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- Development of a performance-based toolkit of the treatable traits of functioning in hospitalised patients with exacerbation of COPD: a survey-based study protocolPublication . Leonardi, Naiara Tais; Kawakami, Débora Mayumi Oliveira; Cruz, Joana; Burtin, Chris; Borghi-Silva, Audrey; Mendes, Renata GonçalvesBackground The management of COPD has been based on the premise of identifying problems that guide personalised treatment based on a multidimensional assessment, known as treatable traits. Exacerbation of COPD (ECOPD) results in physical and functional impairments, limitation of daily activities and negative impact on patients’ quality of life and prognosis. In this context, identifying treatable traits in patients with ECOPD is essential to properly guide individualised patient care. There is a need to develop a performance-based toolkit to identify the main treatable traits of functioning in hospitalised patients with ECOPD. Methods and analysis This is a study protocol of a survey method observational study to develop a performance-based toolkit. The study will include the following steps: 1) definition of treatable traits by both physiotherapists who provide or have provided care to hospitalised patients with ECOPD on a regular basis, and patients who have experienced at least one ECOPD which required hospitalisation; 2) selection of the most appropriate measures (markers) for each treatable trait based on established criteria and a previous systematic review; and 3) implementation of the toolkit in a pilot/feasibility study with hospitalised patients with ECOPD. Conclusion The development of a feasible performance-based toolkit with the best markers for each key treatable trait of functioning in hospitalised patients with ECOPD will make it possible to create individualised patient care for the specific demands of these patients.
- Dynamics of Decapoda larvae communities in a southwest Iberian estuary: Understanding the impact of different thermal regimesPublication . Monteiro, Marta; Cruz, Joana; Azeiteiro, Ulisses; Marques, Sónia Cotrim; Baptista, Vânia; Teodosio, Maria AlexandraEnvironmental conditions play a pivotal role in shaping the dynamics of meroplanktonic communities, which represent a vital life stage, crucial for successful recruitment. Specifically, temperature can impact the survival and duration of larval development in decapod crustacean species. The objective of this study is to analyze the community of decapod larvae in the Guadiana estuary, located in southwest Iberia. The analysis focuses on the community's taxonomic composition, temporal variability, and the influence of environmental factors. Particularly, the study emphasizes investigating the impacts of different thermal regimes on the abundance of these assemblages. A comprehensive zooplankton sampling program was conducted at a single station in the lower estuary, from 2014 to 2022. The decapod larvae assemblages are dominated by Upogebia spp., followed by Diogenes pugilator, Panopeus africanus, Afropinnotheres monodi, and Polybius henslowii species. The results of structural equation modeling unveiled a strong influence of water temperature and salinity on the community, while chlorophyll-a concentration, river runoff, and the large-scale climatic mode North Atlantic Oscillation (NAO) revealed no impact on the abundance of these assemblages. Overall, the community and the main taxa displayed a positive linear trend in response to increased salinity. However, the effect of increasing temperature varied among species. In the current climatic scenario, water temperature emerges as a critical factor in predicting seasonal variation of the assemblages' abundances, exhibiting a marked seasonality during spring and summer. Predictive models used to investigate future scenarios, Representative Concentration Pathway (RCP) 2.6 and RCP 8.5, defined by the International Panel on Climate Change (IPCC), where the temperature is expected to rise 2 °C and 4.3 °C by 2100, suggest the possibility for an alteration in assemblages' composition, where the abundances of D. pugilator, the second most abundant species, tend to decrease abruptly. Reported evidence, coupled with the typical Mediterranean climate of the region, where extreme climatic events, like marine heatwaves, are becoming more frequent, the high connectivity with the Mediterranean Sea, where invasion by non-indigenous species is increasing, also connected with changes in freshwater discharges, may trigger significant alterations in species dominance and abundance, with ecological and socio-economic implications.
- Effect of home-based exercise prehabilitation on postoperative outcomes in colorectal cancer surgery: a systematic review and meta-analysisPublication . Machado, Pedro; Paixão, André; Oliveiros, Bárbara; Martins, Raul A.; Cruz, JoanaPurpose Home-based exercise training may improve access to surgical prehabilitation in colorectal cancer (CRC) patients, but its efficacy remains unclear. This study systematically investigated the effects of home-based exercise prehabilitation on postoperative exercise capacity, complications, length of hospital stay, and health-related quality of life (HRQoL) in CRC patients. Methods Randomized controlled trials (RCTs) comparing home-based exercise prehabilitation with control in CRC patients were eligible. We searched MEDLINE, Scopus, Web of Science, PEDro, and SPORTDiscus from their inception to June 3, 2024. Methodological quality was assessed using the PEDro scale, and certainty of evidence was assessed using GRADE. Data were synthesized using random-effects meta-analyses, with sensitivity analysis on studies with good methodological quality (PEDro score ≥ 6). Results Eight RCTs involving 1092 participants were included. The primary analysis showed a significant improvement in postoperative 6-min walk distance following home-based exercise prehabilitation compared to control (mean difference (MD) = 30.62: 95% CI: [2.94; 57.79]; low-certainty evidence). However, sensitivity analysis revealed no significant between-group differences (MD = 22.60: 95% CI: [− 6.27; 51.46]). No significant effects of home-based exercise prehabilitation were found on postoperative complications (risk ratio = 1.00: 95% CI: [− 0.78; 1.29]; moderate‐certainty evidence), length of hospital stay (MD = − 0.20: 95% CI: [− 0.65; 0.23]; moderate‐certainty evidence), and HRQoL (physical functioning: MD = 2.62: 95% CI: [− 6.16; 11.39]; mental functioning: MD = 1.35: 95% CI: [− 6.95; 9.65]; low and very-low certainty evidence). Conclusion Home-based exercise prehabilitation does not reduce postoperative complications and length of hospital stay after CRC surgery. Its effects on postoperative exercise capacity and HRQoL remain uncertain due to low-quality evidence.
- ERS International Congress 2023: Highlights from the Allied Respiratory Professionals assemblyPublication . Jacinto, Tiago; Smith, Elizabeth; Diciolla, Nicola S.; van Herck, Maarten; Silva, Liliana; Santiago, Maria Granados; Volpato, Eleonora; Grønhaug, Louise Muxoll; Verkleij, Marieke; Peters, Jeannette B.; Sylvester, Karl; Inal-Ince, Deniz; Padilha, José Miguel; Langer, Daniel; Demeyer, Heleen; Cruz, JoanaThis paper summarises some of the outstanding sessions that were (co)organised by the Allied Respiratory Professionals Assembly during the 2023 European Respiratory Society (ERS) International Congress. Two sessions from each Assembly group are outlined in the present paper, covering the following topics: Group 9.1 focuses on respiratory physiology techniques, specifically on predicted values and reference equations, device development and novel applications of cardiopulmonary exercise tests; Group 9.2 presents an overview of the talks given at the mini-symposium on exercise training, physical activity and self-management at home and outlines some of the best abstracts in respiratory physiotherapy; Group 9.3 highlights the nursing role in global respiratory health and presents nursing interventions and outcomes; and Group 9.4 provides an overview of the best abstracts and recent advances in behavioural science and health psychology. This Highlights paper provides valuable insight into the latest scientific data and emerging areas affecting the clinical practice of Allied Respiratory Professionals.