Clinical recommendations for dry powder inhaler use in the management of COPD in primary care.

Over 1400 patients using dry powder inhalers (DPIs) to deliver COPD maintenance therapies were recruited across Europe and Australia. Their peak inspiratory flow (PIF) was measured, inhaler technique was observed, and adherence to treatment assessed. From relating the findings with patient health status, and thereby identifying critical errors, key clinical recommendations for primary care clinicians were determined, namely - measure PIF before prescribing a DPI to ensure inhalation manoeuvre ability is well-matched with the device.

Suboptimal Peak Inspiratory Flow and Critical Inhalation Errors are Associated with Higher COPD-Related Healthcare Costs.

Purpose: To assess the relationship between suboptimal Peak Inspiratory Flow (sPIF), inhalation technique errors, and non-adherence, with Healthcare Resource Utilisation (HCRU) in Chronic Obstructive Pulmonary Disease (COPD) patients receiving maintenance therapy via a Dry Powder Inhaler (DPI).

Patients And Methods: The cross-sectional, multi-country PIFotal study included 1434 COPD patients (≥40 years) using a DPI for maintenance therapy. PIF was measured with the In-Check DIAL G16, and sPIF was defined as a typical PIF lower than required for the device.

Factors associated with health status and exacerbations in COPD maintenance therapy with dry powder inhalers.

The study aimed to determine the associations of Peak Inspiratory Flow (PIF), inhalation technique and adherence with health status and exacerbations in participants with COPD using DPI maintenance therapy. This cross-sectional multi-country observational real-world study included COPD participants aged ≥40 years using a DPI for maintenance therapy. PIF was measured three times with the In-Check DIAL G16: (1) typical PIF at resistance of participant's inhaler, (2) maximal PIF at resistance of participant's inhaler, (3) maximal PIF at low resistance.

Competition Effects during Femtosecond Laser Induced Element Redistribution in Ba- and La-Migration Based Laser Written Waveguides.

Fs-laser induced element redistribution (FLIER) has been a subject of intensive research in recent years. Its application to various types of glasses has already resulted in the production of efficient optical waveguides, tappers, amplifiers and lasers. Most of the work reported on FLIER-based waveguides refers to structures produced by the cross-migration of alkali (Na, K) and lanthanides (mostly La).

Role of the La/K Compositional Ratio in the Properties of Waveguides Written by Fs-Laser Induced Element Redistribution in Phosphate-Based Glasses.

The local modification of the composition of glasses by high repetition femtosecond laser irradiation is an attractive method for producing photonic devices. Recently, the successful production of waveguides with a refractive index contrast (Δn) above 10 by fs-laser writing has been demonstrated in phosphate glasses containing LaO and KO modifiers. This large index contrast has been related to a local enrichment in lanthanum in the light guiding region accompanied by a depletion in potassium.

Quantification of inaccurate diagnosis of COPD in primary care medicine: an analysis of the COACH clinical audit.

Inaccurate diagnosis in COPD is a current problem with relevant consequences in terms of inefficient health care, which has not been thoroughly studied in primary care medicine. The aim of the present study was to evaluate the degree of inaccurate diagnosis in Primary Care in Spain and study the determinants associated with it. The Community Assessment of COPD Health Care (COACH) study is a national, observational, randomized, non-interventional, national clinical audit aimed at evaluating clinical practice for patients with COPD in primary care medicine in Spain.

Mid-to-far infrared tunable perfect absorption by a sub - λ/100 nanofilm in a fractal phasor resonant cavity.

Integrating an absorbing thin film into a resonant cavity is the most practical way to achieve perfect absorption of light at a selected wavelength in the mid-to-far infrared, as required to target blackbody radiation or molecular fingerprints. The cavity is designed to resonate and enable perfect absorption in the film at the chosen wavelength λ. However, in current state-of-the-art designs, a still large absorbing film thickness (∼λ/50) is needed and tuning the perfect absorption wavelength over a broad range requires changing the cavity materials.

Community Assessment of COPD Health Care (COACH) study: a clinical audit on primary care performance variability in COPD care.

Background: A thorough evaluation of the adequacy of clinical practice in a designated health care setting and temporal context is key for clinical care improvement. This study aimed to perform a clinical audit of primary care to evaluate clinical care delivered to patients with COPD in routine clinical practice.

Methods: The Community Assessment of COPD Health Care (COACH) study was an observational, multicenter, nationwide, non-interventional, retrospective, clinical audit of randomly selected primary care centers in Spain.

Enhancing the use of Asthma and COPD Assessment Tools in Balearic Primary Care (ACATIB): a region-wide cluster-controlled implementation trial.

Asthma and chronic obstructive pulmonary disease (COPD) health status assessment tools have demonstrated their value in guiding clinical management. Their use in primary care is still suboptimal. The objective of this study was to assess the effect of an educational intervention programme on the use of the Asthma Control Test (ACT), modified Medical Research Council (mMRC) and COPD Assessment Test (CAT) among primary care settings of the Balearic Islands, Spain.