ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients’ perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2–3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data.The document facilitates standardisation of conducting, reporting and interpreting cardiopulmonary exercise tests in chronic lung diseases for comparison of reference data, multi-centre studies and assessment of interventional efficacy. http://bit.ly/31SXeB

An environmentally enlightened accounting

Environmental stewardship must become a primary concern if management is to adequately fulfill its societal responsibilities. Management and accounting information systems must aggressively respond to these emerging requirements in order to support adequately the associated information needs as well as to design organizational systems that motivate and facilitate desired behavior. Our purpose here is to consider a framework useful for developing environmentally enlightening management and accounting information systems that take into account alternative environmental perspectives. The framework can be used to develop prototypes representing different levels of environmental enlightenment and, as such, can provide general guidance for moving collectives and organizations toward a more environmentally responsible posture. The framework is illustrated using an example from the salmon farming industry provided in Georgakopoulos and Thomson (2004)