A randomized multi-arm repeated-measures prospective study of several modalities of portable oxygen delivery during assessment of functional exercise capacity.

BACKGROUND: Ambulatory oxygen is an important component of long-term oxygen therapy. Pulse-dose technology conserves oxygen and thus increases the operation time of a portable oxygen system. METHODS: We tested 4 ambulatory oxygen systems (Helios, HomeFill, FreeStyle, and the compressed-oxygen cylinder system we regularly provide for long-term oxygen therapy at our Veterans Affairs hospital) with 39 subjects with stage-IV chronic obstructive pulmonary disease. Each subject performed one 6-min walk test with each oxygen system, and we measured blood oxygen saturation (via pulse oximetry [S(pO(2))]), heart rate, and modified Borg dyspnea score, and surveyed the subjects' preferences about the oxygen systems. We also studied whether the 2 systems that provide gas with a lower oxygen concentration (from a home concentrator or portable concentrator) showed any evidence of not providing adequate oxygenation. RESULTS: With all 4 systems the mean pre-walk S(pO(2)) at the prescribed pulse-dose setting was 95-96%. The mean post-walk S(pO(2)) was 88-90% after each of the 4 walk tests. Between the 4 systems there were no statistically significant differences between the pre-walk-versus-post-walk S(pO(2)) ( = .42). With each system, the pre-walk-versus-post-walk S(pO(2)) difference was between -8% and -6%. CONCLUSIONS: Between these 4 ambulatory oxygen systems there were no significant differences in S(pO(2)), walk time, or walk distance, and there was no evidence of inadequate oxygenation with the 2 systems that provide a lower oxygen concentration.

Priorities, strategies, and accountability measures in interprofessional education.

PURPOSE: The purpose of this pilot study was to identify the priorities, strategies, and accountability measures for interprofessional education (IPE) being used by health professions programs, allied health colleges, and/or universities. METHOD: An electronic survey was sent to 114 deans, associate deans, and directors (program, clinical education, graduate studies) at six institutions with allied health programs, including three academic medical centers and three comprehensive public institutions. The survey consisted of basic demographic questions and questions assessing knowledge of the Interprofessional Education Collaborative (IPEC) concepts of IPE, program-specific accreditation requirements for IPE, and institutional priorities, strategies, and accountability measures for IPE activities. RESULTS: An overall response rate of 50% (57/114) was achieved with representation from a total of 34 different allied health programs. Chi-squared statistics showed statistically significant differences (p<0.05) between the frequencies of survey responses and institutional types in the inclusion of IPE in the college/school's vision, the physical space available to accommodate IPE needs, and the commitment to set aside time for IPE. CONCLUSION: This study found that there is not a clear mandate or direction from most allied health disciplinary accrediting bodies for IPE. While there appears to be distinct movement by institutions to hold programs accountable for IPE and to integrate IPE into the curricula, barriers remain that have slowed the desired degree of implementation of an interprofessional curricula. While institutions, college, and/or programs may be slow to formally include IPE in its vision, this study found that, in general, support is being provided for IPE activities.