9 research outputs found
Effect of strategies to reduce exposure of infants to environmental tobacco smoke in the home : cross sectional survey
Objective To examine parents' reported knowledge
and use of harm reduction strategies to protect their
infants from exposure to tobacco smoke in the home,
and the relation between reported use of strategies
and urinary cotinine to creatinine ratios in the infants.
Design Cross sectional survey.
Settings Coventry and Birmingham.
Main outcome measures Parentsâ reported
knowledge and use of harm reduction strategies and
urinary cotinine to creatinine ratios in their infants.
Participants 314 smoking households with infants.
Results 86% of parents (264/307) believed that
environmental tobacco smoke is harmful, 90%
(281/314) believed that infants can be protected from
it in the home, and 10% (32/314) were either unaware
of measures or reported using none. 65% of parents
(205/314) reported using two or more measures, but
only 18% (58/314) reported not allowing smoking in
the home. No difference was found in mean log e
transformed urinary cotinine to creatinine ratio in
infants from households that used no measures
compared with households that used less strict
measures. Mean log cotinine to creatinine ratios were
significantly different in households banning smoking
in the home compared with those using less strict or
no measures. Banning smoking in the home was
independently associated with a significant reduction
in urinary cotinine to creatinine ratio by a factor of
2.6 (1.6 to 4.2) after adjustment for average household
cigarette consumption, tenure, and overcrowding.
Conclusions Less than a fifth of parents in smoking
households ban smoking in the home. Banning
smoking was associated with a small but significant
reduction in urinary cotinine to creatinine ratio in
infants, whereas less strict measures compared with
no measures had no effect on the infantsâ exposure to
environmental tobacco smoke
Objectively Measured Physical Activity in Patients with COPD: Recommendations from an International Task Force on Physical Activity
Physical activity (PA) is of key importance for health among healthy persons and individuals with COPD. PA has multiple dimensions that can be assessed and quantified objectively using activity monitors. Moreover, as shown in the published literature, variable methodologies have been used to date to quantify PA among individuals with COPD, precluding clear comparisons of outcomes across studies. The present paper aims to provide a summary of the available literature for the rationale behind using objectively measured PA and proposes a standardized methodology for assessment, including standard operating procedures for future research. The present paper therefore describes the concept of PA, reports on the importance of PA, summarizes the dimensions of PA, provides a standard operating procedure how to monitor PA using objective assessments and describes the psychometric properties of objectively measured PA. The present international task force recommends implementation of the standard operating procedure for PA data collection and reporting in the future. This should allow to further clarify the relationship between PA and clinical outcomes, to test the impact of treatment interventions on PA in individuals with COPD and to successfully propose a PA endpoint for regulatory qualification in the future
Objectively measured physical activity as a COPD clinical trial outcome
Background
Reduced physical activity is common in COPD and is associated with poor outcomes. Physical activity is therefore a worthy target for intervention in clinical trials, however, trials evaluating physical activity have used heterogeneous methodologies.
Research question
What is the available evidence on the efficacy and/or effectiveness of various interventions to enhance objectively measured physical activity in patients with COPD, taking into account minimal preferred methodological quality of physical activity assessment? Study design and Methods In this narrative review, the COPD Biomarker Qualification Consortium (CBQC) task force searched three scientific databases for articles that reported the effect of an intervention on objectively-measured physical activity in COPD. Based on scientific literature and expert consensus, only studies with â„7 measurement days and â„4 valid days of â„8 hours of monitoring were included in the primary analysis.
Results
37 of 110 (34%) identified studies fulfilled the criteria, investigating the efficacy and/or effectiveness of physical activity behavior change programs (n=7), mobile health or eHealth interventions (n=9), rehabilitative exercise (n=9), bronchodilation (n=6), lung volume reduction procedures (n=3) and other interventions (n=3). Results are generally variable, reflecting the large variation in study characteristics and outcomes. Few studies show an increase beyond the proposed minimal important change of 600-1100 daily steps, indicating that enhancing physical activity levels is a challenge.
Interpretation
Only a third of clinical trials measuring objective physical activity in people with COPD fulfilled the pre-set criteria regarding physical activity assessment. Studies showed variable effects on physical activity even when investigating similar interventions
Altered Cerebellar Development in Nuclear Receptor TAK1/TR4 Null Mice Is Associated with Deficits in GLAST+ Glia, Alterations in Social Behavior, Motor Learning, Startle Reactivity, and Microglia
Integrative Genomics-Based Discovery of Novel Regulators of the Innate Antiviral Response
The burden of mild asthma: Clinical burden and healthcare resource utilisation in the NOVELTY study
Background: Patients with mild asthma represent a substantial proportion of the population with asthma, yet there are limited data on their true burden of disease. We aimed to describe the clinical and healthcare resource utilisation (HCRU) burden of physician-assessed mild asthma.Methods: Patients with mild asthma were included from the NOVEL observational longiTudinal studY (NOVELTY; NCT02760329), a global, 3-year, real-world prospective study of patients with asthma and/or chronic obstructive pulmonary disease from community practice (specialised and primary care). Diagnosis and severity were based on physician discretion. Clinical burden included physician-reported exacerbations and patient-reported measures. HCRU included inpatient and outpatient visits.Results: Overall, 2004 patients with mild asthma were included; 22.8% experienced â„1 exacerbation in the previous 12 months, of whom 72.3% experienced â„1 severe exacerbation. Of 625 exacerbations reported, 48.0% lasted >1 week, 27.7% were preceded by symptomatic worsening lasting >3 days, and 50.1% required oral corticosteroid treatment. Health status was moderately impacted (St George's Respiratory Questionnaire score: 23.5 [standard deviation ± 17.9]). At baseline, 29.7% of patients had asthma symptoms that were not well controlled or very poorly controlled (Asthma Control Test score <20), increasing to 55.6% for those with â„2 exacerbations in the previous year. In terms of HCRU, at least one unscheduled ambulatory visit for exacerbations was required by 9.5% of patients, including 9.2% requiring â„1 emergency department visit and 1.1% requiring â„1 hospital admission.Conclusions: In this global sample representing community practice, a significant proportion of patients with physician-assessed mild asthma had considerable clinical burden and HCRU
Treatable traits in the NOVELTY study
CorrigendumVolume 27, Issue 12, Respirology, pages: 1095-1095. First Published online: November 6, 2022 10.1111/resp.14406International audienceAsthma and chronic obstructive pulmonary disease (COPD) are two prevalent and complex diseases that require personalized management. Although a strategy based on treatable traits (TTs) has been proposed, the prevalence and relationship of TTs to the diagnostic label and disease severity established by the attending physician in a real-world setting are unknown. We assessed how the presence/absence of specific TTs relate to the diagnosis and severity of 'asthma', 'COPD' or 'asthmaâ+âCOPD'