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Objectives: The 22‐question SinoNasal Outcome Test (SNOT‐22) assesses chronic rhinosinusitis (CRS) severity. We aimed to identify predictors of SNOT‐22 score improvement following highly effective modulator therapy (HEMT) initiation and to corroborate the SNOT‐22 minimal clinically important difference (MCID) in adults with cystic fibrosis (CF). Methods: Prospective observational data was pooled from four studies across 10 US centers investigating people with CF (PwCF) and CRS. Three studies evaluated HEMT's impact on CRS. For participants enrolled prior to HEMT initiation, SNOT‐22 scores were obtained at baseline and after 3–6 months of HEMT. Multivariate regression identified predictors of improvement. Cronbach's alpha and four distribution‐based methods were used to assess internal consistency and calculate the MCID of the SNOT‐22. Results: A total of 184 PwCF participated with mean baseline SNOT‐22 scores ranging from 18.1 to 56.7. Cronbach's alpha was ≥0.90 across sites. Participants at sites with pre‐ and post‐HEMT data reported improvement in SNOT‐22 scores after initiating HEMT (all p < 0.05). Worse baseline SNOT‐22 score (odds ratio (OR): 1.05, p < 0.001, 95% CI: 1.02–1.08), F508del homozygosity (OR: 4.30, p = 0.040, 95% CI: 1.14–18.99), and absence of prior modulator therapy (OR: 4.99, p = 0.017, 95% CI: 1.39–20.11) were associated with greater SNOT‐22 improvement. The mean MCID calculated via distribution‐based methods was 8.5. Conclusion: Worse baseline sinonasal symptoms, F508del homozygosity, and absence of prior modulator therapy predicted greater improvement after HEMT initiation. The mean MCID for SNOT‐22 in PwCF is 8.5 points, similar to non‐CF individuals with CRS, and provides a threshold specifically for PwCF. The SNOT‐22 has strong internal consistency in PwCF. Level of Evidence: 3 Laryngoscope, 134:3965–3973, 2024 [ABSTRACT FROM AUTHOR]

Purpose. The purpose of this study was to pilot a home-based pulmonary rehabilitation (PR) program administered via a telemedicine approach using a combination of fitness application and self-selected activity in lung transplant candidates with cystic fibrosis (CF). Methods. We recruited adult patients with CF. The main outcome was adherence, measured by number of sessions completed in 12 weeks. Secondary outcomes were adverse events, six-minute walk distance (6MWD), and dyspnea. Participants were provided a personalized exercise program and equipment including a fitness application that provided exercise videos, recorded exercise time, and corresponding heart rate. We reviewed data daily and provided text messages with feedback. We compared our study outcomes to a retrospective data set of CF patients who participated in a 24-session outpatient hospital-based PR program. Data presented as mean ± standard deviation. Results. Eleven patients participated in the home PR program, 45% female, age 33 ± 7 years , FEV1 27 ± 5 % predicted. Sessions completed were 19 ± 12 home-based PR vs. 9 ± 4 hospital-based PR, p =.03. Fifty percent of the home-based group completed ≥24 sessions in 12 weeks versus 0% of the hospital-based patients (p =.03). There were no adverse events during exercise. Completers of the home-based program demonstrated a clinically meaningful lower decline in 6 MWD than noncompleters (6MWD − 7 ± 15 vs. − 86 ± 108 meters). Only one participant performed a post 6 MWD in the hospital-based PR. Conclusion. Patients with severe CF demonstrated adherence to home PR delivered using fitness application and self-selected activity with no adverse events. This program style may be a viable solution for telerehabilitation in severe CF and is particularly relevant in the COVID era. [ABSTRACT FROM AUTHOR]

The Weipa Mission (1898-1932) on Cape York Peninsula (north-eastern Australia) was one of seven Australian missions designed and staffed by the Moravian Church during the nineteenth and early twentieth centuries. We present findings of archaeological and historical research that illustrate key aspects of the settlement's development and operations. Moravian missionaries at Weipa aimed to create a built landscape that reshaped Aboriginal social, cultural and economic relations, with particular emphasis on children through the use of a dormitory system. However, their efforts were mediated by the open spatial and social boundaries of the settlement, which enabled Aboriginal people to make choices about the nature and extent to which they engaged with the mission. Adopting a political economy approach, we show that this openness emerged through complex social relationships between missionaries and Aboriginal people. While missionaries required access to children and adults, they lacked the ability (or will) to maintain a resident population through force, with limited financial resources also hampering their activities. Instead, Aboriginal people came and went from the settlement, with some establishing and maintaining social relationships with missionaries to access economic and social benefits. We argue that these social relationships led to the development of the settlement as a more open domain. [ABSTRACT FROM AUTHOR]