***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Interstitial lung disease ( ILD ) is characterised by exertional dyspnoea , exercise limitation and reduced quality of life . The role of exercise training in this diverse patient group is unclear . The aims of this study were to establish the safety of exercise training in ILD ; its effects on exercise capacity , dyspnoea and quality of life ; and whether patients with idiopathic pulmonary fibrosis ( IPF ) had similar responses to those with other types of ILD . Methods : 57 subjects with ILD ( 34 IPF ) were r and omised to receive 8 weeks of supervised exercise training or weekly telephone support . The 6 min walk distance ( 6MWD ) , incremental exercise test , modified Medical Research Council ( MRC ) dyspnoea score and Chronic Respiratory Disease Question naire ( CRDQ ) were performed at baseline , following intervention and at 6 months . Results : 80 % of subjects completed the exercise programme and no adverse events were recorded . The 6MWD increased following training ( mean difference to control 35 m , 95 % CI 6 to 64 m ) . A significant reduction in MRC score was observed ( 0.7 points , 95 % CI 0.1 to 1.3 ) along with improvements in dyspnoea ( p = 0.04 ) and fatigue ( p<0.01 ) on the CRDQ . There was no change in peak oxygen uptake ;  however , exercise training  reduced heart rate at maximum isoworkload ( p = 0.01 ) . There were no significant differences in response between those with and without IPF . After 6 months there were no differences between the training and control group for any outcome variable . Conclusions : Exercise training improves exercise capacity and symptoms in patients with ILD , but these benefits are not sustained 6 months following intervention . Trial registration number : Background Exercise training is of benefit for patients with restrictive lung disease . However , it tends to be intolerable for those with severe disease . We examined whether providing ventilatory assistance by using negative pressure ventilators ( NPV ) during exercise training is feasible for such patients and the effects of training . Methods 36 patients with restrictive lung disease were prospect ively enrolled for a 12-week multidisciplinary rehabilitation program . During this program , half of them ( n:18 ; 60.3 ± 11.6 years ; 6 men ; FVC : 32.5 ± 11.7 % predicted ) received regular sessions of exercise training under NPV , whilst the 18 others ( 59.6 ± 12.3 years ; 8 men ; FVC : 37.7 ± 10.2 % predicted ) did not . Exercise capacity , pulmonary function , dyspnea and quality of life were measured . The primary endpoint was the between-group difference in change of 6 minute-walk distance ( 6MWD ) after 12 weeks of rehabilitation . Results All patients in the NPV-exercise group were able to tolerate and completed the program . The between-group differences were significantly better in the NPV-exercise group in changes of 6MWD ( 34.1 ± 12.7 m vs. -32.5 ± 17.5 m ; P = 0.011 ) and St George Score ( −14.5 ± 3.6 vs. 11.8 ± 6.0 ; P < 0.01 ) . There was an improvement in dyspnea sensation ( Borg ’s scale , from 1.4 ± 1.5 point to 0.8 ± 1.3 point , P = 0.049 ) and a small increase in FVC ( from 0.85 ± 0.09 L to 0.91 ± 0.08 L , P = 0.029 ) in the NPV-exercise group compared to the control group . Conclusion Exercise training with NPV support is feasible for patients with severe restrictive lung diseases , and improves exercise capacity and health-related quality of life In recent years quality of life instruments have been featured as primary outcomes in many r and omized trials . One of the challenges facing the investigator using such measures is determining the significance of any differences observed , and communicating that significance to clinicians who will be applying the trial results . We have developed an approach to elucidating the significance of changes in score in quality of life instruments by comparing them to global ratings of change . Using this approach we have established a plausible range within which the minimal clinical ly important difference ( MCID ) falls . In three studies in which instruments measuring  dyspnea , fatigue , and emotional function in patients with chronic heart and lung disease were applied the MCID was represented by mean change in score of approximately 0.5 per item , when responses were presented on a seven point Likert scale . Furthermore , we have established ranges for changes in question naire scores that correspond to moderate and large changes in the domains of interest . This information will be useful in interpreting question naire scores , both in individuals and in groups of patients participating in controlled trials , and in the planning of new trials Background : Pulmonary rehabilitation is a well-recognized treatment option in chronic obstructive lung disease improving exercise performance , respiratory symptoms and quality of life . In occupational respiratory diseases , which can be rather cost-intensive due to the compensation needs , very little information is available . Objectives : This study aims at the evaluation of the usefulness of pulmonary rehabilitation in patients with occupational respiratory diseases , partly involving complex alterations of lung function and of the sustainability of effects . Methods : We studied 263 patients with occupational respiratory diseases ( asthma , silicosis , asbestosis , chronic obstructive pulmonary disease ) using a 4-week inpatient rehabilitation program and follow-up examinations 3 and 12 months later . The outcomes evaluated were lung function , 6-min walking distance ( 6MWD ) , maximum exercise capacity ( Wmax ) , skeletal muscle strength , respiratory symptoms , exacerbations and associated medical consultations , quality of life ( SF-36 , SGRQ ) , anxiety/depression ( HADS ) and Medical Research Council and Baseline and Transition Dyspnea Index scores . Results : Compared to baseline , there were significant ( p < 0.05 ) improvements in 6MWD , Wmax and muscle strength immediately after rehabilitation , and these were maintained over 12 months ( p < 0.05 ) . Effects were less pronounced in asbestosis . Overall , a significant reduction in the rate of exacerbations by 35 % , antibiotic therapy by 27 % and use of health care services by 17 % occurred within 12 months after rehabilitation . No changes were seen in the question naire outcomes . Conclusions : Pulmonary rehabilitation is effective even in the complex setting s of occupational respiratory diseases , providing sustained improvement of functional capacity and reducing health care utilization BACKGROUND Interval ( IT ) and continuous training ( CT ) represent well-established exercise modalities in patients with moderate to severe chronic obstructive pulmonary disease ( COPD ) . However , their effects and feasibility in patients with end-stage COPD remain unclear . METHODS Sixty patients ( 53 ± 6 years , 53 % women ) being evaluated for lung transplantation where r and omly assigned either to IT ( n = 30 , cycling at 100 % peak work rate for 30 seconds alternating with 30 seconds of rest ) or CT ( n = 30 , cycling at 60 % of peak work rate ) during a 3-week inpatient rehabilitation program . Both exercise protocol s yielded an equivalent amount of total work . Patients had a mean forced expiratory volume at 1 second ( FEV(1 ) ) of 25 % ± 8 % of predicted value . RESULTS Patients in both groups achieved similar clinical ly relevant improvements in 6-minute walking distance of 35 ± 29 meters for IT and 36 ± 43 meters for CT , with a between-group difference of 0.3 meters ( 95 % confidence interval , -18.2 to 18.8 ) . Changes in lung function parameters were not significant . Perceived intensity of dyspnea was significantly ( p < 0.05 ) lower in IT ( Borg 6.2 ± 1.8 ) compared with CT ( Borg 7.1 ± 1.7 ) . Patients required a median of 5 unintended breaks ( interquartile range , 2 - 28 ) during IT exercise and 29 ( interquartile range , 6 - 68 ) during CT ( p < 0.001 ) . CONCLUSIONS IT is associated with a lower intensity of dyspnea during exercise and fewer unintended breaks but achieves similar improvements in exercise capacity compared with CT in pre-lung transplant COPD patients Background The study aim ed to determine the short and long-term effects of exercise training on exercise capacity and health-related quality of life ( HRQoL ) compared to usual care in people with dust-related pleural and interstitial respiratory diseases . No previous studies have specifically evaluated exercise training in this patient population . Methods Participants with a diagnosis of a dust-related respiratory disease including asbestosis and asbestos related pleural disease were recruited and r and omised to an eight-week exercise training group ( EG ) or a control group ( CG ) of usual care .  Six-minute walk distance ( 6MWD ) , St George ’s Respiratory Question naire ( SGRQ ) and Chronic Respiratory Disease Question naire ( CRQ ) were measured at baseline , eight weeks and 26 weeks by an assessor blinded to group allocation . Results Thirty-three of 35 male participants completed the study . Sixty-nine percent of participants had asbestos related pleural disease . At eight weeks , compared to the CG , the EG showed a significantly increased 6MWD ( mean difference ( 95%CI ) ) 53 metres ( 32 to 74 ) , improved SGRQ total score , -7 points ( -13 to -1 ) and increased CRQ total score , 6.4 points ( 2.1 to 10.7 ) . At 26 weeks significant between-group differences were maintained in 6MWD , 45 metres ( 17 to 73 ) and CRQ total score , 13.1 points ( 5.2 to 20.9 ) . Conclusion Exercise training improved short and long-term exercise capacity and HRQoL in people with dust-related pleural and interstitial respiratory diseases . Clinical trial registration numberANZCTR12608000147381 . Date trial registered : 27.03.2008 OBJECTIVE Asbestos exposure is causally associated with the development of malignant mesothelioma ( MM ) , which is increasingly being reported after exposure to  asbestos  fibro sheeting in Australia . In this study , we investigate self-reported non-occupational asbestos exposure during home renovation in New South Wales . DESIGN AND SETTING Cross-sectional mailed question naire examining renovation activity , tasks undertaken during renovation and self-reported exposure to asbestos among respondents and their family members in NSW between January and June 2008 . PARTICIPANTS 10 000 adults aged 18 - 99 years , r and omly selected from the NSW electoral roll . We received 3612 responses , while 365 question naires did not reach addressees , giving an overall response rate of 37.5 % . MAIN OUTCOME MEASURES Differences in self-reported asbestos exposure between do-it-yourself ( DIY ) and non-DIY renovators . RESULTS 1597 participants ( 44.2 % ) had renovated their home and among these , 858 participants ( 53.7 % ) self-reported as DIY renovators . Of these , 527 ( 61.4 % ) reported asbestos exposure during home renovations , 337 ( 39.3 % ) reported that their partner had been exposed to asbestos during renovations , and 196 ( 22.8 % ) reported that their children had been exposed . More than 20 % of renovators planned to further renovate their current homes within the next 5 years . CONCLUSIONS Self-reported asbestos exposure during home renovation is common . This preventable exposure could place adults and children at risk of MM many years into the future . Although such exposure is self-reported and ideally should be verified , this study identifies a potentially important problem in NSW Background Interstitial lung disease encompasses a diverse group of chronic lung conditions characterised by distressing dyspnoea , fatigue , reduced exercise tolerance and poor health-related quality of life . Exercise training is one of the few treatments to induce positive changes in exercise tolerance and symptoms , however there is marked variability in response . The aetiology and severity of interstitial lung disease may influence the response to treatment . The aims of this project are to establish the impact of exercise training across the range of disease severity and to identify whether there is an optimal time for patients with interstitial lung disease to receive exercise training . Methods / Design One hundred and sixteen participants with interstitial lung disease recruited from three tertiary institutions will be r and omised to either an exercise training group ( supervised exercise training twice weekly for eight weeks ) or a usual care group ( weekly telephone support ) . The 6-minute walk distance , peripheral muscle strength , health-related quality of life , dyspnoea , anxiety and depression will be measured by a blinded assessor at baseline , immediately following the intervention and at six months following the intervention . The primary outcome will be change in 6-minute walk distance following the intervention , with planned subgroup analyses for participants with idiopathic pulmonary fibrosis , dust-related interstitial lung disease and connective-tissue related interstitial lung disease . The effects of disease severity on outcomes will be evaluated using important markers of disease severity and survival , such as forced vital capacity , carbon monoxide transfer factor and pulmonary hypertension . Discussion This trial will provide certainty regarding the role of exercise training in interstitial lung disease and will identify at what time point within the disease process this treatment is most effective 
    Output:
    
Exercise training did not result in improvements in the Modified Medical Research Council ( MMRC ) dyspnoea scale immediately following exercise training or six months following exercise training .
The improvements following exercise training were similar in a subgroup of participants with dust-related ILDs and in a subgroup of participants with ARPD compared to the control group , with no statistically significant differences in treatment effects between the subgroups .