Home-based pulmonary rehabilitation early after hospitalisation in COPD (early HomeBase): protocol for a randomised controlled trial

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is characterised by exacerbations of respiratory disease, frequently requiring hospital admission. Pulmonary rehabilitation can reduce the likelihood of future hospitalisation, but programme uptake is poor. This study aims to compare hospital readmission rates, clinical outcomes and costs between people with COPD who undertake a home-based programme of pulmonary rehabilitation commenced early (within 2 weeks) of hospital discharge with usual care. METHODS: A multisite randomised controlled trial, powered for superiority, will be conducted in Australia. Eligible patients admitted to one of the participating sites for an exacerbation of COPD will be invited to participate. Participants will be randomised 1:1. Intervention group participants will undertake an 8-week programme of home-based pulmonary rehabilitation commencing within 2 weeks of hospital discharge. Control group participants will receive usual care and a weekly phone call for attention control. Outcomes will be measured by a blinded assessor at baseline, after the intervention (week 9-10 posthospital discharge), and at 12 months follow-up. The primary outcome is hospital readmission at 12 months follow-up. ETHICS AND DISSEMINATION: Human Research Ethics approval for all sites provided by Alfred Health (Project 51216). Findings will be published in peer-reviewed journals, conferences and lay publications. TRIAL REGISTRATION NUMBER: ACTRN12619001122145

The Evolving Role of Consumers

The culmination of the changes in healthcare, motivated in many ways by the rapid evolution of information and communication technologies in parallel with the shift toward increased patient decision-making and empowerment, has critical implications for clinical research, from recruitment and participation to, ultimately, successful outcomes. This chapter explores the developments impacting health consumers from various perspectives, with some focus on foundational issues in health communication and information behaviors as related to health consumerism. An overarching concern is the information environment within which health consumers are immersed, which is increasingly social, and underlying communication issues and emerging technologies contributing to the changing nature of patients’ information world. Not surprisingly, we will see that core findings from communication and information behavior research have relevance for our current understanding and future models of the evolving role of the health consumer

Toward Climate-Resilient Lentils: Challenges and Opportunities

Lentil among legumes has a significant place in crop production and rotation, and the nutritional security of growing human population. Current lentil cultivars have a narrow genetic base and are challenged with many biotic and abiotic stresses. The pressures from changing climate necessitate more efforts to find durable resistance sources for biotic and abiotic stresses. Distant landraces and wild lentil species which are less explored are known to possess such genes to develop resilient cultivars, one of the best adaptation strategies for climate change. The research efforts are currently focusing on enhancing lentil grain yield and resilience to climate change through introgression of desired genes from other gene pools. The current lentil-breeding efforts have concentrated upon conventional plant breeding techniques for the inclusion of the cultivated lentil gene pool only. Unlike other crops, genomics-assisted breeding remains one of the areas to be further explored to speed-up the climate-smart high-yielding cultivars development process, which is reliant on the extensive genomic resources. Several lentil linkage maps have been developed and quantitative trait loci for tolerance to biotic and abiotic stresses have been identified. However, advances in molecular markers, next-generation sequencing, genomewide sequencing, and bioinformatics will further help to precisely identify genes of interest that can be best utilized to breed climate-resilient cultivars for higher production and quality through genetic engineering and plant breeding.No Full Tex