The self-management abilities test (SMAT): a tool to identify the self-management abilities of adults with bronchiectasis

Bronchiectasis is an increasingly common chronic respiratory disease which requires a high level of patient engagement in self-management. Whilst the need for self-management has been recognised, the knowledge and skills needed to do so— and the extent to which patients possess these—has not been well-specified. On one hand, understanding the gaps in people’s knowledge and skills can enable better targeting of self-management supports. On the other, clarity about what they do know can increase patients’ confidence to self-manage. This study aims to develop an assessment of patients’ ability to self-manage effectively, through a consensus-building process with patients, clinicians and policymakers. The study employs a modified, online three-round Delphi to solicit the opinions of patients, clinicians, and policymakers (N = 30) with experience of bronchiectasis. The first round seeks consensus on the content domains for an assessment of bronchiectasis self-management ability. Subsequent rounds propose and refine multiple-choice assessment items to address the agreed domains. A group of ten clinicians, ten patients and ten policymakers provide both qualitative and quantitative feedback. Consensus is determined using content validity ratios. Qualitative feedback is analysed using the summative content analysis method. Overarching domains are General Health Knowledge, Bronchiectasis-Specific Knowledge, Symptom Management, Communication, and Addressing Deterioration, each with two sub-domains. A final assessment tool of 20 items contains two items addressing each sub-domain. This study establishes that there is broad consensus about the knowledge and skills required to self-manage bronchiectasis effectively, across stakeholder groups. The output of the study is an assessment tool that can be used by patients and their healthcare providers to guide the provision of self-management education, opportunities, and support.

Smart Heart Disease Prediction System with IoT and Fog Computing Sectors Enabled by Cascaded Deep Learning Model

Chronic illnesses like chronic respiratory disease, cancer, heart disease, and diabetes are threats to humans around the world. Among them, heart disease with disparate features or symptoms complicates diagnosis. Because of the emergence of smart wearable gadgets, fog computing and “Internet of Things” (IoT) solutions have become necessary for diagnosis. The proposed model integrates Edge-Fog-Cloud computing for the accurate and fast delivery of outcomes. The hardware components collect data from different patients. The heart feature extraction from signals is done to get significant features. Furthermore, the feature extraction of other attributes is also gathered. All these features are gathered and subjected to the diagnostic system using an Optimized Cascaded Convolution Neural Network (CCNN). Here, the hyperparameters of CCNN are optimized by the Galactic Swarm Optimization (GSO). Through the performance analysis, the precision of the suggested GSO-CCNN is 3.7%, 3.7%, 3.6%, 7.6%, 67.9%, 48.4%, 33%, 10.9%, and 7.6% more advanced than PSO-CCNN, GWO-CCNN, WOA-CCNN, DHOA-CCNN, DNN, RNN, LSTM, CNN, and CCNN, respectively. Thus, the comparative analysis of the suggested system ensures its efficiency over the conventional models.

A National Analysis of Inpatient Pediatric Adenoidectomy

Objective: Hospital admission following pediatric adenoidectomy without tonsillectomy is not well characterized. The objective of our study is to better characterize risk factors for post-operative complications in younger children undergoing inpatient adenoidectomy. Methods: A cross-sectional analysis using data derived from the Kid’s Inpatient Database (KID) was performed. Study participants included children <3 years of age who underwent an adenoidectomy and were admitted to hospitals participating in the KID for years 1997, 2000, 2003, 2006, 2009, and 2012. Descriptive statistical analysis and a multivariate logistic regression analysis were performed to identify risk factors for post-operative complication. Results: A total of 3406 children (mean age 1.1 ± 0.7 years) were included. The overall post-operative bleeding and respiratory complication rates were 0.6% and 5.4%, respectively. Children less than 18 months of age demonstrated increased rates of post-operative respiratory complications ( P = .009), but not bleeding complications ( P = .857). Presence of cardiopulmonary congenital malformations (OR 1.54, 95% CI 1.07-2.20), chronic respiratory disease of the newborn (OR 5.03, 95% CI 2.86-8.85), and neuromuscular disorders (OR 1.97, 95% CI 1.09-3.57) were associated with post-operative respiratory distress. Conclusions: This analysis of a national dataset suggests that otherwise healthy children less than 18 months of age and children 18 months to 3 years of age with certain comorbidities may benefit from overnight observation following adenoidectomy.

Chronic respiratory disease in adult outpatients in three African countries: a cross-sectional study

BACKGROUND: The greatest burden of chronic respiratory disease is in low- and middle-income countries, with recent population-based studies reporting substantial levels of obstructive and restrictive lung function.OBJECTIVE: To characterise the common chronic respiratory diseases encountered in hospital outpatient clinics in three African countries.METHODS This was a cross-sectional study of consecutive adult patients with chronic respiratory symptoms (>8 weeks) attending hospital outpatient departments in Ethiopia, Kenya and Sudan. Patients were assessed using a respiratory questionnaire, spirometry and chest radiography. The diagnoses of the reviewing clinicians were ascertained.RESULT: A total of 519 patients (209 Kenya, 170 Ethiopia, 140 Sudan) participated; the mean age was 45.2 years (SD 16.2); 53% were women, 83% had never smoked. Reviewing clinicians considered that 36% (95% CI 32–40) of patients had asthma, 25% (95% CI 21–29) had chronic bronchitis, 8% (95% CI 6–11) chronic obstructive pulmonary disease (COPD), 5% (95% CI 4–8) bronchiectasis and 4% (95% CI 3–6) post-TB lung disease. Spirometry consistent with COPD was present in 35% (95% CI 30–39). Restriction was evident in 38% (95% CI 33–43). There was evidence of sub-optimal diagnosis of asthma and COPD.CONCLUSION: In Ethiopia, Kenya and Sudan, asthma, COPD and chronic bronchitis account for the majority of diagnoses in non-TB patients with chronic respiratory symptoms. The suboptimal diagnosis of these conditions will require the widespread use of spirometry.

Get vaccinated when it is your turn and follow the local guidelines

The nurse has an important role caring for the patient infected with the coronavirus disease (COVID- 19). It is an infectious disease caused by the SARS-CoV-2 virus. The virus can spread from the mouth or nose of an infected person in small liquid particles when they cough, sneeze, speak, sing, or breathe. These particles range from larger respiratory droplets to smaller aerosols. It is important to practice respiratory etiquette, for example coughing into a flexed elbow, and to stay home and self-isolate until you recover if you feel unwell. Most people infected with the virus will experience mild to moderate respiratory illness and will recover without requiring special treatment. Older people and people with underlying medical conditions such as cardiovascular disease, diabetes, chronic respiratory disease, or cancer are more likely to develop serious illnesses. The goal of the research is to propose the best way to prevent and slow down transmission is to be well informed about the disease and how the virus spreads. Protect yourself and others from infection by staying at least 1 meter away from others, wearing a well-fitting mask, and washing your hands or using an alcohol-based rub frequently.

Rehabilitation in acute post COVID-19 symptoms with intracranial space occupying lesion: a case report

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2. Older people and those with underlying medical conditions like cardiovascular disease, diabetes, chronic respiratory disease or cancer is more likely to develop serious illness. Acute post COVID-19 patients will get a variety of problems with normal functioning. Rehabilitation could be an effective method for decreasing COVID-19's effects on patient health and function. A 20 years old, female was diagnosed with COVID-19 5 weeks ago, it had been reported shortness of breath, difficult clearing phlegm, headache, nausea and vomiting. The patient had a history of intracranial space occupying lesion (SOL), cerebello pontine angle (CPA) tumor 3 years ago, craniotomy resection of 4th ventricular tumour one year ago and a second craniotomy scheduled for 2021. Several exercises were scheduled for patients including prone position, respiratory muscle training, controlled breathing techniques, bronchial hygiene-airway clearance techniques, aerobic exercise, three times a week, exercises were scheduled. After having completed the exercise program for four weeks, exercise improved shortness of breath, phlegm expenditure, muscle strength, improve lung recoil, vital capacity, range of motion, patient balance and the patient's ability to maximize activity.

Pulmonary comorbidity in chronic lymphoproliferative diseases: realities of the problem in the Dnipro region

The prevalence of the chronic lymphoproliferative diseases is increasing worldwide with increase of the population age. It is known that the presence of comorbidities in such patients plays an important role in predicting treatment outcomes. The aim of the work was to study the prevalence and determine the structure of respiratory symptoms and comorbid pulmonary pathology in patients with chronic lymphoproliferative diseases (CLPD) in the Dnipro region of Ukraine. After analyzing 986 cards of inpatients of the hematology department, whose average age was 65 (56; 69) years, it was determined that 9.0% of patients had at least one chronic respiratory disease, the most common among which were chronic bronchitis, chronic obstructive pulmonary disease, as well as community-acquired pneumonia. Dyspnea and tachypnea are also common among patients with CLPD without established respiratory comorbidity, cardiovascular disease, or anemia. Based on the data obtained, we can recommend a study of the respiratory function and pulse oximetry, as well as a thorough collection of anamnesis of smoking and analysis of the results of chest computed tomography in all patients with CLPD in order to identify the possible cause of shortness of breath and establish the presence of respiratory comorbidity.