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BackgroundChronic obstructive pulmonary disease (COPD) is a progressive chronic disease characterized by airflow obstruction that leads to shortness of breath and substantial negative impacts on health-related quality of life (HRQL). The course of COPD includes periodic acute exacerbations that require changes in treatment and/or hospitalizations. This study was designed to examine the responsiveness of Patient-Reported Outcomes Measurement Information System® (PROMIS®) measures to changes associated with COPD exacerbation recovery.MethodsA longitudinal analysis using mixed-effects models was conducted of people who were enrolled while stable (n = 100) and those who experienced an acute exacerbation (n = 85). PROMIS (physical function, pain interference, pain behavior, fatigue, anxiety, depression, anger, social roles, discretionary social activities, Global Health, dyspnea severity and dyspnea functional limitations) and COPD-targeted HRQL measures were completed at baseline and at 12 weeks.ResultsWe administered PROMIS measures using computer adaptive testing (CAT), followed by administration of any remaining short form (SF) items that had not yet been administered by CAT. Examination of the difference between group differences from baseline to 12 weeks in the stable and exacerbation groups revealed that the exacerbation group changed (improved) significantly more than the stable group in anxiety (p

PurposeThe Patient-Reported Outcomes Measurement Information System (PROMIS(®)) initiative was developed to advance the methodology of PROs applicable to chronic diseases. Chronic obstructive pulmonary disease (COPD) is a progressive chronic disease associated with poor health. This study was designed to examine the correlation of PROMIS health-related quality of life (HRQOL) scales and clinical measures among COPD patients.MethodsA cross-sectional analysis was conducted comparing patients who were stable (n = 100) with those currently experiencing a COPD exacerbation (n = 85). All PROMIS measures for adults available at the time of the study (2008), disease-targeted and other HRQOL instruments, health literacy, percent predicted FEV1, and a 6-min walk distance were assessed when patients were considered clinically stable.ResultsStable COPD patients reported significantly (p ≤ 0.05) better health-related quality of life on PROMIS domains than patients experiencing an exacerbation. PROMIS domain scores were significantly (p ≤ 0.01) correlated with each of legacy measures. Six-min walk scores were most highly correlated with the PROMIS physical function domain scores (r = 0.53) followed by the fatigue (r = -0.26), social (r = 0.24) and to a lesser extent depression (r = -0.23), and anxiety (r = -0.22) domain scores. Percent predicted FEV1 score was significantly associated with PROMIS physical function scores (r = 0.27).ConclusionThis study provides support for the validity of the PROMIS measures in COPD patients.

Pharmacotherapies and avoidance of environmental/inhaled toxins are core to managing COPD. Compared to the drugs available 50 years ago, there has been substantial progress with COPD pharmacotherapies, but gaps in adherence and inhaler use persist. Personalizing inhaled pharmacotherapies is now possible with digital technologies by objectively documenting adherence and guiding inhaler technique. Another means to improve existing pharmacotherapies is through phenotyping and biomarkers. This is especially important considering the heterogeneity of the disease COPD. Blood eosinophils are now a recommended biomarker to guide use of inhaled corticosteroids and biologics in COPD. On the near horizon, we will see new inhaled medications as dual phosphodiesterase inhibitors, drugs to treat basic protein abnormalities as in alpha-1 antitrypsin deficiency that could have remarkable benefits, and biologic drugs targeting specific cell/mediator types in the COPD population. Characterization of COPD phenotypes, as asthma/COPD overlap and comorbid heart disease are vital to understand how to optimize pharmacotherapies. Importantly, we must determine how to optimize current medications; otherwise, we will repeat the same mistakes with new medications. But as we know so well, as we peel one layer of complexity, we encounter many more questions, all the while dedicated to limiting the burden of COPD. [ABSTRACT FROM AUTHOR]

The purpose of this study is to determine whether differences in academic attainment between university students could be correlated with their use of English for academic purposes. Using the diagnostic language assessment procedure known as Measuring the Academic Skills of University Students (MASUS), as well as informal analysis of assignment feedback and interviews with students, students' performance in assignments in three subject areas was investigated. Results confirmed that there was a strong correlation between the overall scores students obtained in the MASUS language assessment and their attainment as represented by their assignment grade. However, analysis of the five separate categories of the MASUS scores showed that only the scores for the category, "use of source material," correlated strongly with student attainment and that the scores on the more explicit language categories, "structure and development of the text," "academic writing style," and "grammar," did not. The paper considers the implications of these findings for future studies of the role of English for academic purposes in students' attainment and for EAP pedagogy. (Contains 1 table.)

Two approaches to English for Academic Purposes (EAP) research and teaching which have arisen in recent years are systemic functional linguistics (SFL) approaches in Australia and elsewhere (e.g. Hood, 2006; Lee, 2010; Woodward-Kron, 2009) and Academic Literacies approaches in the UK and elsewhere (e.g. Lillis & Scott, 2008; Thesen & Pletzen, 2006; Turner, 2004). Although these approaches both draw from ethnographic and sociocultural traditions, they have tended to focus on different aspects of EAP. SFL as a theory of language has employed linguistic analysis to establish the nature of disciplinary discourses and ways of encouraging students to engage in these discourses; research and pedagogy have concentrated on texts, language in use and the language system. Academic Literacies as a research paradigm has maintained a strong commitment to ethnographic investigation and to critiquing dominant academic and institutional practices; methods have concentrated on identifying practices, student identities, and conflicts that individual language users experience in university writing. This article reflects on the two approaches by reviewing their two literatures, uncovering key questions that characterise each, and illuminating similarities and difference in epistemology and methodology. The article concludes by recognising the potential of dialogue and collaboration across the SFL and Academic Literacies research and teaching communities to address current imperatives facing EAP.

On film studies courses, students are asked to treat as objects of study the same films which they may more commonly experience as entertainment. To explore the role of academic writing in this, an action research project was carried out on a university film studies course using a systemic functional linguistics approach. This paper presents a key assessment essay genre, referred to as a "taxonomic film analysis". This genre was analysed drawing on the work of Halliday and Mathiessen (2004), Martin (1992) and Lemke, (1985, 1990), focussing on three aspects: the genre acts performed in the process of analysing film; the conceptual frameworks of film studies knowledge, or "thematic formations" (Lemke, 1993) drawn on and re-constituted in the assignment; the particular ways that language is used to perform these acts and build these thematic formations. For EAP to be relevant to film students, it is proposed that EAP specialists need to engage with these three aspects of film study. This application of SFL in film studies EAP is intended as an illustration of how SFL tools can be used for relevant EAP provision across the HE curriculum. (Contains 5 figures.)

Economic forecasting in the world of international finance confronts economists with challenging cross-cultural writing tasks. Producing forecasts in English which convey confidence and credibility entails an understanding of linguistic conventions which typify the genre. A typical linguistic feature of commercial economic forecasts produced by British or US banks is a wide range of modal forms. These can be seen as "hedging" devices, expressing the forecaster's degree of certainty about predictions in the forecast. This article draws on recent accounts of modalisation which elaborate on the notion of "hedging". The article is based on a study of English language forecasts carried out by the author, motivated by the resistance of a group of Dutch economists to using a wide range of modals in their English language forecasts. The study suggested that modalisation in English language forecasts contributes to the performance of three major functions: "Conversation, Discrimination and Organisation." "Conversation" refers to the dialogue--or the appearance of it--constructed by forecasters with their readership and the wider economics community. "Discrimination" refers to the way interpretations of the economy are woven into a plausible construct of the future by foregrounding and backgrounding predictions. "Organisation" refers to the means whereby forecasters construct a text in order to realise the "Conversation" and "Discrimination" effectively.