scholarly journals An Iterative, Mixed Usability Approach Applied to the Telekit System from the Danish TeleCare North Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-13
Author(s):  
Pernille Heyckendorff Lilholt ◽  
Clara Schaarup ◽  
Ole Kristian Hejlesen
Keyword(s):  
Strong Result ◽  
Think Aloud ◽  
Link Type ◽  
Copd Patients ◽  
Degree Of Severity

Objective. The aim of the present study is to evaluate the usability of the telehealth system, coined Telekit, by using an iterative, mixed usability approach. Materials and Methods. Ten double experts participated in two heuristic evaluations (HE1, HE2), and 11 COPD patients attended two think-aloud tests. The double experts identified usability violations and classified them into Jakob Nielsen’s heuristics. These violations were then translated into measurable values on a scale of 0 to 4 indicating degree of severity. In the think-aloud tests, COPD participants were invited to verbalise their thoughts. Results. The double experts identified 86 usability violations in HE1 and 101 usability violations in HE2. The majority of the violations were rated in the 0–2 range. The findings from the think-aloud tests resulted in 12 themes and associated examples regarding the usability of the Telekit system. The use of the iterative, mixed usability approach produced both quantitative and qualitative results. Conclusion. The iterative, mixed usability approach yields a strong result owing to the high number of problems identified in the tests because the double experts and the COPD participants focus on different aspects of Telekit’s usability. This trial is registered with Clinicaltrials.gov, NCT01984840, November 14, 2013.

scholarly journals The leukocyte telomere length, single nucleotide polymorphisms near TERC gene and risk of COPD

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12190
Author(s):  
Tanya Tacheva ◽  
Shanbeh Zienolddiny ◽  
Dimo Dimov ◽  
Denitsa Vlaykova ◽  
Tatyana Vlaykova
Keyword(s):  
Oxidative Stress ◽  
Single Nucleotide Polymorphisms ◽  
Telomere Length ◽  
Airflow Obstruction ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide ◽  
Genotype Combination ◽  
Link Type ◽  
Genotype Frequencies ◽  
Copd Patients

Chronic obstructive pulmonary disease (COPD) is characterized by irreversible airflow obstruction and is associated with chronic local and systemic inflammation and oxidative stress. The enhanced oxidative stress and inflammation have been reported to affect telomere length (TL). Furthermore, a number of SNPs at loci encoding the main components of the telomerase genes, TERT and TERC have been shown to correlate with TL. We aimed to explore the leukocyte TL and genotypes for single nucleotide polymorphisms, rs12696304 (C > G) and rs10936599 (C > T) near TERC in COPD cases and matched healthy controls using q-PCR technologies. Successful assessment of TL was performed for 91 patients and 88 controls. The patients had shorter TL (17919.36 ± 1203.01 bp) compared to controls (21 271.48 ± 1891.36 bp) although not significant (p = 0.137). The TL did not associate with the gender, age, spirometric indexes, smoking habits but tended to correlate negatively with BMI (Rho = − 0.215, p = 0.076) in the controls, but not in COPD patients. The genotype frequencies of the SNPs rs12696304 and rs10936599 were compared between patients and controls and the odds ratios (OR) for developing COPD were calculated. The carriers of the common homozygous (CC) genotypes of the SNPs had higher risk for COPD, compared to carriers of the variants alleles (rs12696304 CG+GG vs. CC; OR: 0.615, 95% CI [0.424–0.894], p = 0.011 and for rs10936599 CT+TT vs. CC OR = 0.668, 95% CI [0.457–0.976], p = 0.044). Analysis on the combined effects of the TERC rs12696304 (C > G) and rs10936599 (C > T) genotypes, CC/CC genotype combination was associated with higher risk for COPD (p < 0.0001) and marginally lower FEV1% pr. in patients with GOLD II (p = 0.052). There was no association between the SNP genotypes and TL. In summary, our results suggest that COPD patients may have shorter TL, and rs12696304 and rs10936599 near TERC may affect the risk of COPD independently of TL.

scholarly journals Impaired training-induced angiogenesis process with loss of pericyte-endothelium interactions is associated with an abnormal capillary remodelling in the skeletal muscle of COPD patients

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Léo Blervaque ◽  
Emilie Passerieux ◽  
Pascal Pomiès ◽  
Matthias Catteau ◽  
Nelly Héraud ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Skeletal Muscle ◽  
Exercise Training ◽  
Exercise Intolerance ◽  
Moderate Intensity ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Link Type ◽  
Copd Patients ◽  
Response To Exercise

Abstract Chronic obstructive pulmonary disease (COPD) is associated with exercise intolerance and limits the functional gains in response to exercise training in patients compared to sedentary healthy subjects (SHS). The blunted skeletal muscle angiogenesis previously observed in COPD patients has been linked to these limited functional improvements, but its underlying mechanisms, as well as the potential role of oxidative stress, remain poorly understood. Therefore, we compared ultrastructural indexes of angiogenic process and capillary remodelling by transmission electron microscopy in 9 COPD patients and 7 SHS after 6 weeks of individualized moderate-intensity endurance training. We also assessed oxidative stress by plasma-free and esterified isoprostane (F2-IsoP) levels in both groups. We observed a capillary basement membrane thickening in COPD patients only (p = 0.008) and abnormal variations of endothelial nucleus density in response to exercise training in these patients when compared to SHS (p = 0.042). COPD patients had significantly fewer occurrences of pericyte/endothelium interdigitations, a morphologic marker of capillary maturation, than SHS (p = 0.014), and significantly higher levels of F2-IsoP (p = 0.048). Last, the changes in pericyte/endothelium interdigitations and F2-IsoP levels in response to exercise training were negatively correlated (r = − 0.62, p = 0.025). This study is the first to show abnormal capillary remodelling and to reveal impairments during the whole process of angiogenesis (capillary creation and maturation) in COPD patients. Trial registration NCT01183039 & NCT01183052, both registered 7 August 2010 (retrospectively registered).

scholarly journals Effects of specific inspiratory muscle training combined with whole-body endurance training program on balance in COPD patients: Randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257595
Author(s):  
Bilel Tounsi ◽  
Amal Acheche ◽  
Thierry Lelard ◽  
Zouhair Tabka ◽  
Yassine Trabelsi ◽  
...  
Keyword(s):  
Endurance Training ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Training Period ◽  
Muscle Training ◽  
Functional Balance ◽  
Link Type ◽  
Copd Patients ◽  
Abc Scale ◽  
Experimental Group

Purpose This study aims to assess the effect of inspiratory muscle training (IMT) combined with endurance training (ET) on balance in patients with chronic obstructive pulmonary disease (COPD). Methods We studied 32 male patients (62 ± 6 years) with moderate to very severe COPD. They were randomly assigned to an experimental group (IMT+ET) n = 16 or a control group (ET) n = 16 with similar characteristics. The evaluations were carried out at inclusion and after eight weeks of the training period. Functional balance was assessed by the Berg Balance Scale (BBS), the Timed-up and Go (TUG), the Single Leg Stance test (SLS), and the Activities-specific Balance Confidence (ABC) scale. The strength of the inspiratory muscles (PImax) was assessed by maximal inspiratory mouth pressure. Functional exercise performance was assessed by the 6 minutes walking test (6MWT). IMT program consists in performing two daily sets of 30 inspirations with 50% of PImax increased by 10% every two weeks. ET program consists in performing 30 min treadmill exercise at 60% to 80% of the average speed achieved during the 6MWT three days per week. Results After the training period, the experimental group demonstrated greater improvements in BBS (IMT+ET vs. ET; p = 0.019), and in ABC (IMT+ET vs. ET; p = 0.014). However, no significant differences between groups were observed for TUG, SLS, and 6MWT. There was a significant difference between groups in PImax (IMT+ET vs. ET; p = 0.030). Significant moderate correlations were obtained between ΔPImax and ΔBBS for both groups (IMT+ET: r = 0.624, p = 0.010; ET r = 0.550, p = 0.027) as well as for ΔABC but only in the experimental group (IMT+ET: r = 0.550, p = 0.027). Conclusion Compared to ET alone, the results suggest that IMT combined with ET enhances inspiratory muscle function and functional balance according to BBS and ABC in patients with COPD. We suggest that inspiratory muscle training might be introduced as additional training to pulmonary rehabilitation programs aimed at improving balance in COPD patients. Trial registration The trial registry name: Clinical Trials; Registration number: NCT04084405; URL: https://clinicaltrials.gov/ct2/show/NCT04084405.

scholarly journals High-flow nasal cannula oxygen therapy versus non-invasive ventilation for chronic obstructive pulmonary disease patients after extubation: a multicenter, randomized controlled trial

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Dingyu Tan ◽  
Joseph Harold Walline ◽  
Bingyu Ling ◽  
Yan Xu ◽  
Jiayan Sun ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Treatment Failure ◽  
Risk Difference ◽  
Chronic Obstructive ◽  
Invasive Ventilation ◽  
Obstructive Pulmonary Disease ◽  
Hypercapnic Respiratory Failure ◽  
Link Type ◽  
Copd Patients ◽  
Non Invasive Ventilation

Abstract Background High-flow nasal cannula (HFNC) oxygen therapy is being increasingly used to prevent post-extubation hypoxemic respiratory failure and reintubation. However, evidence to support the use of HFNC in chronic obstructive pulmonary disease (COPD) patients with hypercapnic respiratory failure after extubation is limited. This study was conducted to test if HFNC is non-inferior to non-invasive ventilation (NIV) in preventing post-extubation treatment failure in COPD patients previously intubated for hypercapnic respiratory failure. Methods COPD patients with hypercapnic respiratory failure who were already receiving invasive ventilation were randomized to HFNC or NIV at extubation at two large tertiary academic teaching hospitals. The primary endpoint was treatment failure, defined as either resumption of invasive ventilation or switching to the other study treatment modality (NIV for patients in the NFNC group or vice versa). Results Ninety-six patients were randomly assigned to the HFNC group or NIV group. After secondary exclusion, 44 patients in the HFNC group and 42 patients in the NIV group were included in the analysis. The treatment failure rate in the HFNC group was 22.7% and 28.6% in the NIV group—risk difference of − 5.8% (95% CI, − 23.8–12.4%, p = 0.535), which was significantly lower than the non-inferior margin of 9%. Analysis of the causes of treatment failure showed that treatment intolerance in the HFNC group was significantly lower than that in the NIV group, with a risk difference of − 50.0% (95% CI, − 74.6 to − 12.9%, p = 0.015). One hour after extubation, the mean respiratory rates of both groups were faster than their baseline levels before extubation (p < 0.050). Twenty-four hours after extubation, the respiratory rate of the HFNC group had returned to baseline, but the NIV group was still higher than the baseline. Forty-eight hours after extubation, the respiratory rates of both groups were not significantly different from the baseline. The average number of daily airway care interventions in the NIV group was 7 (5–9.3), which was significantly higher than 6 (4–7) times in the HFNC group (p = 0.006). The comfort score and incidence of nasal and facial skin breakdown of the HFNC group was also significantly better than that of the NIV group [7 (6–8) vs 5 (4–7), P < 0.001] and [0 vs 9.6%, p = 0.027], respectively. Conclusion Among COPD patients with severe hypercapnic respiratory failure who received invasive ventilation, the use of HFNC after extubation did not result in increased rates of treatment failure compared with NIV. HFNC also had better tolerance and comfort than NIV. Trial registration chictr.org (ChiCTR1800018530). Registered on 22 September 2018, http://www.chictr.org.cn/usercenter.aspx

Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oral Cavity ◽  
Pulmonary Disease ◽  
Thermal Sensation ◽  
Sensory Function ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.

SIG 15 Perspectives Vol. 20, No. 3, September 2015

2015 ◽  
Vol 20 (3) ◽  
Keyword(s):  
Learning Center ◽  
Link Type

Abstract Download the CE Questions PDF from the toolbar, above. Use the questions to guide your Perspectives reading. When you're ready, purchase the activity from the ASHA Store and follow the instructions to take the exam in ASHA's Learning Center. Available until August 13, 2018.

SIG 11 Perspectives Vol. 22, No. 2, July 2012

2012 ◽  
Vol 22 (2) ◽  
Author(s):  
Kathryn Taylor ◽  
Emily White ◽  
Rachael Kaplan ◽  
Colleen M. O'Rourke
Keyword(s):  
Link Type

Sorry, this activity is no longer available for CEUs. Visit the SIG 11 page on the ASHA Store to see available CE activities. Use the CE questions PDF here as study questions to guide your Perspectives reading.

SIG 14 Perspectives Vol. 20, No. 3, December 2013

2013 ◽  
Vol 20 (3) ◽  
Keyword(s):  
Link Type

Sorry, this activity is no longer available for CEUs. Visit the SIG 14 page on the ASHA Store to see available CE activities. Use the CE questions PDF here as study questions to guide your Perspectives reading.

SIG 17 Perspectives Vol. 2, No. 1, May 2012

2012 ◽  
Vol 2 (1) ◽  
pp. 1-5
Author(s):  
Celeste Domsch
Keyword(s):  
Link Type

Sorry, this activity is no longer available for CEUs. Visit the SIG 17 page on the ASHA Store to see available CE activities. Use the CE questions PDF here as study questions to guide your Perspectives reading.

SIG 12 Perspectives Vol. 21, No. 4, December 2012

2012 ◽  
Vol 21 (4) ◽  
pp. 1-6 ◽  
Author(s):  
Cathy Binger ◽  
Jennifer Kent-Walsh
Keyword(s):  
Link Type

Sorry, this activity is no longer available for CEUs. Visit the SIG 12 page on the ASHA Store to see available CE activities. Use the CE questions PDF here as study questions to guide your Perspectives reading.

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