The causes of misdiagnosis of COPD are attributable mainly to spirometry and to the healthcare professional performing the diagnostic assessment. With a view to limiting misdiagnosis of COPD, future research should help clarify strategies for alternative objective tests for determining if a patient has COPD and explore how to better support primary care in the diagnosing of COPD.

This study addresses development of a content-valid cross-Nordic version of the Housing Enabler and investigation of its inter-rater reliability when used in occupational therapy rating situations, involving occupational therapists, clients, and their home environments. The instrument was translated from the original Swedish version of the Housing Enabler, and adapted according to accessibility norms and guidelines for housing design in Sweden, Denmark, Finland, and Iceland. This iterative process involved occupational therapists, architects, building engineers, and professional translators, resulting in the Nordic Housing Enabler. For reliability testing, the sampling strategy and data collection procedures used were the same in all countries. Twenty voluntary occupational therapists, pair-wise but independently of each other, collected data from 106 cases by means of the Nordic Housing Enabler. Inter-rater reliability was calculated by means of percentage agreement and kappa statistics. Overall good percentage agreement for the personal and environmental components of the instrument was shown, indicating that the instrument was sufficiently reliable for application in practice and research in the Nordic context. The varying kappa results highlight the need for further study in order to understand the influence of prevalence more profoundly, which should be kept in mind when interpreting the results.

This study supports the use of the Danish version of the ETUQ in a sample of older adults with or without COPD. Application to practice: The Danish version of the ETUQ is an evidence-based evaluation that can reliably contribute to clinical occupational therapy and research in Denmark focusing on everyday technology use.

The aim was to explore the use of an activity-based approach to determine the validity of a set of housing standards addressing accessibility. This included examination of the frequency and the extent of accessibility problems among older people with physical functional limitations who used no mobility device (n=10) or who used a wheelchair (n=10) or a rollator (n=10). The setting was a kitchen designed according to current housing standards. The participants prepared lunch in the kitchen Accessibility problems were assessed by observation and self-report. Differences between the three participant groups were examined. Performing well-known kitchen activities was associated with accessibility problems for all three participant groups, in particular those using a wheelchair. The overall validity of the housing standards examined was poor. Observing older people interacting with realistic environments while performing real everyday activities seems to be an appropriate method for assessing accessibility problems.

Based on the presented stepwise approach, a high-fidelity Housing Enabler prototype app was successfully developed. The development process has emphasized the importance of combining design participants' knowledge and experiences, and has shown that methods should seem relevant to participants to increase their engagement.