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Summary. This target paper focuses on the teaching of tests and psychological assessment, and presents the results of a short questionnaire on which tests and assessment procedures are presented to psychology students. The questionnaire was sent to AIP (Associazione Italiana di Psicologia) members giving at least one class on the topic of interest. The questionnaire was composed by two sections. The first section included general questions on the disciplinary sector of the class given by respondents, and on which psychological instruments were taught. The second section explored more in detail which typology of tests and instruments are taught in Italian universities. Results showed a low completion rate of the questionnaire, and a complex and scattered picture of the teaching of tests and assessment processes. This paper represents a starting point for the debate on this topic from other colleagues. This debate is particularly important given the incumbent transformation the laurea in psicologia as only requirement to practice as psychologist in Italy.

Drunkorexia is an at-risk behavior consisting in dietary restriction before the assumption of alcoholic beverages, for reducing the caloric intake or for enhancing the alcohol effects. This study investigated the role of family functioning in predicting drunkorexia behaviors in adolescence, controlling for the effects of individual variables (gender, age), binge drinking and drunkorexia motives. Participants were 269 Italian adolescents aged 16 to 21 years. Self-report questionnaires were administered at school. Drunkorexia was found positively predicted by binge drinking and drunkorexia motives (enhancement and conformity), whilst was negatively predicted by an adaptive family functioning. Clinical and research implications are discussed.

Exacerbations are part of the natural history of chronic obstructive pulmonary disease and asthma. Severe exacerbations can cause acute respiratory failure, which may ultimately require mechanical ventilation. This review summarizes practical ventilator strategies for the management of patients with obstructive airway disease. Such strategies include non-invasive mechanical ventilation to prevent intubation, invasive mechanical ventilation, from the time of intubation to weaning, and strategies intended to prevent post-extubation acute respiratory failure. The role of tracheostomy, the long-term prognosis, and potential future adjunctive strategies are also discussed. Finally, the physiological background that underlies these strategies is detailed. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.

Mechanical ventilation can cause acute diaphragm atrophy and injury, and this is associated with poor clinical outcomes. Although the importance and impact of lung-protective ventilation is widely appreciated and well established, the concept of diaphragm-protective ventilation has recently emerged as a potential complementary therapeutic strategy. This Perspective, developed from discussions at a meeting of international experts convened by PLUG (the Pleural Pressure Working Group) of the European Society of Intensive Care Medicine, outlines a conceptual framework for an integrated lung- and diaphragm-protective approach to mechanical ventilation on the basis of growing evidence about mechanisms of injury. We propose targets for diaphragm protection based on respiratory effort and patient-ventilator synchrony. The potential for conflict between diaphragm protection and lung protection under certain conditions is discussed; we emphasize that when conflicts arise, lung protection must be prioritized over diaphragm protection. Monitoring respiratory effort is essential to concomitantly protect both the diaphragm and the lung during mechanical ventilation. To implement lung- and diaphragm-protective ventilation, new approaches to monitoring, to setting the ventilator, and to titrating sedation will be required. Adjunctive interventions, including extracorporeal life support techniques, phrenic nerve stimulation, and clinical decision-support systems, may also play an important role in selected patients in the future. Evaluating the clinical impact of this new paradigm will be challenging, owing to the complexity of the intervention. The concept of lung- and diaphragm-protective ventilation presents a new opportunity to potentially improve clinical outcomes for critically ill patients.

Assessing respiratory mechanics and muscle function is critical for both clinical practice and research purposes. Several methodological developments over the past two decades have enhanced our understanding of respiratory muscle function and responses to interventions across the spectrum of health and disease. They are especially useful in diagnosing, phenotyping and assessing treatment efficacy in patients with respiratory symptoms and neuromuscular diseases. Considerable research has been undertaken over the past 17 years, since the publication of the previous American Thoracic Society (ATS)/ European Respiratory Society (ERS) statement on respiratory muscle testing in 2002. Key advances have been made in the field of mechanics of breathing, respiratory muscle neurophysiology (electromyography, electroencephalography and transcranial magnetic stimulation) and on respiratory muscle imaging (ultrasound, optoelectronic plethysmography and structured light plethysmography). Accordingly, this ERS task force reviewed the field of respiratory muscle testing in health and disease, with particular reference to data obtained since the previous ATS/ERS statement. It summarises the most recent scientific and methodological developments regarding respiratory mechanics and respiratory muscle assessment by addressing the validity, precision, reproducibility, prognostic value and responsiveness to interventions of various methods. A particular emphasis is placed on assessment during exercise, which is a useful condition to stress the respiratory system. © ERS 2019.