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Sample records for asthma doctors completing

  1. Completion Mindsets and Contexts in Doctoral Supervision

    Science.gov (United States)

    Green, Pam; Bowden, John

    2012-01-01

    Purpose: Doctoral candidates are now located within a research context of performativity where the push to successfully complete in a timely manner is central. The purpose of this paper is to develop a model of completion mindset within a completion context to assist research students and supervisors. Design/methodology/approach: The research was…

  2. Doctoral Dissertations Recently Completed or in Progress.

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    Miller, Louise

    1994-01-01

    Reviews six doctoral dissertations currently in progress or completed during 1993 that may be of interest to those in the school library media field. Topics include technology; information seeking; literacy; the portrayal of African American males in realistic fiction picture books; and the role of youth services librarians. (KRN)

  3. Drug prescription pattern for asthma among nigerian doctors in general practice: A cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Ademola E Fawibe

    2012-01-01

    Conclusion: The poor anti-asthma prescribing behavior among these doctors is associated with a low level of participation at update training on asthma management and poor awareness of asthma guidelines. The Nigerian Medical Association and the Nigerian Thoracic Society should urgently address these problems.

  4. What Works for Doctoral Students in Completing Their Thesis?

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    Lindsay, Siân

    2015-01-01

    Writing a thesis is one of the most challenging activities that a doctoral student must undertake and can represent a barrier to timely completion. This is relevant in light of current and widespread concerns regarding doctoral completion rates. This study explored thesis writing approaches of students post or near Ph.D. completion through…

  5. Inhaled medication for asthma management: evaluation of how asthma patients, medical students, and doctors use the different devices

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    Muniz Janaína Barbosa

    2003-01-01

    Full Text Available Asthma results from a combination of three essential features: airflow obstruction, hyperresponsiveness of airways to endogenous or exogenous stimuli and inflammation. Inadequacy of the techniques to use different inhalation devices is one of the causes of therapeutic failure. The main purpose of this study was to evaluate how 20 medical students, 36 resident physicians of Internal Medicine/Pediatrics, and 40 asthma patients used three devices for inhalation therapy containing placebo. All patients were followed at the Pulmonary Outpatient Service of Botucatu Medical School and had been using inhaled medication for at least six months. The following devices were evaluated: metered dose inhalers (MDI, dry powder inhalers (DPI, and MDI attached to a spacer device. A single observer applied a protocol containing the main steps necessary to obtain a good inhaler technique to follow and grade the use of different devices. Health care professionals tested all three devices and patients tested only the device being used on their management. MDI was the device best known by doctors and patients. MDI use was associated with errors related to the coordination between inspiration and device activation. Failure to exhale completely before inhalation of the powder was the most frequent error observed with DPI use. In summary, patients did not receive precise instruction on how to use inhaled medication and health care professionals were not well prepared to adequately teach their patients.

  6. The Relation of Asthma and Allergic Diseases Diagnosed by Doctor with Fast Foods in Schoolchildren

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    Betül Battaloğlu İnanç

    2014-06-01

    Full Text Available Objective: It would not be right to link the reasons for the worldwide increase in incidents of childhood obesity and those of allergic diseases only to genetics. Obesity, asthma and allergic diseases can be prevented through the consumption of healthy food. In this study, children’s eating habits, obesity, asthma and other allergic diseases were intended to determine their relationship with each other. Methods: In a high socioeconomic level school in Mardin , asthma and allergic diseases of children aged between 7-15 were diagnosed by a doctor, and their eating habits between meals, food types they buy from the school canteen and their family data were determined by survey. Results: Obesity and overweight was higher with the boys than the girls. 21.7% of the girls , 13.4% of the boys had allergic diseases. Allergic diseases were remarkably frequent with girls (p<0.0001. 1.6% of the girls and 2.3% of the boys had asthma. Allergic diseases was higher with the overweight and obese groups. Children who had breakfast regularly had significantly less tendency to be overweight or obese (p<0.00001. Conclusion: Genetic predisposition is the most important factor in emerging obesity and allergic diseases. However, it is not possible to explain the worldwide increase of obesity, allergic diseases and asthma only by genetics. The part played by complex dietary factors should be explained for obesity, asthma and other allergic diseases and understood through a multidisciplinary approach.

  7. Completing the Three Stages of Doctoral Education: An Event History Analysis

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    Ampaw, Frim D.; Jaeger, Audrey J.

    2012-01-01

    Doctoral programs have high dropout rates of 43% representing the highest among all post-baccalaureate programs. Cross sectional studies of doctoral students' retention have showed the importance of financial aid in predicting degree completion. These studies however, do not estimate the labor market's effect on doctoral student retention and…

  8. Predictors of Timely Doctoral Student Completions by Type of Attendance: The Utility of a Pragmatic Approach

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    Rodwell, John; Neumann, Ruth

    2008-01-01

    Federal government changes to the funding of doctoral students have focused the attention of university management on their completion rates. The aims of this paper are to inform the allocation of institutional resources in a manner that improves the likelihood of timely doctoral completions and to highlight a process that can also be used for…

  9. Doctoral Theses in Library and Information Science Completed in Indian Universities, 2001-2007

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    Mestri, D. D.

    2008-01-01

    Provides a complete listing and analysis of 219 doctoral theses submitted to the departments of library and information science (DLIS) in 45 Indian universities between January 2001 and December 2007. (Contains 10 tables.)

  10. A study of the lived experiences of African American women STEM doctoral degree completers

    Science.gov (United States)

    Squires, Stephanie Michelle

    This study examined the lived experiences of African American women (AAW) who completed doctoral degrees in a STEM (science, technology, engineering, and mathematics) discipline in the United States. This study sought to fill the gap in the literature by examining how AAW described and made meaning of lived STEM educational experiences during doctoral degree completion in the context of the intersection of being African American and a woman. This study utilized a theoretical perspective based upon three theories: (a) critical race theory as a framework to gather AAW's narratives about STEM doctorate education, (b) Black feminist thought as a framework to view the intersection of being African American and a woman in the United States, and (c) the science identity model as a framework to view how women of color successfully complete scientific graduate degrees. Participants revealed that being an African American and a woman in a STEM doctoral program often complicated an already difficult process of completing the doctoral degree. The participants described the educational experience as challenging, particularly the writing of the dissertation. The challenges that the participants faced were due to various factors such as difficult advisor/advisee relationships, tedious writing and revision processes, politics, and lack of information regarding the doctoral degree process. The findings suggested that AAW participants confronted intrinsic bias while completing STEM doctoral degrees, which led to isolation and feelings of being an impostor---or feelings of not belonging in scientific studies. The findings also indicated that the women in this study ascribed success in dissertation writing and degree completion to one or more of the following attributes: (a) having a clear plan, (b) taking ownership of the writing process, (c) having an engaged advisor, (d) learning the writing style of the advisor, (e) understanding the temperament of the advisor, (f) personal will

  11. The Relationship between Doctoral Completion Time, Gender, and Future Salary Prospects for Physical Scientists

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    Potvin, Geoff; Tai, Robert H.

    2012-03-01

    Drawing from a national survey of Ph.D.-holding physical scientists, we present evidence that doctoral completion time is a strong predictor of future salary prospects: each additional year in graduate school corresponds to a substantially lower average salary. This is true even while controlling for typical measures of scientific merit (grant funding and publication rates) and several other structural and career factors expected to influence salaries. Extending this picture to include gender effects, we show that women earn significantly less than men overall and experience no effect of doctoral completion time on their salaries, while men see a significant gain in salary stemming from earlier completion times. Doctoral completion time is shown to be largely unconnected to measures of prior academic success, research independence, and scientific merit suggesting that doctoral completion time is, to a great extent, out of the control of individual graduate students. Nonetheless, it can be influential on an individual's future career prospects, as can gender-related effects.

  12. Timely Doctoral Completion Rates in Five Fields: A Two-Part Study

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    Miller, Angela Melissa

    2013-01-01

    Roughly half of all doctoral students who begin a program do not continue through graduation, and many of them face significant financial losses and emotional burdens as a result. Although this completion rate has stayed fairly constant for the past few decades, it has recently gained attention on a national level. In 2011, the National Research…

  13. Can Low-Cost Support Programmes with Coaching Accelerate Doctoral Completion in Health Science Faculty Academics?

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    Geber, Hilary; Bentley, Alison

    2012-01-01

    Career development for full-time Health Sciences academics through to doctoral studies is a monumental task. Many academics have difficulty completing their studies in the minimum time as well as publishing after obtaining their degree. As this problem is particularly acute in the Health Sciences, the PhD Acceleration Programme in Health Sciences…

  14. Do You Have Work-Related Asthma? A Guide for You and Your Doctor

    Science.gov (United States)

    ... Industry& pID= 278. 5. Consider referral to an occupational medicine, pulmonary and/or allergy specialist for supplemental testing ... other states, contact your local health or labor department.) • NIOSH Asthma and Allergies web page: www. cdc. ...

  15. Asthma

    Directory of Open Access Journals (Sweden)

    Kim Harold

    2011-11-01

    Full Text Available Abstract Asthma is the most common respiratory disorder in Canada. Despite significant improvement in the diagnosis and management of this disorder, the majority of Canadians with asthma remain poorly controlled. In most patients, however, control can be achieved through the use of avoidance measures and appropriate pharmacological interventions. Inhaled corticosteroids (ICSs represent the standard of care for the majority of patients. Combination ICS/long-acting beta2-agonists (LABA inhalers are preferred for most adults who fail to achieve control with ICS therapy. Allergen-specific immunotherapy represents a potentially disease-modifying therapy for many patients with asthma, but should only be prescribed by physicians with appropriate training in allergy. Regular monitoring of asthma control, adherence to therapy and inhaler technique are also essential components of asthma management. This article provides a review of current literature and guidelines for the appropriate diagnosis and management of asthma.

  16. Asthma

    Science.gov (United States)

    ... 1.25 million of those individuals have severe asthma, a condition that can be difficult to control and treat. Learn more about his research by visiting the NHLBI Laboratory of Asthma and Lung Inflammation website: http://www.nhlbi.nih. ...

  17. Asthma

    OpenAIRE

    Kim, Harold; Mazza, Jorge

    2011-01-01

    Asthma is the most common respiratory disorder in Canada. Despite significant improvement in the diagnosis and management of this disorder, the majority of Canadians with asthma remain poorly controlled. In most patients, however, control can be achieved through the use of avoidance measures and appropriate pharmacological interventions. Inhaled corticosteroids (ICSs) represent the standard of care for the majority of patients. Combination ICS/long-acting beta2-agonists (LABA) inhalers are pr...

  18. Asthma

    OpenAIRE

    Kim Harold; Mazza Jorge

    2011-01-01

    Abstract Asthma is the most common respiratory disorder in Canada. Despite significant improvement in the diagnosis and management of this disorder, the majority of Canadians with asthma remain poorly controlled. In most patients, however, control can be achieved through the use of avoidance measures and appropriate pharmacological interventions. Inhaled corticosteroids (ICSs) represent the standard of care for the majority of patients. Combination ICS/long-acting beta2-agonists (LABA) inhale...

  19. Diagnosis and management of rhinitis: complete guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology. American Academy of Allergy, Asthma, and Immunology.

    Science.gov (United States)

    Dykewicz, M S; Fineman, S; Skoner, D P; Nicklas, R; Lee, R; Blessing-Moore, J; Li, J T; Bernstein, I L; Berger, W; Spector, S; Schuller, D

    1998-11-01

    This document contains complete guidelines for diagnosis and management of rhinitis developed by the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology, representing the American Academy of Allergy, Asthma and Immunology, the American College of Allergy, Asthma and Immunology and the Joint Council on Allergy, Asthma and Immunology. The guidelines are comprehensive and begin with statements on clinical characteristics and diagnosis of different forms of rhinitis (allergic, non-allergic, occupational rhinitis, hormonal rhinitis [pregnancy and hypothyroidism], drug-induced rhinitis, rhinitis from food ingestion), and other conditions that may be confused with rhinitis. Recommendations on patient evaluation discuss appropriate use of history, physical examination, and diagnostic testing, as well as unproven or inappropriate techniques that should not be used. Parameters on management include use of environmental control measures, pharmacologic therapy including recently introduced therapies and allergen immunotherapy. Because of the risks to patients and society from sedation and performance impairment caused by first generation antihistamines, second generation antihistamines that reduce or eliminate these side effects should usually be considered before first generation antihistamines for the treatment of allergic rhinitis. The document emphasizes the importance of rhinitis management for comorbid conditions (asthma, sinusitis, otitis media). Guidelines are also presented on special considerations in patients subsets (children, the elderly, pregnancy, athletes and patients with rhinitis medicamentosa); and when consultation with an allergist-immunologist should be considered.

  20. An audit cycle of consent form completion: A useful tool to improve junior doctor training

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    Catherine Leng

    2016-01-01

    Full Text Available Background: Consent for surgical procedures is an essential part of the patient's pathway. Junior doctors are often expected to do this, especially in the emergency setting. As a result, the aim of our audit was to assess our practice in consenting and institute changes within our department to maintain best medical practice. Methods: An audit of consent form completion was conducted in March 2013. Standards were taken from Good Surgical Practice (2008 and General Medical Council guidelines. Inclusion of consent teaching at a formal consultant delivered orientation programme was then instituted. A re-audit was completed to reassess compliance. Results: Thirty-seven consent forms were analysed. The re-audit demonstrated an improvement in documentation of benefits (91–100% and additional procedures (0–7.5%. Additional areas for improvement such as offering a copy of the consent form to the patient and confirmation of consent if a delay occurred between consenting and the procedure were identified. Conclusion: The re-audit demonstrated an improvement in the consent process. It also identified new areas of emphasis that were addressed in formal teaching sessions. The audit cycle can be a useful tool in monitoring, assessing and improving clinical practice to ensure the provision of best patient care.

  1. Organic Collaborative Teams: The Role of Collaboration and Peer to Peer Support for Part-Time Doctoral Completion

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    Cathy M. Littlefield

    2015-02-01

    Full Text Available With doctoral completion rates hovering around 50%, students, faculty and institutions are seeking methods for improvement. This narrative inquiry examined the impact of collaboration and peer to peer experiences on doctoral completion of three peers in a part-time doctoral program. Prior to this inquiry, minimal research existed on the impact of peer to peer support and collaboration on doctoral completion; therefore, the three peer authors defined, described, and recommended ways to encourage organic collaboration. The authors’ defined organic collaboration as a naturally-formed dynamic peer to peer support group, built on individual strengths and differences, while focused on a common goal. Themes found during the narrative inquiry included the identification of a common goal, amicable group dynamics, peer to peer support, and intentional relational learning. The peer authors provided practical knowledge on ways students, faculty and higher education institutions can benefit from encouraging and supporting organic collaboration. This narrative inquiry demonstrated the long-term benefits of peer to peer support and collaboration that led to scholarly, professional, and personal support.

  2. [Underdiagnosed asthma in third-grade children].

    Science.gov (United States)

    Walus, I; Richard, G; Laquerrière, B; Perucca, M; Tuveri, R; Einbinder, V; Muller, B; Beydon, N

    2016-01-01

    Undiagnosed asthma has been poorly studied before adolescence since it can go unnoticed by parents and doctors. Moreover, it is unusual to look for undiagnosed asthma by directly questioning children on the presence of current respiratory symptoms. Epidemiologic studies show that more adolescents quote symptoms suggestive of asthma than the prevalence of doctor-diagnosed asthma, but respiratory symptoms compatible with asthma remain undetected by parents of younger children more frequently than doctors diagnose asthma in their children. We attempted to evaluate the relevance of a questionnaire used since 2011 by school doctors in Paris to detect asthma. In this questionnaire, the family history of atopy and asthma were completed by the parents when they met the school doctor (last year of preschool) and questions on current respiratory symptoms were answered by third-grade children seen alone by the school doctor. One hundred and thirty-one children out of 1135 children questioned had a positive questionnaire for suspected asthma. In three-quarters of the cases, questionnaires were positive based on the children's answers on their respiratory symptoms (without a positive answer on personal or family history being necessary). The outcome of 41 children screened by the questionnaire was known. Twenty (49%) children had received a final diagnosis of asthma, of whom 12 were put on asthma controllers. Among these 20 children, two children underwent lung function testing and two others underwent tests for allergy. In eight children, tests had been requested by the child's GP, but no final diagnosis was reported by the parents. None of the 13 children in whom asthma was ruled out had any test performed. It was concluded that it is possible to detect undiagnosed asthma in children as young as 8 years by directly asking them about their respiratory symptoms. The knowledge of personal and family history can improve screening for asthma in these children. A more thorough

  3. Asthma - child - discharge

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    Pediatric asthma - discharge; Wheezing - discharge; Reactive airway disease - discharge ... Your child has asthma , which causes the airways of the lungs to swell and narrow. In the hospital, the doctors and nurses helped ...

  4. The Relationship between Maternal Atopy and Childhood Asthma in Pretoria, South Africa.

    Science.gov (United States)

    Abbott, Salome; Becker, Piet; Green, Robin J

    2013-01-01

    Introduction. Asthma is the commonest chronic condition of children. Diagnosis of this condition remains difficult. Many surrogate markers are used, such as documenting evidence of atopy. Method. A random sample of asthmatic children and their mothers attending the Children's Chest and Allergy Clinic at Steve Biko Academic Hospital were enrolled. Children were classified as having atopic or nonatopic asthma. Mothers completed a questionnaire to uncover atopic features. Results. Along with their mothers, 64 children with atopic asthma and 36 with nonatopic asthma were studied. The proportion of children with atopic asthma does not differ for mothers with and without a positive SPT (P = 0.836), a history of asthma (P = 0.045), symptoms suggestive of an allergic disease (P = 1.000), or who were considered to be allergic (P = 0.806). The odds ratio of a child having atopic asthma when having a mother with a doctor diagnosed history of asthma is 4.76, but the sensitivity is low (21.9%). Conclusion. The data demonstrates that all maternal allergic or asthmatic associations are poor predictors of childhood atopic asthma. Despite the increased risk of atopic asthma in a child to a mother that has a doctor diagnosis of asthma (OR 4.76 P = 0.045), this is a poor predictor of atopic asthma (sensitivity 21.9%).

  5. Survey among doctors related with bronchial asthma patients in central hospitals of region level cities in Shaanxi province%陕西省地区级城市中心医院支气管哮喘相关科室医师的调查分析

    Institute of Scientific and Technical Information of China (English)

    宋立强; 吴昌归; 呼彩莲; 李海东; 李文革; 何小鹏; 张和平

    2008-01-01

    表示为每位接诊的哮喘患者制定了长期用药方案及随访计划.结论 通过调查了解了陕西省地区级城市中心医院医师对哮喘知识的掌握程度.总体来看,呼吸内科医师的掌握程度高于其他专科,但距离普及规范化治疗理念还任重而道远.这些资料将为联盟在西部地区的医师教育工作提供参考.%Objective To evaluate the situation of grasping bronchial asthma(asthma) knowledge ofdoctors related with asthma patients in central hospitals of region level cities in Shaanxi province, and toappraise the effect of doctor education in order to provide evidence for the next step of education. MethodsSix hospitals were selected from six region level cities, where questionnaire survey was completed in thedorctors from the department of respiratory medicine, internal medicine, emergency or pediatrics. Thequestionnaire involved pathogenesy, prevention, treatment and advencement of global initiative for asthma(GINA). Results 187 doctors completed the qusetionnaire,and the ratio of every speciality was 29.9%,23.0%,26.7% and 20.3%, respectively. 58.9%-62.5% dorctors in respiratory knew the organization ofasthma clearly and the ratio was very higher than that in other spciality. But 10.7% dorctors did not knowthe significance of GINA. World Asthma Day was known in 87.6%. 69.9% doctors understood thepathogenesy of slow airway inflammation, while the highest ratio was 78.6% in repiralogy and the lowestone was 55.8% in internal medcine. Repiratory doctor knew the classification of asthma according tocontroled level most clearly in all people. 54.8%-75.0% doctors knew the importance of inhaledcorticosteroid (ICS)in therapy. But the effect of asthma control test and stort-acting β2-agonist wasunderstood only by 7.1% and 42.9% respiratory doctors. 37.8% doctors knew the use of long-actingβ2-agonist should be combined with ICS. 52.0%-76.4% doctors knew the blocker of leukotriene receptorwas control medcine. 51

  6. Use of the Iowa Model of Research in Practice as a Curriculum Framework for Doctor of Nursing Practice (DNP) Project Completion.

    Science.gov (United States)

    Lloyd, Susan T; D'Errico, Ellen; Bristol, Shirley T

    2016-01-01

    Doctoral education requires academic motivation and persistence on the part of nursing students; commitment to the process is essential and should be linked to programmatic structure. Programmatic issues in doctor of nursing practice (DNP) programs may be barriers to completion of the final project and lead to attrition. A large, private health care university developed an infrastructure for the DNP curriculum and final project utilizing the Iowa Model of Research in Practice. The purpose was to ensure competency fulfillment, retention and timely completion, and implementation of evidence-based practice and translation science utilizing a leadership approach. The program has experienced a high completion rate to date.

  7. Obesity and Asthma

    DEFF Research Database (Denmark)

    Juel, Caroline Trunk-Black; Ulrik, Charlotte Suppli

    2013-01-01

    Asthma is more prevalent in obese compared with normal weight subjects. Our aim has been to review current knowledge of the impact of obesity on asthma severity, asthma control, and response to therapy.Several studies have shown that overweight and obesity is associated with more severe asthma...... and impaired quality of life compared with normal weight individuals. Furthermore, obesity is associated with poorer asthma control, as assessed by asthma control questionnaires, limitations in daily activities, breathlessness and wheezing, use of rescue medication, unscheduled doctor visits, emergency...... department visits, and hospitalizations for acute asthma. Studies of the impact of a high body mass index (BMI) on response to asthma therapy have, however, revealed conflicting results. Most studies show that overweight and obesity is associated with less favorable response to asthma therapy with regard...

  8. 宣桂琪主任辨治小儿哮喘与提高疗效的思路%Doctor Xuan Guiqi's Experience in the Diagnosis and Treatment of Childhood Asthma and the Thinking of Improving Efficacy

    Institute of Scientific and Technical Information of China (English)

    宣晓波; 宣桂琪

    2013-01-01

    [Objective]To summarize Doctor Xuan Guiqi's experience in the treatment of childhood asthma and the idea of improving the curative efficacy. [Methods]By learning from Doctor Xuan and clearing up medical cases, the author finishes the summary on doctor Xuan's clinical experience on child-hood asthma based on the syndrome differentiation and clinical medication.[Results]The childhood asthma is divided into acute and chronic, the former is divided into cold asthma, heat asthma and wind-phlegm types. At the same time, we strengthen pertinence treatment of clearing heat and removing toxi-city, Qi spasmolytics, dispel ing wind and desensitization, activating blood and eliminating stasis, promoting Qi and regulating middle-jiao and relieving dyspepsia.[Conclusions] Doctor Xuan Guiqi's experience in the diagnosis and treatment of childhood asthma can significantly improve the clinical efficacy , and it is meaningful to clinic.%  [目的]总结宣桂琪主任对于小儿哮喘的临床治疗经验及提高疗效的思路。[方法]笔者通过跟师学习、整理医案,从辨证分型和临床用药等方面分析和总结宣主任治疗小儿哮喘的临床经验。[结果]宣主任将小儿哮喘分为急性哮喘与慢性哮喘进行辨治,其中前者又分寒哮、热哮、风痰哮三型,同时加强清热解毒、理气解痉、祛风脱敏、活血祛瘀、理气调中、消导积滞等针对性治疗,显著提高了哮喘的疗效。[结论]宣桂琪主任对小儿哮喘分型辨治及根据不同病因病机的针对性治疗显著提高了临床疗效,具有临床启示意义。

  9. Treating Asthma in Children Ages 5 to 11

    Science.gov (United States)

    ... triggers such as cigarette smoke or seasonal allergies. Asthma emergencies Severe asthma attacks can be life-threatening ... doctor at every visit. Immunotherapy for allergy-induced asthma Allergy-desensitization shots (immunotherapy) may help if your ...

  10. Asthma Basics

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Asthma Basics KidsHealth > For Parents > Asthma Basics A A ... Asthma Categories en español Asma: aspectos fundamentales About Asthma Asthma is a common lung condition in kids ...

  11. Chronic Diseases: Asthma and You | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... develop with your doctor Taking medicines correctly Avoiding asthma triggers (except physical activity; you can take medication to ... school, or work environments, which alter exposure to asthma triggers. Medicines may need to be increased if asthma ...

  12. Are asthma-like symptoms in elite athletes associated with classical features of asthma?

    DEFF Research Database (Denmark)

    Lund, T.K.; Pedersen, L.; Anderson, S.D.;

    2009-01-01

    Background: Asthma is frequent in elite athletes and clinical studies in athletes have found increased airway inflammation. Objective: To investigate asthma-like symptoms, airway inflammation, airway reactivity (AR) to mannitol and use of asthma medication in Danish elite athletes. Methods......: The study group consisted of 54 elite athletes (19 with doctor-diagnosed asthma), 22 non-athletes with doctor-diagnosed asthma (steroid naive for 4 weeks before the examination) and 35 non-athletes without asthma; all aged 18-35 years. Examinations (1 day): questionnaires, exhaled nitric oxide (e......NO) in parts per billion, spirometry, skin prick test, AR to mannitol and blood samples. Induced sputum was done in subjects with asthma. Results: No significant difference was found in values for eNO, AR and atopy between 42 elite athletes with and 12 without asthma-like symptoms. Elite athletes with doctor...

  13. Are doctors still failing to assess and treat asthma attacks? An audit of the management of acute attacks in a health district.

    Science.gov (United States)

    Pinnock, H; Johnson, A; Young, P; Martin, N

    1999-06-01

    This audit aimed to observe the management of acute asthma by primary and secondary care within a Health District. Asthma attacks occurring during the first 6 weeks of 1996 to patients between the ages of 3 and 74 years in Canterbury and Thanet District were notified by general practitioners, out-of-hours co-operatives and hospitals. Data were obtained retrospectively from the patient records. A total of 378 episodes was registered: 342 (90%) to primary care. Of these 234 (76% of patients aged 6 years or over) had a peak flow recorded; 114 (30%) were given emergency bronchodilation: oxygen was not used in primary care; 204 (54%) were given systemic steroids; and 43 (11%) were referred for hospital care of whom 36 were admitted. Of the attacks, 212 (69% of the patients aged 6 years or over) could be classified by percentage predicted peak flow and management compared to the Guidelines published by the British Thoracic Society. Twenty-eight patients presented with 'life-threatening' asthma: 20 (71%) were given emergency bronchodilation; oxygen was used in only two; 24 (86%) were given systemic steroids; and six (21%) were referred for admission. In their confidential enquiry into the asthma deaths the British Thoracic Society identified a failure to appreciate the severity of the attack, resulting in inadequate emergency treatment and delay in referring to hospital. These data suggest that, 15 years later, these problems may still exist.

  14. Fertility outcomes in asthma

    DEFF Research Database (Denmark)

    Gade, Elisabeth Juul; Thomsen, Simon Francis; Lindenberg, Svend;

    2016-01-01

    Evidence is increasing of an association between asthma and aspects of female reproduction. However, current knowledge is limited and furthermore relies on questionnaire studies or small populations. In a prospective observational cohort study to investigate whether time to pregnancy, the number...... of fertility treatments, and the number of successful pregnancies differ significantly between women with unexplained infertility with and without asthma.245 women with unexplained infertility (aged 23-45 years) underwent questionnaires and asthma and allergy testing while undergoing fertility treatment. 96...... women entering the study had either a former doctor's diagnosis of asthma or were diagnosed with asthma when included. After inclusion they were followed for a minimum of 12 months in fertility treatment, until they had a successful pregnancy, stopped treatment, or the observation ended.The likelihood...

  15. Maternal vitamin D and E intakes during pregnancy are associated with asthma in children.

    Science.gov (United States)

    Allan, Keith M; Prabhu, Nanda; Craig, Leone C A; McNeill, Geraldine; Kirby, Bradley; McLay, James; Helms, Peter J; Ayres, Jon G; Seaton, Anthony; Turner, Stephen W; Devereux, Graham

    2015-04-01

    Are maternal vitamin D and E intakes during pregnancy associated with asthma in 10-year-old children? In a longitudinal study of 1924 children born to women recruited during pregnancy, maternal vitamin D intake during pregnancy was assessed by the Food Frequency Questionnaire (FFQ) and vitamin E by FFQ and plasma α-tocopherol; respiratory questionnaires were completed for the 10-year-old children. Their treatment for asthma was also ascertained using administrative data. Longitudinal analyses included data collected at 1, 2, 5 and 10 years. Symptom data were available for 934 (49%) children and use of asthma medication for 1748 (91%). In the children maternal vitamin D intake during pregnancy was negatively associated with doctor-diagnosed asthma at 10 years of age (OR per intake quintile 0.86, 95% CI 0.74-0.99) and over the first 10 years (hazard ratio 0.90, 95% CI 0.81-1.00). Maternal plasma α-tocopherol at 11 weeks gestation was negatively associated with children receiving asthma treatment (OR per standard deviation increase 0.52, 95% CI 0.31-0.87). Maternal vitamin E intake was negatively associated with doctor-diagnosed asthma (OR 0.89, 95% CI 0.81-0.99) in the first 10 years. Low maternal vitamin D and E intakes during pregnancy are associated with increased risk of children developing asthma in the first 10 years of life. These associations may have significant public health implications.

  16. Difficult childhood asthma: management and future.

    Science.gov (United States)

    Tillie-Leblond, Isabelle; Deschildre, Antoine; Gosset, Philippe; de Blic, Jacques

    2012-09-01

    Diagnosis and management of severe asthma implies the definition of different entities, that is, difficult asthma and refractory severe asthma, but also the different phenotypes included in the term refractory severe asthma. A complete evaluation by a physician expert in asthma is necessary, adapted for each child. Identification of mechanisms involved in different phenotypes in refractory severe asthma may improve the therapeutic approach. The quality of care and monitoring of children with severe asthma is as important as the prescription drug, and is also crucial for differentiating between severe asthma and difficult asthma, whereby expertise is required.

  17. Pediatric Asthma

    Science.gov (United States)

    ... Plan Asthma Epidemic Eating with Asthma Helping Your Child Cope With a Medical Condition Nasal Wash Guide Cleaning Dirty Items Impact on Families Asthma & Pets Peak Flow Meter Athletes & Asthma Helpful Tools for ...

  18. Difficult Asthma

    Directory of Open Access Journals (Sweden)

    Ahmet Uslu

    2003-03-01

    Full Text Available Difficult asthma is a distinct entity of asthma, comprising approximately %5 of asthmatic patients. There is no agreed definition of difficult asthma. It will include asthma uncontrolled by new standard therapy, steroid dependent, steroid resistant and severe asthma. In this study difficult asthma; clinical features, risk factors, pathophysiology and novel therapies are summarized by literatures.

  19. Difficult asthma

    OpenAIRE

    Ahmet Uslu; Tülay Özdemir

    1989-01-01

    Difficult asthma is a distinct entity of asthma, comprising approximately %5 of asthmatic patients. There is no agreed definition of difficult asthma. It will include asthma uncontrolled by new standard therapy, steroid dependent, steroid resistant and severe asthma. In this study difficult asthma; clinical features, risk factors, pathophysiology and novel therapies are summarized by literatures.

  20. Basal or stress-induced cortisol and asthma development : the TRAILS study

    NARCIS (Netherlands)

    Vink, Nienke M; Boezen, Hendrika; Postma, Dirkje S; Rosmalen, Judith G M

    2013-01-01

    We examined the association between: 1) cortisol levels and asthma or asthma development; 2) cortisol levels upon stress and asthma. In addition, we performed a post hoc meta-analysis on results from the literature. Cortisol, cortisol upon stress, asthma (doctor diagnosis of asthma and/or symptoms a

  1. The disease management approach to controlling asthma.

    Science.gov (United States)

    Haahtela, T

    2002-02-01

    Asthma has become an important public health issue worldwide and certain groups, such as children, are at particular risk of the disease. Often asthma remains under-diagnosed and under-treated. Despite these worrying trends, the disease management approach to asthma control can help most asthma patients achieve a 'normal' way of life. The increased prevalence and greater diagnostic awareness of asthma have placed increased demands on healthcare resources, but effective asthma control can minimize the personal, social and economic burdens of asthma. Early diagnosis and immediate anti-inflammatory treatment is the first step in gaining control of symptoms. A stepwise approach is then used to classify asthma severity and treatment, with the number and frequency of medications increasing (step up) as asthma severity increases and decreasing (step down) when asthma is under control. This stepwise approach to asthma management necessitates regular review of treatment once asthma is under control. However, effective asthma management is dependent on successful patient education, adherence to prescribed medication and good doctor patient partnerships. Current treatment guidelines recommend the use of a written asthma management plan that should be agreed between the doctor and patient. These plans should cover all aspects of asthma treatment, including prevention steps for long-term control and action steps to stop attacks once a worsening in asthma has been recognized. This comprehensive approach to asthma management increases the likelihood of achieving asthma control, which in turn reduces the need for emergency visits to the hospital or clinic and reduces the limitations on physical activity previously imposed by the condition.

  2. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... avoid an attack by taking your medicine exactly as your doctor or other medical professional tells you ... keep them with your Asthma Action Plan. Using a metered dose inhaler with a spacer Your browser ...

  3. Occupational asthma

    Science.gov (United States)

    ... Names Asthma - occupational exposure; Irritant-induced reactive airways disease Images Spirometry Respiratory system References Lemiere C, Vandenplas O. Occupational allergy and asthma. In: Adkinson NF Jr., Bochner ...

  4. Prevalence of asthma-like symptoms, asthma and its treatment in elite athletes

    DEFF Research Database (Denmark)

    Lund, T; Pedersen, L; Larsson, B;

    2008-01-01

    The objective was to determine the prevalence of asthma-like symptoms and asthma and the use of asthma medication in Danish elite athletes. A cross-sectional questionnaire survey of Danish elite athletes was conducted in 2006. All elite athletes (N=418) financially supported by the national...... organization of elite athletes comprised the study group; 329 (79%) completed the questionnaire concerning their sport, asthma-like symptoms, asthma and use of asthma medication. Asthma-like symptoms at rest were reported by 41% of respondents; 55% reported asthma-like symptoms at rest or at exercise...... among Danish elite athletes....

  5. Self-reported asthma and allergies in top athletes compared to the general population - results of the German part of the GA2LEN-Olympic study 2008

    Directory of Open Access Journals (Sweden)

    Thomas Silke

    2010-11-01

    Full Text Available Abstract Background Prevalence of asthma and allergies in top athletes is high. However, most previous studies did not include a general population comparison group. We aimed to compare the prevalence of asthma, allergies and medical treatment in different groups of German top athletes to the general population. Methods Prior to the 2008 Summer Olympic Games, 291 German candidates for participation (65% completed a questionnaire on respiratory and allergic symptoms. Results were compared to those of a general population study in Germany (n = 2425, response 68%. Furthermore, associations between types of sports and the self-reported outcomes were calculated. All models were adjusted for age, sex, level of education and smoking. Results Athletes reported significantly more doctors' diagnosed asthma (17% vs. 7%, more current use of asthma medication (10% vs. 4% and allergic rhinitis (25% vs. 17% compared to the general population. After adjustment, top athletes only had an increased Odds Ratio for doctor's diagnosed asthma (OR: 1.6; 95% CI 1.1-2.5. Compared to the general population, athletes in endurance sports had an increased OR for doctor's diagnosed asthma (2.4; 1.5-3.8 and current use of asthma medication (1.8; 1.0-3.4. In this group, current wheeze was increased when use of asthma medication was taken into account (1.8; 1.1-2.8. For other groups of athletes, no significantly increased ORs were observed. Conclusions Compared to the general population, an increased risk of asthma diagnosis and treatment was shown for athletes involved in endurance sports. This might be due to a better medical surveillance and treatment of these athletes.

  6. Prevalence of asthma-like symptoms, asthma and its treatment in elite athletes.

    Science.gov (United States)

    Lund, T; Pedersen, L; Larsson, B; Backer, V

    2009-04-01

    The objective was to determine the prevalence of asthma-like symptoms and asthma and the use of asthma medication in Danish elite athletes. A cross-sectional questionnaire survey of Danish elite athletes was conducted in 2006. All elite athletes (N=418) financially supported by the national organization of elite athletes comprised the study group; 329 (79%) completed the questionnaire concerning their sport, asthma-like symptoms, asthma and use of asthma medication. Asthma-like symptoms at rest were reported by 41% of respondents; 55% reported asthma-like symptoms at rest or at exercise. Physician-diagnosed asthma was present in 16% and 14% had current asthma. Asthma medication was taken by 7% of the athletes, of whom 79% used inhaled corticosteroids and 21% used inhaled beta(2)-agonists only. Athletes participating in endurance sports had higher prevalences of current asthma (24%) and use of asthma medication (15%) than all other athletes (Pendurance sports have a higher prevalence of asthma and use of asthma medication. The frequency of asthma medication is lower than the prevalence of current asthma indicating that there is no overuse of asthma medication among Danish elite athletes.

  7. Controlling Your Symptoms of Asthma

    Science.gov (United States)

    ... a disease that affects the tubes in your lungs that carry air (oxygen). These tubes are called airways. In people with asthma, the airways can be sensitive to pollen, dust mites, animal dander, chemicals, tobacco smoke, wood Visit your doctor to talk about your health ...

  8. The Saudi Initiative for asthma

    Directory of Open Access Journals (Sweden)

    Al-Moamary Mohamed

    2009-01-01

    Full Text Available The Saudi Initiative for Asthma (SINA provides up-to-date guidelines for healthcare workers managing patients with asthma. SINA was developed by a panel of Saudi experts with respectable academic backgrounds and long-standing experience in the field. SINA is founded on the latest available evidence, local literature, and knowledge of the current setting in Saudi Arabia. Emphasis is placed on understanding the epidemiology, pathophysiology, medications, and clinical presentation. SINA elaborates on the development of patient-doctor partnership, self-management, and control of precipitating factors. Approaches to asthma treatment in SINA are based on disease control by the utilization of Asthma Control Test for the initiation and adjustment of asthma treatment. This guideline is established for the treatment of asthma in both children and adults, with special attention to children 5 years and younger. It is expected that the implementation of these guidelines for treating asthma will lead to better asthma control and decrease patient utilization of the health care system.

  9. Doctors Today

    LENUS (Irish Health Repository)

    Murphy, JFA

    2012-03-01

    Doctors’ relationship with patients and their role in society is changing. Until the 1960s doctors concentrated on the welfare of patients with less emphasis placed on patients’ rights1. Over recent decades there has been increasing empowerment of the individual across all facets of society including health care. Doctors continue to be perceived as having expertise and authority over medical science. Patients, however, now hold sway over questions of values or preferences. We all must be aware of this change in the doctor- patient interaction. We need to be more aware of the outcomes that patients view as important. The concept of shared decision-making with the patient is now widely appreciated. The process involves a change in mind set particularly for doctors who trained in an earlier era.

  10. Coexistence of asthma and polycystic ovary syndrome

    DEFF Research Database (Denmark)

    Zierau, Louise; Gade, Elisabeth Juul; Lindenberg, Svend;

    2016-01-01

    Asthma may be associated with polycystic ovary syndrome (PCOS), and possibly patients with PCOS have a more severe type of asthma. The purpose of this systematic literature review is to summarize evidence of a coexistense of PCOS and asthma using the available literature. The search was completed...... on 01.01.2016. English language articles were retrieved using the search terms 'Asthma' AND 'PCOS', 'Asthma' AND 'systemic inflammation', 'Asthma' AND 'metabolic syndrome', 'asthma' AND 'gynaecology', 'PCOS' AND 'systemic inflammation', 'PCOS' AND 'metabolic syndrome', 'PCOS' AND 'allergy'. Five papers...... meeting prespecified search criteria were found of which two were registry studies of relevance. The current literature supports a coexistense of PCOS and asthma and gives us an indication of the causes for the possible link between PCOS and asthma. Further research in the area must be conducted...

  11. Asthma and obesity: does weight loss improve asthma control? a systematic review

    Directory of Open Access Journals (Sweden)

    Juel CTB

    2012-06-01

    Full Text Available Caroline Trunk-Black Juel,1 Zarqa Ali,1 Lisbeth Nilas,2 Charlotte Suppli Ulrik11Respiratory Section, Internal Medicine Unit, 2Department of Obstetrics and Gynaecology, Hvidovre Hospital and University of Copenhagen, Hvidovre, DenmarkAim and methods: Obesity is a major health problem, and obesity is associated with a high incidence of asthma and poor asthma control. The aim of the present paper is to systematically review the current knowledge of the effect on overall asthma control of weight reduction in overweight and obese adults with asthma.Results: Weight loss in obese individuals with doctor-diagnosed asthma is associated with a 48%–100% remission of asthma symptoms and use of asthma medication. Published studies, furthermore, reveal that weight loss in obese asthmatics improves asthma control, and that especially surgically induced weight loss results in significant improvements in asthma severity, use of asthma medication, dyspnoea, exercise tolerance, and acute exacerbations, including hospitalizations due to asthma. Furthermore, weight loss in obese asthmatics is associated with improvements in level of lung function and airway responsiveness to inhaled methacholine, whereas no significant improvements have been observed in exhaled nitric oxide or other markers of eosinophilic airway inflammation.Conclusion: Overweight and obese adults with asthma experience a high symptomatic remission rate and significant improvements in asthma control, including objective measures of disease activity, after weight loss. Although these positive effects of weight loss on asthma-related health outcomes seem not to be accompanied by remission or improvements in markers of eosinophilic airway inflammation, it has potentially important implications for the future burden of asthma.Keywords: asthma, weight loss, diet, bariatric surgery, asthma control

  12. Japanese Guideline for Childhood Asthma

    Directory of Open Access Journals (Sweden)

    Toshiyuki Nishimuta

    2011-01-01

    JAGL differs from the Global Initiative for Asthma Guideline (GINA in that the former emphasizes long-term management of childhood asthma based on asthma severity and early diagnosis and intervention at <2 years and 2–5 years of age. However, a management method, including step-up or step-down of long-term management agents based on the status of asthma symptoms, is easy to understand and thus JAGL is suitable for routine medical treatment. JAGL also introduced treatment and management using a control test for children, recommending treatment and management aimed at complete control through avoiding exacerbation factors and appropriate use of antiinflammatory agents.

  13. Going to the Doctor

    Science.gov (United States)

    ... Happens in the Operating Room? Going to the Doctor KidsHealth > For Kids > Going to the Doctor A ... it's time to meet the doctor. continue Hello, Doctor The doctor will come in and say hello, ...

  14. Obesity and asthma: impact on severity, asthma control, and response to therapy.

    Science.gov (United States)

    Juel, Caroline Trunk-Black; Ulrik, Charlotte Suppli

    2013-05-01

    Asthma is more prevalent in obese, compared with normal weight, subjects. Our aim has been to review current knowledge of the impact of obesity on asthma severity, asthma control, and response to therapy. Several studies have shown that overweight and obesity is associated with more severe asthma and impaired quality of life, compared with normal weight individuals. Furthermore, obesity is associated with poorer asthma control, as assessed by asthma control questionnaires, limitations in daily activities, breathlessness and wheezing, use of rescue medication, unscheduled doctor visits, emergency department visits, and hospitalizations for acute asthma. Studies of the impact of a high body mass index on response to asthma therapy have, however, revealed conflicting results. Most studies show that overweight and obesity is associated with less favorable response to asthma therapy, with regard to symptoms, level of FEV1, fraction of exhaled nitric oxide, and airway responsiveness. Some studies suggest that asthma in the obese patient might be more responsive to leukotriene modifiers, orchestrated by leptin and/or adiponectin derived from adipose tissue, than to inhaled corticosteroids, possibly reflecting differences in the underlying airway inflammation in obese versus non-obese asthmatics. In conclusion, overweight and obesity is associated with poorer asthma control and, very importantly, overall poorer response to asthma therapy, compared with normal weight individuals.

  15. Individual-level socioeconomic status is associated with worse asthma morbidity in patients with asthma

    Directory of Open Access Journals (Sweden)

    Bouchard Anne

    2009-12-01

    Full Text Available Abstract Background Low socioeconomic status (SES has been linked to higher morbidity in patients with chronic diseases, but may be particularly relevant to asthma, as asthmatics of lower SES may have higher exposures to indoor (e.g., cockroaches, tobacco smoke and outdoor (e.g., urban pollution allergens, thus increasing risk for exacerbations. Methods This study assessed associations between adult SES (measured according to educational level and asthma morbidity, including asthma control; asthma-related emergency health service use; asthma self-efficacy, and asthma-related quality of life, in a Canadian cohort of 781 adult asthmatics. All patients underwent a sociodemographic and medical history interview and pulmonary function testing on the day of their asthma clinic visit, and completed a battery of questionnaires (Asthma Control Questionnaire, Asthma Quality of Life Questionnaire, and Asthma Self-Efficacy Scale. General Linear Models assessed associations between SES and each morbidity measure. Results Lower SES was associated with worse asthma control (F = 11.63, p Conclusions Results suggest that lower SES (measured according to education level, is associated with several indices of worse asthma morbidity, particularly worse asthma control, in adult asthmatics independent of disease severity. Results are consistent with previous studies linking lower SES to worse asthma in children, and add asthma to the list of chronic diseases affected by individual-level SES.

  16. 医患沟通对全口义齿修复满意率的影响%The effect of doctor-patient communication on complete denture restoration

    Institute of Scientific and Technical Information of China (English)

    王万伟; 韦玉舫; 李军; 张婷婷

    2013-01-01

      目的评估医患沟通对全口义齿临床修复效果的影响.方法选择初次就诊行全口义齿修复的患者270例,分为试验组和对照组,试验组给予充分的医患沟通,对照组按照正常操作流程进行常规修复,在修复佩戴全口义齿2月后统计分析患者对修复体的满意率.结果所有患者对全口义齿修复的总满意率84.44%,试验组的满意率为89.24%,对照组的为77.68%,两组差异有统计学意义(P<0.001).结论进行良好的医患沟通能够提高全口义齿修复的满意度,缩短适应时间.%Objective To assess the effect of doctor-patient communication on complete denture restoration. Methods Two hundred and seventy patients of complete denture restoration were randomly divided into the experimental group and control group. The experimental group was given an effective communication; the control group was for regular repair. Two months after repairing, the satisfaction of restoration was statistical analyzed. Results The all satisfaction rate of complete denture restoration was 84.44%, the experimental group was up to 89.24%, the control group reached 77.68%. The differences between two groups were statistical significantly(P<0.001). Conclusion Effective doctor-patient communication can improve the satisfaction of complete denture restoration, short the adaptation time.

  17. Do accident and emergency senior house officers know the British guidelines on the management of acute asthma?

    Science.gov (United States)

    Ulahannan, T; Hardern, R D; Hamer, D W

    1996-03-01

    Avoidable deaths from asthma continue, even in hospital. Since the management of acute severe asthma is often initiated in the Accident and Emergency department, it is crucial that staff there have adequate knowledge. An anonymous questionnaire, containing items based on chart 6 of the UK guidelines, was completed by 66 Accident and Emergency Senior House Officers from the Yorkshire region. The study aim was to establish these doctors' levels of knowledge about the recommended management of acute asthma in Accident and Emergency. The median score was 10 (out of a possible 24) and the interquartile range 8-13. Further efforts are required to implement these guidelines so that the best patient outcomes can be achieved.

  18. Pediatric asthma controller therapy.

    Science.gov (United States)

    Anselmo, Mark

    2011-02-01

    The treatment of children with asthma has historically relied upon expert opinion using data extrapolated from adult studies. Over the past few years, landmark studies have been completed providing healthcare professionals with evidence on which a reasonable approach can be made for children suffering from this common and serious disease. Asthmatic phenotype in children, unlike adults, tends to differ according to age, which must be taken into account as well as triggers, severity, and level of control. The care of the child with asthma is complex, but accumulating data have demonstrated that we are on the right path for optimizing control while reducing the burden of side effects. The newest Global Initiative for Asthma (GINA) guidelines, as well as recent updates from the landmark CAMP (Childhood Asthma Management Program) study and information from the PACT (Pediatric Asthma Control Trial) and budesonide/formoterol controller and reliever studies, along with recent comparisons of higher dose inhaled corticosteroids (ICS), and ICS/long-acting β(2)-adrenoceptor agonist (LABA) combination and leukotriene receptor antagonist (LTRA) therapies in children have clarified a few of the big questions in pediatric asthma. For children with asthma aged 5 years and older, the CAMP trial demonstrated that regular use of ICS reduces the frequency of symptoms; however, height was adversely affected and there is no evidence for altering the natural history of asthma. In patients aged 6 years and over whose asthma is uncontrolled on ICS alone, combination therapy with ICS and a LABA has been recently compared with the use of higher dose ICS and the addition of an LTRA in pediatric patients. The addition of a LABA statistically will be of most benefit; however, some children will have optimal control with doubling the baseline dose of ICS or addition of an LTRA. Use of budesonide/formoterol as a controller and reliever therapy extends the time to first exacerbation versus

  19. Talking to Your Doctor

    Science.gov (United States)

    ... Doctor Research Underway Plain Language Talking to Your Doctor Preparing for Your Medical Appointment (4:37) Understanding ... sources of information. How to Talk to your Doctor Talking With Your Doctor , NIH News in Health ...

  20. Acute bronchial asthma

    Directory of Open Access Journals (Sweden)

    Susanna Ramuscello

    2007-04-01

    Full Text Available Asthma is one of the main causes of morbidity worldwide. It affects some 300 million individuals and has risen over the past 20 years, especially in the paediatric population. Asthma is a chronic inflammation of the airways, subject to periodic exacerbations, characterised by coughing and progressive dyspnoea. Clinical conditions may vary greatly, ranging from moderate exacerbation with an increase in nocturnal awakening and a less than 20% reduction in the flow peak, through to severe respiratory insufficiency that requires immediate intubation of the airways. Pharmacological treatment envisages a step approach that aims to obtain and maintain control over the symptoms, taking into consideration the effectiveness of the treatment available, potential side effects and cost. β2-agonists and corticosteroids are the drugs of election for both maintenance therapy and for treating exacerbations. Other therapeutic devices may prove useful in particular cases. One fundamental key point in treatment over time is the cooperation between patient and attending doctor. The latest review of the Global Initiative for Asthma (GINA guidelines was published in 2006.

  1. Asthma pharmacotherapy.

    Science.gov (United States)

    Schofield, Minka L

    2014-02-01

    Asthma is a chronic inflammatory disease of the airway that leads to airway obstruction via bronchoconstriction, edema, and mucus hypersecretion. The National Asthma Education and Prevention Program has outlined evidence-based guidelines to standardize asthma therapy and improve outcomes. The initial recommendation of choice for persistent asthmatic patients is an inhaled corticosteroid (ICS). Long-acting beta-2 agonists in combination with ICS, oral corticosteroids, leukotriene modifiers, and anti-IgE therapeutic options can be considered for patients with persistent or worsening symptoms. Many novel therapies are being developed, with an emphasis on anti-inflammatory mechanisms, gene expression, and cytokine modification.

  2. Educational outreach to general practitioners reduces children's asthma symptoms: a cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Sladden Michael

    2007-09-01

    Full Text Available Abstract Background Childhood asthma is common in Cape Town, a province of South Africa, but is underdiagnosed by general practitioners. Medications are often prescribed inappropriately, and care is episodic. The objective of this study is to assess the impact of educational outreach to general practitioners on asthma symptoms of children in their practice. Methods This is a cluster randomised trial with general practices as the unit of intervention, randomisation, and analysis. The setting is Mitchells Plain (population 300,000, a dormitory town near Cape Town. Solo general practitioners, without nurse support, operate from storefront practices. Caregiver-reported symptom data were collected for 318 eligible children (2 to 17 years with moderate to severe asthma, who were attending general practitioners in Mitchells Plain. One year post-intervention follow-up data were collected for 271 (85% of these children in all 43 practices. Practices randomised to intervention (21 received two 30-minute educational outreach visits by a trained pharmacist who left materials describing key interventions to improve asthma care. Intervention and control practices received the national childhood asthma guideline. Asthma severity was measured in a parent-completed survey administered through schools using a symptom frequency and severity scale. We compared intervention and control group children on the change in score from pre-to one-year post-intervention. Results Symptom scores declined an additional 0.84 points in the intervention vs. control group (on a nine-point scale. p = 0.03. For every 12 children with asthma exposed to a doctor allocated to the intervention, one extra child will have substantially reduced symptoms. Conclusion Educational outreach was accepted by general practitioners and was effective. It could be applied to other health care quality problems in this setting.

  3. Exercise and Asthma

    Science.gov (United States)

    ... Español Text Size Email Print Share Exercise and Asthma Page Content Article Body Almost every child (and ... of Pediatrics about asthma and exercise. What is asthma Asthma is the most common chronic medical problem ...

  4. Asthma and Hispanic Americans

    Science.gov (United States)

    ... and Data > Minority Population Profiles > Hispanic/Latino > Asthma Asthma and Hispanic Americans In 2014, 2.1 million Hispanics reported that they currently have asthma. Puerto Rican Americans have almost twice the asthma ...

  5. Childhood Asthma

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  6. Occupational Asthma

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  7. Asthma Quiz

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  8. Basal or stress-induced cortisol and asthma development: the TRAILS study.

    Science.gov (United States)

    Vink, Nienke M; Boezen, H Marike; Postma, Dirkje S; Rosmalen, Judith G M

    2013-04-01

    We examined the association between: 1) cortisol levels and asthma or asthma development; 2) cortisol levels upon stress and asthma. In addition, we performed a post hoc meta-analysis on results from the literature. Cortisol, cortisol upon stress, asthma (doctor diagnosis of asthma and/or symptoms and/or treatment in the past 12 months) and asthma development (asthma at a specific survey while not having asthma at the previous survey(s)) were assessed in the TRAILS study (n=2230, mean age at survey 1 11 years, survey 2 14 years and survey 3 16 years). Logistic regression models were used to study associations between: 1) cortisol (cortisol awakening response, area under the curve (AUC) with respect to the ground (AUCg) or with respect to the increase (AUCi), and evening cortisol) and asthma or asthma development; 2) cortisol upon stress (AUCg or AUCi) and asthma. The meta-analyses included nine case-control articles on basal cortisol in asthma. No significant association was found between: 1) cortisol and asthma (age 11 years) or asthma development (age 14 or 16 years); 2) cortisol upon stress and asthma (age 16 years). The meta-analysis found lower morning and evening cortisol levels in asthmatics compared to non-asthmatics; however, the summary estimates were not significant. We found no evidence supporting a role for cortisol in asthma and asthma development.

  9. Recognizing asthma mimics and asthma complications.

    Science.gov (United States)

    Amundson, Dennis; Seda, Gilbert; Daheshia, Massoud

    2011-10-01

    Asthma is a chronic inflammatory disorder of the airways characterized by airflow obstruction, bronchial hyperreactivity, and underlying inflammation. Two common reasons asthmatics fail standard therapy are incorrect diagnosis and failure to recognize underlying contributing factors. A correct diagnosis of asthma is of great importance to military practitioners since misdiagnosis or uncontrolled asthma affects an individual's operational readiness or determines whether one can receive a medical waiver to enlist in military service. This article presents four cases of patients with dyspnea that have conditions which mimic asthma or complicate asthma management: vocal cord dysfunction misdiagnosed as asthma, respiratory bronchiolitis interstitial lung disease mistaken as asthma, difficult-to-control asthma because of bronchiectasis and allergic bronchopulmonary aspergillosis, and difficult and fatal asthma. Asthma is contrasted to other respiratory disorders, and an outlined approach to asthma diagnosis and management is presented using the Global Initiative for Asthma guidelines.

  10. A Qualitative Examination of Challenges Influencing Doctoral Students in an Online Doctoral Program

    Science.gov (United States)

    Deshpande, Anant

    2016-01-01

    The main purpose of the study was to investigate the challenges faced by students in completion of an online doctoral program at the University of Liverpool, Online Doctoral Business Administration program. We analyse the responses of 91 doctoral students in an online DBA program. Based on the exploratory qualitative study themes were developed…

  11. [Epidural emphysema complicating bronchial asthma].

    Science.gov (United States)

    Rouetbi, N; Ben Saad, A; Joobeur, S; Skhiri, N; Cheikh Mhamed, S; Mribah, H; El Kamel, A

    2012-12-01

    Epidural emphysema is an exceptional complication of bronchial asthma, revealed by an incidental finding in chest tomography. We report a case of a 21-year-old man admitted with asthma attack complicated by subcutaneous and mediastinal emphysema. Chest tomography confirmed the mediastinal emphysema and also revealed the epidural emphysema within the vertebral canal. Neurological examination was negative. The patient showed complete recovery 10days after the onset of symptoms. The epidural emphysema is a rare complication during asthma attacks. The benignity of this complication should not require a systematic chest tomography.

  12. Control of asthma in real life: still a valuable goal?

    Directory of Open Access Journals (Sweden)

    Andriana I. Papaioannou

    2015-06-01

    Full Text Available Although studies show that control of asthma can be achieved in the majority of patients, surveys repeatedly show that this is not the case in real life. Important measures to implement in order to achieve asthma control are trained healthcare professionals, a good patient–doctor relationship, patient education, avoidance of exposure to triggers, personalised management and adherence to treatment. These measures help the majority of asthma patients but have not yet been widely implemented and there should be a concerted action for their implementation. Moreover, further and focused research is needed in severe/refractory asthma.

  13. Comparison of clinically diagnosed asthma with parental assessment of children's asthma in a questionnaire

    DEFF Research Database (Denmark)

    Hederos, C.A.; Hasselgren, M.; Hedlin, G.;

    2007-01-01

    Epidemiological evaluations of the prevalence of asthma are usually based on written questionnaires (WQs) in combination with validation by clinical investigation. In the present investigation, we compared parental assessment of asthma among their preschool children in response to a WQ...... with the corresponding medical records in the same region. An International Study of Asthma and Allergies in Childhood (ISAAC)-based WQ was answered by 75% of the parents of 6295 children aged 1-6 yr. Clinically diagnosed asthma, recorded in connection with admissions to the hospital or a visit to any of the outpatient...... clinics in the same region, were analysed in parallel. Finally, a complementary WQ was sent to the parents of children identified as asthmatic by either or both of this approaches. In response to the WQ 5.9% were claimed to suffer from asthma diagnosed by a doctor. According to the medical records...

  14. Endotoxin as a determinant of asthma and wheeze among rural dwelling children and adolescents: A case–control study

    Directory of Open Access Journals (Sweden)

    Lawson Joshua A

    2012-09-01

    Full Text Available Abstract Background The association between endotoxin exposure and asthma is complex and has been associated with rural living. We examined the relationship between domestic endotoxin and asthma or wheeze among rural school-aged children (6–18 years and assessed the interaction between endotoxin and other characteristics with these outcomes. Methods Between 2005 and 2007 we conducted a case–control study of children 6–18 years in the rural region of Humboldt, Canada. Cases (n = 102 reported doctor-diagnosed asthma or wheeze in the past year. Controls (n = 208 were randomly selected from children without asthma or wheeze. Data were collected to ascertain symptoms, asthma history and indoor environmental exposures (questionnaire, endotoxin (dust collection from the play area floor and child’s mattress, and tobacco smoke exposure (saliva collection. Statistical testing was completed using multiple logistic regression to account for potential confounders and to assess interaction between risk factors. A stratified analysis was also completed to examine the effect of personal history of allergy. Results Among children aged 6–12 years, mattress endotoxin concentration (EU/mg and load (EU/m2 were inversely associated with being a case [odds ratio (OR = 0.44, 95% confidence interval (CI = 0.20-0.98; and OR = 0.38, 95% CI = 0.20-0.75, respectively]. These associations were not observed in older children or with play area endotoxin. Conclusions Our results suggest that endotoxin exposure might be protective for asthma or wheeze. The protective effect is found in younger school-aged, non-allergic children. These results may help explain the inconsistencies in previous studies and suggest that the protective effects of endotoxin in the prevention of atopy and asthma or wheeze are most effective earlier in life.

  15. Heritability of self-reported asthma and allergy : A study in adult Dutch twins, siblings and parents

    NARCIS (Netherlands)

    Willemsen, Gonneke; van Beijsterveldt, Toos C. E. M.; van Baal, Caroline G. C. M.; Postma, Dirkje; Boomsma, Dorret I.

    2008-01-01

    The present study assessed the prevalence of asthma and allergy, and estimated the importance of genetic and environmental influences on asthma and allergy liability and their association. Longitudinal data on self-reported, doctor-diagnosed asthma and allergy were collected in over 14,000 individua

  16. Bronchial asthma

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008049 Activation ralated genes of memory CD+4 T cells in asthma patients. PI Weifeng(皮卫峰),et al. Dept Respir Med, Xinhua Hosp, Sch Med, Shanghai Jiaotong Univ, Shanghai 200092. Chin J Tuberc Respir Dis 2007;30(12):932-935. Objective To screen and identify the genes of activated memory CD+4 T cells in asthma. Methods Differential display polymerase chain reaction(DDPCR) was utilized to identify genes of memory CD+4 T cells after activation from asthmatic patients and normal individuals,

  17. Improving acute medical management: Junior Doctor Emergency Prescription Cards.

    Science.gov (United States)

    Hutton, Joe; Gingell, Megan; Hutchinson, Lisa

    2016-01-01

    Doctors commencing Foundation Year (FY) training face many stresses and challenges. FY doctors are often the first point of contact for acutely unwell and deteriorating patients. Trust guidelines are used to aid acute medical management. Accessing guidelines is often fraught with barriers. Evidence suggests aide-memoire cards can provide easier access to guidelines and management pathways. We aimed to improve prescribing accuracy and efficiency of FY doctors for acute medical conditions within Gloucestershire trust by improving access to and usability of trust guidelines. Questionnaires were distributed to FY doctors to identify acute medical conditions to include on the emergency prescription cards (EPCs). Two small double-sided cards were created containing bullet pointed trust guidelines for: hyper/hypokalaemia, status epilepticus, diabetic emergencies, arrhythmias, myocardial infarction, acute asthma, pulmonary oedema, anaphylaxis and a ward-round checklist. Feedback was used to improve EPCs prior to distribution. Pre (N=53) and post-intervention (N=46) written questionnaires were completed by FY doctors. These assessed acute clinical management including use of guidance, confidence in management, speed of prescribing and EPC "usability". To assess prescribing accuracy, prescriptions for acute medical conditions were reviewed pre (N=8) and post-intervention (N=12). The EPCs were well received (80% quite/very useful) and found "easy to use" (83%). The introduction of EPCs increased guidance use (pre-intervention 58.8%, post-intervention 71.7%), increased confidence (pre-intervention 79%, post-intervention 89%) and significantly improved prescribing speed (p=0.05). There was a significant correlation with confidence and prescribing speed (p = 0.023). The accuracy of prescribed doses improved (pre-intervention 62.5%, post-intervention 87.5% accurate) as did details regarding route / additional required information (pre-intervention 75%, post-intervention 97

  18. [Severe asthma].

    Science.gov (United States)

    González, Claudio D

    2016-01-01

    The objectives of this work were to investigate the frequency of severe asthma (SA) according to WHO definition and to compare SA patients' characteristics with those of non-severe asthma (NSA); secondly, to investigate the level of control reached throughout a period of regular treatment. Between 1-1-2005 and 12-31-2014, 471 medical records from patients with bronchial asthma assisted in Buenos Aires City were analyzed. SA frequency was 40.1% (189/471), being significantly higher among patients from the public health system (47.7%, 108/226 vs. 33%, 81/245, p = 0.001). SA patients were older than NSA ones (51.3 ± 17.4 vs. 42.6 ± 17.1 years, p = 0.000), presented longer time since onset of the disease (median 30 vs. 20 years, p = 0.000), lower educational levels (secondary level or higher 41.7% vs. 58.1%, p = 0.000), lower frequency of rhinitis (47% vs. 60.6%, p = 0.004), more severe levels of airway obstruction (FEV% 50.2 ± 13.7 vs. 77.7 ± 12.4, p = 0.000), more frequent antecedents of Near Fatal Asthma (11.1% vs. 2.8%, p = 0.000), higher levels of serum IgE (median of 410 vs. 279 UI/l, p = 0.01) and higher demand of systemic steroids requirements and hospitalizations (68.7% vs. 50.7%, p = 0.000 and 37.5% vs. 15.9%, p = 0.000, respectively). A 30.6% of SA patients (58/189) reached a follow-up period of 12 months, 13 (22.5%) of whom reached the controlled asthma level. The frequency of SA found seems to be considerable. Multicenter studies to investigate the levels of control reached by SA patients with access to proper treatment are recommended.

  19. Doctors' involvement in torture

    DEFF Research Database (Denmark)

    Sonntag, Jesper

    2008-01-01

    Doctors from both non-democratic and democratic countries are involved in torture. The majority of doctors involved in torture are doctors at risk. Doctors at risk might compromise their ethical duty towards patients for the following possible reasons: individual factors (such as career, economic...

  20. Managing Asthma in Elementary and Middle Schools: Adherence to Federal Laws and National Guidelines

    Science.gov (United States)

    Schilling, Ethan J.; Neuharth-Pritchett, Stacey; Getch, Yvette Q.; Lease, A. Michele

    2017-01-01

    The current study examined teacher-reported asthma management practices in school and adherence to federal guidelines for students with asthma. 593 kindergarten-eighth grade teachers completed surveys regarding compliance with federal laws and policies, information-seeking behavior, asthma-related professional development, and asthma management…

  1. Allergies, asthma, and dust

    Science.gov (United States)

    Reactive airway disease - dust; Bronchial asthma - dust; Triggers - dust ... Things that make allergies or asthma worse are called triggers. Dust is a common trigger. When your asthma or allergies become worse due to dust, you are ...

  2. Allergies, asthma, and molds

    Science.gov (United States)

    Reactive airway - mold; Bronchial asthma - mold; Triggers - mold; Allergic rhinitis - pollen ... Things that make allergies or asthma worse are called triggers. Mold is a common trigger. When your asthma or allergies become worse due to mold, you are ...

  3. Asthma: Basic Information

    Science.gov (United States)

    ... Air Pollution & Respiratory Health Learn How to Control Asthma Language: English Español (Spanish) Recommend on Facebook Tweet ... Treated? Select a Language Español (Spanish) What Is Asthma? Asthma is a disease that affects your lungs. ...

  4. Asthma in Children

    Science.gov (United States)

    ... have asthma. Nearly 9 million of them are children. Children have smaller airways than adults, which makes asthma especially serious for them. Children with asthma may experience wheezing, coughing, chest tightness, ...

  5. Asthma triggers (image)

    Science.gov (United States)

    ... things make your asthma worse. These are called asthma "triggers". Avoiding them is your first step toward feeling better. The most common asthma triggers are mold, pets, dust, grasses, pollen, cockroaches, odors ...

  6. Difficult asthma in adults: recognition and approaches to management.

    Science.gov (United States)

    Harrison, B D W

    2005-09-01

    Difficult asthma must be distinguished from severe asthma. It is then important in patients with suspected difficult asthma to ensure that the diagnosis is correct, and that if the patient has asthma that the attributed symptoms are indeed all genuinely due to the asthma and not to coexisting physical or psychogenic respiratory conditions. It is also important to be alert when there is discordance between symptoms and objective lung function in order to recognize both poor perceivers and over-reactors. Difficult asthma can occur in patients with objectively mild, moderate or severe disease, but the consequences are most dramatic in patients with severe asthma. Asthma may be difficult for the patient, for the clinician or both because of disease factors, doctor or nurse therapist factors, and/or patient factors. Investigation requires access to the full range of respiratory, imaging and allergy tests. It also requires a multidisciplinary approach involving ear, nose and throat specialists and speech therapists, and access to psychiatric and psychological assessment and therapies. Poor compliance is associated with significantly poorer asthma and asthma-related health outcomes. Poor compliance can be recognized in two-thirds of such patients by their not attending scheduled appointments. Poor compliance is significantly associated with anxiety, social deprivation and adverse family circumstances, and these characteristics and adversities probably contribute to the poorly compliant behaviour. In difficult asthma it is important to identify and manage the condition causing the symptoms rather than prescribing more and more asthma therapy. Recognizing psychosocial adversity is essential. A structured approach is essential. There remains a small number of patients with genuine steroid-resistant asthma, some with predominately neutrophilic rather than eosinophilic airway inflammation, and others for whom the secondary gain of continuing symptoms is overwhelming. There is

  7. [Asthma clinical practice guidelines: advantages and pitfalls].

    Science.gov (United States)

    Plaza, Vicente; Bellido-Casado, Jesús; Alonso-Coello, Pablo; Rodrigo, Gustavo

    2009-01-01

    The Clinical Practice Guidelines on asthma have contributed towards unifying concepts and reaching a consensus on performances between different professional groups. However, they have failed in the overall improvement in the management of asthma, the final objective that they are meant to achieve. Today, almost 20 years after they appeared, the majority of asthmatic patients are still inadequately controlled, partly due to lack of follow up by doctors and the rest of health care staff who have to look after them. This lack of follow up of these recommendations is probably associated with a lack of well structured planning in their circulation and implementation. Also, although the recommendations of these guidelines agree in what is essential, they differ in other aspects, which in turn could be determining factors in clinical practice. The purpose of this article has been to establish the main differences in the recommendations that the principal clinical practice guidelines on the disease propose on the diagnosis, classification and treatment of asthma. To do this we have compared, The British Guideline on the Management of Asthma 2007, The Global Strategy for Asthma Management and Prevention/Global Initiative for Asthma 2006 (GINA), the National Prevention program for Education on Asthma (Programa Nacional de Prevención para la Educación del Asma) (NAEPP), the Spanish Guide for the Management of Asthma (Guía Española para el Manejo del Asma 2003) (GEMA) and the ALAT y SEPAR guides, Latin-America and Spain. Recommendations for the Prevention and Treatment of Asthma Exacerbation (América Latina y España. Recomendaciones para la Prevención y el Tratamiento de la Exacerbación Asmática 2008) (ALERTA).

  8. Asthma essentials

    Directory of Open Access Journals (Sweden)

    Timothy Greene

    2013-12-01

    Full Text Available Asthma is a chronic, reversible obstructive disease that when in exacerbation can present to the emergency department in a spectrum of severity. Prompt recognition of the potentially severely ill asthmatic requires a careful history and physical exam while considering alternative diagnoses for the presenting symptoms. Early administration of salbutamol and corticosteroids is indicated in almost all patients with other medications such as ipratropium and magnesium and supportive modalities like BiPAP reserved for sicker patients. The global impact of asthma is increasing, especially amongst children. While the benign clinical presentation is most common and mortality has decreased in recent decades due to improved recognition and care, the ubiquity of the condition and frequent lack of regular outpatient management contribute to the disease claiming 250,000 lives worldwide annually. The emergency physician must be prepared to assess and appropriately manage both the young child with a mild wheeze and the adult in respiratory failure.

  9. Coaching doctoral students

    DEFF Research Database (Denmark)

    Godskesen, Mirjam Irene; Kobayashi, Sofie

    2016-01-01

    of a project on coaching doctoral students. We explore how coaching can contribute to the doctoral students’ development of a broad set of personal competences and suggest that coaching could work as a means to engender self-management and improve relational competences. The analysis of the participants’ self......In this paper we focus on individual coaching carried out by an external coach as a new pedagogical element that can impact doctoral students’ sense of progress in doctoral education. The study used a mixed methods approach in that we draw on quantitative and qualitative data from the evaluation......-reported gains from coaching show that doctoral students experience coaching as an effective method to support the doctoral study process. This study also provides preliminary empirical evidence that coaching of doctoral students can facilitate the doctoral study process so that the doctoral students experience...

  10. Cost incentives for doctors

    DEFF Research Database (Denmark)

    Schottmüller, Christoph

    2013-01-01

    If doctors take the costs of treatment into account when prescribing medication, their objectives differ from their patients' objectives because the patients are insured. This misalignment of interests hampers communication between patient and doctor. Giving cost incentives to doctors increases...... welfare if (i) the doctor's examination technology is sufficiently good or (ii) (marginal) costs of treatment are high enough. If the planner can costlessly choose the extent to which doctors take costs into account, he will opt for less than 100%. Optimal health care systems should implement different...... degrees of cost incentives depending on type of disease and/or doctor....

  11. Finding a Doctor for Your New Baby

    Science.gov (United States)

    ... Your 1- to 2-Year-Old Finding a Doctor for Your New Baby KidsHealth > For Parents > Finding ... to be board certified in their subspecialty. Family Physicians Family physicians must complete 3 years of residency ...

  12. Doctoral research on cadastral development

    DEFF Research Database (Denmark)

    Cagdas, Volkan; Stubkjær, Erik

    2009-01-01

    . The article focuses on the methodological aspect of doctoral research by analyzing ten doctoral dissertations. Our analysis is based on a taxonomy of methodological elements and aims at identifying commonalities and differences among the dissertations in the use of concepts and methods. Having completed......The multitude of rights in land and the recording of these rights are addressed by a number of studies, yet a recognized paradigm for such studies seems missing. Rights in land are recorded and managed through either cadastral systems or land administration systems depending on the legal system...... of cadastral development. This research is multi-disciplinary and draws on elements of theories and methodologies from the natural, the social, the behavioral, and the formal sciences. During the last decade or so, doctoral dissertations have come to constitute a substantial part of this research effort...

  13. Respiratory symptoms and asthma in primary school children in Kuala Lumpur.

    Science.gov (United States)

    Omar, A H

    1990-04-01

    In a cross-sectional study of 7 to 12-year-old primary school children in Kuala Lumpur, the prevalence of chronic cough and/or phlegm, persistent wheeze, and doctor-diagnosed asthma were 8.0%, 8.0% and 8.7%, respectively. The prevalence of asthma (defined as persistent wheeze and/or doctor-diagnosed asthma) was 13.8%. 4.3% experienced at least one episode of chest illness that resulted in inactivity for at least 3 days in the previous year. The mean age of commencement of symptoms in the doctor-diagnosed asthma group was 2.75 years. The prevalence of chronic cough and/or phlegm and persistent wheeze were highest among Indian children (p less than 0.05). More Malays had been diagnosed as having asthma than the other ethnic groups but the differences were not statistically significant. The patients' fathers' low levels of education were associated with chronic cough and/or phlegm (p less than 0.05) but not with other complaints. Asthma was significantly more common among boys than girls. No age differences were noted. Further analysis showed that persistent wheeze and doctor-diagnosed asthma were associated with increased likelihood of other respiratory illnesses or doctor-diagnosed allergy before the age of 2 years.

  14. Are operating room nurses at higher risk of severe persistent asthma? The Nurses' Health Study.

    NARCIS (Netherlands)

    Moual, N. le; Varraso, R.; Zock, J.P.; Henneberger, P.; Speizer, F.E.; Kauffmann, F.; Camargo, C.A.

    2013-01-01

    Objective: To assess the associations between operating room (OR) nursing, a category of health care workers at high risk of exposure to various inhaled agents, and asthma severity/control among women with asthma. Methods: The level of severity/control in nurses with prevalent doctor-diagnosed asthm

  15. Asthma and obesity

    DEFF Research Database (Denmark)

    Juel, Caroline Trunk-Black; Ali, Zarqa; Nilas, Lisbeth

    2012-01-01

    Obesity is a major health problem, and obesity is associated with a high incidence of asthma and poor asthma control. The aim of the present paper is to systematically review the current knowledge of the effect on overall asthma control of weight reduction in overweight and obese adults with asthma....

  16. Find a Cancer Doctor

    Science.gov (United States)

    ... Home > Find a Cancer Doctor Find a Cancer Doctor Status message Locating you... The Find an Oncologist ... and caregivers. The database includes the names of physicians and other health professionals from certain ASCO membership ...

  17. Physiopathology of severe asthma

    OpenAIRE

    Todo-Bom, Ana; Mota-Pinto, Anabela

    2006-01-01

    A história natural da asma e as condições determinantes de evolução para formas moderadas ou graves não estão completamente estabelecidas. Contudo, quer os fatores genéticos quer os fatores ambientais serão determinantes na fisiopatologia e no prognóstico da doença. Nesta revisão são apresentados os mecanismos envolvidos na fisiopatologia da asma grave The natural history of asthma and the determinant factors involved in its evolution from moderate to severe forms are not completely establ...

  18. Perceived involvement in condition management among inner-city youth with asthma and their primary caregivers.

    Science.gov (United States)

    Greenley, Rachel Neff; Josie, Katherine Leigh; Drotar, Dennis

    2006-11-01

    This study examined patterns of agreement versus disagreement in family perceptions of caregiver and youth involvement in asthma management tasks and associations of these patterns with youth asthma outcomes. Fifty-six caregiver-child dyads completed questionnaires of family involvement in asthma management and asthma health outcomes (i.e., symptom days, health care utilization, and medication adherence). Discrepancies were documented for perceptions of both caregiver and youth involvement. Caregiver overestimation of youth involvement in asthma management was associated with greater asthma severity and more asthma symptoms. Discrepancies in family perceptions of involvement pose salient challenges for effective clinical management and require clinical attention.

  19. Occupational asthma in Japan

    OpenAIRE

    Dobashi, Kunio

    2012-01-01

    Research into occupational asthma (OA) in Japan has been led by the Japanese Society of Occupational and Environmental Allergy. The first report about allergic OA identified konjac asthma. After that, many kinds of OA have been reported. Cases of some types of OA, such as konjac asthma and sea squirt asthma, have been dramatically reduced by the efforts of medical personnel. Recently, with the development of new technologies, chemical antigen-induced asthma has increased in Japan. Due to adva...

  20. Talking to Your Child's Doctor

    Science.gov (United States)

    ... to 2-Year-Old Talking to Your Child's Doctor KidsHealth > For Parents > Talking to Your Child's Doctor ... an important role in your child's health? The Doctor-Patient Relationship Today, doctors are pressured to see ...

  1. Working with doctors and nurses

    Science.gov (United States)

    ... doctor Working with doctors and nurses Working with doctors and nurses Answering questions, filling out papers, getting ... my ability to pay? What questions will the doctor or nurse ask? top It’s a good idea ...

  2. Asthma in childhood: a complex, heterogeneous disease

    Directory of Open Access Journals (Sweden)

    Hai Lee Chung

    2011-01-01

    Full Text Available Asthma in childhood is a heterogeneous disease with different phenotypes and variable clinical manifestations, which depend on the age, gender, genetic background, and environmental influences of the patients. Several longitudinal studies have been conducted to classify the phenotypes of childhood asthma, on the basis of the symptoms, triggers of wheezing illness, or pathophysiological features of the disease. These studies have provided us with important information about the different wheezing phenotypes in young children and about potential mechanisms and risk factors for the development of chronic asthma. The goal of these studies was to provide a better insight into the causes and natural course of childhood asthma. It is well-known that complicated interactions between genes and environmental factors contribute to the development of asthma. Because childhood is a period of rapid growth in both the lungs and the immune system, developmental factors should be considered in the pathogenesis of childhood asthma. The pulmonary system continues to grow and develop until linear growth is completed. Longitudinal studies have reported significant age-related immune development during postnatal early life. These observations suggest that the phenotypes of childhood asthma vary among children and also in an individual child over time. Improved classification of heterogeneous conditions of the disease will help determine novel strategies for primary and secondary prevention and for the development of individualized treatment for childhood asthma.

  3. Doctors in Balzac's work.

    Science.gov (United States)

    Moulin, Thierry

    2013-01-01

    Balzac wrote his novels during a time of great literary and scientific change. Romanticism gave way to the school of realism, of which Balzac could be considered the founder. It was via realism, where both the positive and negative aspects of life were depicted, that doctors naturally gained a much more active role in novels. In conjunction with this was the development of science and medicine, which fascinated Balzac, also leading to the significant and prevalent role of doctors in his works. His fascination with the sciences led to him to gain many acquaintances and much knowledge in the medical domain, especially in neuropsychiatry and physiology. His fictional doctors, such as Desplein and Bianchon, thus demonstrate considerable knowledge of pathology, physiology, and neuropsychiatry. The doctors in Balzac's novels can be grouped into four categories: provincial doctors, Parisian doctors, country doctors, and military doctors. They were most often fictitious representations of real individuals (e.g. Guillaume Dupuytren), and often symbolize schools of thought which were in vogue at the time. In addition to the accurate scientific depiction of doctors, it must be noted that his doctors not only played an active role in clinically assessing their patients, but also had a sociological role in assessing society; it is through his doctors that Balzac gave his opinion of the world in which he lived.

  4. What's an Asthma Action Plan?

    Science.gov (United States)

    ... to 2-Year-Old What's an Asthma Action Plan? KidsHealth > For Parents > What's an Asthma Action Plan? ... normal everyday activities without having asthma symptoms. Action Plans Are Unique Each person's experience with asthma is ...

  5. Stay away from asthma triggers

    Science.gov (United States)

    Asthma triggers - stay away from; Asthma triggers - avoiding; Reactive airway disease - triggers; Bronchial asthma - triggers ... to them. Have someone who does not have asthma cut the grass, or wear a facemask if ...

  6. How does a doctor study other doctors being doctors?

    DEFF Research Database (Denmark)

    Risør, Torsten

    The intension of this presentation is to encourage debate on auto-ethnography in medical systems. The empirical starting point will be my present study of how young doctors learn to make decisions about diagnosis and treatment of the individual patient. The study is an ethnographic field study...... that is a part of me? How can I represent the experience and learning of my informants without simply reproducing my own experience? This makes the project both anthropology-at-home and auto-ethnography. I will present an example from the field work to illustrate the many ways in which the auto- part...... involving participant observation and individual interviews with nine newly graduated doctors for a period of 18 months. The background of the ethnographer who is also the author of the present abstract poses a few interesting challenges to the study. I am a doctor doing fieldwork in my own medical culture...

  7. Group asthma education in a pediatric inpatient setting.

    Science.gov (United States)

    Tolomeo, Concettina

    2009-12-01

    Asthma education is an important component of asthma care and management. Children and parents often do not receive asthma education, and frequently, education programs are time consuming. The purpose of this medical record review was to retrospectively determine the impact of a short, group-based, inpatient asthma self-management program on the number of children/parents who received complete asthma education before discharge. The self-management program was instituted in 2006. Participants consisted of all children admitted to a New England children's hospital from January 1, 2005, through December 31, 2006, with a primary diagnosis of asthma. Findings revealed that significantly more (p asthma education before discharge in 2006 versus 2005.

  8. Doctors and pharmaceutical industry.

    Science.gov (United States)

    Beran, Roy G

    2009-09-01

    The pharmaceutical industry is seen as seducing doctors by providing expensive gifts, subsidising travel and underwriting practice expenses in return for those doctors prescribing products that otherwise they would not use. This paints doctors in a very negative light; suggests doctors are available to the highest bidder; implies doctors do not adequately act as independent agents; and that doctors are driven more by self-interest than by patient needs. Similar practices, in other industries, are accepted as normal business behaviour but it is automatically assumed to be improper if the pharmaceutical industry supports doctors. Should the pharmaceutical industry withdraw educational grants then there would be: fewer scientific meetings; reduced attendance at conferences; limited post graduate education; and a depreciated level of maintenance of professional standards. To suggest that doctors prescribe inappropriately in return for largesse maligns their integrity but where there is no scientific reason to choose between different treatments then there can be little argument against selecting the product manufactured by a company that has invested in the doctor and the question arises as to whether this represents bad medicine? This paper will examine what constitutes non-professional conduct in response to inducements by the pharmaceutical industry. It will review: conflict of interest; relationships between doctors and pharma and the consequences for patients; and the need for critical appraisal before automatically decrying this relationship while accepting that there remain those who do not practice ethical medicine.

  9. Asthma and obesity.

    Science.gov (United States)

    Boulet, L-P

    2013-01-01

    The prevalence and incidence of asthma have increased among obese children and adults, particularly among women. Obesity seems to be a predisposing factor for the development of asthma, but the underlying mechanisms of its influence are still uncertain. Various hypotheses have been proposed to explain the link between obesity and asthma such as a common genetic predisposition, developmental changes, altered lung mechanics, the presence of a systemic inflammatory process, and an increased prevalence of associated comorbid conditions. Over-diagnosis of asthma does not seem to be more frequent in obese compared to non-obese subjects, but the added effects of obesity on respiratory symptoms can affect asthma control assessment. Obesity can make asthma more difficult to control and is associated with a reduced beneficial effect of asthma medications. This could be due to a change in asthma phenotype, particularly evidenced as a less eosinophilic type of airway inflammation combined to the added effects of changes in lung mechanics. Weight loss is associated with a universal improvement of asthma and should be part of asthma management in the obese patient. Additional research should be conducted to better determine how obesity influences the development and clinical expression of asthma, establish the optimal management of asthma in this population and determine how obesity affects long-term asthma outcomes in these patients.

  10. The prevalence of asthma in schoolboys of travellers' families.

    LENUS (Irish Health Repository)

    Kearney, P M

    2012-02-03

    This study compared the prevalence of asthma in travelling schoolboys and settled controls to determine whether the travelling lifestyle may be a protective factor in the development of asthma. Information was collected by parental responses to the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire. The design was a cross-sectional study with descriptive and analytical components. The subjects were six to twelve year old schoolboys from all male travelling children in Cork and from a selection of settled schoolboys. In addition the study collected information on the predictor variables--age, passive smoking and number of siblings. The questionnaire was administered to 54 travelling boys and 129 controls. The parent reported prevalence of wheeze and related symptoms were all more common in controls compared with the travelling boys. The values were significant for wheeze in the last year (31.3% v 14.8%; OR-5.6, p = 0.025), and for doctor diagnosed asthma (25.6% v 11.1%; OR = 5.1, p = 0.04). Schoolboys from travelling families have less wheeze and doctor diagnosed asthma than controls. The experience of the travelling lifestyle maybe a protective factor in the development of asthma.

  11. Exercise-Induced Asthma

    Science.gov (United States)

    ... management of exercise-induced bronchoconstriction: A practice parameter. Annals of Allergy, Asthma & Immunology. 2010;105:S1. Krafczyk ... up exercise on exercise-induced bronchoconstriction. Medicine and Science in Sports and Exercise. 2012;44:383. Asthma ...

  12. Psychopathology in difficult asthma

    NARCIS (Netherlands)

    Prins, L.C.; van Son, M.J.M.; Keimpema, A.R.; van Ranst, D; Pommer, A; Meijer, J.W.; Pop, V.J.M.

    2015-01-01

    OBJECTIVE: Within the asthma population, difficult asthma (DA) is a severe condition in which patients present with frequent exacerbations, hospitalizations and emergency room visits. The identification and treatment of psychopathology is included in the management of DA. Psychopathology is supposed

  13. Test Your Asthma Knowledge

    Science.gov (United States)

    ... narrowing of the bronchi. This can make breathing difficult, particularly expiration (exhaling) and can cause a feeling of tightness in the chest. Answer: D. All of these can make asthma worse. But some things that make asthma worse ...

  14. Allergies, asthma, and pollen

    Science.gov (United States)

    Reactive airway - pollen; Bronchial asthma - pollen; Triggers - pollen; Allergic rhinitis - pollen ... Things that make allergies or asthma worse are called triggers. It is important to know your triggers because avoiding them is your first step toward feeling better. ...

  15. Exercise-induced asthma

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000036.htm Exercise-induced asthma To use the sharing features on this page, ... such as running, basketball, or soccer. Use Your Asthma Medicine Before you Exercise Take your short-acting, ...

  16. Smoking and asthma

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000504.htm Smoking and asthma To use the sharing features on ... your allergies or asthma worse are called triggers. Smoking is a trigger for many people who have ...

  17. Obesity and asthma

    DEFF Research Database (Denmark)

    Ali, Zarqa; Ulrik, Charlotte Suppli

    2013-01-01

    Epidemiological data has established increasing adiposity as a risk factor for incident asthma. However, the mechanisms underlying the association between obesity and asthma are incompletely understood. In the present paper, we review current knowledge of possible mechanisms mediating the observed...

  18. Long-term ambient ozone concentration and the incidence of asthma in nonsmoking adults: The Ahsmog study

    Energy Technology Data Exchange (ETDEWEB)

    McDonnell, W.F. [Environmental Protection Agency, Research Triangle Park, NC (United States). National Health and Environmental Effects Research Lab.; Abbey, D.E.; Nishino, N. [Loma Linda Univ., CA (United States). School of Public Health; Lebowitz, M.D. [Univ. of Arizona Coll. of Medicine, Tucson, AZ (United States).

    1999-02-01

    The authors conducted a prospective study of a cohort of 3091 nonsmokers, ages 27 to 87 years, to evaluate the association between long-term ambient ozone exposure and development of adult-onset asthma. Over a 15-year period, 3.2% of males and 4.3% of females reported new doctor diagnoses of asthma. For males, they observed a significant relationship between report of doctor diagnosis of asthma and 20-year mean 8-h average ambient ozone concentration. The authors observed no such relationship for females. Other variables significantly related to development of asthma were a history of ever-smoking for males, and for females, number of years worked with a smoker, age, and a history of childhood pneumonia or bronchitis. Addition of other pollutants to the models did not diminish the relationship between ozone and asthma for males. These data suggest that long-term exposure to ambient ozone is associated with development of asthma in adult males.

  19. Genetics of asthma

    DEFF Research Database (Denmark)

    Thomsen, Simon F

    2015-01-01

    Asthma runs in families, and children of asthmatic parents are at increased risk of asthma. Prediction of disease risk is pivotal for the clinician when counselling atopic families. However, this is not always an easy task bearing in mind the vast and ever-increasing knowledge about asthma genetics...... of methods and advances in asthma genetics in an attempt to help the clinician keep track of the most important knowledge in the field....

  20. Fatal asthma or anaphylaxis?

    OpenAIRE

    Rainbow, J; Browne, G

    2002-01-01

    The incidence of anaphylaxis is under-reported. Children with asthma are frequently atopic and prone to allergic reactions. Parents and clinicians may attribute wheeze of rapid onset to acute severe asthma, rather than recognising an anaphylactic event. Two cases of fatal anaphylaxis are reported who were initially diagnosed as acute severe asthma, and responded poorly to bronchodilator treatment. Survivors of "acute asphyxic asthma" should be screened for reactions to common allergens that p...

  1. Identifying asthma triggers.

    Science.gov (United States)

    McCarty, Justin C; Ferguson, Berrylin J

    2014-02-01

    Asthma has many triggers including rhinosinusitis; allergy; irritants; medications (aspirin in aspirin-exacerbated respiratory disease); and obesity. Paradoxic vocal fold dysfunction mimics asthma and may be present along with asthma. This article reviews each of these triggers, outlining methods of recognizing the trigger and then its management. In many patients more than one trigger may be present. Full appreciation of the complexity of these relationships and targeted therapy to the trigger is needed to best care for the patient with asthma.

  2. Asthma and Pregnancy

    Science.gov (United States)

    ... in the airways of the lungs. When an asthma attack occurs, it is difficult for air to pass through the lungs which ... others have not. In these studies, it is difficult to determine whether the problems noted were due to the mother’s asthma, the medicines needed to control the asthma, or ...

  3. Severe asthma in children.

    Science.gov (United States)

    Guilbert, Theresa W; Bacharier, Leonard B; Fitzpatrick, Anne M

    2014-01-01

    Severe asthma in children is characterized by sustained symptoms despite treatment with high doses of inhaled corticosteroids or oral corticosteroids. Children with severe asthma may fall into 2 categories, difficult-to-treat asthma or severe therapy-resistant asthma. Difficult-to-treat asthma is defined as poor control due to an incorrect diagnosis or comorbidities, or poor adherence due to adverse psychological or environmental factors. In contrast, treatment resistant is defined as difficult asthma despite management of these factors. It is increasingly recognized that severe asthma is a highly heterogeneous disorder associated with a number of clinical and inflammatory phenotypes that have been described in children with severe asthma. Guideline-based drug therapy of severe childhood asthma is based primarily on extrapolated data from adult studies. The recommendation is that children with severe asthma be treated with higher-dose inhaled or oral corticosteroids combined with long-acting β-agonists and other add-on therapies, such as antileukotrienes and methylxanthines. It is important to identify and address the influences that make asthma difficult to control, including reviewing the diagnosis and removing causal or aggravating factors. Better definition of the phenotypes and better targeting of therapy based upon individual patient phenotypes is likely to improve asthma treatment in the future.

  4. School and Asthma

    Science.gov (United States)

    ... What Happens in the Operating Room? School and Asthma KidsHealth > For Kids > School and Asthma A A A What's in this article? Have ... La escuela y el asma If you have asthma , you probably have a routine at home for ...

  5. Exercise-Induced Asthma

    Science.gov (United States)

    ... Your 1- to 2-Year-Old Exercise-Induced Asthma KidsHealth > For Parents > Exercise-Induced Asthma A A ... previous continue Tips for Kids With Exercise-Induced Asthma For the most part, kids with exercise-induced ...

  6. Traveling and Asthma

    Science.gov (United States)

    ... What Happens in the Operating Room? Traveling and Asthma KidsHealth > For Kids > Traveling and Asthma A A A What's in this article? Pack ... Or how about sleepover camp? If you have asthma , you'll be packing more than your clothes ...

  7. Do Allergies Cause Asthma?

    Science.gov (United States)

    ... Happens in the Operating Room? Do Allergies Cause Asthma? KidsHealth > For Kids > Do Allergies Cause Asthma? A A A en español ¿Las alergias provocan ... kinds of allergies are more likely to have asthma. Do you have allergies that affect your nose ...

  8. Antifungals in severe asthma

    NARCIS (Netherlands)

    Parulekar, Amit D.; Diamant, Zuzana; Hanania, Nicola A.

    2015-01-01

    Purpose of review Despite guideline-based treatment, many patients with severe asthma continue to have uncontrolled disease. Fungal allergy is being increasingly recognized in the pathogenesis of severe asthma. Limited data exist on the approach to treatment of fungal asthma. This review summarizes

  9. Nocturnal Dry Cough in the First 7 Years of Life is Associated With Asthma at School Age

    NARCIS (Netherlands)

    Boudewijn, Ilse M.; Savenije, Olga E. M.; Koppelman, Gerard H.; Wijga, Alet H.; Smit, Henriette A.; de Jongste, Johan C.; Gehring, Ulrike; Postma, Dirkje S.; Kerkhof, Marjan

    2015-01-01

    Background: Childhood wheeze is an important, well-known risk factor for asthma, yet little is known about the contribution of nocturnal dry cough. We investigated the association of nocturnal dry cough at ages 1-7 years with doctor-diagnosed asthma at 8 years of age, both in the presence and absenc

  10. Nocturnal dry cough in the first 7 years of life is associated with asthma at school age

    NARCIS (Netherlands)

    Boudewijn, Ilse M; Savenije, Olga E M; Koppelman, Gerard H; Wijga, Alet H; Smit, Henriëtte A; de Jongste, Johan C; Gehring, Ulrike; Postma, Dirkje S; Kerkhof, Marjan

    2015-01-01

    BACKGROUND: Childhood wheeze is an important, well-known risk factor for asthma, yet little is known about the contribution of nocturnal dry cough. We investigated the association of nocturnal dry cough at ages 1-7 years with doctor-diagnosed asthma at 8 years of age, both in the presence and absenc

  11. Attentional Bias in Children with Asthma with and without Anxiety Disorders.

    Science.gov (United States)

    Dudeney, Joanne; Sharpe, Louise; Sicouri, Gemma; Lorimer, Sarah; Dear, Blake F; Jaffe, Adam; Selvadurai, Hiran; Hunt, Caroline

    2017-01-09

    Children with asthma have a high prevalence of anxiety disorders, however, very little is known about the mechanisms that confer vulnerability for anxiety in this population. This study investigated whether children with asthma and anxiety disorders display attentional biases towards threatening stimuli, similar to what has been seen in children with anxiety disorders more generally. We also examined the relationships between attentional biases and anxiety symptomatology and asthma control for children with asthma. Ninety-three children, aged 8-13, took part in the study and were recruited into one of four conditions (asthma/anxiety, asthma, anxiety, control). Asthma was medically confirmed and anxiety was assessed through clinical interview. We used self- and parent-report questionnaires to measure child asthma (ATAQ) and anxiety (SCAS, CASI) variables. Participants completed a visual dot-probe task designed to measure attentional bias towards two types of stimuli: asthma related words and general threat words, as well as tasks to assess reading ability and attentional control. Results showed that attentional biases did not differ between the groups, although children with anxiety disorders displayed poorer attentional control. A significant correlation was found between poor asthma control and an attentional bias of asthma stimuli. While we found no evidence that anxiety disorders in children with asthma were associated with threat- or asthma-related attentional biases, preliminary evidence suggested that children with poor asthma control displayed biases towards asthma-specific stimuli. Future research is needed to explore whether these attentional biases are adaptive.

  12. [Cytokines and asthma].

    Science.gov (United States)

    Gani, F; Senna, G; Piglia, P; Grosso, B; Mezzelani, P; Pozzi, E

    1998-10-01

    Asthma is a chronic inflammatory lung disease in which eosinophils are one of the most important involved cells. These cells accumulate in the lung because of cytokines, which are able to regulate cellular responses. The role of cytokines is well known in allergic asthma: IL4, IL5, IL3, GMCSF are the principally cytokine involved. IL4 regulate IgE synthesis while IL5, (and IL3) cause the activation and accumulation of eosinophils. In non allergic asthma, whilst only IL5 seemed to be important recent data, shows that also IL4 plays an important role. Therefore nowadays no relevant difference seems to exist between allergic and non allergic asthma; instead the primer is different: the allergen in allergic asthma and often an unknown factor in the non allergic asthma. Recently other cytokines have been proved to play a role in the pathogenesis of asthma. IL8 is chemotactic not only for neutrophils but also for eosinophils and might cause chronic inflammation in severe asthma. IL13 works like IL4, while RANTES seems to be a more important chemotactic agent than IL5. Finally IL10, which immunoregulates T lymphocyte responses, may reduce asthma inflammation. In conclusion cytokine made us to learn more about the pathogenesis of asthma even if we do not yet know when and how asthma inflammation develops.

  13. Obesity and asthma.

    Science.gov (United States)

    Gibson, Peter G

    2013-12-01

    There is a global epidemic of asthma and obesity that is concentrated in Westernized and developed countries. A causal association in some people with asthma is suggested by observations that obesity precedes the onset of asthma and that bariatric surgery for morbid obesity can resolve asthma. The obese asthma phenotype features poor asthma control, limited response to corticosteroids, and an exaggeration of the physiological effects of obesity on lung function, which includes a reduction in expiratory reserve volume and airway closure occurring during tidal breathing. Obesity has important implications for asthma treatment. Increasing corticosteroid doses based on poor asthma control, as currently recommended in guidelines, may lead to overtreatment with corticosteroids in obese asthma. Enhanced bronchodilation, particularly of the small airways, may reduce the component of airway closure due to increased bronchomotor tone and suggests that greater emphasis should be placed on long-acting bronchodilators in obese asthma. The societal implications of this are important: with increasing obesity there will be increasing asthma from obesity, and the need to identify successful individual and societal weight-control strategies becomes a key goal.

  14. Epigenetics of asthma.

    Science.gov (United States)

    Durham, Andrew L; Wiegman, Coen; Adcock, Ian M

    2011-11-01

    Asthma is caused by both heritable and environmental factors. It has become clear that genetic studies do not adequately explain the heritability and susceptibility to asthma. The study of epigenetics, heritable non-coding changes to DNA may help to explain the heritable component of asthma. Additionally, epigenetic modifications can be influenced by the environment, including pollution and cigarette smoking, which are known asthma risk factors. These environmental trigger-induced epigenetic changes may be involved in skewing the immune system towards a Th2 phenotype following in utero exposure and thereby enhancing the risk of asthma. Alternatively, they may directly or indirectly modulate the immune and inflammatory processes in asthmatics via effects on treatment responsiveness. The study of epigenetics may therefore play an important role in our understanding and possible treatment of asthma and other allergic diseases. This article is part of a Special Issue entitled: Biochemistry of Asthma.

  15. Obesity and asthma

    DEFF Research Database (Denmark)

    Sivapalan, Pradeesh; Diamant, Zuzana; Ulrik, Charlotte Suppli

    2015-01-01

    PURPOSE OF REVIEW: Obesity has significant impact on asthma incidence and manifestations. The purpose of the review is to discuss recent observations regarding the association between obesity and asthma focusing on underlying mechanisms, clinical presentation, response to therapy and effect...... of weight reduction. RECENT FINDINGS: Clinical and epidemiological studies indicate that obese patients with asthma may represent a unique phenotype, which is more difficult to control, less responsive to asthma medications and by that may have higher healthcare utilization. A number of common comorbidities...... have been linked to both obesity and asthma, and may, therefore, contribute to the obese-asthma phenotype. Furthermore, recently published studies indicate that even a modest weight reduction can improve clinical manifestations and outcome of asthma. SUMMARY: Compared with normal-weight patients, obese...

  16. A comparison of three methods to measure asthma in epidemiologic studies

    DEFF Research Database (Denmark)

    Hansen, Susanne; Strøm, Marin; Maslova, Ekaterina;

    2012-01-01

    Asthma is a heterogeneous outcome and how the condition should be measured to best capture clinically relevant disease in epidemiologic studies remains unclear. We compared three methods of measuring asthma in the Danish National Birth Cohort (n>50.000). When the children were 7 years old...... the asthma prevalence was 3.6%. In conclusion, self-reported asthma, ICD-10 diagnoses from a hospitalization registry and data on anti-asthmatic medication use from a prescription registry lead to different prevalences of asthma in the same cohort of children. The non-overlap between the methods may be due......, the prevalence of asthma was estimated from a self-administered questionnaire using parental report of doctor diagnoses, ICD-10 diagnoses from a population-based hospitalization registry, and data on anti-asthmatic medication from a population-based prescription registry. We assessed the agreement between...

  17. Does using an asthma prompting form improve asthma care in a pediatric office?

    Science.gov (United States)

    Pile, Debra

    2013-01-01

    An asthma exacerbation can be a life-threatening experience. This project tested the effectiveness of using a prompting form to improve childhood asthma care. Thirty randomly selected charts without a prompt form in a pediatric practice were compared for differences with thirty randomly selected charts with a completed prompting form. The number of medications reviewed (p=.001) and the frequency of refills written (p=.024) were significantly higher in the prompt group. Education was higher (p=.000) and triggers were more frequently discussed in the prompt group. The use of a prompting form facilitates discussion and improves preventive asthma care.

  18. Do asthma patients prefer to monitor symptoms or peak flow?

    Science.gov (United States)

    Harver, Andrew; Humphries, C Thomas; Kotses, Harry

    2009-11-01

    We administered a 65-item survey to patients to assess preference of symptoms and peak flow to detect worsening asthma and to collect information about asthma triggers, asthma knowledge sources, and barriers to peak flow meter use. It was completed by 139 asthma patients. Survey responses were comparable for adult and pediatric patients and for those who owned peak flow meters and those who did not. But patients who owned a peak flow meter reported more severe asthma than others. On average, the patients preferred symptoms to peak flow for assessing worsening asthma. It is likely that the preference for symptom over peak flow monitoring was effort related: Patients preferred symptom monitoring because it was the easier of the two to conduct.

  19. Parent misperception of control in childhood/adolescent asthma: the Room to Breathe survey.

    Science.gov (United States)

    Carroll, W D; Wildhaber, J; Brand, P L P

    2012-01-01

    The aim of our study was to determine how often asthma control is achieved in children and adolescents, and how asthma affects parents' and children's daily lives. Interviews, including the childhood asthma control test (C-ACT), were conducted with 1,284 parents of asthmatic children (aged 4-15 yrs), as well as with the children themselves (aged 8-15 yrs; n=943), in Canada, Greece, Hungary, the Netherlands, South Africa and the UK. Parents reported mild asthma attacks at least weekly in 11% of children, and serious attacks (requiring oral corticosteroids or hospitalisation) at least annually in 35%. Although 73% of parents described their child's asthma as mild or intermittent, 40% of children/adolescents had C-ACT scores ≤ 19, indicating inadequate control, and only 14.7% achieved complete Global Initiative for Asthma (GINA)-defined control and just 9.2% achieved Scottish Intercollegiate Guidelines Network (SIGN)/British Thoracic Society (BTS)-defined control. Guideline-defined asthma control was significantly less common than well-controlled asthma using the C-ACT (pAsthma restricted the child's activities in 39% of families and caused lifestyle changes in 70%. Complete asthma control is uncommon in children worldwide. Guideline-defined control measures appear to be more stringent than those defined by C-ACT or families. Overall, parents underestimate their child's asthma severity and overestimate asthma control. This is a major potential barrier to successful asthma treatment in children.

  20. The prevalence, management and burden of asthma - a Nigerian study.

    Science.gov (United States)

    Oni, Alexander O; Erhabor, G E; Egbagbe, E E

    2010-03-01

    Inadequate attention given to the management of asthma and ways of improving treatment could be a significant factor for the increase morbidity and mortality from asthma despite major advances in our understanding of the pathophysiology of the disease. There seems to be paucity of data concerning the management pattern and burden of asthma in Africa. This study was under taken to determine the prevalence, management pattern and the burden of asthma. This study was a cross sectional design involving clinical and lung function assessment. The diagnosis of asthma was made using the clinical features of asthma and lung function parameters (Forced expiratory volume in one second, Peak expiratory flow rate, Reversibility tests). Totally, 120 asthma patients participated in this study. All subjects completed the clinical asthma control questionnaires. All items were rated with the calculation of their mean and percentages. Student t-test was used to calculate the difference between the mean of the lung function tests for subjects and control. The prevalence of asthma among respiratory unit patients was 6.6% and higher in the first three decades of life with female preponderance (F:M=1.5-1).There is a strong family history of asthma(81.7%). Associated allergies include rhinitis (75%), pharyngitis (54%), conjunctivitis (54%) and dermatitis (30%). Percentage of asthma patients treated with bronchodilators alone (70%), combined inhaled bronchodilators and steroid (28.3%). Impaired daily activities include sports (84%), Job career (60%), Physical activity (55%), Social activity (54%), Household chores (61%), Disturbed sleep (53%), Daytime symptoms (51%), Hospitalized(50%). Subjects had significant low lung function values when compared with control (P asthma is very high despite the advanced knowledge of the pathophysiology and management of asthma.

  1. Exploring the impact of workplace cyberbullying on trainee doctors

    OpenAIRE

    Farley, S; Coyne, I; Sprigg, C.; Axtell, C.; Subramanian, G.

    2015-01-01

    Objectives: Workplace bullying is an occupational hazard for trainee doctors. However, little is known about their experiences of cyberbullying at work. This study examines the impact of cyberbullying among trainee doctors, and how attributions of blame for cyberbullying influence individual and work-related outcomes.\\ud \\ud Methods: Doctors at over 6 months into training were asked to complete an online survey that included measures of cyberbullying, blame attribution, negative emotion, job ...

  2. The doctor(s) in house: an analysis of the evolution of the television doctor-hero.

    Science.gov (United States)

    Strauman, Elena C; Goodier, Bethany C

    2011-03-01

    The medical drama and its central character, the doctor-hero have been a mainstay of popular television. House M.D. offers a new (and problematic) iteration of the doctor-hero. House eschews the generic conventions of the "television doctor" by being neither the idealized television doctor of the past, nor the more recent competent but often fallible physicians in entertainment texts. Instead, his character is a fragmented text which privileges the biomedical over the personal or emotional with the ultimate goal of scientifically uncovering and resolving instances of disease. This article examines the implicit and explicit messages in House M.D. and critically analyzes both the show and its lead character in relation to the traditional medical drama genre that highlights the "doctor-hero" as the central character. While at first House seems to completely violate narrative and generic norms, ultimately the program provides a new form that reinforces the presence of the doctor-hero, but highlights House's character as the central figure who is personally and interpersonally problematic but biomedically effective.

  3. Talking to Your Doctor

    Medline Plus

    Full Text Available ... your appointment. Consider bringing a close friend or family member with you. Take notes about what the doctor says, or ask a friend or family member to take notes for you. Learn how ...

  4. Doctor of osteopathic medicine

    Science.gov (United States)

    ... and Wilkins; 2010. Gevitz N. The "doctor of osteopathy": expanding the scope of practice. J Am Osteopath ... 6):ES28-S38. Moore WJ. The eccentricities of osteopathy. BMJ . 2012;345:e5890. Stark J. A degree ...

  5. Finding the Right Doctor

    Science.gov (United States)

    ... you meet someone that doesn’t match your communication style, you should switch,” Dr. Krumholz said. Another part ... for looking around: When you feel that the communication style is not matching your own If your doctor ...

  6. Talking to Your Doctor

    Medline Plus

    Full Text Available ... Simple Clear Health from NIH Cultural Respect Language Access Talking to Your Doctor Research Underway Plain Language ... to take notes for you. Learn how to access your medical records, so you can keep track ...

  7. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... 1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma ... 1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health File Formats Help: How do I ...

  8. Examining the association between childhood asthma and parent and grandparent asthma status: Implications for Practice

    OpenAIRE

    Valerio, Melissa A.; Andreski, Patricia M.; Schoeni, Robert F.; McGonagle, Katherine A.

    2010-01-01

    Examination of intergenerational asthma beyond maternal asthma has been limited. The association between childhood asthma and intergenerational asthma status among a national cohort of children was examined.

  9. University strategy for doctoral training: the Ghent University Doctoral Schools.

    Science.gov (United States)

    Bracke, N; Moens, L

    2010-01-01

    The Doctoral Schools at Ghent University have a three-fold mission: (1) to provide support to doctoral students during their doctoral research, (2) to foster a quality culture in (doctoral) research, (3) to promote the international and social stature and prestige of the doctorate vis-a-vis potential researchers and the potential labour market. The Doctoral Schools offer top-level specialized courses and transferable skills training to doctoral students as part of their doctoral training programme. They establish mechanisms of quality assurance in doctoral research. The Doctoral Schools initialize and support initiatives of internationalization. They also organize information sessions, promotional events and interaction with the labour market, and as such keep a finger on the pulse of external stakeholders.

  10. Asthma in the Elderly

    Directory of Open Access Journals (Sweden)

    Domenico Lorenzo Urso

    2009-01-01

    Full Text Available Bronchial asthma is a common problem with enormous medical and economics impacts. It is an inflammatory disease of the airways associated with intermittent episodes of bronchospasm. Asthma is not uncommon in the elderly patients. Prevalence of asthma is similar in older and younger adults. Asthma in the elderly patient is underdiagnosed because of false perceptions by both patient and physician. The high incidence of comorbid conditions in the elderly patient makes the diagnosis and management more difficult. Correct diagnosis is demonstrated with spirometry. The goals of asthma treatment are to achieve and maintain control of symptoms and to prevent development of irreversible airflow limitation. Asthma drugs are preferably inhaled because this route minimizes systemic absorption and, thus, improves the ratio of the therapeutic benefit to the potential side-effects in elderly patients.

  11. Tobaksrygning og asthma

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Lange, Peter

    2002-01-01

    with asthma. Substantial evidence suggests that smoking affects asthma adversely. Exposure to environmental tobacco smoke, especially maternal smoking in children, may be a significant risk factor for asthma. Such exposure in patients with established asthma is not only associated with more severe symptoms......Cigarette smoking is a well-known health hazard, probably not least for patients suffering from asthma. This review gives a short overview of the effects of passive and active smoking on the inception and outcome with of longitudinal changes in the lung function and mortality of patients......, but also with a poorer quality of life, reduced lung function, and increased utilisation of health care including hospital admissions. Active smoking does not appear to be a significant risk factor for asthma, but is associated with a worse outcome with regard to both longitudinal changes in lung function...

  12. Asthma and obesity

    DEFF Research Database (Denmark)

    Ulrik, Charlotte S

    2016-01-01

    PURPOSE OF REVIEW: Obesity has significant negative impact on asthma control and risk of exacerbations. The purpose of this review is to discuss recent studies evaluating the effects of weight reduction on asthma control in obese adults. RECENT FINDINGS: Clinical studies have shown that weight...... reduction in obese patients is associated with improvements in symptoms, use of controller medication, and asthma-related quality of life together with a reduction in the risk for severe exacerbations. Furthermore, several studies have also revealed improvements in lung function and airway responsiveness...... reduction in obese adults with asthma leads to an overall improvement in asthma control, including airway hyperresponsiveness and inflammation. Weight reduction should be a cornerstone in the management of obese patients with asthma....

  13. Asthma among mink workers

    DEFF Research Database (Denmark)

    Grøntved, Berit; Carstensen, Ole; Petersen, Rolf

    2014-01-01

    We report two cases of asthma among mink workers. The first case is about a mink farmer who had asthma that was difficult to treat. In the medical history there was no clear relation to work, and no conclusive work relation with peak flow monitoring. He had a positive histamine release test to mink...... urine. The second case is about a mink farm worker, who had an asthma attack when handling mink furs. Peak flow monitoring showed a clear relation to this work, but there were no signs of allergy. We conclude that these two cases suggest an increased risk of asthma among mink workers....

  14. Linking obesity and asthma.

    Science.gov (United States)

    Sutherland, E Rand

    2014-04-01

    A growing body of literature suggests that obesity has a significant impact on asthma risk, phenotype, and prognosis. Epidemiological studies have clearly demonstrated that asthma is more likely to occur in obese patients, and health status is impaired in obese individuals with asthma, with obese asthmatics experiencing more symptoms, worse quality of life, increased healthcare use, and increased asthma severity. However, obesity has well-described effects on lung function and mechanics that can lead to symptoms of dyspnea without causing the pathophysiologic changes of asthma. Adding to the challenges of evaluating this association, some studies have failed to demonstrate a robust relationship between obesity and traditional biomarkers of airway inflammation in adult asthmatics, leading to the conclusion that obesity does not necessarily worsen airway inflammation in asthma. In this regard, emerging data suggest that nonatopic mechanisms may be relevant in obese asthmatics, and that these mechanisms may have a direct impact on the response of obese asthmatics to asthma therapies, most notably inhaled glucocorticoids. This article will review selected aspects of the contributions of obesity-related airway and systemic inflammation to asthma, with a focus on the impact of obesity as a modifier of risk, prognosis, and therapeutic response in asthma.

  15. Pharmacogenomics of pediatric asthma

    Directory of Open Access Journals (Sweden)

    Gupta Sarika

    2010-01-01

    Full Text Available Context: Asthma is a complex disease with multiple genetic and environmental factors contributing to it. A component of this complexity is a highly variable response to pharmacological therapy. Pharmacogenomics is the study of the role of genetic determinants in the variable response to therapy. A number of examples of possible pharmacogenomic approaches that may prove of value in the management of asthma are discussed below. Evidence Acquisition: A search of PubMed, Google scholar, E-Medicine, BMJ and Mbase was done using the key words "pharmacogenomics of asthma", "pharmacogenomics of β-agonist, glucocorticoids, leukotriene modifiers, theophylline, muscarinic antagonists in asthma". Results: Presently, there are limited examples of gene polymorphism that can influence response to asthma therapy. Polymorphisms that alter response to asthma therapy include Arg16Gly, Gln27Glu, Thr164Ile for β-agonist receptor, polymorphism of glucocorticoid receptor gene, CRHR1 variants and polymorphism of LTC4S, ALOX5. Polymorphic variants of muscarinic receptors, PDE4 and CYP450 gene variants. Conclusion: It was concluded that genetic variation can improve the response to asthma therapy. However, no gene polymorphism has been associated with consistent results in different populations. Therefore, asthma pharmacogenomic studies in different populations with a large number of subjects are required to make possible tailoring the asthma therapy according to the genetic characteristic of individual patient.

  16. Asthma, sports, and death.

    Science.gov (United States)

    DiDario, A Geoffrey; Becker, Jack M

    2005-01-01

    The impact of asthma on the general population has been described in detail in medical literature. However, asthma also has a significant impact on the pediatric and adult athlete. This is rarely reported in either the lay press or the medical literature. In 2003, Becker and coworkers conducted a retrospective analysis of the incidence of asthma as a direct cause of death in competitive athletes across the United States between 1993 and 2000. They sought to raise awareness that severe asthma exacerbations and even death can occur during sports from asthma in athletes, while still supporting the concept of maximal participation in sporting activities. To their knowledge, this remains the only published study looking specifically at this issue. Fortunately, fatal asthma events are infrequent in either the adult or the pediatric populations. Those rare cases involving athletes are commonly highlighted in the lay press when they do occur, e.g., when the victim is a college football player such as Rashidi Wheeler. Wheeler died of a fatal asthma exacerbation on August 3, 2002, during a conditioning drill as a member of the Northwestern University football team. Although he was known to have chronic asthma with no obvious barriers to health care, he nevertheless succumbed to his condition. Here, we report a similar, although less well-known, case of an adolescent who died as a direct result of an asthma exacerbation during a high school physical education class. We also offer a brief review of the literature regarding morbidity and mortality in athletes.

  17. NAC Manchester Asthma and Allergy Study (NACMAAS): risk factors for asthma and allergic disorders in adults.

    Science.gov (United States)

    Simpson, B M; Custovic, A; Simpson, A; Hallam, C L; Walsh, D; Marolia, H; Campbell, J; Woodcock, A

    2001-03-01

    Asthma and atopic disorders are the most common chronic diseases in the developed countries. Knowledge of the risk factors for these disorders may facilitate the development of preventive strategies aimed at reducing prevalence rates. To investigate the risk factors for asthma and allergic diseases in a large number of adults who are the parents of children in the National Asthma Campaign Manchester Asthma and Allergy Study. All pregnant women and their partners attending "Booking" antenatal clinics were invited to take part in the study. Questionnaire data were collected including the history of asthma and other atopic diseases, pet ownership and smoking habits, and skin prick tests were performed. The prevalence of atopy and the risk factors for asthma and allergic disorders were investigated in all subjects who completed the questionnaire and underwent skin testing. Statistical analysis was carried out using logistic regression. Initially, risk factors were assessed by univariate analysis to see how each potential explanatory variable affected the probability of having allergic disease. Variables were then tested in a forward stepwise multivariate analysis. In 5687 adult subjects there was a very high (48.2%) prevalence of atopy, and 9.7% of subjects had a diagnosis of asthma. In a multivariate regression analysis sensitization to dust mite, cat, dog and mixed grasses were all independently associated with asthma. The odds ratios for current asthma increased with the increasing number of positive skin tests (any two allergens - OR 4.3, 95% CI 3.3-5.5; any three allergens - OR 7.0 95% CI 5.3-9.3; all four allergens - OR 10.4, 95% CI 7.7-14; P Dog ownership (OR 1.31, 95% CI 1.10-1.57; P = 0.003) and current smoking (OR 1.36, 95% CI 1.15-1.62; P = 0.0004) were significantly and directly associated with "asthma ever". Thirteen per cent of participants reported a history of eczema. In the multivariate analysis the strongest independent associate of eczema was

  18. THE DOCTORATE IN ADULT EDUCATION, 1935-1965.

    Science.gov (United States)

    BUSKEY, JOHN H.; HOULE, CYRIL O.

    COMPLETED QUESTIONNAIRES SUBMITTED BY 480 HOLDERS OF AMERICAN ADULT EDUCATION DOCTORATES WERE ANALYZED, PRIMARILY BY KINDS OF WORK PERFORMED AND TYPES OF EMPLOYING INSTITUTIONS. TOTAL DOCTORATES AWARDED BY 30 INSTITUTIONS DURING 1935-65 WERE INDICATED, TOGETHER WITH TOTALS FOR SPECIFIC YEARS. DATA WERE OBTAINED ON (1) AGE DISTRIBUTION OF…

  19. Nutrition communication styles of family doctors: results of quantitative research

    NARCIS (Netherlands)

    Dillen, van S.M.E.; Hiddink, G.J.; Koelen, M.A.; Woerkum, van C.M.J.

    2005-01-01

    Objective: To assess the nutrition communication styles of Dutch family doctors and in particular to assess its psychosocial and sociodemographic correlates. Design: A cross-sectional study in which a representative sample of 600 Dutch family doctors completed a questionnaire. Setting: The survey wa

  20. Doctoral Accounting Candidates: A Profile of Demographics and Perceptions.

    Science.gov (United States)

    Backmon, Ida Robinson

    1998-01-01

    Presents information on minority doctoral students in accounting, drawing on surveys completed by 47 such students. Outlines demographic characteristics, and identifies respondents' rankings of costs and benefits of pursuing a doctorate in accounting. Most respondents were professionally certified and were interested in academic careers. (SLD)

  1. Importance and benefits of the doctoral thesis for medical graduates

    Directory of Open Access Journals (Sweden)

    Giesler, Marianne

    2016-02-01

    Full Text Available Introduction: The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates’ view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation.Method: Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514 and 2010/2011 (N=598 were analysed.Results: One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently “a doctorate is usual” (85% and “improvement of job opportunities” (75%, 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not.Discussion: Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious.

  2. Effects of improved home heating on asthma in community dwelling children: randomised controlled trial

    OpenAIRE

    Howden-Chapman, Philippa; Pierse, Nevil; Nicholls, Sarah; Gillespie-Bennett, Julie; Viggers, Helen; Cunningham, Malcolm; Phipps, Robyn; Boulic, Mikael; Fjällström, Pär; Free, Sarah; Chapman, Ralph; Lloyd, Bob; Wickens, Kristin; Shields, David; Baker, Michael

    2008-01-01

    Objective To assess whether non-polluting, more effective home heating (heat pump, wood pellet burner, flued gas) has a positive effect on the health of children with asthma. Design Randomised controlled trial. Setting Households in five communities in New Zealand. Participants 409 children aged 6-12 years with doctor diagnosed asthma. Interventions Installation of a non-polluting, more effective home heater before winter. The control group received a replacement heater at the end of the tria...

  3. Preschool asthma in Italy: prevalence, risk factors and health resource utilization.

    Science.gov (United States)

    Peroni, Diego G; Piacentini, Giorgio L; Bodini, Alessandro; Boner, Attilio L

    2009-01-01

    Asthma in preschool children is greatly under-diagnosed worldwide. Aim was to investigate prevalence of wheezing, and asthma risk factors, doctor diagnosis, treatment and health resource utilization in preschool children. About 1402 children (3-5 years) attending local kindergartens participated in the study. The International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire (WQ) was used with additional questions on risk factors, asthma diagnosis, treatments, resource utilization. Allergic sensitisation was evaluated by skin prick tests for the common allergens. Prevalence of "wheezing in previous 12 months" and "doctor diagnosed asthma" were 12.1% and 8.6%, respectively. 4.7% of children have had both wheezing in the last 12 months and asthma diagnosis. Significant risk factors for wheezing were rhinitis, parental history of atopy and sensitivity to mites and grass pollens. 27.3% of children with asthma diagnosis, but only 4.9% of children without diagnosis, received regular treatment during the previous year (p<0.0001). Children with more than 4 episodes of wheezing a year received more frequently an asthma diagnosis, but 68.6% were not on regular treatment. Asthma diagnosis was associated with a significant increase in control visits for wheezing (p<0.0001). The prevalence of children requiring at least one hospital emergency visit in the previous year was not different among the two groups (83.3% vs. 82.5%). In preschool children the prevalence of wheezing and asthma is elevated. Preschool asthma seems to be under-treated with few cases receiving regular therapy. The social cost of the disease at this age seems to be elevated because of the high frequency of control and emergency visits.

  4. Parental education on asthma severity in the emergency department and primary care follow-up rates.

    Science.gov (United States)

    Williams, Kelli W; Word, Carolyn; Streck, Maria R; Titus, M Olivia

    2013-07-01

    Asthma is the most prevalent chronic condition affecting children and a common chief complaint in emergency departments (EDs). We aimed to improve parents' understanding of their child's asthma severity on accessing our pediatric ED for an acute asthma exacerbation. A retrospective chart review was conducted to determine outpatient follow-up rates from our ED in 2010-2011. In an attempt to educate parents at ED discharge about their child's asthma severity at presentation, we included a visual severity scale on their discharge instructions. Postdischarge telephone interviews were completed to determine postintervention follow-up rates. Asthma follow-up rates at 1 week improved from 20.8% to 50% after intervention. This difference was statistically significant after controlling for age and clinical asthma score with logistic regression (P education about a child's initial asthma severity is a simple intervention that significantly improved follow-up rates for children seen in the ED for asthma exacerbation.

  5. Not asthma, but GERD: case report.

    Science.gov (United States)

    Wang, Zhonggao

    2007-02-01

    Asthma is a disorder of the lungs characterized by increased responsiveness of the airways, as manifested by episodes of wheezing and increased resistance to expiratory airflow because of varying degrees of smooth muscle contraction, edema of the mucosa, and mucus in the lumen of the bronchi and bronchioles. The stimuli vary widely and include antigens, infection, air pollutants, respiratory tract irrtants, exercise, and emotional factors. This condition is completely different from distress breathing because of laryngotracheal spasm. One of its causes is the gastric content reflux through the pharynx to the larynx because of gastroesophageal reflux disease (GERD), in addition to the typical human avian flu that may cause immediate suffocation by laryngospasm owing to acute larygotrachitis. A patient suffered from GERD without esophageal symptoms, which was diagnosed and treated as bronchial asthma during his five emergency admissions. The admissions were because of episodic attacks of severe air hunger owing to an extreme throat tightening. The patient was being treated for as long as two years. After the correct diagnosis was made and treatment of laporascopic fundaplication was performed, the longstanding "bronchial asthma", after all, completely disappeared. The concept of "not asthma, but GERD" seems undervalued, unappreciated, even misunderstood among patients with intractable asthma. Therefore, such a case is reported in detail, similar cases are mentioned briefly as well, and a mechanism responsible for GERD-originated larryngo-or laryngotracho-spasm is proposed.

  6. Prevalence of childhood asthma in Istanbul, Turkey.

    Science.gov (United States)

    Oneş, U; Sapan, N; Somer, A; Dişçi, R; Salman, N; Güler, N; Yalçin, I

    1997-05-01

    In order to determine the asthma prevalence in 6-12-year-old schoolchildren in Istanbul, we issued 2350 questionnaires, according to ISAAC criteria, in six randomly selected city primary schools to be completed at home by parents. A total of 2232 of the questionnaires were completed, an overall response rate of 94.9%, and 2216 questionnaires were taken into consideration. The prevalence of asthma was found to be 9.8% and wheezing 15.1%. To investigate the effect of socioeconomic status on the prevalence of asthma, we evaluated the heating system at home, the place of residence, the educational levels of the mother and father, the number of people living in the house, the sharing of bedrooms, and the annual family income. In conclusion, the prevalence of childhood asthma was not affected by any of these factors. Atopic family history, food allergy, eczema, and frequent otitis media and sinusitis attacks were evaluated and found to be significant in asthma prevalence.

  7. Nutrition and Asthma

    Directory of Open Access Journals (Sweden)

    Gupta K

    2007-01-01

    Full Text Available Increase in the asthma prevalence in many countries over the recent decades, highlights the need for a greater understanding of the risk factors for asthma. Be-cause asthma is the result of interaction between genetic and environmental fac-tors, increasing prevalence is certainly the result of changes in environmental fac-tors because of process of wesernization. That is the reason for higher prevalence in countries where a traditional to a westernized lifestyle occurred earlier. This increasing prevalence has affected both rural and urban communities, suggesting that local environmental factors such as exposure to allergens or industrial air pol-lutions are not the sole cause. In the last few years, nutrition has represented an important conditioning factor of many cardiovascular, gastrointestinal and chronic pulmonary diseases. So it has been hypothesized that dietary constituents influence the immune system and thus, may also be actively involved in the onset of asthma and other allergic diseases. Dietary constituents can play beneficial as well as det-rimental role in asthma. The possible role of diet in the development of asthma can be described as follows: first, a food allergen can cause asthma. Second, there is role of breast-feeding for prevention of asthma later in life. Third, a low intake of antioxidative dietary constituents might be a risk factor for asthma. Moreover, role of cations such as sodium, potassium and magnesium has been described in development of asthma. Finally, intake of fatty acids specially the role of omega-3 and omega-6 fatty acids play important role in cause of asthma.

  8. Indications for the use of bronchial thermoplasty in severe asthma.

    Science.gov (United States)

    Dheda, Keertan; Koegelenberg, Coenraad F N; Esmail, Aliasgar; Irusen, Elvis; Wechsler, Michael E; Niven, Rob M; Chung, Kian Fan; Bateman, Eric D

    2015-09-18

    Approximately 5% of the ~3 million asthmatics in South Africa have severe asthma that is associated with substantial morbidity, cost, absenteeism, preventable mortality, and the requirement for costly chronic medication that may be associated with significant adverse events. There is an unmet need for alternative safer and more effective interventions for severe asthma. A recently introduced option, bronchial thermoplasty (BT), imparts radiofrequency-generated heat energy to the airways to cause regression of airway smooth muscle. The effectiveness of this technique has been confirmed in randomised control trials and is now endorsed by several international guidelines, including the Global Initiative for Asthma (GINA) guideline, the British Asthma Guideline, and the UK National Institute of Clinical Excellence (NICE) guideline. We recommend BT as a potential therapeutic intervention for severe uncontrolled asthma, provided that it is performed by an experienced pulmonologist at an accredited centre and done within the broader context of appropriate management of the disease by doctors experienced in treating difficult-to-control asthma.

  9. Effect of a home intervention program on pediatric asthma in an environmental justice community.

    Science.gov (United States)

    Shani, Zalika; Scott, Richard G; Schofield, Lynne Steuerle; Johnson, John H; Williams, Ellen R; Hampton, Janiene; Ramprasad, Vatsala

    2015-03-01

    Asthma prevalence rates are at an all-time high in the United States with over 25 million persons diagnosed with asthma. African Americans and other minorities have higher asthma prevalence and higher exposure to environmental factors that worsen asthma as compared to Caucasians. This article describes the evaluation of an inner-city home-based asthma education and environmental remediation program that addressed both indoor and outdoor triggers through collaboration between a health system and local environmental justice organization. The program enrolled 132 children older than 2.5 years and centers on a 4- to 6-week intervention with peer counselors using the U.S. Environmental Protection Agency Asthma Home Environment Checklist and the You Can Control Asthma curriculum. Families receive asthma-friendly environmental home kits. Peer counselors reinforce key asthma management messages and facilitate the completion of Asthma Action Plans. The environmental justice community partner organized block cleanups to reduce outdoor triggers. The evaluation used a pretest-posttest design to assess changes in client behavior and asthma symptoms. Data were collected at baseline and during a 6-month postintervention period. Participants saw enhanced conditions on asthma severity and control. The improvement was greatest for children whose asthma was considered "severe" based on the validated Asthma Control Test. Other positive results include the following: greater completion of Asthma Action Plans, significant reduction in the number of emergency room visits (p = .006), and substantial decreases in school absenteeism (p = .008) and use of rescue medications (p = .049). The evaluation suggests that the program was effective in improving asthma self-management in a high-risk population living within an environmental justice community.

  10. Are doctors altruistic?

    Science.gov (United States)

    Glannon, W; Ross, L F

    2002-04-01

    There is a growing belief in the US that medicine is an altruistic profession, and that physicians display altruism in their daily work. We argue that one of the most fundamental features of medical professionalism is a fiduciary responsibility to patients, which implies a duty or obligation to act in patients' best medical interests. The term that best captures this sense of obligation is "beneficence", which contrasts with "altruism" because the latter act is supererogatory and is beyond obligation. On the other hand, we offer several examples in which patients act altruistically. If it is patients and not the doctors who are altruistic, then the patients are the gift-bearers and to that extent doctors owe them gratitude and respect for their many contributions to medicine. Recognising this might help us better understand the moral significance of the doctor-patient relationship in modern medicine.

  11. How Is Asthma Diagnosed?

    Science.gov (United States)

    ... 1.25 million of those individuals have severe asthma, a condition that can be difficult to control and treat. Learn more about his research by visiting the NHLBI Laboratory of Asthma and Lung Inflammation website: http://www.nhlbi.nih. ...

  12. Traveling and Asthma

    Science.gov (United States)

    ... Emergency Room? What Happens in the Operating Room? Traveling and Asthma KidsHealth > For Kids > Traveling and Asthma A A A What's in this ... t have to get in the way of travel fun. Let's find out how to be prepared ...

  13. Undiagnosed asthma in childhood

    NARCIS (Netherlands)

    van Gent, R.

    2008-01-01

    Asthma is the most prevalent chronic disease in childhood. To study the actual prevalence and impact of undiagnosed childhood asthma in daily life (i.e. quality of life, participation in physical and school activities) we performed a survey in schoolchildren (aged 7-10 years) in the southern part of

  14. Asthma in childhood.

    Science.gov (United States)

    de Benedictis, Fernando Maria; Attanasi, Marina

    2016-03-01

    Several topics on childhood asthma were addressed in the Paediatric Clinical Year in Review session at the 2015 European Respiratory Society International Congress. With regard to the relationship between lower respiratory tract infections and asthma, it emerges that is the number of respiratory episodes in the first years of life, but not the particular viral trigger, to be associated with later asthma development. Understanding which characteristics of individual patients are associated with an increased risk for asthma exacerbation is a critical step to implement strategies preventing these seasonal events. Recent data suggest the possibility that exhaled volatile organic compounds may qualify as biomarkers in detecting early signs of asthma. Adding information of exhaled volatile organic compounds and expression of inflammation genes to a clinical tool significantly improves asthma prediction in preschool wheezy children. Personal communication with children and adolescents is likely more important than the tools actually used for monitoring asthma. Systemic corticosteroids do not affect the long-term prognosis in children with first viral-induced wheezing episode and should be used cautiously during acute episodes. Finally, stress and a polymorphism upstream of a specific gene are both associated with reduced bronchodilator response in children with asthma.

  15. Asthma in childhood

    Directory of Open Access Journals (Sweden)

    Fernando Maria de Benedictis

    2016-03-01

    Full Text Available Several topics on childhood asthma were addressed in the Paediatric Clinical Year in Review session at the 2015 European Respiratory Society International Congress. With regard to the relationship between lower respiratory tract infections and asthma, it emerges that is the number of respiratory episodes in the first years of life, but not the particular viral trigger, to be associated with later asthma development. Understanding which characteristics of individual patients are associated with an increased risk for asthma exacerbation is a critical step to implement strategies preventing these seasonal events. Recent data suggest the possibility that exhaled volatile organic compounds may qualify as biomarkers in detecting early signs of asthma. Adding information of exhaled volatile organic compounds and expression of inflammation genes to a clinical tool significantly improves asthma prediction in preschool wheezy children. Personal communication with children and adolescents is likely more important than the tools actually used for monitoring asthma. Systemic corticosteroids do not affect the long-term prognosis in children with first viral-induced wheezing episode and should be used cautiously during acute episodes. Finally, stress and a polymorphism upstream of a specific gene are both associated with reduced bronchodilator response in children with asthma.

  16. Reflexology and bronchial asthma

    DEFF Research Database (Denmark)

    Brygge, T; Heinig, J H; Collins, P

    2001-01-01

    Many asthma patients seek alternative or adjunctive therapies. One such modality is reflexology, whereby finger pressure is applied to certain parts of the body. The aim of the study was to examine the popular claim that reflexology treatment benefits bronchial asthma. Ten weeks of active...

  17. [Occupational asthma in Hungary].

    Science.gov (United States)

    Endre, László

    2015-05-10

    Occupational asthma belongs to communicable diseases, which should be reported in Hungary. During a 24-year period between January 1990 and December 2013, 180 occupational asthma cases were reported in Hungary (52 cases between 1990 and 1995, 83 cases between 1996 and 2000, 40 cases between 2001 and 2006, and 5 cases between 2007 and 2013). These data are unusual, because according to the official report of the National Korányi Pulmonology Institute in Budapest, at least 14,000 new adult asthma cases were reported in every year between 2000 and 2012 in Hungary. Also, international data indicate that at least 2% of adult patients with asthma have occupational asthma and at least 50 out of 1 million employees develop occupational asthma in each year. In 2003, 631 new occupational asthma patients were reported in the United Kingdom, but only 7 cases in Hungary. Because it is unlikely that the occupational environment in Hungary is much better than anywhere else in the world, it seems that not all new occupational asthma cases are reported in Hungary. Of the 180 reported cases in Hungary, 55 were bakers or other workers in flour mills. There were 11 metal-workers, 10 health care assistants, 9 workers dealing with textiles (tailors, dressmakers, workers in textile industry) and 9 employees worked upon leather and animal fur. According to international data, the most unsafe profession is the animal keeper in scientific laboratories, but only 4 of them were reported as having occupational asthma during the studied 24 years in Hungary. Interestingly, 3 museologists with newly-diagnosed occupational asthma were reported in 2003, but not such cases occurred before or after that year. In this paper the Hungarian literature of occupational asthma is summarized, followed by a review on the classification, pathomechanism, clinical presentation, predisposing factors, diagnostics and therapeutic aspects of the disease. Epidemiological data of adult asthma in Hungary and data from

  18. Surviving the Doctoral Years

    Directory of Open Access Journals (Sweden)

    Scott P. Kerlin

    1995-11-01

    Full Text Available This article probes the implications of neo-conservative public education policies for the future of the academic profession through a detailed examination of critical issues shaping contemporary doctoral education in U.S. and Canadian universities. Institutional and social factors such as financial retrenchment, declining support for affirmative action, downward economic mobility, a weak academic labor market for tenure-track faculty, professional ethics in graduate education, and backlash against women's progress form the backdrop for analysis of the author's survey of current doctoral students' opinions about funding, support, the job market, and quality of learning experiences.

  19. Women Doctors in 1914

    Institute of Scientific and Technical Information of China (English)

    1998-01-01

    THE five women shown here are doctors. Eighty-four years ago, they sat for this photographic portrait. The photo depicts the tasteful combination of East and West. While the photographic studio was decorated in the European style, the women doctors were dressed in traditional Chinese fashion with their hair coiled in Japanese style. We can also see that though the ladies were in vogue for their time, they still displayed shyness facing a male photographer, as most can be observed shifting their eyesight away from the lens.

  20. Mandatory notification of impaired doctors.

    Science.gov (United States)

    Beran, R G

    2014-12-01

    Mandatory reporting of impaired doctors is compulsory in Australasia. Australian Health Practitioner Regulation Agency guidelines for notification claim high benchmark though the Royal Australasian College of Surgeons and the Royal Australasian College of Physicians suggest they still obstruct doctors seeking help. Western Australia excludes mandatory reporting of practitioner-patients. This study examines reporting, consequences and international experiences with notification. Depressed doctors avoid diagnosis and treatment, fearing consequences, yet are more prone to marital problems, substance dependence and needing psychotherapy. South African research confirms isolation of impaired doctors and delayed seeking help with definable characteristics of those at risk. New Zealand data acknowledge: errors occur; questionable contribution from mandatory reporting; issues concerning competence assessment; favouring reporting to senior colleagues or self-intervention to compliance with mandatory reporting. UK found an anaesthetist guilty of professional misconduct for not reporting and sanctioned doctors regarding Harold Shipman. Australians are reluctant to report, fearing legalistic intrusion into care. Australian research confirmed definable characteristics for doctors with psychiatric illness or alcohol abuse. Exposure to legal medicine evokes personal disenchantment for doctors involved. Medicine poses barriers for impaired doctors. Spanish and UK doctors do not use general practitioners and may have suboptimal care. US and European doctors self-medicate using samples. US drug-dependent doctors also prescribe for spouses. Junior doctors are losing empathy with the profession. UK doctors favour private care, avoiding public scrutiny. NZ and Brazil created specific services for doctors, which appear effective. Mandatory reporting may be counterproductive requiring reappraisal.

  1. [Distinguishing asthma from COPD].

    Science.gov (United States)

    Ohara, Kouhei; Samukawa, Takuya; Inoue, Hiromasa

    2016-05-01

    Asthma and chronic obstructive pulmonary disease (COPD) are major public health burdens. Asthma is characterized by airway inflammation, airway narrowing with reversibility, and hyperresponsiveness of airways. COPD has been associated with smoking and exposure to environmental fumes, which typically characterized by persistent airflow limitation and chronic inflammation of the airways. These differences are most apparent when young non-smoker with asthma and older smokers with COPD are compared. However, it would be difficult to differentiate asthma from COPD, especially in elderly who currently smoke or have a significant history of smoking. Furthermore, some patients exhibit characteristics of both diseases, this may represent a phenotype known as asthma-COPD overlap syndrome (ACOS). Therefore, the precise understanding of these diseases is important.

  2. Asthma control in children

    DEFF Research Database (Denmark)

    Pedersen, Søren

    2016-01-01

    The goal of asthma management is to achieve disease control. Poorly controlled asthma is associated with an increased number of days lost from school, exacerbations and days in hospital. Furthermore, children with uncontrolled asthma have more frequent contacts with the health-care system. Recent...... studies have added new information about the effects of poorly controlled asthma on a range of important, but less studied outcomes, including risk of obesity, daily physical activity, cardiovascular fitness, stress, concentration and focused attention, learning disabilities and risk of depression. From...... these studies it seems that poor asthma control may have a greater impact on the child than previously thought. This may have important long-term consequences for the child such as an increased risk of life-style associated diseases and poorer school performance. The level of control seems to be the most...

  3. How to Complete Chronic Disease Prevention and Rehabilitation Using Self-efficacy The-ory for Community Doctors%基于自我效能理论探讨社区医生在慢性病预防与康复中的作用

    Institute of Scientific and Technical Information of China (English)

    杜双霞; 李玉生; 张晓红; 赵合意

    2014-01-01

    现阶段我国社区医疗建设尚属起步阶段,大量社区医生面对新生事物无法快速进入角色,同时社会老龄化进程又使得众多慢性病患者的预防和康复工作进展缓慢。自我效能理论作为一种心理学和社会学的理论,能够较好地指导和帮助社区医生完成对社区慢性病人群的管理。对社区医生运用自我效能理论在慢性病预防与康复方面的作用进行分析探讨。%Community health construction is still in its infancy at present in our country.A large number of com-munity doctors cannot enter the role when facing new things quickly.At the same time,the social aging process make the progress of chronic diseases prevention and rehabilitation slowly with a large number of patients.As a psychology and sociology theory,self-efficacy theory can preferably guide and help the community doctor complete the management of community habitants with chronic diseases.This paper tends to investigate the role of self-effi-cacy theory in chronic disease prevention and rehabilitation for the community doctors.

  4. Asthma control: Patient and environment

    NARCIS (Netherlands)

    Rijssenbeek-Nouwens, L.H.M.

    2015-01-01

    Control of asthma, the goal of asthma treatment, seems hard to obtain. However, it is largely unknown why control of asthma remains difficult in many patients in spite of available powerful medication. In this thesis we studied non-pharmacological factors influencing asthma control: patient related

  5. Factors associated with asthma control.

    NARCIS (Netherlands)

    Vries, M.P. de; Bemt, E.A.J.M. van den; Lince, S.; Muris, J.W.M.; Thoonen, B.P.A.; Schayck, C.P. van

    2005-01-01

    The aim of this study was to evaluate which factors are associated with asthma control experienced by asthma patients. In a cross-sectional study patients aged 16-60 years with mild to moderate asthma were selected. The influence of the following factors on asthma control was studied in a multivaria

  6. The Association of Health Literacy with Illness and Medication Beliefs Among Older Adults with Asthma

    Science.gov (United States)

    Federman, Alex D.; Wolf, Michael; Sofianou, Anastasia; Wilson, Elizabeth A.H.; Martynenko, Melissa; Halm, Ethan A.; Leventhal, Howard; Wisnivesky, Juan P.

    2013-01-01

    Background Suboptimal health literacy (HL) and asthma beliefs are associated with poor asthma self-management and outcomes. We tested the hypothesis that low HL is associated with inaccurate beliefs. Methods Asthmatics ≥ 60 were recruited from hospital and community practices in New York, NY and Chicago, IL (n=420). HL was measured with the Short Test of Functional Health Literacy in Adults; validated instruments derived from the Self Regulation model were used to assess beliefs. The association of beliefs with HL was evaluated with multivariate models. Results Thirty-six percent of patients had low HL; 54% believed they only have asthma when symptoms are present, 29% believed they will not always have asthma and 20% believed that their doctor can cure asthma. HL was associated with beliefs of not having asthma all the time and that asthma can be cured (OR: 1.84, 95% CI: 1.2 to 2.82; OR: 2.22, 95% CI: 1.29 to 3.82, respectively). Patients with low HL were also more likely to be concerned about medication use (β = 0.92, p = .05), despite recognizing their necessity (β = -1.36, p = .01). Conclusions Older asthmatics with low HL endorse erroneous asthma beliefs. Practice implications Health communications for improving self-management behaviors in asthma should employ both health literacy-appropriate strategies and messages to counter illness-related misconceptions. PMID:23523196

  7. Advances in pediatric asthma in 2013: coordinating asthma care.

    Science.gov (United States)

    Szefler, Stanley J

    2014-03-01

    Last year's "Advances in pediatric asthma: moving toward asthma prevention" concluded that "We are well on our way to creating a pathway around wellness in asthma care and also to utilize new tools to predict the risk for asthma and take steps to not only prevent asthma exacerbations but also to prevent the early manifestations of the disease and thus prevent its evolution to severe asthma." This year's summary will focus on recent advances in pediatric asthma on prenatal and postnatal factors altering the natural history of asthma, assessment of asthma control, and new insights regarding potential therapeutic targets for altering the course of asthma in children, as indicated in Journal of Allergy and Clinical Immunology publications in 2013 and early 2014. Recent reports continue to shed light on methods to understand factors that influence the course of asthma, methods to assess and communicate levels of control, and new targets for intervention, as well as new immunomodulators. It will now be important to carefully assess risk factors for the development of asthma, as well as the risk for asthma exacerbations, and to improve the way we communicate this information in the health care system. This will allow parents, primary care physicians, specialists, and provider systems to more effectively intervene in altering the course of asthma and to further reduce asthma morbidity and mortality.

  8. Fourth Doctoral Student Assembly

    CERN Multimedia

    Ingrid Haug

    2016-01-01

    On 10 May, over 130 PhD students and their supervisors, from both CERN and partner universities, gathered for the 4th Doctoral Student Assembly in the Council Chamber.   The assembly was followed by a poster session, at which eighteen doctoral students presented the outcome of their scientific work. The CERN Doctoral Student Programme currently hosts just over 200 students in applied physics, engineering, computing and science communication/education. The programme has been in place since 1985. It enables students to do their research at CERN for a maximum of three years and to work on a PhD thesis, which they defend at their University. The programme is steered by the TSC committee, which holds two selection committees per year, in June and December. The Doctoral Student Assembly was opened by the Director-General, Fabiola Gianotti, who stressed the importance of the programme in the scientific environment at CERN, emphasising that there is no more rewarding activity than lear...

  9. How doctors search

    DEFF Research Database (Denmark)

    Lykke, Marianne; Price, Susan; Delcambre, Lois

    2012-01-01

    to context-specific aspects of the main topic of the documents. We have tested the model in an interactive searching study with family doctors with the purpose to explore doctors’ querying behaviour, how they applied the means for specifying a search, and how these features contributed to the search outcome...

  10. Allergic and nonallergic asthma in children: are they distinct phenotypes?

    Directory of Open Access Journals (Sweden)

    Seyed Alireza Mahdaviani

    2014-10-01

    Full Text Available The aim of current study is to describe clinical similarities and differences between atopic and non-atopic asthma in children. In a cross-sectional study, 95 asthmatic children (75 allergics and 20 nonallergics were included in the study. Demographic, clinical, and familial history were compared between two groups. There was no significant differences between variables like sex, age of onset (p=0.75, severity (p=0.70, and family history among the two groups (p=0.42. Patients with allergic asthma were significantly older than those with non- allergic asthma (11.28 ± 3.19 and 9.75 ± 2.35 years, respectively, p=0.02. The controversy lingers over the presence of a completely distinct phenotype of non-atopic asthma in children. Our study suggested that phenotypes of allergic and non-allergic asthma in children were not entirely distinct.

  11. The Moderating Effect of Personality Traits on Advisor Relationships in Predicting Doctoral Student Burnout

    Science.gov (United States)

    Kosh, Emily P.

    2014-01-01

    Personality affects relationships. During the doctoral education, the second most important factor in degree completion, after financial support, is the student-advisor relationship. Approximately half of doctoral students do not finish their degrees. While it is known mentors have a profound impact on the success of doctoral students, the effect…

  12. Emotional Labour, Training Stress, Burnout, and Depressive Symptoms in Junior Doctors

    Science.gov (United States)

    Rogers, Mary E.; Creed, Peter A.; Searle, Judy

    2014-01-01

    Junior doctors are at risk of work-related burnout and mental health problems due to training workload demands and responsibilities. This study investigated the predictors of work-related burnout and depressive symptoms in junior doctors. Participants were 349 Australian doctors in postgraduate years 1-4, who completed a web-based survey assessing…

  13. The Role of Self-Regulation in Doctoral Students' Status of All but Dissertation (ABD)

    Science.gov (United States)

    Kelley, Martha J.; Salisbury-Glennon, Jill D.

    2016-01-01

    Doctoral student enrollment and study require significant resources such as faculty time, student time, and funding. However, doctoral student attrition is a serious problem nationwide, especially at the dissertation level. When doctoral students do not complete their dissertations, their potential contributions to society are substantially…

  14. Tobaksrygning og asthma

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Lange, Peter

    2002-01-01

    Cigarette smoking is a well-known health hazard, probably not least for patients suffering from asthma. This review gives a short overview of the effects of passive and active smoking on the inception and outcome with of longitudinal changes in the lung function and mortality of patients with ast......Cigarette smoking is a well-known health hazard, probably not least for patients suffering from asthma. This review gives a short overview of the effects of passive and active smoking on the inception and outcome with of longitudinal changes in the lung function and mortality of patients...... with asthma. Substantial evidence suggests that smoking affects asthma adversely. Exposure to environmental tobacco smoke, especially maternal smoking in children, may be a significant risk factor for asthma. Such exposure in patients with established asthma is not only associated with more severe symptoms......, but also with a poorer quality of life, reduced lung function, and increased utilisation of health care including hospital admissions. Active smoking does not appear to be a significant risk factor for asthma, but is associated with a worse outcome with regard to both longitudinal changes in lung function...

  15. Asthma in adolescent athletes.

    Science.gov (United States)

    Carlsen, Kai-Håkon; Hem, Erlend; Stensrud, Trine

    2011-12-01

    Athletes active in endurance sports are at an increased risk of acquiring asthma through their sports activities, especially so for cross-country skiers, biathlon skiers, swimmers and athletes of other endurance sports. Asthma may be present from early childhood or develop while in active sports. This article focuses on the physical activity and sports activities in children and adolescents. Exercise-induced asthma (EIA) is found in 8-10% of a normal child population of school age and in about 35% of children with current asthma. EIA is caused by the markedly increased ventilation during exercise, with increased heat and water loss through respiration, leading to bronchial constriction. The risk of developing asthma in the young athlete is related to the repeated daily training activity with increased epithelial damage of the airways, delayed repair due to the daily repetition of the training and increased airway mucosal inflammation. The increased environmental exposure through the sports activity to environmental agents, such as cold, dry air in skiers and chlorine compounds in swimmers, increases symptoms and signs of asthma and bronchial hyper-responsiveness, either worsening an existing asthma or leading to a novel disease in a previously healthy athlete. Several specific aspects of daily training life, environmental exposure, diagnostic procedures and aspects of treatment related to the regulations of medication use in sports need particular attention when addressing the adolescent athlete with respiratory symptoms.

  16. Teachers’ knowledge of Asthma in primary schools

    Directory of Open Access Journals (Sweden)

    "Movahedi M

    2000-11-01

    Full Text Available A survey was carried out in 1998-99 among 20 selected primary schools in the north, south, east and west regions of Tehran to determine the level of teachers’ knowledge of asthma. 387 (96.7% of 400 questionnaires were completed and evaluated. Five items were investigated: “general knowledge”, “symptoms and triggers”, exercise”, treatment” and “individual experience”. Statistical analysis was performed by using counting statistics. For the correlation of items, Spearman correlation coefficients and willcoxon’s test were used. The teachers in primary schools showed a good basic knowledge of asthma and trigger factors of asthma; 40.6% teachers knew that asthma could not be transmitted by virus. There was no statistically significant effect of teaching experience in terms of years, level of education and contact with asthmatic child on the knowledge score. 24% of teachers felt they had the average information about asthma. We suggest that teachers at primary school receive further instructions in this regard.

  17. The Effect of Endoscopic Sinus Surgery in Chronic Rhinosinusitis Patients With Concurrent Asthma

    Directory of Open Access Journals (Sweden)

    Taheri

    2016-07-01

    Full Text Available Background Chronic rhinosinusitis (CRS and asthma are among the most important health-related conditions with evident socio-economic effects. The relationship between asthma and CRS has been considered in medical references for centuries. Previous studies have shown that treatment interventions targeting disease in one part of the airway are effective for general asthma management. However, the effect of endoscopic sinus surgery (ESS in CRS patients with concurrent asthma remains controversial. Therefore, we aimed to assess the effects of ESS on improvement of asthma in CRS patients with concurrent asthma. Objectives The aim of this study was to evaluate the impact of ESS on asthma in CRS patients. Methods Twenty-five CRS patients with asthma who met our inclusion criteria after taking a complete history underwent physical examination and diagnostic nasal endoscopy, and the asthma control test (ACT questionnaire was administered to them. Six months after ESS, the patients’ asthma was again assessed using the ACT questionnaire. Results Overall, the mean ACT score significantly increased from 12.56 at the baseline to 20.71 after a six-month follow up period (0.001. Conclusions Given the remarkable improvement in asthma control levels, ESS can be considered a useful method for treating CRS patients suffering from asthma.

  18. Eosinophilic Endotype of Asthma.

    Science.gov (United States)

    Aleman, Fernando; Lim, Hui Fang; Nair, Parameswaran

    2016-08-01

    Asthma is a heterogeneous disease that can be classified into different clinical endotypes, depending on the type of airway inflammation, clinical severity, and response to treatment. This article focuses on the eosinophilic endotype of asthma, which is defined by the central role that eosinophils play in the pathophysiology of the condition. It is characterized by elevated sputum and/or blood eosinophils on at least 2 occasions and by a significant response to treatments that suppress eosinophilia. Histopathologic demonstration of eosinophils in the airways provides the most direct diagnosis of eosinophilic asthma; but it is invasive, thus, impractical in clinical practice.

  19. Pediatric asthma disease management.

    Science.gov (United States)

    Myers, T R; Chatburn, R L

    2000-03-01

    The prevalence of asthma in children in the United States is estimated at more than 5% of the population, and it has risen more than 40% in the previous decade. Several guidelines for the management of acute and chronic asthma exist, and they all emphasize several basic components including state-of-the-art pharmacologic treatment, trigger avoidance, and patient self-management skills. This Article highlights the necessary components for pediatric asthma disease management to insure a smooth continuum of care across all disciplines and settings.

  20. Concise guidance: diagnosis, management and prevention of occupational asthma.

    Science.gov (United States)

    Nicholson, Paul J; Cullinan, Paul; Burge, Sherwood

    2012-04-01

    This concise guidance, prepared for physicians, summarises the British Occupational Health Research Foundation guideline for the prevention, identification and management of occupational asthma. Approximately one in six people of working age who develop asthma have work-related asthma, where work has either caused or aggravated their disease. Physicians who assess working adults with asthma need to ask the patient about their job and the materials they work with, and be aware of those that carry particular risks; they should also ask whether symptoms improve regularly on days away from work. A diagnosis of occupational asthma (ie asthma caused by work) should not be made on the basis of history alone, but be supported by immunological and physiological investigations of proven diagnostic benefit. Following a validated diagnosis of occupational asthma, physicians should recommend early avoidance of further exposure, because this offers the best chance of complete recovery. If appropriate and timely interventions are not taken, the prognosis of occupational asthma is poor, with only approximately one-third of workers achieving full symptomatic recovery.

  1. Optimising the management of patients with difficult asthma.

    Science.gov (United States)

    Palmer, Evelyn; Higgins, Bernard

    2015-11-01

    Asthma affects 5.4 million people in the UK, around 1 in 12 of the population. Between 5 and 10% of asthma (depending on the definition used) is categorised as difficult asthma, a term which generally refers to patients who continue to experience symptoms and frequent exacerbations despite the prescription of high-dose asthma therapy. Difficult asthma is an indication for specialist review by an appropriate respiratory physician, but close liaison between primary, secondary and tertiary care is critical and it is therefore important that primary care health professionals should be aware of the principles of management. One of the most important questions to ask is whether the individual with difficult asthma is taking their treatment Identifying this, however, is not easy. GPs could assess prescription uptake, looking for low use of preventers and excess use of short-acting bronchodilators. Newer means of assessing adherence have been developed. Inhaler devices that can monitor completion and timing of actuations have been produced. Meters that measure FeNO are available. A recent UK study found that 12 out of 100 patients referred for difficult asthma did not have reversible airflow obstruction or a history suggestive of asthma. Diagnoses included COPD, cystic fibrosis, cardiomyopathy, respiratory muscle dysfunction and severe anxiety with vocal cord dysfunction.

  2. Asthma in the Elderly: Current Understanding and Future Research Needs

    Science.gov (United States)

    Hanania, Nicola A.; King, Monroe J.; Braman, Sidney S.; Saltoun, Carol; Wise, Robert A.; Enright, Paul; Falsey, Ann A; Mathur, Sameer K.; Ramsdell, Joe W.; Rogers, Linda; Stempel, David A.; Lima, John J.; Fish, James E.; Wilson, Sandra R.; Boyd, Cynthia; Patel, Kushang V.; Irvin, Charles G.; Yawn, Barbara P.; Halm, Ethan A; Wasserman, Stephen I.; Sands, Mark F.; Ershler, William B.; Ledford, Dennis K.

    2011-01-01

    Asthma in the elderly (AIE) is under diagnosed and under treated and there is a paucity of knowledge. The National Institute on Aging convened this workshop to identify what is known, what gaps in knowledge remain and suggest research directions needed to improve the understanding and care of AIE. Asthma presenting at an advanced age often has similar clinical and physiologic consequences as seen with younger individuals but co-morbid illnesses and the psychosocial effects of aging may affect the diagnosis, clinical presentation and care of asthma in this population. At least two phenotypes exist among elderly asthma; those with long-standing asthma have more severe airflow limitation and less complete reversibility than those with late-onset asthma. Many challenges exist in the recognition and treatment of asthma in the elderly. Furthermore, the pathophysiological mechanisms of AIE are likely to be different from those seen in young asthmatics and these differences may influence the clinical course and outcomes of asthma in this population. PMID:21872730

  3. Alexithymia and posttraumatic stress disorder following asthma attack.

    Science.gov (United States)

    Chung, Man Cheung; Wall, Natalie

    2013-09-01

    This study examined the levels of posttraumatic stress disorder (PTSD) following asthma attack (post-asthma attack PTSD) and psychiatric co-morbidity among college students. It also investigated the association between these variables and alexithymia. One hundred and six college students participated in the study and completed an on-line survey comprising the Asthma Symptom Checklist, PTSD Checklist, General Health Questionnaire-28 and Toronto Alexithymia Scale. Ninety-one students without asthma and major illness formed the control group. 2 % met the diagnostic criteria for full-PTSD, while 42 and 56 % met the partial and no-PTSD criteria respectively. Compared with the control, the asthma group reported significantly more somatic problems, social dysfunction and depression and was five times more likely to have an elevated risk of developing a general psychiatric disorder. After adjusting age, marital status, asthma experience and symptoms, alexithymia did not predict PTSD, while difficulty identifying feelings predicted psychiatric co-morbidity. Mediational analyses showed that asthma symptoms partially mediated the link between difficulty identifying feelings and psychiatric co-morbidity. People can develop PTSD symptoms and other psychological difficulties following asthma attack. Alexithymia influenced general psychological difficulties independently of PTSD symptoms.

  4. Doctorateness as a Threshold Concept

    Science.gov (United States)

    Trafford, Vernon; Leshem, Shosh

    2009-01-01

    Achieving a doctorate presents candidates with certain challenges--undertaking the research, writing the thesis and defending both at their viva. Throughout that doctoral journey, candidates are expected to display doctorateness in their thesis via the characteristics of high-quality scholarly research. The blockages that occur and prevent…

  5. Entrepreneurship and UK Doctoral Graduates

    Science.gov (United States)

    Hooley, Tristram; Bentley, Kieran; Marriott, John

    2011-01-01

    This paper discusses the experience of UK doctoral graduates in pursuing entrepreneurial careers: there is evidence that this applies to a substantial number--about 10%--of doctoral graduates. The nature of their experience was explored using 37 interviews with doctoral entrepreneurs. The research was funded by Vitae (www.vitae.ac.uk), an…

  6. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Recommend on Facebook Tweet Share Compartir You can control your asthma and avoid an attack by taking ... people with asthma live healthier lives by gaining control over their asthma. Quick Links Asthma Action Plan ...

  7. TCM Differential Treatment of Cough Variant Asthma

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhong-de; DENG Yi-qi; ZHANG Yu; HAN Yun; LIN Lin; CHAO En-xiang

    2010-01-01

    @@ Cough variant asthma (CVA), also called latent asthma or cough asthma, is a special type of asthma. With gradually deepened understanding of CVA in recent years, good curative effect has been achieved in TCM treatment of CVA.

  8. What's an Asthma Flare-Up?

    Science.gov (United States)

    ... Your 1- to 2-Year-Old What's an Asthma Flare-Up? KidsHealth > For Parents > What's an Asthma ... of a straw that's being pinched. Causes of Asthma Flare-Ups People with asthma have airways that ...

  9. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Children with Current Asthma Overuse of quick-relief medication among persons with active asthma Use of long-term control medication among persons with active asthma Uncontrolled Asthma among ...

  10. Changing doctor prescribing behaviour

    DEFF Research Database (Denmark)

    Gill, P.S.; Mäkelä, M.; Vermeulen, K.M.;

    1999-01-01

    The aim of this overview was to identify interventions that change doctor prescribing behaviour and to derive conclusions for practice and further research. Relevant studies (indicating prescribing as a behaviour change) were located from a database of studies maintained by the Cochrane Collabora......The aim of this overview was to identify interventions that change doctor prescribing behaviour and to derive conclusions for practice and further research. Relevant studies (indicating prescribing as a behaviour change) were located from a database of studies maintained by the Cochrane...... Collaboration on Effective Professional Practice. This register is kept up to date by searching the following databases for reports of relevant research: DHSS-DATA; EMBASE; MEDLINE; SIGLE; Resource Database in Continuing Medical Education (1975-1994), along with bibliographies of related topics, hand searching...

  11. Asthma Triggers: Gain Control

    Science.gov (United States)

    Jump to main content US EPA United States Environmental Protection Agency Search Search Asthma Share Facebook Twitter Google+ ... remove an animal from the home, it is important to thoroughly clean the floors, walls, carpets and ...

  12. Asthma Medications and Pregnancy

    Science.gov (United States)

    ... correctly. Other Asthma Related Medication Treatment Annual influenza vaccine (flu shot) The annual flu shot is recommended for ... second or third trimester. Read more about the flu vaccine . Immunotherapy (allergy shots) Allergy shots should not be ...

  13. Asthma and Food Allergies

    Science.gov (United States)

    ... Pediatrician Health Issues Conditions Abdominal ADHD Allergies & Asthma Autism Cancer Chest & Lungs Chronic Conditions Cleft & Craniofacial Developmental ... prepared food. Last Updated 11/21/2015 Source Nutrition: What Every Parent Needs to Know (Copyright © American ...

  14. Interleukin-16 in asthma

    Institute of Scientific and Technical Information of China (English)

    DENG Jing-min; SHI Huan-zhong

    2006-01-01

    @@ Bronchial asthma is a chronic inflammatory disease of the airways that is characterized by lymphocyte, eosinophil, and mast cell infiltration of the submucosa along with mucous gland hyperplasia and subepithelial fibrosis.

  15. Zoneterapi og asthma

    DEFF Research Database (Denmark)

    Brygge, Thor; Heinig, John Hilligsøe; Collins, Philippa;

    2002-01-01

    INTRODUCTION: Many patients with asthma seek alternative or adjunctive therapies. One such modality is reflexology. Our aim was to examine the popular claim that reflexology treatment benefits bronchial asthma. MATERIAL AND METHODS: Ten weeks of either active or simulated (placebo) reflexology were...... compared in an otherwise blind, controlled trial of 40 patients with asthma. RESULTS: Objective lung function tests did not change. Subjective scores and bronchial sensitivity to histamine improved on both regimens, but no differences were found in the groups receiving active or placebo reflexology....... However, a trend in favour of reflexology became significant when a supplementary analysis of symptom diaries was carried out. At the same time a significant pattern compatible with subconscious un-blinding was found. DISCUSSION: We found no evidence that reflexology has a specific effect on asthma beyond...

  16. Inhaled Asthma Medications

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  17. Asthma, Allergies and Pregnancy

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  18. Exercise and Asthma

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  19. Precipitating factors of asthma.

    Science.gov (United States)

    Lee, T H

    1992-01-01

    Asthma is characterised by bronchial hyperresponsiveness. This feature of the asthmatic diathesis predisposes patients to wheezing in response to a number of different factors. These precipitating factors include specific allergen acting via sensitised mediator cells through an IgE-dependent mechanism. There are irritants which may work through a non-specific manner, or stimuli such as exercise and hyperventilation, which probably also act through mediator release via a non-IgE-dependent manner. The mechanism whereby physical stimuli such as exercise induce bronchoconstriction is of interest, because it increases the context in which the mast cell may participate in acute asthmatic bronchoconstriction. Respiratory infections also commonly provoke asthma, especially in infants and may, indeed, precipitate the asthmatic state itself. Finally, drugs can often trigger asthma attacks and the mechanisms of asthma precipitated by non-steroidal anti-inflammatory drugs such as aspirin have been the subject of recent research.

  20. Find a Doctor - American Optometric Association

    Science.gov (United States)

    ... Doctor Login Join Find a Doctor Find a Doctor Search our database of 28,417 Optometrists. 1 ... Guidelines Evidence-based Optometry Marketplace Home > Find a Doctor Basic Search Advanced Search Fine Tune Your Results ...

  1. Relvar Ellipta for asthma.

    Science.gov (United States)

    2014-08-01

    ▼Relvar Ellipta (GSK) is a dry powder inhaler that contains a corticosteroid (fluticasone furoate) and a long-acting beta2 agonist (vilanterol trifenatate). It is licensed for once-daily use as maintenance therapy for chronic obstructive pulmonary disease (COPD) and asthma. In a previous article we considered its use in the management of COPD.1 Here we review the evidence for Relvar Ellipta in the treatment of patients with asthma.

  2. Doctoral education from a distance.

    Science.gov (United States)

    Effken, Judith A

    2008-12-01

    This article describes the environmental factors that have contributed to the recent rapid growth of nursing doctoral education at a distance. Early and recent efforts to deliver distance doctoral education are discussed, using The University of Arizona College of Nursing experience as the key exemplar. The Community of Inquiry model is introduced as an appropriate model for doctoral education and then used as a framework to evaluate the current state of the art in distance doctoral nursing education. Successes and challenges in delivering doctoral education from a distance are described.

  3. [Asthma, obesity and diet].

    Science.gov (United States)

    Barranco, P; Delgado, J; Gallego, L T; Bobolea, I; Pedrosa, Ma; García de Lorenzo, A; Quirce, S

    2012-01-01

    Asthma and obesity have a considerable impact on public health and their prevalence has increased in recent years. Numerous studies have linked both disorders. Most prospective studies show that obesity is a risk factor for asthma and have found a positive correlation between baseline body mass index (BMI) and the subsequent development of asthma, although these results are not conclusive when studying the association between airway hyperresponsiveness with BMI. Furthermore, several studies suggest that whereas weight gain increases the risk of asthma, weight loss improves the course of the illness. Different factors could explain this association. Obesity is capable of reducing pulmonary compliance, lung volumes and the diameter of peripheral respiratory airways as well as affecting the volume of blood in the lungs and the ventilation-perfusion relationship. Furthermore, the increase in the normal functioning of adipose tissue in obese subjects leads to a systemic proinflammatory state, which produces a rise in the serum concentrations of several cytokines, the soluble fractions of their receptors and chemokines. Many of these mediators are synthesized and secreted by cells from adipose tissue and receive the generic name of adipokines, including IL-6, IL-10, eotaxin, TNF-α, TGF- 1, PCR, leptin y adiponectin. Finally, specific regions of the human genome which are related to both asthma and obesity have been identified. Most studies point out that obesity is capable of increasing the prevalence and incidence of asthma, although this effect appears to be modest. The treatment of obese asthmatics must include a weight control program.

  4. Doctor-Shopping Behavior among Patients with Eye Floaters

    Directory of Open Access Journals (Sweden)

    Gow-Lieng Tseng

    2015-07-01

    Full Text Available Patients suffering from eye floaters often resort to consulting more than one ophthalmologist. The purpose of this study, using the Health Belief Model (HBM, was to identify the factors that influence doctor-shopping behavior among patients with eye floaters. In this cross-sectional survey, 175 outpatients who presented floaters symptoms were enrolled. Data from 143 patients (77 first time visitors and 66 doctor-shoppers who completed the questionnaire were analyzed. Descriptive and logistic regression analyses were performed. We found that women and non-myopia patients were significantly related with frequent attendance and doctor switching. Though the HBM has performed well in a number of health behaviors studies, but most of the conceptual constructors of HBM did not show significant differences between the first time visitors and true doctor-shoppers in this study. Motivation was the only significant category affecting doctor-shopping behavior of patients with eye floaters.

  5. Unity and Detachment: A Discourse Analysis of Doctoral Supervision

    Directory of Open Access Journals (Sweden)

    Caroline Bradbury-Jones

    2007-12-01

    Full Text Available In this article the authors report on an approach that they used to enhance their understanding of the complex nature of doctoral supervision by analyzing e-mail communication within a supervisory relationship. Although some scholars have discussed research supervision, empirical research on the subject is limited, and the authors found no published attempts to explore doctoral supervision through the analysis of e-mail communication. The authors analyze correspondence between one doctoral student and two supervisors using discourse analysis influenced by the Foucauldian notion of disciplinary power. The findings revealed the discourses of unity and detachment operating throughout the course of the doctoral relationship. The authors suggest that research students might be no less detached from their supervisors on completion of their studies than at the beginning of their relationship and argue that understanding the discourses of doctoral supervision can enhance the quality and successful outcome of the experience.

  6. Doctor-Shopping Behavior among Patients with Eye Floaters.

    Science.gov (United States)

    Tseng, Gow-Lieng; Chen, Cheng-Yu

    2015-07-13

    Patients suffering from eye floaters often resort to consulting more than one ophthalmologist. The purpose of this study, using the Health Belief Model (HBM), was to identify the factors that influence doctor-shopping behavior among patients with eye floaters. In this cross-sectional survey, 175 outpatients who presented floaters symptoms were enrolled. Data from 143 patients (77 first time visitors and 66 doctor-shoppers) who completed the questionnaire were analyzed. Descriptive and logistic regression analyses were performed. We found that women and non-myopia patients were significantly related with frequent attendance and doctor switching. Though the HBM has performed well in a number of health behaviors studies, but most of the conceptual constructors of HBM did not show significant differences between the first time visitors and true doctor-shoppers in this study. Motivation was the only significant category affecting doctor-shopping behavior of patients with eye floaters.

  7. Prognostic characteristics of asthma diagnosis in early childhood in clinical practice

    NARCIS (Netherlands)

    Wever-Hess, J; Kouwenberg, JM; Duiverman, EJ; Hermans, J; Wever, AMJ

    1999-01-01

    A registration study from clinical practice was set up to assess the prognostic value of symptoms and laboratory data at first visit for doctor-diagnosed 'asthma' in early childhood. A total of 419 children aged 0-4 y, who were newly referred to the outpatient department of the Juliana Children's Ho

  8. Role of Asthma Education in the Management of Adult Asthma

    Directory of Open Access Journals (Sweden)

    Johanne Côté

    1995-01-01

    Full Text Available When a patient is newly diagnosed as having asthma, he or she is often prescribed new medication without getting much information on the disease and its treatment. This article emphasizes the need to educate asthmatics. Asthma treatment should begin with a proper adjustment of the medication, allowing asthmatics to lead a normal life. All asthmatics should be shown how to use their inhalation device properly. They should he knowledgeable about the basic aspects of asthma, airway inflammation and bronchoconstriction, use or medication and early symptoms heralding an asthma attack. Environmental factors that may trigger an asthma attack should be explained. Patients should be able to self-monitor asthma using either symptom severity or a peak flow meter. Because asthma is an unpredictable disease, patients should have a self-action plan to implement when their asthma deteriorates.

  9. Agricultural exposure and asthma risk in the AGRICAN French cohort.

    Science.gov (United States)

    Baldi, Isabelle; Robert, Céline; Piantoni, Florence; Tual, Séverine; Bouvier, Ghislaine; Lebailly, Pierre; Raherison, Chantal

    2014-01-01

    Epidemiological studies have reported an increased risk of respiratory diseases in agricultural population, but a protective "farm-effect" has also been reported for asthma. In the AGRICAN cohort, self-reported doctor-diagnosed asthma was analyzed according to allergy, in relation with history of life-time exposure to 13 crops and 5 livestock, pesticide exposure and early life on a farm, taking into account sex, age, education and body mass index. Among the 1246 asthmatics (8.0%), 505 were allergic (3.3%) and 719 non-allergic (4.6%). In multivariate analysis, a significant excess was observed, only for allergic asthma, in vine-growing (OR=1.43, p=0.002), fruit-growing (OR=1.58, p=0.001), greenhouses (OR=1.66, p=0.02), grasslands (OR=1.35, p=0.009), beets (OR=1.52, p=0.003) and horses (OR=1.35, p=0.04). Pesticide use and history of pesticide poisoning were significantly associated with allergic asthma in grassland, vineyards and fruit-growing and with non-allergic asthma in beets. Living on a farm in the first year of life tended to be protective for childhood allergic asthma in farms with livestock (OR=0.72, p=0.07) but deleterious in farms with vineyards, fruit or vegetables (OR=1.44, p=0.07). In AGRICAN, an increased risk of allergic asthma was observed with crop exposure, pesticide use and early life on a farm, especially in vine-growing, grassland, beets, fruit and vegetable-growing.

  10. The Significance of Asthma Follow-Up Consultations for Adherence to Asthma Medication, Asthma Medication Beliefs, and Asthma Control

    Directory of Open Access Journals (Sweden)

    Malin Axelsson

    2015-01-01

    Full Text Available Objective. The aim was to investigate adherence to asthma medication treatment, medication beliefs, and asthma control in relation to asthma follow-up consultations in asthmatics in the general population. A further aim was to describe associations between adherence, medication beliefs, and asthma control. Method. In the population-based West Sweden Asthma Study, data allowing calculation of adherence for 4.5 years based on pharmacy records were obtained from 165 adult asthmatics. Additional data were collected through questionnaires and structured interviews. Results. The mean adherence value for filled prescriptions for regular asthma medication was 68% (median 55.3% but varied over the year under study. Adherence to combination inhalers with corticosteroids and long-acting beta2 agonists was higher than adherence to single inhalers with corticosteroids only. More than one-third of participants reported not having seen an asthma nurse or physician for several years. Regular asthma follow-up consultations were associated with both higher adherence and the belief that asthma medication was necessary but were not associated with asthma control. Conclusions. Adherence to asthma medication treatment was low and varied over the year under study. The current study suggests that quality improvements in asthma care are needed if adherence to asthma medication is to be improved.

  11. Asthma control cost-utility randomized trial evaluation (ACCURATE: the goals of asthma treatment

    Directory of Open Access Journals (Sweden)

    Honkoop Persijn J

    2011-11-01

    Full Text Available Abstract Background Despite the availability of effective therapies, asthma remains a source of significant morbidity and use of health care resources. The central research question of the ACCURATE trial is whether maximal doses of (combination therapy should be used for long periods in an attempt to achieve complete control of all features of asthma. An additional question is whether patients and society value the potential incremental benefit, if any, sufficiently to concur with such a treatment approach. We assessed patient preferences and cost-effectiveness of three treatment strategies aimed at achieving different levels of clinical control: 1. sufficiently controlled asthma 2. strictly controlled asthma 3. strictly controlled asthma based on exhaled nitric oxide as an additional disease marker Design 720 Patients with mild to moderate persistent asthma from general practices with a practice nurse, age 18-50 yr, daily treatment with inhaled corticosteroids (more then 3 months usage of inhaled corticosteroids in the previous year, will be identified via patient registries of general practices in the Leiden, Nijmegen, and Amsterdam areas in The Netherlands. The design is a 12-month cluster-randomised parallel trial with 40 general practices in each of the three arms. The patients will visit the general practice at baseline, 3, 6, 9, and 12 months. At each planned and unplanned visit to the general practice treatment will be adjusted with support of an internet-based asthma monitoring system supervised by a central coordinating specialist nurse. Patient preferences and utilities will be assessed by questionnaire and interview. Data on asthma control, treatment step, adherence to treatment, utilities and costs will be obtained every 3 months and at each unplanned visit. Differences in societal costs (medication, other (health care and productivity will be compared to differences in the number of limited activity days and in quality adjusted

  12. Association between Electronic Cigarette Use and Asthma among High School Students in South Korea.

    Directory of Open Access Journals (Sweden)

    Jun Ho Cho

    Full Text Available Little is known about health outcomes related to electronic cigarette (EC use, despite its growing popularity. The aim of this study is to investigate the association between EC use and asthma.The study design is a cross-sectional study. A total of 35,904 high school students were included as the final study population. The presence of asthma was based on a student's self-reported doctor diagnosis of asthma in the past 12 months.Prevalence rates of asthmatics in 'current EC users' (n = 2,513, 'former EC users' (n = 2,078, and 'never EC users' (n = 31,313, were 3.9% (n = 98, 2.2% (n = 46 and 1.7% (n = 530, respectively. Comparing 'current EC' users with 'never EC' users, the unadjusted OR for asthma was 2.36 (95% CI: 1.89-2.94. In order to control for the effect of conventional cigarette (CC smoking, after stratifying the subjects by the three CC smoking categories (never CC, former CC, and current CC, within the 'never CC' category, the unadjusted OR for asthma for 'current EC' users was 3.41 (95% CI: 1.79-6.49, and the adjusted OR was 2.74 (95% CI: 1.30-5.78. Severe asthma was reflected by the number of days absent from school due to asthma symptoms; current EC users had the highest adjusted OR for severe asthma compared to 'never EC' users.When compared to a reference population of high school students in South Korea, EC users have an increased association with asthma and are more likely to have had days absent from school due to severe asthma symptoms. In conclusion, the results indicate that EC use may be a risk factor for asthma. The results may be useful in developing a scientific basis for the evaluation of a potential health hazard by EC.

  13. The potential role of vitamin D in the link between obesity and asthma severity/control in children.

    Science.gov (United States)

    Vo, Phuong; Bair-Merritt, Megan; Camargo, Carlos A

    2015-06-01

    Childhood obesity and asthma are major public health problems. Obesity is not only associated with increased risk of incident asthma, but it may worsen asthma severity/control. Although the mechanisms linking obesity with asthma expression have not been completely elucidated, evidence suggests that increased frequency of acute respiratory infection (ARI) and decreased corticosteroid responsiveness may help to explain how obesity worsens asthma expression. In addition, obese individuals have low vitamin D status, and emerging evidence suggests vitamin D affects risk of ARI and corticosteroid responsiveness in individuals with asthma. In this review, we summarize the association between obesity and asthma severity/control in children and discuss ARI and corticosteroid responsiveness as potential mediators in the obesity-asthma pathway. We also discuss the potential role of vitamin D, including a brief summary of recent randomized controlled trials of vitamin D supplementation.

  14. Genetics Home Reference: allergic asthma

    Science.gov (United States)

    ... 1 link) American Academy of Allergy Asthma and Immunology: Asthma Treatment and Management General Information from MedlinePlus (5 links) Diagnostic Tests Drug Therapy Genetic Counseling Palliative Care Surgery and Rehabilitation Related Information How are genetic conditions ...

  15. Allergy and Asthma Health Magazine

    Science.gov (United States)

    ... Of Age Older Adults Allergy and Asthma Health Magazine Women Infant, Children and Teenagers Living With Lung ... written by Respiratory Experts Like no other health magazine, Allergy & Asthma Health Magazine is published by people ...

  16. Smoking and Asthma (For Parents)

    Science.gov (United States)

    ... get absorbed into upholstery, clothing, and carpeting, leaving carcinogens that can't be washed away with soap ... asthma, let friends, relatives, and caregivers know that tobacco smoke may cause an asthma flare-up. To ...

  17. Junior doctors' knowledge of applied clinical anatomy.

    Science.gov (United States)

    Gupta, Yuri; Morgan, Mia; Singh, Annika; Ellis, Harold

    2008-05-01

    This study examines the level of knowledge of applied clinical anatomy among junior doctors. A multiple-choice questionnaire was designed, which covered 15 areas of anatomical knowledge essential to clinical practice, for example, important surface landmarks and interpretation of radiographs. The questionnaire was completed by 128 individuals. They comprised anatomy demonstrators, preregistration house officers (PRHOs), senior house officers (SHOs) and specialist registrars (SpRs) across the range of medical and surgical specialities. Answers were scored and analyzed by group, allowing comparison not only between newly qualified PRHOs and more senior doctors, but also with anatomy demonstrators who had undergone more traditional anatomical training. The results reveal a wide variation of knowledge among junior doctors, with PRHOs scoring an average of 72.1%, SHOs 77.1%, SpRs 82.4%, and demonstrators 82.9%. This progression in knowledge up the clinical hierarchy may reflect clinical experience building upon the foundations laid in medical school, although with demonstrators topping the league table, it seems that intensive academic training is the most beneficial. With junior doctors' training in the UK currently in flux, these results highlight the need for training in clinical anatomy to hold an important place in the development of tomorrow's clinicians.

  18. Doctor Alberto Zabaleta Lombana

    OpenAIRE

    2011-01-01

    El Doctor Alberto Zabaleta Lombana nació en la población de Turbaco, Bolívar, el nueve de Abril de 1923. Toda su formación intelectual transcurrió en los claustros de la Universidad de Cartagena. En 1936 ingresó a la Facultad de Filosofía y Letras (Bachillerato), luego pasó a la Facultad de Medicina hasta obtener su grado de Médico en 1953. Posteriormente en 1959 inició la Jefatura de Clínica Obstetricia (Residencia como se denominan en el presente) en la Universidad de Cartagena y en la Clín...

  19. Comparing a disease-specific and a generic health-related quality of life instrument in subjects with asthma from the general population

    Directory of Open Access Journals (Sweden)

    Rochat Thierry

    2008-02-01

    Full Text Available Abstract Background Few epidemiologic studies have assessed health-related quality of life (HRQL of asthma patients from a general population and it is unclear which instrument is best suitable for this purpose. We investigated the validity of the Asthma Quality of Life Questionnaire (AQLQ and the SF-36 completed by individuals with asthma from the population-based SAPALDIA (Swiss study on air pollution and lung diseases in adults cohort. Methods The study included 258 participants with a physician-diagnosed asthma who had completed the AQLQ and SF-36. We assessed floor and ceiling effects, internal consistency reliability and cross-sectional validity with a priori hypotheses that correlations between the specific HRQL domains (e.g. "symptoms" or "physical functioning" and the corresponding external validation measures (respiratory symptoms, need for doctor visits, limitation in activities due to asthma and lung function would capture similar aspects and be correlated moderately (≥ 0.3 to strongly (≥ 0.5, whereas non-corresponding domains be correlated weakly with each other ( Results The AQLQ showed pronounced ceiling effects with all median domain scores above 6 (scores varied from 1–7. For the SF-36, ceiling effects were present in 5 out of 8 domains. Cronbach's alpha was >0.7 for all AQLQ and SF-36 domains. Correlations between the AQLQ domains "respiratory symptoms", "activity limitation" and "environmental exposure", and the validation measures ranged from 0.29–0.57. Correlations between the "emotional function" domain and the validation measures were also in this range (0.31–0.55 and not as low as we hypothesized. For the SF-36, correlations between "physical functioning" and "role physical", and the validation measures ranged from 0.25–0.56, whereas "role emotional" and "mental health" correlated with these measures from 0.01–0.23. Conclusion The AQLQ and the SF-36 showed fairly good internal consistency. Both instruments

  20. Japanese Guideline for Adult Asthma

    Directory of Open Access Journals (Sweden)

    Ken Ohta

    2011-01-01

    Full Text Available Adult bronchial asthma (hereinafter, asthma is characterized by chronic airway inflammation, reversible airway narrowing, and airway hyperresponsiveness. Long-standing asthma induces airway remodeling to cause an intractable asthma. The number of patients with asthma has increased, while the number of patients who die from asthma has decreased (1.7 per 100,000 patients in 2009. The aim of asthma treatment is to enable patients with asthma to lead a healthy life without any symptoms. A partnership between physicians and patients is indispensable for appropriate treatment. Long-term management with agents and elimination of causes and risk factors are fundamental to asthma treatment. Four steps in pharmacotherapy differentiate mild to intensive treatments; each step includes an appropriate daily dose of an inhaled corticosteroid (ICS, varying from low to high doses. Long-acting β2 agonists (LABA, leukotriene receptor antagonists, and theophylline sustained-release preparation are recommended as concomitant drugs, while anti-IgE antibody therapy is a new choice for the most severe and persistent asthma. Inhaled β2 agonists, aminophylline, corticosteroids, adrenaline, oxygen therapy, etc., are used as needed against acute exacerbations. Allergic rhinitis, chronic obstructive pulmonary disease (COPD, aspirin induced asthma, pregnancy, and cough variant asthma are also important factors that need to be considered.

  1. Childhood asthma and physical activity

    DEFF Research Database (Denmark)

    Lochte, Lene; Nielsen, Kim G; Petersen, Poul Erik

    2016-01-01

    BACKGROUND: Childhood asthma is a global problem affecting the respiratory health of children. Physical activity (PA) plays a role in the relationship between asthma and respiratory health. We hypothesized that a low level of PA would be associated with asthma in children and adolescents...

  2. Genetics of onset of asthma

    NARCIS (Netherlands)

    Dijk, F. Nicole; de Jongste, Johan C.; Postma, Dirkje S.; Koppelman, Gerard H.

    2013-01-01

    Purpose of review Most asthma starts early in life. Defining phenotypes of asthma at this age is difficult as many preschool children have asthma-like respiratory symptoms. This review discusses progress in defining early wheezing phenotypes and describes genetic factors associated with the age of o

  3. Defining asthma in genetic studies

    NARCIS (Netherlands)

    Koppelman, GH; Postma, DS; Meijer, G.

    1999-01-01

    Genetic studies have been hampered by the lack of a gold standard to diagnose asthma. The complex nature of asthma makes it more difficult to identify asthma genes. Therefore, approaches to define phenotypes, which have been successful in other genetically complex diseases, may be applied to define

  4. How Do Asthma Medicines Work?

    Science.gov (United States)

    ... What Happens in the Operating Room? How Do Asthma Medicines Work? KidsHealth > For Kids > How Do Asthma Medicines Work? A A A en español ¿Cómo funcionan los medicamentos para el asma? People with asthma have what is called a chronic (say: KRAH- ...

  5. Rhinitis: a complication to asthma

    DEFF Research Database (Denmark)

    Hansen, J W; Thomsen, S F; Nolte, H;

    2010-01-01

    Asthma and rhinitis often co-occur, and this potentially increases the disease severity and impacts negatively on the quality of life. We studied disease severity, airway responsiveness, atopy, quality of life and treatment in subjects with both asthma and rhinitis compared to patients with asthma...

  6. Compliance amongst asthma patients registered for an asthma disease risk-management programme in South Africa.

    Science.gov (United States)

    Opedun, Ntombombuso; Ehlers, Valerie J; Roos, Janetta H

    2011-09-27

    The study attempted to identify the factors that influence compliance amongst 1039 members and their dependants of a particular medical aid scheme in South Africa who were registered for an asthma disease risk-management (DRM) programme. The sample consisted of 200 systematically selected individuals or their dependants. A quantitative, exploratory, and descriptive study was undertaken. Questionnaires for completion were posted to the individuals or their dependants. The Statistica 7.1 computer program was used to analyse the data.Most asthma patients did not comply with the DRM programme because they lacked knowledge of the programme. Asthma patients' compliance with the DRM programme can be enhanced by the sustained, positive attitudes of their health providers and case managers; better promotion of the programme; and by involving the patients to a greater extent in the long-term management of their disease.Asthma patients require education about healthy lifestyles that would empower them to successfully manage their condition, which would prevent or at least reduce asthma attacks and/or hospital admissions.

  7. Compliance amongst asthma patients registered for an asthma disease risk-management programme in South Africa

    Directory of Open Access Journals (Sweden)

    Ntombombuso Opedun

    2011-09-01

    Full Text Available The study attempted to identify the factors that influence compliance amongst 1039 members and their dependants of a particular medical aid scheme in South Africa who were registered for an asthma disease risk-management (DRM programme. The sample consisted of 200 systematically selected individuals or their dependants. A quantitative, exploratory, and descriptive study was undertaken. Questionnaires for completion were posted to the individuals or their dependants. The Statistica 7.1 computer program was used to analyse the data.Most asthma patients did not comply with the DRM programme because they lacked knowledge of the programme. Asthma patients’ compliance with the DRM programme can be enhanced by the sustained, positive attitudes of their health providers and case managers; better promotion of the programme; and by involving the patients to a greater extent in the long-term management of their disease.Asthma patients require education about healthy lifestyles that would empower them to successfully manage their condition, which would prevent or at least reduce asthma attacks and/or hospital admissions.

  8. 260例哮喘部分控制儿童发病因素的病例对照研究%Casecontrol study on risk factors for 260 cases of children with partial control of asthma

    Institute of Scientific and Technical Information of China (English)

    张岩; 宋桂华; 郭彦荣; 于素平; 管志伟; 吕伟刚

    2016-01-01

    Objective:To investigate the risk factors and protective factors for children with partial control of asthma. Methods:260 cases of children with partial control of asthma were as the study group.260 cases of children with complete control of asthma were as the control group,which was analyzed with univariate and multivariate Logistic regression. Results:The misuse of drugs,history of severe pneumonia,complicated with sinusitis,the accumulated use of antibiotic more than 30 days in one year were risk factors for the control of asthma.Some guidelines from clinical asthma physicians and the adjuvant therapy by Chinese medicine from Traditional Chinese medicine doctor at catabasis were the protective factors for asthma.Conclusion:The risk factors for children with partial control of asthma were related to the children’s own factors and the guidelines from clinical asthma physicians.%目的:探讨哮喘部分控制儿童发病因素和保护因素。方法:收治部分控制哮喘儿童260例作为研究组,完全控制哮喘儿童260例作为对照组,采用单因素和多因素Logistic回归分析。结果:使用药物方法错误、既往有重症肺炎病史、合并鼻窦炎、1年抗生素使用累计大于30 d为哮喘控制的危险因素。有固定哮喘专业临床医师指导、缓解期有中医医师指导使用中药辅助治疗为哮喘的保护因素。结论:哮喘部分控制儿童发病因素与患儿自身因素和有哮喘专业医生的指导用药有关。

  9. Japanese Guideline for Childhood Asthma 2014

    Directory of Open Access Journals (Sweden)

    Yuhei Hamasaki

    2014-01-01

    Full Text Available The Japanese Guideline for the Diagnosis and Treatment of Allergic Diseases 2013 (JAGL 2013 describes childhood asthma after the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2012 (JPGL 2012 by the Japanese Society of Pediatric Allergy and Clinical Immunology. JAGL 2013 provides information on diagnosis by age group from infancy to puberty (0–15 years of age, treatment for acute exacerbations, long-term management by anti-inflammatory drugs, daily life guidance, and patient education to allow non-specialist physicians to refer to this guideline for routine medical treatment. JAGL differs from the Global Initiative for Asthma Guideline (GINA in that JAGL emphasizes early diagnosis and intervention at <2 years and 2–5 years of age. A management method, including step-up or step-down of long-term management drugs based on the status of asthma control levels, as in JAGL, is easy to understand, and thus the Guideline is suitable as a frame of reference for routine medical treatment. JAGL has also introduced treatment and management using a control test on children, recommending that the physician aim at complete control by avoiding exacerbation factors and by appropriate use of anti-inflammatory drugs.

  10. Langerhans Cell Histiocytosis Presenting as Uncontrolled Asthma

    Directory of Open Access Journals (Sweden)

    Frederic A. Rawlins

    2013-01-01

    Full Text Available Langerhans cell histiocytosis (LCH is an uncommon disorder affecting primarily young adult smokers. It is characterized by abnormal proliferation of Langerhans cells, specialized monocyte-macrophage lineage antigen-presenting cells. LCH can affect the lungs in isolation or as part of a systemic disease. Most commonly, the disease presents in the third or fourth decade without gender predominance. Symptoms typically include dyspnea and cough. Commonly, physical examination is unremarkable but cor pulmonale may be observed in advanced disease. The chest radiograph is typically abnormal with nodular or interstitial infiltrates and cystic changes. High-resolution computed tomography of the chest with these findings in the middle and upper lobes of an adult smoker is virtually diagnostic of LCH. Pulmonary function assessment is variable. Asthma has rarely been reported in association with this disorder. There are only three reported cases of the diagnosis of concomitant asthma which have been made in association with the diagnosis of LCH. We present a case in which our patient presented with signs and symptoms of asthma to include confirmatory findings of airway hyperresponsiveness. The diagnosis of LCH was established after the patient failed to respond to conventional treatment for asthma, and further evaluation was completed.

  11. Environmental air toxics: role in asthma occurrence?

    OpenAIRE

    Larsen, Gary L.; Beskid, Craig; Shirnamé-Moré, Lata

    2002-01-01

    The National Urban Air Toxics Research Center (NUATRC) hosted its first scientific workshop in 1994 that focused on possible relationships between air toxics and asthma. From that meeting came recommendations for future research including a need for more complete individual personal exposure assessments so that determinations of personal exposures to pollutants could be made. In the spring of 2001, NUATRC held a second such workshop to review progress made in this area during the intervening ...

  12. The Effect of Labor Market Conditions and Financial Aid on Doctoral Student Retention

    Science.gov (United States)

    Ampaw, Frimpomaa D.

    2010-01-01

    Forty-three percent of doctoral students never complete their degree. This dropout is the highest among graduate and professional degree programs. Previous cross sectional studies of doctoral students' retention show the importance of financial aid in predicting degree completion. The studies however, do not estimate the labor market's effect on…

  13. Student Satisfaction with Graduate Supervision in Doctoral Programs Primarily Delivered in Distance Education Settings

    Science.gov (United States)

    Erichsen, Elizabeth Anne; Bolliger, Doris U.; Halupa, Colleen

    2014-01-01

    There are no universal, precise, or explicit criteria for completing a doctoral degree successfully. Researchers and practitioners have pointed out how difficult and time consuming the supervision of graduate student research can be. When students in doctoral programs complete their degrees via distance delivery, supervision of graduate students…

  14. Re-Imagining Doctoral Education: Professional Doctorates and beyond

    Science.gov (United States)

    Lee, Alison; Brennan, Marie; Green, Bill

    2009-01-01

    Portents of the demise of the Professional Doctorate have emerged in some recent policy and institutional circles in Australia, raising questions about the meaning and relevance of the Professional Doctorate in an era of "league tables" and research assessment in Australia. This article argues that such portents, based largely on narrow…

  15. Ion channels in asthma.

    Science.gov (United States)

    Valverde, Miguel A; Cantero-Recasens, Gerard; Garcia-Elias, Anna; Jung, Carole; Carreras-Sureda, Amado; Vicente, Rubén

    2011-09-23

    Ion channels are specialized transmembrane proteins that permit the passive flow of ions following their electrochemical gradients. In the airways, ion channels participate in the production of epithelium-based hydroelectrolytic secretions and in the control of intracellular Ca(2+) levels that will ultimately activate almost all lung cells, either resident or circulating. Thus, ion channels have been the center of many studies aiming to understand asthma pathophysiological mechanisms or to identify therapeutic targets for better control of the disease. In this minireview, we focus on molecular, genetic, and animal model studies associating ion channels with asthma.

  16. Are the prevalence and treatment of asthma similar in elite athletes and the aged-matched non-athlete population?

    Science.gov (United States)

    Locke, S; Marks, G

    2007-12-01

    The objective of this study was to determine the prevalence of asthma and use of asthma medications in elite athletes compared with an age-matched non-athlete population. Data were collected from the respiratory component of annual medical screening of 424 elite athletes from the Queensland Academy of Sport. Measures included the prevalence of current asthma and ever doctor-diagnosed asthma, and the prevalence of use of treatment for asthma including beta-agonists and inhaled corticosteroid medication. The prevalence of current asthma in athletes aged 18-29 years was 14% (95% CI, 9-19%), which did not differ significantly from the prevalence in the non-athlete control population (11%; 95% CI, 9-12%, P=0.3). Of athletes with current asthma, 27% were not taking any medications for asthma, and 25% were treated with short-acting beta-agonist medications alone and were not taking inhaled corticosteroids. These data indicate that the overall cumulative and period prevalence of asthma in Queensland athletes is similar to that in the general age-matched population. Athletes use beta-agonists with a frequency similar to the general population.

  17. Asthma care: Structural foundations at primary health care at Al-Qassim region, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    AL-Haddad Nasser

    2006-01-01

    Full Text Available BACKGROUND: Proper structural foundations for asthma care at primary health care centers [PHCCs], are of essential importance, regarding its management. OBJECTIVE: To assess the adherence of PHCCs to the recommended structural foundation for asthma care. MATERIALS AND METHODS: 35 PHCCs were selected in a cluster random fashion. A questionnaire for structural standards was designed, based on the Saudi national protocol for the management of asthma (SNPMA. A physician and a nurse, each from PHCC, were trained for data collection. Structural facilities deficiency was arbitrarily classified into: least deficient (>75%, moderate to severe deficient (25-75% and most deficient (< 25%. RESULTS: The total population registered, was 131190 [urban: 85701 (65.4%, rural: 45489 (34.6%]. Total registered asthmatics was 4093 [urban: 2585 (63.1%, rural: 1508 (36.9%]. The asthma prevalence rate did not differ significantly between urban (3% and rural (3.3% areas . Structural facilities distribution for asthma care, did not significantly vary among urban and rural PHCCs and none of them fulfilled 100% of the desired standards. The least deficient, were the availability of asthma register and salbutamol, in its various forms. The moderately to severely deficient were the SNPMA, peak flow meter (PFM, nebulizer system, Theophylline and systemic corticosteroid. However, they were most deficient in trained doctors and nurses, record charts for Peak flow meter, spacer, educational material and inhalers of corticosteroid or cromoglycate. CONCLUSION: Proper structural foundations for asthma care at PHCCs, at AL-Qassim region, were below the desired national standards. They were most deficient in trained doctors and nurses, record charts for PFM, spacers, educational material and anti-inflammatory inhalers. Future health directorate strategies have to provide such beneficial interventions for proper asthma care.

  18. What is the optimal management option for occupational asthma?

    Directory of Open Access Journals (Sweden)

    O. Vandenplas

    2012-06-01

    Full Text Available The optimal management of occupational asthma remains uncertain in clinical practice. The aim of this review was to analyse the published information pertaining to the management of occupational asthma in order to produce evidence-based statements and recommendations. A systematic literature search was conducted up to March 2010 to identify original studies addressing the following different treatment options: 1 persistence of exposure; 2 pharmacological treatment; 3 complete avoidance of exposure; 4 reduction of exposure; and 5 the use of personal protective equipment. After full text evaluation of 83 potentially relevant articles, 52 studies were retained for analysis.The conclusions from this systematic review are limited by the methodological weaknesses of most published studies. Critical analysis of available evidence indicates that: 1 persistent exposure to the causal agent is more likely to result in asthma worsening than complete avoidance; 2 there is insufficient evidence to determine whether pharmacological treatment can alter the course of asthma in subjects who remain exposed; 3 avoidance of exposure leads to recovery of asthma in less than one-third of affected workers; 4 reduction of exposure seems to be less beneficial than complete avoidance of exposure; and 5 personal respiratory equipment does not provide complete protection.

  19. Determinants of allergic rhinitis in young children with asthma.

    Directory of Open Access Journals (Sweden)

    Lise Moussu

    Full Text Available BACKGROUND: In the preschool period, allergic rhinitis (AR is infrequent and thus under-diagnosed. However, recent works have highlighted the occurrence of AR in toddlers although the causes of AR in this young population remain unknown. The objective of this study was to identify determinants of AR in young children with asthma. METHODS: We carried out a case-control study of 227 children with active asthma and enrolled in the Trousseau Asthma Program. AR and other allergic diseases (asthma, food allergy and eczema were diagnosed by medical doctors using standardized questionnaires. Parental history of AR and asthma, biological markers of atopy (total IgE, blood eosinophilia, allergic sensitization towards food and aeroallergens and environmental parameters were also collected. RESULTS: Forty one of the children (18.1% had AR. By univariate logistic regression analysis, AR was mainly associated with peanut sensitization (OR = 6.75; p = 0.002; food allergy (OR = 4.31; p = 0.026; mold exposure (OR = 3.81 p<0.01 and parental history of AR (OR = 1.42; p = 0.046. Due to the strong link between food allergy and peanut sensitization three models of multivariate logistic regression were performed and confirmed that AR is associated with peanut sensitization but also food allergy and mold exposure. A random forest analysis was also performed to explain AR. The results reinforced the logistic analysis that peanut sensitization and mold exposure were the principal determinants of AR. CONCLUSIONS & CLINICAL RELEVANCE: These results stress the importance of investigating AR in young children with asthma to potentially diagnose a particularly severe allergic asthmatic phenotype. Moreover, these data evoke the hypothesis that peanut could be an aeroallergen.

  20. Modeling the impact of increased adherence to asthma therapy.

    Directory of Open Access Journals (Sweden)

    Amory Schlender

    Full Text Available BACKGROUND: Nonadherence to medications occurs in up to 70% of patients with asthma. The effect of improving adherence is not well quantified. We developed a mathematical model with which to assess the population-level effects of improving medication prescribing and adherence for asthma. METHODS: A mathematical model, calibrated to clinical trial data from the U.S. NHLBI-funded SOCS trial and validated using data from the NHLBI SLIC trial, was used to model the effects of increased prescribing and adherence to asthma controllers. The simulated population consisted of 4,930 individuals with asthma, derived from a sample the National Asthma Survey. Main outcomes were controller use, reliever use, unscheduled doctor visits, emergency department (ED visits, and hospitalizations. RESULTS: For the calibration, simulated outcomes agreed closely with SOCS trial outcomes, with treatment failure hazard ratios [95% confidence interval] of 0.92 [0.58-1.26], 0.97 [0.49-1.45], and 1.01 [0-1.87] for simulation vs. trial in the in placebo, salmeterol, and triamcinolone arms, respectively. For validation, simulated outcomes predicted mid- and end-point treatment failure rates, hazard ratios 1.21 [0.08-2.34] and 0.83 [0.60-1.07], respectively, for patients treated with salmeterol/triamcinolone during the first half of the SLIC study and salmeterol monotherapy during the second half. The model performed less well for patients treated with salmeterol/triamcinolone during the entire study duration, with mid- and end-point hazard ratios 0.83 [0.00-2.12] and 0.37 [0.10-0.65], respectively. Simulation of optimal adherence and prescribing indicated that closing adherence and prescription gaps could prevent as many as nine million unscheduled doctor visits, four million emergency department visits, and one million asthma-related hospitalizations each year in the U.S. CONCLUSIONS: Improvements in medication adherence and prescribing could have a substantial impact on

  1. The Social Work Practice Doctorate

    Science.gov (United States)

    Hartocollis, Lina; Cnaan, Ram A.; Ledwith, Kate

    2014-01-01

    This article provides a systematic review of the emerging practice doctorate in social work. Based on the experience of the first such Doctor of Social Work (DSW) program, we provide information regarding the program origins and rationale, development, current structure, and future direction. Such information will enrich the discussion on the role…

  2. Will Medical Technology Deskill Doctors?

    Science.gov (United States)

    Lu, Jingyan

    2016-01-01

    This paper discusses the impact of medical technology on health care in light of the fact that doctors are becoming more reliant on technology for obtaining patient information, making diagnoses and in carrying out treatments. Evidence has shown that technology can negatively affect doctor-patient communications, physical examination skills, and…

  3. Talking to Your Child's Doctor

    Science.gov (United States)

    ... a Better Relationship en español Cómo conversar con el médico de su hijo Your child's doctor can ... don't be afraid to give the doctor feedback about your office visit experience, such as whether ...

  4. Allergy, asthma and the environment; Allergie, Asthma und Umwelt

    Energy Technology Data Exchange (ETDEWEB)

    Ring, J. [Klinik und Poliklinik fuer Dermatologie und Allergologie am Biederstein, Technische Univ. Muenchen (Germany); Gfesser, M. [Klinik und Poliklinik fuer Dermatologie und Allergologie am Biederstein, Technische Univ. Muenchen (Germany)

    1996-10-11

    Asthma is a chronic inflammatory disease of the airways. Asthma and other allergic diseases have increased in prevalence during the last decades in many industrialized countries. Among other hypotheses, the possible role of environmental pollutants has received much public and scientific attention. Some pollutants may modulate the different phases of allergic reactions. Inflammation is a critical feature in the pathogenesis of asthma and therefore, beside allergen avoidance, anti-inflammatory treatment is the first line therapy of asthma. Cysteinyl-leukotrienes are lipid mediators which appear to play a major role in the pathophysiology of asthma. Based on current data, it appears that leukotrience receptor antagonists have bronchodilative and anti-inflammatory effects and may therefore enrich the pharmacotherapeutic spectrum within the therapeutic concept of patient management in asthma. (orig.) [Deutsch] Asthma bronchiale ist eine entzuendliche Erkrankung der Atemwege. Epidemiologische Studien konnten eine deutliche Zunahme der Erkrankung in den letzten zwei Jahrzehnten aufzeigen. In der Entstehung von Allergien und Asthma bronchiale spielen Umwelteinfluesse eine grosse Rolle. Luftschadstoffe scheinen mit verschiedenen Allergie-Parametern bei der Sensibilisierung, Symptombildung und Chronifizierung zu interferieren. Da beim Asthma bronchiale neben der Bronchokonstriktion die Entzuendung der Bronchialschleimhaut eine besondere Rolle spielt, wird heute neben Allergenkarenz und prophylaktischen Massnahmen eine fruehzeitige antientzuendliche Asthmatherapie angestrebt. Cysteinyl-Leukotriene gehoeren zu den wirksamsten Entzuendungsmediatoren beim Asthma bronchiale. Leukotrien-Rezeptorantagonisten scheinen sowohl bronchodilatatorische als auch antientzuendliche Wirkungen zu haben und koennten so innerhalb eines Gesamtkonzeptes von antiallergischer und antiasthmatischer Therapie das pharmakotherapeutische Spektrum bereichern. (orig.)

  5. Early identification of atopy in the prediction of persistent asthma in children

    NARCIS (Netherlands)

    Sly, Peter D.; Boner, Attilio L.; Bjorksten, Bengt; Bush, Andy; Custovic, Adnan; Eigenmann, Philippe A.; Gern, James E.; Gerritsen, Jorrit; Hamelmann, Eckard; Helms, Peter J.; Lemanske, Robert F.; Martinez, Fernando; Pedersen, Soren; Renz, Harald; Sampson, Hugh; von Mutius, Erika; Wahn, Ulrich; Holt, Patrick G.

    2008-01-01

    The long-term solution to the asthma epidemic is thought to be prevention, and not treatment of established disease. Atopic asthma arises from gene-environment interactions, which mainly take place during a short period in prenatal and postnatal development. These interactions are not completely und

  6. Predictors of changes in sick leave in workers with asthma: a follow-up study.

    NARCIS (Netherlands)

    Boot, C.R.L.; Vercoulen, J.H.M.M.; Gulden, J.W.J. van der; Orbon, K.H.; Rooijackers, J.; Weel, C. van; Folgering, H.T.M.

    2005-01-01

    OBJECTIVE: The aim of this prospective study was to investigate predictors of 1-year changes in sick leave in workers with asthma. METHODS: The initial cohort consisted of 111 workers with asthma. One-hundred and one participants completed the follow-up after 1 year. Self-reported sick leave over th

  7. Changes in prevalence of chronic obstructive pulmonary disease and asthma in the US population and associated risk factors.

    Science.gov (United States)

    Halldin, Cara N; Doney, Brent C; Hnizdo, Eva

    2015-02-01

    Chronic lower airway diseases, including chronic obstructive pulmonary disease (COPD) and asthma, are currently the third leading cause of death in the United States. We aimed to evaluate changes in prevalence of and risk factors for COPD and asthma among the US adult population. We evaluated changes in prevalence of self-reported doctor-diagnosed COPD (i.e. chronic bronchitis and emphysema) and asthma and self-reported respiratory symptoms comparing data from the 1988-1994 and 2007-2010 National Health and Nutrition Examination Surveys. To investigate changes in the severity of each outcome over the two periods, we calculated changes in the proportions of spirometry-based airflow obstruction for each outcome. Prevalence of doctor-diagnosed chronic bronchitis and emphysema decreased significantly mainly among males, while asthma increased only among females. The self-reported disease and the respiratory symptoms were associated with increased prevalence of airflow obstruction for both periods. However, the prevalence of airflow obstruction decreased significantly in the second period among those with shortness of breath and doctor-diagnosed respiratory conditions (chronic bronchitis, emphysema, and asthma). COPD outcomes and asthma were associated with lower education, smoking, underweight and obesity, and occupational dusts and fumes exposure. Chronic lower airway diseases continue to be major public health problems. However, decreased prevalence of doctor-diagnosed chronic bronchitis and emphysema (in males) and decreased prevalence of airflow obstruction in those with respiratory symptoms and doctor-diagnosed respiratory diseases may indicate a declining trend and decrease in disease severity between the two periods. Continued focus on prevention of these diseases through public health interventions is prudent.

  8. Bronchial Thermoplasty in Asthma

    Directory of Open Access Journals (Sweden)

    Wayne Mitzner

    2006-01-01

    Full Text Available In this review we discuss the potential of a new procedure, termed Bronchial Thermoplasty to prevent serious consequences resulting from excessive airway narrowing. The most important factor in minimizing an asthmatic attack is limiting the degree of smooth muscle shortening. The premise that airway smooth muscle can be either inactivated or obliterated without any long-term alteration of other lung tissues, and that airway function will remain normal, albeit with reduced bronchoconstriction, has now been demonstrated in dogs, a subset of normal subjects, and mild asthmatics. Bronchial Thermoplasty may thus develop into a useful clinical procedure to effectively impair the ability for airway smooth muscle to reach the levels of pathologic narrowing that characterizes an asthma attack. It may also enable more successful treatment of asthma patients who are unresponsive to more conventional therapies. Whether this will remain stable for the lifetime of the patient still remains to be determined, but at the present time, there are no indications that the smooth muscle contractility will return. This successful preliminary experience showing that Bronchial Thermoplasty could be safely performed in patients with asthma has led to an ongoing clinical trial at a number of sites in Europe and North America designed to examine the effectiveness of this procedure in subjects with moderately severe asthma.

  9. Elastin in asthma

    NARCIS (Netherlands)

    Reddel, Caroline J; Weiss, Anthony S; Burgess, Janette K

    2012-01-01

    Extracellular matrix is generally increased in asthma, causing thickening of the airways which may either increase or decrease airway responsiveness, depending on the mechanical requirements of the deposited matrix. However, in vitro studies have shown that the altered extracellular matrix produced

  10. Occupational Neutrophilic Asthma

    Directory of Open Access Journals (Sweden)

    Richard Leigh

    1999-01-01

    Full Text Available Occupational asthma is typically associated with an eosinophilic bronchitis. The case of a 41-year-old woman who developed symptoms of asthma after occupational exposure to metal working fluids is reported. The diagnosis of asthma was confirmed by an forced expiratory volume in 1 s (FEV1 of 1.7 (59% predicted, with 11% reversibility after inhaled bronchodilator and a provocation concentration of methacholine to cause a fall in FEV1 of 20% (PC20 of 0.4 mg/mL. Induced sputum examination showed a marked neutrophilia. Over the next six months, serial sputum analyses confirmed the presence of a marked sterile neutrophilic bronchitis during periods of occupational exposure to metal working fluids, which resolved when the patient was away from work and recurred when she returned to work. The sputum findings were mirrored by corresponding changes in spirometry and PC20 methacholine. The findings indicate the occurrence of occupational asthma associated with an intense, sterile neutrophilic bronchitis after exposure to metal working fluids.

  11. The microbiome in asthma.

    Science.gov (United States)

    Huang, Yvonne J; Boushey, Homer A

    2015-01-01

    The application of recently developed sensitive, specific, culture-independent tools for identification of microbes is transforming concepts of microbial ecology, including concepts of the relationships between the vast complex populations of microbes associated with ourselves and with states of health and disease. Although most work initially focused on the community of microbes (microbiome) in the gastrointestinal tract and its relationship to gastrointestinal disease, interest has expanded to include study of the relationships of the airway microbiome to asthma and its phenotypes and to the relationships between the gastrointestinal microbiome, development of immune function, and predisposition to allergic sensitization and asthma. Here we provide our perspective on the findings of studies of differences in the airway microbiome between asthmatic patients and healthy subjects and of studies of relationships between environmental microbiota, gut microbiota, immune function, and asthma development. In addition, we provide our perspective on how these findings suggest the broad outline of a rationale for approaches involving directed manipulation of the gut and airway microbiome for the treatment and prevention of allergic asthma.

  12. Managing Asthma at School.

    Science.gov (United States)

    Madden, Julie A.

    2000-01-01

    School personnel must know which students have asthma, typical warning signs, and appropriate actions in an emergency. Administering appropriate medication and reducing environmental triggers are not enough. Policymaking in schools and workplaces and legislation to increase health care access and eliminate substandard housing and air pollution are…

  13. Stress and asthma

    Directory of Open Access Journals (Sweden)

    Shoji Nagata

    1999-01-01

    Full Text Available Three factors in recent medical research and treatment (advances in the field of psychoneuroimmunology, epidemiological evidence regarding important interaction between psychosocial factors and development of disease, and the recognition of the importance of patient education for self-management of asthma have led clinicians and researchers to reconsider the role of psychosocial stress in asthma. There are many reports suggesting that stressful life events, family problems and a behavior pattern that increases psychological conflict may influence the development or relapse of asthma and influence its clinical course. Depression is known as one of the risk factors of fatal asthmatic attack. In laboratory studies, about 20% of asthmatics were considered reactors who showed an airway change after exposure to emotional stress. Studies regarding the pathway of stress effect on allergy and asthma are reviewed and discussed from the standpoint of psychoneuroimmunology; for example, the enhancement of IgE production and increased susceptibility to respiratory infection by stress, conditioned anaphylaxis and nerve/mast cell interaction, the effect of stress on various bronchial responses and the inhibition of the immediate and late asthmatic response by anterior hypothalamic lesioning.

  14. Mast cell-nerve interactions in asthma

    NARCIS (Netherlands)

    Kleij, Hanneke Paulina Maria van der

    2002-01-01

    Asthma is characterized by a chronic inflammatory reaction in the airways. Roughly, asthma can be subdivided into atopic asthma involving elevated levels of serum IgE and a less familiar form, non-atopic asthma. Non-atopic asthma is an increasing problem in the developed world. The mechanisms involv

  15. Do Written Asthma Action Plans Improve Outcomes?

    OpenAIRE

    Kelso, John M.

    2016-01-01

    With appropriate management, children with asthma should expect few symptoms, no limits on activity, rare exacerbations, and normal lung function. Appropriate education of parents and other caregivers of children with asthma has clearly been shown to help achieve these goals. Although recommended in asthma guidelines, providing written asthma action plans does not improve outcomes beyond asthma education alone.

  16. Teaching and Assessing Doctor-Patient Communication Using Remote Standardized Patients and SKYPE: Feedback from Medical Residents

    Science.gov (United States)

    Horber, Dot; Langenau, Erik E.; Kachur, Elizabeth

    2014-01-01

    Teaching and assessing doctor-patient communication has become a priority in medical education. This pilot study evaluated resident physicians' perceptions of teaching and assessing doctor-patient communication skills related to pain management using a web-based format. Fifty-nine resident physicians completed four doctor-patient clinical…

  17. Allergy and Asthma Care in the Mobile Phone Era.

    Science.gov (United States)

    Huang, Xinyuan; Matricardi, Paolo Maria

    2016-05-21

    Strategies to improve patients' adherence to treatment are essential to reduce the great health and economic burden of allergic rhinitis and asthma. Mobile phone applications (apps) for a better management of allergic diseases are growing in number, but their usefulness for doctors and patients is still debated. Controlled trials have investigated the feasibility, cost-effectiveness, security, and perspectives of the use of tele-medicine in the self-management of asthma. These studies focused on different tools or devices, such as SMS, telephone calls, automatic voice response system, mobile applications, speech recognition system, or cloud-computing systems. While some trials concluded that m-Health can improve asthma control and the patient's quality of life, others did not show any advantage in relation to usual care. The only controlled study on allergic rhinitis showed an improvement of adherence to treatment among tele-monitored patients compared to those managed with usual care. Most studies have also highlighted a few shortcomings and limitations of tele-medicine, mainly concerning security and cost-efficiency. The use of smartphones and apps for a personalized asthma and allergy care needs to be further evaluated and optimized before conclusions on its usefulness can be drawn.

  18. Regular-soda intake independent of weight status is associated with asthma among US high school students.

    Science.gov (United States)

    Park, Sohyun; Blanck, Heidi M; Sherry, Bettylou; Jones, Sherry Everett; Pan, Liping

    2013-01-01

    Limited research shows an inconclusive association between soda intake and asthma, potentially attributable to certain preservatives in sodas. This cross-sectional study examined the association between regular (nondiet)-soda intake and current asthma among a nationally representative sample of high school students. Analysis was based on the 2009 national Youth Risk Behavior Survey and included 15,960 students (grades 9 through 12) with data for both regular-soda intake and current asthma status. The outcome measure was current asthma (ie, told by doctor/nurse that they had asthma and still have asthma). The main exposure variable was regular-soda intake (ie, drank a can/bottle/glass of soda during the 7 days before the survey). Multivariable logistic regression was used to estimate the adjusted odds ratios for regular-soda intake with current asthma after controlling for age, sex, race/ethnicity, weight status, and current cigarette use. Overall, 10.8% of students had current asthma. In addition, 9.7% of students who did not drink regular soda had current asthma, and 14.7% of students who drank regular soda three or more times per day had current asthma. Compared with those who did not drink regular soda, odds of having current asthma were higher among students who drank regular soda two times per day (adjusted odds ratio=1.28; 95% CI 1.02 to 1.62) and three or more times per day (adjusted odds ratio=1.64; 95% CI 1.25 to 2.16). The association between high regular-soda intake and current asthma suggests efforts to reduce regular-soda intake among youth might have benefits beyond improving diet quality. However, this association needs additional research, such as a longitudinal examination.

  19. Doctoral education for WOC nurses considering advanced practice nursing.

    Science.gov (United States)

    Pieper, Barbara; Colwell, Janice

    2012-01-01

    Advanced practice nursing education is at a crossroads. Societal changes, increased health care demands, and leadership nursing organizations have identified the need of a doctor of nursing practice (DNP) degree as the advanced practice degree. WOC nurses need to examine DNP programs when considering returning for an advanced practice degree. This article explores nursing education at the doctorate level and areas the WOC nurse should consider when making a decision about attending a program. The WOC nurse needs to understand the similarities and differences of the doctor of philosophy and the DNP, issues about each program and its completion, personal factors, and the application process. Although selecting a doctoral program is a daunting experience, the education will provide opportunities for the WOC nurse to excel as a scholar, thus influencing the profession and the practice.

  20. Children with Asthma and Sports

    Directory of Open Access Journals (Sweden)

    Selda Yuzer

    2014-06-01

    Full Text Available Asthma is one of the chronic diseases which have are widely seen among the children. The disease has recently been in the increase all over the world and affects many children. In a study conducted with International Study of Asthma and Allergies in Childhood (ISAAC method, it was found out that prevalence of childhood asthma was 17.1%. Participation in sportive activities by the children with asthma, which is today considered as a part of asthma treatment program, makes contributions to their physical, mental and psychological development and increases their quality of life. The most recommended sports for the children with asthma are swimming and water sports. Sports like tennis and volleyball are too advised. Choice of sports depends on severity of asthma, child and #8217;s choice and whether or not asthma is kept under control. Nursing approaches for the children with asthma include correction of symptoms, training of children and their families, assistance with disease adaptation, continuing asthma care at home and interventions to make children lead healthy activities of daily life of children. With protective measures to be taken by families and children; children should be encourage for sportive activities. [TAF Prev Med Bull 2014; 13(3.000: 241-244

  1. Dementia - what to ask your doctor

    Science.gov (United States)

    What to ask your doctor about dementia; Alzheimer disease - what to ask your doctor; Cognitive impairment - what to ask your doctor ... who is losing or has lost their memory? What type of words should I use? What is ...

  2. Epilepsy - what to ask your doctor - adult

    Science.gov (United States)

    What to ask your doctor about epilepsy - adult; Seizures - what to ask your doctor - adult; Seizure - what to ask your doctor ... call to find more information about driving and epilepsy? What should I discuss with my boss at ...

  3. Introduction to genetics and genomics in asthma: genetics of asthma.

    Science.gov (United States)

    Mathias, Rasika Ann

    2014-01-01

    While asthma is a heterogeneous disease, a strong genetic basis has been firmly established. Rather than being a single disease entity, asthma consists of related, overlapping syndromes [Barnes (Proc Am Thor Soc 8:143-148, 2011)] including three general domains: variable airway obstruction, airway hyper-responsiveness, and airway inflammation with a considerable proportion, but not all, of asthma being IgE-mediated further adding to its heterogeneity. This chapter reviews the approaches to the elucidation of genetics of asthma from the early evidence of familial clustering to the current state of knowledge with genome-wide approaches. The conclusion is that research efforts have led to a tremendous repository of genetic determinants of asthma, most of which fall into the above phenotypic domains of the syndrome. We now look to future integrative approaches of genetics, genomics (Chap. 10), and epigenetics (Chap. 11) to better understand the causal mechanism through which, these genetic loci act in manifesting asthma.

  4. Digital Curation and Doctoral Research

    Directory of Open Access Journals (Sweden)

    Daisy Abbott

    2015-02-01

    Full Text Available This article considers digital curation in doctoral study and the role of the doctoral supervisor and institution in facilitating students’ acquisition of digital curation skills, including some of the potentially problematic expectations of the supervisory relationship with regards to digital curation. Research took the form of an analysis of the current digital curation training landscape, focussing on doctoral study and supervision. This was followed by a survey (n=116 investigating attitudes towards importance, expertise, and responsibilities regarding digital curation. This research confirms that digital curation is considered to be very important within doctoral study but that doctoral supervisors and particularly students consider themselves to be largely unskilled at curation tasks. It provides a detailed picture of curation activity within doctoral study and identifies the areas of most concern. A detailed analysis demonstrates that most of the responsibility for curation is thought to lie with students and that institutions are perceived to have very low responsibility and that individuals tend to over-assign responsibility to themselves. Finally, the research identifies which types of support system for curation are most used and makes suggestions for ways in which students, supervisors, institutions, and others can effectively and efficiently address problematic areas and improve digital curation within doctoral study.

  5. Turning Doctors Into Employees

    Directory of Open Access Journals (Sweden)

    Matthew Anderson

    2014-05-01

    Full Text Available Background: Much of the contentious debate surrounding the Patient Protection and Affordable Care Act (“Obamacare” concerned its financing and its attempt to guarantee (near universal access to healthcare through the private insurance market.  Aside from sensationalist stories of “death panels,” much less attention went to implications of the bill for the actual provision of healthcare. Methodology: This paper examines the "patient-centered medical home" (PCMH model which has been widely promoted as a means of reviving and improving primary care (i.e. general internal medicine, family medicine, and pediatrics. Argument: The PCMH and many of its components (e.g pay-for-performance, electronic medical records were interventions that were implemented on a massive basis without any evidence of benefit. Recent research has not generally supported clinical benefits with the PCMH model. Instead it seems to designed to de-professionalize (make proletarians of health care workers and enforce corporate models of health. The core values of professional work are undermined while the PCMH does nothing to address the structural marginalization of primary care within US health care. Conclusions: The development of alternative models will require political changes. Both doctors and teachers are in a position of advocate for more progressive systems of care and education.

  6. Can the Weather Affect My Child's Asthma?

    Science.gov (United States)

    ... Year-Old Can the Weather Affect My Child's Asthma? KidsHealth > For Parents > Can the Weather Affect My ... empeorar el asma de mi hijo? Weather and Asthma The effect of weather on asthma symptoms isn' ...

  7. Influenza vaccination for children with asthma

    OpenAIRE

    Friedman, Bat-Chen; Goldman, Ran D.

    2010-01-01

    QUESTION Parents of children with asthma are encouraged by many health organizations to vaccinate their children against seasonal influenza viruses. Is the influenza vaccine efficient in preventing asthma exacerbation? Are current vaccinations safe to administer to children with asthma?

  8. Asthma and Native Hawaiians/Pacific Islanders

    Science.gov (United States)

    ... Population Profiles > Native Hawaiian/Other Pacific Islander > Asthma Asthma and Native Hawaiians/Pacific Islanders Native Hawaiians/Pacific Islanders are 70 percent more likely to have asthma as non-Hispanic whites. National data for this ...

  9. Asthma and American Indians/Alaska Natives

    Science.gov (United States)

    ... Minority Population Profiles > American Indian/Alaska Native > Asthma Asthma and American Indians/Alaska Natives In 2014, 218, ... Native American adults reported that they currently have asthma. American Indian/Alaska Native children are 30% more ...

  10. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Brochures Facts Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, ... among persons with active asthma Use of long-term control medication among persons with active asthma Uncontrolled ...

  11. Violence and Asthma: A Review

    Directory of Open Access Journals (Sweden)

    Takeo Fujiwara

    2008-01-01

    Full Text Available Recent research shows that exposure to community violence is, directly and indirectly, associated with asthma. This article reviews the findings on the impact of violence on asthma, and the pathways for the association of violence and asthma are suggested: 1 exposure to violence is directly associated with asthma, mainly through dysregulation of sympathetic-adrenal-medullary (SAM and hypothalamic-pituitary-adrenal (HPA axis, 2 exposure to violence is associated with the change of susceptibility of outdoor air pollution on asthma, probably through the change of an immune response, and 3 behavioral change due to exposure to violence (e.g. keeping children indoors leads to more exposure to indoor pollutants. The suggested framework may be useful to develop health policy on asthma in high-violence communities.

  12. Association between severe asthma and changes in the stomatognathic system

    Directory of Open Access Journals (Sweden)

    Mayra Carvalho-Oliveira

    Full Text Available ABSTRACT Objective: To describe orofacial muscle function in patients with severe asthma. Methods: This was a descriptive study comparing patients with severe controlled asthma (SCA and severe uncontrolled asthma (SUA. We selected 160 patients, who completed a sociodemographic questionnaire and the 6-item Asthma Control Questionnaire (ACQ-6, as well as undergoing evaluation of orofacial muscle function. Results: Of the 160 patients evaluated, 126 (78.8% and 34 (21.2% presented with SCA and SUA, respectively, as defined by the Global Initiative for Asthma criteria. Regardless of the level of asthma control, the most frequent changes found after evaluation of muscle function were difficulty in chewing, oronasal breathing pattern, below-average or poor dental arch condition, and difficulty in swallowing. When the sample was stratified by FEV1 (% of predicted, was significantly higher proportions of SUA group patients, compared with SCA group patients, showed habitual open-mouth chewing (24.8% vs. 7.7%; p < 0.02, difficulty in swallowing water (33.7% vs. 17.3%; p < 0.04, and voice problems (81.2% vs. 51.9%; p < 0.01. When the sample was stratified by ACQ-6 score, the proportion of patients showing difficulty in swallowing bread was significantly higher in the SUA group than in the SCA group (66.6% vs. 26.6%; p < 0.01. Conclusions: The prevalence of changes in the stomatognathic system appears to be high among adults with severe asthma, regardless of the level of asthma control. We found that some such changes were significantly more common in patients with SUA than in those with SCA.

  13. Association between severe asthma and changes in the stomatognathic system

    Science.gov (United States)

    Carvalho-Oliveira, Mayra; Salles, Cristina; Terse, Regina; D'Oliveira, Argemiro

    2016-01-01

    ABSTRACT Objective: To describe orofacial muscle function in patients with severe asthma. Methods: This was a descriptive study comparing patients with severe controlled asthma (SCA) and severe uncontrolled asthma (SUA). We selected 160 patients, who completed a sociodemographic questionnaire and the 6-item Asthma Control Questionnaire (ACQ-6), as well as undergoing evaluation of orofacial muscle function. Results: Of the 160 patients evaluated, 126 (78.8%) and 34 (21.2%) presented with SCA and SUA, respectively, as defined by the Global Initiative for Asthma criteria. Regardless of the level of asthma control, the most frequent changes found after evaluation of muscle function were difficulty in chewing, oronasal breathing pattern, below-average or poor dental arch condition, and difficulty in swallowing. When the sample was stratified by FEV1 (% of predicted), was significantly higher proportions of SUA group patients, compared with SCA group patients, showed habitual open-mouth chewing (24.8% vs. 7.7%; p < 0.02), difficulty in swallowing water (33.7% vs. 17.3%; p < 0.04), and voice problems (81.2% vs. 51.9%; p < 0.01). When the sample was stratified by ACQ-6 score, the proportion of patients showing difficulty in swallowing bread was significantly higher in the SUA group than in the SCA group (66.6% vs. 26.6%; p < 0.01). Conclusions: The prevalence of changes in the stomatognathic system appears to be high among adults with severe asthma, regardless of the level of asthma control. We found that some such changes were significantly more common in patients with SUA than in those with SCA. PMID:28117472

  14. Persistent asthma increases the risk of chronic kidney disease: a retrospective cohort study of 2354 patients with asthma

    Institute of Scientific and Technical Information of China (English)

    LIU Dong-wei; ZHEN Xing-gang; LIANG Yan; JING Xiao-gang; ZHANG Tie-shuan; ZHANG Guo-jun; LIU Zhang-suo

    2013-01-01

    Background Chronic kidney disease (CKD) is a growing public health problem with well-established risk factors.Other contributing factors,however,remain to be identified.Systemic inflammation in asthma plays a significant role in the development of other diseases.We therefore initiated a study to assess whether the growing prevalence of asthma is associated with an increase in the risk of CKD.Methods We conducted a retrospective cohort study using data from 3015 patients with asthma aged 14 years and older who were registered and followed up in Asthma Control Study at the Department of Respiratory Medicine of three medical centers from 2005 to 2011.History,asthma control test (ACT),and asthma stage were used to assess the traits of asthma.CKD was defined as proteinuria and/or reduced estimated glomerular filtration rate (eGFR) (<60 ml·min-1·1.73 m-2) in two consecutive follow-up surveys.We used logistic regression models,adjusting for age,sex,and other confounding factor to determine associations between the traits of asthma and CKD.Kaplan-Meier curves were used to analyze patient outcomes.Results A total of 2354 subjects with complete data were recruited for this study with mean age (45.4±10.4) years.After 6 years of follow-up,9.6% (n=227) of the analytic cohort developed proteinuria and 3.1% (n=72) progressed to eGFR <60 ml·min-1·1.73 m-2.The patients with >20 years asthma history,not well-controlled or persistent asthma patients had higher incidence of proteinuria and reduced eGFR compared with patients with <20 years asthma history,at least well-controlled or remission asthma,respectively.The multivariable adjusted OR for proteinuria and reduced eGFR in participants with persistent asthma was 1.49; (95% confidence interval (CI) 1.17-1.91) and 2.07 (95% CI 1.34-4.42).Compared to patients with no asthma traits,there was a significant risk (OR,3.39; 95% CI 1.36-8.73) for those who met all three traits,including asthma history >20 years

  15. Pediatric obesity and asthma quality of life.

    Science.gov (United States)

    Velsor-Friedrich, Barbara; Militello, Lisa K; Kouba, Joanne; Harrison, Patrick R; Manion, Amy; Doumit, Rita

    2013-06-01

    Widely researched as separate entities, our understanding of the comorbid effects of childhood obesity and asthma on quality of life is limited. This article discusses the effects of childhood obesity and asthma on self-reported quality of life in low-income African American teens with asthma. When controlling for the influence of symptom frequency, asthma classification, asthma self-efficacy, and asthma self-care levels, body mass index remains a most important factor in determining self-reported quality of life among teens with asthma. Although overweight and obesity did not change the effectiveness of the asthma intervention program, obesity did affect participants quality of life scores.

  16. Asthma in elite athletes

    DEFF Research Database (Denmark)

    Elers, Jimmi; Pedersen, Lars; Backer, Vibeke

    2011-01-01

    Asthma is frequently found among elite athletes performing endurance sports such as swimming, rowing and cross-country skiing. Although these athletes often report symptoms while exercising, they seldom have symptoms at rest. Moreover, compared with nonathletic asthmatic individuals, elite athletes...... have been shown to have a different distribution of airway inflammation and unequal response to bronchial provocative test. Elite athletes display signs of exercise-induced symptoms, for example, nonasthmatic inspiratory wheeze, vocal cord dysfunction and cardiac arrhythmias, which could limit...... be aware of the doping aspects. Systemic β2-agonist intake is strictly prohibited, whereas inhaled treatment is allowed in therapeutic doses when asthma is documented and dispensation has been granted when needed....

  17. Asthma in elite athletes

    DEFF Research Database (Denmark)

    Elers, Jimmi; Pedersen, Lars; Backer, Vibeke

    2011-01-01

    Asthma is frequently found among elite athletes performing endurance sports such as swimming, rowing and cross-country skiing. Although these athletes often report symptoms while exercising, they seldom have symptoms at rest. Moreover, compared with nonathletic asthmatic individuals, elite athletes...... have been shown to have a different distribution of airway inflammation and unequal response to bronchial provocative test. Elite athletes display signs of exercise-induced symptoms, for example, nonasthmatic inspiratory wheeze, vocal cord dysfunction and cardiac arrhythmias, which could limit...... be aware of the doping aspects. Systemic ß2-agonist intake is strictly prohibited, whereas inhaled treatment is allowed in therapeutic doses when asthma is documented and dispensation has been granted when needed....

  18. Future treatment for asthma

    Directory of Open Access Journals (Sweden)

    Jeremy Charriot

    2016-03-01

    Full Text Available The landscape of asthma has considerably changed after 40 years of inhaled corticosteroid development and nearly 20 years since the first monoclonal antibodies (mAbs were approved. New members of pharmacological families and more effective drug-delivery devices have been designed but the proportion of uncontrolled patients, unfortunately, remains stable. The most promising treatments now rely on targeted therapies that encourage the improvement of the characterisation of our patients. These clinical (phenotype or new biological (endotype tools lead to palpable personalised medicine. This review examines not only the future of mAbs and other new ways of treating asthma but also describes futuristic views based on the paradigm shifts that are ready to occur.

  19. Steroid resistant asthma.

    Science.gov (United States)

    Luhadia, S K

    2014-03-01

    Inspite of very safe and effective treatment, Bronchial asthmatics do not respond well in 5-10% of cases which are labelled as Refractory Asthma. Besides compliance, presence of psychogenic and trigger factors and comorbid illness, steroid insensitiveness or resistance may play a significant role in the poorly controlled/responding asthmatics. Type I Steroid resistance is due to lack of binding affinity of steroids to glucocorticoid receptors and may respond to higher doses of steroids while type II steroid resistance is because of reduced number of cells with glucocorticoid receptors, which is very rare and do not respond to even higher doses of systemic steroids and these cases require alternative/novel therapies. Future treatment of steroid resistant and severe refractory asthma is likely to be targeted towards cytokines and Bronchial Thermoplasty.

  20. Intravenous magnesium for acute asthma?

    Science.gov (United States)

    2003-10-01

    Each year in the UK, around 1,500 people die from asthma. Standard treatment has been based on bronchodilators (e.g. beta 2-stimulants) and anti-inflammatory drugs (corticosteroids). The recently revised British Guideline on the Management of Asthma suggests also using a single dose of i.v. magnesium sulphate in patients with acute severe asthma, an unlicensed indication. Here we discuss the rationale for giving i.v. magnesium and whether it offers any advantage for patients with acute severe asthma.

  1. Doctor, Clinic, and Dental Visits

    Science.gov (United States)

    ... Viral Suppression Doctor, Clinical & Dental Visits Treatment Adherence Mental Health Substance Abuse Issues Sexual Health Nutrition & Food Safety Exercise Immunizations Aging with HIV/AIDS Women’s Health Housing ...

  2. Occupational allergies and asthma.

    OpenAIRE

    Tarlo, S.M.

    1999-01-01

    OBJECTIVE: To review aspects of occupational allergies and asthma for primary care physicians recognizing, diagnosing, and managing patients with these conditions. QUALITY OF EVIDENCE: Studies in the medical literature mainly provide level 2 evidence, that is, from at least one well-designed clinical trial without randomization, from cohort or case-control analytical studies, from multiple time series, or from dramatic results in uncontrolled experiments. MAIN MESSAGE: Occupational allergies ...

  3. Asthma symptoms improvement in moderate persistent asthma patients with gastroesophageal reflux disease (GERD: the role of proton-pump inhibitor

    Directory of Open Access Journals (Sweden)

    Agus D. Susanto

    2008-09-01

    Full Text Available This study aimed to evaluate effect of proton pump inhibitor (esomeprazole on asthma symptoms, use of inhaled bronchodilator and peak expiratory flow rate (PEFR in moderate persistent asthma with gastroesofageal refluks disease (GERD. This randomized single blind, controlled clinical trial study was conducted at Persahabatan Hospital, Jakarta from July 2004 until October 2005. Samples were moderate persistent asthma patients with GERD. GERD is diagnosed GERD symptoms and proof of oesophagitis from endoscopy and or histapatologic examination from oesophagus biopsy. Phase 1:2 week run-in period patient received inhaled budesonide 2x200 ug/day. Phase 2: patient randomised to receive inhaled budesonide 2 x 400 ug/day with esomeprazole 40 mg/day or without esomeprazole (control group for 8 weeks. Phase 3: 4 week wash out period, patient receive inhaled budesonide 2 x 200 ug/day. Diary cards were assessed at run-in periode, after treatment 4 weeks, 8 weeks and wash out. There were 32 patients (23 female and 9 male completed the study. Mean total asthma symptoms score daily were significantly decreased on esomeprazole vs without esomeprazole after 8 weeks (-2.29 vs -0.90; p < 0.05. Mean use of inhaled bronchodilator was significantly decreased on esomeprazole vs without esomeprazole after 8 weeks (-1.09 vs -0.42; p < 0.05. Morning and evening PEFR improved higher on esomeprazole than without esomeprazol but were not significantly difference. In conclusion, administration esomeprazole 40 mg daily improved asthma symptoms and lower the use of inhaled bronchodilator in moderate persistent asthma patients with GERD. (Med J Indones 2008; 17: 169-74Keywords: Asthma symptoms, inhaled bronchodilator, moderate persistent asthma, GERD, esomeprazole

  4. APPENDIX:A Doctor's Confession

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Not long ago, Xinhua News Agency reported on a confession by Xiao Qiwei regarding corruption in medicine purchases at a hospital in Sichuan. Excerpts follow: I have been working as a doctor for 35 years. As far as I know, corruption in medicine purchases dates from the 1990s. After 1998, all kinds of medicine salespersons surged into hospitals and talked to doctors face to face, stating clearly that they

  5. [Asthma and cyclic neutropenia].

    Science.gov (United States)

    Salazar Cabrera, A N; Berrón Pérez, R; Ortega Martell, J A; Onuma Takane, E

    1996-01-01

    We report a male with history of recurrent infections (recurrent oral aphtous disease [ROAD], middle ear infections and pharyngo amigdalitis) every 3 weeks since he was 7 months old. At the age of 3 years cyclic neutropenia was diagnosed with cyclic fall in the total neutrophil count in blood smear every 21 days and prophylactic antimicrobial therapy was indicated. Episodic events every 3 weeks of acute asthma and allergic rhinitis were detected at the age of 6 years old and specific immunotherapy to Bermuda grass was given during 3 years with markedly improvement in his allergic condition but not in the ROAD. He came back until the age of 16 with episodic acute asthma and ROAD. The total neutrophil count failed to 0 every 21 days and surprisingly the total eosinophil count increased up to 2,000 at the same time, with elevation of serum IgE (412 Ul/mL). Specific immunotherapy to D.pt. and Aller.a. and therapy with timomodulin was indicated. After 3 months we observed clinical improvement in the asthmatic condition and the ROAD disappeared, but the total neutrophil count did not improve. We present this case as a rare association between 2 diseases with probably no etiological relationship but may be physiopatological that could help to understand more the pathogenesis of asthma.

  6. Asma ocupacional Occupational asthma

    Directory of Open Access Journals (Sweden)

    Ana Lusia Godoy Fernandes

    2006-05-01

    Full Text Available A asma relacionada ao trabalho é uma das principais doenças respiratórias ocupacionais em termos de prevalência. Inúmeras substâncias químicas utilizadas nas mais diversas atividades produtivas podem desencadear ou agravar essa doença. A definição e a classificação da asma relacionada ao trabalho são descritas, bem como, suas repercussões epidemiológicas, história natural, critérios diagnósticos, evolução, prognóstico e seus aspectos legais, de forma resumida, objetivando alertar sobre essa doença e suas implicações trabalhistas.Work-related asthma is one of the principal occupational respiratory diseases in terms of prevalence. Innumerable chemical substances used in various production processes can cause or aggravate occupational asthma. This chapter contains a brief description of the definition and classification of work-related asthma, as well as the epidemiological repercussions, natural course, diagnostic criteria, progression and legal aspects of the disease, with the objective of raising an alert regarding this disease and its implications for workers.

  7. Asthma and PM10

    Directory of Open Access Journals (Sweden)

    Gilmour M Ian

    2000-07-01

    Full Text Available Abstract PM10 (the mass of particles present in the air having a 50% cutoff for particles with an aerodynamic diameter of 10 μm is the standard measure of particulate air pollution used worldwide. Epidemiological studies suggest that asthma symptoms can be worsened by increases in the levels of PM10. Epidemiological evidence at present indicates that PM10 increases do not raise the chances of initial sensitisation and induction of disease, although further research is warranted. PM10 is a complex mixture of particle types and has many components and there is no general agreement regarding which component(s could lead to exacerbations of asthma. However pro-inflammatory effects of transition metals, hydrocarbons, ultrafine particles and endotoxin, all present to varying degrees in PM10, could be important. An understanding of the role of the different components of PM10 in exacerbating asthma is essential before proper risk assessment can be undertaken leading to advice on risk management for the many asthmatics who are exposed to air pollution particles.

  8. Impact of online patient reminders to improve asthma care: A randomized controlled trial

    Science.gov (United States)

    Pool, Andrew C.; Kraschnewski, Jennifer L.; Poger, Jennifer M.; Smyth, Joshua; Stuckey, Heather L.; Craig, Timothy J.; Lehman, Erik B.; Yang, Chengwu; Sciamanna, Christopher N.

    2017-01-01

    Importance Asthma is one of the most burdensome chronic illnesses in the US. Despite widespread dissemination of evidence-based guidelines, more than half of the adults with asthma have uncontrolled symptoms. Objective To examine the efficacy of an online tool designed to improve asthma control. Design 12-month single blind randomized controlled trial of the online tool (Intervention condition, IC) versus an active control tool (CC). Setting Patients enrolled in an insurance plan. Participants Participants were 408 adults (21–60 years of age) with persistent asthma. Intervention At least once each month and before provider visits, participants in the IC answered questions online about their asthma symptoms, asthma medications and asthma care received from providers, such as an asthma management plan. The tool then provided tailored feedback to remind patients 1) to ask health care providers specific questions that may improve asthma control (e.g., additional controller medications) and 2) to consistently perform specific self-care behaviors (e.g., proper inhaler technique). Participants in the CC received similar questions and feedback, yet focused instead on preventive services unrelated to asthma control (e.g., cancer screening). Main outcome measures The main outcome measure was asthma control, as assessed by the 5-question Asthma Control Test (ACT). Secondary outcomes included quality of life, medication use and healthcare utilization (e.g., emergency department visits). Results After 12 months, 323 participants completed follow-up measures (79.2%). Participants in the IC reported a greater mean improvement in the ACT score than participants in the CC (2.3 vs. 1.2; p = 0.02) and 9 of 11 individual asthma control survey items showed non-significant improvements favoring the IC. No differences were observed in medication adherence, number of asthma controller medications or health care utilization. Conclusion and relevance Simple and brief online patient

  9. Asthma self-assessment in a Medicaid population

    Directory of Open Access Journals (Sweden)

    Gay Charlene

    2009-07-01

    Full Text Available Abstract Background Self-assessment of symptoms by patients with chronic conditions is an important element of disease management. A recent study in a commercially-insured population found that patients who received automated telephone calls for asthma self-assessment felt they benefitted from the calls. Few studies have evaluated the effectiveness of disease self-assessment in Medicaid populations. The goals of this study were to: (1 assess the feasibility of asthma self-assessment in a population predominantly insured by Medicaid, (2 study whether adding a gift card incentive increased completion of the self-assessment survey, and (3 evaluate how the self-assessment affected processes and outcomes of care. Methods We studied adults and children aged 4 years and older who were insured by a Medicaid-focused managed care organization (MCO in a pre- and post-intervention study. During the pre-incentive period, patients with computerized utilization data that met specific criteria for problematic asthma control were mailed the Asthma Control Test (ACT, a self-assessment survey, and asked to return it to the MCO. During the intervention period, patients were offered a $20 gift card for returning the completed ACT to the MCO. To evaluate clinical outcomes, we used computerized claims data to assess the number of hospitalization visits and emergency department visits experienced in the 3 months after receiving the ACT. To evaluate whether the self-management intervention improved processes of care, we conducted telephone interviews with patients who returned or did not return the ACT by mail. Results During the pre-incentive period, 1183 patients were identified as having problems with asthma control; 25 (2.0% of these returned the ACT to the MCO. In contrast, during the incentive period, 1612 patients were identified as having problems with asthma control and 87 (5.4% of these returned the ACT to the MCO (p During the 3 months after they received the

  10. Occupational asthma often goes unrecognised.

    Science.gov (United States)

    Cullinan, Paul; Cannon, Julie

    2012-01-01

    Occupational asthma is induced de novo by an airborne agent encountered in the workplace. The risk of occupational asthma is greater in those with a prior atopic history. Work-exacerbated asthma is the provocation of pre-existing, or coincidental, disease by one or more irritant exposures at work. Distinguishing occupational from work-exacerbated asthma can be difficult but it is important since the two have very different clinical, occupational and legal implications. Occupational asthma is underrecognised, the disease often develops in young people who are otherwise fit. They may not recognise their symptoms as anything out of the ordinary, or may confuse them with hay fever or a cold. It is sensible to consider occupational and work-exacerbated asthma in every working adult who has asthma or who presents with suggestive symptoms such as rhinitis. Occupational asthma almost always arises from an immediate-type hypersensitivity reaction to a respiratory sensitising agent in the workplace. The disease has a short latency with symptoms developing 6 to 36 months after employment in a new job. Rhinitis is common and in those working in an environment with airborne proteins the absence of rhinitis effectively rules out occupational asthma. In occupational asthma, symptoms (including nasal symptoms) improve away from work. Once the disease is established symptoms are provoked by even very small exposures at work and begin to be provoked by a wide variety of irritant exposures both at, and away from, work. It is good practice to enquire into the employment of every working-age adult with asthma, or rhinitis, and particularly in those presenting with new symptoms or symptoms that have become more difficult to manage. Patients should routinely be asked whether their symptoms improve when they are not at work.

  11. AsthmaVent – Effect of Ventilation on Asthma Control

    DEFF Research Database (Denmark)

    Hogaard, Nina Viskum; Rubak, Sune Leisgaard Mørck; Halken, Susanne

    Background House dust mite (HDM) allergy is a frequent cause of allergic asthma among children. Children spend 14 hours of their time indoor everyday in aberage, where they are exposed to different components in the indoor air. These components are children with asthma and HDM allergy specially...... air quality and thereby asthma symptoms and quality of life, in children with house dust mite allergy and asthma. Materials and Methods Randomized double-blind placebo-controlled intervention study, including 80 children from 3 Danish Pediatric outpatient clinics, with: Verified asthma, requiring...... a minimum of 400 µg of inhaled steroid daily Verified HDM allergy Verified exposure to HDMallergene No pet- or birch allergy A ventilation system will be placed in to the child’s bedroom, ventilating the room with a rate of 2-3 air changes per hour for 9 months during the winter season. We monitor indoor...

  12. Doctors and nurses benefit from interprofessional online education in dermatology

    Directory of Open Access Journals (Sweden)

    Flytkjær Vibeke

    2011-10-01

    Full Text Available Abstract Background Benefits of online learning in the health sector have been demonstrated in previous studies. We examined the potential benefits of a joint web-based curriculum on atopic eczema for health personnel. Methods Enrolled doctors and nurses had access to the curriculum for 8 weeks. After the course learners completed a questionnaire. Two dermatologists rated the quality of the submitted homework assignments. Based on data from the project's budget and the Norwegian Medical Association, we estimated the saved travel expenses. Results Eighty-eight learners (46 doctors registered for the course. We received 55 questionnaires (response rate 63%. Twenty-seven learners (31%; 16 doctors, 11 nurses; χ2 = 0.03; P = 0.87 used the discussion forum. We found no significant differences in the total questionnaire scores between doctors and nurses. The homework assignments were given an average score of 3.6 for doctors and 3.5 for nurses (P = 0.8 by rater 1. Rater 2 scored 3.9 and 3.6 for doctors and nurses respectively (P = 0.2. The break-even between travel/hotel expenses and course development costs occurred at 135 saved travel refund applications. Conclusions Doctors and nurses were equally satisfied with a joint web-based course on atopic eczema. The use of an online discussion forum was limited but similar between doctors and nurses. There were no significant differences in the quality of submitted homework assignments. The cost of developing the course was 716 841 NOK and the first 86 learners saved 455 198 NOK in travel expenses.

  13. Obesity, Diet, and Activity in relation to Asthma and Wheeze among Rural Dwelling Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Joshua A. Lawson

    2013-01-01

    Full Text Available Aims and Objectives. We investigated associations between weight status, activity level, and diet with asthma or wheeze as well as the interrelationship between these factors. Methods. We conducted a case-control study of 6–18-year olds from 2005 to 2007. Cases ( were subjects reporting episodes or breathing medication use along with doctor-diagnosed asthma or wheeze in the past 12 months. Controls were randomly selected ( and without asthma or wheeze. Data regarding health outcomes, diet, and activity were obtained from questionnaire. Objectively measured height and weight were collected. Results. In the adjusted analysis, there was a trend ( towards an increased risk of asthma or wheeze associated with high fast food and/or pop consumption. Among cases, a significantly lower proportion (66% classified as overweight participated in hard exercise in ≥9 of the past 14 days compared to those who were not overweight (86%. This pattern was not seen among controls (76% participating in hard exercise versus 78%, resp.. However, based on perceived weight status by the parent, the patterns were similar regardless of case-control status. Conclusions. Overweight status may negatively impact activity level among those with asthma or wheeze. Efforts should be made to encourage healthy food choices, and activity programming must consider the needs of overweight children with asthma.

  14. A pilot survey of junior doctors' confidence in tasks related to broad aspects of competence

    DEFF Research Database (Denmark)

    Skaarup, Anne Marie; Davis, Deborah; Ringsted, Charlotte Vibeke

    2005-01-01

    The aim of this study was to survey junior doctors' growth in confidence in different physician roles. A total of 165 junior doctors in internal medicine completed a self-administered survey of confidence levels in physician roles. Confidence levels between training levels were compared....

  15. Digital Native and Digital Immigrant Use of Scholarly Network for Doctoral Learners

    Science.gov (United States)

    Berman, Ronald; Hassell, Deliesha

    2014-01-01

    The Doctoral Community Network (DC) is a learner driven, scholarly community designed to help online doctoral learners successfully complete their dissertation and program of study. While digital natives grew up in an environment immersed in technology, digital immigrants adapted to this environment through their ability to learn and adjust to…

  16. Review of Doctoral Research on Second Language Teaching and Learning in Spain (2008-2010)

    Science.gov (United States)

    Serrano, Raquel; Miralpeix, Imma

    2013-01-01

    This paper reviews a selection of doctoral theses on language learning and teaching completed in Spain between 2008 and 2010. A total of 16 theses have been identified as representative--in terms of the topics under investigation and the methodology employed--of the doctoral research undertaken in Spain. Current topics include the development of…

  17. Predicting adult asthma in childhood

    NARCIS (Netherlands)

    Vonk, JM; Boezen, HM

    2006-01-01

    PURPOSE OF REVIEW: There still is no cure for asthma. Early identification of patients at risk for disease progression may lead to better treatment opportunities and hopefully better disease outcomes in adulthood. Recent literature on childhood risk factors associated with the outcome of asthma in a

  18. Environment and asthma in adults.

    Science.gov (United States)

    Le Moual, Nicole; Jacquemin, Bénédicte; Varraso, Raphaëlle; Dumas, Orianne; Kauffmann, Francine; Nadif, Rachel

    2013-09-01

    The present review addresses recent advances and especially challenging aspects regarding the role of environmental risk factors in adult-onset asthma, for which the causes are poorly established. In the first part of the review, we discuss aspects regarding some environmental risk factors for adult-onset asthma: air pollution, occupational exposures with a focus on an emerging risk represented by exposure to cleaning agents (both at home and in the workplace), and lifestyle and nutrition. The second part is focused on perspectives and challenges, regarding relevant topics on which research is needed to improve the understanding of the role of environmental factors in asthma. Aspects of exposure assessment, the complexity of multiple exposures, the interrelationships of the environment with behavioral characteristics and the importance of studying biological markers and gene-environment interactions to identify the role of the environment in asthma are discussed. We conclude that environmental and lifestyle exposures play an important role in asthma or related phenotypes. The changes in lifestyle and the environment in recent decades have modified the specific risk factors in asthma even for well-recognized risks such as occupational exposures. To better understand the role of the environment in asthma, the use of objective (quantitative measurement of exposures) or modern tools (bar code, GPS) and the development of multidisciplinary collaboration would be very promising. A better understanding of the complex interrelationships between socio-economic, nutritional, lifestyle and environmental conditions might help to study their joint and independent roles in asthma.

  19. Adult-onset eosinophilic asthma

    NARCIS (Netherlands)

    de Groot, J.C.

    2017-01-01

    In the last decades, it has been recognized that asthma is not a single disease, but comprises several clinical syndromes, which all share respiratory symptoms and lung function abnormalities, associated with different types of airway inflammation. These syndromes are now known as different asthma p

  20. The management of acute asthma.

    Science.gov (United States)

    Cross, S

    1997-04-01

    Health professionals likely to come into contact with people experiencing an acute episode of asthma, such as school nurses, ambulance personnel and A&E staff, need clear guidelines on management. The British Thoracic Society guidelines, revised this year, advise on the categorisation of asthma, assessment and treatment.

  1. Asthma in patients with psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, A S; Skov, L; Skytthe, A;

    2015-01-01

    We read with interest the report by Fang and colleagues of the relationship between psoriasis and asthma in a large retrospective case-control study from Taiwan [1]. The study found a 1.38-fold increased risk of asthma among patients with psoriasis, and with an increasing risk according to higher...

  2. Adolescents and Exercise Induced Asthma

    Science.gov (United States)

    Hansen, Pamela; Bickanse, Shanna; Bogenreif, Mike; VanSickle, Kyle

    2008-01-01

    This article defines asthma and exercise induced asthma, and provides information on the triggers, signs, and symptoms of an attack. It also gives treatments for these conditions, along with prevention guidelines on how to handle an attack in the classroom or on the practice field. (Contains 2 tables and 1 figure.)

  3. DNA vaccine and asthma therapy

    Institute of Scientific and Technical Information of China (English)

    SHI Huan-zhong

    2005-01-01

    @@ Allergic asthma is currently considered a chronic airway inflammatory disorder associated with the presence of activated CD4+ Th2-type lymphocytes, eosinophils, and mast cells. Interestingly, therapeutic strategies based on immune deviation and suppression have been shown to successfully attenuate the development of the asthma phenotype.

  4. Occupational asthma in maritime environments

    DEFF Research Database (Denmark)

    Lucas, David; Loddé, Brice; Jepsen, Jørgen Riis

    2016-01-01

    In 2006 we published our first review based on the available literature on occupational asthma in maritime environments in the “International Maritime Health” journal. Since then, we have obtained a great deal of new knowledge on asthma in seafood workers and fishermen and on the impact of exposu...

  5. Smoking and Asthma (For Teens)

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Smoking and Asthma KidsHealth > For Teens > Smoking and Asthma A A A What's in this ... family photo albums full of pictures with people smoking at all kinds of events, from kids' birthday ...

  6. Prenatal Stress, Prematurity, and Asthma.

    Science.gov (United States)

    Medsker, Brock; Forno, Erick; Simhan, Hyagriv; Celedón, Juan C

    2015-12-01

    Asthma is the most common chronic disease of childhood, affecting millions of children in the United States and worldwide. Prematurity is a risk factor for asthma, and certain ethnic or racial minorities such as Puerto Ricans and non-Hispanic blacks are disproportionately affected by both prematurity and asthma. In this review, we examine current evidence to support maternal psychosocial stress as a putative link between prematurity and asthma, while also focusing on disruption of the hypothalamic-pituitary-adrenal (HPA) axis and immune responses as potential underlying mechanisms for stress-induced "premature asthma." Prenatal stress may cause not only abnormalities in the HPA axis but also epigenetic changes in the fetal glucocorticoid receptor gene (NR3C1), leading to impaired glucocorticoid metabolism. Moreover, maternal stress can alter fetal cytokine balance, favoring TH2 (allergic) immune responses characteristic of atopic asthma: interleukin 6 (IL-6), which has been associated with premature labor, can promote TH2 responses by stimulating production of IL-4 and IL-13. Given a link among stress, prematurity, and asthma, future research should include birth cohorts aimed at confirming and better characterizing "premature asthma." If confirmed, clinical trials of prenatal maternal stress reduction would be warranted to reduce the burden of these common comorbidities. While awaiting the results of such studies, sound policies to prevent domestic and community violence (eg, from firearms) are justified, not only by public safety but also by growing evidence of detrimental effects of violence-induced stress on psychiatric and somatic health.

  7. Doctor's perception of doctor-patient relationships in emergency departments: What roles do gender and ethnicity play?

    Directory of Open Access Journals (Sweden)

    Borde Theda

    2008-04-01

    Full Text Available Abstract Background Emergency departments continuously provide medical treatment on a walk-in basis. Several studies investigated the patient's perception of the doctor-patient relationship, but few have asked doctors about their views. Furthermore, the influence of the patient's ethnicity and gender on the doctor's perception remains largely unanswered. Methods Based on data collated in three gynaecology (GYN/internal medicine (INT emergency departments in Berlin, Germany, we evaluated the impact of the patient's gender and ethnicity on the doctors' satisfaction with the course of the treatment they provided. Information was gathered from 2.429 short questionnaires completed by doctors and the medical records of the corresponding patients. Results The patient's ethnicity had a significant impact on the doctors' satisfaction with the doctor-patient relationship. Logistic regression analysis showed that the odds ratio (OR for physician satisfaction was significantly lower for patients of Turkish origin (OR = 2.6 INT and 5.5 GYN than for those of German origin. The main reasons stated were problems with communication and a perceived lack of urgency for emergency treatment. The odds ratios for dissatisfaction due to a lack of language skills were 4.48 (INT and 6.22 (GYN, and those due to perceived lack of urgency for emergency treatment were 0.75 (INT and 0.63 (GYN. Sex differences caused minor variation. Conclusion The results show that good communication despite language barriers is crucial in providing medical care that is satisfactory to both patient and doctors, especially in emergency situations. Therefore the use of professional interpreters for improved communication and the training of medical staff for improved intercultural competence are essential for the provision of adequate health care in a multicultural setting.

  8. Trends in Doctoral Research on English Language Teaching in Turkey

    Science.gov (United States)

    Özmen, Kemal Sinan; Cephe, Pasa Tevfik; Kinik, Betül

    2016-01-01

    This review examines the doctoral research in Turkey completed between 2010 and 2014 in the area of English language teaching and learning. All of the dissertations (N = 137) indexed in the National Theses Database have been included in order to analyze dissertations' subject areas, research paradigms/techniques, and research contexts as well as…

  9. "Kickin' Asthma": School-Based Asthma Education in an Urban Community

    Science.gov (United States)

    Magzamen, Sheryl; Patel, Bina; Davis, Adam; Edelstein, Joan; Tager, Ira B.

    2008-01-01

    Background: In urban communities with high prevalence of childhood asthma, school-based educational programs may be the most appropriate approach to deliver interventions to improve asthma morbidity and asthma-related outcomes. The purpose of this study was to evaluate the implementation of "Kickin' Asthma", a school-based asthma curriculum…

  10. Asthma symptoms in obese adults

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli

    2016-01-01

    The association between asthma and obesity is well-described, but not straightforward, and according to current guidelines asthma control is more difficult to achieve in obese patients. The currently available studies evaluating response to pharmacological asthma therapy in obese patients show...... that these patients have an altered, in general less favorable, response to both reliever and controller medication compared to normal weight patients. However, at present, the limited available evidence precludes evidence-based recommendations. The 'obesity-related asthma' phenotype has different characteristics......, including association with atopy and type of airway inflammation, compared to 'classic' asthma. Furthermore, weight loss in patients with this phenotype leads to an improvement in symptoms, lung function, and airway responsiveness, as well as a reduction in medication utilization and hospital admissions...

  11. Infectious triggers of pediatric asthma.

    Science.gov (United States)

    Gern, James E; Lemanske, Robert F

    2003-06-01

    Respiratory infections can cause wheezing illnesses in children of all ages and also can influence the causation and disease activity of asthma. For years it has been recognized that respiratory syncytial virus infections often produce the first episode of wheezing in children who go on to develop chronic asthma. More recently, it has been proposed that repeated infections with other common childhood viral pathogens might help the immune system develop in such a way as to prevent the onset of allergic diseases and possibly asthma. In addition to the effects of viral infections, infections with certain intracellular pathogens, such as chlamydia and mycoplasma, may cause acute and chronic wheezing in some individuals, whereas common cold and acute sinus infections can trigger acute symptoms of asthma. In this article, the epidemiologic, mechanistic, and treatment implications of the association between respiratory infections and asthma are discussed.

  12. BENEFIT OF ASTHMA ACTION PLAN

    Directory of Open Access Journals (Sweden)

    Pagadpally

    2015-09-01

    Full Text Available AIM: The aim of this study was to evaluate the role of asthma action plan on asthma control, reducing unscheduled hospital visits of children with asthma. The study also was to know if the instructions regarding management are being documented in the patient notes. METHOD: It was a retrospective study. The data was collected from a random sample of 100 patients with asthma between Jan . 2012 to Dec . 2014 who were admitted as in - patients to the children’s ward in our hospital. RESULTS: Children who received asthma action plan had fewer exacerbations and fewer lost school days. Good documentation of symptoms led to better compliance and outcome in the child KEYWORDS: A sthma; A ction plan.

  13. Asthma treatment in children and adolescents in an urban area in southern Brazil: popular myths and features

    Directory of Open Access Journals (Sweden)

    Cristian Roncada

    2016-04-01

    Full Text Available Objective: To describe the frequency of popular myths about and features of asthma treatment in children and adolescents in an urban area in southern Brazil. Methods: The parents or legal guardians of public school students (8-16 years of age completed a specific questionnaire regarding their understanding of asthma, asthma control, and treatment characteristics. The sample included parents or legal guardians of students with asthma (n = 127 and healthy controls (n = 124. Results: The study involved 251 parents or legal guardians, of whom 127 (68.5% were the mothers and 130 (51.8% were White. The mean age of these participants was 38.47 ± 12.07 years. Of the participants in the asthma and control groups, 37 (29.1% and 26 (21.0%, respectively, reported being afraid of using asthma medications, whereas 61 (48% and 56 (45.2%, respectively, believed that using a metered dose inhaler can lead to drug dependence. However, only 17 (13.4% and 17 (13.7% of the participants in the asthma and control groups, respectively, reported being afraid of using oral corticosteroids. In the asthma group, 55 students (43.3% were diagnosed with uncontrolled asthma, only 41 (32.3% had a prescription or written treatment plan, and 38 (29.9% used asthma medications regularly. Conclusions: Popular myths about asthma treatment were common in our sample, as were uncontrolled asthma and inappropriate asthma management. Further studies in this field should be conducted in other developing countries, as should evaluations of pediatric asthma treatment programs in public health systems.

  14. URGENT NEED OF A DOCTOR

    CERN Multimedia

    Medical Service

    2001-01-01

    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGAD 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European EmergencyCall 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors will...

  15. Asthma mortality in the Danish child population

    DEFF Research Database (Denmark)

    Jørgensen, Inger Merete; Jensen, V B; Bülow, S

    2003-01-01

    Child death due to asthma is a rare and potentially preventable event. We investigated possible risk factors for death due to asthma in children and adolescents, as a step towards preventing or minimizing asthma death in this age group, and improving asthma management and care. We reviewed all 10...

  16. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Breathing Easier [PDF – 1.1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Know ... Breathing Easier [PDF – 1.1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health File ...

  17. Exploring the obesity-asthma link

    DEFF Research Database (Denmark)

    Fenger, R V; Gonzalez-Quintela, A; Vidal, C;

    2012-01-01

    Obesity and risk of asthma are linked. Different distributions of adiposity, such as visceral, subcutaneous or ectopic adiposity, may affect asthma risk differently.......Obesity and risk of asthma are linked. Different distributions of adiposity, such as visceral, subcutaneous or ectopic adiposity, may affect asthma risk differently....

  18. Sources of Stress in Children with Asthma.

    Science.gov (United States)

    Walsh, Michelle; Ryan-Wenger, Nancy M.

    1992-01-01

    Children with asthma were studied to determine their perceptions of the frequency and severity of stressors they experienced other than asthma. Results indicated children with asthma were similar to peers regarding perceptions of stressors. Perceptions of most stressors related more strongly to gender role development than to asthma. (SM)

  19. Asma ocupacional Occupational asthma

    Directory of Open Access Journals (Sweden)

    P. Cebollero

    2005-01-01

    Full Text Available Asma ocupacional es aquella entidad que se desarrolla por causas o condiciones derivadas de un determinado medio laboral y no por estímulos que se encuentran fuera del trabajo. El asma ocupacional constituye hoy en día la enfermedad respiratoria ocupacional más frecuente en la mayoría de los países industrializados y se calcula que la proporción de nuevos casos de asma atribuibles a la exposición laboral se sitúa en torno al 10-15%. Puede desarrollarse tanto por un mecanismo inmunológico como no inmunológico. En su desarrollo influyen el tipo de agente al que se está expuesto, el nivel y modo de exposición y factores genéticos de susceptibilidad. En el proceso diagnóstico concurre la confirmación de que el paciente tiene asma bronquial y la confirmación de que ésta se produce por causa laboral. Como demuestra la historia natural de la enfermedad, un diagnóstico precoz y las consiguientes acciones posteriores redundan en un mejor pronóstico de la misma.Occupational asthma is an entity caused by conditions deriving from a certain work milieu and not from stimuli found outside the workplace. Nowadays, occupational asthma is the most frequent respiratory occupational disease in the majority of the industrialised countries and it is estimated that the proportion of new cases of asthma that can be attributed to exposure at work is around 10-15%. It can be developed due to an immunological mechanism or to a non-immunological mechanism. Influential in its development are the type of agent exposed to, the level and form of exposure and genetic factors of susceptibility. In the diagnostic process there is a concurrent confirmation that the patient has bronchial asthma and that this has been caused by occupational reasons. As shown by the natural history of the disease, an early diagnosis and the consequent posterior actions result in an improved prognosis.

  20. Thunderstorm-associated bronchial Asthma: A forgotten but very present epidemic

    Directory of Open Access Journals (Sweden)

    Abdullah M Al-Rubaish

    2007-01-01

    Doctors should be aware of this phenomenon and the potential outbreak of asthma during heavy rains. A & E departments and ICU should be alert for possible rush of asthmatic admissions and reinforce ventilators and requirements of cardio-pulmonary resuscitation. Scientific approach should be adopted to investigate such outbreaks in the future and must include meteorological, bio-aerosole pollutants and chemical pollutant assessment. Regional team work is mandatory.

  1. Negative impact of asthma on patients in different age groups

    Directory of Open Access Journals (Sweden)

    Marcela Batan Alith

    2015-02-01

    Full Text Available Objective: To evaluate the impact of asthma on patients in Brazil, by age group (12-17 years, 18-40 years, and ≥ 41 years. Methods: From a survey conducted in Latin America in 2011, we obtained data on 400 patients diagnosed with asthma and residing in one of four Brazilian state capitals (São Paulo, Rio de Janeiro, Curitiba, and Salvador. The data had been collected using a standardized questionnaire in face-to-face interviews. For the patients who were minors, the parents/guardians had completed the questionnaire. The questions addressed asthma control, number of hospitalizations, number of emergency room visits, and school/work absenteeism, as well as the impact of asthma on the quality of life, sleep, and leisure. We stratified the data by the selected age groups. Results: The proportions of patients who responded in the affirmative to the following questions were significantly higher in the 12- to 17-year age group than in the other two groups: "Have you had at least one episode of severe asthma that prevented you from playing/exercising in the last 12 months?" (p = 0.012; "Have you been absent from school/work in the last 12 months?" (p < 0.001; "Have you discontinued your asthma relief or control medication in the last 12 months?" (p = 0.008. In addition, 30.2% of the patients in the 12- to 17-year age group reported that normal physical exertion was very limiting (p = 0.010 vs. the other groups, whereas 14% of the patients in the ≥ 41-year age group described social activities as very limiting (p = 0.011 vs. the other groups. Conclusions: In this sample, asthma had a greater impact on the patients between 12 and 17 years of age, which might be attributable to poor treatment compliance.

  2. The poorly explored impact of uncontrolled asthma

    DEFF Research Database (Denmark)

    O'Byrne, Paul M; Pedersen, Søren; Schatz, Michael

    2013-01-01

    The goal of asthma management is to achieve disease control; however, despite the availability of effective and safe medications, for many patients asthma remains uncontrolled. One reason for this is the fear of long-term side effects from the regular use of inhaled corticosteroids (ICSs). Adverse...... effects of poorly controlled asthma (for example, obesity, pneumonia, and risks to the fetus) can be perceived as side effects of ICSs. Poorly controlled asthma adversely affects children's cardiovascular fitness, while children with well-controlled asthma perform at the same level as their peers...... and concentration are negatively affected in patients with untreated asthma, and patients with asthma are at greater risk for depression. Also, poorly controlled asthma increases the risks of severe asthma exacerbations following upper respiratory and pneumococcal pulmonary infections. ICSs used to improve asthma...

  3. Understanding mild persistent asthma in children

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Szefler, Stanley J

    2005-01-01

    Limitations in asthma prevalence studies and difficulties in diagnosing pediatric asthma lead to uncertainty over the full extent of mild persistent asthma in children and adolescents. Although recent surveys have reported that the majority of pediatric patients with asthma in the United States...... and Europe have symptoms consistent with mild disease, these surveys have limitations in design. Thus, the true prevalence of mild asthma remains unknown. It is unclear whether children with mild persistent asthma progress to more severe asthma, but the risk of severe asthma exacerbations seems...... to be unrelated to the symptom severity. Clinical studies restricted to pediatric patients with mild asthma are limited, but available data do suggest substantial morbidity of mild persistent asthma in this population and support inhaled corticosteroid intervention. There is a need for further investigation...

  4. Learning Dynamics in Doctoral Supervision

    DEFF Research Database (Denmark)

    Kobayashi, Sofie

    This doctoral research explores doctoral supervision within life science research in a Danish university. From one angle it investigates doctoral students’ experiences with strengthening the relationship with their supervisors through a structured meeting with the supervisor, prepared as part...... investigates learning opportunities in supervision with multiple supervisors. This was investigated through observations and recording of supervision, and subsequent analysis of transcripts. The analyses used different perspectives on learning; learning as participation, positioning theory and variation theory....... The research illuminates how learning opportunities are created in the interaction through the scientific discussions. It also shows how multiple supervisors can contribute to supervision by providing new perspectives and opinions that have a potential for creating new understandings. The combination...

  5. [The clown doctor: an introduction].

    Science.gov (United States)

    Rösner, M

    2010-02-01

    In the literature, increasing numbers of practitioners have reported their experience using clown doctors in geriatric settings. The reports agree on the positive effects on persons with dementia and also on their caregivers. However, empirical studies on its effectiveness are rare. This article presents the field of activity of a clown doctor in geriatric settings as well as an overview of current scientific research on the topic and the effects on persons with dementia and nursing staff. It will be become clear that the clown doctor is a supporting therapeutic intervention. Through the clown representation, it is possible to obtain access to and interact with a person with dementia, thus, maintaining social contact of the patient with his/her environment. This effect leads to an increase of well-being and contributes to a reduction of problematic behavior. In addition to reduced workload and relief for the nursing staff, it has a positive effect on the working atmosphere.

  6. Solo doctors and ethical isolation.

    Science.gov (United States)

    Cooper, R J

    2009-11-01

    This paper uses the case of solo doctors to explore whether working in relative isolation from one's peers may be detrimental to ethical decision-making. Drawing upon the relevance of communication and interaction for ethical decision-making in the ethical theories of Habermas, Mead and Gadamer, it is argued that doctors benefit from ethical discussion with their peers and that solo practice may make this more difficult. The paper identifies a paucity of empirical research related to solo practice and ethics but draws upon more general medical ethics research and a study that identified ethical isolation among community pharmacists to support the theoretical claims made. The paper concludes by using the literary analogy of Soderberg's Doctor Glas to illustrate the issues raised and how ethical decision-making in relative isolation may be problematical.

  7. 支气管哮喘学术源流探讨%Academic Origins of Asthma

    Institute of Scientific and Technical Information of China (English)

    陈凯佳; 陈虹; 刘小斌; 肖莹; 何婉婉; 庞震苗

    2011-01-01

    Chinese medicine has a long history of bronchial asthma, it was called "stridor" in endo- meridians. "Medical Treasures of the Golden Chamber" laid the foundation for treating asthma. ZHU Dan- xi called "asthma" as a Disease Name first. Pathogenesis and treatment of asthma gradually developed . Consummate in Ming and Qing Dynasty. Some views are proposed by the Ming Dynasty physicians such as roaring with "perennial" , recurrent, strengthening healthy qi to eliminate pathogens to cure, and identify Asthma and asthma. Qing Doctors concluded there are exogenous pathogens, daily life at home, diet initiat retained phlegm which induced asthma, and there are also exist genetic factors induced asthma, treatment are different to period of onset and paracmasis, and treat according to different etiopathogenisis and entrails, treat internal and external together and use auto-moxibustion are promoted.%祖国医学对支气管哮喘的认识源远流长,《内经》中即有“喘鸣”等称呼,《金匮》奠定了哮喘辨治的基础.元代朱丹溪首提“哮喘”病名,明清对哮喘的病因病机和治疗逐步发展完善,明代医家提出哮有“宿根”,反复发作,治疗宜“扶正祛邪”,并对哮与喘进行鉴别.清代医家总结有外邪、起居、饮食引发宿痰而致哮喘,也有遗传因素的“幼稚天哮”.治疗要分发作期和缓解期,要辨寒热虚实,和分肺脾论治,并倡导内外兼治和天灸疗法.

  8. Scholarly Capacities, Habits of Mind, and Dispositions: Case Studies of Education Doctoral Students in a Dissertation Proposal Seminar

    Science.gov (United States)

    McArthur, Dana Lynn

    2011-01-01

    The completion of a formal proposal for a dissertation research project is a standard requirement as a prelude to the process of conducting research and writing a doctoral dissertation for students who complete a doctoral degree in most academic fields including all the branches of the field of education. Many students satisfactorily complete…

  9. Gender differences in the perception of asthma and respiratory symptoms in a population sample of asthma patients in four Brazilian cities

    Directory of Open Access Journals (Sweden)

    Laura Russo Zillmer

    2014-12-01

    Full Text Available OBJECTIVE: To evaluate the impact of asthma, by gender, in a population sample of asthma patients in Brazil. METHODS: We conducted face-to-face interviews with 400 subjects (> 12 years of age included in a national probability telephone sample of asthma patients in the Brazilian state capitals of São Paulo, Rio de Janeiro, Curitiba, and Salvador. Each of those 400 subjects completed a 53-item questionnaire that addressed five asthma domains: symptoms; impact of asthma on quality of life; perception of asthma control; exacerbations; and treatment/medication. RESULTS: Of the 400 patients interviewed, 272 (68% were female. In relation to respiratory symptoms, the proportion of women reporting extremely bothersome symptoms (cough with sputum, tightness in the chest, cough/shortness of breath/tightness in the chest during exercise, nocturnal shortness of breath, and nocturnal cough was greater than was that of men. Daytime symptoms, such as cough, shortness of breath, wheezing, and tightness in the chest, were more common among women than among men. Women also more often reported that their asthma interfered with normal physical exertion, social activities, sleep, and life in general. Regarding the impact of asthma on quality of life, the proportion of subjects who reported that asthma caused them to feel that they had no control over their lives and affected the way that they felt about themselves was also greater among women than among men. CONCLUSIONS: Among women, asthma tends to be more symptomatic, as well as having a more pronounced effect on activities of daily living and on quality of life.

  10. Health-related quality of life (HRQOL) in Latino families experiencing pediatric asthma.

    Science.gov (United States)

    Garro, Adrienne

    2011-12-01

    The purpose of the present study was to examine health-related quality of life (HRQOL) in Latino children with asthma and their parents. Twenty-six parents completed the Pediatric Asthma Caregivers Quality of Life Questionnaire (PACQLQ), the Health Status and Activities Questionnaire for Children with Asthma (HSAQ) and four subscales from the Family Environment Scale. The results indicated that, overall, neither children with asthma nor their parents showed significant impairments in their HRQOL, though higher illness severity was associated with lower child quality of life and lower parent quality of life related to activity limitations. Other child and family variables, including dimensions of family functioning, did not correlate significantly with HRQOL. However, child and parent HRQOL were significantly associated with each other. This study provides additional context for understanding the experiences of Latino families dealing with pediatric asthma.

  11. Genetic Ancestry and Asthma and Rhinitis Occurrence in Hispanic Children: Findings from the Southern California Children's Health Study.

    Directory of Open Access Journals (Sweden)

    Muhammad T Salam

    Full Text Available Asthma and rhinitis are common childhood health conditions. Being an understudied and rapidly growing population in the US, Hispanic children have a varying risk for these conditions that may result from sociocultural (including acculturative factors, exposure and genetic diversities. Hispanic populations have varying contributions from European, Amerindian and African ancestries. While previous literature separately reported associations between genetic ancestry and acculturation factors with asthma, whether Amerindian ancestry and acculturative factors have independent associations with development of early-life asthma and rhinitis in Hispanic children remains unknown. We hypothesized that genetic ancestry is an important determinant of early-life asthma and rhinitis occurrence in Hispanic children independent of sociodemographic, acculturation and environmental factors.Subjects were Hispanic children (5-7 years who participated in the southern California Children's Health Study. Data from birth certificates and questionnaire provided information on acculturation, sociodemographic and environmental factors. Genetic ancestries (Amerindian, European, African and Asian were estimated based on 233 ancestry informative markers. Asthma was defined by parental report of doctor-diagnosed asthma. Rhinitis was defined by parental report of a history of chronic sneezing or runny or blocked nose without a cold or flu. Sample sizes were 1,719 and 1,788 for investigating the role of genetic ancestry on asthma and rhinitis, respectively.Children had major contributions from Amerindian and European ancestries. After accounting for potential confounders, per 25% increase in Amerindian ancestry was associated with 17.6% (95% confidence interval [CI]: 0.74-0.99 and 13.6% (95% CI: 0.79-0.98 lower odds of asthma and rhinitis, respectively. Acculturation was not associated with either outcome.Earlier work documented that Hispanic children with significant

  12. Regional variation of airway hyperresponsiveness in children with asthma.

    Science.gov (United States)

    Carroll, W D; Lenney, W; Proctor, A; Whyte, M C; Primhak, R A; Cliffe, I; Jones, P W; Strange, R C; Fryer, A A; Child, F

    2005-04-01

    Families with asthmatic children were recruited to take part in a multi-centre collaborative study into the genetics of asthma. Detailed phenotypic information was collected on all family members including: lung function, anthropomorphic measurements, response to methacholine challenge, skin prick testing, serum IgE measurements and a detailed nurse-administered questionnaire. Families were eligible for entry into the study if they had two children with a doctor-diagnosis of asthma. Bennett/Twin nebulisers were supplied to each centre from a single source and these were calibrated to determine gravimetric nebuliser output prior to use. Asthmatic probands from each centre had similar degrees of asthma severity and atopy. There was no significant difference in the sex ratios or ages of the probands or numbers of parents with a history of smoking in the families recruited at each centre. However, there was a significant difference in the number of children with airway hyperresponsiveness, with 90% of the North Staffordshire group but only 60% of the Sheffield group having a PC20 of <8 mg/ml for methacholine. This difference highlights the difficulty of using families from different centres in genetic and epidemiological studies.

  13. Cotinine level is associated with asthma severity in passive smoker children.

    Science.gov (United States)

    Hassanzad, Maryam; Khalilzadeh, Soheila; Eslampanah Nobari, Shabnam; Bloursaz, Mohammadreza; Sharifi, Hooman; Mohajerani, Seyed Amir; Tashayoie Nejad, Sabereh; Velayati, Ali Akbar

    2015-02-01

    Asthma environmental triggers play important roles in severity of disease. Passive smoking could exacerbate asthma symptoms and enhance the decrease in lung function. Cotinine levels could be a reflection of passive exposure to the cigarette both in adults and pediatrics. The aim of this study was to determine degree of association of asthma severity and cotinine level as a marker of passive smoking. In a cross-sectional study, 100 pediatric patients (under 10 years old) with asthma were enrolled, 50 of whom, had been exposed to passive smoking and 50 others included as controls. A complete clinical history, lab exam, and spirometry were performed. A sample of urine, serum and saliva was collected from all attendant patients and controls in the study after confirmation of diagnosis and determination of severity of asthma. The results revealed that age, sex, age of onset of asthma, family history and allergic history were not significantly different between two groups of patients. According to GINA classification, percentage of patients with severe asthma was significantly higher in passive smoker group (p=0.001). Cotinine was significantly higher in passive smoker group compared to control group in serum (p=001), saliva (p=0.001), and urine (p=0.0014). In passive smoker group, cotinine levels were significantly higher in serum (p=0.001), urine (p=0.007), and saliva (p=0.01) of patients with severe asthma than moderate and mild asthma. Serum cotinine (OR: 1.81, 95% CI: 1.35-2.32, p=0.024), urine cotinine (OR: 3.56,95% CI = 1.29-5.53, p=0.01) and saliva cotinine (OR: 1.66, 95% CI: 1.23-1.98, p=0.031) were also significantly associated with higher risk of severe asthma. Cotinine levels were higher in passive smokers compared to non-passive smokers. Besides, cotinine was a predictive risk factor for severe asthma.

  14. Cotinine level is associated with asthma severity in passive smoker children.

    Directory of Open Access Journals (Sweden)

    Maryam Hassanzad

    2015-02-01

    Full Text Available Asthma environmental triggers play important roles in severity of disease. Passive smoking could exacerbate asthma symptoms and enhance the decrease in lung function. Cotinine levels could be a reflection of passive exposure to the cigarette both in adults and pediatrics. The aim of this study was to determine degree of association of asthma severity and cotinine level as a marker of passive smoking. In a cross-sectional study, 100 pediatric patients (under 10 years old with asthma were enrolled, 50 of whom, had been exposed to passive smoking and 50 others included as controls. A complete clinical history, lab exam, and spirometry were performed. A sample of urine, serum and saliva was collected from all attendant patients and controls in the study after confirmation of diagnosis and determination of severity of asthma. The results revealed that age, sex, age of onset of asthma, family history and allergic history were not significantly different between two groups of patients. According to GINA classification, percentage of patients with severe asthma was significantly higher in passive smoker group (p=0.001. Cotinine was significantly higher in passive smoker group compared to control group in serum (p=001, saliva (p=0.001, and urine (p=0.0014. In passive smoker group, cotinine levels were significantly higher in serum (p=0.001, urine (p=0.007, and saliva (p=0.01 of patients with severe asthma than moderate and mild asthma. Serum cotinine (OR: 1.81, 95% CI: 1.35-2.32, p=0.024, urine cotinine (OR: 3.56,95% CI = 1.29-5.53, p=0.01 and saliva cotinine (OR: 1.66, 95% CI: 1.23-1.98, p=0.031 were also significantly associated with higher risk of severe asthma. Cotinine levels were higher in passive smokers compared to non-passive smokers. Besides, cotinine was a predictive risk factor for severe asthma.

  15. The Prevalence, Management and Burden of Asthma-A Nigerian Study

    Directory of Open Access Journals (Sweden)

    Alexander O. Oni

    2010-03-01

    Full Text Available Inadequate attention given to the management of asthma and ways of improving treatment could be a significant factor for the increase morbidity and mortality from asthma despite major advances in our understanding of the pathophysiology of the disease. There seems to be paucity of data concerning the management pattern and burden of asthma in Africa. This study was undertaken to determine the prevalence, management pattern and the burden of asthma.This study was a cross sectional design involving clinical and lung function assessment. The diagnosis of asthma was made using the clinical features of asthma and lung function parameters (Forced expiratory volume in one second, Peak expiratory flow rate, Reversibility tests. Totally, 120 asthma patients participated in this study. All subjects completed the clinical asthma control questionnaires. All items were rated with the calculation of their mean and percentages. Student t-test was used to calculate the difference between the mean of the lung function tests for subjects and control. The prevalence of asthma among respiratory unit patients was 6.6% and higher in the first three decades of life with female preponderance (F:M=1.5-1.There is a strong family history of asthma(81.7%. Associated allergies include rhinitis (75%, pharyngitis (54%, conjunctivitis (54% and dermatitis (30%. Percentage of asthma patients treated with bronchodilators alone (70%, combined inhaled bronchodilators and steroid (28.3%. Impaired daily activities include sports (84%, Job career (60%, Physical activity (55%, Social activity (54%, Household chores (61%, Disturbed sleep (53%, Daytime symptoms (51%, Hospitalized(50%. Subjects had significant low lung function values when compared with control (P

  16. Asthma and dualism.

    Science.gov (United States)

    Paley, J

    2000-06-01

    The rejection of Cartesian dualism can be taken to imply that the mind is implicated in health and illness to a greater degree than conventional medicine would suggest. Surprisingly, however, there appears to be a train of thought in antidualist nursing theory which takes the opposite view. This paper looks closely at an interesting example of antidualist thinking - an article in which Benner and her colleagues comment on the ways in which people with asthma make sense of their condition - and concludes that it places unduly stringent and arbitrary limits on the mind's role. It then asks how antidualism can lead to such a dogmatic rejection of the idea that states of the body are clinically influenced by states of mind. The answer to this question is that Benner assimilates very different philosophical theories into the same 'tradition'. On this occasion, she has combined Descartes, Kant and the Platonist ascetics into a single package, misleadingly labelled 'Cartesianism', and this move accounts for her unexpected views on the relation between mind and body in asthma.

  17. Indoor Domestic environment and asthma

    Directory of Open Access Journals (Sweden)

    Papadimitriou E.

    2010-01-01

    Full Text Available Introduction: Genesis and development of asthma are greatly affected by the indoor environmental quality. Duringrecent years, it is noted an important increase in asthma cases worldwide which is mainly caused by the effects ofpollutants in indoor environments. Purpose: In this study, there has been an effort to show the impact of indoorenvironment on asthma development. Methodology: Reviewing bibliography by information retrieval from thePubmed and TRIP Database.Conclusion: Indoor air pollution is an interdisciplinary subject. The great number ofpollutants, their variety on structure and action, the conditions under which they are developed as well as theirdifferent and disparate ways of treatment and control require knowledge from many scientific fields. By assuming newdimensions in world climate changes, increasing sensitization in allergens, using respiratory irritants, such aspesticides and compounds and chemicals of industrial origin, and at the same time the poor home indoor air qualityand the family history of asthma lead to new asthma cases worldwide. An important number of asthma cases in afamily could be avoided by implementing a better environmental policy inside our homes. Finally, by understandingbetter the link between environment and asthma as well as by explaining the involved gene action, they will bedelivered more effective prevention and treatment programs.

  18. Childhood asthma and physical activity

    DEFF Research Database (Denmark)

    Lochte, Lene; Nielsen, Kim G; Petersen, Poul Erik;

    2016-01-01

    BACKGROUND: Childhood asthma is a global problem affecting the respiratory health of children. Physical activity (PA) plays a role in the relationship between asthma and respiratory health. We hypothesized that a low level of PA would be associated with asthma in children and adolescents. The obj......BACKGROUND: Childhood asthma is a global problem affecting the respiratory health of children. Physical activity (PA) plays a role in the relationship between asthma and respiratory health. We hypothesized that a low level of PA would be associated with asthma in children and adolescents...... and extracted data from original articles that met the inclusion criteria. Summary odds ratios (ORs) and confidence intervals (CIs) were used to express the results of the meta-analysis (forest plot). We explored heterogeneity using funnel plots and the Graphic Appraisal Tool for Epidemiology (GATE). RESULTS......: We retrieved 1,571 titles and selected 11 articles describing three cohort and eight cross-sectional studies for inclusion. A meta-analysis of the cohort studies revealed a risk of new-onset asthma in children with low PA (OR [95 % CI] 1.32 [0.95; 1.84] [random effects] and 1.35 [1.13; 1.62] [fixed...

  19. Role of Obesity in Asthma Control, the Obesity-Asthma Phenotype

    OpenAIRE

    2013-01-01

    Asthma is a disease with distinct phenotypes that have implications for both prognosis and therapy. Epidemiologic studies have demonstrated an association between asthma and obesity. Further studies have shown that obese asthmatics have poor asthma control and more severe asthma. This obese-asthma group may represent a unique phenotype. The mechanisms behind poor asthma control in obese subjects remain unclear, but recent research has focused on adipokines and their effects on the airways as ...

  20. Perceptions of Asthma Quality of Life in Children and Parent Dyads in Two Rural Counties in West Virginia

    Science.gov (United States)

    Pinto, Susan; McCrone, Susan; Shapiro, April L.

    2016-01-01

    This study examines perceived quality of life (QOL) in a convenience sample of children (aged 7-11) with asthma and their parents from two schools in rural West Virginia. Forty-nine child-parent dyads representing 25 males and 24 females completed the study. The PedsQL™ 3.0 Asthma Module was utilized to separately measure child and parent…

  1. Environmental factors and childhood asthma.

    Science.gov (United States)

    Phipatanakul, Wanda

    2006-09-01

    Indoor allergens are potent triggers for acute and chronic pediatric asthma. Environmental control measures of these allergens should be considered first-line treatment measures. Allergen avoidance can produce changes in disease activity and symptoms that can be beneficial before any medical intervention is implemented. In addition to allergen avoidance, studies evaluating other exposures, such as endotoxin and diet, in the pathogenesis of asthma are in progress. Understanding the complex relationships between exposure and allergy/asthma development is vitally important to the development of potentially more effective primary and secondary prevention strategies.

  2. Typhoid fever as a triggering factor in acute and intractable bronchial asthma attack.

    Science.gov (United States)

    Wardhana; Surachmanto, Eko E; Datau, E A

    2013-10-01

    Typhoid fever is an enteric infection caused by Salmonella typhi. In Indonesia, typhoid fever is endemic with high incidence of the disease. In daily practice we frequently have patients with bronchial asthma, and it is becoming worse when these patients get typhoid fever. After oral ingestion, Salmonella typhi invades the the intestine mucosa after conducted by microbial binding to epithelial cells, destroying the microfold cells (M cell) then passed through the lamina propria and detected by dendritic cells (DC) which express a variety of pathogen recognition receptors on the surfaces, including Toll-Like Receptor (TLR). expressed on macrophages and on intestinal epithelial cells inducing degradation of IB, and translocation of NF-B (Nuclear Factor-Kappa Beta). This process initiates the induction of pro-inflammatory gene expression profile adhesion molecules, chemokines, adhesion molecules, and other proteins that induce and perpetuate the inflammation in host cells then will induce acute ant intractable attack of bronchial asthma. The role of typhoid fever in bronchial asthma, especially in persons with acute attack of bronchial asthma, is not well understood. In this article, we will discuss the role of typhoid fever in the bronchial asthma patients which may cause bronchial asthma significantly become more severe even triggering the acute and intractable attack of bronchial asthma. This fact makes an important point, to treat completely the typhoid fever in patients with bronchial asthma.

  3. Factors related to the incorrect use of inhalers by asthma patients

    Directory of Open Access Journals (Sweden)

    Paulo de Tarso Roth Dalcin

    2014-01-01

    Full Text Available OBJECTIVE: To evaluate inhaler technique in outpatients with asthma and to determine associations between the correctness of that technique and the level of asthma control. METHODS: This was a cross-sectional study involving patients > 14 years of age with physician-diagnosed asthma. The patients were recruited from the Asthma Outpatient Clinic of the Hospital de Clínicas de Porto Alegre, in the city of Porto Alegre, Brazil. The patients completed two questionnaires (a general questionnaire and an asthma control questionnaire based on the 2011 Global Initiative for Asthma guidelines, demonstrated their inhaler technique, and performed pulmonary function tests. Incorrect inhaler technique was defined as the incorrect execution of at least two of the predefined steps. RESULTS: We included 268 patients. Of those, 81 (30.2% showed incorrect inhaler technique, which was associated with poor asthma control (p = 0.002. Logistic regression analysis identified the following factors associated with incorrect inhaler technique: being widowed (OR = 5.01; 95% CI, 1.74-14.41; p = 0.003; using metered dose inhalers (OR = 1.58; 95% CI, 1.35-1.85; p 2 comorbidities (OR = 3.80; 95% CI, 1.03-14.02; p = 0.045. CONCLUSIONS: In the sample studied, incorrect inhaler technique was associated with poor asthma control. Widowhood, use of metered dose inhalers, low socioeconomic level, and the presence of > 2 comorbidities were associated with incorrect inhaler technique.

  4. Effects of early intervention with inhaled sodium cromoglycate in childhood asthma.

    Science.gov (United States)

    Yoshihara, S; Kanno, N; Yamada, Y; Ono, M; Fukuda, N; Numata, M; Abe, T; Arisaka, O

    2006-01-01

    International and Japanese guidelines classify childhood asthma as mild, moderate, or severe, and recommend treatment with "as needed" bronchodilators, inhaled sodium cromoglycate, and inhaled corticosteroids, respectively. Alternatively, some investigators proposed inhaled corticosteroids as first-line therapy to prevent airway inflammatory obstruction. This article describes a clinical study assessing the effect of early intervention with inhaled sodium cromoglycate in childhood asthma. This was a retrospective study of 189 asthmatic children treated with inhaled sodium cromoglycate for five years and whose age of onset of asthma was six year of age or younger. An end-of-study questionnaire completed the examination. Children administered oral or inhaled corticosteroids simultaneously with sodium cromoglycate, were excluded. Asthma scores as defined by the Japanese Pediatric Allergic Committee, were reduced continuously during the five years after the start of sodium cromoglycate treatment. The frequency of emergency department visits and hospitalizations also decreased. Significant between-period intervention differences showed improvement of clinical outcomes for children with severe asthma during the five years of sodium cromoglycate inhalation. The early intervention regime of starting sodium cromoglycate inhalation within two years of the onset of asthma shows a large improvement in the long-term prognosis of childhood asthma, especially for children with severe asthma. It is possible that starting inhaled sodium cromoglycate earlier than the present recommendation of corticosteroids could further improve clinical outcomes, but a prospective study should be performed to verify our results.

  5. [Occupational asthma--the case of bakers' asthma].

    Science.gov (United States)

    Bishara, Hasham; Carel, Rafael S

    2013-08-01

    Occupational asthma (OA) is the most common of all occupational lung diseases in industrialized countries and its prevalence has been rising steadily. It is estimated that occupational factors account for one out of six cases of adult asthmatic patients causing significant morbidity, disability and costs. Due to its high prevalence and substantial health and socio-economic impacts OA represents a significant public health concern. OA can be divided into allergic and non allergic asthma. Allergic OA is further divided into IgE mediated and non IgE mediated. Baker's asthma (BA), is the leading cause of IgE mediated OA caused by high molecular weight antgens in industrialized countries. Innovations in the baking industry during the last few decades have led to the introduction of new allergens inducing OA. OA is potentially preventable, through early diagnosis and exposure cessation interventions. Thus, clinicians should consider the occupational history in every adult patient presenting with newly diagnosed asthma.

  6. Predicting Asthma in Preschool Children with Asthma-Like Symptoms

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  7. Robert Paine Doctor Honoris Causa

    Directory of Open Access Journals (Sweden)

    Per Mathiesen

    1998-02-01

    Full Text Available Professor Emeritus Dr. Robert Paine was conferred the degree of Doctor Honoris Causa at the University of Tromsø on August 27 1998 as a recognition of his long lasting and continuing influence on the anthropological study of modern society, and in particular his many contributions to the understanding of Sami reindeer husbandry and the Sami culture in general.

  8. Critical Reflection as Doctoral Education

    Science.gov (United States)

    Brookfield, Stephen D.

    2015-01-01

    This chapter considers how doctoral education, particularly in applied settings such as education, social work, counseling, and health care, could be reimagined if it was organized around the idea and process of critical reflection: of helping students to better understand how power operates in educational environments and how students' sense of…

  9. Literature Reviews: Advising Doctoral Students

    Science.gov (United States)

    Muirhead, Brent

    2007-01-01

    The rapid expansion of available information has created new opportunities and challenges for today's research students. Academic and public libraries have developed sophisticated electronic databases to better manage knowledge to make it more accessible to researchers. Literature reviews are a major challenge for doctoral students. The focus of…

  10. Doctoral Students' Conceptions of Research

    Science.gov (United States)

    Pitcher, Rod

    2011-01-01

    In this paper I report a study of the conceptions of research held by a sample of doctoral students at an Australian research-intensive university. I take a unique approach by using metaphor analysis to study the students' conceptions. The students in this study were recruited for an on-line survey in which they answered questions relating to…

  11. Industry-Oriented Doctorate Established.

    Science.gov (United States)

    Chemical and Engineering News, 1982

    1982-01-01

    Describes an industry-related program at the University of Texas (Arlington) leading to a Doctorate of Science in Applied Chemistry. The program requires an industrial internship and a dissertation based on research involving both the university's chemistry faculty and chemists in industry. (SK)

  12. Sources and prevalence of self-reported asthma diagnoses in adults in urban and rural settings of Bangladesh.

    Science.gov (United States)

    Bartlett, Emily; Parr, John; Lindeboom, Wietze; Khanam, Masuma Akter; Koehlmoos, Tracy Pérez

    2013-01-01

    This study provides data on the sources of asthma diagnoses in the adult Bangladeshi population in urban and rural settings. The paper also reports the prevalence of self-reported asthma diagnoses and associated socio-demographic factors. A cross-sectional study was conducted in three communities: two rural settings and one urban setting, with a total sample size of 32,665 subjects. Pre-existing surveillance data provided individual socio-demographic factors. Provider categories were based on previous research describing provider plurality in Bangladesh. Descriptive statistics, univariate regression and multivariate regression analyses were performed. Bachelor of Medicine, Bachelor of Surgery (MBBS) generalists provided the largest proportion of diagnoses in both urban (54.6%) and rural (42.4%) sites. The largest proportion of non-MBBS-trained healthcare workers providing diagnoses of asthma was spiritual healers (13.3%) in the urban settings and village doctors (42.4%) in rural settings. The overall prevalence of self-reported asthma diagnoses was 5.0% in the urban population and 3.5% in the rural population. The results highlight the importance of non-MBBS doctors in serving the healthcare needs of the Bangladeshi population. This study reveals a higher prevalence of self-reported asthma diagnoses in the urban setting than in rural ones, which is consistent with international literature on the topic.

  13. Clinical Progress on Moxibustion Treatment of Asthma

    Institute of Scientific and Technical Information of China (English)

    WU Yao-chi; SHI Yin; HUANG Guo-qi

    2004-01-01

    In the treatment of asthma, there are the commonly-used external therapies of scarring moxibustion, ginger-insulated moxibustion and acupoint herb-applying method, etc, with better clinical effects. But, strict recruitment standard was lacked and the designs of clinical studies were not complete in some reports. Therefore, the design of clinical study on moxibustion therapy and acupoint herb-applying method in the treatment of asthma needs to be strict and complete in the future studies.%治疗哮喘的常用外治法有化脓灸,隔姜灸和穴位贴敷等,均有较好的临床效果,但部分报道缺乏严格的纳入标准,而且临床研究设计不完善,有待于在以后的研究中严格与完善灸法和穴位贴敷防治哮喘的临床研究设计.

  14. Japanese Guideline for Adult Asthma 2014

    Directory of Open Access Journals (Sweden)

    Ken Ohta

    2014-01-01

    Full Text Available Adult bronchial asthma (hereinafter, asthma is characterized by chronic airway inflammation, reversible airway narrowing, and airway hyperresponsiveness. Long-standing asthma induces airway remodeling to cause intractable asthma. The number of patients with asthma has increased, and that of patients who die from asthma has decreased (1.5 per 100,000 patients in 2012. The aim of asthma treatment is to enable patients with asthma to lead a normal life without any symptoms. A good relationship between physicians and patients is indispensable for appropriate treatment. Long-term management with antiasthmatic agents and elimination of the causes and risk factors of asthma are fundamental to its treatment. Four steps in pharmacotherapy differentiate between mild and intensive treatments; each step includes an appropriate daily dose of an inhaled corticosteroid, varying from low to high. Long-acting 02-agonists, leukotriene receptor antagonists, and sustained-release theophylline are recommended as concomitant drugs, while anti-immunoglobulin E antibody therapy has been recently developed for the most severe and persistent asthma involving allergic reactions. Inhaled 02-agonists, aminophylline, corticosteroids, adrenaline, oxygen therapy, and others are used as needed in acute exacerbations by choosing treatment steps for asthma exacerbations depending on the severity of attacks. Allergic rhinitis, chronic obstructive pulmonary disease, aspirin-induced asthma, pregnancy, asthma in athletes, and coughvariant asthma are also important issues that need to be considered.

  15. Adherence to asthma guidelines in general practices.

    Science.gov (United States)

    Roghmann, M C; Sexton, M

    1999-06-01

    Adherence to asthma practice guidelines is low. Improved compliance could potentially improve care of patients with asthma. The purpose of this study was to determine if patients managed in a general practice with an associated asthma clinic are more likely to use asthma medications according to clinical practice guidelines than patients managed in the general surgery of the practice. A cross-sectional study of adult asthmatics, aged 18-55 years, was conducted in six British general practices. Prescription data on all asthma medication was collected for a 6-month period. Information on asthma clinic attendance, age, sex, employment status, other medical illness, and how patients used their inhaled beta2-agonist was collected through questionnaire. The prescription data for asthma medication and patient use of inhaled beta2-agonist were compared to the British Thoracic Society's (BTS) Guidelines for Management of Asthma in Adults to determine if the patient's asthma medication regimen was appropriate. There was no significant association found between appropriate asthma medication and asthma clinic attendance or other patient characteristics. Adherence to the BTS guidelines was low. Fifty-eight percent of the asthma patients used asthma medication regimens that were not consistent with the BTS guidelines published 1 year earlier. Adherence to the BTS guidelines was low regardless of patient characteristics, including asthma clinic attendance, age, sex, employment status, other medical illness, or individual practice. These findings underscore the need to document the utility of clinical practice guidelines which may improve physician compliance.

  16. Asthma in Adults Fact Sheet

    Science.gov (United States)

    ... States: 2002-2007. Journal of Allergy and Clinical Immunology . 2011; 127:145-52. American Lung Association Asthma ... Oppose House-Passed REINS Act Blog: Why Lung Cancer Screening Isn’t for Never Smokers Blog: The ...

  17. The placebo effect in asthma.

    Science.gov (United States)

    Dutile, Stefanie; Kaptchuk, Ted J; Wechsler, Michael E

    2014-08-01

    The placebo effect is a complex phenomenon occurring across a variety of clinical conditions. While much placebo research has been conducted in diseases defined by self-report such as depression, chronic pain, and irritable bowel syndrome (IBS), asthma has been proposed as a useful model because of its easily measured objective outcomes. Studies examining the placebo response in asthma have not only contributed to an understanding of the mechanisms behind the placebo response but also shed an interesting light on the current treatment and diagnosis of asthma. This paper will review current literature on placebos in general and specifically on the placebo response in asthma. It focuses on what we know about the mechanisms behind the placebo effect, whether there is a specific portion of the population who responds to placebos, which patient outcomes are influenced by the placebo effect, and whether the effect can be augmented.

  18. Teaching Your Child about Asthma

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  19. Cholesterol - what to ask your doctor

    Science.gov (United States)

    ... your doctor; What to ask your doctor about cholesterol ... What is my cholesterol level? What should my cholesterol level be? What are HDL ("good") cholesterol and LDL ("bad") cholesterol? Does my cholesterol ...

  20. Lyme disease - what to ask your doctor

    Science.gov (United States)

    What to ask your doctor about Lyme disease; Lyme borreliosis - questions; Bannwarth syndrome - questions ... I am treated with antibiotics? How can my doctor diagnose me with Lyme disease? Can I be ...

  1. Enlarged prostate - what to ask your doctor

    Science.gov (United States)

    What to ask your doctor about enlarged prostate; Benign prostatic hypertrophy - what to ask your doctor; BPH - what to ... nlm.nih.gov/pubmed/23234640 . Roehrborn CG. Benign prostatic hyperplasia: Etiology, pathophysiology, epidemiology, and natural history. In: Wein ...

  2. [Macrophages in asthma].

    Science.gov (United States)

    Medina Avalos, M A; Orea Solano, M

    1997-01-01

    Every time they exist more demonstrations of the paper than performs the line monocytes-macrophage in the patogenesis of the bronchial asthma. The mononuclear phagocytes cells, as the alveolar macrophages, also they can be activated during allergic methods. The monocytes macrophages are possible efficient inductors of the inflammation; this due to the fact that they can secrete inflammatory mediators, between those which are counted the pre-forming granules of peptides, metabolites of oxidation activation, activator of platelets activator and metabolites of the arachidonic acid. The identification of IL-1 in the liquidate of the bronchial ablution of sick asthmatic, as well as the identification of IL-1 in the I bronchioalveolar washing of places of allergens cutaneous prick, supports the activation concept mononuclear of phagocytic cells in allergic sufferings.

  3. Identification of asthma clusters in two independent Korean adult asthma cohorts.

    Science.gov (United States)

    Kim, Tae-Bum; Jang, An-Soo; Kwon, Hyouk-Soo; Park, Jong-Sook; Chang, Yoon-Seok; Cho, Sang-Heon; Choi, Byoung Whui; Park, Jung-Won; Nam, Dong-Ho; Yoon, Ho-Joo; Cho, Young-Joo; Moon, Hee-Bom; Cho, You Sook; Park, Choon-Sik

    2013-06-01

    Asthma is a heterogeneous airway disease with various clinical phenotypes. It is crucial to clearly identify clinical phenotypes to achieve better asthma management. We used cluster analysis to classify the clinical groups of 724 asthmatic patients from the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA), and in 1843 subjects from another independent Korean asthma cohort of Soonchunhyang University Asthma Genome Research Centre (SCH) (Bucheon, Republic of Korea). Hierarchical cluster analysis was performed by Ward's method, followed by κ-means cluster analysis. Cluster analysis of the COREA cohort indicated four asthma subtypes: 1) smoking asthma; 2) severe obstructive asthma; 3) early-onset atopic asthma; and 4) late-onset mild asthma. An independent cluster analysis of the SCH cohort also indicated four clusters that were similar to the COREA clusters. Our results indicate that adult Korean asthma patients can be classified into four distinct clusters.

  4. Exacerbations of asthma during pregnancy

    DEFF Research Database (Denmark)

    Ali, Z; Hansen, A V; Ulrik, C S

    2016-01-01

    that asthma exacerbations during pregnancy increase the risk of pre-eclampsia, gestational diabetes, placental abruption and placenta praevia. Furthermore, these women also have higher risk for breech presentation, haemorrhage, pulmonary embolism, caesarean delivery, maternal admission to the intensive care...... unit and longer postpartum hospital stay. Asthma has been associated with increased risk of intrauterine growth retardation, small-for-gestational age, low birth weight, infant hypoglycaemia and preterm birth, but more recent prospective studies have not revealed significant associations with regard...

  5. Asthma and Obstructive Sleep Apnea

    Institute of Scientific and Technical Information of China (English)

    Yi-Xian Qiao; Yi Xiao

    2015-01-01

    Objective:To get a comprehensive understanding about the relationship between obstructive sleep apnea (OSA) and asthma by reviewing the epidemiology,pathophysiology,and clinical manifestation and then summarizing the latest progress on diagnosis and treatment.Data Sources:Articles referred in this review were mainly collected from a comprehensive search of the PubMed published in English from 1990 to 2015 with the terms "OSA" and “asthma'" as the main keywords.Highly regarded older publications were also included.Study Selection:Information about the features of the two diseases in common,the pathophysiologic association between them and their current treatments from the literature search were identified,retrieved,and summarized.Results:Both OSA and asthma are very prevalent conditions.The incidences of them have kept on rising in recent years.Asthma is often accompanied by snoring and apnea,and OSA often combines with asthma,as well.They have many predisposing and aggravating factors in common.Possible shared direct mechanistic links between them include mechanical effects,intermittent hypoxia,nerve reflex,inflammation,leptin,etc.Indirect mechanistic links include medication,nose diseases,smoking,obesity,and gastroesophageal reflux disease.Since OSA presents many similar features with nocturnal asthma,some scholars termed them as a sole syndrome "alternative overlap syndrome,"and proved that asthma symptoms in those patients could be improved through the treatment of continuous positive airway pressure.Conclusions:OSA and asthma are closely associated in pathogenesis,symptoms,and therapies.With the growing awareness of the relationship between them,we should raise our vigilance on the coexistence of OSA in those difficult-to-control asthmatic patients.Further studies are still needed to guide the clinical works.

  6. Respiratory Reviews in Asthma 2013

    OpenAIRE

    Kim, Tae-Hyung

    2014-01-01

    From January 2012 up until March 2013, many articles with huge clinical importance in asthma were published based on large numbered clinical trials or meta-analysis. The main subjects of these studies were the new therapeutic plan based on the asthma phenotype or efficacy along with the safety issues regarding the current treatment guidelines. For efficacy and safety issues, inhaled corticosteroid tapering strategy or continued long-acting beta agonists use was the major concern. As new thera...

  7. Persistent cough: is it asthma?

    OpenAIRE

    Faniran, A; Peat, J; Woolcock, A

    1998-01-01

    The aim of this study was to determine if children in the community with persistent cough can be considered to have asthma. A validated questionnaire was given to the parents of 1245 randomly selected children aged 6-12 years. Atopy was measured with skin prick tests. Children with persistent cough had less morbidity and less atopy compared with children with wheeze. Although the syndrome commonly referred to as "cough variant asthma" could not be shown in this study, a sign...

  8. Asthma in Sickle Cell Disease

    Directory of Open Access Journals (Sweden)

    Manisha Newaskar

    2011-01-01

    Full Text Available In recent years, evidence has increased that asthma predisposes to complications of sickle cell disease (SCD, such as pain crises, acute chest syndrome, pulmonary hypertension, and stroke, and is associated with increased mortality. An obstructive pattern of pulmonary function, along with a higher-than-expected prevalence of airway hyper-responsiveness (AHR when compared to the general population, has led some researchers to suspect that underlying hemolysis may contribute to the development of a pulmonary disease similar to asthma in patients with SCD. While the pathophysiologic mechanism in atopic asthma involves up-regulation of Th2 cytokines, mast cell– and eosinophil-driven inflammation, plus increased activity of inducible nitric oxide synthase (iNOS and arginase in airway epithelium resulting in obstructive changes and AHR, the exact mechanisms of AHR, obstructive and restrictive lung disease in SCD is unclear. It is known that SCD is associated with a proinflammatory state and an enhanced inflammatory response is seen during vaso-occlusive events (VOE. Hemolysis-driven acute-on-chronic inflammation and dysregulated arginines–nitric oxide metabolism are potential mechanisms by which pulmonary dysfunction could occur in patients with SCD. In patients with a genetic predisposition of atopic asthma, these changes are probably more severe and result in increased susceptibility to sickle cell complications. Early recognition and aggressive management of asthma based on established National Institutes of Health asthma guidelines is recommended in order to minimize morbidity and mortality.

  9. Childhood Asthma: Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Wim M. van Aalderen

    2012-01-01

    Full Text Available Many children suffer from recurrent coughing, wheezing and chest tightness. In preschool children one third of all children have these symptoms before the age of six, but only 40% of these wheezing preschoolers will continue to have asthma. In older school-aged children the majority of the children have asthma. Quality of life is affected by asthma control. Sleep disruption and exercised induced airflow limitation have a negative impact on participation in sports and social activities, and may influence family life. The goal of asthma therapy is to achieve asthma control, but only a limited number of patients are able to reach total control. This may be due to an incorrect diagnosis, co-morbidities or poor inhalation technique, but in the majority of cases non-adherence is the main reason for therapy failures. However, partnership with the parents and the child is important in order to set individually chosen goals of therapy and may be of help to improve control. Non-pharmacological measures aim at avoiding tobacco smoke, and when a child is sensitised, to avoid allergens. In pharmacological management international guidelines such as the GINA guideline and the British Guideline on the Management of Asthma are leading.

  10. Childhood asthma: diagnosis and treatment.

    Science.gov (United States)

    van Aalderen, Wim M

    2012-01-01

    Many children suffer from recurrent coughing, wheezing and chest tightness. In preschool children one third of all children have these symptoms before the age of six, but only 40% of these wheezing preschoolers will continue to have asthma. In older school-aged children the majority of the children have asthma. Quality of life is affected by asthma control. Sleep disruption and exercised induced airflow limitation have a negative impact on participation in sports and social activities, and may influence family life. The goal of asthma therapy is to achieve asthma control, but only a limited number of patients are able to reach total control. This may be due to an incorrect diagnosis, co-morbidities or poor inhalation technique, but in the majority of cases non-adherence is the main reason for therapy failures. However, partnership with the parents and the child is important in order to set individually chosen goals of therapy and may be of help to improve control. Non-pharmacological measures aim at avoiding tobacco smoke, and when a child is sensitised, to avoid allergens. In pharmacological management international guidelines such as the GINA guideline and the British Guideline on the Management of Asthma are leading.

  11. [Difficult to control severe asthma].

    Science.gov (United States)

    Magnan, Antoine; Pipet, Anaïs

    2011-03-01

    Difficult to control severe asthma is characterized by the persistence of inacceptable symptoms of asthma despite a continuous treatment with at least high doses of inhaled steroids and long acting bronchodilators. The diagnosis is done after a period of observation and some investigations that will allow confirm the diagnosis of asthma, eliminate alternative diagnosis and etiological forms that would be difficult to treat intrinsically (allergic broncho-pulmonary aspergillosis, Churg and Strauss disease, chronic eosinophilic pneumonia, occupational asthma). At the end of this period devoted to diagnosis a systematic approach is set up to take care of these patients. Therapeutic education includes action plans and measures for triggering factors avoidance in order to prevent exacerbations. Comorbidities such as rhinitis, nasal polyposis, gastro-oesophageal reflux and obesity are taken into account. Lastly, the treatment must be adapted according to the patient's preferences and aims, and to the asthma severity. Ultimately in steroid-dependent asthma, the lowest efficient dose is tracked continuously. For these patients, new molecules are needed.

  12. Patient and physician asthma deterioration terminology: results from the 2009 Asthma Insight and Management survey.

    Science.gov (United States)

    Blaiss, Michael S; Nathan, Robert A; Stoloff, Stuart W; Meltzer, Eli O; Murphy, Kevin R; Doherty, Dennis E

    2012-01-01

    Long-term achievement of asthma control is dependent in part on the use of mutually understandable asthma terminology in all verbal and written patient-physician communications. Using data from the Asthma Insight and Management (AIM) survey, the objective of this analysis is to provide a contemporary depiction of asthma deterioration terminology as used by current asthma patients and physicians in the United States. As part of the 2009 AIM survey, current asthma patients (≥12 years of age; weighted n = 2499) and physicians (n = 309) were queried about their recognition, understanding, and/or use of the terms "asthma attack," "asthma flare-up," and "asthma exacerbation" in telephone interviews. Nearly all patients had heard the term "asthma attack" (97%), but relatively few had heard the term "asthma exacerbation" (24%); 71% had heard "asthma flare-up." In contrast, physicians reported using the term "asthma attack" least (65%) and the term "asthma exacerbation" most (77%) when discussing asthma with their patients; 70% reported using "asthma flare-up." Among patients familiar with "asthma flare-up" and "asthma exacerbation" (n = 502), only 38% said that the terms mean the same thing; nearly all physicians (94%) said that the terms mean the same thing. Collectively, data from the AIM survey suggest that patients and physicians use different asthma deterioration terminology and, more importantly, that they do not necessarily understand each other's terms. Standardizing asthma deterioration terminology may help optimize asthma patient-physician communication to improve patient understanding of written asthma action plans and therefore, enhance patient outcomes.

  13. Prenatal Maternal Stress Predicts Childhood Asthma in Girls: Project Ice Storm

    Directory of Open Access Journals (Sweden)

    Anne-Marie Turcotte-Tremblay

    2014-01-01

    Full Text Available Little is known about how prenatal maternal stress (PNMS influences risks of asthma in humans. In this small study, we sought to determine whether disaster-related PNMS would predict asthma risk in children. In June 1998, we assessed severity of objective hardship and subjective distress in women pregnant during the January 1998 Quebec Ice Storm. Lifetime asthma symptoms, diagnoses, and corticosteroid utilization were assessed when the children were 12 years old (N=68. No effects of objective hardship or timing of the exposure were found. However, we found that, in girls only, higher levels of prenatal maternal subjective distress predicted greater lifetime risk of wheezing (OR=1.11; 90% CI = 1.01–1.23, doctor-diagnosed asthma (OR=1.09; 90% CI = 1.00–1.19, and lifetime utilization of corticosteroids (OR=1.12; 90% CI = 1.01–1.25. Other perinatal and current maternal life events were also associated with asthma outcomes. Findings suggest that stress during pregnancy opens a window for fetal programming of immune functioning. A sex-based approach may be useful to examine how prenatal and postnatal environments combine to program the immune system. This small study needs to be replicated with a larger, more representative sample.

  14. Prenatal maternal stress predicts childhood asthma in girls: project ice storm.

    Science.gov (United States)

    Turcotte-Tremblay, Anne-Marie; Lim, Robert; Laplante, David P; Kobzik, Lester; Brunet, Alain; King, Suzanne

    2014-01-01

    Little is known about how prenatal maternal stress (PNMS) influences risks of asthma in humans. In this small study, we sought to determine whether disaster-related PNMS would predict asthma risk in children. In June 1998, we assessed severity of objective hardship and subjective distress in women pregnant during the January 1998 Quebec Ice Storm. Lifetime asthma symptoms, diagnoses, and corticosteroid utilization were assessed when the children were 12 years old (N = 68). No effects of objective hardship or timing of the exposure were found. However, we found that, in girls only, higher levels of prenatal maternal subjective distress predicted greater lifetime risk of wheezing (OR = 1.11; 90% CI = 1.01-1.23), doctor-diagnosed asthma (OR = 1.09; 90% CI = 1.00-1.19), and lifetime utilization of corticosteroids (OR = 1.12; 90% CI = 1.01-1.25). Other perinatal and current maternal life events were also associated with asthma outcomes. Findings suggest that stress during pregnancy opens a window for fetal programming of immune functioning. A sex-based approach may be useful to examine how prenatal and postnatal environments combine to program the immune system. This small study needs to be replicated with a larger, more representative sample.

  15. Difficult asthma: assessment and management, Part 1.

    Science.gov (United States)

    Long, Aidan A; Fanta, Christopher H

    2012-01-01

    A minority of asthma patients have disease that proves difficult to control with usual medications and experience ongoing symptoms, poor quality of life, and limitations in activity and/or frequent asthma exacerbations. This group of patients accounts for much of the expense associated with asthma care and is the focus of national and international collaborative study groups. Distinguishing between "difficult-to-manage asthma" and truly "therapy-resistant asthma" is helpful and promotes a systematic consideration of contributory factors. Critical evaluation of factors contributing to difficult-to-manage asthma including adverse environment, comorbidities, nonadherence, and incorrect diagnosis is recommended in a systematic fashion in Part 1 of this contribution.

  16. Childhood Asthma Management and Environmental Triggers.

    Science.gov (United States)

    Hollenbach, Jessica P; Cloutier, Michelle M

    2015-10-01

    Asthma is the most common chronic disease among children. It cannot be prevented but can be controlled. Industrialized countries experience high lifetime asthma prevalence that has increased over recent decades. Asthma has a complex interplay of genetic and environmental triggers. Studies have revealed complex interactions of lung structure and function genes with environmental exposures such as environmental tobacco smoke and vitamin D. Home environmental strategies can reduce asthma morbidity in children but should be tailored to specific allergens. Coupled with education and severity-specific asthma therapy, tailored interventions may be the most effective strategy to manage childhood asthma.

  17. The Learning Alliance: Ethics in Doctoral Supervision

    Science.gov (United States)

    Halse, Christine; Bansel, Peter

    2012-01-01

    This paper is concerned with the ethics of relationships in doctoral supervision. We give an overview of four paradigms of doctoral supervision that have endured over the past 25 years and elucidate some of their strengths and limitations, contextualise them historically and consider their implications for doctoral supervision in the contemporary…

  18. Politeness in Doctor-Potient Diolog

    Institute of Scientific and Technical Information of China (English)

    张继媛

    2011-01-01

    In our everyday communication, we often use Euphemism to express our thought indirectly, for example, doctors usually do not tell the patients the truth when treating serious patients. This paper aims at exploring the nature of euphemism in doctor-patient interactions and how do doctors use euphemism to attain the goal of politeness on the basis of the Face Theory and Politeness theory.

  19. Hybrid Doctoral Program: Innovative Practices and Partnerships

    Science.gov (United States)

    Alvich, Dori; Manning, JoAnn; McCormick, Kathy; Campbell, Robert

    2012-01-01

    This paper reflects on how one mid-Atlantic University innovatively incorporated technology into the development of a hybrid doctoral program in educational leadership. The paper describes a hybrid doctoral degree program using a rigorous design; challenges of reworking a traditional syllabus of record to a hybrid doctoral program; the perceptions…

  20. Culturable mold in indoor air and its association with moisture-related problems and asthma and allergy among Swedish children

    DEFF Research Database (Denmark)

    Holme, J.; Hagerhed-Engman, L.; Mattsson, J.;

    2010-01-01

    by professional inspectors and reported by parents), (ii) visible signs of dampness in the homes of the children (observed and reported), and (iii) doctor-diagnosed asthma/allergy in children. No association was found between the spore concentration indoor and moldy odor and signs of visible dampness in the homes...... in indoor air and asthma/allergy in the children.......In a nested case-control study with 198 children with asthmatic and allergic symptoms (cases) and 202 healthy controls in Varmland. Sweden, we have investigated the relationship between mold spore exposure (mean colony-forming unit) indoor and (i) different indexes of moldy odor indoor (observed...

  1. Validity of three asthma-specific quality of life questionnaires: the patients' perspective

    Science.gov (United States)

    Jones, Christina J; Frew, Anthony; Smith, Helen

    2016-01-01

    Objectives It is not known which of the many asthma-specific quality of life (QoL) questionnaires best capture the lived experience of people with asthma. The objective of this study was to explore patients' views of three commonly used asthma-specific QoL questionnaires. Design Qualitative study using semistructured interviews. Setting Primary and secondary care in Brighton and Hove, UK. Participants 30 adult people with a physician-diagnosis of asthma who were asked to complete the Juniper Asthma Quality of Life Questionnaire (AQLQ-J), the Sydney Asthma Quality of Life Questionnaire (AQLQ-S) and the Living with Asthma Questionnaire (LWAQ) to elicit their views on the content validity of these. Results Thematic content analysis revealed a lack of congruence between the concerns of people with asthma and the questionnaire content in terms of missing (eg, allergies) and irrelevant (eg, smoky restaurants) content. The AQLQ-J was perceived as a ‘narrow’, ‘medical’ questionnaire focused on symptoms, the environment and functional ability. In contrast, the LWAQ and the AQLQ-S were perceived to be ‘non-medical’. The LWAQ was described as a ‘test’ and as a wide-ranging, embracing and holistic questionnaire. Its strong emotional focus was irritating to some. The AQLQ-S was described as a simple, quick and easy questionnaire, although there was a perception that it was lacking in depth. Conclusions Patient interviews highlighted strengths and shortcomings in the content validity of these three asthma-specific questionnaires. For patients, the AQLQ-S content seemed to be the most pertinent in its adequacy of coverage of medical, social and emotional aspects of health-related QoL in asthma. PMID:28007706

  2. Towards excellence in asthma management (TEAM): a populational disease-management model.

    Science.gov (United States)

    Boulet, Louis-Philippe; Thivierge, Robert L; Amesse, André; Nunes, Fatima; Francoeur, Suzanne; Collet, Jean-Paul

    2002-06-01

    Asthma management is not always optimal, and deficiencies such as inadequate treatment and insufficient patient education are often reported. Towards Excellence in Asthma Management (TEAM) is a four-phase disease management program of the Quebec Asthma Education Network (QAEN), to be carried out over a 5-year period. The program aims to achieve a continuous improvement of asthma management by caregivers and patients. The first phase, completed in January 2000, consisted of determining the actual level of asthma-associated morbidity and mortality in various Quebec regions. The second phase, which began in September 1999, included three parts: 1. Definition of the burden of asthma, taking into account the socioeconomic consequences of the disease and the quality of life of the patients, 2. Comparison of current medical practices with the Canadian Asthma Consensus Guidelines for adult and pediatric populations, 3. Evaluation of the level of compliance with medical treatment and with the environmental changes recommended to asthmatic patients. This phase is carried out via a cohort study of physicians, mainly general practitioners and pediatricians, generating a patient cohort study, in addition to substudies evaluating specific aspects of asthma care. Once the care gap is identified, it will be possible to define, apply, and evaluate a series of interventions for physicians, other health professionals, and patients. The interventions will be particularly targeted at regions where asthma incidence and morbidity are higher. We hope that this model of disease management will progressively reduce the burden associated with asthma, and potentially other chronic diseases, and will result in the more effective use of health services.

  3. Understanding childhood asthma in focus groups: perspectives from mothers of different ethnic backgrounds

    Directory of Open Access Journals (Sweden)

    McKenzie Sheila

    2001-09-01

    Full Text Available Abstract Background Diagnosing childhood asthma is dependent upon parental symptom reporting but there are problems in the use of words and terms. The purpose of this study was to describe and compare understandings of childhood 'asthma' by mothers from three different ethnic backgrounds who have no personal experience of diagnosing asthma. A better understanding of parents' perceptions of an illness by clinicians should improve communication and management of the illness. Method Sixty-six mothers living in east London describing their ethnic backgrounds as Bangladeshi, white English and black Caribbean were recruited to 9 focus groups. Discussion was semi-structured. Three sessions were conducted with each ethnic group. Mothers were shown a video clip of a boy with audible wheeze and cough and then addressed 6 questions. Sessions were recorded and transcribed verbatim. Responses were compared within and between ethnic groups. Results Each session, and ethnic group overall, developed a particular orientation to the discussion. Some mothers described the problem using single signs, while others imitated the sound or made comparisons to other illnesses. Hereditary factors were recognised by some, although all groups were concerned with environmental triggers. Responses about what to do included 'normal illness' strategies, use of health services and calls for complementary treatment. All groups were concerned about using medication every day. Expectations about the quality of life were varied, with recognition that restrictions may be based on parental beliefs about asthma, rather than asthma itself. Conclusion Information from these focus groups suggests mothers know a great deal about childhood asthma even though they have no personal experience of it. Knowledge of how mothers from these ethnic backgrounds perceive asthma may facilitate doctor – patient communication with parents of children experiencing breathing difficulties.

  4. Usage of inhalation devices in asthma and chronic obstructive pulmonary disease: a Delphi consensus statement.

    OpenAIRE

    Ninane, Vincent; Brusselle, Guy G.; Louis, Renaud; Dupont, Lieven; Liistro, Giuseppe; De Backer,Wilfried; Schlesser, Marc; Vincken, Walter

    2014-01-01

    OBJECTIVES: The study aimed to assess usage of inhalation devices in asthma and chronic obstructive pulmonary disease (COPD). METHODS: In this two-round Delphi survey, 50 experts in asthma and COPD completed a 13-item, Internet-based, self-administered questionnaire about choice of inhalation device, training and monitoring of inhalation techniques, the interchangeability and the role of costs in the selection of inhalation devices. For each item, the median (central tendency) and interquarti...

  5. Doctoral specialization in nursing informatics.

    OpenAIRE

    Gassert, C. A.; Mills, M. E.; Heller, B R

    1991-01-01

    A prototype program of doctoral study has been developed at the University of Maryland School of Nursing to prepare students with nursing expertise in the conceptualization and research of computer based information systems in hospitals, industry and other health care organizations. The graduate will be prepared to design effective nursing information systems; create innovative information technology; conduct research regarding integration of technology with nursing practice, administration, ...

  6. Another successful Doctoral Student Assembly

    CERN Multimedia

    Katarina Anthony

    2014-01-01

    On Wednesday 2 April, CERN hosted its third Doctoral Student Assembly in the Council Chamber.   CERN PhD students show off their posters in CERN's Main Building. Speaking to a packed house, Director-General Rolf Heuer gave the assembly's opening speech and introduced the poster session that followed. Seventeen CERN PhD students presented posters on their work, and were greeted by their CERN and University supervisors. It was a very successful event!

  7. Unsuspected pseudophysiologic emphysema in chronic persistent asthma.

    Science.gov (United States)

    Gelb, A F; Zamel, N

    2000-11-01

    The current literature emphasizes the role of airway remodeling in chronic persistent asthma and its putative effect on causing fixed expiratory airflow limitation. We studied 18 adults with chronic persistent asthma; 12 men, six women, age 59 +/- 15 yr (mean +/- SD) with fixed expiratory airflow obstruction. We measured lung elastic recoil and examined the mechanism of expiratory airflow limitation. Diaphragmatic strength was also measured in six asthmatics, using both sniff and partially occluded airway technique. All 18 asthmatics had markedly abnormal maximal expiratory flow-volume curves at both high and low lung volumes. Hyperinflation was present at residual volume (RV), FRC, and TLC in all subjects. Diffusing capacity was normal or elevated and lung computed tomography (CT) was normal in all 18 asthmatic subjects. There was a significant loss of lung elastic recoil in three of four asthmatics age 30 to 49, all five age 51 to 60 yr, and seven of nine age 61 to 82 yr. Maximal expiratory airflow limitation in only four elderly asthmatics and only at low lung volumes was due completely to loss of lung elastic recoil. In the others, we estimate the reduction in lung elastic recoil was responsible for 35% reduction in maximal expiratory airflow at 80% of TLC, and 55% at 70% of TLC. Despite hyperinflation, transdiaphragmatic pressures and strength were normal. The mechanisms responsible for loss of lung elastic recoil remain elusive. The high incidence of loss of lung elastic recoil in chronic persistent asthma was unexpected, and its contribution to abnormal lung function needs to be emphasized.

  8. Mastectomy and breast reconstruction - what to ask your doctor

    Science.gov (United States)

    Mastectomy - what to ask your doctor; Breast reconstruction - what to ask your doctor; TRAM flap - what to ... your doctor; What to ask your doctor about mastectomy and breast reconstruction; Breast cancer - mastectomy - what to ...

  9. Parent and Clinician Preferences for an Asthma App to Promote Adolescent Self-Management: A Formative Study

    Science.gov (United States)

    Roberts, Courtney A; Sage, Adam J; Coyne-Beasley, Tamera; Sleath, Betsy L; Carpenter, Delesha M

    2016-01-01

    Background Most youth asthma apps are not designed with parent and clinician use in mind, and rarely is the app development process informed by parent or clinician input. Objective This study was conducted to generate formative data on the use, attitudes, and preferences for asthma mHealth app features among parents and clinicians, the important stakeholders who support adolescents with asthma and promote adolescent self-management skills. Methods We conducted a mixed-methods study from 2013 to 2014 employing a user-centered design philosophy to acquire feedback from a convenience sample of 20 parents and 6 clinicians. Participants were given an iPod Touch and asked to evaluate 10 features on 2 existing asthma apps. Participant experiences using the apps were collected from questionnaires and a thematic analysis of audio-recorded and transcribed (verbatim) interviews using MAXQDA. Descriptive statistics were calculated to characterize the study sample and app feature feedback. Independent samples t tests were performed to compare parent and clinician ratings of app feature usefulness (ratings: 1=not at all useful to 5=very useful). Results All parents were female (n=20), 45% were black, 20% had an income ≥US $50,000, and 45% had a bachelor’s degree or higher education. The clinician sample included 2 nurses and 4 physicians with a mean practice time of 13 years. Three main themes provided an understanding of how participants perceived their roles and use of asthma app features to support adolescent asthma self-management: monitoring and supervision, education, and communication/information sharing. Parents rated the doctor report feature highest, and clinicians rated the doctor appointment reminder highest of all evaluated app features on usefulness. The peak flow monitoring feature was the lowest ranked feature by both parents and clinicians. Parents reported higher usefulness for the doctor report (t(10)=2.7, Pdesigned to help support youth asthma management

  10. Korean Asthma Guideline 2014: Summary of Major Updates to the Korean Asthma Guideline 2014.

    Science.gov (United States)

    Kim, Deog Kyeom; Park, Yong Bum; Oh, Yeon-Mok; Jung, Ki-Suck; Yoo, Ji Hong; Yoo, Kwang-Ha; Kim, Kwan Hyung

    2016-07-01

    Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.

  11. "Kickin' Asthma": School-Based Asthma Education in an Urban Community

    Science.gov (United States)

    Magzamen, Sheryl; Patel, Bina; Davis, Adam; Edelstein, Joan; Tager, Ira B.

    2008-01-01

    Background: In urban communities with high prevalence of childhood asthma, school-based educational programs may be the most appropriate approach to deliver interventions to improve asthma morbidity and asthma-related outcomes. The purpose of this study was to evaluate the implementation of "Kickin' Asthma", a school-based asthma…

  12. The role of polymorphisms in ADAM33, a disintegrin and metalloprotease 33, in childhood asthma and lung function in two German populations

    Directory of Open Access Journals (Sweden)

    Klopp Norman

    2006-06-01

    Full Text Available Abstract Background ADAM33, the first asthma candidate gene identified by positional cloning, may be associated with childhood asthma, lung function decline and bronchial hyperresponsiveness. However, replication results have been inconclusive in smaller previous study populations probably due to inconsistencies in asthma phenotypes or yet unknown environmental influences. Thus, we tried to further elucidate the role of ADAM33 polymorphisms (SNPs in a genetic analysis of German case control and longitudinal populations. Methods Using MALDI-TOF, ten ADAM33 SNPs were genotyped in 1,872 children from the International Study of Asthma and Allergy in Childhood (ISAAC II in a case control setting and further 824 children from the longitudinal cohort Multicentre Study of Allergy (MAS. In both populations the effects of single SNPs and haplotypes were studied and a gene environment analysis with passive smoke exposure was performed using SAS/Genetics. Results No single SNP showed a significant association with doctor's diagnosis of asthma. A trend for somewhat more profound effects of ADAM33 SNPs was observed in individuals with asthma and BHR. Haplotype analyses suggested a minor effect of the ADAM33 haplotype H4 on asthma (p = 0.033 but not on BHR. Associations with non atopic asthma and baseline lung function were identified but no interaction with passive smoke exposure could be detected. Conclusion The originally reported association between ADAM33 polymorphisms and asthma and BHR could not be confirmed. However, our data may suggest a complex role of ADAM33 polymorphisms in asthma ethiology, especially in non atopic asthma.

  13. John McCrae (1872-1918): doctor-soldier-poet.

    Science.gov (United States)

    Carter, R

    1997-01-01

    Out of the ruins of World War I arose the poignant verse of the "Trench Poets." Lieutenant Colonel John McCrae, Canadian doctor, professor, and soldier, exemplified this verse in his haunting poem "In Flanders Fields." After establishing himself as a respected physician and university lecturer in Canada and the United States, he served in World War I as a physician and artillery commander. In 1918, after a grueling tour of duty, McCrae witnessed one of the Great War's most horrific technological creations: chemical warfare. He suffered from asthma and probable chronic obstructive pulmonary disease all his life, dying at age 45 of cerebral meningitis.

  14. Remote monitoring of inhaled bronchodilator use and weekly feedback about asthma management: an open-group, short-term pilot study of the impact on asthma control.

    Directory of Open Access Journals (Sweden)

    David Van Sickle

    Full Text Available OBJECTIVE: Adequate symptom control is a problem for many people with asthma. We asked whether weekly email reports on monitored use of inhaled, short-acting bronchodilators might improve scores on composite asthma-control measures. METHODS: Through an investigational electronic medication sensor attached to each participant's inhaler, we monitored 4 months' use of inhaled, short-acting bronchodilators. Participants completed surveys, including the Asthma Control Test(TM (ACT, to assess asthma control at entry and monthly thereafter. After the first month, participants received weekly email reports for 3 months. The reports summarized inhaled bronchodilator use during the preceding week and provided suggestions derived from National Asthma Education and Prevention Program (NAEPP guidelines. Paired t-tests and random-effects mixed models were implemented to assess changes in primary asthma endpoints. RESULTS: Thirty individuals participated in the 4-month study; 29 provided complete asthma control information. Mean age was 36.8 years (range: 19-74 years; 52% of respondents were female. Mean ACT scores were 17.6 (Standard Deviation [SD]  = 3.35 at entry and 18.4 (SD = 3.60 at completion of the first month. No significant difference appeared between ACT values at entry and completion of the first month (p = 0.66; however, after participants began receiving email reports and online information about their inhaler use, mean ACT scores increased 1.40 points (95% CI: 0.61, 2.18 for each subsequent study month. Significant decreases occurred in 2-week histories of daytime symptoms (β = -1.35, 95% CI: -2.65, -0.04 and nighttime symptoms (β = -0.84, 95% CI: -1.25, -0.44; no significant change in activity limitation (β = -0.21, 95% CI: -0.69, 0.26 was observed. Participants reported increased awareness and understanding of asthma patterns, level of control, bronchodilator use (timing, location and triggers, and improved

  15. Sleep Problems in Asthma and COPD

    Science.gov (United States)

    ... Mini Series #5 Sleep Problems in Asthma and COPD NORMAL AIRWAY Good quality sleep is important for ... with asthma and/or Chronic Obstructive Pulmonary Disease (COPD) may have sleep issues that can lead to ...

  16. Obesity-related asthma in adults.

    Science.gov (United States)

    Bhatt, Nikunj A; Lazarus, Angeline

    2016-08-01

    Obesity as a risk factor for asthma has been identified in previous studies. Additionally, a disproportionate number of patients with severe or difficult-to-control asthma are obese. Patients with obesity-related asthma tend to have worse asthma control and quality of life disproportionate to their pulmonary function tests, are less responsive to corticosteroid therapy, and are more likely to have obesity-related comorbidities such as obstructive sleep apnea and gastroesophageal disease that complicate asthma treatment. With the increasing prevalence of obesity, the prevalence of asthma is anticipated to grow proportionally. Addressing weight loss and encouraging activity is essential in the management of obesity-related asthma. This article briefly overviews the epidemiology, unique distinguishing features, potential mechanisms, and approach to management of patients with obesity-related asthma in adults.

  17. Asthma Medication Ratio Predicts Emergency Depart...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in Asthma Medication Ratio Predicts Emergency Department Visits and Hospitalizations in Children with Asthma, published in Volume 3,...

  18. American College of Allergy, Asthma & Immunology

    Science.gov (United States)

    ... Care Professionals Find an Allergist American College of Allergy, Asthma, and Immunology Seeking Relief? Find an Allergist ... shots? View All Postings Ask the Allergist Index Allergy & Asthma News Are tree nut allergies diagnosed too ...

  19. Physician Asthma Management Practices in Canada

    Directory of Open Access Journals (Sweden)

    Robert Jin

    2000-01-01

    Full Text Available OBJECTIVES: To establish national baseline information on asthma management practices of physicians, to compare the reported practices with the Canadian Consensus recommendations and to identify results potentially useful for interventions that improve physician asthma management practices.

  20. Asthma Research: The NIH–NJRC Connection

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Special Section Asthma Research: The NIH–NJRC Connection Past Issues / Fall ... the many ways that NIH supports and promotes asthma research is through its strong relationship with National ...

  1. Diagnosing Asthma in Very Young Children

    Science.gov (United States)

    ... Listen Español Text Size Email Print Share Diagnosing Asthma in Babies & Toddlers Page Content Article Body One ... family with recurrent bronchitis or sinus problems. When Asthma is Not the Cause Your pediatrician will listen ...

  2. Childhood Asthma: A Chance to HEAL

    Science.gov (United States)

    ... Home Current Issue Past Issues Special Section Childhood Asthma: A Chance to HEAL Past Issues / Fall 2007 ... a peak flow meter. Photo courtesy of MCAN Asthma, a reality of daily life for more than ...

  3. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Territory Data AsthmaStats Asthma and Fair or Poor Health Usual Place for Medical Care among Children Number of Visits to a Health Care Provider(s) among Children Health Care Coverage among ...

  4. Asthma: New Information for the Early Interventionist.

    Science.gov (United States)

    Simeonsson, Nancy; And Others

    1995-01-01

    This article highlights key portions of the National Institutes of Health's National Asthma Education Program. Guidelines for understanding asthma triggers and medications are provided, and approaches to controlling environmental factors are suggested. (Author/PB)

  5. Childhood Asthma May Encourage Obesity, Study Suggests

    Science.gov (United States)

    ... Human Services. More Health News on: Asthma in Children Obesity in Children Recent Health News Related MedlinePlus Health Topics Asthma in Children Obesity in Children About MedlinePlus Site Map FAQs Customer ...

  6. Doctorate time rising sharply: How long should it take?

    Science.gov (United States)

    Glen, William

    The period 1967-1987 saw a 20% increase in the time it takes to complete the doctorate. That figure is based on data provided by the National Research Council from 11 scientific and engineering fields, including the Earth, atmospheric and marine sciences.The median time spent earning the degree rose from 5.4 years in 1967 to 6.1 years in 1977 to 6.9 years in 1987—an increase of 1.5 years in a single generation. Completion time still seems to be rising! All graduating doctoral students in 1987 had a median age of 33.6 years; chemistry students were youngest at 29, and education students were the oldsters at 39.8 years.

  7. Suicidal ideation and suicide attempts among asthma

    OpenAIRE

    2016-01-01

    Background The present study aimed to investigate the mental health status in patients with asthma and assess the effects of asthma on suicidal ideation and attempts using a representative sample from Korea. Methods Individual-level data were obtained from 228,744 participants (6372 with asthma and 222,372 without asthma) of the 2013 Korean Community Health Survey. Demographic characteristics, socioeconomic status, physical health status, and mental health status were compared between patient...

  8. Asthma care for children and adolescents

    OpenAIRE

    2015-01-01

    Background: Asthma is one of the most common chronic diseases among young children and adolescents. With high quality health care, most children and adolescents with asthma can live an active and normal life. Yet, many children and adolescents have uncontrolled asthma, with symptoms and exacerbations which may affect their daily life. Adolescence is a sensitive period and asthma may be difficult to treat due to poor adherence to treatment. Little is known about health care professionals’ adhe...

  9. Svær asthma bronchiale

    DEFF Research Database (Denmark)

    von Bülow, Anna; Backer, Vibeke; Porsbjerg, Celeste

    2015-01-01

    Severe asthma is defined by persistent symptoms and frequent exacerbations despite intensive asthma therapy. The prevalence is estimated to be 5-10% of all asthmatics. Severe asthma is responsible for a major burden of illness including low quality of life and a disproportionate use of health......-care resources. The clinical assessment of severe asthma must include verification of the correct diagnosis, adherence to medication, excluding differential diagnosis and identification and treatment of aggravating co-morbidities and trigger factors....

  10. Progress in the management of childhood asthma

    OpenAIRE

    Vichyanond, Pakit; Pensrichon, Rattana; Kurasirikul, Suruthai

    2012-01-01

    Asthma has become the most common chronic disease in childhood. Significant advances in epidemiological research as well as in therapy of pediatric asthma have been made over the past 2 decades. In this review, we look at certain aspects therapy of childhood asthma, both in the past and present. Literature review on allergen avoidance (including mites, cockroach and cat), intensive therapy with β2-agonists in acute asthma (administering via continuous nebulization and intravenous routes), a r...

  11. [Severe asthma--where are we today?].

    Science.gov (United States)

    von Bülow, Anna; Backer, Vibeke; Porsbjerg, Celeste

    2014-01-13

    Severe asthma is defined by persistent symptoms and frequent exacerbations despite intensive asthma therapy. The prevalence is estimated to be 5-10% of all asthmatics. Severe asthma is responsible for a major burden of illness including low quality of life and a disproportionate use of health-care resources. The clinical assessment of severe asthma must include verification of the correct diagnosis, adherence to medication, excluding differential diagnosis and identification and treatment of aggravating co-morbidities and trigger factors.

  12. Broadening the search for minority science and engineering doctoral starts

    Science.gov (United States)

    Brazziel, William E.; Brazziel, Marian E.

    1995-06-01

    This analysis looked at doctorate completion in science and engineering (S&E) by underrepresented minorities: blacks, Hispanics and Indian Americans. These are the groups we must increasingly depend upon to make up for shortfalls in science and engineering doctorate production among American citizens. These shortfalls derive from truncated birth rates among white people, for the most part. The analysis answered several questions officials will need to know the answers to if we are to plan effectively to develop the talents of these individuals. Specifically, the National Science Foundation asked us to look at the feasibility of involving nontraditional minority science and engineering graduates (baccalaureates at 25+) as doctoral starts, along with minority S&E graduates who had taken jobs with corporations to pay off student loans and military personnel involved in S&E study and S&E work (see NSF report of research under grant SED-9107756). We found that nontraditional minority S&E doctorate recipients matched their traditional counterparts in elapsed time to degree and similar indicators. They had less in the way of support for doctoral study, however. We found that minority S&E graduates who took jobs in corporations were keenly interested in returning to campus to complete degrees. We also found that many bright minority youngsters are studying S&E subjects in the Community College of the Air Force and in U.S. Army SOC colleges. Some have enrolled in baccalaureate programs on university campuses and plan to continue on to the PhD. We concluded that money is important in tapping these talent pools to make up for the demographically driven shortfalls discussed above.

  13. Not asthma,but GERD:case report

    Institute of Scientific and Technical Information of China (English)

    WANG Zhonggao

    2007-01-01

    Asthma is a disorder of the lungs characterized by increased responsiveness of the airways,as manifested by episodes of wheezing and increased resistance to expiratory airflow because of varying degrees of smooth muscle contraction,edema of the mucosa,and mucus in the lumen of the bronchi and bronchioles.The stimuli vary widely and include antigens,infection,air pollutants,respiratory tract irritants,exercise,and emotional factors.This condition is completely different from distress breathing because of laryngotracheal spasm.One of its causes is the gastric content reflux through the pharynx to the larynx because of gastroesophageal reflux disease (GERD),in addition to the typical human avian flu that may cause immediate suffocation by laryngospasm owing to acute larygotrachitis.A patient suffered from GERD without esophageal symptoms,which was diagnosed and treated as bronchial asthma during his five emergency admissious.The admissions were because of episodic attacks of severe air hunger owing to an extreme throat tightening.The patient was being treated for as long as two years.After the correct diagnosis was made and treatment of laporascopic fundaplication was performed,the longstanding "bronchial asthma",after all,completely disappeared.The concept of "not asthma,but GERD" seems undervalued,unappreciated,even misunderstood among patients with intractable asthma.Therefore,such a case is reported in detail,similar cases are mentioned briefly as well,and a mechanism responsible for GERD-originated larryngo- or laryngotracho-spasm is proposed.

  14. An Online Simulation in Pediatric Asthma Management

    Science.gov (United States)

    Hopper, Keith B.

    2004-01-01

    The Centers for Disease Control (CDC) estimates that nearly 20 million Americans suffer from asthma, 6.3 million of which are children (Centers for Disease Control and Prevention, 2004). It is not merely an annoyance disease, as is commonly believed. Asthma kills. It takes more than 5,000 American lives each year (Asthma Statistics in America,…

  15. Treating Asthma in Children under 5

    Science.gov (United States)

    ... inflammation makes the airways vulnerable to episodes of difficult breathing (asthma attacks). Common triggers include allergies, colds and exercise. ... asthma in children under age 5 can be difficult. In infants and young children, the ... symptoms of asthma — wheezing and coughing — may be caused by other ...

  16. How Can I Deal with My Asthma?

    Science.gov (United States)

    ... Breakfasts Shyness How Can I Deal With My Asthma? KidsHealth > For Teens > How Can I Deal With My Asthma? A A A What's in this article? Taking ... Tips en español ¿Cómo puedo afrontar mi asma? Asthma is more common these days than it used ...

  17. Managing Asthma in the Early Childhood Setting

    Science.gov (United States)

    Graville, Iris

    2011-01-01

    Asthma, one of the most common chronic disorders in childhood, affects more than seven million children in the United States, and is the third leading cause of hospitalization for children. Statistics like these make planning and preparing for asthma in the early childhood setting a high priority. With the high rates of asthma in the U.S. today,…

  18. Taking ACTion for better control of asthma

    Institute of Scientific and Technical Information of China (English)

    SUN Yong-chang

    2007-01-01

    @@ The global prevalence of asthma ranges from 1% to 18% of the population in different countries.1 In China, while national data of asthma prevalence are still lacking, an epidemiological study in Beijing showed that the prevalence of asthma in occupational populations was 1.25%.2

  19. Jackie Joyner-Kersee: Living with Asthma

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Asthma Jackie Joyner-Kersee: Living with Asthma Past Issues / Fall 2011 Table of Contents Jackie ... the heptathlon and long-jump competitions, despite severe asthma. While she was a top student-athlete at ...

  20. Asthma: Not Just a Childhood Condition.

    Science.gov (United States)

    Strauss, Kandra

    2002-01-01

    Asthma has grown to epidemic proportions among school-age children, and nearly 10 million U.S. adults suffer from it. This paper describes asthma and its triggers and explains how to take measures to manage asthma symptoms within the school (e.g., dusting regularly and keeping medications available). A sidebar presents tips on controlling asthma…

  1. Children with Asthma: Strategies for Educators.

    Science.gov (United States)

    Neuharth-Pritchett, Stacey; Getch, Yvette Q.

    1999-01-01

    Guidelines for managing the child with asthma in educational settings address effects of asthma on academic performance, psychosocial effects, the need for collaboration with parents and medical personnel, common triggers of asthmatic episodes, symptoms, communication with parents, and resources. A sample asthma care plan is attached. (DB)

  2. Understanding Children with Asthma: Trouble and Triggers

    Science.gov (United States)

    Lim, JungHa; Wood, Beatrice L.; Cheah, PoAnn

    2009-01-01

    Asthma is one of the most common illnesses of childhood; in the United States, nearly 9% of children have the condition (Federal Interagency Forum on Child and Family Statistics, 2006). Among children with chronic illnesses, asthma is the most common cause for school absence and hospitalization (Akinbami, 2006). Asthma is a chronic disorder of the…

  3. Adult Asthma Consensus Guidelines Update 2003

    Directory of Open Access Journals (Sweden)

    Catherine Lemière

    2004-01-01

    Full Text Available BACKGROUND: Several sets of Canadian guidelines for the diagnosis and management of asthma have been published over the past 15 years. Since the last revision of the 1999 Canadian Asthma Consensus Report, important new studies have highlighted the need to incorporate new information into the asthma guidelines.

  4. Childhood diet and asthma and atopy at 8 years of age: the PIAMA birth cohort study.

    Science.gov (United States)

    Willers, S M; Wijga, A H; Brunekreef, B; Scholtens, S; Postma, D S; Kerkhof, M; de Jongste, J C; Smit, H A

    2011-05-01

    Diet may affect the development of asthma. We investigated whether asthma or atopy outcomes at 8 yrs of age were associated with long-term dietary exposure, and whether associations were different for consumption at early or later age. The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort enrolled 4,146 participants at baseline, who were followed up to 8 yrs of age. Dietary intakes of interest were fruit, vegetables, brown/wholemeal bread, fish, milk, butter and margarine. Associations between food intake at early (2-3 yrs) and later (7-8 yrs) age, and long-term intake, asthma and atopy at 8 yrs of age were calculated by logistic regression. Complete longitudinal dietary data for at least one of the food groups were available for 2,870 children. Fruit consumption at early age was associated with reduced asthma symptoms (OR per 1 consumption day per week increase 0.93, 95% CI 0.85-1.00). Long-term fruit intake was inversely associated with asthma symptoms (OR 0.90, 95% CI 0.82-0.99) and sensitisation to inhaled allergens (OR 0.90, 95% CI 0.82-0.99). We found no consistent associations between diet and outcomes for other foods. This study indicates no consistent effects of increased early or late consumption, or long-term intake of certain foods on asthma and atopy in 8-yr-olds, with a possible exception for fruit.

  5. Effect of supplemental folic acid in pregnancy on childhood asthma: a prospective birth cohort study.

    Science.gov (United States)

    Whitrow, Melissa J; Moore, Vivienne M; Rumbold, Alice R; Davies, Michael J

    2009-12-15

    This study aimed to investigate the effect of the timing, dose, and source of folate during pregnancy on childhood asthma by using data from an Australian prospective birth cohort study (n = 557) from 1998 to 2005. At 3.5 years and 5.5 years, 490 and 423 mothers and children participated in the study, respectively. Maternal folate intake from diet and supplements was assessed by food frequency questionnaire in early (late (30-34 weeks) pregnancy. The primary outcome was physician-diagnosed asthma, obtained by maternal-completed questionnaire. Asthma was reported in 11.6% of children at 3.5 years (n = 57) and in 11.8% of children at 5.5 years (n = 50). Folic acid taken in supplement form in late pregnancy was associated with an increased risk of childhood asthma at 3.5 years (relative risk (RR) = 1.26, 95% confidence interval (CI): 1.08, 1.43) and with persistent asthma (RR = 1.32, 95% CI: 1.03, 1.69). The effect sizes did not change with adjustment for potential confounders. The association was similar at 5.5 years but did not reach statistical significance (RR = 1.17, 95% CI: 0.96, 1.42) in univariable models. These findings on childhood asthma support previous observations that supplementation with folate in pregnancy leads to an allergic asthma phenotype in mice via epigenetic mechanisms and is associated with poorer respiratory outcomes in young children.

  6. Effects of Symptom Perception Interventions on Trigger Identification and Quality of Life in Children with Asthma

    Directory of Open Access Journals (Sweden)

    Thomas Janssens

    2015-01-01

    Full Text Available Background. Management of individual triggers is suboptimal in practice. In this project, we investigated the impact of symptom perception interventions on asthma trigger identification and self-reported asthma quality of life. Methods. Children with asthma (n=227 participated in three asthma education sessions and then were randomized first to one of three home monitoring conditions (symptom monitoring and peak flow training with feedback, peak flow training without feedback, or no peak flow training and then subsequently to one of three resistive load discrimination training conditions (signal detection training with feedback, signal detection training without feedback, or no training. Triggers were reported at enrollment, following home monitoring, and following discrimination training; quality of life was measured after home monitoring and after resistive load testing. Results. Symptom perception interventions resulted in increases in reported triggers, which increased reliably as a function of home monitoring, and increased further in participants who completed discrimination training with feedback. Increases in the number of reported asthma triggers were associated with decreases in quality of life. Discussion. Patients may benefit from strategies that make trigger-symptom contingencies clear. Complementary strategies are needed to address changes in the perceived burden of asthma which comes from awareness of new asthma triggers.

  7. Physical deconditioning as a cause of breathlessness among obese adolescents with a diagnosis of asthma.

    Directory of Open Access Journals (Sweden)

    Yun M Shim

    Full Text Available BACKGROUND: Obese children frequently complain of breathlessness. Asthma and obesity can both contribute to the symptoms during exercise, and this symptom can contribute to a diagnosis of asthma in these children. Despite the high prevalence of obesity few studies have investigated the cardiopulmonary physiology of breathlessness in obese children with a diagnosis of asthma. METHODS: In this case-control study, thirty adolescents between age 12 and 19 were studied with baseline spirometry and a cardiopulmonary exercise test. Ten adolescents were normal controls, ten had obesity without a diagnosis of asthma, and ten had obesity with a history of physician-diagnosed asthma. RESULTS: Baseline characteristics including complete blood count and spirometry were comparable between obese adolescents with and without a diagnosis of asthma. During exercise, obese asthmatic and obese non-asthmatic adolescents had significantly reduced physical fitness compared to healthy controls as evidenced by decreased peak oxygen uptake after adjusting for actual body weight (21.7 ± 4.5 vs. 21.4 ± 5.4 vs. 35.3 ± 5.8 ml/kg/min, respectively. However, pulmonary capacity at the peak of exercise was comparable among all three groups as evidenced by similar pulmonary reserve. CONCLUSION: In this study, breathlessness was primarily due to cardiopulmonary deconditioning in the majority of obese adolescents with or without a diagnosis of asthma.

  8. The impact of asthma control on salivary cortisol level in adult asthmatics.

    Science.gov (United States)

    Shin, Yoo Seob; Liu, Jing Nan; Kim, Joo-Hee; Nam, Young-Hee; Choi, Gil Soon; Park, Hae-Sim

    2014-09-01

    Asthma is a chronic disease causing psychological stress which leads to the activation of hypothalamus-pituitary-adrenal axis. The purpose of this study is to compare morning salivary cortisol levels in persistent asthma patients according to their disease severities and control status. Total 206 adult asthma patients were recruited from four university hospitals. Spirometry, questionnaire of Asthma Quality of Life (AQOL) and Asthma Control Test (ACT) were completed, and saliva samples were collected prospectively to measure morning cortisol level. The mean patient age was 56.5±15.3 years with mean asthma duration of 9.1±11.1 years. Sixty five patents (31.6%) were classified as mild persistent asthma, and 141 patients (68.4%) were classified as moderate persistent asthma according to the Expert Panel Report 3. The mean predicted FEV1 was 88.8%±18.4%, and the methacholine PC20 was 9.6±8.5 mg/mL in all study population. The mean ACT score for all patients was 19.9±3.6, and there were 71 (34.5%) patients in poorly controlled and 135 (65.5%) in well controlled asthma. The poorly controlled asthma patients were characterized by significantly lower FEV1 (84.6%±17.6% vs 91.1%±18.5%, P=0.018), lower AQOL scores (46.0±13.9 vs 73.8±26.3, Pcortisol levels (0.14±0.08 vs 0.18±0.11 µg/dL, P=0.04) compared to well controlled asthma. The ACT score was significantly related to salivary cortisol levels (P=0.034) after adjusting for age. There was no significant difference in salivary cortisol levels (0.17±0.12 vs 0.16±0.08, P=0.725) when analyzed according to the dose of used corticosteroid and lung function. Asthma control status affects morning salivary cortisol level. Measuring the morning salivary cortisol level might be a simple and new way to assess asthma control status.

  9. Role of psychiatric disorders and irritable bowel syndrome in asthma patients

    Directory of Open Access Journals (Sweden)

    Ayse Yilmaz

    2011-01-01

    Full Text Available OBJECTIVES: The goals of the study were the following: 1 to determine the frequency of psychiatric disorders and irritable bowel syndrome in patients with asthma and 2 to compare the frequency of these disorders in patients with asthma to their frequency in healthy controls. INTRODUCTION: Patients with asthma have a higher frequency of irritable bowel syndrome and psychiatric disorders. METHODS: We evaluated 101 patients with bronchial asthma and 67 healthy subjects. All subjects completed the brief version of the Bowel Symptoms Questionnaire and a structured clinical interview for DSM-IV axis disorders (SCID-I/CV. RESULTS: There were 37 cases of irritable bowel syndrome in the group of 101 stable asthma patients (36.6% and 12 cases in the group of 67 healthy subjects (17.9% (p = 0.009. Irritable bowel syndrome comorbidity was not related to the severity of asthma (p = 0.15. Regardless of the presence of irritable bowel syndrome, psychiatric disorders in asthma patients (52/97; 53.6% were more common than in the control group (22/63, 34.9% (p = 0.02. Although psychiatric disorders were more common in asthma patients with irritable bowel syndrome (21/35, 60% than in those without irritable bowel syndrome (31/62, 50%, the difference was not significant (p = 0.34. In asthma patients with irritable bowel syndrome and psychiatric disorders, the percentage of forced expiratory volume in 1 s (FEV1 was lower than it was in those with no comorbidities (p = 0.02. CONCLUSIONS: Both irritable bowel syndrome and psychiatric disorders were more common in asthma patients than in healthy controls. Psychiatric disorders were more common in asthma patients with irritable bowel syndrome than in those without irritable bowel syndrome, although the differences failed to reach statistical significance. In asthma patients with IBS and psychiatric disorders, FEV1s were significantly lower than in other asthma patients. It is important for clinicians to accurately

  10. Anemia as a risk factor for childhood asthma

    Directory of Open Access Journals (Sweden)

    Ramakrishnan K

    2010-01-01

    Full Text Available Objective: This prospective-(cohort study was conducted to evaluate whether anemia is a risk factor for childhood asthma. Materials and Methods: Two hundred children in the age group of 2-18 years who attended the Outpatient Department with upper respiratory / lower respiratory tract infections were included in this study. One hundred children with anemia were taken as the study group and another 100, age - and sex-matched children without anemia were taken as the control.They were subjected to complete blood count (CBC C-reactive protein (CRP estimation, Mantoux test and chest X-ray. Pulmonary function tests (PFTs were performed on those above six years showing evidence of asthma. Peripheral smear, serum ferritin and serum iron-binding capacity were estimated for all anemic children. Results: Asthma was present in 74 (74% children in the study group and in 33 (33% children in the control group. Iron-deficiency anemia was present in 85 (85% anemia of chronic infection in 20 (20% and the other five (5% had hemolytic anemia. Anemia was found to be a risk factor for childhood asthma. Conclusion: Anemic children were 5.75 times more susceptible to asthmatic attacks when compared with nonanemic children.

  11. Air toxics and asthma: Impacts and end points

    Energy Technology Data Exchange (ETDEWEB)

    Eschenbacher, W.L.; Holian, A.; Campion, R.J. [Mickey Leland National urban Air Toxics Research Center, Houston, TX (United States)

    1995-09-01

    The National Urban Air Toxics Research Center (NUATRC) hosted a medical/scientific workshop (February 1994) focused on possible asthma/air toxics relationships, with the results of the NUATRC`s first research contract with the University of Cincinnati as the point of discussion. The workshop explored the impact of various environmental factors, including air toxics, on asthma incidence and exacerbation; and emphasis was placed on future research directions. The information presented at the workshop suggested a possible association of asthma exacerbations with ozone and particulate matter (PM{sub 10}); however, direct relationships between worsening asthma and air toxic ambient levels were not established. Possible respiratory health effects associated with air toxics will require considerably more investigation, especially in the area of human exposure assessment. Two major recommendations for future research resulted form this workshop and an accompanying NUATRC Scientific Advisory Panel meeting: a need for more complete individual personal exposure assessments so that accurate determinations of actual personal exposures to various pollutants can be made; and a need for field experiments utilizing biomarkers of exposure and effect to more accurately assess the extent and variability of the biological effects, if any, of individual air toxics. 8 refs.

  12. [Education of patients with asthma, chronic bronchitis and pulmonary emphysema].

    Science.gov (United States)

    Krstić-Burić, M; Pavicić, F; Rozman, A; Bogić, B; Crc, M; Plesko, N; Sarajlić, N

    1997-02-01

    Patients' education belongs to the most efficient therapeutic measures in the management of asthma, chronic bronchitis and pulmonary emphysema. The following paper reports the experience in the educational programme at the Polyclinic for Respiratory Diseases in Zagreb. Each patient's education lasted 5 days, 3 lessons per day, in groups of 10-15 persons. The education was carried out by a teaching team consisting of pulmonologists, psychosomatologist, pharmacist, physiotherapist and biometeterologist. From March 1995 to February 1996 135 persons completed the educational programme, 65 of whom were asthma patients. Data on cough and dyspnoea, skills in inhaler and breathing technique were collected at the beginning and 3 months after the education in all asthma patients. Three months after the education the asthma patients showed a significant decrease in dyspnoea and a significant improvement in inhaler and breathing technique. A standard questionnaire was given to all patients at the end of the education and in more than 80% the education was well accepted by the patients. Initial results are encouraging and the programme should be expanded to all parts of Croatia.

  13. Allergy and asthma prevention 2014

    DEFF Research Database (Denmark)

    Nieto, Antonio; Wahn, Ulrich; Bufe, Albrecht

    2014-01-01

    Asthma and allergic diseases have become one of the epidemics of the 21st century in developed countries. Much of the success of other areas of medicine, such as infectious diseases, lies on preventive measures. Thus, much effort is also being placed lately in the prevention of asthma and allergy....... This manuscript reviews the current evidence, divided into four areas of activity. Interventions modifying environmental exposure to allergens have provided inconsistent results, with multifaceted interventions being more effective in the prevention of asthma. Regarding nutrition, the use of hydrolyzed formulas...... in high-risk infants reduces the incidence of atopic dermatitis, while there is for now not enough evidence to recommend other dietary modifications, pre-biotics, probiotics, or other microbial products. Pharmacologic agents used until now for prevention have not proved useful, while there is hope...

  14. Epogam evening primrose oil treatment in atopic dermatitis and asthma.

    OpenAIRE

    Hederos, C A; Berg, A

    1996-01-01

    Essential fatty acids are claimed to have positive effects in atopic diseases. In a double blind, placebo controlled, parallel group study 58 out of 60 children, with atopic dermatitis and the need for regular treatment with topical skin steroids, completed a 16 weeks' treatment period with either Epogam evening primrose oil or placebo capsules. Twenty two of these subjects also had asthma. The parents used diaries to record symptom scores and concomitant medication. Peak expiratory flow was ...

  15. Doctoral Students in Music Education: Occupational Identity, Career Intent and Commitment, and Confidence for Teaching in Higher Education

    Science.gov (United States)

    Martin, Lisa D.

    2016-01-01

    The purpose of this study was to examine music education doctoral students' shifting occupational identity beliefs, career intent and commitment, and overall confidence for teaching in higher education. A total of 124 music education doctoral students, enrolled at 29 institutions of higher education in the United States, completed a onetime,…

  16. Attitudes towards euthanasia and physician-assisted suicide among Pakistani and Indian doctors: A survey

    Directory of Open Access Journals (Sweden)

    Syed Qamar Abbas

    2008-01-01

    Full Text Available Aim: This study attempts to assess the attitude of Pakistani and Indian doctors to euthanasia and physician-assisted suicide. Methods: We used a questionnaire survey that included one case history of a patient with cancer and another of one suffering from motor neurone disease (MND. Results: Fifty-two of 100 doctors from Pakistan returned the completed questionnaires. Eight of the 52 (15.3% doctors agreed with the concept of euthanasia being an acceptable option for the patient with MND. Six of the 52 (11.5% supported a similar approach for the cancer patient. From India, 60/100 doctors returned the completed questionnaires. Sixteen of the 60 (26.6% doctors supported euthanasia as an option for the patient with MND whereas 15 (25% supported a similar option for the cancer patient. Conclusion: We conclude that only a minority of the doctors support euthanasia. This group belongs to a younger age group. In Pakistan, they were more likely to be males. The religion of the doctors did not appear to be a determining factor.

  17. DOCTOR JAIME ANTONIO BARRIOS AMAYA

    OpenAIRE

    Revista Ciencias Biomedicas

    2014-01-01

    El doctor Jaime Antonio Barrios Amaya, nació en Cartagena de Indias, Colombia, el 4 de noviembre de 1935. Realizó estudios de primaria en el colegio Fernández Baena y de secundaria en el Liceo de Bolívar, donde se graduó de Bachiller superior en 1956. Inmediatamente ingresó a la Universidad de Cartagena, adelantando estudios médicos y egresó en 1963 con el título de Médico Cirujano. Poco tiempo después regresó a la Universidad de Cartagena e ...

  18. What Makes a Good Doctor?

    Institute of Scientific and Technical Information of China (English)

    C. Richard Coati

    2011-01-01

    @@ Introduction In the United States and I suspect in all parts of the world, a good doctor is an individual who, in addition to training in their area of interest, i.e., family practice, internal medicine, or a subspecialty area, has participated actively in the educational programs relating to their training which make them eligible to take examinations in those areas (if they are available) and pass them.All physicians generally like to have some procedural skills,but the most important part of their skills relate to their cognitive knowledge which in the long term insures optimal patient care.

  19. Publishing Time-Frame Evaluation for Doctoral Students in United Kingdom

    Directory of Open Access Journals (Sweden)

    Andrada Elena URDA-CÎMPEAN

    2014-09-01

    Full Text Available The first objective of the study was to compute the time to completion and publication of original scientific publications for medical doctoral students in the UK. A second objective was to evaluate if PhD theses format (monograph or publication-based can influence the time to completion and publication of original scientific publications. We assessed a small sample of free full text medical doctoral theses from universities in the United Kingdom (mostly from the University of Manchester, which have produced at least 2 original scientific publications by the end of the doctoral studies. The time elapsed between 2 consecutive publications from the same thesis was considered an approximation of the time to completion and publication of the second publication. In the case of prospective theses, the median time to completion and publication of original scientific publications from medical doctoral theses was 10.17 months. We found that there was a statistically significant difference between the time (to completion and publication medians of the publications from traditional theses format and of the publications from publication-based theses format. Time to completion and publication of original scientific publications for medical doctoral students needs to be further evaluated on a larger scale, based on more theses from several medical faculties in the UK.

  20. Complete prewetting

    Science.gov (United States)

    Yatsyshin, P.; Parry, A. O.; Kalliadasis, S.

    2016-07-01

    We study continuous interfacial transitions, analagous to two-dimensional complete wetting, associated with the first-order prewetting line, which can occur on steps, patterned walls, grooves and wedges, and which are sensitive to both the range of the intermolecular forces and interfacial fluctuation effects. These transitions compete with wetting, filling and condensation producing very rich phase diagrams even for relatively simple prototypical geometries. Using microscopic classical density functional theory to model systems with realistic Lennard-Jones fluid-fluid and fluid-substrate intermolecular potentials, we compute mean-field fluid density profiles, adsorption isotherms and phase diagrams for a variety of confining geometries.

  1. Sodium cromoglycate in nocturnal asthma.

    Science.gov (United States)

    Morgan, A D; Connaughton, J J; Catterall, J R; Shapiro, C M; Douglas, N J; Flenley, D C

    1986-01-01

    To investigate whether mast cell degranulation was important in producing nocturnal asthma, the effect of a single high dose of nebulised sodium cromoglycate on overnight bronchoconstriction, oxygen saturation, and breathing patterns in eight patients with nocturnal wheeze was examined. The study took the form of a double blind placebo controlled crossover comparison. Treatment with cromoglycate did not reduce the overnight fall in FEV1 or FVC, although it was associated with improved nocturnal oxygenation. This study suggests that mast cell degranulation may not be important in the pathogenesis of nocturnal asthma. PMID:3085257

  2. An exploration of clinical interventions provided by pharmacists within a complex asthma service

    Directory of Open Access Journals (Sweden)

    LeMay KS

    2015-03-01

    Full Text Available Background: Pharmacists in Australia are accessible health care professionals, and their provision of clinical pharmacy interventions in a range of areas has been proven to improve patient outcomes. Individual clinical pharmacy interventions in the area of asthma management have been very successful. An understanding of the nature of these interventions will inform future pharmacy services. What we do not know is when pharmacists provide a complex asthma service, what elements of that service (interventions they choose to deliver. Objective: To explore the scope and frequency of asthma-related clinical interventions provided by pharmacists to patients in an evidence-based complex asthma service. Methods: Pharmacists from 4 states/territories of Australia were trained in asthma management. People with asthma had 3 or 4 visits to the pharmacy. Guided by a structured patient file, the pharmacist assessed the patient’s asthma and management and provided interventions where and when considered appropriate, based on their clinical decision making skills. The interventions were recorded in a checklist in the patient file. They were then analysed descriptively and thematically. Results: Pharmacists provided 22,909 clinical pharmacy interventions over the service to 570 patients (398 of whom completed the service. The most frequently delivered interventions were in the themes ‘Education on asthma’, ‘Addressing trigger factors’, ‘Medications – safe and effective use’ and ‘Explore patient perspectives’. The patients had a high and ongoing need for interventions. Pharmacists selected interventions based on their assessment of perceived need then revisited and reinforced these interventions. Conclusion: Pharmacists identified a number of areas in which patients required interventions to assist with their asthma management. Many of these were perceived to require continuing reinforcement over the duration of the service. Pharmacists were

  3. Sex differences in the relationship between asthma and overweight in Dutch children: a survey study.

    Directory of Open Access Journals (Sweden)

    Maartje Willeboordse

    Full Text Available OBJECTIVE: Obesity has been identified as a risk factor for asthma in children. However, in the Netherlands, the obesity prevalence is rising while the asthma prevalence in children is stabilising. The aim of this study is to clarify the association between asthma and Body Mass Index (BMI in children and whether this association is influenced by sex. STUDY DESIGN: Parents of 39,316 children (6-16 years in the south of the Netherlands were invited to complete an online questionnaire on respiratory symptoms, anthropometric variables and several potential confounding factors for asthma and obesity (including sex, birth weight and breastfeeding. Data was analysed by multivariable logistic regression models and an ordinal regression model. RESULTS: The response rate was 24% (n boys= 4,743, n girls= 4,529. The prevalence of asthma, overweight and obesity was 8%, 15% and 2% respectively. Body mass index--standard deviation Score (BMI-SDS was related to current asthma (adjusted OR: 1.29; 95%CI: 1.14-1.45, p ≤ 0.001. When stratified for sex, asthma and BMI-SDS were only related in girls (Girls: adjusted OR: 1.31; 95%CI: 1.13-1.51, p ≤ 0.001. Boys: adjusted OR: 1.01; 95%CI: 0.91-1.14, p=0.72. CONCLUSIONS: The positive association between BMI-SDS and asthma is only present in girls, not boys. Future studies into obesity and asthma should correct for sex in their analyses.

  4. Doctoral education in a successful ecological niche

    DEFF Research Database (Denmark)

    Christensen, Mette Krogh; Lund, Ole

    2014-01-01

    explore the microclimate in an ecological niche of doctoral education. Based on a theoretical definition of microclimate as the emotional atmosphere that ties group members together and affects their actions, we conducted a case study that aimed to describe the key features of the microclimate...... in a successful ecological niche of doctoral education, and the ways in which the microclimate support the doctoral students’ learning. The methods we applied in the case study were based on short-term ethnographic fieldwork. The results reveal four key features of the emotional atmosphere in the microclimate...... successful doctoral education because it: 1) fleshes out the professional attitude that is necessary for becoming a successful researcher in the department, 2) shapes and adapts the doctoral students’ desires to grasp and identify with the department’s practices, and 3) provides the doctoral students...

  5. Women who doctor shop for prescription drugs.

    Science.gov (United States)

    Worley, Julie; Thomas, Sandra P

    2014-04-01

    Doctor shopping is a term used to describe a form of diversion of prescription drugs when patients visit numerous prescribers to obtain controlled drugs for illicit use. Gender differences exist in regard to prescription drug abuse and methods of diversion. The purpose of this phenomenological study guided by the existential philosophy of Merleau-Ponty was to understand the lived experience of female doctor shoppers. Interviews were conducted with 14 women, which were recorded, transcribed, and analyzed. Included in the findings are figural aspects of the participants' experience of doctor shopping related to the existential grounds of world, time, body, and others. Four themes emerged from the data: (a) feeding the addiction, (b) networking with addicts, (c) playing the system, and (d) baiting the doctors. The findings suggest several measures that nurses can take to reduce the incidence of doctor shopping and to provide better care for female doctor shoppers.

  6. Wheezing and Asthma in Infants

    Science.gov (United States)

    ... The doctor also may ask you whether your child has breathing problems in different circumstances, such as during a cold, or when exposed to: cold air allergens , such as pets or dust smoke It's important to tell the ...

  7. Treatment of psychological factors in a child with difficult asthma: a case report.

    Science.gov (United States)

    Anbar, Ran D; Sachdeva, Shagun

    2011-07-01

    Difficult asthma is defined as the persistence of asthma symptoms, abnormal pulmonary function showing airway obstruction, and continued requirement for short-acting bronchodilator therapy, despite adequate treatment with inhaled corticosteroids. It calls for a thorough evaluation of the patient to look into alternate and complicating diagnoses. The authors report a case of a 9-year-old patient with difficult asthma who failed to respond to conventional therapy. Although it was recognized that he had a number of potential medical complicating factors including allergies, chronic sinusitis, and gastroesophageal reflux, a psychological intervention using hypnosis ultimately appeared to help alleviate his symptoms completely. Thus, psychological evaluation and intervention should be considered early in the course of management of a patient with difficult asthma, because it may help avoid time-consuming and expensive investigations of potential complicating factors, and it may yield rapid improvement in the patient's clinical condition.

  8. Antinuclear Antibodies in Asthma Patients- A Special Asthma Phenotype?

    Directory of Open Access Journals (Sweden)

    Agache Ioana

    2009-03-01

    Full Text Available Several studies reported the appearance of asthma and autoimmune conditions in the same patient, but the clinical significance of this association was not yet assessed. One hundred asthmatic patients were observed for one year evolution with death, severe exacerbations, intake of > 1000 micrograms of beclometasone or equivalent (high ICS and FEV1 decline >100 ml, in relation with ANA (ELISA, sputum and blood eosinophilia (EO, NSAID intolerance, BMI >25, chronic rhinosinusitis, smoking status and FEV1 After 1 year of observation, there were 5 deaths, 28 severe asthma exacerbations requiring hospitalisations, 24 cases requiring high inhaled corticosteroid intake, and 19 patients with fast FEV1 decline (>100 ml/year. Multiple regression analysis pointed out several different independent risk factors for severe asthma evolution: for death presence of ANA (P=0.037, NSAID intolerance (P100 ml ANA (P=0.006, sputum EO (P=0.037, BMI>25 (P=0.046 and NSAID intolerance (P=0.017The presence of ANA is an independent risk factor in asthma for evolution with death, severe exacerbations, high inhaled corticosteroid intake and FEV1 decline >100 ml.

  9. Correlation study on the daily exercise and asthma control in adult patients with asthma%成年哮喘患者日常运动和哮喘控制的相关性研究

    Institute of Scientific and Technical Information of China (English)

    朱巧巧

    2016-01-01

    目的:研究成年哮喘患者日常活动和哮喘控制的关联。方法:收治哮喘患者214例,患者完成哮喘控制问卷(ACG)、哮喘生活质量问卷(AQLQ)和空闲时间体力活动(LTPA)。结果:LTPA与哮喘控制存在关联(β=0.013),适度LTPA的哮喘患者哮喘控制明显优于非活动患者。与夏季LTPA(β=0.019)相比,冬季LTPA(β=0.027)与ACQ评分联系更密切。LTPA和哮喘控制无相关性。结论:较高强度LTPA与成年哮喘患者更好的哮喘控制相关。%Objective:To study the correlation of daily exercise and asthma control in adult patients with asthma.Methods:214 patients with asthma were selected.The patients completed the asthma control questionnaire(ACG) and the asthma quality of life questionnaire(AQLQ) and leisure time physical activity(LTPA).Results:LTPA and asthma control had correlation(β=0.013).The asthma control of asthma patients with moderate LTPA was significantly better than that of non active patients.Compared with the summer LTPA( β =0.019),the relation between winter LTPA( β =0.027) and the ACQ score was more close.There was no correlation between LTPA and asthma control.Conclusion:Higher intensity of LTPA is associated with better asthma control in adult patients with asthma.

  10. URGENT NEED OF A DOCTOR

    CERN Multimedia

    2002-01-01

    GENEVA PATIENT NOT FIT TO BE MOVED: Call your family doctor  Or SOS MEDECINS (24H/24H) Or ASSOC. MEDECINS DE GENEVE (7H-23H) 022 748-49-50 022 322-20-20 PATIENT CAN BE MOVED: HOPITAL CANTONAL 24 Micheli du Crest  022 372-33-11 / 022 382-33-11 URGENCES PEDIATRIQUES  30 Bd de la Cluse  022 382-45-55  MATERNITY 24 Micheli du Crest  022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer  022 382-84-00 HOPITAL DE LA TOUR  Meyrin  022 719-61-11 URGENCES ADULTES  Meyrin  022 719-66-80  URGENCES : AMBULANCE (GENEVE ET VAUD) : 144 FIRE BRIGADE CERN 767-44-44  FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON 24H/24H  01-251-51-510 APPEL D'URGENCE EUROPEEN 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (ou­or 15) PATIENT CAN BE MOVED: HOPITAL DE ST. JULIEN  Rue Amédée VIII de Savoie&a...

  11. Urgent Need of a Doctor

    CERN Multimedia

    2004-01-01

    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or: SOS MEDECINS (24H/24H) 022 748-49-50 Or: ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: • HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 PAEDIATRIC EMERGENCIES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGY 22 Alcide Jentzer 022 382-84-00 • HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTS Meyrin 022 719-66-80 EMERGENCIES: AMBULANCE (GENEVE AND VAUD) 144 FIRE BRIGADE 118 FIRE BRIGADE CERN 022 767-44-44 POLICE 117 ANTI POISON CENTRE (24H/24H) 01-251-51-51 EUROPEAN EMERGENCY CALL  112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: • HOPITAL DE ST. JULIEN Rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES Rue Amédée VIII de Savoie 04.50-49-65-83 MATERNITY Rue Am&...

  12. Urgent need of a doctor

    CERN Multimedia

    2003-01-01

    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or: SOS MEDECINS (24H/24H) 022 748-49-50 Or: ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: • HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 URGENCES PEDIATRIQUES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer 022 382-84-00 • HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTES Meyrin 022 719-66-80 EMERGENCIES: AMBULANCES (GENEVE AND VAUD) 144 FIRE BRIGADE CERN 022 767-44-44 FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON (24H/24H): 01-251-51-51 EUROPEAN EMERGENCY CALL: 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: • HOPITAL DE ST. JULIEN rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES rue Amédée VIII de Savoie 04-50-49-65-83 MATERNITY r...

  13. Urgent Need of a Doctor

    CERN Multimedia

    2004-01-01

    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or: SOS MEDECINS (24H/24H) 022 748-49-50 Or: ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: • HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 PAEDIATRIC EMERGENCIES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGY 22 Alcide Jentzer 022 382-84-00 • HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTS Meyrin 022 719-66-80 EMERGENCIES: AMBULANCE (GENEVE AND VAUD) 144 FIRE BRIGADE 118 FIRE BRIGADE CERN 022 767-44-44 POLICE 117 ANTI POISON CENTRE (24H/24H) 01-251-51-51 EUROPEAN EMERGENCY CALL  112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: • HOPITAL DE ST. JULIEN Rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES Rue Amédée VIII de Savoie 04.50-49-65-83 MATERNITY Rue Am...

  14. URGENT NEED OF A DOCTOR

    CERN Multimedia

    2003-01-01

    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or: SOS MEDECINS (24H/24H) 022 748-49-50 Or: ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 EMERGENCIES PEDIATRIQUES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer 022 382-84-00 HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTES Meyrin 022 719-66-80 EMERGENCIES: AMBULANCES (GENEVE ET VAUD) 144 FIRE BRIGADE CERN 022 767-44-44 FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON: 24H/24H 01-251-51-51 EUROPEAN EMERGENCY CALL: 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: HOPITAL DE ST. JULIEN rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES rue Amédée VIII de Savoie 04-50-49-65-83 MATERNITY rue Amédée VIII de Savoie 04-50-49-66-07 HOPITAL D'ANNEMASSE 17 r...

  15. URGENT NEED OF A DOCTOR

    CERN Multimedia

    2003-01-01

    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or : SOS MEDECINS (24H/24H) 022 748-49-50 Or : ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 EMERGENCIES PEDIATRIQUES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer 022 382-84-00 HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTES Meyrin 022 719-66-80 EMERGENCIES: AMBULANCES (GENEVE ET VAUD) 144 FIRE BRIGADE CERN 022 767-44-44 FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON: 24H/24H 01-251-51-51 EUROPEAN EMERGENCY CALL: 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: HOPITAL DE ST. JULIEN rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES rue Amédée VIII de Savoie 04-50-49-65-83 MATERNITY rue Amédée VIII de Savoie 04-50-49-66-07 HOPITAL D'ANNEMASSE 17 rue du Jura, Ambilly 04-50-87-47-47 EMERGENCIES 17 rue...

  16. Urgent need of a doctor

    CERN Multimedia

    2003-01-01

    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or : SOS MEDECINS (24H/24H) 022 748-49-50 Or : ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 EMERGENCIES PEDIATRIQUES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer 022 382-84-00 HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTS Meyrin 022 719-66-80 EMERGENCIES: AMBULANCES (GENEVE ET VAUD) 144 FIRE BRIGADE CERN 022 767-44-44 FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON 24H/24H: 01-251-51-51 EUROPEAN EMERGENCY CALL : 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: HOPITAL DE ST. JULIEN rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES rue Amédée VIII de Savoie 04-50-49-65-83 MATERNITY rue Amédée VIII de Savoie 04-50-49-66-07 HOPITAL D'ANNEMASSE 1...

  17. Childhood asthma prediction models: a systematic review.

    Science.gov (United States)

    Smit, Henriette A; Pinart, Mariona; Antó, Josep M; Keil, Thomas; Bousquet, Jean; Carlsen, Kai H; Moons, Karel G M; Hooft, Lotty; Carlsen, Karin C Lødrup

    2015-12-01

    Early identification of children at risk of developing asthma at school age is crucial, but the usefulness of childhood asthma prediction models in clinical practice is still unclear. We systematically reviewed all existing prediction models to identify preschool children with asthma-like symptoms at risk of developing asthma at school age. Studies were included if they developed a new prediction model or updated an existing model in children aged 4 years or younger with asthma-like symptoms, with assessment of asthma done between 6 and 12 years of age. 12 prediction models were identified in four types of cohorts of preschool children: those with health-care visits, those with parent-reported symptoms, those at high risk of asthma, or children in the general population. Four basic models included non-invasive, easy-to-obtain predictors only, notably family history, allergic disease comorbidities or precursors of asthma, and severity of early symptoms. Eight extended models included additional clinical tests, mostly specific IgE determination. Some models could better predict asthma development and other models could better rule out asthma development, but the predictive performance of no single model stood out in both aspects simultaneously. This finding suggests that there is a large proportion of preschool children with wheeze for which prediction of asthma development is difficult.

  18. Pediatric asthma: an integrative approach to care.

    Science.gov (United States)

    Mark, John David

    2009-01-01

    Asthma in children and young adults is a complex disease with many different phenotypic expressions. Diagnosis is often made based on history and lung function including measuring airway reversibility. However, in children younger than 6 years of age, the diagnosis is more difficult because many children wheeze in the first 4-6 years of life, especially with viral infections. For those children, asthma treatment is often started empirically. Those who go on to develop chronic asthma most likely have a genetic predisposition and exposure to various environmental factors resulting in chronic inflammation of the lower respiratory tract. There are established national guidelines for diagnosing and treating asthma in children and adults. For persistent asthma, it is recommended that medications be taken on a regular basis after identifying and avoiding environmental triggers. Because many factors play a role in developing asthma in children, many nonmedical approaches to asthma and asthma-like conditions have been promoted even when the diagnosis is at times uncertain. The nonmedical approaches and therapies are often referred to as complementary and alternative medicine (CAM). This review will discuss the conventional therapies recommended for children with asthma in addition to CAM therapies, some of which have supporting scientific evidence. Integrating conventional and CAM therapies can prove to be an effective way to treat pediatric asthma, a common and chronic childhood lung disorder. A case is provided to illustrate how such an integrative approach was used in the successful treatment of a child with moderate persistent asthma.

  19. Pediatric asthma self-management: current concepts.

    Science.gov (United States)

    Robinson, L. D.

    1999-01-01

    The concept of asthma self-management began in asthma camps in the 1970s. Today all asthma camps are required to provide an educational asthma self-management program. The interaction between children and educators is brief, and if the children do not continue in an associated program after camp, the benefits may be lost. Open Airways, the first program developed specifically for minority children, has been the prototype for community asthma self-management. School-based intervention programs have incorporated asthma education into the health curriculum. Some asthma education programs include an emphasis on the environment. Another approach is to develop intervention projects with parents, as in the Head Start program. This program has been very effective in increasing early recognition of asthma and decreasing recidivism in a high-risk population. Another type of project addressed the reading ability and reading comprehension of asthmatic children. Improvement in reading skills resulted in a 47% decrease in asthma recidivism. After 18 months, there were only two hospitalizations among the enrolled participants. Asthma self-management programs that are most effective for inner-city children provide an interactive, culturally relevant form of asthma education and address issues such as literacy and continuity. PMID:12653391

  20. The Danish National Database for Asthma

    DEFF Research Database (Denmark)

    Backer, Vibeke; Lykkegaard, Jesper; Bodtger, Uffe;

    2016-01-01

    AIM OF THE DATABASE: Asthma is the most prevalent chronic disease in children, adolescents, and young adults. In Denmark (with a population of 5.6 million citizens), >400,000 persons are prescribed antiasthmatic medication annually. However, undiagnosed cases, dubious diagnoses, and poor asthma...... management are probably common. The Danish National Database for Asthma (DNDA) was established in 2015. The aim of the DNDA was to collect the data on all patients treated for asthma in Denmark and to monitor asthma occurrence, the quality of diagnosis, and management. STUDY POPULATION: Persons above the age...... year, the inclusion criteria are a second purchase of asthma prescription medicine within a 2-year period (National Prescription Registry) or a diagnosis of asthma (National Patient Register). Patients with chronic obstructive pulmonary disease are excluded, but smokers are not excluded. DESCRIPTIVE...

  1. Obesity in asthma: approaches to treatment.

    Science.gov (United States)

    Pradeepan, Shyamala; Garrison, Garth; Dixon, Anne E

    2013-10-01

    There is mounting evidence that obesity is associated with asthma, both of which are seeing a dramatic increase in prevalence. Not only is obesity a risk factor for the development of asthma but it is also associated with poor asthma control. Asthma phenotypes associated with obesity include early-onset allergic asthma and late-onset non-allergic asthma. The pathogenesis of the linkage is complex; obesity causes a variety of mechanical, metabolic, and immunological changes that can affect the airways. The treatment of asthma in obesity can be challenging, as obesity is associated with poor response to standard controller medications. A tailored approach that involves combining pharmacologic and non-pharmacologic therapies including weight loss, dietary interventions, and exercise, along with identification and treatment of obstructive sleep apnea, should therefore be considered in this population.

  2. Svær asthma bronchiale

    DEFF Research Database (Denmark)

    von Bülow, Anna; Backer, Vibeke; Porsbjerg, Celeste

    2015-01-01

    Severe asthma is defined by persistent symptoms and frequent exacerbations despite intensive asthma therapy. The prevalence is estimated to be 5-10% of all asthmatics. Severe asthma is responsible for a major burden of illness including low quality of life and a disproportionate use of health-car......-care resources. The clinical assessment of severe asthma must include verification of the correct diagnosis, adherence to medication, excluding differential diagnosis and identification and treatment of aggravating co-morbidities and trigger factors.......Severe asthma is defined by persistent symptoms and frequent exacerbations despite intensive asthma therapy. The prevalence is estimated to be 5-10% of all asthmatics. Severe asthma is responsible for a major burden of illness including low quality of life and a disproportionate use of health...

  3. Do junior doctors take sick leave?

    Science.gov (United States)

    Perkin, M R; Higton, A; Witcomb, M

    2003-09-01

    Nosocomial infections place a heavy burden on overstretched health services. An audit of junior doctors' sick leave behaviour was undertaken in 1993 and again in 2001. The object was to ascertain the level of common infectious illness and to investigate whether junior doctors were remaining at work inappropriately. The doctors were asked if any factors had influenced their decision to take sick leave or not. Between the two audits several initiatives have been introduced to improve the working conditions of junior doctors, including the New Deal to reduce hours of work. Eighty one junior doctors in a large teaching hospital participated in 1993 and 110 in 2001. The number reporting an infectious illness in the previous six months was similar (61.7% in 1993, 68.2% in 2001). There had been a significant increase in the percentage of infectious illness episodes for which the doctors took sick leave (15.1% in 1993, 36.8% in 2001, p work (72% in 1993, 68% in 2001). Consultant pressure was cited by 26% (1993) and 20% (2001). Use of the staff occupational health unit was minimal, with none of the ill doctors contacting the department in 1993 and only three in 2001. Overall, despite the reduction in the number of infectious doctors not taking sick leave, the majority remained at work. Fundamental changes are needed if potentially infected doctors are not to present a risk of iatrogenic infection.

  4. Psychiatric Prescribers' Experiences With Doctor Shoppers.

    Science.gov (United States)

    Worley, Julie; Johnson, Mary; Karnik, Niranjan

    2015-01-01

    Doctor shopping is a primary method of prescription medication diversion. After opioids, benzodiazepines and stimulants are the next most common prescription medications used nonmedically. Studies have shown that patients who engage in doctor shopping find it fun, exciting, and easy to do. There is a lack of research on the prescriber's perspective on the phenomenon of doctor shopping. This study investigates the experiences of prescribers in psychiatry with patients who engage in doctor shopping. Fifteen prescribers including psychiatrists and psychiatric nurse practitioners working in outpatient psychiatry were interviewed to elicit detailed information about their experiences with patients who engage in doctor shopping. Themes found throughout the interview were that psychiatric prescribers' experience with patients who engage in doctor shopping includes (a) detecting red flags, (b) negative emotional responding, (c) addressing the patient and the problem, and (d) inconsistently implementing precautions. When red flags were detected when prescribing controlled drugs, prescribers in psychiatry experienced both their own negative emotional responses such as disappointment and resentment as well as the negative emotions of the patients such as anger and other extreme emotional responses. Psychiatric prescribers responded to patient's doctor shopping in a variety of ways such as changing their practice, discharging the patients or taking steps to not accept certain patients identified as being at risk for doctor shopping, as well as by talking to the patient and trying to offer them help. Despite experiencing doctor shopping, the prescribers inconsistently implemented precautionary measures such as checking prescription drug monitoring programs.

  5. Relationship between Pesticide Metabolites, Cytokine Patterns, and Asthma-Related Outcomes in Rural Women Workers

    Directory of Open Access Journals (Sweden)

    Hussein H. Mwanga

    2016-09-01

    Full Text Available The objective of this study was to investigate the relationship between exposure to organophosphate (OP and pyrethroid (PYR pesticides with serum cytokine patterns and asthma-related outcomes among rural women workers. A cross-sectional study was conducted among rural women (n = 211, including those working and living on farms and nearby town dwellers. Pesticide exposure was assessed using urinary metabolite concentrations of OP and PYR pesticides. Health outcome assessment was ascertained through the European Community Respiratory Health Survey (ECRHS questionnaire, fractional exhaled nitric oxide (FeNO, and serum cytokines associated with asthma. The prevalence of doctor-diagnosed asthma was 11%, adult-onset asthma 9%, and current asthma 6%. In this population, the proportion of T helper type 2 (Th2 cytokines (interleukin (IL-4, IL-5, and IL-13 detectable in subjects was between 18% and 40%, while the proportion of non-Th2 cytokines (IL-6, IL-8, IL-10, IL-17, and interferon gamma was between 35% and 71%. Most Th2 and non-Th2 cytokines were positively associated with either OP or PYR metabolites. Non-Th2 cytokines showed much stronger associations with OP metabolites (Dimethyl phosphate OR = 4.23; 95% CI: 1.54–11.65 than Th2 cytokines (Dimethyl phosphate OR = 1.69; 95% CI: 0.83–3.46. This study suggests that exposure to most OP and some PYR pesticides may be associated with asthma-related cytokines, with non-Th2 cytokines demonstrating consistently stronger relationships.

  6. Asthma in the elderly: Current understanding and future research needs--a report of a National Institute on Aging (NIA) workshop.

    Science.gov (United States)

    Hanania, Nicola A; King, Monroe J; Braman, Sidney S; Saltoun, Carol; Wise, Robert A; Enright, Paul; Falsey, Ann R; Mathur, Sameer K; Ramsdell, Joe W; Rogers, Linda; Stempel, David A; Lima, John J; Fish, James E; Wilson, Sandra R; Boyd, Cynthia; Patel, Kushang V; Irvin, Charles G; Yawn, Barbara P; Halm, Ethan A; Wasserman, Stephen I; Sands, Mark F; Ershler, William B; Ledford, Dennis K

    2011-09-01

    Asthma in the elderly is underdiagnosed and undertreated, and there is a paucity of knowledge on the subject. The National Institute on Aging convened this workshop to identify what is known and what gaps in knowledge remain and suggest research directions needed to improve the understanding and care of asthma in the elderly. Asthma presenting at an advanced age often has similar clinical and physiologic consequences as seen with younger patients, but comorbid illnesses and the psychosocial effects of aging might affect the diagnosis, clinical presentation, and care of asthma in this population. At least 2 phenotypes exist among elderly patients with asthma; those with longstanding asthma have more severe airflow limitation and less complete reversibility than those with late-onset asthma. Many challenges exist in the recognition and treatment of asthma in the elderly. Furthermore, the pathophysiologic mechanisms of asthma in the elderly are likely to be different from those seen in young asthmatic patients, and these differences might influence the clinical course and outcomes of asthma in this population.

  7. Allergy and asthma prevention 2014.

    Science.gov (United States)

    Nieto, Antonio; Wahn, Ulrich; Bufe, Albrecht; Eigenmann, Philippe; Halken, Susanne; Hedlin, Gunilla; Høst, Arne; Hourihane, Jonathan; Just, Jocelyne; Lack, Gideon; Lau, Susanne; Matricardi, Paolo Maria; Muraro, Antonella; Papadopoulos, Nikos; Roberts, Graham; Simpson, Angela; Valovirta, Erkka; Weidinger, Stephan; Wickman, Magnus; Mazon, Angel

    2014-10-01

    Asthma and allergic diseases have become one of the epidemics of the 21st century in developed countries. Much of the success of other areas of medicine, such as infectious diseases, lies on preventive measures. Thus, much effort is also being placed lately in the prevention of asthma and allergy. This manuscript reviews the current evidence, divided into four areas of activity. Interventions modifying environmental exposure to allergens have provided inconsistent results, with multifaceted interventions being more effective in the prevention of asthma. Regarding nutrition, the use of hydrolyzed formulas in high-risk infants reduces the incidence of atopic dermatitis, while there is for now not enough evidence to recommend other dietary modifications, prebiotics, probiotics, or other microbial products. Pharmacologic agents used until now for prevention have not proved useful, while there is hope that antiviral vaccines could be useful in the future. Allergen-specific immunotherapy is effective for the treatment of allergic patients with symptoms; the study of its value for primary and secondary prevention of asthma and allergy is in its very preliminary phases. The lack of success in the prevention of these disorders lies on their complexity, which involves many genetic, epigenetic, and environmental interactions. There is a need to identify target populations, involved mechanisms and interactions, and the best interventions. These must be effective, feasible, implementable, and affordable.

  8. [Asthma mortality trends in Mexico].

    Science.gov (United States)

    Salas Ramírez, M; Segura Méndez, N H; Martínez-Cairo Cueto, S

    1994-04-01

    The objective of this cross-sectional study was to estimate mortality and morbidity from asthma in Mexico by federative entity (state) of residence, age, and sex during the period between 1960 and 1988. Statistics published by the National Institute of Statistics, Geography, and Information Science were reviewed, as were vital statistics and information from other sources. Data were selected on mortality, hospital admissions, and outpatient visits, as well as population by federative entity, age, and sex. Mortality and morbidity rates were adjusted for age using the direct method. From 1960 to 1987, mortality decreased for both sexes. The groups with the highest asthma mortality were those under 4 years of age and those over 50. From 1960 to the present, the state with the highest mortality was Tlaxcala. Hospitalizations increased from 10 to 140 per 100,000 population for the country as a whole. When both outpatient visits and hospitalizations were considered, the morbidity rates rose from 180 to 203.4 per 100,000 between 1960 and 1970. In 1970, hospital morbidity was higher among males than females. From 1960 up to the 1990s, the highest rates of hospitalization and outpatient visits were registered among those under 4 and those over 60. The states with the highest asthma hospitalization rates were Morelos, Baja California Sur, Nuevo León, Durango, and Tamaulipas. It is concluded that asthma mortality in Mexico is showing a downward trend, while morbidity is increasing considerably, especially among adolescents.

  9. Childhood asthma and risk factors

    Directory of Open Access Journals (Sweden)

    Ljuština-Pribić Radmila

    2010-01-01

    Full Text Available Introduction. This article summarizes the contribution of epidemiology to the understanding of childhood asthma. The first task in epidemiology is to determine prevalence and incidence of any disease. Prevalence. Epidemiological investigations are aimed at evaluating hypotheses about causes of disease by defining demographic characteristics of a certain population as well as by determining possible effects of environmental factors. In spite of some limitations, data obtained by epidemiological investigations have been valuable in confirming both the increasing incidence of asthma and the differences in prevalence in certain population groups. The observance of this phenomenon has led to much speculation and a lot of attempts to identify the reasons behind the rising prevalence. Risk factors. Epidemiological studies have identified risk factors for the development of childhood asthma and provided insight into natural history of disease and prognosis. Factors ranging from increased numbers of immunizations to increased air pollution have been suggested, but subsequent analysis has failed to provide the supporting evidence to implicate most of these possibilities. The concept known as the hygiene hypothesis has gained some support from epidemiological studies. Conclusion. The development of asthma as well as its severity are affected by numerous factors and their interactions can be explained by the heterogeneous nature of this disease.

  10. Occupational asthma caused by palladium

    Energy Technology Data Exchange (ETDEWEB)

    Daenen, M.; Rochette, F.; Demedts, M.; Nemery, B. [K.U. Leuven, Pneumology (Belgium); Rogiers, P. [A.Z. St-Lucas, Brugge (Belgium); Walle, C. Van de [Siemens, Oostkamp (Belgium)

    1999-01-01

    Occupational exposure to complex platinum salts is a well-known cause of occupational asthma. Although there is evidence that platinum refinery workers may also be sensitized to other precious metals, such as palladium or rhodium, no instances of occupational asthma due to an isolated sensitization to palladium have been reported. A case is reported of occupational rhinoconjunctivitis and asthma in a previously healthy worker exposed to the fumes of an electroplating bath containing palladium. There was no exposure to platinum. Sensitization to palladium was documented by skin-prick tests. The skin-prick test was positive with Pd(NH{sub 3}){sub 4}Cl{sub 2}, but not with (NH{sub 4}){sub 2}PdCl{sub 4}. Corresponding salts of platinum were all negative. A bronchial provocation test with Pd(NH{sub 34})Cl{sub 2} (0.0001 % for a total of 315 s, followed by 0.001 % for a total of 210 s) led to an early decrease in forced expiratory volume in one second (-35%). A similar exposure (0.001 % for a total of 16 min) in an unrelated asthmatic gave no reaction. This case shows that an isolated sensitization to palladium can occur and that respiratory exposure to palladium is a novel cause of metal-induced occupational asthma. (au) 24 refs.

  11. Carboxyhemoglobin and Methemoglobin in Asthma

    Science.gov (United States)

    Naples, Robert; Laskowski, Dan; McCarthy, Kevin; Mattox, Emmea; Comhair, Suzy A. A.; Erzurum, Serpil C.

    2015-01-01

    Nitric oxide (NO) and carbon monoxide (CO) are synthesized at high levels in asthmatic airways. NO can oxidize hemoglobin (Hb) to methemoglobin (MetHb). CO binds to heme to produce carboxyhemoglobin (COHb). We hypothesized that MetHb and COHb may be increased in asthma. COHb, MetHb, and Hb were measured in venous blood of healthy controls (n=32) and asthmatics (n=31). Arterial COHb and oxyhemoglobin were measured by pulse CO-oximeter. Hb, oxyhemoglobin, and deoxyhemoglobin were similar among groups, but arterial COHb was higher in asthmatics than controls (p=0.04). Venous COHb was similar among groups, and thus arteriovenous COHb (a-v COHb) concentration difference was greater in asthma compared with controls. Venous MetHb was lower in asthma compared to controls (p=0.01) and correlated to venous NO (p=0.009). The greater a-v COHb in asthma suggests CO offloading to tissues, but lower than normal MetHb suggests countermeasures to avoid adverse effects of high NO on gas transfer. PMID:25680415

  12. Gastric asthma : a pathophysiological entity?

    NARCIS (Netherlands)

    Peters, FTM; Kleibeuker, JH; Postma, DS

    1998-01-01

    Background: Gastro-oesophageal reflux disease (GORD) is manifested by typical reflux symptoms and atypical extra-oesophageal symptoms. Important in this respect are respiratory conditions. Gastric asthma is a prominent example of these extra-oesophageal manifestations of GORD. There is, however, muc

  13. Obesity and Asthma: Physiological Perspective

    Directory of Open Access Journals (Sweden)

    Bill Brashier

    2013-01-01

    Full Text Available Obesity induces some pertinent physiological changes which are conducive to either development of asthma or cause of poorly controlled asthma state. Obesity related mechanical stress forces induced by abdominal and thoracic fat generate stiffening of the lungs and diaphragmatic movements to result in reduction of resting lung volumes such as functional residual capacity (FRC. Reduced FRC is primarily an outcome of decreased expiratory reserve volume, which pushes the tidal breathing more towards smaller high resistance airways, and consequentially results in expiratory flow limitation during normal breathing in obesity. Reduced FRC also induces plastic alteration in the small collapsible airways, which may generate smooth muscle contraction resulting in increased small airway resistance, which, however, is not picked up by spirometric lung volumes. There is also a possibility that chronically reduced FRC may generate permanent adaptation in the very small airways; therefore, the airway calibres may not change despite weight reduction. Obesity may also induce bronchodilator reversibility and diurnal lung functional variability. Obesity is also associated with airway hyperresponsiveness; however, the mechanism of this is not clear. Thus, obesity has effects on lung function that can generate respiratory distress similar to asthma and may also exaggerate the effects of preexisting asthma.

  14. Asthma and Respiratory Allergic Disease

    Science.gov (United States)

    The pathogenesis of non-communicable diseases such as allergy is complex and poorly understood. The causes of chronic allergic diseases including asthma involve to a large extent, immunomodulation of the adaptive and particularly the innate immune systems and are markedly influen...

  15. Children with problematic severe asthma: A biopsychosocial perspective

    NARCIS (Netherlands)

    Verkleij, M.

    2016-01-01

    This thesis focuses on problematic severe asthma in children and its treatment from a biopsychosocial perspective. Asthma is a chronic inflammatory disease of the airways. In children with problematic severe asthma, asthma is not under control despite optimal medical treatment. Asthma control is the

  16. Asthma and Adolescents: Review of Strategies to Improve Control

    Science.gov (United States)

    Hennessy-Harstad, Ellen

    2013-01-01

    One of every 10 adolescents in the United States has asthma. Adolescents who lack asthma control are at increased risk for severe asthma episodes and death. The National Heart, Lung, and Blood Institute 2007 asthma guidelines and research studies indicated that school nurses are instrumental in assisting adolescents to monitor their asthma, learn…

  17. Effect of Air Pollution, Contamination and High Altitude on Bronchial Asthma

    Directory of Open Access Journals (Sweden)

    Nesriene El margoushy*, Mohamad El Nashar**, Hatem Khairy*, Nihad El Nashar*, Hala Mohamad

    2013-01-01

    Full Text Available Epidemiological studies have shown that the prevalence of asthma has risen dramatically worldwide and evidence suggests that environmental factors have an important role in the etiology of the disease. Most respiratory diseases are caused by airborne agents. Our lungs are uniquely vulnerable to contamination from the air we breathe. Air pollution exposure is associated with increased asthma and allergy morbidity and is a suspected contributor to the increasing prevalence of allergic conditions. Observational studies continue to strengthen the association between air pollution and allergic respiratory disease. The effects of air pollution should be viewed in two different groups: healthy people and people with chronic heart or lung disease. Although the fundamental causes of asthma are not completely understood, the strongest risk factors for developing asthma are inhaled asthma triggers. These include: indoor allergens (for example house dust mites in bedding, carpets and stuffed furniture, pollution and pet dander, outdoor allergens (such as pollens and moulds, tobacco smoke and chemical irritants in the workplace. Other triggers can include cold air, extreme emotional arousal such as anger or fear, and physical exercise. Even certain medications can trigger asthma such as aspirin and other non-steroid anti-inflammatory drugs, and beta-blockers. Urbanization has also been associated with an increase in asthma; however the exact nature of this relationship is unclear. Medication is not the only way to control asthma. It is also important to avoid asthma triggers - stimuli that irritate and inflame the airways. Prevalence of asthma is generally low within the Middle East, although high rates have been recorded in the Kingdom of Saudi Arabia, Kuwait, Lebanon, and Israel. The prevalence of asthma and asthma-related symptoms is high among 16- to 18-year-old adolescents in Saudi Arabia, and the symptoms are more common in boys than in girls

  18. A Survey of U.S. Doctoral Degrees Related to the Teaching of German--1983.

    Science.gov (United States)

    Benseler, David P.

    1984-01-01

    Lists titles of doctoral dissertations related to the teaching of German and completed in U.S. universities during 1982. Included are dissertations completed in German, comparative literature, linguistics, and foreign language education departments. The list is derived from the annual survey done by the Modern Language Journal. (SED)

  19. Supervision Provided to Indigenous Australian Doctoral Students: A Black and White Issue

    Science.gov (United States)

    Trudgett, Michelle

    2014-01-01

    The number of Indigenous Australians completing doctoral qualifications is disparately below their non-Indigenous contemporaries. Whilst there has been a steady increase in Indigenous completions in recent years, significant work remains to redress the imbalance. Supervision has been identified as a primary influencer of the likely success of…

  20. Overcoming Problems in Doctoral Writing through the Use of Visualisations: Telling Our Stories

    Science.gov (United States)

    Barrett, Terry; Hussey, Jennie

    2015-01-01

    Doctoral students experience many challenges on the long journey towards completion. Common problems include: synthesising data, working at a conceptual level, clarifying the relationship of the parts of the thesis to the whole, finding a voice and completing a viva successfully. Few authors have addressed the use of visualisations to meet these…