Interval exercise versus continuous exercise in patients with moderate to severe chronic obstructive pulmonary disease – study protocol for a randomised controlled trial [ISRCTN11611768]

BACKGROUND: Physical exercise has become a cornerstone of management of chronic obstructive pulmonary disease (COPD) because it leads to clinically relevant improvements of exercise capacity and health-related quality of life (HRQL). Despite the scarcity of randomised trials directly comparing exercise protocols, current guidelines recommend high intensity continuous exercise for lower extremities as the probably most effective exercise modality. However, for patients admitted to inpatient respiratory rehabilitation programmes, it is often difficult to initiate such an exercise programme because they are severely limited by dyspnoea and leg fatigue and therefore unable to perform continuous exercise at higher intensities and for periods longer than 30 minutes. Interval exercise may be an attractive alternative for these COPD patients because it allows high intensity exercise with recovery periods. The aim of this study is to assess if interval exercise compared to high intensity continuous exercise is not of inferior effectiveness in terms of HRQL and exercise capacity improvements but associated with better exercise tolerance in patients with moderate to severe COPD at the beginning of a respiratory rehabilitation. METHODS/DESIGN: We will assign patients with moderately severe to severe COPD to either continuous exercise or interval exercise using a stratified randomisation. Patients will follow 12–15 exercise sessions during a comprehensive inpatient respiratory rehabilitation. Primary end point for effectiveness is HRQL as measured by the Chronic Respiratory Questionnaire (CRQ) two weeks after the end of rehabilitation and secondary endpoints include additional clinical outcomes such as functional exercise capacity, other HRQL measures, patients' experience of physical exercise as well as physiological measures of the effects of physical exercise such as cardiopulmonary exercise testing. Including expected drop-outs, we will need 52 patients per group to show differences corresponding to the minimal clinically important difference of the CRQ. Outcome assessors and investigators involved in data analysis will be blinded to group assignment until analyses have been carried out. DISCUSSION: Clinicians and the scientific community need evidence on the benefits and tolerance of exercise protocols available in clinical practice. The proposed trial will provide important and needed data on interval and continuous exercise for decision making in clinical practice

Nothing Lasts Forever: Environmental Discourses on the Collapse of Past Societies

The study of the collapse of past societies raises many questions for the theory and practice of archaeology. Interest in collapse extends as well into the natural sciences and environmental and sustainability policy. Despite a range of approaches to collapse, the predominant paradigm is environmental collapse, which I argue obscures recognition of the dynamic role of social processes that lie at the heart of human communities. These environmental discourses, together with confusion over terminology and the concepts of collapse, have created widespread aporia about collapse and resulted in the creation of mixed messages about complex historical and social processes

Modelling GDPR-Compliant Explanations for Trustworthy AI

Through the General Data Protection Regulation (GDPR), the European Union has set out its vision for Automated Decision- Making (ADM) and AI, which must be reliable and human-centred. In particular we are interested on the Right to Explanation, that requires industry to produce explanations of ADM. The High-Level Expert Group on Artificial Intelligence (AI-HLEG), set up to support the implementation of this vision, has produced guidelines discussing the types of explanations that are appropriate for user-centred (interactive) Explanatory Tools. In this paper we propose our version of Explanatory Narratives (EN), based on user-centred concepts drawn from ISO 9241, as a model for user-centred explanations aligned with the GDPR and the AI-HLEG guidelines. Through the use of ENs we convert the problem of generating explanations for ADM into the identification of an appropriate path over an Explanatory Space, allowing explainees to interactively explore it and produce the explanation best suited to their needs. To this end we list suitable exploration heuristics, we study the properties and structure of explanations, and discuss the proposed model identifying its weaknesses and strengths

YouTube interactions between agonism, antagonism and dialogue: Video responses to the anti-Islam film Fitna

This article was accepted for publication in the journal New Media & Society: http://nms.sagepub.com/content/13/8/1283Fitna is a 2008 short film made by a Dutch member of parliament to support his fight against Islam. It shows shocking footage of terrorism, violence and women’s oppression and claims that these are inherent to Islam. The film caused immense controversy and mobilized people across the world to produce and upload their own views to YouTube. In this article we analyze these videos using different theoretical models of democratic interaction, and distinguishing between antagonism, ‘agonism’ and dialogue. On the basis of a cybermetric network analysis we find that the videos are mostly isolated reactions to the film. Only 13 percent or fewer of the posters interacted with each other through comments, subscriptions or ‘friendship’. These interactions could be qualified as antagonistic or agonistic, but very rarely involved dialogue. We therefore conclude that YouTube enabled a multiplication of views rather than an exchange or dialogue between them