Factors influencing the physical activity in daily life of male patients with different levels of severity of chronic obstructive pulmonary disease

[Purpose] Physical activity influences the prognosis of chronic obstructive pulmonary disease and is influenced by exercise tolerance, and environmental, psychological, and many other factors, but the influence of these factors on physical activity levels in each stage of chronic obstructive pulmonary disease is unknown. This study aimed to clarify this matter. [Participants and Methods] Seventy-one male patients with chronic obstructive pulmonary disease (aged 72.2 ± 4.5 years) participated in this study. We compared physical activity levels (determined as daily steps), presence or absence of daily routine (e.g., housework or hobby), 6-minute walking distance, psychological factors (using the Hospital Anxiety and Depression Scale), and health-related quality of life (Physical and Mental component summary of the 36-item short-form health survey) between patients in different stages of chronic obstructive pulmonary disease. [Results] When examined at each stage of chronic obstructive pulmonary disease, physical activity levels correlated with the presence or absence of daily routine, 6-minute walking distance, and Physical component summary in all stages, but the scores in the anxiety and depression components of the Hospital Anxiety and Depression Scale and Mental component summary correlated only with stage 4. [Conclusion] Physical functioning was related to physical activity levels at any stage of chronic obstructive pulmonary disease, although psychological functioning was related to the progress of disease severity. The approach to promote an active lifestyle must be selected depending on the stage of chronic obstructive pulmonary disease.

Utility of daily routine portable chest X-ray in mechanically ventilated patients in the pediatric intensive care unit

The utility of daily routine chest X-rays (CXRs) in mechanically ventilated patients in intensive care units is still controversial. The present study compared the diagnostic, therapeutic and outcome efficacy between daily routine and non-routine (clinically indicated) CXRs in children patients in pediatric intensive care unit (PICU). A prospective randomized study conducted in tertiary center 18-bed PICU, Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia. The study selected 52 children, who were mechanically intubated for at least 48 hr. The children were randomized to receive either routine (29 patients) or non-routine (23 patients) CXRs and were followed until extubation or death. Demographic and outcome data were collected and analyzed as appropriate. Although children in the non-routine group received fewer CXRs, the lengths of stay (LOS) in intensive care unit and hospital and mortality rate were nearly the same compared with routine group. The percentage of CXRs with new findings was higher in the non-routine group (83%; 53 CXRs) compared to that in the routine group (69%; 156 CXRs) with an odds ratio (OR) of 2.10 (95% confidence interval [CI] = 0.60-8.11). Also, the percentage of CXRs with new findings that result in intervention was higher in non-routine group (78% vs. 69%; OR = 1.60; 95% CI = 0.50-5.70). The daily routine CXRs was not associated with a reduced effect on length of stay in PICU and hospital or mortality and it does not seem to add any advantages over non-routine CXRs in PICU. Large multicenter studies are needed to confirm these results.

Adults with autism in India: a mixed-method approach to make meaning of daily routines

Although individuals with Autism Spectrum Disorder (ASD) have been diagnosed in India for over fifty years, virtually nothing is known about the social circumstances of adults, their daily lives, and their families. Where are adults with autism? How do they spend their time? Who are they with, and what are they doing all day? A mixed-method approach was used to obtain information on daily routines of 54 adults with ASD living in New Delhi, India, and about parent levels of stress associated with these routines during a study collected from January through June, 2013. Whether or not they attended a structured setting during the day (59% did so), adults engaged in some 20 activities both inside and outside their home. Contrary to our expectations, most adults were not "hidden" and were out in public at least on occasion. Higher functioning adults were more likely to attend a structured setting, but parents described challenging behaviors, both adult and parent preference, and lack of options as reasons that adults stayed home. The amount of time adults spent outside their home was not associated with parent reported stress, but stress was significantly higher for mothers who were employed. Most families described adaptation to caring for their adult children. A partnership with an Indian nongovernmental organization provided mechanisms to amplify our research findings, making them meaningful to our participants and others.