Prognosis and longitudinal changes of physical activity in idiopathic pulmonary fibrosis

Background: Physical activity (PA) is associated with disease severity in idiopathic pulmonary fibrosis (IPF), but longitudinal studies evaluating its prognostic value and changes over time are lacking. Methods: We measured PA (steps per day, SPD) in a cohort of 46 IPF-patients (mean age, 67 years; mean FVC, 76.1%pred.) by accelerometry at baseline, recorded survival status during 3 years follow-up and repeated measurements in survivors. We compared the prognostic value of PA to established mortality predictors including lung function (FVC, DLCO) and 6-min walking-distance (6MWD). Results: During follow-up (median 34 months) 20 patients (43%) died. SPD and FVC best identified non-survivors (AUROC-curve 0.79, p < 0.01). After adjustment for confounders (sex, age, therapy), a standardized increase (i.e. one SD) in SPD, FVC%pred. or DLCO%pred. was associated with a more than halved risk of death (HR < 0.50; p < 0.01). Compared to baseline, SPD, FVC, and 6MWD annually declined in survivors by 973 SPD, 130 ml and 9 m, resulting in relative declines of 48.3% (p < 0.001), 13.3% (p < 0.001) and 7.8% (p = 0.055), respectively. Conclusion: While PA predicts mortality of IPF patients similar to established functional measures, longitudinal decline of PA seems to be disproportionally large. Our data suggest that the clinical impact of disease progression could be underestimated by established functional measures

Clinical Correlates of Reduced Physical Activity in Idiopathic Pulmonary Fibrosis

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Little is known about the consequences of idiopathic pulmonary fibrosis (IPF) for physical activity (PA). &lt;b&gt;&lt;i&gt;Objectives:&lt;/i&gt;&lt;/b&gt; We aimed to investigate levels of PA in IPF and to study associations of PA with lung function, exercise capacity, symptoms, and quality of life. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; In stable patients with IPF we measured PA (steps per day, SPD; physical activity level, PAL; minutes of moderate activity, MMA) by accelerometry (SenseWear Armband) for 1 week. We also assessed lung function (forced vital capacity, FVC; diffusing capacity for carbon monoxide, D&lt;smlcap&gt;LCO&lt;/smlcap&gt;); exercise capacity (6-minute walking distance, 6MWD); dyspnea (modified Medical Research Council, mMRC); fatigue (Multidimensional Fatigue Inventory, MFI-20), and generic (12-Item Short Form Survey, SF-12) and health-related quality of life (St. George's Respiratory Questionnaire) as further clinical variables. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; We investigated 48 patients with IPF in two centers (mean age, 67 years; 75% male; 23% on long-term oxygen therapy; mean FVC 75%pred.; mean D&lt;smlcap&gt;LCO&lt;/smlcap&gt; 43%pred.; mean 6MWD 355 ± 140 m; mean SPD 5,017 ± 3,360). On a bivariate level, all clinical variables were significantly associated with SPD (p &lt; 0.05). The associations of mMRC, MFI-20, SF-12 (physical health), and 6MWD with SPD were independent of impaired lung function (p &lt; 0.05). At multivariate analyses, either 6MWD (total explained variance of the model, total R&lt;sup&gt;2&lt;/sup&gt;: 42%) or MFI-20 (total R&lt;sup&gt;2&lt;/sup&gt;: 39%) were the strongest independent predictors of SPD. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; Fatigue and exercise capacity are strong and independent predictors of PA in patients with IPF, which suggests that both measures should be assessed when the consequences of IPF for PA in daily life are studied.</jats:p

Reconstructive Social Innovation Cycles in Women-Led Initiatives in Rural Areas

Social innovations can tackle various challenges related to gender equity in rural areas, especially when such innovations are initiated and developed by women themselves. We examine cases located in rural areas of Canada, Italy, Lebanon, Morocco, and Serbia, where women are marginalized by gender roles, patriarchal values, male dominated economy and policy, and lack of opportunities for education and employment. Our objective is to analyze five case studies on how women-led social innovation processes can tackle gender equity related challenges manifested at the levels of everyday practice, institutions, and cognitive frames. The analyses are based on interviews, workshops, literature screening, and are examined via the qualitative abductive method. Results summarize challenges that rural women are facing, explore social innovation initiatives as promising solutions, and analyze their implications on gender equity in the five case studies. Based on our results we propose a new concept: reconstructive social innovation cycle. It refers to is defined as cyclical innovation processes that engage women via civil society initiatives. These initiatives reconstruct the existing state of affairs, by questioning marginalizing and discriminative practices, institutions, and cognitive frames that are often perceived as normal. The new concept helps with to assessing the implications that women-led social innovations have for gender equity.</jats:p

Reconstructive social innovation cycles in women-led initiatives in rural areas

Abstract Social innovations can tackle various challenges related to gender equity in rural areas, especially when such innovations are initiated and developed by women themselves. We examine cases located in rural areas of Canada, Italy, Lebanon, Morocco, and Serbia, where women are marginalized by gender roles, patriarchal values, male dominated economy and policy, and lack of opportunities for education and employment. Our objective is to analyze five case studies on how women-led social innovation processes can tackle gender equity related challenges manifested at the levels of everyday practice, institutions, and cognitive frames. The analyses are based on interviews, workshops, literature screening, and are examined via the qualitative abductive method. Results summarize challenges that rural women are facing, explore social innovation initiatives as promising solutions, and analyze their implications on gender equity in the five case studies. Based on our results we propose a new concept: reconstructive social innovation cycle. It refers to is defined as cyclical innovation processes that engage women via civil society initiatives. These initiatives reconstruct the existing state of affairs, by questioning marginalizing and discriminative practices, institutions, and cognitive frames that are often perceived as normal. The new concept helps with to assessing the implications that women-led social innovations have for gender equity

The olfaction of a fire beetle leads to new concepts for early fire warning systems

The European fire beetle Melanophila cuspidata oviposits on stems damaged by fire to provide its xylophagous larvae with nutrition. We investigated the beetle's ability to estimate the heating stage of the wood beneath the charred bark by means of volatiles. Such biologically preselected volatiles can enable a reliable differentiation between fresh, heated, and burned wood and can be used for early fire warning systems. 25 compounds of heated pine wood chips (Pinus sylvestris) were identified and quantified by GC-MS. Electrophysiological experiments (GC-MS/EAD, EAG) and behavioral studies with M. cuspidata revealed eight electrophysiologically active and behaviorally attractive compounds. Furfural was selected as a marker volatile for heated wood and a nanoporous semiconductor metal oxide gas sensor was developed for the detection of this compound. In a burning chamber, this sensor detected furfural at low concentration prior to the ignition of pine wood chips (P. sylvestris). The furfural emission in this chamber was monitored simultaneously by an online mass-spectrometer. The utilization of M. cuspidata as an information filter for marker volatile selection and the feasibility of the nanoporous sensor for early fire warning systems in the wood processing industry are discussed. (c) 2013 Elsevier B.V. All rights reserved

Analysis of nocturnal actigraphic sleep measures in patients with COPD and their association with daytime physical activity

Background: Sleep disturbances are common in patients with chronic obstructive pulmonary disease (COPD) with a considerable negative impact on their quality of life. However, factors associated with measures of sleep in daily life have not been investigated before nor has the association between sleep and the ability to engage in physical activity on a day-to-day basis been studied. Aims: To provide insight into the relationship between actigraphic sleep measures and disease severity, exertional dyspnoea, gender and parts of the week; and to investigate the association between sleep measures and next day physical activity. Methods: Data were analysed from 932 patients with COPD (66% male, 66.4±8.3 years, FEV1% predicted=50.8±20.5). Participants had sleep and physical activity continuously monitored using a multisensor activity monitor for a median of 6 days. Linear mixed effects models were applied to investigate the factors associated with sleep impairment and the association between nocturnal sleep and patients' subsequent daytime physical activity. Results: Actigraphic estimates of sleep impairment were greater in patients with worse airflow limitation and worse exertional dyspnoea. Patients with better sleep measures (ie, non-fragmented sleep, sleeping bouts ≥225 min, sleep efficiency ≥91% and time spent awake after sleep onset < 57 min) spent significantly more time in light (p < 0.01) and moderate-to-vigorous physical activity (p < 0.01). Conclusions: There is a relationship between measures of sleep in patients with COPD and the amount of activity they undertake during the waking day. Identifying groups with specific sleep characteristics may be useful information when designing physical activity-enhancing interventions