Canadian Journal of Respiratory Therapy最新文献

{"title":"A multi-institution longitudinal randomised control trial of speaking up: Implications for theory and practice.","authors":"Efrem Violato, Jennifer Stefura, Meredith Patey, Brian Witschen","doi":"10.29390/001c.124914","DOIUrl":"10.29390/001c.124914","url":null,"abstract":"<p><strong>Background: </strong>Speaking up is an important yet challenging aspect of health professional communication. To overcome social-cognitive influences and improve speaking up, an intervention based on Kolb's experiential learning cycle was developed, which integrated Virtual Simulation, curriculum, and practice speaking up. The present study investigated if integrating Virtual Simulation influenced Respiratory Therapy students' ability to challenge a physician compared to a control condition at multiple time points during training.</p><p><strong>Methods: </strong>A multi-institutional longitudinal randomized control trial was conducted. Students from two schools completed a Virtual Simulation or No Virtual Simulation before classroom instruction on speaking up and an in-person simulation requiring speaking up. After three-to-six months and post-clinical placement, students completed a second simulation requiring speaking up. The student's ability to speak up and use CUS (Concerned, Uncomfortable, Safety Issue) was measured.</p><p><strong>Results: </strong>No significant effects for the intervention were observed across time points, <i>p>.05</i>, with a small effect for using CUS, ϕ=.28. During the study, two unexpected findings emerged with theoretical and practical implications. The multi-institutional design created a natural experiment that allowed for the identification of instructor effects on speaking up and Bloom's Two-Sigma problem. Observations were also made related to perceptual limitations that diminish the ability to speak up.</p><p><strong>Conclusions: </strong>Single speaking-up interventions continue to appear to be ineffective. To substantially influence behaviour, consistent mentorship through a \"champion\" is likely necessary to train for and create a culture of speaking up. Training in situational awareness is also likely needed to counter human perceptual limitations in complex situations.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"152-163"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11509214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cut-off values of one-minute sit-to-stand test for determining physical performance in mild-post-COVID-19 individuals.","authors":"Arunrat Srithawong, Puttipong Poncumhak, Tichanon Promsrisuk, Patchareeya Amput","doi":"10.29390/001c.124110","DOIUrl":"https://doi.org/10.29390/001c.124110","url":null,"abstract":"<p><strong>Background: </strong>This study aims to establish cutoff values for the one-minute sit-to-stand test (1STST) to predict physical performance in mild-post- coronavirus disease 2019 (COVID-19) individuals and to compare the 1STST with the 6-minute walk test (6MWT) in assessing hemodynamic response and to explore the correlation between 1STST, 6MWT, and muscle strength, including leg and respiratory muscle strength.</p><p><strong>Methods: </strong>A cross-sectional study of 93 participants with mild post-COVID-19 symptoms was conducted. Sociodemographic and anthropometric data were collected, and pulmonary function, as well as respiratory and quadriceps muscle strength, were evaluated. Functional capacity was assessed using the 6MWT and 1STST. Additionally, hemodynamic responses, fatigue, and dyspnea were measured before and after each test.</p><p><strong>Results: </strong>The cutoff for the 1STST in mild post-COVID-19 individuals was ≥29 repetitions, with an AUC of 0.84, sensitivity of 80.52%, and specificity of 75.00%. The 1STST resulted in higher heart rate, systolic blood pressure, and dyspnea compared to the 6MWT, and showed a significant moderate correlation with the 6MWT (r = 0.532, <i>p</i> < 0.0001) and weak correlations with leg strength and respiratory muscle strength.</p><p><strong>Conclusion: </strong>A cutoff of less than 29 repetitions on the 1STST indicates functional impairment in mild post-COVID-19 cases, as it induces greater physiological stress than the 6MWT and correlates with muscle strength, making it crucial for rehabilitation assessment.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"143-151"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing scholarly practice in respiratory therapy: A call for professional evolution.","authors":"Elizabeth Rohrs","doi":"10.29390/001c.122734","DOIUrl":"10.29390/001c.122734","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"140-142"},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The scholarly and practice profile of respiratory therapists in Canada: A cross-sectional survey.","authors":"Marco Zaccagnini, André Bussières, Peter Nugus, Andrew West, Aliki Thomas","doi":"10.29390/001c.122345","DOIUrl":"https://doi.org/10.29390/001c.122345","url":null,"abstract":"<p><strong>Introduction: </strong>Respiratory therapists (RTs) are expected to provide high-quality care for patients with chronic and acute cardiopulmonary conditions across the lifespan by staying abreast of emerging scientific evidence and effectively integrating it into clinical practice. This integration of evidence is encompassed within the competency of scholarly practice. However, there is currently a limited understanding of RTs' scholarly practice. Furthermore, despite RTs' widespread presence in the Canadian healthcare system, comprehensive studies describing the profiles of RTs are lacking. This study aimed to describe the demographic characteristics, scholarly and practice profiles of the respiratory therapy profession in Canada.</p><p><strong>Methods: </strong>A cross-sectional survey was distributed via the national professional association and regulatory bodies. The survey contained seven sections with 52 items. We calculated means and standard deviations, or medians and interquartile ranges for continuous variables and frequencies and proportions for categorical variables. Open-ended questions were analyzed using summative content analysis.</p><p><strong>Results: </strong>We analyzed data from 832 participants (6.8% response rate) from Ontario (17.8%), Québec (15.7%), and Alberta (13.3%), and across other provinces. Nearly 40% had completed an undergraduate degree beyond their respiratory therapy diploma. Few participants had authored or co-authored peer-reviewed publications. RTs reported reading approximately 2.2 peer-reviewed publications monthly. Most participants agreed on the importance of critical reflection in practice (93.1%) and that having a supportive work environment was vital. Almost three-quarters of participants (73.4%) reported that they believe that RTs are valued members of interprofessional teams, and 78% agreed that understanding research enables them to engage in patient advocacy.</p><p><strong>Conclusion: </strong>This survey provides a portrait of the practice and scholarly profile of the respiratory therapy profession in Canada. While the profession shows potential for growth, concerns persist regarding limited engagement in activities related to scholarly practice. Addressing these challenges and nurturing a culture of scholarly practice are likely necessary to support the development of scholarly practice in the profession. Creating supportive environments, providing access to resources, and encouraging professional development activities may advance the scholarly practice of RTs. Future national surveys could employ random sampling strategies to achieve a more representative sample of the profession.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"122-139"},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11393024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival analysis of COVID-19 versus non-COVID-19 patients requiring intensive care for acute respiratory distress syndrome: An observational retrospective study.","authors":"Paulo Navas Boada, Kevin Chamorro, Santiago Ballaz","doi":"10.29390/001c.122402","DOIUrl":"https://doi.org/10.29390/001c.122402","url":null,"abstract":"<p><strong>Background/aim: </strong>This study analyzed clinical factors impacting the survival of COVID-19 patients with acute respiratory distress síndrome, or ARDS (CARDS) to ICU compared to non-COVID-19 ARDS patients.</p><p><strong>Methods: </strong>Clinical variables from 1,008 CARDS cases and 332 ARDS cases were computed using learning algorithms. The multivariable Cox proportional hazards regression models with the enter method evaluated risk factors and ICU mortality relationships. The survival analysis was completed with Kaplan-Meier and the log-rank tests.</p><p><strong>Results: </strong>A Random Forest model revealed that mechanical ventilation-related factors, oxygenation, blood pH, superinfection, shock, and ICU length of stay have the greatest effects on ICU survival. According to a multivariate Cox model, reintubation and a high-flow nasal cannula were essential for survival in CARDS patients during the ICU stay. The length of stay in the ICU diminishes in patients older than 45 years, regardless of the source of ARDS.</p><p><strong>Conclusion: </strong>This study gives recommendations for the respiratory care of ARDS in COVID-19 patients.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"112-121"},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of physical activity levels in people with chronic obstructive pulmonary disease and healthy subjects residing in hypobaric hypoxia environments.","authors":"Wilder A Villamil-Parra","doi":"10.29390/001c.122163","DOIUrl":"10.29390/001c.122163","url":null,"abstract":"<p><strong>Background: </strong>The reduced level of physical activity in individuals with chronic obstructive pulmonary disease (COPD) is associated with disease severity; however, mild COPD may or may not decrease individuals' physical fitness. Currently, it is unknown whether high-altitude hypoxia is a modifying factor of physical activity levels in COPD compared to healthy subjects.</p><p><strong>Objective: </strong>To compare physical activity levels in individuals with COPD versus healthy subjects residing in high-altitude environments.</p><p><strong>Methods: </strong>Individuals with COPD GOLD 1(A, B) and control subjects residing at high altitudes (>2500m) were studied. Physical activity level was measured for seven days using triaxial accelerometry. Measurement variables included METs/hour, energy expenditure in kcal/hour, total daily energy expenditure, and number of steps per day.</p><p><strong>Results: </strong>Daily caloric expenditure associated with physical activity showed only a slight decrease (3.1%) in COPD patients compared to the control group; there was a significant 61.32% lower hourly calorie consumption rate in the COPD group. Additionally, COPD patients exhibited lower MET/hour (9.64% difference) and a substantial difference in the number of steps per day, with 139.41% fewer steps compared to the control group.</p><p><strong>Conclusion: </strong>COPD patients in hypobaric hypoxia environments exhibit significantly lower levels of physical activity compared to healthy individuals. Altitude hypoxia contributes to low levels of physical activity in both COPD patients and healthy subjects.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"103-111"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volatile gas scavenging in the paediatric intensive care unit: Occupational health and safety assessment.","authors":"Katherine Reise, Jason Macartney, Richard La, Angela Jerath, Marat Slessarev, Brian H Cuthbertson, Saptharishi Lalgudi Ganesan, Nicole K McKinnon","doi":"10.29390/001c.118513","DOIUrl":"10.29390/001c.118513","url":null,"abstract":"<p><strong>Introduction: </strong>The use of volatile anesthetic agents in the paediatric intensive care unit (PICU) is experiencing increased interest since the availability of the miniature vapourizing device. However, the effectiveness of scavenging systems in the presence of humidifiers in the ventilator circuit is unknown.</p><p><strong>Approach methods: </strong>We performed a bench study to evaluate the effectiveness of the Deltasorb® scavenging system in the presence of isoflurane and active humidity by simulating both infant and child ventilator test settings. A total of four ventilators were set to ventilate test lungs, all with active humidity and a Deltasorb scavenging canister collecting exhaled ventilation gas. Two ventilators also had isoflurane delivered using the Anesthesia Conserving Device- small (ACD®-S) on the inspiratory limb (also called alternative ventilator configuration). We performed instantaneous measurements of isoflurane and continuous sampling with passive badges to measure average environmental exposure over a test period of 6.5 hours. Scavenging canisters were returned to the company, where desorption analysis showed the volume of water and isoflurane captured in each canister.</p><p><strong>Findings: </strong>Both instantaneous point sampling and diffusive sampling results were below the occupational exposure limit confirming safety. The canisters collected both isoflurane and a portion of the water vapour delivered; the percentage of captured water and isoflurane collected in infants was higher than the child ventilator test settings.</p><p><strong>Practice implications conclusion: </strong>The tested scavenging configuration was effective in maintaining a safe working environment with active humidity and inspiratory limb (alternative) ventilator configuration of the the miniature vapourizing device.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"95-102"},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the impact of long-term inhaled corticosteroid therapy on patients with COVID-19 and coexisting chronic lung disease: A multicenter retrospective cohort study.","authors":"Adela Pina Belmonte, Manuel Madrazo, Laura Piles, Manuel Rubio-Rivas, Lucía de Jorge Huerta, María Gómez Antúnez, Juan Francisco López Caleya, Francisco Arnalich Fernández, Martin Gericó-Aseguinolaza, Paula Maria Pesqueira Fontan, Nicolás Rhyman, Marina Prieto Dehesa, Juan Luis Romero Cabrera, Gema María García García, Gonzalo García-Casasola, Ane Labirua-Iturburu Ruiz, Francisco Javier Carrasco-Sánchez, Sara Martínez Hernández, Maria de Los Reyes Pascual Pérez, José López Castro, José Luis Serrano Carrillo de Albornoz, José F Varona, Ricardo Gómez-Huelgas, Juan-Miguel Antón-Santos, Carlos Lumbreras-Bermejo","doi":"10.29390/001c.118514","DOIUrl":"10.29390/001c.118514","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic lung disease (CLD), such as asthma or chronic obstructive pulmonary disease, were expected to have an increased risk of clinical manifestations and severity of COVID-19. However, these comorbidities have been reported less frequently than expected. Chronic treatment with inhaled corticosteroids (ICS) may impact the clinical course of COVID-19. The main objective of this study is to know the influence of chronic treatment with ICS on the prognosis of COVID-19 hospitalized patients with CLD.</p><p><strong>Methods: </strong>A multicenter retrospective cohort study was designed, including patients hospitalized with COVID-19. Epidemiological and clinical data were collected at admission and at seven days, and clinical outcomes were collected. Patients with CLD with and without chronic treatment with ICS were compared.</p><p><strong>Results: </strong>Two thousand five hundred ninety-eight patients were included, of which 1,171 patients had a diagnosis of asthma and 1,427 of COPD (53.37% and 41.41% with ICS, respectively). No differences were found in mortality, transfer to ICU, or development of moderate-severe ARDS. Patients with chronic ICS had a longer hospital stay in both asthma and COPD patients (9 vs. 8 days, <i>p =</i> 0.031 in asthma patients), (11 vs. 9 days, <i>p =</i> 0.018 in COPD patients); although they also had more comorbidity burden.</p><p><strong>Conclusions: </strong>Patients with chronic inhaled corticosteroids had longer hospital stays and more chronic comorbidities, measured by the Charlson comorbidity index, but they did not have more severe disease at admission, evaluated with qSOFA and PSI scores. Chronic treatment with inhaled corticosteroids had no influence on the prognosis of patients with chronic lung disease and COVID-19.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"86-94"},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of adding a six-month Pilates exercise program to three months of traditional community-based pulmonary rehabilitation in individuals with COPD: a prospective cohort study.","authors":"Marisela Barbosa, Cristina A de Melo, Rui Torres","doi":"10.29390/001c.117966","DOIUrl":"10.29390/001c.117966","url":null,"abstract":"<p><strong>Introduction: </strong>Pilates exercise may complement traditional pulmonary rehabilitation in individuals with chronic obstructive pulmonary disease (COPD). The objective was to analyze the effects of adding a six-month Pilates exercise program to a three-month pulmonary rehabilitation for individuals with COPD.</p><p><strong>Methods: </strong>Thirty-five participants with COPD (GOLD B) were assigned to the intervention (n=14) or control (n=21) group. Both groups received an initial three months of a pulmonary rehabilitation program. The intervention group further underwent six months of pilates. Participants were evaluated at baseline and at three, six, and nine months. Lung function and strength of respiratory muscles were defined as primary outcomes. Secondary outcomes included cardiac, physical function, and exacerbation episodes.</p><p><strong>Results: </strong>There were no consistent statistically significant differences between groups for the lung function outcomes (<i>p</i><0.05). Maximal inspiratory and expiratory pressure increased significantly at three months in both groups (<i>p</i><0.05). It was significantly superior in the intervention group at nine months for maximal inspiratory pressure (<i>p</i>=0.005) and six and nine months for maximal expiratory pressure (<i>p</i>=0.027 and <i>p</i><0.001, respectively). Changes in muscle strength (knee extension and handgrip) were comparable between groups (<i>p</i>>0.05), but exercise-induced fatigue and balance were significantly superior in the intervention group at the six- and nine-month follow-ups (<i>p</i><0.05).</p><p><strong>Discussion: </strong>Pilates exercise programs may be implemented to augment traditional pulmonary rehabilitation with the goal of improving the strength of respiratory muscles.</p><p><strong>Conclusion: </strong>Adding a Pilates exercise program to pulmonary rehabilitation resulted in superior strength of respiratory muscles, higher resistance to exercise-induced fatigue, and improved balance.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"68-85"},"PeriodicalIF":0.0,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11144029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141198999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proceedings from the Canadian Society of Respiratory Therapists Annual Conference May 3-5, 2024","authors":"","doi":"10.29390/001c.117111","DOIUrl":"https://doi.org/10.29390/001c.117111","url":null,"abstract":"Conference abstracts","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140982191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}