The Short- and Long-Term Impact of Pulmonary Rehabilitation in Subjects with Sarcoidosis: A Prospective Study and Review of the Literature

Respiration ◽  
2021 ◽  
pp. 1-9
Author(s):  
Elad Guber ◽  
Ori Wand ◽  
Gali Epstein Shochet ◽  
Ayal Romem ◽  
David Shitrit
Keyword(s):  
Exercise Capacity ◽  
Pulmonary Rehabilitation ◽  
Pulmonary Sarcoidosis ◽  
Walking Distance ◽  
Unknown Etiology ◽  
Short And Long Term ◽  
Long Term Impact ◽  
The Impact

<b><i>Background:</i></b> Sarcoidosis is a heterogeneous multisystemic disorder of unknown etiology. Dyspnea and fatigue are two of the most common and debilitating symptoms experienced by subjects with sarcoidosis. There is limited evidence regarding the short- and long-term impact of pulmonary rehabilitation (PR) on exercise capacity and fatigue in these individuals. <b><i>Objective:</i></b> To evaluate the benefit of PR in subjects with pulmonary sarcoidosis at different severity stages and to review the current literature about PR in sarcoidosis. <b><i>Methods:</i></b> PR included a 12-week training program of a twice-weekly 90-min workouts. Fifty-two subjects with stable pulmonary sarcoidosis were recruited. Maximal exercise capacity, defined as VO<sub>2</sub>max, was measured using the cardiopulmonary exercise test (CPET). Pulmonary function tests, 6-min walking distance (6MWD), St. George’s Respiratory Questionnaire (SGRQ), and the modified Medical Research Council (mMRC) and Hospital Anxiety and Depression Scale (HADS) questionnaires were given before and after PR and following 6 months (follow-up). <b><i>Results:</i></b> The PR program significantly increased the VO<sub>2</sub>max (1.8 ± 2.3 mL/kg/min, <i>p</i> = 0.002), following 12 weeks. mMRC and SGRQ scores were also improved (−0.3 ± 0.8, <i>p</i> = 0.03, and −3.87 ± 10.4, <i>p</i> = 0.03, respectively). The impact of PR on VO<sub>2</sub>max was more pronounced in subjects with pulmonary parenchymal involvement. The increase in VO<sub>2</sub>max correlated with initial disease severity (indicated by FEV1/FVC, <i>p</i> = 0.01). Subjects with FEV1/FVC &#x3c;70% showed greater improvement in 6MWD. 6MWD also improved in those with a transfer coefficient of the lung for CO (KCO) above 80% predicted (<i>p</i> &#x3c; 0.05). At 6-month follow-up, the VO<sub>2</sub>max, 6MWD, and SGRQ scores remained stable, thus suggesting lasting effects of PR. <b><i>Conclusion:</i></b> PR is a promising complementary therapeutic intervention for subjects with sarcoidosis. Further study is needed to validate these findings.

Abstract 19771: Persistent Thrombocytopenia after Myocardial Infarction is Associated with Increased Short- and Long-Term Mortality

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Anirudh Kumar ◽  
Salim Virani ◽  
Scott Bassett ◽  
Mahboob Alam ◽  
Ravi Hira ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Bleeding Complications ◽  
Group Differences ◽  
Long Term Outcomes ◽  
Post Discharge ◽  
Short And Long Term ◽  
The Impact ◽  
Long Term Mortality

Background: Thrombocytopenia (TCP) occurs commonly in patients hospitalized with acute myocardial infarction (AMI). It is unclear whether persistent TCP after discharge among AMI survivors is associated with worse outcomes. Methods: We examined the impact of persistent post-discharge TCP on outcomes in a registry of consecutive AMI patients hospitalized between January 2004 and December 2007. In-hospital (IH) TCP was defined by a nadir platelet count < 150 x 109/L. Resolved TCP was defined as IH TCP which resolved within 3 months after discharge while persistent TCP was defined as IH TCP which did not resolve within 3 months. Results: Of 842 patients hospitalized for a first AMI, we examined data on 617 hospital survivors who had follow-up within 3 months of discharge and documented long-term outcomes. Of those, 474 (76.8%) patients did not experience IH TCP while 42 (6.8%) and 101 (16.4%) had persistent and resolved TCP, respectively (Table). Patients with persistent TCP were older, had worse comorbidities, and were more likely to have TCP at baseline and discharge. There were no inter-group differences in infarct size, major bleeding complications, revascularization, or ejection fraction at discharge. Mortality following discharge was higher at all time-points among AMI patients with persistent TCP compared to patients with resolved or without IH TCP (Figure). Patients with resolved TCP had comparable mortality to those without IH TCP. Conclusion: Persistent TCP within 3 months after hospital discharge for AMI is associated with significantly increased short- and long-term mortality compared to patients with recovered TCP or without IH TCP.

Wet weather water quality modelling of a Portuguese urban catchment: difficulties and benefits

2002 ◽  
Vol 45 (3) ◽  
pp. 131-140 ◽  
Author(s):  
L.M. David ◽  
R.S. Matos
Keyword(s):  
Water Quality ◽  
River Flow ◽  
Integrated Approach ◽  
Integrated Modelling ◽  
Sewer System ◽  
Deterministic Modelling ◽  
Short And Long Term ◽  
Long Term Impact ◽  
The Impact

This paper discusses the use of water quality deterministic modelling together with an integrated approach to assess the impact of urban stormwater discharges into ephemeral watercourses, based on the study of a Portuguese catchment. The description of the main aspects, difficulties and benefits found during data collection and model calibration and verification is presented, and the associated uncertainties and errors discussed. Experimental results showed a strong short- and long-term impact of sewer discharges on rivers, and confirmed deposition, resuspension and transport of pollutants as important processes for the water quality. However, the resuspension of riverbed sediment pollutants during storms was probably more significant than the direct impact of the urban discharges. The HydroWorks™ model was used since it allows for the calculation of pollutant build-up on catchment surfaces and in gully pots, their wash-off, and the deposition and erosion of sediments in sewers. However, it uses several constants, which could not be independently calibrated, increasing the uncertainty already associated with the data. River flows have quite different magnitude from the sewer system overflows, which, together with the difficulties in evaluating river flow rates, makes the integrated modelling approach rather complex and costly.

scholarly journals On the Outside Looking In: A Global Doula Response to COVID-19

2021 ◽  
Vol 6 ◽  
Author(s):  
Julie Johnson Searcy ◽  
Angela N. Castañeda
Keyword(s):  
Initial Study ◽  
Qualitative Survey ◽  
Obstetric Violence ◽  
The World ◽  
Hospital Policies ◽  
Long Term Impact ◽  
Virtual Support ◽  
The Impact

From around the world, doulas report the impact of new COVID-19 restrictions on their ability to provide continuous emotional, physical, and informational support to pregnant people and their families. In a qualitative survey conducted in March and April 2020, we heard from over 500 doulas in 24 countries. Doulas practicing across the world revealed rapid changes to hospital policies. Even accounting for different public health responses across countries, the doulas in our study pointed to one common theme - their absence at births and the subsequent need to support birthing people virtually. In a follow-up survey and in interviews we conducted in July, we reconnected with doulas from our initial study to track their access to institutional birthing spaces. As countries experienced the effects of “flattening the curve,” we found that doulas were still not considered “essential” workers and the majority could not attend births. Our research shows that doulas have ambiguous feelings about the efficacy of virtual support, that they raise concerns about the long-term impact of COVID on their profession and that they are concerned about mistreatment and obstetric violence as birthing people enter hospitals alone.

scholarly journals Long term impact on lung function of patients with moderate and severe COVID-19. A prospective cohort study

2021 ◽  
Author(s):  
Sonia Qureshi ◽  
Nosheen Nasir ◽  
Naveed Haroon Rashid ◽  
Naveed Ahmed ◽  
Zoya Haq ◽  
...  
Keyword(s):  
Cohort Study ◽  
Lung Function ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
List Type ◽  
Long Term Impact ◽  
Study Participants ◽  
The Impact

AbstractIntroductionA significant number of patients continue to recover from COVID-19; however, little is known about the lung function capacity among survivors. We aim to determine the long-term impact on lung function capacity in patients who have survived moderate or severe COVID-19 disease in a resource-poor setting.Methods and analysisThis prospective cohort study will include patients aged 15 years and above and have reverse transcriptase-polymerase chain reaction (RT-PCR) positive for COVID 19 (nasopharyngeal or oropharyngeal). Patients with a pre-existing diagnosis of obstructive or interstitial lung disease, lung fibrosis and cancers, connective tissue disorders, autoimmune conditions affecting the lungs, underlying heart disease, history of syncope and refuse to participate will be excluded. Pulmonary function will be assessed using spirometry and diffusion lung capacity for carbon monoxide (DLCO) at three- and six-months interval. A chest X-ray at three and six-month follow-up and CT-chest will be performed if clinically indicated after consultation with the study pulmonologist or Infectious Disease (ID) physician. Echocardiogram (ECHO) to look for pulmonary hypertension at the three months visit and repeated at six months if any abnormality is identified initially. Data analysis will be performed using standard statistical software.Ethics and disseminationThe proposal was reviewed and approved by ethics review committee (ERC) of the institution (ERC reference number 2020-4735-11311). Informed consent will be obtained from each study participant. The results will be disseminated among study participants, institutional, provincial and national level through seminars and presentations. Moreover, the scientific findings will be published in high-impact peer-reviewed medical journals.Strengths and Limitations of this study-The study has the potential to develop context-specific evidence on the long-term impact on lung function among COVID-19 survivors-Findings will play key role in understanding the impact of the disease on vital functions and help devise rehabilitative strategies to best overcome the effects of disease-This is a single-center, study recruiting only a limited number of COVID-19 survivors-The study participants may loss-to-follow up due to uncertain conditions and disease reemergence

Long-term impact of coordinated warren ripping programmes on rabbit populations

2010 ◽  
Vol 37 (1) ◽  
pp. 68 ◽  
Author(s):  
S. R. McPhee ◽  
K. L. Butler
Keyword(s):  
Population Decline ◽  
Biological Control Agents ◽  
Control Effort ◽  
Rabbit Haemorrhagic Disease ◽  
Long Term Impact ◽  
Haemorrhagic Disease ◽  
The Impact ◽  
The Relationship

Context. It is important to examine the long-term effectiveness of rabbit management programmes based on warren destruction using modern warren ripping machinery, at a time when the continuing impacts of both myxomatosis and rabbit haemorrhagic disease (RHD) may have reduced the capacity of rabbit populations to recover. Aims. To determine the long-term effectiveness of coordinated warren ripping programmes in reducing rabbit densities and maintaining these low densities. Methods. Commencing in 1998, 14 sites with coordinated warren ripping programmes and three sites without rabbit control were monitored within Victoria. Spotlight counts of rabbit numbers recorded before the spread of RHD and warren ripping were compared with numbers recorded from 2005 to 2008. The efficacy of coordinated warren ripping programmes was assessed in relation to the machinery used, the manner in which the warrens were ripped, the characteristics of the ripped areas and the impact of follow-up control. Key results. Warren ripping programmes were very successful in reducing rabbit numbers for up to 10 years, whereas rabbit populations that were not managed returned to pre-RHD densities. The most effective warren ripping programmes, which reduced populations to 97% of the pre-RHD densities and maintained them at this level, used heavy, powerful ripping machinery to rip all warrens within 12 months. There was no evidence that the relationship between rabbit population decline and warren ripping was affected by the characteristics of the ripped areas or the follow-up control effort. Conclusions. Following the spread of RHD in areas where warren ripping is practicable, well-managed ripping programmes provide an immediate solution for achieving and sustaining low rabbit populations. Implications. The efficacy of RHD in regulating rabbit populations has diminished. The improvement of existing or the development of new biological control agents could take decades. In contrast, coordinated warren ripping programmes provide more predictable long-term reductions in rabbit populations.

scholarly journals Decentering the discipline? Archaeology, museums and social media

2017 ◽  
Vol 4 (2) ◽  
pp. 77 ◽  
Author(s):  
Dominic Walker
Keyword(s):  
Social Media ◽  
New Media ◽  
Media Studies ◽  
Impact Studies ◽  
Collaborative Archaeology ◽  
Shared Authority ◽  
Short And Long Term ◽  
Long Term Impact ◽  
The Impact

In recent years archaeologists have asserted the value of social media for achieving goals such as ‘shared authority’ and the ‘empowerment’ of various communities. These assertions often resemble techno-utopian discourse. However, it is essential to critically consider these assertions with reference to the important studies emerging from the fields of new media studies and Indigenous and collaborative archaeology, which have particularly emphasised the need for a greater awareness of sociopolitical contexts. Informed by this literature, this paper surveys some of the emerging and established uses of social media by archaeologists and museums, and proceeds to introduce factors that challenge the broadly positive discourses about the impact of social media on various communities. It also highlights the need for short- and long-term impact studies.

scholarly journals Impact of Built Environments on Body Weight (the Moving to Health Study): Protocol for a Retrospective Longitudinal Observational Study (Preprint)

2019 ◽  
Author(s):  
Stephen J Mooney ◽  
Jennifer F Bobb ◽  
Philip M Hurvitz ◽  
Jane Anau ◽  
Mary Kay Theis ◽  
...  
Keyword(s):  
Body Weight ◽  
Health Study ◽  
Built Environments ◽  
King County ◽  
Kaiser Permanente ◽  
Neighborhood Conditions ◽  
Long Term Impact ◽  
The Impact

BACKGROUND Studies assessing the impact of built environments on body weight are often limited by modest power to detect residential effects that are small for individuals but may nonetheless comprise large attributable risks. OBJECTIVE We used data extracted from electronic health records to construct a large retrospective cohort of patients. This cohort will be used to explore both the impact of moving between environments and the long-term impact of changing neighborhood environments. METHODS We identified members with at least 12 months of Kaiser Permanente Washington (KPWA) membership and at least one weight measurement in their records during a period between January 2005 and April 2017 in which they lived in King County, Washington. Information on member demographics, address history, diagnoses, and clinical visits data (including weight) was extracted. This paper describes the characteristics of the adult (aged 18-89 years) cohort constructed from these data. RESULTS We identified 229,755 adults representing nearly 1.2 million person-years of follow-up. The mean age at baseline was 45 years, and 58.0% (133,326/229,755) were female. Nearly one-fourth of people (55,150/229,755) moved within King County at least once during the follow-up, representing 84,698 total moves. Members tended to move to new neighborhoods matching their origin neighborhoods on residential density and property values. CONCLUSIONS Data were available in the KPWA database to construct a very large cohort based in King County, Washington. Future analyses will directly examine associations between neighborhood conditions and longitudinal changes in body weight and diabetes as well as other health conditions. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/16787

scholarly journals Impact of intraocular pressure fluctuations on progression of normal tension glaucoma

2021 ◽  
Vol 14 (10) ◽  
pp. 1553-1559
Author(s):  
Susanne Hopf ◽  
◽  
Irene Schmidtmann ◽  
Norbert Pfeiffer ◽  
Esther Maria Hoffmann ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Optic Disc ◽  
Cox Regression ◽  
Group Analysis ◽  
Normal Tension Glaucoma ◽  
Short And Long Term ◽  
The Impact

AIM: To investigate short- and long-term intraocular pressure (IOP) fluctuations and further ocular and demographic parameters as predictors for normal tension glaucoma (NTG) progression. METHODS: This retrospective, longitudinal cohort study included 137 eyes of 75 patients with NTG, defined by glaucomatous optic disc or visual field defect with normal IOP (<21 mm Hg), independently from therapy regimen. IOP fluctuation, mean, and maximum were inspected with a mean follow-up of 38mo [standard deviation (SD) 18mo]. Inclusion criteria were the performance of minimum two 48-hour profiles including perimetry, Heidelberg retina tomograph (HRT) imaging, and optic disc photographs. The impact of IOP parameters, myopia, sex, cup-to-disc-ratio, and visual field results on progression of NTG were analyzed using Cox regression models. A sub-group analysis with results from optical coherence tomography (OCT) was performed. RESULTS: IOP fluctuations, average, and maximum were not risk factors for progression in NTG patients, although maximum IOP at the initial IOP profile was higher in eyes with progression than in eyes without progression (P=0.054). The 46/137 (33.5%) eyes progressed over the follow-up period. Overall progression (at least three progression confirmations) occurred in 28/137 eyes (20.4%). Most progressions were detected by perimetry (36/46). Long-term IOP mean over all pressure profiles was 12.8 mm Hg (SD 1.3 mm Hg); IOP fluctuation was 1.4 mm Hg (SD 0.8 mm Hg). The progression-free five-year rate was 58.2% (SD 6.5%). CONCLUSION: Short- and long-term IOP fluctuations do not result in progression of NTG. As functional changes are most likely to happen, NTG should be monitored with visual field testing more often than with other devices.

scholarly journals Emotional Reactivity and Wellbeing of Adolescents During the COVID-19 Pandemic: Short and Long Term Effects and The Impact of Social and Socioeconomic Stressors

2021 ◽  
Author(s):  
Kayla Green ◽  
Suzanne van de Groep ◽  
Sophie Sweijen ◽  
Andrik Becht ◽  
Moniek Buijzen ◽  
...  
Keyword(s):  
Young Adults ◽  
Emotional Reactivity ◽  
Formative Period ◽  
Long Term Effects ◽  
Daily Diary Study ◽  
Adolescent Sample ◽  
Short And Long Term ◽  
The Impact

Adolescence is a formative period for socio-emotional development which is threatened by the COVID-19 pandemic. The current longitudinal study examined the impact of the pandemic on young people’s mood, emotional reactivity, and wellbeing (i.e., operationalized as balancing needs of self and others). Hence, we conducted an online two-week daily diary study among 462 Dutch adolescents (Mage = 15.27 years, 64% females) and 371 young adults (Mage = 21.49 years, 81% females) in May 2020, with a follow-up to study long-term effects in November 2020 (N = 238 and 231, respectively adolescents and young adults). In May 2020, young adults and older relative to younger adolescents showed higher levels and more fluctuations in tension and depression and lower levels of vigor. Vigor levels decreased and tension and depression levels increased between May 2020 and November 2020, especially for younger adolescents. A closer examination in the adolescent sample, revealed positive associations between instability of negative emotions (i.e. tension and depression fluctuations) and the exposure to social and socioeconomic stressors (i.e. family stress and inequality of online homeschooling). Together, this study demonstrates vulnerability regarding young people’s mood and emotional reactivity during the COVID-19 pandemic, especially for adolescents who experience more stressors.

Was it Worth it?

2020 ◽  
pp. 355-370
Author(s):  
Petar Finci
Keyword(s):  
Criminal Justice ◽  
International Criminal ◽  
International Criminal Tribunal ◽  
International Criminal Justice ◽  
Target Groups ◽  
Outreach Programme ◽  
Short And Long Term ◽  
Long Term Impact ◽  
The Impact

The International Criminal Tribunal for the former Yugoslavia’s (ICTY) Outreach Programme was a new effort in the field of international criminal justice, with little existing experience to build upon. Relying on fundraising for financing and operating in sometimes openly hostile political circumstances in the former Yugoslavia, the Outreach Programme nevertheless managed to engage its target groups over nearly two decades. This chapter starts with an analysis of the early activities of the Outreach Programme, with particular focus on evaluation (or the lack thereof) of the impact. It then offers a more detailed discussion of outreach projects implemented from 2010 onwards and some differences in evaluation of their short- and long-term impact. It concludes with some recommendations on possible ways to use the experiences beyond the closure of the ICTY.

Sign in / Sign up

Export Citation Format

Share Document