Natural disasters : what is the role for social safety nets?

This paper makes the case for why safety nets are an important tool for managing the risk of natural hazards. The use of safety nets is advocated both ex ante, to prevent and mitigate the impact of natural disaster and ex post, to cope with the impacts of natural shocks. Firstly, the paper explores the implications of contextual factors to be taken into account in the design of an effective safety net system to respond to the needs generated by natural disasters. Learning from the responses to a number of recent natural disasters, a typology of the different types of natural hazards which require different approaches to reduce their risk is introduced. Secondly, the paper considers some'guidelines'for improving the design and implementation of safety nets either to prevent and/or to recover from natural disasters. Finally, some conclusions and recommendations for more effective safety net and suggestions for addressing key issues are outlined.Safety Nets and Transfers,Hazard Risk Management,Food&Beverage Industry,Labor Policies,Natural Disasters

Amalgam.

According to the Internet, the word “amalgam” can mean one of two things. It can refer to either “an alloy of mercury with another metal, especially one used for dental fillings” or “a mixture or blend.” While using a musical work as dental filling is an interesting idea, this work falls under the latter definition. This amalgam consists of elements evoking rock, metal, hiphop, pop, Mozart, and a little bit of Bach. Other influences may have leaked into the piece, but this listing contains the items that were at the front of my mind during the composition process. During my childhood, music-making consisted of listening and singing along to the rock albums my parents had. These albums were from Bon Jovi, Prince, Guns N’ Roses, Boston, and Chicago, to name a few. I began listening to jazz, metal, rap, pop, and the Classical repertoire, particularly Bach and Mozart, midway through high school. Mozart’s Requiem especially resonated with me during this time and continues to do so today. This piece quotes and reworks some of the material from the “Kyrie/Cum sanctis” and “Introit” movements of the Requiem in addition to bits of a Bach sarabande. These reworked materials are juxtaposed and intermingled with a melodic motive first heard in the piano. These ideas and other melodic ideas develop throughout the work through contrapuntal and rhythmic transformations

The Hedonic Character of Nostalgia: An Integrative Data Analysis

We conducted an integrative data analysis to examine the hedonic character of nostalgia. We combined positive and negative affect measures from 41 experiments manipulating nostalgia (N = 4,659). Overall, nostalgia inductions increased positive and ambivalent affect, but did not significantly alter negative affect. The magnitude of nostalgia’s effects varied markedly across different experimental inductions of the emotion. The hedonic character of nostalgia, then, depends on how the emotion is elicited and the benchmark (i.e., control condition) to which it is compared. We discuss implications for theory and research on nostalgia and emotions in general

Keeping patients with cancer exercising in the age of COVID-19

The novel 2019 coronavirus disease (COVID-19) pandemic is a global public health emergency. To date, physical distancing and good personal hygiene have been the only effective measures to limit spread. The pandemic has altered routine cancer care, including allied health and supportive care interventions. Clinicians must adapt and find ways to continue to deliver optimal patient care at this time. The prescription of exercise to people with cancer has been demonstrated to have meaningful benefits for both physical and mental health and quality of life, and may even enhance survival. Such exercise interventions provide the largest benefit to patients when delivered in a supervised, group, clinic-based setting. In the age of COVID-19, group-based exercise in communal facilities presents risks for both aerosol and surface transmission of the virus among people exercising, necessitating a pivot from the usual methods of exercise delivery to home-based exercise programs. In this article, we discuss the challenges that need to be overcome in moving to a home-based program for patients with cancer while maintaining the benefits of targeted and high-fidelity exercise medicine. We provide practical recommendations for how home-based exercise can be supported and nurtured by qualified exercise professionals who treat people living with cancer, as well as pointing to resources that are available online to assist practitioners. Despite the challenges faced during this pandemic, we believe that it is important for people to continue to benefit from exercise in a safe environment with the support of exercise specialists

Dilemmas in anticoagulation and use of inferior vena cava filters in venous thromboembolism; A survey of respiratory physicians, haematologists and medical oncologists and a review of the literature

© The Author(s) 2021. Twenty percent of patients with Cancer Associated Thrombosis receive an inferior vena cava filter annually. Insertion is guided by practice guidelines, which do not specify or discuss the use of inferior vena cava filters in malignancy. Adherence to these guidelines is known to be variable. We aimed to see if there was consistent management of venous thromboembolism among Medical Oncologists/Haematologists and Respiratory Physicians, with respect to inferior vena cava filter use in the setting of suspected and confirmed malignancy. Medical Oncologists, Haematologists and Respiratory Physicians were surveyed with four theoretical cases. Case 1 concerns a patient who develops a pulmonary embolism following spinal surgery. Cases 2 and 4 explore the use of inferior vena cava filters in the setting of malignancy. Case 3 covers the role of inferior vena cava filters in recurrent thrombosis despite systemic anticoagulation. There were 56 responses, 32 (57%) Respiratory Physicians and 24 (43%) Haematologists/Oncologists. Respiratory Physicians were significantly more likely to insert an inferior vena cava filter in case 1 (p = 0.04) whilst Haematologists/Medical Oncologists were more likely to insert an inferior vena cava filter in case 3 (p = 0.03). No significant differences were found in cases 2 and 4. There were significant disparities in terms of type and timing of anticoagulation. Consistency of recommendations with guidelines was variable likely in part because guidelines are themselves inconsistent. The heterogeneity in responses highlights the variations in venous thromboembolism management, especially in Cancer Associated Thrombosis. International Societies should consider addressing inferior vena cava filter use specifically in the setting of Cancer Associated Thrombosis. Collaboration between interested specialities would assist in developing consistent, evidence-based guidelines for the use of inferior vena cava filters in the management of venous thromboembolism

Patterns of immunotherapy-induced pneumonitis in patients with non-small-cell lung cancer: A case series

Background: Immunotherapy has become an efficacious option in the management of solid organ malignancies. Immune-related adverse events including pneumonitis are well described and may be particularly of concern in patients receiving immunotherapy for non-small-cell lung cancer. Case presentations: In this paper, we describe three cases of immunotherapy-induced pneumonitis occurring in the management of lung malignancy. Our cases include a 54-year-old Caucasian woman with squamous cell lung cancer who was successfully rechallenged with immunotherapy after prior significant pneumonitis, a 65-year-old Caucasian man with metastatic squamous cell lung cancer who developed pneumonitis after multiple cycles of uneventful immunotherapy, and a 73-year-old Caucasian man with squamous cell lung cancer who developed early-onset pneumonitis with rebound on steroid taper. Conclusions: This case series has provided further insight into the presentation and risk factors for pneumonitis in patients with non-small-cell lung cancer. Each of the cases of immunotherapy-induced pneumonitis illustrates the different potential patterns that may arise when immunotherapy-induced pneumonitis develops. This case series provides key learning points that may assist physicians managing non-small-cell lung cancer with immunotherapy

Chemical Oxygen Demand as a Measure of Fluvial Organic Matter Oxidation State

The oxidative ratio (OR) of the terrestrial biosphere is directly related to the size of the terrestrial biosphere carbon sink. In turn, OR of naturally occurring organic matter can be directly related to the oxidation state of the carbon in naturally occurring organic matter (Cox). Chemical oxygen demand (COD) is a widely measured water quality parameter that has been used as a short‐term substitute for the biochemical oxygen demand (BOD). Here, we propose that if the concentration of reduced species is known, then COD measurement can be used to assess the oxidation state (Cox) of fluvial organic C. Using a Bayesian hierarchical modeling approach, this study analyzed 21 years of water quality monitoring across England to calculate Cox of fluvial organic matter. The study showed that (a) COD could not be considered separately from the reduced species (e.g., NH4) commonly occurring in freshwater water samples, but it was still possible to calculate the Cox of dissolved organic carbon (DOC) and particulate organic carbon (POC). (b) The median Cox of DOC was 0.23 with a 95th percentile range of −0.1 to 0.4. (c) The median Cox of POC was 0.20 with a 95th percentile range of 0.03–0.37. (d) The estimated Cox in fluvial systems confirms that BOD is decoupled from the production of CO2. Including new Cox estimates in the global estimate of OR gives a new median value of 1.059 with a 95th percentile range of 1.047–1.071, giving the annual flux of CO2 to land (fland) of 1.45 ± 0.1 Gt C/year

Inferior vena cava filters (IVCFs): A review of uses and application to international guidelines at a single Australian center; implications of venous thromboembolism associated with malignancy

Venous thromboembolism (VTE) is a potentially lethal event. Anticoagulation is the cornerstone of treatment. Inferior vena cava filters (IVCFs) may be used in circumstances when anticoagulation is contraindicated or as an adjunct to anticoagulation. IVCF use is not without controversy due to concerns over their safety profile, differences in guidelines from international societies, and a limited randomized control trial evidence. We retrospectively undertook a review of IVCF use over a three-year period (2014–2016) at our center, which has a large oncology service but no trauma unit. There were 44 patients with successful IVCF insertion and one patient with an unsuccessful attempt. Indications for insertion included: a contraindication to anticoagulation (n¼28); recurrent VTE on anticoagulation (n¼10); and extensive VTE (n¼7). There were 13 retrieval attempts, of which ten were successful. There were five documented IVCF complications (tilting: n¼2, IVC thrombus: n¼3) with one episode of IVCF failure and two episodes of deep vein thrombosis during the follow-up period. Of the patients, 71% had an active malignancy (of whom 71% had metastatic disease). Seventeen patients died due to progressive malignancy during the study period. There were no life-threatening VTEs or IVCF associated mortalities. Adherence with published international guidelines was variable. Patients with malignancy were less likely to undergo IVCF retrieval and had a reduced rate of retrieval success. None of the international guidelines comment on the use of IVCFs in patients with malignancy despite being commonly used. IVCF use may be an underappreciated tool in this group

Patterns of immunotherapy-induced pneumonitis in patients with non-small-cell lung cancer: A case series

Background: Immunotherapy has become an efficacious option in the management of solid organ malignancies. Immune-related adverse events including pneumonitis are well described and may be particularly of concern in patients receiving immunotherapy for non-small-cell lung cancer. Case presentations: In this paper, we describe three cases of immunotherapy-induced pneumonitis occurring in the management of lung malignancy. Our cases include a 54-year-old Caucasian woman with squamous cell lung cancer who was successfully rechallenged with immunotherapy after prior significant pneumonitis, a 65-year-old Caucasian man with metastatic squamous cell lung cancer who developed pneumonitis after multiple cycles of uneventful immunotherapy, and a 73-year-old Caucasian man with squamous cell lung cancer who developed early-onset pneumonitis with rebound on steroid taper. Conclusions: This case series has provided further insight into the presentation and risk factors for pneumonitis in patients with non-small-cell lung cancer. Each of the cases of immunotherapy-induced pneumonitis illustrates the different potential patterns that may arise when immunotherapy-induced pneumonitis develops. This case series provides key learning points that may assist physicians managing non-small-cell lung cancer with immunotherapy

Mechanical suppression of osteolytic bone metastases in advanced breast cancer patients: A randomised controlled study protocol evaluating safety, feasibility and preliminary efficacy of exercise as a targeted medicine

Background: Skeletal metastases present a major challenge for clinicians, representing an advanced and typically incurable stage of cancer. Bone is also the most common location for metastatic breast carcinoma, with skeletal lesions identified in over 80% of patients with advanced breast cancer. Preclinical models have demonstrated the ability of mechanical stimulation to suppress tumour formation and promote skeletal preservation at bone sites with osteolytic lesions, generating modulatory interference of tumour-driven bone remodelling. Preclinical studies have also demonstrated anti-cancer effects through exercise by minimising tumour hypoxia, normalising tumour vasculature and increasing tumoural blood perfusion. This study proposes to explore the promising role of targeted exercise to suppress tumour growth while concomitantly delivering broader health benefits in patients with advanced breast cancer with osteolytic bone metastases. Methods: This single-blinded, two-armed, randomised and controlled pilot study aims to establish the safety, feasibility and efficacy of an individually tailored, modular multi-modal exercise programme incorporating spinal isometric training (targeted muscle contraction) in 40 women with advanced breast cancer and stable osteolytic spinal metastases. Participants will be randomly assigned to exercise or usual medical care. The intervention arm will receive a 3-month clinically supervised exercise programme, which if proven to be safe and efficacious will be offered to the control-arm patients following study completion. Primary endpoints (programme feasibility, safety, tolerance and adherence) and secondary endpoints (tumour morphology, serum tumour biomarkers, bone metabolism, inflammation, anthropometry, body composition, bone pain, physical function and patient-reported outcomes) will be measured at baseline and following the intervention. Discussion: Exercise medicine may positively alter tumour biology through numerous mechanical and nonmechanical mechanisms. This randomised controlled pilot trial will explore the preliminary effects of targeted exercise on tumour morphology and circulating metastatic tumour biomarkers using an osteolytic skeletal metastases model in patients with breast cancer. The study is principally aimed at establishing feasibility and safety. If proven to be safe and feasible, results from this study could have important implications for the delivery of this exercise programme to patients with advanced cancer and sclerotic skeletal metastases or with skeletal lesions present in haematological cancers (such as osteolytic lesions in multiple myeloma), for which future research is recommended. Trial registration: anzctr.org.au, ACTRN-12616001368426. Registered on 4 October 2016