Abstract: Not all living wage standards are equally inclusive. Mainstream ‘shopping basket’ calculations for determining the living wage do not capture the diverse needs and experiences of workers and their households, and/or only identify an indeterminate living wage range. Addressing these concerns is an alternative approach which measures wages and wellbeing directly, using induction to discover not only the wage range in which there is a cusp in wellbeing but also how far it can be adjusted as a psychometric cutoff score to maximize the number of workers and households benefitting, in-context, from its coverage. Evidence from a study of wage and wellbeing conducted in New Zealand, before and during the COVID-19 pandemic, reveals that applying this protocol could have provided a significantly greater number of individuals and households with a functional living wage. Some of the wellbeing indicators used have theoretical and empirical links to work productivity. This psychometric protocol thereby addresses both halves of Sustainable Development Goals (SDG) 8, i.e., Decent Work and economic prosperity. It may render econometric methods, based on shopping basket assumptions and conducted largely by fiat, unnecessary.

The concept of a sustainable livelihood affords protection from crises and protects people, including future generations. Conceptually, this paper serves as a study protocol that extends the premises of decent work to include and integrate criteria that benefit people, planet, and prosperity. Existing measures of sustainability principally serve organisations and governments, not individual workers who are increasingly looking for ‘just transitions’ into sustainable livelihoods. Incorporating extant measurement standards from systems theory, vocational psychology, psychometrics, labour and management studies, we conceptualise a classification of livelihoods, criteria for their sustainability, forming a study protocol for indexing these livelihoods, a set of theory-based propositions, and a pilot test of this context-sensitive model.

Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus that effects both pediatrics and adult patients in Canada and is increasing in prevalence. No Canadian focused best practice recommendations currently exist to guide clinical practice. The study used a modified Delphi technique to develop evidence and expert opinion-based recommendations for providing care for patients with EoE. The Delphi process consisted of 3 rounds of quantitative surveys and qualitative consensus meetings. Experts were included in the Delphi if they had experience caring for EoE patients in Canada within one of the following professional groups: allergist, adult gastroenterologists, pathologists, pediatric gastroenterologists, and dieticians. Delphi rounds were completed between May 1, 2024, and June 30, 2024. A total of 31 experts in EoE care from across Canada were recruited to participate in the Delphi consensus process. All participants completed all three rounds of Delphi surveys. The final statement includes 38 recommendations for the care of patients with EoE organized into three sections: definition, diagnosis, and management. A Table of research gaps is provided to stimulate further knowledge development on this topic. This consensus statement includes actionable recommendations to support quality care of patients with EoE at any age across Canada. We encourage EoE centers in Canada to come together in a multi-disciplinary form to not only provide clinical care but also do much needed research on Canadian specific topics and gaps in EoE care.

In 1994, the United Nations human security taxonomy signaled a major shift from security as preservation of the nation-state towards a broader and more recent ‘decagonal’ model of human security (entailing everyday needs for personal, health, food, cyber, community, economic, national, environmental, political and, most recently, global security). Building on those foundations, this paper proposes a psychological theory of human security. The latter we propose is a question of ‘systems fit’ between everyday needs and priorities to official responses during crises like the COVID-19 pandemic. During COVID-19 lockdowns in 2021, across Australia and New Zealand, we asked N = 2,162 Australasians whether they had each type of security, how important each type was to them, and what each of the 10 sub-types of security meant to them. On face value, a pandemic is a primary threat to national public health. In everyday life, however, all 10 dimensions of human security remained salient and interconnected.

Abstract Atopic dermatitis (AD) is a common, chronic skin disorder that can significantly impact the quality of life (QoL) of affected individuals as well as their families. Although the pathogenesis of the disorder is not yet completely understood, it appears to result from the complex interplay between defects in skin barrier function, environmental and infectious agents, and immune dysregulation. There are no diagnostic tests for AD; therefore, the diagnosis is based on specific clinical criteria that take into account the patient’s history and clinical manifestations. Successful management of the disorder requires a multifaceted approach that involves education, optimal skin care practices, anti-inflammatory treatment with topical corticosteroids, topical calcineurin inhibitors (TCIs) and/or phosphodiesterase-4 (PDE-4) inhibitors, the management of pruritus, and the treatment of skin infections. Systemic immunosuppressive agents may also be used, but are generally reserved for severe flare-ups or more difficult-to-control disease. Newer systemic agents, such as Janus Kinase (JAK) inhibitors and biologics, have a more favourable safety and efficacy profile than the older, traditional systemic immunosuppressives. Topical corticosteroids are the first-line pharmacologic treatments for AD, and evidence suggests that these agents may also be beneficial for the prophylaxis of disease flare-ups. Although the prognosis for patients with AD is generally favourable, those patients with severe, widespread disease and concomitant atopic conditions, such as asthma and allergic rhinitis, are likely to experience poorer outcomes. Newer systemic agents have been approved which are greatly improving the QoL of these patients.

Eosinophilic esophagitis (EoE) is a chronic, progressive, type 2 inflammatory esophageal disease presenting as dysphagia to solid food and non-obstructive food impaction. Knowledge gaps exist in its diagnosis and management. These expert recommendations focused on the diagnosis of EoE in the United Arab Emirates. An electronic search of PubMed and Embase databases was used to gather evidence from systematic reviews, randomized controlled trials, consensus papers, and expert opinions from the last five years on the diagnosis of EoE. The evidence was graded using the Oxford system. Literature search findings were shared with the expert panel. A 5-point scale (strongly agree, agree, neither agree nor disagree, disagree, and strongly disagree) was used, and a concordance rate of >75% among experts indicated agreement. Using a modified Delphi technique, 18 qualified experts provided 17 recommendations. Eleven statements achieved high agreement, four got moderate agreement, and two got low agreement. Challenges exist in diagnosing EoE, particularly in children. Esophageal biopsies were crucial in diagnosis, irrespective of visible mucosal changes. Further research on diagnostic tools like endoscopic mucosal impedance and biomarkers is needed. Diagnosis relies on esophageal biopsies and symptom-histology correlation; however, tools like EoE assessment questionnaires and endoscopic mucosal impedance could enhance the accuracy and efficiency of EoE diagnosis. The diagnosis of EoE is challenging since the symptoms seldom correlate with the histological findings. Currently, diagnosis is based on patient symptoms and endoscopic and histological findings. Further research into mucosal impedance tests and the role of biomarkers is needed to facilitate diagnosis.

Atopic dermatitis (AD) is a common, chronic skin disorder that can significantly impact the quality of life (QoL) of affected individuals as well as their families. Although the pathogenesis of the disorder is not yet completely understood, it appears to result from the complex interplay between defects in skin barrier function, environmental and infectious agents, and immune dysregulation. There are no diagnostic tests for AD; therefore, the diagnosis is based on specific clinical criteria that take into account the patient's history and clinical manifestations. Successful management of the disorder requires a multifaceted approach that involves education, optimal skin care practices, anti-inflammatory treatment with topical corticosteroids, topical calcineurin inhibitors (TCIs) and/or phosphodiesterase-4 (PDE-4) inhibitors, the management of pruritus, and the treatment of skin infections. Systemic immunosuppressive agents may also be used, but are generally reserved for severe flare-ups or more difficult-to-control disease. Newer systemic agents, such as Janus Kinase (JAK) inhibitors and biologics, have a more favourable safety and efficacy profile than the older, traditional systemic immunosuppressives. Topical corticosteroids are the first-line pharmacologic treatments for AD, and evidence suggests that these agents may also be beneficial for the prophylaxis of disease flare-ups. Although the prognosis for patients with AD is generally favourable, those patients with severe, widespread disease and concomitant atopic conditions, such as asthma and allergic rhinitis, are likely to experience poorer outcomes. Newer systemic agents have been approved which are greatly improving the QoL of these patients.

Atopic dermatitis (AD) is a common, chronic skin disorder that can significantly impact the quality of life (QoL) of affected individuals as well as their families. Although the pathogenesis of the disorder is not yet completely understood, it appears to result from the complex interplay between defects in skin barrier function, environmental and infectious agents, and immune dysregulation. There are no diagnostic tests for AD; therefore, the diagnosis is based on specific clinical criteria that take into account the patient’s history and clinical manifestations. Successful management of the disorder requires a multifaceted approach that involves education, optimal skin care practices, anti-inflammatory treatment with topical corticosteroids, topical calcineurin inhibitors (TCIs) and/or phosphodiesterase-4 (PDE-4) inhibitors, the management of pruritus, and the treatment of skin infections. Systemic immunosuppressive agents may also be used, but are generally reserved for severe flare-ups or more difficult-to-control disease. Newer systemic agents, such as Janus Kinase (JAK) inhibitors and biologics, have a more favourable safety and efficacy profile than the older, traditional systemic immunosuppressives. Topical corticosteroids are the first-line pharmacologic treatments for AD, and evidence suggests that these agents may also be beneficial for the prophylaxis of disease flare-ups. Although the prognosis for patients with AD is generally favourable, those patients with severe, widespread disease and concomitant atopic conditions, such as asthma and allergic rhinitis, are likely to experience poorer outcomes. Newer systemic agents have been approved which are greatly improving the QoL of these patients.

This position statement addresses the critical concerns and recommended practices surrounding the use of panel food testing for diagnosing food allergies. Food allergies are a significant public health concern, and the misdiagnosis of food allergies remains a prevalent concern, made worse by the ongoing use of panel food testing. The practice of screening patients for multiple food allergens, regardless of clinical relevance, is commonly referred to as “panel food testing.” Fundamentally, a panel food test is not simply a single test; a panel food test is a series of several distinct tests for multiple foods, each with its own variable predictive value. These tests have not been adequately validated as screening tests and carry a considerable false positive rate. The resulting false diagnoses lead to unnecessary dietary restrictions, increased healthcare costs, and significant psychosocial distress for patients and their families.

Eosinophilic esophagitis (EoE) is an atopic condition of the esophagus that has become increasingly recognized over the last decade. Diagnosis of the disorder is dependent on the patient's clinical manifestations and histologic findings on esophageal mucosal biopsies. Patients with eosinophilic esophagitis should be referred to both an allergist and gastroenterologist for optimal management, which may include dietary modifications, pharmacologic agents such as corticosteroids, leukotriene modifiers and biologics as well as mechanical dilatation of the esophagus. The epidemiology, pathophysiology, diagnosis, treatment, and prognosis of EoE are discussed in this review.

Abstract: Social entrepreneurship is gaining increased prominence internationally as a vehicle for addressing a range of socioeconomic issues, including access to decent and inclusive work. In Vietnam, such enterprises have become a key component of the country’s sustainable development strategy, with national competitions awarding start-up prizes for a few of the many young would-be social entrepreneurs. Competitions like this risk a sense of broken promise, in which unsuccessful and thereby disappointed applicants quit the sector prematurely. Recent research in Vietnam highlights a pivotal retentive support role for mentoring these promising social entrepreneurs, based on traditional village values of cooperation. Research shows these values to be central to social entrepreneurial resilience and success in Vietnam. It further suggests an extant network of successful social entrepreneurs who could mentor young runners-up, so that their ideas, energy, and career pathways are not lost. A national network of social entrepreneurs has been formed; and its mentors have indicated their willingness to support young people. This brief thereby proposes a next step: creation of a pro bono nationwide academy, dispersed in location but united in purpose, to support social entrepreneurship among Vietnamese youth.

Since its inception as a modern and evolving discipline, psychology has been concerned with issues of human security. This think piece offers an initial conceptualisation of human security as a broad security concept that encompasses a range of interrelated dimensions that have been responded to by different sub-disciplinary domains within psychology. We advance an argument for a human security psychology as a connecting focal point for general psychology that enables us to bring knowledge from across our eclectic discipline into further dialogue. This is a necessary step in understanding better the state of current thinking on the psychology of security and as a basis for informing further theory, research and practice efforts to address issues of human (in)security. This initial effort is informed by Assemblage Theory, which offers a dynamic and contextually rich perspective on people as agentive beings entangled within evolving natural and social formations that can foster or undermine their experiences of [in]security. The article is completed with a brief agenda for advancing human security psychology.

Background: An understanding of how patient characteristics such as age, baseline peanut-specific IgE, and atopic comorbidities may influence potential safety outcomes during peanut oral immunotherapy (P-OIT) could aid in shared decision making between clinicians and patient families. Objective: This study explored the relationship between baseline patient characteristics and reactions during P-OIT using a large sample size to better understand potential risk factors influencing P-OIT safety. Methods: Data were obtained from the Food Allergy Immunotherapy (FAIT) registry, which collects real-world OIT data from community and academic allergy clinics across Canada. Multivariable logistic regression modeling was performed to examine the relationship between baseline patient characteristics and reactions during P-OIT. Multiple imputation was applied to reduce potential bias caused by missingness and to maximize the use of available information to preserve statistical power. Results: Between April 2017 and June 2021, a total of 653 eligible patients initiated P-OIT. Multivariable regression analysis showed pre-OIT grade 2+ initial reaction (odds ratio [OR] = 1.33, 95% confidence interval [CI] 1.10, 1.61), allergic rhinitis (OR = 1.60, 95% CI 1.08, 2.38), older age (OR = 1.01, 95% CI 1.00, 1.02), and higher baseline peanut-specific IgE (OR = 1.02, 95% CI 1.02, 1.03) were associated with grade 2+ reaction during P-OIT after adjusting for potential risk factors. Conclusion: Our study identified several clinically important risk factors for grade 2+ reactions during P-OIT: pre-OIT grade 2+ initial reaction, allergic rhinitis, older age, and higher baseline peanut-specific IgE. These results highlight the need for individualized risk stratification for OIT. (J Allergy Clin Immunol Global 2023;2:100094.)

Preschool peanut oral immunotherapy (OIT) is safe, but studies on which patient characteristics may predict less favourable safety outcomes are lacking. We explored the relationship between baseline patient characteristics and reactions during preschool peanut OIT to better understand factors influencing OIT safety. Data were obtained from the Canadian food allergy immunotherapy registry. Multivariate logistic regression modeling was run with maximum grade of reaction (grade 2+ vs. grade 1/no reaction) over the course of OIT (build-up, maintenance, and follow-up OFC) as the outcome. Predictors included: sex, age, reaction grade pre-OIT (grade 2+ vs. grade 1/no reaction), atopic conditions, sIgE level, skin prick test size, time on OIT, OIT starting dose, and dose eliciting symptoms during OIT. Odds ratios and 95% confidence intervals were obtained, and significance was defined as 95%CI not crossing null. Data were available for 672 preschoolers (median age at OIT entry: 24 months), of which 35.7% had grade 2+ reactions, and 1.19% had grade 4 reactions during OIT. The model showed older age (OR=1.027, 95%CI:1.009,1.044), higher baseline sIgE (OR=1.029, 95%CI:1.017,1.041), pre-OIT grade 2+ initial reaction (OR=2.420, 95%CI:1.433,4.088), and lower eliciting dose (OR=0.988, 95%CI:0.983,0.993) predicted grade 2+ reaction during OIT. Our data suggest older age, higher baseline sIgE, grade 2+ pre-OIT reaction, and lower eliciting dose, predict grade 2+ reactions during OIT. These preliminary results will help in the development of a personalized approach to improve OIT safety, including selecting appropriate starting doses and frequency of buildup, and encourage shared decision-making between families and healthcare providers.

Early introduction of peanut reduces the risk for peanut allergy, as noted in the landmark Learning Early About Peanut Allergy study1; however, some infants fail primary prevention and still develop peanut allergy.2 There is evidence that preschoolers tend to have milder, more modifiable food allergy,3 which may make them excellent candidates for immunotherapy.4 Real-world data from our group have shown peanut oral immunotherapy (P-OIT) to be particularly safe and effective in preschoolers (aged <70 months),5,6 but there was no specific focus on infants (aged <12 months).

Our group previously showed the safety of peanut oral immunotherapy (OIT) in 270 preschool-aged children (0.4% had severe reactions). The impact of preschool OIT on parental quality of life (QoL) has not been previously described. We enrolled preschool-aged children into OIT. The project was conducted in four clinics across Canada (Halifax, Winnipeg, Edmonton, Vancouver). The OIT protocol used capsules and/or food, and the maintenance dose was 300mg of protein daily. The 17-item Food Allergy Quality of Life– Parental Burden (FAQL-PB) questionnaire was administered to parents at baseline and end of build-up, and Wilcoxon signed-rank test was performed to compare the FAQL-PB scores between timepoints. Between May/2019-August/2020, 29 patients aged 9–32.3 months (58.6% males) completed OIT (28 peanut, 1 sesame), and FAQL-PB questionnaires. There was a significant improvement in FAQL-PB from baseline to end of build-up with a median change in score of -14 ((IQR: -33.5, -7.5); p<0.00001), representing a change of 0.82 in mean total score (≥0.5 is considered a minimal clinically important difference [MCID]). Our real-world study found that preschool OIT improves parent QoL from baseline to end of build-up (exceeding the MCID), even though families may be most fearful of potential reactions during this period based on reaction risks described in older children. This reduction in parental burden is most likely associated with the superior safety experienced by families of preschoolers. Future work will involve analyzing QoL at various timepoints during maintenance, to determine whether improvement in QoL holds over time.