Vaccines for Respiratory Syncytial Virus Prevention in Older Adults.

OBJECTIVE: This review evaluates the efficacy and safety of novel respiratory syncytial virus (RSV) vaccines approved for adults aged 60 years and older. DATA SOURCES: A literature search through February 27, 2024 was conducted using search terms, such as RSV, viral respiratory illness, vaccine, RSVpreF, RSVpreF3, Prefusion F, Abrysvo, and Arexvy. STUDY SELECTION AND DATA EXTRACTION: Data from primary literature and vaccine prescribing information were reviewed, encompassing evaluations of clinical pharmacology, efficacy, safety, adverse events, warnings, and precautions. DATA SYNTHESIS: The literature review process resulted in 10 articles included within this article's scope, including the results of 2 major phase III trials presented in detail. Two RSV vaccines, Respiratory Syncytial Virus Vaccine (recombinant [adjuvanted]; RSVpreF3-ASO1E, Arexvy) and Respiratory Syncytial Virus Vaccine (recombinant; RSVpreF, Abrysvo), approved for preventing RSV-associated lower respiratory tract disease (LRTD) in adults aged 60 years or older in the United States are discussed. Results from Phase III trials have demonstrated the efficacy of 1 dose of these vaccines in preventing RSV-associated LRTD across 2 RSV seasons. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: The Advisory Committee on Immunization Practices currently recommends use of these vaccines under shared clinical decision-making for adults aged 60 years or older. Most common adverse effects include injection site reactions (eg, site pain, redness, and swelling). Administration requires a single intramuscular injection of 0.5 mL, reconstituted prior to administration. CONCLUSIONS: The RSVpreF3-ASO1E and RSVpreF vaccines effectively prevent RSV-associated LRTD in adults aged 60 years and older.

Let's stay in touch: Frequency (but not mode) of interaction between leaders and followers predicts better leadership outcomes.

Successful leadership requires leaders to make their followers aware of expectations regarding the goals to achieve, norms to follow, and task responsibilities to take over. This awareness is often achieved through leader-follower communication. In times of economic globalization and digitalization, however, leader-follower communication has become both more digitalized (virtual, rather than face-to-face) and less frequent, making successful leader-follower-communication more challenging. The current research tested in four studies (three preregistered) whether digitalization and frequency of interaction predict task-related leadership success. In one cross-sectional (Study 1, N = 200), one longitudinal (Study 2, N = 305), and one quasi-experimental study (Study 3, N = 178), as predicted, a higher frequency (but not a lower level of digitalization) of leader-follower interactions predicted better task-related leadership outcomes (i.e., stronger goal clarity, norm clarity, and task responsibility among followers). Via mediation and a causal chain approach, Study 3 and Study 4 (N = 261) further targeted the mechanism; results showed that the relationship between (higher) interaction frequency and these outcomes is due to followers perceiving more opportunities to share work-related information with the leaders. These results improve our understanding of contextual factors contributing to leadership success in collaborations across hierarchies. They highlight that it is not the digitalization but rather the frequency of interacting with their leader that predicts whether followers gain clarity about the relevant goals and norms to follow and the task responsibilities to assume.

Perception of repeated pain relief with controllable and uncontrollable pain.

BACKGROUND: The ultimate goal of pain research is to provide effective routes for pain relief. Nevertheless, the perception pain relief as a change in pain intensity and un-/pleasantness has only been rarely investigated. It has been demonstrated that pain relief has rewarding and reinforcing properties, but it remains unknown whether the perception of pain relief changes when pain reductions occur repeatedly. Further, it remains an open question whether the perception of pain relief depends on the controllability of the preceding pain. METHODS: In this study, healthy volunteers (N = 38) received five cycles of painful heat stimulation and reduction of this stimulation to a non-painful warm stimulation once in a condition with control of the stimulation and once without control. Participants rated perceived intensity and un-/pleasantness on visual analogue scales during the heat stimulation and immediately after its reduction. RESULTS: Results showed that perceived pain relief, estimated by the difference in ratings during ongoing heat stimulation and after its reduction, increased with repetitions. However, this increase levelled off after two to four repetitions. Further, perceived pain relief was larger in the condition without control compared to the condition with control. CONCLUSION: The perception of pain relief can be modulated similar to the perception of pain by stimulus characteristics and psychological factors. Mechanistic knowledge about such modulating factors is important, because they can determine, e.g., the amount of requested pain killers in clinical settings and the efficacy of pain relief as a reinforcing stimulus. SIGNIFICANCE: When in pain, pain relief can become an all-dominate goal. The perception of such pain relief can vary depending on external and internal characteristics and thus modulate, e.g., requests for pain killers in clinical settings. Here, we show that perceived intensity and pleasantness of pain relief changes with repetitions and whether the preceding pain is perceived as uncontrollable. Such mechanistic knowledge needs to be considered to maximize the effects of pain relief as a rewarding and reinforcing stimulus.