Laughter and humor therapy have been used in health care to achieve physiological and psychological health-related benefits. The application of these therapies to the dialysis context remains unclear. This paper reviews the evidence related to laughter and humor therapy as a medical therapy relevant to the dialysis patient population. Studies from other groups such as children, the elderly, and persons with mental health, cancer, and other chronic conditions are included to inform potential applications of laughter therapy to the dialysis population. Therapeutic interventions could range from humorous videos, stories, laughter clowns through to raucous simulated laughter and Laughter Yoga. The effect of laughter and humor on depression, anxiety, pain, immunity, fatigue, sleep quality, respiratory function and blood glucose may have applications to the dialysis context and require further research.
Both quality management and the use of information technology have been widely researched over recent years. However, there has been no well-founded empirical research on the two together ± on how IT can support quality management practices. This paper presents a research instrument to be used in such research. In order to measure the extent to which IT supports QM, the construct``quality management, supported by information technology'' was operationalised. Data from 110 public organisations that have applied for the Malaysian Prime Minister's Quality Award (Public Sector) were gathered in a field survey to enable a rigorous examination of the construct operationalised. Analysis of literature suggested eight dimensions of quality management, namely leadership, output quality assurance, strategic planning process, human resource utilisation, important innovations, information and analysis, customer satisfaction, and quality results. The research findings supported this and suggested a ninth dimension, supplier quality assurance. The empirical work indicated that``quality management supported by information technology'' construct demonstrate the key psychometric properties including reliability, construct validity, and predictive validity.
Paradoxical vocal cord movement is more often associated with asthma symptoms accompanied by airflow limitation and dysfunctional breathing. Further studies are needed to determine whether PVCM is induced by dysfunctional breathing practices and/or airway obstruction. How PVCM links with symptomatic asthma and VCD also requires evaluation.
BackgroundDietary nitrate supplementation has been shown to decrease the oxygen cost of exercise and prolong exercise tolerance, as measured by sub-maximal exercise endurance distance and time at 85% V̇O2max, in both elite athletes and normal healthy subjects. Patients with chronic obstructive pulmonary disease (COPD) have reduced quality of life and ability to perform activities of daily living attributable to diminished exercise tolerance, and dietary nitrate may be able to ameliorate this.MethodsWe performed a double-blind, computer-randomized placebo control crossover trial at a tertiary Australian hospital to investigate whether dietary nitrate supplementation as beetroot juice (BR) would augment submaximal exercise endurance in individuals with spirometrically confirmed stable moderate COPD. Volunteers underwent an incremental shuttle walk test to determine V̇O2max followed by a test dose of BR to establish safety in the study population. Participants performed an endurance shuttle walk test (ESWT) at 85% V̇O2max after randomization to either a 3 day wash-in of BR (4.8 mmol twice a day) or placebo (nitrate deplete BR), with a final dose on the morning of testing. They then crossed over after 4 day washout. Repeated measures two sided paired t-tests were employed.Results35 participants were recruited with 19 completing the trial. In the initial safety phase, we measured systolic blood pressure over four hours post first dose of BR, and found a mean 10 mmHg decrement maximal at 1 hour. One individual developed symptomatic postural hypotension and was excluded. The primary outcomes of ESWT distance and time to fatigue improved by 11% and 6% respectively; however these differences did not achieve statistical significance (p = 0.494 and 0.693 respectively).ConclusionsOur study does not support a role for routine dietary nitrate supplementation for enhancement of exercise endurance in COPD.Trial registrationAustralia and New Zealand Clinical Trial Register: ACTRN12611001088932Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-015-0057-4) contains supplementary material, which is available to authorized users.
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