Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Study Evaluating the Effects of a Structured Lifestyle Intervention on Daily Physical Activity Level of COPD Patients in the First, Second and Third Echelon.
Brief Summary: Chronic Obstructive Pulmonary Disease (COPD) is increasing in the Netherlands. COPD is characterized by a deterioration of lung function, a lowering physical activity level and a low state of quality of life.

The aim of this randomized controlled study is to investigate the effects of a structured lifestyle program compared with usual care (in the first, second and third echelon) on the physical activity level of COPD patients.

150 COPD patients (GOLD I-IV) will be included, aged between 40 and 80 years. In each echelon 25 patients will participate in a structured lifestyle program and 25 patients will be treated with usual care.

In the structured lifestyle program, patients will be stimulated individually to enhance a physically active lifestyle. The primary outcome parameter is daily physical activity (steps/ day) assessed with a pedometer.

According to the study protocol patients in the experimental group and the control group participate in four measurement sessions distributed over 15 months. In each assessment a physical fitness test, lung function and questionnaires are taken. Patients of the experimental group participate in five individual counseling sessions and one telephonic counseling.


Options:
A: Inclusion Criteria:

* Adults 40 years and above diagnosed with COPD according to GOLD criteria i.e. Forced expiratory volume in one second (FEV1)/ forced vital capacity (FVC) \< 0.70.
* Needs to understand Swedish or have access to anyone who understands Swedish.

Exclusion Criteria:

* Not COPD
B: Inclusion Criteria:

* confirmed COPD (GOLD stages B-D) according to GOLD-guidelines

Exclusion Criteria:

* Mental or physical disability (mini-mental score \<20) precluding informed consent or compliance with the protocol
* morphine medication
* Primary diagnosis of heart failure
* Uncontrolled arrhythmias causing symptoms or hemodynamic compromise
* Severe co-morbidity (acute coronary syndrome, unstable angina terminal renal failure, concomitant pulmonary embolism, very severe pneumonia: CURB65\>3)
* Severe untreated arterial hypertension at rest (\> 200 mm Hg systolic, \> 120 mm Hg diastolic)
C: Inclusion Criteria:

* Spirometry diagnosed COPD with FEV1/FVC ratio less than 70% and FEV1 less than 80% predicted
* clinically stable and exacerbation free in the past 4 weeks
* history of at least one COPD exacerbation in the past one year

Exclusion Criteria:

* patients allergic or intolerant to NAC
* Recent use of NAC in the past one month
* history of asthma, non COPD respiratory disorders like bronchiectasis, pneumoconiosis or any active pulmonary infection
* patients on long term steroid
* patients on long term oxygen therapy or non invasive ventilation
D: Inclusion Criteria:

* Age 40-80 years
* COPD GOLD stage I-IV
* Written informed consent

Exclusion Criteria:

* Comorbidity, like serious cardiovascular problems, serious limitations in neuromuscular performance and exacerbations in the previous two months, which can effect the outcome of the study.

Answer: D