The use of inhaled corticosteroid in preschool wheezers: what's the point today?

Among the preschool children who wheeze two different groups can be identify: children who have a viral infection and those who respond to multiple triggers, such as exercise or allergens

Exploring the journey to services

Firms are increasingly providing services to complement their product offerings. The vast majority of studies on the service journey, also known as servitization or service transition, examine the challenges and enablers of the process of change through cases studies. Investigations that provide an in-depth longitudinal analysis of the steps involved in the service journey are much rarer. Such a detailed understanding is required in order to appreciate fully how firms can leverage the enablers while overcoming the challenges of servitization. This study investigates what does a service journey look like? It analyzes in some detail the actual service journeys undertaken by three firms in the well-being, engineering and learning sectors. The paper offers four contributions. First, in the change literature, there are two dominant theories: The punctuated equilibrium model and the continuous change model. This study demonstrates that servitization follows a continuous change rather than a punctuated equilibrium. It shows that such continuous change is neither logical nor structured but much more emergent and intuitive in nature. Second, the study provides empirical evidence to support a contingency view of the dominance and sequencing of the different process models of change across the change journey. Third, this research shows the pace of service development and when the coexistence of basic, intermediate and complex services occurs. Finally, it contributes to the literature in the service field by presenting three actual service journeys and the associated seven stages of the service strategy model that organizations should consider when managing their service journeys

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services

The measurement of exhaled nitric oxide in routine practice.

Exhaled nitric oxide (NO) is considered the most easily available clinical test to indirectly assess the level of eosinophilic airway inflammation in asthma, and to predict the efficacy of anti-inflammatory treatment with inhaled corticosteroids (ICS). It is possible to measure the level of exhaled NO using online or offline methods. The most widely used online method employs techniques that enable NO in exhaled air to be measured in a single exhalation, calculating the value at the end-expiratory plateau. Because of the correlation between the level of exhaled NO with the level of eosinophilic inflammation in the airway of asthmatic patients, it has been proposed as a clinical marker in the practice of respiratory and allergy physicians with differing targets. In particular it is considered to be highly effective in the diagnosis of allergic asthma, to be capable of identifying those patients with a higher response probability to inhaled corticosteroids, and to a lesser extent, to be of value in contributing to the management of the disease. The possibility of easily taking measurements of FeNO in an office setting even by relatively young children, and the availability of a portable device, opens a significant perspective for the routine use of FeNO evaluation in daily practice

Un respiro\u2026 bollente (la temperatura dell\u2019aria esalata)

L\u2019asma \ue8 una malattia infiammatoria delle vie aeree. Essendo il \u201ccalore\u201d uno dei segni cardinali della flogosi, numerosi studi hanno valutato se la temperatura dell\u2019aria esalata possa riflettere la risposta patologica delle vie aeree nell\u2019asma bronchiale. \uc8 ipotizzabile che una notevole quantit\ue0 di \u201ccalore\u201d venga prodotta durante lo svolgimento delle diverse fasi dell\u2019infiammazione e del rimodellamento delle vie aeree del soggetto con asma. L\u2019insieme dei risultati ottenuti dagli studi fino ad oggi disponibili suggeriscono che la valutazione della temperatura dell\u2019aria esalata possa rappresentare un indicatore composito di malattia in grado di riflettere non soltanto la componente infiammatoria ma anche quella relativa al rimodellamento delle vie aeree. Si pu\uf2 pertanto ipotizzare un ruolo pratico nella valutazione del controllo di malattia e nel monitoraggio della risposta alla terapi