun, PhD, GSK group of companies (Employee) Anne Schuind, MD, GSK (Employee, Other Financial or Material Support, own GSK stock options or restricted shares as part of renumeration)

Perceived onboard passengers' experience: Flight attendants' point of view

BACKGROUND

Cabin research is mostly based on passenger reports. However, it is also important to consider the perceptions of flight attendants as onboard service providers, since they can convey a complementary view shedding light on important aspects related to passenger experience.

OBJECTIVE

This study seeks to analyze flight-attendants' perception regarding passengers' inflight activities and experience.

METHODS

Twenty-eight flight attendants were interviewed on more than twenty-three inflight activities that were extracted from a brainstorming session. A survey was designed based on these activities and was distributed to flight attendants.

RESULTS

Overall, flight attendants perceived the activities 'resting/relaxing', 'sleeping' and 'using the restroom' for comfort as the most important activities to passengers, while activities 'talking to neighbors' and 'thinking and observing' were the least important ones. Interesting was the fact that flight attendants scored satisfaction of some activities higher then passengers.

CONCLUSIONS

Flight attendants had a similar idea on importance of activities of passengers, but they valued some activities as more satisfactory.

Comfort and discomfort during smartphone use on a bed

BACKGROUND:

The number of smartphone users is immense. People can do ever more with a smartphone. Smartphones are used everywhere, including in bed and on the sofa. The awkward postures taken in these situations affect comfort and discomfort. In designing a bed, it might be useful to know which position is comfortable for smartphone use on a bed.

OBJECTIVE:

The objective was to define the most comfortable trunk angle for smartphone use on a bed.

METHODS:

To study comfort and discomfort, 52 participants were asked to use the smartphone on a bed. The trunk angle of this bed was adjusted to 6 positions from flat to upright and for each angle the comfort and discomfort was recorded.

RESULTS:

The results showed that the participants prefer a trunk angle range around 120 and 142 degrees. At the best trunk angle 29% of the participants felt comfort in the legs, 25% in the upper back and 16% in the shoulders. However, in this position 36% also mentioned discomfort in the lower back and 24 % in the neck.

CONCLUSIONS:

For smartphone use a bed is preferable which enables a trunk angle of around 120–140 degrees. For the legs this is comfortable. However, for the neck and upper back the problem of discomfort still needs attention.

PCQ: Preferred Comfort Questionnaires for product design

BACKGROUND:

Selecting the most suitable questionnaire(s) in comfort research for product design is always a challenge, even for experienced researchers.

OBJECTIVE:

The objective of this research is to create a list of Preferred Comfort Questionnaires (PCQ) for product design to help researchers in the selection of questionnaires for comfort research.

METHODS:

Fifteen questionnaires that are often used in comfort research for product design were selected as candidate questionnaires. During the Second International Comfort Congress (ICC 2019), 55 researchers and practitioners working in the field of comfort joined together in a workshop to rate these questionnaires individually as well as rank them in groups based on their experience. The criteria of rating and ranking included easiness to answer, easiness for data interpretation, time needed to complete, the need for prior training, as well as mapping the applicable design phases and field of application.

RESULTS:

The elicited responses related to each questionnaire were analyzed. For comfort research in five proposed application fields and four design phases, the preferred questionnaires were highlighted and categorized into four categories: preferred questionnaire, suitable for less prior training, suitable for fast completion and generally applicable, which led to a list of PCQ for product design.

CONCLUSION:

We expect that the PCQ list can be used as a useful instrument to help researchers in selecting questionnaires for comfort research in product design.

The effect of the standing angle on reducing fatigue among prolonged standing workers

BACKGROUND

Many occupations require workers to stand for prolonged periods, which can cause discomfort, pain and even injures. Some supermarkets in life provide a foot pad for checkout staff to let them stand on it at work, thereby reducing standing fatigue caused by standing for a long time. The inclined platform is the same as the foot pad mentioned above. That is, the staff stepped on it and relieved standing fatigue to a certain extent.

OBJECTIVE

The study aims to analyze how the standing angle affects fatigue among prolonged standing workers and tries to find an inclined platform with a specific angle to reduce standing fatigue.

METHODS

This experiment studied fatigue of the inclined platforms with different angles on prolonged standing workers, eight participants were selected to participate in the test. The plantar pressures and sEMG (Surface Electromyography) were used to collect the physiological information change of prolonged standing participants in the lower limb and waist. The visual analogue scale was used as a subjective method to measure the psychological fatigue.

RESULTS AND CONCLUSION

The study highlights the relationship between standing angle and lower limb fatigue. The inclination of the standing platform has different effects on the participants under different time conditions. When participants stand on inclined platforms at 0°, 5° and 10°, the iEMG (Integrated Electromyography) values of the gastrointestinal muscle were not significantly different until the third sampling point (40 minutes). After that self-regulation of lower limb muscles is better when standing on an inclined platform between 5° and 10°, it has a certain effect on alleviating lower limb fatigue. This knowledge is crucial for the design of the inclined working platforms fitting the needs of prolonged standing workers.

Human behaviour should be recorded in (dis)comfort research

(Dis)comfort research that has no information on behaviour of the participants can be considered as incomplete, as major influencing factors could be missed. For (dis)comfort research it is important to capture factors such as context, task/activity, posture, movement, (distracting) stimuli and time, as these factors have influence on the experienced (dis)comfort. Recording the behaviour allows for better evaluation of and comparison between studies, contributing to an increase of scientific knowledge on (dis)comfort.

Seat pitch and comfort of a staggered seat configuration

BACKGROUND:

Staggered seats are a solution for the Flying-V aircraft, where the cabin’s longitudinal axis has a 26 degrees angle with respect to the direction of flight, to compensate for an otherwise oblique sitting position. However, little is known on acceptable pitches in this staggered configuration.

OBJECTIVE:

The goal of this research is to evaluate the comfort of different pitches for seats that are staggered relative to the cabin’s longitudinal axis.

METHODS:

Two rows of staggered seats are positioned at three different pitches (27, 29 and 31 inches). 53 participants were seated in each setup. For each, a questionnaire was completed including questions on comfort and discomfort, top view photos were taken to analyse postures and physical dimensions were recorded to define passengers’ space.

RESULTS:

Comfort as well as discomfort were significantly different for the three setups. The comfort at 27 inches was seen as unacceptably low. The 29 and 31-inch configurations showed to result in acceptable levels of comfort, comparable to higher-end seating layouts. There were very little complaints about space in lateral direction (elbow and seat width), showing the advantage of having your won armrest and shoulder space in the staggered configuration. Interesting was that at larger pitches more complaints were found for the seat characteristics, probably in the shorter pitch the other discomfort was overruling this.

CONCLUSION:

The 26-degree staggered configuration offers improvements in shoulder- and elbow-space. The results for the 29- and 31-inch are expected to allow enough design freedom for further exploration of such a configuration for the Flying-V cabin interior.

Designing a floor plan using aircraft seat comfort knowledge by aircraft interior experts

BACKGROUND:

Recent research indicated that an 18^′′ ×30^′′ aircraft seat resulted in nearly the same level of comfort as a 17^′′ ×34^′′ seat. However, it took less space in the floor plan.

OBJECTIVES:

This study explores seat layouts preferred by experts regarding different criteria. Those results of the experts are later compared to layouts produced by computational algorithms to evaluate the advantages of each method.

METHODS:

Eighty-eight experts in the field of aircraft interior were invited to make a floor plan of a part of a Boeing 777 aircraft where comfort was one of the main goals. Participants worked in groups of 3 and are given the freedom to design a section of the cabin between economy and first-class (5.87 m wide and 3.7 m long), where besides these two types of seats, an old business-class size seat of 20^′′ ×36^′′ was introduced as well for more flexibilities in design. Computational algorithms were also applied with the same inputs and constraints to generate layouts as a comparison.

RESULTS:

In total, 29 floor-plans were made, and these plans were analysed to compare against the complexity of the operations, the number of passengers on board, the revenue of the airline, and the width of the aisle. Results showed that 14 groups opted for the economy seats, while the rest utilized a hybrid setup where the business class seats were used in the configuration. These results are compared to the 126 computerized layouts generated.

CONCLUSIONS:

Among all layouts designed by experts, a combination of 28 18^′′ ×30^′′ seats and 20 17^′′ ×34^′′ seats had the highest potential revenue of US$21,984. This floor plan fits the regulations with an aisle width of 0.93 m. The computerized layout had a better outcome in maximizing profit of US$22,416 with 32 18^′′ ×30^′′ seats and 16 20^′′ ×36^′′ seats. However, the comfort of such results was to be explored as some seats were rotated 90 degrees.

The effect of aircraft seat pitch on comfort

This study explores the relationship between seat pitch and comfort, and the influencing factors, like space experience and anthropometric measurements. Two hundred ninety-four participants experienced economy class seats in a Boeing 737 with 28-inch, 30-inch, 32-inch and 34-inch seat pitches. Anthropometric measurements of the participants were measured. Participants completed a questionnaire on comfort (10-scale), discomfort (CP-50) and space experience and the results were analysed using SPSS 25. This study showed a significant relationship between seat pitch and comfort as well as discomfort. Additionally, it was found that the mean rank of discomfort of each pitch size for the middle seat was higher than the window and aisle seat, though seat pitch did affect the (dis)comfort more compared with seat location. It was also found that anthropometric sizes significantly affect the (dis)comfort on smaller pitch sizes, and all space experience questions had a correlation to the pitch sizes.

A system to measure seat-human interaction parameters which might be comfort relevant

In this paper a measurement tool is described and tested to evaluate the characteristics of different elements of a seat. Many studies report a relationship between discomfort and pressure distribution, but it is unknown what exactly is happening in the interaction. The purpose of this study is to present a measuring device, which records the comfort relevant seat parameters pressure and elongation while loading a seat. The results of the study, including the repeatability, reproducibility and detectability show that the measurement method is appropriate for our purpose, although the reproducibility has to be improved by operator experience or by a more intuitive assembling of the measurement setup. An application example illustrates that the interaction of the seat components highly affect the resulting comfort relevant parameters. The question is whether this objectively recorded differences are also experienced by seat occupants, which is interesting to study in future research.

Integrating and applying models of comfort

This paper gives an overview of the relevance of the comfort concept, its definitions, boundary conditions, and stakeholders. Current comfort theories are presented and reflected on, both in their applicability and testing methodology. Questionnaires commonly used to study comfort and discomfort are also reviewed. An example of a comfort lab is introduced in its functionality and tools, which can be useful as a benchmark for others studying comfort.

Future vehicles: the effect of seat configuration on posture and quality of conversation

The percentage of passengers that prefer travelling in groups is increasing. In most vehicles, passengers sit side by side and need to turn their body to be engaged in the conversation with their fellow travellers. However, rotating the body could lead to discomfort which influences conversation quality. The aim of this research is to study the effect of seat configuration on the (dis)comfort experience, conversation quality and posture. Experiments in which participants were asked to talk to each other while sitting at the same distance (1 m) were conducted in four seating arrangements (with seat-belts on), where the angle between the forward directions of two seats were positioned at 0° (side by side), 22.5°, 90° and 120° (almost opposite each other), respectively. Optical tracking has been deployed and the collected data were processed with MatLab^® to acquire postural angles over time. Questionnaires were also used to evaluate the perceived (dis)comfort and the quality of the conversation. Experiment results indicate that the 120° configuration scored the best in the overall comfort and the quality of conversation, but only slightly better than the 90° configuration. Practitioner summary: Seating side by side is not optimal to have a comfortable conversation with your seatmate. To improve comfort and quality of conversation in future vehicles, we tested four seating arrangements analysing the effect of seat layout on (dis)comfort experience. Statistical analysis of objective and subjective data shows the optimal configuration for a comfortable conversation. Abbreviation: LPD: localized postural discomfort; PDF: probability density function; OCRA: occupational repetitive action.

Neck posture and muscle activity in a reclined business class aircraft seat watching IFE with and without head support

The purpose of this study is to research if a headrest benefits the comfort of the passenger and lowers muscle activity in the neck when sitting in a reclined (slouched) posture while watching in flight entertainment (IFE) in an aircraft business class seat. No significant differences in muscle activity in the musculus sternocleidomastoid and musculus trapezius pars descendant were found between the conditions with headrest and without headrest. A significant difference in expected comfort rating was found. Subjects indicated they expect to experience more comfort with a headrest when watching IFE for a duration of two movies during a long-haul flight. This study also found a significant difference in posture. In the condition without headrest the head was more upright compared to the condition with headrest. The lack of significant difference in muscle activity and the significant difference in posture may indicate that humans tend to look for a head position that is neutral, in the sense of minimal muscle effort. This study shows that the use of a headrest may benefit the comfort experience of the passenger during flight. However, further research is necessary on the design of the headrest and the long-term effects of head support on comfort, discomfort, muscle activity and fatigue for watching IFE in a slouched posture.

Towards comfortable communication in future vehicles

This research aims to study the effect of seat and/or backrest rotation on comfort and quality of conversation. Different sitting arrangements were tested to study the effect of the seat layout on: 1) (dis)comfort experience; 2) conversation quality and 3) postures. Two seats were arranged in different angles (0°, 45°, 90°, and 180°) at the same distance (1 m) and participants were asked to talk to each other. The participants' postures were acquired by using cameras and markers on the participants' body. Questionnaires were used to rate the perceived (dis)comfort and quality of conversation. Results show that 90° configuration scored the best both in overall comfort and quality of conversation; while the 0° configuration scored the lowest in both ratings. A strong correlation was established between high comfort and good quality of conversation.

How incremental video training did not guarantee implementation due to fluctuating population prevalence

Patients with stroke admitted at the neurology/neurosurgery ward of the Academic Medical Centre in Amsterdam, The Netherlands, may experience problems in communication, such as aphasia, severe confusion/delirium or severe language barriers. This may prevent self-reported pain assessment; therefore, pain behaviour observation scales are needed. In this project, we therefore aimed to implement the Rotterdam Elderly Pain Observation Scale (REPOS) by video training.

We used a stepped-wedge cluster design with clusters of four to five nurses with intervals of 2 weeks, for a total study duration of 34 weeks. Primary endpoint was the proportion of shifts in which nurses used the REPOS when caring for an eligible patient. A questionnaire was send biweekly to assess self-perceived competence and attitude on pain measurement in patients able or unable to self-report pain intensity. No other strategies were used to promote the use of the REPOS.

Though the proportion of shifts in which trained nurses cared for eligible patients increased from 0% at baseline to 83% at the end of the study, the proportion of cumulative shifts where the REPOS was used decreased from 14% to 6%, respectively. Process evaluation suggests that this decrease can (in part) be attributed to low and varying prevalence of eligible patients and opportunities for practice. In total, 24 (45.3%) nurses had used the REPOS at least once after 34 weeks, with a median of two times (1–33). Nurses perceived themselves 'competent' to 'very competent' in pain behaviour observation. There was no negative attitude towards pain measurement.

This study shows that education alone may not be effective when implementing a pain behaviour observation scale for non-communicative patients with Acquired Brain Injury. Individual motivation of health professionals and individual patient factors may be of influence for the use of the REPOS.

An aircraft seat discomfort scale using item response theory

The purpose of this study is to construct an aircraft seat discomfort scale and verify the evidence of its validity and reliability. We developed a questionnaire and presented it to 1500 Brazilian passengers at an airport. The data analysis included: 1) factor analysis; 2) the analysis of the items to be used in the scale created using Item Response Theory. The scale covered all levels, from "without discomfort" to "maximum discomfort". At the level of minimal, a passenger feels that the aircraft seat is cramped and has little space. Discomfort tends to increase when passengers are unable to perform desired activities (eg: reading, sleeping), which causes irritation and disappointment. The maximum discomfort level occurs when noise disrupts activities and an aircraft seat is considered hard. The scale developed presented indications that it is reliable and valid, proving to be a useful tool for identifying levels of discomfort in aircraft seats.

Identifying bottlenecks and designing ideas and solutions for improving aircraft passengers' experience during boarding and disembarking

Interferences during the boarding procedure are one of the main reasons of delay and increased turnaround time, becoming a relevant problem for airlines. Observations of the boarding process and questionnaires inside the aircraft revealed three main bottlenecks during the boarding process: (1) Hand luggage: Storage space is not sufficient and/or not used efficiently; (2) Preparation: Passengers are not well prepared for the boarding process; and (3) Communication: Audio announcements are unclear and unfocused. By translating these bottlenecks as possibilities for improvement, solutions were designed for the airport and aircraft interiors to reduce boarding time and improve the passenger boarding experience. Concepts ranged from an app to scan your hand luggage at home and make a reservation for overhead bin space; to a redesigned waiting area to help passengers prepare for boarding; to new boarding methods and redesigned aircraft seats. In this paper, several design concepts are presented in more detail.

Immunogenicity and safety of the adjuvanted recombinant zoster vaccine in patients with solid tumors, vaccinated before or during chemotherapy: A randomized trial

BACKGROUND

The adjuvanted recombinant zoster vaccine (RZV) has demonstrated >90% efficacy against herpes zoster in adults ≥50 years of age and 68% efficacy in autologous hematopoietic stem cell transplant recipients ≥18 years of age. We report the immunogenicity and safety of RZV administered to patients with solid tumors (STs) before or at the start of a chemotherapy cycle.

METHOD

In this phase 2/3 observer-blind, multicenter study (NCT01798056), patients with STs who were ≥18 years of age were randomized (1:1) to receive 2 doses of RZV or placebo 1-2 months apart and stratified (4:1) according to the timing of the first dose with respect to the start of a chemotherapy cycle (first vaccination 8-30 days before the start or at the start [±1 day] of a chemotherapy cycle). Anti-glycoprotein E (gE) antibody concentrations, gE-specific CD4+ T cell frequencies, and vaccine response rates (VRRs) were assessed 1 month after dose 1 and 1 and 12 months after dose 2. Reactogenicity and safety were assessed in the total vaccinated cohort through 12 months after dose 2.

RESULTS

There were 232 participants in the total vaccinated cohort, 185 participants in the according-to-protocol cohort for humoral immunogenicity, and 58 participants in the according-to-protocol cohort for cell-mediated immunogenicity. Postvaccination anti-gE antibody concentrations, gE-specific CD4+ T cell frequencies and VRRs were higher in RZV recipients than in placebo recipients. Solicited adverse events (AEs) were more frequent among RZV recipients than placebo recipients. Incidence of unsolicited AEs, serious AEs, fatalities, and potential immune-mediated diseases were similar between RZV and placebo recipients.

CONCLUSION

RZV was immunogenic in patients with STs receiving immunosuppressive chemotherapies. Humoral and cell-mediated immune responses persisted 1 year after vaccination. No safety concerns were identified.

Effect of in-seat exercising on comfort perception of airplane passengers

Sitting still for extended periods of time can lead to physical discomfort and even serious health risks. Due to safety regulations, reducing passenger' sitting time in aircrafts is not feasible. This paper presents the results of a laboratory study, in where an interactive airplane seat was compared with a current economy class seat. Participants used both seats for 3.5 h, and performed significantly more in-seat movements when using the interactive seating system. Furthermore, this interactive seat predominantly lead to significantly better comfort experiences and reduced discomfort experiences, however no significant differences have been found in self-reported localized musculoskeletal discomfort. Passengers indicated that they would prefer this interactive seat over a standard aircraft seat.

Behavior Change Techniques in mHealth Apps for the Mental and Physical Health of Employees: Systematic Assessment

Background

Employees remain at risk of developing physical and mental health problems. To improve the lifestyle, health, and productivity many workplace interventions have been developed. However, not all of these interventions are effective. Mobile and wireless technology to support health behavior change (mobile health [mHealth] apps) is a promising, but relatively new domain for the occupational setting. Research on mHealth apps for the mental and physical health of employees is scarce. Interventions are more likely to be useful if they are rooted in health behavior change theory. Evaluating the presence of specific combinations of behavior change techniques (BCTs) in mHealth apps might be used as an indicator of potential quality and effectiveness.

Objective

The aim of this study was to assess whether mHealth apps for the mental and physical health of employees incorporate BCTs and, if so, which BCTs can be identified and which combinations of BCTs are present.

Methods

An assessment was made of apps aiming to reduce the risk of physical and psychosocial work demands and to promote a healthy lifestyle for employees. A systematic search was performed in iTunes and Google Play. Forty-five apps were screened and downloaded. BCTs were identified using a taxonomy applied in similar reviews. The mean and ranges were calculated.

Results

On average, the apps included 7 of the 26 BCTs (range 2-18). Techniques such as “provide feedback on performance,” “provide information about behavior-health link,” and “provide instruction” were used most frequently. Techniques that were used least were “relapse prevention,” “prompt self-talk,” “use follow-up prompts,” and “provide information about others’ approval.” “Stress management,” “prompt identification as a role model,” and “agree on behavioral contract” were not used by any of the apps. The combination “provide information about behavior-health link” with “prompt intention formation” was found in 7/45 (16%) apps. The combination “provide information about behavior-health link” with “provide information on consequences,” and “use follow-up prompts” was found in 2 (4%) apps. These combinations indicated potential effectiveness. The least potentially effective combination “provide feedback on performance” without “provide instruction” was found in 13 (29%) apps.

Conclusions

Apps for the occupational setting might be substantially improved to increase potential since results showed a limited presence of BCTs in general, limited use of potentially successful combinations of BCTs in apps, and use of potentially unsuccessful combinations of BCTs. Increasing knowledge on the effectiveness of BCTs in apps might be used to develop guidelines for app developers and selection criteria for companies and individuals. Also, this might contribute to decreasing the burden of work-related diseases. To achieve this, app developers, health behavior change professionals, experts on physical and mental health, and end-users should collaborate when developing apps for the working context.

Evaluating an mHealth App for Health and Well-Being at Work: Mixed-Method Qualitative Study

BACKGROUND

To improve workers' health and well-being, workplace interventions have been developed, but utilization and reach are unsatisfactory, and effects are small. In recent years, new approaches such as mobile health (mHealth) apps are being developed, but the evidence base is poor. Research is needed to examine its potential and to assess when, where, and for whom mHealth is efficacious in the occupational setting. To develop interventions for workers that actually will be adopted, insight into user satisfaction and technology acceptance is necessary. For this purpose, various qualitative evaluation methods are available.

OBJECTIVE

The objectives of this study were to gain insight into (1) the opinions and experiences of employees and experts on drivers and barriers using an mHealth app in the working context and (2) the added value of three different qualitative methods that are available to evaluate mHealth apps in a working context: interviews with employees, focus groups with employees, and a focus group with experts.

METHODS

Employees of a high-tech company and experts were asked to use an mHealth app for at least 3 weeks before participating in a qualitative evaluation. Twenty-two employees participated in interviews, 15 employees participated in three focus groups, and 6 experts participated in one focus group. Two researchers independently coded, categorized, and analyzed all quotes yielded from these evaluation methods with a codebook using constructs from user satisfaction and technology acceptance theories.

RESULTS

Interviewing employees yielded 785 quotes, focus groups with employees yielded 266 quotes, and the focus group with experts yielded 132 quotes. Overall, participants muted enthusiasm about the app. Combined results from the three evaluation methods showed drivers and barriers for technology, user characteristics, context, privacy, and autonomy. A comparison between the three qualitative methods showed that issues revealed by experts only slightly overlapped with those expressed by employees. In addition, it was seen that the type of evaluation yielded different results.

CONCLUSIONS

Findings from this study provide the following recommendations for organizations that are planning to provide mHealth apps to their workers and for developers of mHealth apps: (1) system performance influences adoption and adherence, (2) relevancy and benefits of the mHealth app should be clear to the user and should address users' characteristics, (3) app should take into account the work context, and (4) employees should be alerted to their right to privacy and use of personal data. Furthermore, a qualitative evaluation of mHealth apps in a work setting might benefit from combining more than one method. Factors to consider when selecting a qualitative research method are the design, development stage, and implementation of the app; the working context in which it is being used; employees' mental models; practicability; resources; and skills required of experts and users.

The high and low comfort peaks in passengers' flight

BACKGROUND

Knowing the high and low peaks in comfort during a flight could be useful in prioritizing aircraft interior improvements.

OBJECTIVE

The first objective of this study was to identify whether there are differences in comfort experiences during different phases of a flight. The second objective of this study was to identify similarities between recalled and real time reported comfort experiences.

METHODS

149 participants were asked to rate the comfort in the different phases of their last flight on a scale from 1-10. Additionally, a combination of a self-reporting design probe and generative interview was used to investigate the appraisal patterns of emotions in nine passengers.

RESULTS

The 149 subjects reported the highest comfort after take-off and arriving at the destination, the lowest while stowing the luggage and during the cruise flight. The qualitative long haul inflight study showed after take-off and while arriving at the destination the most positive emotions and during the cruise flight there is a negative experience phase.

CONCLUSIONS

Suggestions are given to improve the cruise flight phase, by for example stimulation of movement or better service.

Thirty years of anthropometric changes relevant to the width and depth of transportation seating spaces, present and future

This paper reports the results of an investigation into changes in body shape anthropometry over the past several decades and discusses the impact of those changes on seating in transport, especially airliners. Changes in some body shape dimensions were confirmed in a sample of students at TU Delft; several of the changes, e.g. hip breadth, seated, are relevant to the ongoing design of seating. No change in buttock knee length was observed. The fit between current user anthropometry and current airline seat design, especially regarding seat width, was investigated. A comparison of the average current seat breadth with global anthropometric data suggests that accommodation may be problematic, with less than optimal width for passengers' shoulder and elbow widths.

Immunogenicity and Safety of a Candidate Subunit Adjuvanted Herpes Zoster Vaccine (HZ/su) in Adults Post Renal Transplant: a Phase III Randomized Clinical Trial

Background

The incidence rate of herpes zoster (HZ) in individuals with solid organ transplants (SOTs) is estimated as 8–9 times higher than the rate in the overall US population (3.2/1000 person-years). No vaccine is currently available to prevent HZ in immunocompromised individuals. GSK’s HZ/su candidate vaccine, containing varicella-zoster virus glycoprotein E (gE) and AS01B Adjuvant System, has shown >90% efficacy for HZ prevention in immunocompetent adults ≥50 years of age (YOA). We performed a study to determine immunogenicity and safety of HZ/su in adult renal transplant (RT) recipients (RTR) on chronic immunosuppressive therapy; RT was chosen as it can be representative of SOTs due to the nature of administered immunosuppressive therapies.

Methods

In this phase III, observer-blind, multicenter study (NCT02058589), RTRs ≥18 YOA were randomized 1:1 to receive 2 doses of HZ/su or placebo intramuscularly 1–2 months apart. gE-specific vaccine response rates (VRRs) and geometric means (GMs) were assessed for humoral and CD4+ cell-mediated immune (CMI) responses 1 month post dose 2 (M2). Solicited adverse events (AEs) were recorded for 7 days and unsolicited AEs and medically-attended AEs (MAEs) for 30 days after each dose. Solicited general and unsolicited AEs were also collected for 7 days prior to dose 1. Potential immune-mediated diseases (pIMDs) and serious AEs (SAEs) were recorded until 1 year post dose 2. Data from dose 1 through M2 is presented.

Results

At M2, 240 subjects (121 HZ/su; 119 placebo) were included in the humoral immunogenicity according-to-protocol (ATP) cohort. All immunogenicity success criteria were met at M2 (Table 1). VRRs for ATP humoral immune cohort and CMI sub-cohort (72 subjects: 36 HZ/su; 36 placebo) were higher in HZ/su groups. Humoral GM concentrations and CMI GM frequencies were significantly higher in HZ/su compared with placebo groups. The frequency of AEs was higher in HZ/su vs. placebo groups for solicited local AEs, but similar for solicited general AEs, unsolicited AEs, MAEs and SAEs. No pIMDs, vaccine-related SAEs or transplant rejections were reported (Table 2).

Conclusion

HZ/su was highly immunogenic in adults with RT at M2. No safety concerns were identified.

Funding

GlaxoSmithKline Biologicals SA

Disclosures

P. Vink, GSK group of companies: Employee, Salary and stock options and stock granted

Immunogenicity and Safety of a Candidate Subunit Adjuvanted Herpes Zoster Vaccine in Adults with Solid Tumors Vaccinated Before or During Immunosuppressive Chemotherapy Treatment: A Phase II/III, Randomized Clinical Trial

Background

No herpes zoster (HZ) vaccine for immunosuppressed individuals is currently available. GSK’s candidate HZ vaccine containing recombinant varicella zoster virus glycoprotein E (gE) subunit and AS01_B Adjuvant System (HZ/su) showed >90% efficacy for HZ prevention in immunocompetent adults aged ≥50 years. The HZ incidence in individuals with solid tumors (ST) receiving immunosuppressive chemotherapy (chemo) is estimated as 3–4 times higher than in the overall US population (3.2/1000 person-years). We present HZ/su immunogenicity and safety in ST adults aged ≥18 years.

Methods

In this phase II/III, observer-blind, multicenter study (NCT01798056), ST adults received 2 doses of HZ/su or placebo intramuscularly 1–2 months apart and were randomized 4:4:1:1 to receive a first dose 8–30 days (D) pre-chemo (HZ/su – HZ/su-PreC group, placebo – Pl-PreC) or on chemo start (±1 D) (HZ/su-OnC, Pl-OnC). Vaccine response rates (VRRs) and geometric means (GMs)/means were evaluated for gE humoral immune and gE-specific CD4⁺ cell-mediated immune (CMI) responses 1 month (M2) and 12 months (M13) post-dose 2. Solicited adverse events (AEs) were recorded for 7 D and unsolicited and medically-attended AEs (MAEs) for 30 D post each dose. Potential immune-mediated diseases (pIMDs) and serious AEs (SAEs) were recorded until study end.

Results

185 subjects (65 HZ/su-PreC, 78 Pl-PreC, 22 HZ/su-OnC, 20 Pl-OnC) were included in the according-to-protocol (ATP) cohort for humoral immunogenicity and 58 (27 HZ/su-PreC, 31 Pl-PreC) in the ATP sub-cohort for CMI. The most common ST were breast tumors (54% HZ/su, 49% placebo), followed by colorectal, lung, then other. Humoral and CMI VRRs were higher in HZ/su than Pl groups at M2 and M13. GM concentration (GMC) was highest at M2 in HZ/su-PreC. M13 GMCs were similar in the HZ/su-PreC and HZ/su-OnC groups (Table 1). The frequency of local solicited AEs was higher in HZ/su than Pl groups (Table 2); that of general solicited, unsolicited AEs, MAEs and SAEs was similar among groups (Table 3). 1 pIMD (Pl-OnC) and 23 fatal SAEs were reported. No SAE was considered vaccine-related by investigators.

Conclusion

HZ/su was highly immunogenic in ST adults receiving chemo. No safety concerns were raised.

Funding

GlaxoSmithKline Biologicals SA

Disclosures

P. Vink, GSK group of companies: Employee, Salary and stock options and stock granted

Design and validation of an aircraft seat comfort scale using item response theory

This article aims to evaluate the psychometric properties of a scale that measures aircraft seat comfort. Factor analysis was used to study data variances. Psychometric quality was checked by using Item Response Theory. The sample consisted of 1500 passengers who completed a questionnaire at a Brazilian airport. Full information factor analysis showed the presence of one dominant factor explaining 34% of data variance. The scale generated covered all levels of comfort data, from 'no comfort' to 'maximum comfort'. The results show that the passengers consider there is comfort, but this is very minimal when these passengers have to perform their desired activities. It tends to increase when aspects of the aircraft seating are improved and positive emotions are elicited. Comfort peaks when pleasure is experienced and passenger expectations are exceeded (maximum comfort). This outcome seems consistent with the literature. Further research is advised to compare the outcome of this questionnaire with other research methods, and to check if the questionnaire is sensitive enough and whether its conclusions are useful in practice.

Predicting passenger seat comfort and discomfort on the basis of human, context and seat characteristics: a literature review

This literature review focused on passenger seat comfort and discomfort in a human-product-context interaction. The relationships between anthropometric variables (human level), activities (context level), seat characteristics (product level) and the perception of comfort and discomfort were studied through mediating variables, such as body posture, movement and interface pressure. It is concluded that there are correlations between anthropometric variables and interface pressure variables, and that this relationship is affected by body posture. The results of studies on the correlation between pressure variables and passenger comfort and discomfort are not in line with each other. Only associations were found between the other variables (e.g. activities and seat characteristics). A conceptual model illustrates the results of the review, but relationships could not be quantified due to a lack of statistical evidence and large differences in research set-ups between the reviewed papers. Practitioner Summary: This literature review set out to quantify the relationships between human, context and seat characteristics, and comfort and discomfort experience of passenger seats, in order to build a predictive model that can support seat designers and purchasers to make informed decisions. However, statistical evidence is lacking from existing literature.

Clinimetric properties of the Nociception Coma Scale (-Revised): A systematic review

The Nociception Coma Scale is a nociception behaviour observation tool, developed specifically for patients with disorders of consciousness (DOC) due to (acquired) brain injury. Over the years, the clinimetric properties of the NCS and its revised version (NCS‐R) have been assessed, but no formal summary of these properties has been made. Therefore, we performed a systematic review on the clinimetric properties (i.e. reliability, validity, responsiveness and interpretability) of the NCS(‐R). We systematically searched CENTRAL, CINAHL, Embase, PsycInfo and Web of Science until August 2015. Two reviewers independently selected the clinimetric studies and extracted data with a structured form. Included studies were appraised on quality with the COSMIN checklist. Eight studies were found eligible and were appraised with the COSMIN checklist. Although nearly all studies lacked sample size calculation, and were executed by the same group of authors, the methodological quality ranged from fair to excellent. Important aspects of reliability, construct validity and responsiveness have been studied in depth and with sufficient methodological quality. The overview of clinimetric properties in this study shows that the NCS and NCS‐R are both valid and useful instruments to assess nociceptive behaviour in DOC patients. The studies provide guidance for the choice in NCS‐R cut‐off value for possible pain treatment and cautions awareness of interprofessional differences in NCS‐R measurements.

Significance

This systematic review provides a structured overview of the clinimetric properties of the Nociception Coma Scale (‐Revised) and provides insights for a solid evidence‐based nociception behaviour assessment and treatment plan.

Application of ideal pressure distribution in development process of automobile seats

BACKGROUND

In designing a car seat the ideal pressure distribution is important as it is the largest contact surface between the human and the car. Because of obstacles hindering a more general application of the ideal pressure distribution in seating design, multidimensional measuring techniques are necessary with extensive user tests.

OBJECTIVE

The objective of this study is to apply and integrate the knowledge about the ideal pressure distribution in the seat design process for a car manufacturer in an efficient way.

METHODS

Ideal pressure distribution was combined with pressure measurement, in this case pressure mats. In order to integrate this theoretical knowledge of seating comfort in the seat development process for a car manufacturer a special user interface was defined and developed.

RESULTS

The mapping of the measured pressure distribution in real-time and accurately scaled to actual seats during test setups directly lead to design implications for seat design even during the test situation. Detailed analysis of the subject's feedback was correlated with objective measurements of the subject's pressure distribution in real time. Therefore existing seating characteristics were taken into account as well.

CONCLUSIONS

A user interface can incorporate theoretical and validated 'state of the art' models of comfort. Consequently, this information can reduce extensive testing and lead to more detailed results in a shorter time period.