Impact of dietary vitamin D on immunoregulation and disease pathology in lupus-prone NZB/W F1 mice.

Vitamin D (VD) deficiency is a highly prevalent worldwide phenomenon and is extensively discussed as a risk factor for the development of systemic lupus erythematosus (SLE) and other immune-mediated diseases. In addition, it is now appreciated that VD possesses multiple immunomodulatory effects. This study aims to explore the impact of dietary VD intake on lupus manifestation and pathology in lupus-prone NZB/W F1 mice and identify the underlying immunological mechanisms modulated by VD.

Survival following pulmonary rehabilitation in patients with COPD: the effect of program completion and change in incremental shuttle walking test distance.

Rationale: Pulmonary rehabilitation (PR) in patients with COPD has consistently been shown to produce benefits in exercise capacity, symptoms, and health status. The data surrounding survival following PR are less clear. Our aims were to compare the long-term survival in two cohorts of patients referred for PR; those who successfully completed PR, and a comparator group constructed from patients who either did not complete PR or did not start the program.

A qualitative study of patients' experiences of participating in SPACE for COPD: a Self-management Programme of Activity, Coping and Education.

The aim of this study was to understand experiences of participation in a supported self-management programme for chronic obstructive pulmonary disease (COPD). There is a wealth of clinical trials examining the outcomes of self-management interventions for individuals with COPD, but current understanding regarding patients' perspectives of such complex interventions is limited. Further insight may help to tailor self-management interventions and maximise patient engagement.

Experiences of patients undergoing pulmonary rehabilitation during an exacerbation of chronic respiratory disease.

Chronic obstructive pulmonary disease (COPD) is characterized in the later stages by acute exacerbations that often require hospitalization. Pulmonary rehabilitation is recommended for patients with COPD to aid symptom control, improve quality of life and increase physical activity. We have previously reported a large intervention trial commenced during a hospital admission.

Development of a training program to support health care professionals to deliver the SPACE for COPD self-management program.

Background: With the growing burden of COPD and associated morbidity and mortality, a need for self-management has been identified. The Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD) manual was developed to support self-management in COPD patients. Currently, there is no literature available regarding health care professionals' training needs when supporting patients with COPD on self-management.

Interactive web-based pulmonary rehabilitation programme: a randomised controlled feasibility trial.

Objectives: The aim of this study was to determine if an interactive web-based pulmonary rehabilitation (PR) programme is a feasible alternative to conventional PR.

Design: Randomised controlled feasibility trial.

Setting: Participants with a diagnosis of chronic obstructive pulmonary disease were recruited from PR assessments, primary care and community rehabilitation programmes.

Blood Eosinophils and Outcomes in Severe Hospitalized Exacerbations of COPD.

Background: Patients with moderate exacerbations of COPD and the eosinophilic phenotype have better outcomes with prednisolone. Whether this outcome is similar in patients hospitalized with a severe exacerbation of COPD is unclear. We investigated the rate of recovery of eosinophilic and noneosinophilic exacerbations in patients participating in a multicenter randomized controlled trial assessing health outcomes in hospitalized exacerbations.

The evaluation of an interactive web-based Pulmonary Rehabilitation programme: protocol for the WEB SPACE for COPD feasibility study.

Introduction: Pulmonary Rehabilitation (PR) is an evidence-based intervention that has been recommended in guidelines to be available to those who may benefit. However, not all patients with chronic obstructive pulmonary disease (COPD) have access to this service. Healthcare services have shown the need for the provision of PR in other forms to enable patient choice and service capacity.

A self-management programme for COPD: a randomised controlled trial.

Studies of programmes of self-management support for chronic obstructive pulmonary disease (COPD) have been inconclusive. The Self-Management Programme of Activity, Coping and Education (SPACE) FOR COPD is a 6-week self-management intervention for COPD, and this study aimed to evaluate the effectiveness of this intervention in primary care. A single-blind randomised controlled trial recruited people with COPD from primary care and randomised participants to receive usual care or SPACE FOR COPD.

An early rehabilitation intervention to enhance recovery during hospital admission for an exacerbation of chronic respiratory disease: randomised controlled trial.

Objective: To investigate whether an early rehabilitation intervention initiated during acute admission for exacerbations of chronic respiratory disease reduces the risk of readmission over 12 months and ameliorates the negative effects of the episode on physical performance and health status.

Design: Prospective, randomised controlled trial.

Setting: An acute cardiorespiratory unit in a teaching hospital and an acute medical unit in an affiliated teaching district general hospital, United Kingdom.

How do informal self-care strategies evolve among patients with chronic obstructive pulmonary disease managed in primary care? A qualitative study.

Background: There is much description in the literature of how patients with chronic obstructive pulmonary disease (COPD) manage their breathlessness and engage in self-care activities; however, little of this is from the perspective of those with less severe disease, who are primarily managed in primary care. This study aimed to understand the self-care experiences of patients with COPD who are primarily managed in primary care, and to examine the challenges of engaging in such behaviors.

Methods: Semistructured interviews were carried out with 15 patients with COPD as part of a larger project evaluating a self-management intervention.

Differences in content and organisational aspects of pulmonary rehabilitation programmes.

The aim was to study the overall content and organisational aspects of pulmonary rehabilitation programmes from a global perspective in order to get an initial appraisal on the degree of heterogeneity worldwide. A 12-question survey on content and organisational aspects was completed by representatives of pulmonary rehabilitation programmes that had previously participated in the European Respiratory Society (ERS) COPD Audit. Moreover, all ERS members affiliated with the ERS Rehabilitation and Chronic Care and/or Physiotherapists Scientific Groups, all members of the American Association of Cardiovascular and Pulmonary Rehabilitation, and all American Thoracic Society Pulmonary Rehabilitation Assembly members were asked to complete the survey via multiple e-mailings.

Validation of the i-BODE index as a predictor of hospitalization and mortality in patients with COPD participating in pulmonary rehabilitation.

Abstract The aim of this study was to examine the value of the i-BODE index to predict hospital admission and to confirm its usefulness to predict mortality in a Danish population. The incremental shuttle walking test (ISWT) is widely used in the UK and Europe and previous work has examined the replacement of the 6MWT with the ISWT within the BODE index for predicting the prognosis of COPD (i-BODE). The 674 patients included in the analysis participated in a 7-week pulmonary rehabilitation program from 2002 to 2011.

The development and pilot testing of the self-management programme of activity, coping and education for chronic obstructive pulmonary disease (SPACE for COPD).

Purpose: There is no independent standardized self-management approach available for chronic obstructive pulmonary disease (COPD). The aim of this project was to develop and test a novel self-management manual for individuals with COPD.

Patients: Participants with a confirmed diagnosis of COPD were recruited from primary care.

Pulmonary rehabilitation and interstitial lung disease: aiding the referral decision.

Background: Limited evidence exists regarding the effectiveness of pulmonary rehabilitation (PR) within interstitial lung disease (ILD). Oxygen is frequently prescribed for these patients but has not been explored in the context of PR. The aim of this study was to compare short-term outcomes of PR and 2-year mortality in patients with ILD, who use home oxygen against those without oxygen.

Reliability of pedometers to measure step counts in patients with chronic respiratory disease.

Purpose: There are a variety of devices currently available to measure physical activity. Activity monitors are technologically advanced and provide complex data, leading to higher costs. Pedometers are simple, inexpensive devices that provide easy-to-view data.

Does body mass index influence the outcomes of a Waking-based pulmonary rehabilitation programme in COPD?

Body mass index (BMI) is an important prognostic measure in chronic obstructive pulmonary disease (COPD). However, its effects on pulmonary rehabilitation (PR) are unknown. This study aimed to evaluate the effectiveness of a walking-based PR programme across the BMI range and the impact of BMI on exercise performance and health status.

Development of the i-BODE: validation of the incremental shuttle walking test within the BODE index.

Background: The BODE index has been shown to predict mortality in COPD. The index includes the 6 min walking test as the measure of exercise capacity. The incremental shuttle walking test (ISWT) is an alternative measure of exercise capacity which can be used to prescribe exercise and has been found to correlate well with peak VO2.

The development of a self-reported version of the chronic heart questionnaire.

Purpose: Health status is increasingly recognized as an important outcome for the management of chronic heart failure (CHF). The Chronic Heart Questionnaire (CHQ) is valid, reliable, and responsive but is interview led. The aim of this study was to develop a self-reported version (CHQ-SR) to aid practical application of the questionnaire.

Measuring a change in self-efficacy following pulmonary rehabilitation: an evaluation of the PRAISE tool.

Background: Self-efficacy explores the emotional functioning and coping skills of an individual and is thought to be a strong predictor of health behaviors, which is particularly important for pulmonary rehabilitation (PR). However, to our knowledge, there is no measure of self-efficacy developed to explore behavior change in the context of PR.

Methods: We investigated the reproducibility and sensitivity of Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE): a tool adapted from the General Self-Efficacy Scale (GSES) to measure the dimension of self-efficacy at the time of a course of PR.

Interrater reliability of the Physical Ability Scale for patients after stroke: a pilot study.

This study aimed to evaluate the interrater reliability of the Physical Ability Scale (PAS) and secondly to test the statistical methods to analyse the scoring. Williamson ( 1993a ) stated that the PAS measures the degree of compatibility of the trunk with gravity and the supporting surface through investigation of limb, head, and posture in five different positions, each with six levels of ability. Four experienced physiotherapists observed a video of 10 inpatients from a general hospital stroke unit being assessed with the PAS up to 5 months after a stroke.

Seasonal variations affect physical activity and pulmonary rehabilitation outcomes.

Seasonal differences may influence levels of physical activity and outcomes of a pulmonary rehabilitation (PR) program. This study examined the effect of seasonal variations upon baseline measures and outcomes of physical activity, exercise performance, and health status in PR. Stable patients (N = 95) with chronic obstructive pulmonary disease (COPD) were studied and placed into the seasonal group corresponding to when PR commenced: spring (n = 18), summer (n = 23), autumn (n = 34), winter (n = 20).

Can individualized rehabilitation improve functional independence in elderly patients with COPD?

Study Objectives: The aims of this study were to establish whether pulmonary rehabilitation (PR) improves domestic function and daily activity levels in COPD and whether individually targeted exercise is more effective than general exercise.

Design: Prospective randomized, controlled trial.

Setting: Outpatient PR program in secondary care.