Considerations for asthma management and viral transmission in the era of COVID-19

Background: As the global COVID-19 pandemic has unfolded, there has been much debate surrounding the optimal management of patients with asthma who are at risk of or contract COVID-19, whether asthma and steroids are risk factors for severe COVID-19, and how transmissible the virus is among children. Objective: The objective of this study is to provide allergists and other clinicians with pearls pertaining to the management of patients with asthma in the setting of the COVID-19 pandemic and to provide some information regarding the risk of transmission among the pediatric population. Methods: Utilizing the case of one of our own patients with asthma who developed COVID-19 as context, we review the recent literature discussing the risk of COVID-19 in patients with asthma, the management of asthma medications in the time of the pandemic, and the risk of viral transmission. Results: Despite initial reports that asthma was a risk factor for developing severe COVID-19, subsequent investigation has shown that this is likely not true. Additionally, the use of systemic or inhaled glucocorticoids does not appear to increase the risk of severe COVID-19, but there is no evidence guiding the use of biologic therapy. There is conflicting evidence regarding the ability of children to transmit the virus. Conclusion: We provide pearls that asthma does not appear to be associated with an increased risk of COVID-19 and continued use of inhaled corticosteroids appears to be safe. While there is no evidence guiding the use of biologic therapies, a recent position paper suggests that they should be continued unless a patient contracts COVID-19, at which point they should be held until clinical recovery occurs.

Delirium disorder

ObjectiveAs the US population ages and with no definitive delirium treatments on the horizon, the delirium epidemic is on course to expand over the coming decades. Recognizing the import of this condition, a recent position statement from 10 medical societies—among whom the American Academy of Neurology was represented—issued recommendations on preferred nomenclature of delirium and acute encephalopathy: it concluded by preferring both terms. Urgently needed is an integrated model that addresses the near-total segregation of these separate bodies of literature, ideally one that offers an interdisciplinary framework to bring these 2 terms and those who use them together.MethodsWe review the historical forces that have led these terms to diverge and consider the unique benefits of each approach as well as their liabilities when considered in isolation. We then explore the potential implications of integrating these concepts and propose a hybrid model to capitalize on the strengths of both the model of delirium and that of acute encephalopathy.ResultsThe model we propose—delirium disorder—builds on the recommendations of this recent position statement and provides a unifying framework designed to have clinical utility and interdisciplinary appeal. It also broadens the translational landscape by identifying 4 distinct treatment targets: underlying causes, procognitive factors, delirium (phenotype alone), and neurophysiologic targets.ConclusionsThis person-centered model aims to integrate delirium and acute encephalopathy within a single framework and shared nomenclature. It is hoped that this model aids in harmonizing research efforts and advancing clinical practice.

Comparing employability priorities of emerging and experienced interior designers

While design scholars have long explored the design process and its underlining decision-making tactics, few empirical studies have examined other judgements that may also influence design practice, such as the skills and contributions of new hires and their fit with their firms’ management style, culture and values. To probe employability priorities, this study first explored broad-based and discipline-specific literature, accreditation standards, and recent position announcements from interior design practice. Next, in order to define those skills and traits most highly valued in commercial interior design, new quantitative survey data was collected from emerging interior designers, and, in turn, was compared to extant research findings on the hiring priorities of experienced management practitioners within the interior design consultancy industry. Survey responses support earlier findings emphasizing soft skills while contributing to the literature by highlighting differing priorities between experienced interior designers and those whom they are likely to hire (i.e. emerging design professionals). Such differing priorities may have resonance in allied design disciplines, which is discussed with implications for design management hiring practice, emerging design professionals’ employability efforts, and practices of educators aiming to enhance the employability of design graduates.

Comparing employability priorities of emerging and experienced interior designers

While design scholars have long explored the design process and its underlining decision-making tactics, few empirical studies have examined other judgements that may also influence design practice, such as the skills and contributions of new hires and their fit with their firms’ management style, culture and values. To probe employability priorities, this study first explored broad-based and discipline-specific literature, accreditation standards, and recent position announcements from interior design practice. Next, in order to define those skills and traits most highly valued in commercial interior design, new quantitative survey data was collected from emerging interior designers, and, in turn, was compared to extant research findings on the hiring priorities of experienced management practitioners within the interior design consultancy industry. Survey responses support earlier findings emphasizing soft skills while contributing to the literature by highlighting differing priorities between experienced interior designers and those whom they are likely to hire (i.e. emerging design professionals). Such differing priorities may have resonance in allied design disciplines, which is discussed with implications for design management hiring practice, emerging design professionals’ employability efforts, and practices of educators aiming to enhance the employability of design graduates.

Evolutionary aspects on the origin, distribution and ramifications of the ischiadicus nerve in the giant anteater (Myrmecophaga tridactyla)

ABSTRACT This work aimed to describe the origin, distribution, and ramifications of the ischiadicus nerve in the giant anteater and to provide anatomical data which could explain not only the evolutionary aspects but also provide important information for other related works. For the present study, four specimens were used, prepared by perfusion of 10% formaldehyde solution via the femoral artery, for conservation and dissection. The origin of the right and left ischiadicus nerves in the giant anteater from the ventral ramification of the third lumbar (L3) and the first (S1), second (S2), and third (S3) sacral spinal nerves. These nerves were symmetrical in all animals studied. The distribution and ramification occurred to the superficial, middle, and deep gluteal, gemelli, piriform, quadratus femoris, tensor fasciae latae, caudal crural abductor, cranial and caudal parts of the biceps femoris, adductor, semitendinous, and cranial and caudal parts of the semimembranous muscles. Based on the origins of the ischiadicus nerves, there is a caudal migration in the nerve location in animals in a more recent position on the evolutionary scale due to reconfiguration of the lumbosacral plexus, resulting from the increase in a number of lumbar vertebrae. There is no complete homology of the muscle innervation.

Adapt or perish: Recent developments on social protection in the EU under a gig deal of pressure

In times of the so-called gig economy, access to an adequate level of social protection should not depend on whether or not a person is working on a standard employment contract. Access to social protection for non-standard forms of labour and self-employment is, as a matter of fact, one of the main themes being discussed at the moment within the debates surrounding the European Pillar of Social Rights. This article aims at assessing the recent initiatives at the EU level that have the objective of ensuring access to social protection for all and both granting and enforcing transparent and predictable working conditions for workers. Accordingly, this contribution first sheds some light on the discussion on non-standard forms of labour and the problematics surrounding the emergence of new forms of labour to later analyse the new EU initiatives, in particular, the proposal for a Recommendation on access to social protection for workers and the self-employed. It concludes by welcoming the recent position of the EU with regard to such challenges, yet emphasising also the need to do more.

The PERSONS score for symptoms assessment in simultaneous care setting: A pilot study

One of the first steps to early integrate palliative care into oncology practice is a timely and efficient evaluation of symptoms (Bakitas et al., 2015; Davis et al., 2015; Temel et al., 2010). In a recent position paper, the Italian Association of Medical Oncology tells oncologists that they “must be able to prevent, recognize, measure, and treat all cancer-related symptoms” (Zagonel et al., 2017). Major international scientific societies such as the American Society of Clinical Oncology and the European Society of Medical Oncology have often defined the key role of symptoms evaluation and management to force the integration of palliative care into oncology (Davis et al., 2015; Ferrel et al., 2017). Nevertheless, a recent survey conducted by the Italian Association of Medical Oncology shows that only 20% of oncologists regularly uses valid tools to evaluate symptoms, 45% exclusively use them in the context of clinical trials, 30% use them only occasionally, and 5% never use them (Zagonel et al., 2016).

Sustainable Development, CBD, and IPR

One of the landmark outcomes of Earth Summit was the ‘Convention on Biological Diversity’ which calls upon parties to conserve and sustainably use biological diversity while equitably sharing the benefits of the use of genetic resources. The chapter explores the role of IPR to achieve sustainability. This chapter further provides a study of the development of the concept of Sustainable Development as a tool to meet the social need and will analyse recent position—how can IPR be a handy tool to achieve the objective mentioned under CBD and Nagoya Protocol with the help of TRIPS Agreement. It primarily discusses interlinks and conflicts between the provisions of CBD and IPRs. The chapter argues that Indian policymakers have a crucial but tough role in ensuring that the IPR policies and practices and the need of conservation of biodiversity stands mutually supportive to each other.

Testosterone treatment and cardiovascular and venous thromboembolism risk: what is ‘new’?

In men, testosterone (T) production declines as a function of ageing. Late-onset hypogonadism (LOH) is the most commonly used term to indicate this age-related condition. In LOH, the relative clinical significance and the potential benefit of testosterone treatment (TTh) are still the subject of strong criticisms in the scientific community. The debate is further complicated by the recent position statement of the US Food and Drug Administration (FDA) emphasizing that, in LOH, the benefits and safety of TTh have not been fully established. Hence, the FDA required a labeling change to inform patients about a possible increased cardiovascular (CV) risk of TTh. Similar considerations were previously released by the FDA and by Health Canada concerning a TTh-related venous thromboembolism (VTE) risk. In this review, we will summarize the available evidence concerning a possible link among TTh and CV and VTE risks. For this purpose, data derived from epidemiological studies analyzing relationships between the aforementioned risks and endogenous T levels will be analyzed. In addition, evidence deriving from interventional studies including pharmacoepidemiological and placebo-controlled randomized controlled trials (RCTs) will be examined. Our analysis shows that available data do not support an increased CV risk related to TTh. Similar considerations can be drawn for the relationship between TTh and VTE. The previously reported cases of TTh-related VTE were frequently related to a previously undiagnosed thrombophilia-hypofibrinolysis status. Hence, an anamnestic screening for thrombophilia before starting TTh is recommended, just as it is for the use of oral contraceptives.

Retrospective evaluations of playful experiences

Purpose This paper aims to examine the impact of key affective moments of a playful experience on consumers’ overall retrospective evaluations. Design/methodology/approach The authors build on past literature on hedonic psychology and sequential preferences and link it to specific characteristics of playful experiences to derive their hypotheses. The hypotheses are tested through two field experiments conducted at a videogame arcade. Findings Results demonstrated that consumers’ overall evaluations are better aligned with the affective intensity at the final or end moment of a playful experience. Findings also revealed the complexity of understanding playful experiences, for it is the meaningfulness of end moments rather than simply their recent position in the experience that underlies overall evaluations. When end moments cease to be meaningful, the trough or least affective intense moment impacts overall evaluations. Practical implications This research has implications for marketers who are deciding on which point of a playful experience to concentrate their resources for optimizing evaluations. Originality/value This research contributes to literature on playful consumption by illuminating how consumers rely on affective moments of a playful experience to construct overall evaluations. Additionally, it highlights the important role of meaningfulness of end moments, a relatively underexplored process, which extends literature on key moments and retrospective evaluations.