Sing Your Lungs Out-a community singing group for chronic obstructive pulmonary disease: a 1-year pilot study.

Objective: Singing group participation may benefit patients with chronic obstructive pulmonary disease (COPD). Previous studies are limited by small numbers of participants and short duration of generally hospital-based singing group intervention. This study examines the feasibility of long-term participation in a community singing group for patients with COPD who had completed pulmonary rehabilitation (PR).

Sing Your Lungs Out: a qualitative study of a community singing group for people with chronic obstructive pulmonary disease (COPD).

Objective: To explore the ways in which participation in a community singing group contributed to the health and well-being of patients with chronic obstructive pulmonary disease (COPD).

Design: Qualitative description, based on transcripts from individual interviews and a focus group meeting with people with COPD participating in the singing group, regarding their experience.

Setting: Urban community, Wellington, New Zealand.

Non-technical skills evaluation in the critical care air ambulance environment: introduction of an adapted rating instrument--an observational study.

Background: In the isolated and dynamic health-care setting of critical care air ambulance transport, the quality of clinical care is strongly influenced by non-technical skills such as anticipating, recognising and understanding, decision making, and teamwork. However there are no published reports identifying or applying a non-technical skills framework specific to an intensive care air ambulance setting. The objective of this study was to adapt and evaluate a non-technical skills rating framework for the air ambulance clinical environment.

Calcium scores in the risk assessment of an asymptomatic population: implications for airline pilots.

Background: This study evaluated whether coronary artery calcium score (CACS) improved cardiovascular disease risk prediction when compared to the New Zealand Cardiovascular Risk Charts (NZ-CRC), and describes the potential utilization of CACS in cardiovascular disease (CVD) risk assessment of pilots.

Methods: A cross-sectional study was performed among asymptomatic patients who underwent coronary computed tomography angiography at Pacific Radiology Wellington, New Zealand, between August 2007 and July 2012 and had their CACS and CVD risk score calculated. Receiver-operating characteristics (ROC) analyses were used to measure the accuracy of the NZ-CRC and CACS.

Cardiovascular investigations of airline pilots with excessive cardiovascular risk.

Background: This study examined the prevalence of airline pilots who have an excessive cardiovascular disease (CVD) risk score according to the New Zealand Guideline Group (NZGG) Framingham-based Risk Chart and describes their cardiovascular risk assessment and investigations.

Methods: A cross-sectional study was performed among 856 pilots employed in an Oceania based airline. Pilots with elevated CVD risk that had been previously evaluated at various times over the previous 19 yr were reviewed retrospectively from the airline's medical records, and the subsequent cardiovascular investigations were then described.

A study of airline pilot morbidity.

Introduction: It has long been believed that airline pilots are healthier than the general population. There are a number of reasons why this should be the case. However, there is very little evidence to support this belief as fact.

Cardiovascular risk score and cardiovascular events among airline pilots: a case-control study.

Background: A cardiovascular risk prediction score is routinely applied by aviation authorities worldwide. We examined the accuracy of the Framingham-based risk chart used by the New Zealand Civil Aviation Authority in predicting cardiovascular events among airline pilots.

Methods: A matched case-control design was applied to assess the association of 5-yr cardiovascular risk score and cardiovascular events in Oceania-based airline pilots.

Incidental findings from lung CT scans: implications for research.

Introduction: We aimed to evaluate the number and nature of incidental findings in CT chest scans in the context of a study of the pulmonary effects of cannabis.

Methods: Three hundred fifty-seven participants were recruited: 78 cannabis-only smokers, 92 tobacco-only smokers, 106 smokers of cannabis and tobacco and 81 never smokers. All participants underwent a high-resolution CT scan of their thorax.

Effect of addition of salmeterol versus doubling the dose of fluticasone propionate on specific airway resistance in children with asthma.

Based primarily on extrapolation from adult studies, current pediatric asthma guidelines advise the addition of long-acting beta₂-agonists for children symptomatic on low/moderate-dose inhaled corticosteroids before increasing the corticosteroid dose. This study was designed to compare the effect of combination salmeterol/fluticasone propionate (SFC) with doubling the dose of fluticasone propionate (FP) on specific airway resistance (sR(aw)) in moderate/severe persistent asthmatic children. A double-blind, randomized, controlled study was performed; children with asthma (4-11 years old; sR(aw) > 1.

A case-control study of seated immobility at work as a risk factor for venous thromboembolism.

Objective: To determine the relative risk of prolonged seated immobility at work in patients with a deep vein thrombosis (DVT) or pulmonary embolism (PE).

Design: A case-control study: cases and controls completed an interviewer-administered questionnaire to obtain information on risk factors for venous thromboembolism (VTE), including prolonged seated immobility at work. Univariate and multivariate logistic regression was used to determine the association between predicted variables and the probability of being a case or control.

Cannabis use and cancer of the head and neck: case-control study.

Objective: To investigate whether cannabis smoking increases the risk of head and neck cancer.

Design: Case-control study.

Subjects And Methods: Cases of head and neck cancer < or =55 years identified from hospital databases and the Cancer Registry, and controls randomly selected from the electoral roll completed interviewer-administered questionnaires.

Physiological associations of computerized tomography lung density: a factor analysis.

Background: Objective quantification of emphysema using computerized tomography (CT) density measurements is rapidly gaining wide acceptance as an in vivo measurement tool. However, some studies have suggested that abnormal lung function in the absence of emphysema can affect lung density, and the role of such measurements in identifying and monitoring the progression of emphysema is not clear.

Objective: To clarify the relationship between lung density measurements and pulmonary function.

Is it time to change the approach to oxygen therapy in the breathless patient?

The need to highlight the risks of high flow oxygen in clinical teaching

Effects of cannabis on pulmonary structure, function and symptoms.

Background: Cannabis is the most widely used illegal drug worldwide. Long-term use of cannabis is known to cause chronic bronchitis and airflow obstruction, but the prevalence of macroscopic emphysema, the dose-response relationship and the dose equivalence of cannabis with tobacco has not been determined.

Methods: A convenience sample of adults from the Greater Wellington region was recruited into four smoking groups: cannabis only, tobacco only, combined cannabis and tobacco and non-smokers of either substance.

Pulmonary function testing in New Zealand: the use and importance of reference ranges.

Background And Objectives: The diagnosis, assessment and management of a wide range of respiratory diseases rely on accurate interpretation of lung function tests through the use of reference equations to generate predicted values. This paper ascertains the suitability of reference equations currently used in New Zealand through comparison with newly derived equations from the Wellington Respiratory Survey, and discusses the relevance of the findings to the Asia Pacific region.

Methods: A survey of lung function testing facilities determined the reference equations in common usage.

Reference ranges for exhaled nitric oxide derived from a random community survey of adults.

Rationale: Measurement of the fraction of nitric oxide in exhaled breath (Fe(NO)) has been proposed as a noninvasive marker of airway inflammation. Before the widespread use of this test, there is a need to develop reference ranges to allow clinicians to interpret Fe(NO) measurements.

Objectives: To derive reference ranges for Fe(NO) and to determine which factors in health and disease influence Fe(NO) levels.

Asthma exacerbations. 5: assessment and management of severe asthma in adults in hospital.

It is difficult to understand why there is such a huge discrepancy between the management of severe asthma recommended by evidence-based guidelines and that observed in clinical practice. The recommendations are relatively straightforward and have been widely promoted both in guidelines and reviews. Specialist physicians need to be more proactive in their implementation of such guidelines through the use of locally derived protocols and assessment sheets, reinforced by audit.

An audiovisual reminder function improves adherence with inhaled corticosteroid therapy in asthma.

Background: Adherence to medication regimens is poor in the management of chronic diseases, including asthma.

Objective: To determine whether an audiovisual reminder device improves adherence with inhaled corticosteroid (ICS) therapy in adult asthma.

Methods: A randomized open-label parallel group study of 110 adult or adolescent subjects with asthma was undertaken.

Utility of lung density measurements in the diagnosis of emphysema.

Background: The role of computerised tomography (CT) lung density measurements in objective quantification of emphysema is uncertain. The aim of this study was to determine normal reference values for CT lung density measurements and investigate their utility in identifying subjects with clinical emphysema.

Methods: Normal subjects (non-smokers, no respiratory disease, n=185) and subjects with clinical emphysema (post-bronchodilator FEV(1)/FVC <70%, > or =10 pack years tobacco smoking, no childhood asthma and, either D(LCO)/VA <80% predicted and/or macroscopic emphysema on CT, n=22) were identified from a random population survey.

Magnesium in the treatment of asthma.

Purpose Of Review: To provide an update of recent research on the role of magnesium in the management of asthma.

Recent Findings: Further evidence has been published that long-term oral magnesium supplementation does not lead to improved control in adult asthma. In contrast, updated meta-analyses of randomized controlled trials have confirmed the efficacy of both intravenous and inhaled (as an adjuvant to salbutamol nebulizer solution) magnesium therapy in severe asthma.

External validity of randomized controlled trials in COPD.

Background: COPD is a heterogeneous disease comprising a wide range of clinical phenotypes, depending on the degree to which emphysema, chronic bronchitis, reversible bronchospasm and small airways inflammation are present. Not all of these phenotypes may be represented among the subjects included in randomized controlled drug trials (RCTs) in COPD, making it difficult for doctors to know to what extent RCT evidence applies to individual patients. From a respiratory health survey of adults randomly selected from the community, we have estimated the proportion of subjects with COPD who would have been eligible for inclusion in major COPD RCTs.

External validity of randomised controlled trials in asthma: to whom do the results of the trials apply?

Background: Asthma is a heterogeneous disease with a wide range of clinical phenotypes, not all of which may be encompassed in the subjects included in randomised controlled trials (RCTs). This makes it difficult for clinicians to know to what extent the evidence derived from RCTs applies to a given patient.

Aim: To calculate the proportion of individuals with asthma who would have been eligible for the major asthma RCTs from the data of a random community survey of respiratory health.

Complete reference ranges for pulmonary function tests from a single New Zealand population.

Aim: Reference equations are prerequisites for interpretation of pulmonary function tests and are important in diagnosis, assessment, and management of a range of respiratory conditions. Such equations should be derived from populations who are closely ethnically and anthropomorphically matched to those in whom the equations will be used. This paper uses measurements from a single cohort of New Zealand adults to derive reference equations for all major pulmonary function tests.

Duration of action of the salmeterol/fluticasone combination inhaler administered in the evening: a randomized controlled trial in childhood asthma.

Objective And Background: To investigate the duration of bronchodilator action of a salmeterol/fluticasone combination (SFC) inhaler when administered in the evening to children with asthma.

Design: A double-blind, placebo-controlled, cross-over study.

Setting: Hospital inpatient.