Effectiveness of individualized inhaler technique training on low adherence (LowAd) in ambulatory patients with COPD and asthma

© 2022. This document is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by /4.0/ This document is the published version of a published work that appeared in final form in npj primary care respiratory medicineTo analyze whether there is improvement in adherence to inhaled treatment in patients with COPD and asthma after an educational intervention based on the teach-to-goal method. This is a prospective, non-randomized, single-group study, with intervention and before-after evaluation. The study population included 120 patients (67 females and 53 males) diagnosed with asthma (70.8%) and COPD (29.1%). The level of adherence (low and optimal) and the noncompliance behavior pattern (erratic, deliberate and unwitting) were determined by the Test of the adherence to Inhalers (TAI). This questionnaire allows you to determine the level of adherence and the types of noncompliance. Low Adherence (LowAd) was defined as a score less than 49 points. All patients received individualized educational inhaler technique intervention (IEITI). Before the IEITI, 67.5% of the patients had LowAd. Following IEITI, on week 24, LowAd was 55% (p = 0.024). Each patient can present one or more types of noncompliance. The most frequent type was forgetting to use the inhaler (erratic), 65.8%. The other types were deliberate: 43.3%, and unwitting: 57.5%. All of them had decreased on the final visit: 51.7% (p = 0.009), 25.8% (p = 0.002), 39.2% (p = 0.002). There were no significant differences in adherence between asthma and COPD patients at the start of the study. The only predicting factor of LowAd was the female gender. An individualized educational intervention, in ambulatory patients with COPD and asthma, in real-world clinical practice conditions, improves adherence to the inhaled treatment

Bio-based substances from urban waste as auxiliaries for solar photo-Fenton treatment under mild conditions: Optimization of operational variables

The use of soluble bio-based organic substances (SBO) obtained from urban wastes to expand the pH region where the photo-Fenton process can be applied has been investigated in this study. For this purpose, a mixture of six pollutants, namely acetaminophen, carbamazepine, amoxicillin, acetamiprid, clofibric acid and caffeine, at an initial concentration of 5 mg L-1 each, has been employed. Surface response methodology, based on the Doehlert matrix, has shown to be a useful tool to determine the effect of pH (in the range 3-7), concentration of SBO (15-25 mg L-1) and iron (2-6 mg L-1) on the performance of the photodegradation of the studied pollutants, measured by their half-life. Results indicate that, at high SBO concentration, the optimum pH shifts in most cases to a higher value (between 3 and 4) and that a significant loss of efficiency of the process was only observed at pH values above 5. An iron concentration of 4-5 mg L-1 and an amount of SBO of 19-22 mg L-1 have been determined to be the optimal conditions for the degradation of most of the studied pollutants at pH = 5. (C) 2014 Elsevier B.V. All rights reserved.The authors want to thank the financial support of the European Union (PIRSES-GA-2010-269128, EnvironBOS) and Spanish Ministerio de Educacion y Ciencia (CTQ2012-38754-C03-02). Juan Gomis would like to thank UPV for his FPI grant (2010-07).Gomis Vicens, J.; Carlos, L.; Bianco Prevot, A.; Teixeira, ACSC.; Mora Carbonell, M.; Amat Payá, AM.; Vicente Candela, R.... (2015). Bio-based substances from urban waste as auxiliaries for solar photo-Fenton treatment under mild conditions: Optimization of operational variables. Catalysis Today. 240(Part A):39-45. https://doi.org/10.1016/j.cattod.2014.03.034S3945240Part

Gaining further insight into photo-Fenton treatment of phenolic compounds commonly found in food processing industry

A mixture of eight phenolic compounds, namely 2,4-dinitrophenol, tannic, ellagic, gallic, protocatechuic, vanillic, syringic and sinapic acids, have been treated by means of a photo-Fenton process under simulated and real sunlight. An experimental design methodology, based in Doehlert matrixes, was employed to check the effect of the concentration of Fe(II) and H2O2, as well as pH. Response surfaces show that photo-Fenton can be extended to pH values clearly above 2.8, probably due to complexation of iron with the phenolic substances. Experiments performed under solar irradiation at pH = 3.9 showed that complete removal of the monitored pollutants was achieved in less than 3 min; mineralisation was also efficient, although some organics remained in the solution. Toxicity was monitored according to Pseudokirchneriella subcapitata and Daphnia magna bioassays; Recombinant Yeast Assay (RYA) was employed to assess estrogenic and dioxin-like activities. 2,4-Dinitrophenol was demonstrated to be the major concern and, in general, photo-Fenton resulted in a detoxification of the solution. Finally, excitation emission matrix (EEM) fluorimetry was employed to obtain complementary information on the behaviour of organic matter. Most peaks associated with the parent pollutants disappeared after short irradiation periods and, at 12 min of irradiation chromophores were destroyed, what can be associated with the removal of complex molecules. (C) 2015 Elsevier B.V. All rights reserved.The authors want to thank the financial support of the Spanish Ministerio de Education y Ciencia (CTQ2012-38754-C03-02) and Generalitat Valenciana (GV/2015/074). Sara Garcia-Ballesteros would like to thank Spanish Ministerio de Economia y Competitividad for her fellowship (BES-2013-066201).García Ballesteros, S.; Mora Carbonell, M.; Vicente Candela, R.; Sabater Marco, C.; Castillo López, MÁ.; Arques Sanz, A.; Amat Payá, AM. (2016). Gaining further insight into photo-Fenton treatment of phenolic compounds commonly found in food processing industry. Chemical Engineering Journal. 288:126-136. https://doi.org/10.1016/j.cej.2015.11.031S12613628

Prevalence and factors associated with poor performance in the 5‐chair stand test: findings from the Cognitive Function and Ageing Study II and proposed Newcastle protocol for use in the assessment of sarcopenia

Background Poor performance in the 5‐chair stand test (5‐CST) indicates reduced lower limb muscle strength. The 5‐CST has been recommended for use in the initial assessment of sarcopenia, the accelerated loss of muscle strength and mass. In order to facilitate the use of the 5‐CST in sarcopenia assessment, our aims were to (i) describe the prevalence and factors associated with poor performance in the 5‐CST, (ii) examine the relationship between the 5‐CST and gait speed, and (iii) propose a protocol for using the 5‐CST. Methods The population‐based study Cognitive Function and Ageing Study II recruited people aged 65 years and over from defined geographical localities in Cambridgeshire, Newcastle, and Nottingham. The study collected data for assessment of functional ability during home visits, including the 5‐CST and gait speed. We used multinomial logistic regression to assess the associations between factors including the SARC‐F questionnaire and the category of 5‐CST performance: fast (15 s), or unable, with slow/unable classed as poor performance. We reviewed previous studies on the protocol used to carry out the 5‐CST. Results A total of 7190 participants aged 65+ from the three diverse localities of Cognitive Function and Ageing Study II were included (54.1% female). The proportion of those with poor performance in the 5‐CST increased with age, from 34.3% at age 65–69 to 89.7% at age 90+. Factors independently associated with poor performance included positive responses to the SARC‐F questionnaire, physical inactivity, depression, impaired cognition, and multimorbidity (all P < 0.005). Most people with poor performance also had slow gait speed (57.8%) or were unable to complete the gait speed test (18.4%). We found variation in the 5‐CST protocol used, for example, timing until a participant stood up for the fifth time or until they sat down afterwards. Conclusions Poor performance in the 5‐CST is increasingly common with age and is associated with a cluster of other factors that characterize risk for poor ageing such as physical inactivity, impaired cognition, and multimorbidity. We recommend a low threshold for performing the 5‐CST in clinical settings and provide a protocol for its use

The Physics of the B Factories

This work is on the Physics of the B Factories. Part A of this book contains a brief description of the SLAC and KEK B Factories as well as their detectors, BaBar and Belle, and data taking related issues. Part B discusses tools and methods used by the experiments in order to obtain results. The results themselves can be found in Part C

The Short Physical Performance Battery is a discriminative tool for identifying patients with COPD at risk of disability [Corrigendum]

Bernabeu-Mora R, Medina-Mirapeix F, Llamazares-Herr&aacute;n E, et al. Int J Chron Obstruct Pulmon Dis. 2015;10:619&ndash;2626.&nbsp; Page 2626, Acknowledgments section, the text &ldquo;The authors wish to thank the patients and personnel of the hospital unit for their cooperation during the course of this study. The study was supported by medical manager of AstraZeneca Pharmaceutical Spain, S.A. and Maite P&eacute;rez.&rdquo; Should read &ldquo;The authors wish to thank the patients and personnel of the hospital unit for their cooperation during the course of this study. The study was supported by medical manager AstraZeneca Pharmaceutical Spain, S.A. Maite P&eacute;rez, Pfizer and Menarini.&rdquo;Read the original articl

Rates and predictors of depression status among caregivers of patients with COPD hospitalized for acute exacerbations: a prospective study

Roberto Bernabeu-Mora,1&ndash;3 Gloria Garc&iacute;a-Guillam&oacute;n,2 Joaquina Montilla-Herrador,2,3 Pilar Escolar-Reina,2,3 Jos&eacute; Antonio Garc&iacute;a-Vidal,2 Francesc Medina-Mirapeix2,3 1Division of Pneumology, Hospital Morales Meseguer, 2Department of Physical Therapy, University of Murcia, 3Physiotherapy and Disability Research Group, Instituto Murciano de Investigaci&oacute;n Biosanitaria Virgen de la Arrixaca (IMIB), Murcia, Spain Background: Hospitalization is common for acute exacerbation of COPD, but little is known about its impact on the mental health of caregivers. Objective: The aim of this study was to determine the rates and predictors of depressive symptoms in caregivers at the time of hospitalization for acute exacerbation of COPD and to identify the probability and predictors of subsequent changes in depressive status 3 months after discharge. Materials and methods: This was a prospective study. Depression symptoms were measured in 87 caregivers of patients hospitalized for exacerbation at hospitalization and 3 months after discharge. We measured factors from four domains: context of care, caregiving demands, caregiver resources, and patient characteristics. Univariate and multivariate multiple logistic regressions were used to determine the predictors of depression at hospitalization and subsequent changes at 3 months. Results: A total of 45 caregivers reported depression at the time of hospitalization. After multiple adjustments, spousal relationship, dyspnea, and severe airflow limitation were the strongest independent predictors of depression at hospitalization. Of these 45 caregivers, 40% had a remission of their depression 3 months after discharge. In contrast, 16.7% of caregivers who were not depressive at hospitalization became depressive at 3 months. Caregivers caring &gt;20 hours per week for patients with dependencies had decreased odds of remission, and patients having dependencies after discharge increased the odds of caregivers becoming depressed. Conclusion: Depressive symptoms are common among caregivers when patients are hospitalized for exacerbation of COPD. Although illness factors are determinants of depression at hospitalization, patient dependence determines fluctuations in the depressive status of caregivers. Keywords: caregivers, COPD, depression, acute care, family car