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Sample records for sweden asthma study

  1. Mothers, places and risk of hospitalization for childhood asthma: a nationwide study from Sweden: epidemiology of allergic disease.

    Science.gov (United States)

    Li, X; Sundquist, J; Calling, S; Zöller, B; Sundquist, K

    2013-06-01

    This study examines whether neighbourhood deprivation increases the risk of hospitalization for childhood asthma, after accounting for individual-level maternal socio-demographic characteristics. An open cohort of all singleton children aged 2-11 years was followed between January 1, 1995 and December 31, 2006. Childhood residential addresses were geocoded and classified according to the level of neighbourhood deprivation. Data were analysed by multilevel logistic regression, with individual-level characteristics (sex, age, maternal marital status, family income, maternal educational attainment, maternal immigration status, maternal urban/rural status, mobility, maternal asthma history and maternal smoking) at the first level and level of neighbourhood deprivation at the second level. During the study period, among a total of 866,860 children, 17,682 (2.0%) were hospitalized with childhood asthma. Age-adjusted hospital rates for childhood asthma increased with increasing level of neighbourhood deprivation. In the study population, 1.9% and 2.3% of children in the least and most deprived neighbourhoods, respectively, were affected by childhood asthma. Hospital rates of childhood asthma increased with increasing neighbourhood-level deprivation across all individual-level maternal socio-demographic categories, including marital status, educational attainment, urban/rural status, maternal history of asthma and smoking. The odds ratio (OR) for those living in high-deprivation neighbourhoods vs. those living in low-deprivation neighbourhoods was 1.23 (95% confidence interval, 1.16-1.30). High neighbourhood deprivation remained significantly associated with childhood asthma risk after adjustment for maternal socio-demographic characteristics (OR=1.08, p = 0.016). This study is the largest so far on neighbourhood influences on childhood asthma. Our results suggest that neighbourhood characteristics affect the risk of hospitalization for childhood asthma independent of

  2. Sensitization to pets is a major determinant of persistent asthma and new asthma onset in Sweden.

    Science.gov (United States)

    Uddenfeldt, Monica; Janson, Christer; Lampa, Erik; Rask-Andersen, Anna

    2013-05-01

    Our knowledge about atopy as a longitudinal predictor of asthma is limited. The purpose of this study was to investigate the prognosis of asthma and risk factors for asthma onset, especially sensitization of specific allergens in a population sample. A cohort responded to a respiratory questionnaire in 1990 and 2003. At baseline, 2,060 subjects who, in the screening questionnaire, reported respiratory symptoms and 482 controls were investigated with interviews, spirometry, and skin-prick test. A total of 721 asthmatics and 976 subjects without respiratory disease were clinically verified. At follow-up in 2003, 340 subjects with persistent asthma and 186 subjects with asthma remission were identified, while 76 subjects reported new asthma onset. Sensitization to pets and a high symptom score were significant determinants of persistent asthma (odds ratio (OR) 3.2 (95% CI 1.9-5.6) and 5.7 (2.5-13.3), respectively) and onset of asthma (OR 2.6 (1.1-6.0), and 1.7 (1.2-2.3)). A high self-reported responsiveness to airway irritants (OR 1.6 (1.1-2.2)), and more asthma medications (OR 2.0 (1.3-2.9)) were additional indicators of persistent asthma at the follow-up. Belonging to the older age group decreased the risk both of having persistent asthma and asthma onset. Asthmatics sensitized to pets have a more severe outcome than asthmatics not sensitized to pets. Sensitization to pets was also a strong predictor for onset of asthma. Special attention should be given to asthmatics who report having severe symptoms and problems with airway irritants as such patients are more likely to have persistent problems.

  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. Studies on provoked asthma

    International Nuclear Information System (INIS)

    Munkner, L.; Bundgaard, A.

    1982-01-01

    A group of adult patients with perennial bronchial asthma has been studied as to lung perfusion and alveolar ventilation (81m-Kr) at rest and after provocation of an acute attack. Asthma was provoked by exercise and by histamine inhalation. After provocation the peak expiratory flow values were reduced to less than 80% of the base line values. Perfusion was often deranged. Regional ventilation changed rapidly after provocation and not always in the same fashion after exercise and histamine. During attacks lung volume increased. The expansion decreased (in parallel with increased peak expiratory flow) after inhalator of a #betta#-2 agonist (terbutaline). 81m-Kr offers unique opportunities for studying acute regional changes in alveolar ventilation. (Author)

  5. PVC flooring at home and development of asthma among young children in Sweden, a 10-year follow-up.

    Science.gov (United States)

    Shu, H; Jönsson, B A; Larsson, M; Nånberg, E; Bornehag, C-G

    2014-06-01

    The incidence of asthma and allergy has increased throughout the developed world over the past decades. During the same period of time, the use of industrial chemicals such as phthalates, commonly used as plasticizers in polyvinylchloride (PVC) flooring material, has increased. The aim of this study was to investigate whether PVC flooring in the home of children in the age of 1-5 years is associated with the development of asthma in 5- and 10-year follow-up investigations (n = 3228). Dampness in Buildings and Health Study (DBH Study) commenced in 2000 in Värmland, Sweden. The current analyses included subjects who answered all baseline and follow-up questionnaires. Logistic regression analyses were applied to questionnaire results. Children who had PVC floorings in the bedroom at baseline were more likely to develop doctor-diagnosed asthma during the following 10-year period when compared with children living without. There were indications that PVC flooring in the parents' bedrooms was strongly associated with the new cases of doctor-diagnosed asthma when compared with child's bedroom. Our results suggest that PVC flooring exposure during pregnancy could be a critical period in the development of asthma in children at a later time; prenatal exposure and measurements of phthalate metabolites should be included in the future. This study has found that PVC flooring material in early life was related to incidence of asthma during the following 10 years when compared with other flooring materials and especially when comparing with wood flooring type.The study has further indicated that PVC flooring in the parents’ bedroom (proxy for prenatal exposure) was more associated with the development of asthma than PVC in the child’s bedroom was. Our results suggest that PVC flooring exposure during pregnancy could be a critical period in the development of asthma in children at a later time. In future prospective cohort study, prenatal exposure and measurements of

  6. Rhinitis, Asthma and Respiratory Infections among Adults in Relation to the Home Environment in Multi-Family Buildings in Sweden

    Science.gov (United States)

    Wang, Juan; Engvall, Karin; Smedje, Greta; Norbäck, Dan

    2014-01-01

    Risk factors for rhinitis, asthma and respiratory infections in the home environment were studied by a questionnaire survey. Totally 5775 occupants (≥18 years old) from a stratified random sample of multi-family buildings in Sweden participated (46%). 51.0% had rhinitis in the last 3 months (current rhinitis); 11.5% doctor diagnosed asthma; 46.4% respiratory infections in the last 3 months and 11.9% antibiotic medication for respiratory infections in the last 12 months. Associations between home environment and health were analyzed by multiple logistic regression, controlling for gender, age and smoking and mutual adjustment. Buildings constructed during 1960–1975 were risk factors for day time breathlessness (OR = 1.53, 95%CI 1.03–2.29). And those constructed during 1976–1985 had more current rhinitis (OR = 1.43, 95%CI 1.12–1.84) and respiratory infections (OR = 1.46, 95%CI 1.21–1.78). Cities with higher population density had more current rhinitis (p = 0.008) and respiratory infections (pBuilding dampness was a risk factor for wheeze (OR = 1.42, 95%CI 1.08–1.86) and day time breathlessness (OR = 1.57, 95%CI 1.09–2.27). Building dampness was a risk factor for health among those below 66 years old. Odor at home was a risk factor for doctor diagnosed asthma (OR = 1.49, 95%CI 1.08–2.06) and current asthma (OR = 1.52, 95%CI 1.03–2.24). Environmental tobacco smoke (ETS) was a risk factor for current asthma (OR = 1.53, 95%CI 1.09–2.16). Window pane condensation was a risk factor for antibiotic medication for respiratory infections (OR = 1.41, 95%CI 1.10–1.82). In conclusion, rhinitis, asthma and respiratory infections were related to a number of factors in the home environment. Certain building years (1961–1985), building dampness, window pane condensation and odor in the dwelling may be risk factors. PMID:25136984

  7. Incidence rates of asthma, rhinitis and eczema symptoms and influential factors in young children in Sweden

    DEFF Research Database (Denmark)

    Larsson, M.; Hagerhed-Engman, L.; Sigsgaard, T.

    2008-01-01

    questionnaire based on an ISAAC protocol to all children in the age of 1-6 years. Five years later a follow-up questionnaire was sent to the children that were 1-3 years at baseline. In total, 4779 children (response rate = 73%) participated in both surveys and constitute the study population in this cohort...... period of breast-feeding. Allergic symptoms in parents were also a strong risk factor for incident asthma, as well as for rhinitis and eczema. Conclusion: When comparing incident rates of asthma between different studies it is important to realize that different definitions of the healthy baseline...

  8. Short-Term Fluctuations in Air Pollution and Asthma in Scania, Sweden. Is the Association Modified by Long-Term Concentrations?

    Directory of Open Access Journals (Sweden)

    Tahir Taj

    Full Text Available Asthma is one of the most common respiratory diseases in the world. Research has shown that temporal increases in air pollution concentrations can aggravate asthma symptoms. The aim of this study was to assess whether individuals living in areas with higher air pollution concentrations responded differently to short-term temporal exposure to air pollution than those living in lower air pollution areas.The study was designed as a case-crossover study in Scania, Sweden. Outcome data was visits to primary health care clinics with asthma as the main complaint during the years 2007 to 2010. Nitrogen dioxide levels were obtained from 21 different air pollution monitoring stations. Short-term exposure was defined as the average concentration four days prior to the visit. Data was pooled for areas above and below a two-year average NO2 concentration of 10 μg/m3, dispersion modelled with an emission database.The short-term association between NO2 and asthma visits seemed stronger in areas with NO2 levels below 10 μg/m3, with an odds ratio (OR of 1.15 (95% confidence interval (CI: 1.08-1.23 associated with a 10 μg/m3 increase in NO2 compared to areas above 10 μg/m3 NO2 levels, where corresponding OR of 1.09 (95% CI: 1.02-1.17. However, this difference was not statistically significant. (p = 0.13.The study provided some evidence, although not statistically significant, that short-term associations between air pollution and asthma may depend on background air pollution levels. However, we cannot rule out that the association is due to other spatially dependent factors in Scania. The study should be reproduced in other study areas.

  9. Asthma

    Science.gov (United States)

    ... have asthma if: One or both parents have asthma The child has signs of allergies, including the allergic skin ... asthma, partner with your doctor to manage your asthma or your child's asthma. Children aged 10 or older—and younger ...

  10. The Urban-Rural Gradient In Asthma: A Population-Based Study in Northern Europe

    Directory of Open Access Journals (Sweden)

    Signe Timm

    2015-12-01

    Full Text Available The early life environment appears to have a persistent impact on asthma risk. We hypothesize that environmental factors related to rural life mediate lower asthma prevalence in rural populations, and aimed to investigate an urban-rural gradient, assessed by place of upbringing, for asthma. The population-based Respiratory Health In Northern Europe (RHINE study includes subjects from Denmark, Norway, Sweden, Iceland and Estonia born 1945–1973. The present analysis encompasses questionnaire data on 11,123 RHINE subjects. Six categories of place of upbringing were defined: farm with livestock, farm without livestock, village in rural area, small town, city suburb and inner city. The association of place of upbringing with asthma onset was analysed with Cox regression adjusted for relevant confounders. Subjects growing up on livestock farms had less asthma (8% than subjects growing up in inner cities (11% (hazard ratio 0.72 95% CI 0.57–0.91, and a significant urban-rural gradient was observed across six urbanisation levels (p = 0.02. An urban-rural gradient was only evident among women, smokers and for late-onset asthma. Analyses on wheeze and place of upbringing revealed similar results. In conclusion, this study suggests a protective effect of livestock farm upbringing on asthma development and an urban-rural gradient in a Northern European population.

  11. Asthma

    Science.gov (United States)

    ... by swelling (inflammation) in the airways. When an asthma attack occurs, the lining of the air passages swells ... or a cough may be the main symptom. Asthma attacks can last for minutes to days. Attacks can ...

  12. Predicting asthma in preschool children with asthma symptoms: study rationale and design

    Directory of Open Access Journals (Sweden)

    Hafkamp-de Groen Esther

    2012-10-01

    Full Text Available Abstract Background In well-child care it is difficult to determine whether preschool children with asthma symptoms actually have or will develop asthma at school age. The PIAMA (Prevention and Incidence of Asthma and Mite Allergy Risk Score has been proposed as an instrument that predicts asthma at school age, using eight easy obtainable parameters, assessed at the time of first asthma symptoms at preschool age. The aim of this study is to present the rationale and design of a study 1 to externally validate and update the PIAMA Risk Score, 2 to develop an Asthma Risk Appraisal Tool to predict asthma at school age in (specific subgroups of preschool children with asthma symptoms and 3 to test implementation of the Asthma Risk Appraisal Tool in well-child care. Methods and design The study will be performed within the framework of Generation R, a prospective multi-ethnic cohort study. In total, consent for postnatal follow-up was obtained from 7893 children, born between 2002 and 2006. At preschool age the PIAMA Risk Score will be assessed and used to predict asthma at school age. Discrimination (C-index and calibration will be assessed for the external validation. We will study whether the predictive ability of the PIAMA Risk Score can be improved by removing or adding predictors (e.g. preterm birth. The (updated PIAMA Risk Score will be converted to the Asthma Risk Appraisal Tool- to predict asthma at school age in preschool children with asthma symptoms. Additionally, we will conduct a pilot study to test implementation of the Asthma Risk Appraisal Tool in well-child care. Discussion Application of the Asthma Risk Appraisal Tool in well-child care will help to distinguish preschool children at high- and low-risk of developing asthma at school age when asthma symptoms appear. This study will increase knowledge about the validity of the PIAMA risk score and might improve risk assessment of developing asthma at school age in (specific subgroups

  13. Asthma

    Science.gov (United States)

    ... irritate your airways, like cigarette smoke , perfume, and chalk dust infections, like a cold or the flu exercising breathing in cold air How Is Asthma Diagnosed? If your doctor thinks you have asthma, you'll have to get checked out. One test that helps doctors diagnose asthma is spirometry . ...

  14. A study of asthma severity in adult twins

    DEFF Research Database (Denmark)

    Thomsen, Simon Francis; van der Sluis, Sophie; Kyvik, Kirsten Ohm

    2012-01-01

    Introduction: The tendency to develop asthma runs in families, but whether the severity of asthma symptoms is inherited is not known. Objectives: The aim of this study was to examine whether genetic factors influence the variation in the severity of asthma. Methods: Of a sample of 21 133 adult tw...... of asthma symptoms and objectively measured asthma-related traits, respectively, seem to differ. Please cite this paper as: Thomsen SF, van der Sluis S, Kyvik KO and Backer V. A study of asthma severity in adult twins. Clin Respir J 2011; DOI:10.1111/j.1752-699X.2011.00273.x....

  15. Thermomechanical studies in granite at Stripa, Sweden

    International Nuclear Information System (INIS)

    Cook, N.G.W.; Myer, L.R.

    1981-01-01

    Media other than rock salt are being considered for the deep, geologic disposal of nuclear wastes. The disposal of high-level nuclear waste in a deep, underground repository will subject the rock to a thermal pulse that will induce displacements, strains, and stresses in the rock. Thermomechanical experiments, with electrical heaters simulating the thermal output of waste canisters, were carried out in granite at a depth of 340 m below surface adjacent to a defunct iron ore mine at Stripa, Sweden. Changes in temperature, displacement, and stress in the rock around these heaters were measured, and the measurements were compared with predictions calculated from the theory of linear thermoelasticity. Measured temperature changes agreed well with predictions, but measured displacements and stresses were consistently less than those predicted with constant values for the coefficient of thermal expansion and elastic properties of the rock. A laboratory test program to measure these coefficients over ranges of stress and temperature representing those in the field experiment has been initiated. Test specimens were taken from cores recovered from the instrumentation holes in the Stripa experiments. Preliminary results from laboratory tests on specimens free of joints indicate that the values of Young's modulus and Poisson's ratio increase from about 60 to 80 MPa and from 0.15 to 0.22, respectively, as the confining stress is increased from 2 to 55 MPa; these values decrease with increasing temperature, more so at 2 MPa than at 55 MPa. The linear coefficient of thermal expansion at a confining stress of 30 MPa increases from about 10 x 10 - 6 / 0 C at 40 0 C to about 14 x 10 - 6 / 0 C. The magnitudes of these changes are not sufficient to resolve the disparity between measured and predicted results. Perhaps the properties of test specimens containing joints will show greater variations in the values of the thermomechanical coefficients with temperature and pressure

  16. 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.

  17. Association between asthma and dysphonia: A population-based study.

    Science.gov (United States)

    Park, Bumjung; Choi, Hyo Geun

    2016-09-01

    We investigated whether asthma predisposes patients to organic laryngeal lesions or increases dysphonia in those without organic laryngeal lesions. We performed a cross-sectional study with data from the Korea National Health and Nutrition Examination Survey; 19,330 subjects from 2008 through 2011 were included. The associations of asthma with organic laryngeal lesions and dysphonia were analyzed using a simple/multiple logistic regression analysis with complex sampling while adjusting for confounding factors (age, sex, smoking status, stress level, and body mass index) that could contribute to dysphonia. Compared with non-asthma participants, the asthma patients tended to be older and female and to have higher stress levels. These factors were associated with dysphonia (Age, AOR = 1.20, 95% CI = 1.14 = 1.23, P dysphonia. Compared with non-asthma participants, asthma patients who had not taken asthma medication recently showed a higher AOR (1.62; 95% CI = 1.0-2.42) for dysphonia, and asthma patients who had taken asthma medication recently showed the highest adjusted odds ratio for dysphonia (AOR = 1.97; 95% confidence interval, CI = 1.28-3.02, P = 0.001). On multiple logistic regression analysis, vocal nodules, laryngeal polyps, and laryngitis were not associated with asthma (all P > 0.05). Asthma patients are predisposed to subjective dysphonia due to demographic and clinical characteristics (older age, female, and higher stress level) as well as to asthma itself. However, asthma was not associated with organic laryngeal lesions in this study.

  18. Relevance of specific IgE antibody titer to the prevalence, severity, and persistence of asthma among 19-year-olds in northern Sweden.

    Science.gov (United States)

    Perzanowski, Matthew S; Ronmark, Eva; James, Hayley R; Hedman, Linnea; Schuyler, Alexander J; Bjerg, Anders; Lundback, Bo; Platts-Mills, Thomas A E

    2016-12-01

    Although sensitization to indoor allergens is strongly associated with asthma, there are questions as to how this relates to asthma symptoms. We sought to study the relevance of IgE antibodies to cat and dog allergens in an area in which (1) the climate discourages cockroach, fungal, and mite growth and (2) dander allergens are known to be present in schools and houses without animals. IgE to 8 allergens was tested in 963 sera from a population-based study on 19-year-olds, and associations with asthma symptoms, diagnosis, and treatment were examined. In positive sera IgE to specific cat and dog allergens was also assayed. IgE specific for animal dander had the highest prevalence and strongest relationship to asthma diagnosis. Furthermore, asthma severity, as judged by the frequency of symptoms and use of treatment, was directly associated with the titer of IgE antibodies to animal dander. Among the 103 subjects who had current asthma at age 19 years, 50 had asthma before age 12 years. Among those 50, the odds ratios for asthma related to any IgE antibodies to animal dander or high-titer IgE antibodies (≥17.5 IU/mL) were 9.2 (95% CI, 4.9-17) and 13 (95% CI, 6.9-25), respectively. In multivariable analysis IgE antibodies to Fel d 1 and Can f 5 were each associated with current asthma. High-titer IgE antibodies to cat and dog allergens were strongly associated with the diagnosis, severity, and persistence of asthma; however, a large proportion of patients with current asthma did not live in a house with a cat or dog. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  19. Epidemiological study of risk factors in pediatric asthma | Tageldin ...

    African Journals Online (AJOL)

    Background: Childhood asthma is a major public health problem in Egypt and worldwide. Epidemiologic, physiologic, and social factors appear to be associated with an increased risk of asthma. Objective: The aim of the study was to determine the most frequent risk factors of childhood asthma exacerbation and severity in ...

  20. Preliminary study of the heating market in Sweden

    International Nuclear Information System (INIS)

    1999-01-01

    The successive deregulation of the market for electric power, in Sweden as well as abroad, results in an increased competition in generation and trade of electricity. This market that previously was known for its oligopoly in the production sector and its monopoly in the distribution sector has now been opened for competition. This study is focused on the district heating sector, because it is still comparatively unregulated, and because it partly comprises what is called natural monopolies

  1. Randomized controlled study of CBT in bronchial asthma

    Directory of Open Access Journals (Sweden)

    Grover Naveen

    2007-01-01

    Full Text Available The aim of the present study was to find out efficacy of cognitive behavior therapy, as an adjunct to standard pharmacotherapy, in bronchial asthma. In a random-ized two-group design with pre-and post assessments, forty asthma patients were randomly allotted to two groups: self management group and cognitive behavior therapy group. Both groups were exposed to 6-8 weeks of intervention, asthma self management program and cognitive behavior therapy. Assessment measures used were-Semi structured interview schedule, Asthma Symptom Checklist, Asthma di-ary, Asthma Bother Profile, Hospital Anxiety & Depression Scale, AQLQ and Peak Expiratory Flow Rate. Within group comparison showed significant improvement in both groups at the post assessment. Between group comparisons showed that CBT group reported significantly greater change than that of SM group. Cognitive behavior therapy helps in improving the managment of asthma.

  2. EU Studies in Denmark and Sweden

    DEFF Research Database (Denmark)

    Garski, Salla; Jørgensen, Knud Erik; Manners, Ian

    2012-01-01

    In this brief chapter we take stock of Danish and Swedish scholarship on the European Union (EU). We intend to analyze and evaluate Danish and Swedish scholarship on EU issues, using a mixed methodology integrated into the analysis of this chapter. The method integrates a secondary analysis...... of leading literature by Garský; an extensive comparative bibliometric survey building on Manners (2007); and the comparative assessments of EU studies by Jørgensen and Manners based on their professional experiences of EU studies across Europe. The chapter points out controversies on research perspectives......, and suggests new EU research questions that collaborative projects could address....

  3. A population-based study of animal component sensitization, asthma, and rhinitis in schoolchildren.

    Science.gov (United States)

    Bjerg, Anders; Winberg, Anna; Berthold, Malin; Mattsson, Lars; Borres, Magnus P; Rönmark, Eva

    2015-09-01

    Animal sensitization is a major determinant of asthma in children. Component-resolved studies of unselected pediatric populations are lacking. The aim was to describe sensitization to animal components and the association with asthma and rhinitis in animal-sensitized schoolchildren. A random sample of 696 children (11-12 years) from a Swedish population-based cohort was tested for sensitization to cat, dog, and horse dander using ImmunoCAP. Sera from animal-sensitized children were further analyzed by microarray including three allergen components from cat, four from dog, and two from horse. The parents completed an expanded ISAAC questionnaire. Of 259 animal-sensitized children (≥0.1 kUA /l), 51% were sensitized to all three, 23% to two, and 25% to one species. Current asthma and asthma symptoms following contact with cats were associated with co-sensitization to Fel d 1 and Fel d 4. This association was seen already at moderate-level sensitization (1-15 ISU) to Fel d 4, at which level most children were sensitized to Fel d 1, as well. In dog-sensitized children, the majority was sensitized to more than one dog component, and co-sensitization to Can f 5 and Can f 1/f 2 conferred the greatest risk for asthma. Sensitization to the highly cross-reactive serum albumins was uncommon and not associated with asthma. Among schoolchildren in northern Sweden, where mite allergy is uncommon, furry animals were the primary perennial sensitizers. Asthma was associated with higher levels of component sensitization, and sensitization to more than one component from the same animal conferred the greatest risk. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Longitudinal depression or anxiety in mothers and offspring asthma: a Swedish population-based study.

    Science.gov (United States)

    Brew, Bronwyn K; Lundholm, Cecilia; Viktorin, Alexander; Lichtenstein, Paul; Larsson, Henrik; Almqvist, Catarina

    2018-02-01

    Previous research has found that maternal stress during pregnancy increases the risk of offspring asthma. However, whether this association is consistent with a causal interpretation has never been tested. The objective is to determine whether there is a critical exposure period for maternal depression or anxiety on offspring asthma or whether cumulative exposure is most important, and to investigate evidence of confounding. The study population included all children born in Sweden from July 2006 to December 2009 (n = 360 526). Information about childhood asthma, maternal depression or anxiety (diagnosis or medication) and covariates was obtained from the Swedish national health registers. The associations between exposure periods (pre-conception, pregnancy, postnatal or current) and childhood asthma were estimated using structured life course approach hypothesis testing. Paternal and cousin analyses were used to test for evidence of confounding from shared genes and environment. For childhood asthma, cumulative exposure best described the effect of exposure to maternal depression or anxiety up to a maximum of any two exposure periods [adjusted odds ratio 1.44, 95% confidence interval (CI) 1.38, 1.52]. The hypotheses of a critical period were not supported. The paternal and cousin analyses indicated minimal influence from familial confounding. These findings support an association between cumulative exposure to maternal depression or anxiety and asthma development in offspring. This association is unique for maternal depression or anxiety and not due to familial confounding. The clinical implication is that effective psychological management of women with chronic distress may reduce offspring asthma risk. © The Author 2017; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association

  5. Air pollution and asthma control in the Epidemiological study on the Genetics and Environment of Asthma.

    Science.gov (United States)

    Jacquemin, Bénédicte; Kauffmann, Francine; Pin, Isabelle; Le Moual, Nicole; Bousquet, Jean; Gormand, Frédéric; Just, Jocelyne; Nadif, Rachel; Pison, Christophe; Vervloet, Daniel; Künzli, Nino; Siroux, Valérie

    2012-09-01

    The associations between exposure to air pollution and asthma control are not well known. The objective of this study was to assess the association between long-term exposure to NO(2), O(3) and PM(10) and asthma control in the follow-up of the Epidemiological study on the Genetics and Environment of Asthma (EGEA2) (2003-2007). Modelled outdoor NO(2), O(3) and PM(10) estimates were linked to each residential address using the 4 km grid air pollutant surface developed by the French Institute of Environment in 2004. Asthma control was assessed in 481 subjects with current asthma using a multidimensional approach following the 2006-2009 Global Initiative for Asthma guidelines. Multinomial and ordinal logistic regressions were conducted adjusted for sex, age, body mass index, education, smoking and use of inhaled corticosteroids. The association between air pollution and the three domains of asthma control (symptoms, exacerbations and lung function) was assessed. ORs are reported per IQR. Median concentrations (in micrograms per cubic metre) were 32 (IQR 25-38) for NO(2) (n=465), 46 (41-52) for O(3) and 21 (18-21) for PM(10) (n=481). In total, 44%, 29% and 27% had controlled, partly controlled and uncontrolled asthma, respectively. The ordinal ORs for O(3) and PM(10) with asthma control were 1.69 (95% CI 1.22 to 2.34) and 1.35 (95% CI 1.13 to 1.64), respectively. When including both pollutants in the same model, both associations persisted. Associations were not modified by sex, smoking status, use of inhaled corticosteroids, atopy, season of examination or body mass index. Both pollutants were associated with each of the three main domains of control. The results suggest that long-term exposure to PM(10) and O(3) is associated with uncontrolled asthma in adults, defined by symptoms, exacerbations and lung function.

  6. International Uranium Resources Evaluation Project (IUREP) national favourability studies: Sweden

    International Nuclear Information System (INIS)

    1977-11-01

    Sweden, covers an area of approx. 450 000 square kilometers. It has a population of 8 millions. With few exceptions in the northern part the access can be regarded as good. A dense network of motorroads and railroad exists. The results obtained by the exploration works combined with other available geo-information permit a separation of two principal uranium provinces in Sweden. The first one is confined to sediments of Upper Cambrian and Lower Ordovician which appears in Southern Sweden and along the border of the Caledonian mountain range in Central Sweden. The uranium occurrence are stratiform, of blackshale type which occurs in the Peltura zone of Upper Cambrian or they are associated to a phosphatite-bearing unit of Lower Ordovician overlying the Cambrian shale formation. The distribution of uranium in Upper Cambrian rocks is in general dependant on their lithology which itself is related to the paleography. This conditions explain relatively higher uranium content of the shale from Billigen.The potential resources of the province are estimated at about 1 million tonnes uranium. The second uranium province, called Arjeplog-Arvidsjaur, situated immediately south of the Arctic circle, comprises one deposit - Pleutajokk - and a group of more than twenty occurrences of similar characteristics and age (1 700 - 1 800 my.). The results of the past exploration have shown that uranium is present in different types of rocks. Because of the presence of uranium in many of the pegmatites the possibility of the formation of large low grade deposits should be tested. Favourable areas are those regions where the geological conditions are similar to the geology of the Grenville province in Canada or the Damara belt of SW-Africa. Special studies are recommended on this subject

  7. the Brandenburg asthma and allergy study – BASAL

    OpenAIRE

    Aurich, Franziska

    2014-01-01

    Background Due to their continual rise over the last decades, allergies and asthma developed into common diseases worldwide. Despite international studies such as ISAAC and ECRHS, there are still gaps in our knowledge concerning allergic diseases in certain populations. The aim of the Brandenburg Asthma and Allergy Study (BASAL) was to assess the prevalence of allergic rhinitis, bronchial asthma, atopic dermatitis, urticaria and chronic sinusitis in adults from rural, Eastern Germany. Poss...

  8. Gout in immigrant groups: a cohort study in Sweden.

    Science.gov (United States)

    Wändell, Per; Carlsson, Axel C; Li, Xinjun; Gasevic, Danijela; Ärnlöv, Johan; Holzmann, Martin J; Sundquist, Jan; Sundquist, Kristina

    2017-05-01

    Our aim was to study the association between country of birth and incidence of gout in different immigrant groups in Sweden. The study population included the whole population of Sweden. Gout was defined as having at least one registered diagnosis in the National Patient Register. The association between incidence of gout and country of birth was assessed by Cox regression, with hazard ratios (HRs) and 95% confidence intervals (95% CI), using Swedish-born individuals as referents. All models were conducted in both men and women, and the full model was adjusted for age, place of residence in Sweden, educational level, marital status, neighbourhood socio-economic status and co-morbidities. The risk of gout varied by country of origin, with highest estimates, compared to Swedish born, in fully adjusted models among men from Iraq (HR 1.82, 95% CI 1.54-2.16), and Russia (HR 1.69, 95% CI 1.26-2.27), and also high among men from Austria, Poland, Africa and Asian countries outside the Middle East; and among women from Africa (HR 2.23, 95% CI 1.50-3.31), Hungary (HR 1.98, 95% CI 1.45-2.71), Iraq (HR 1.76, 95% CI 1.13-2.74) and Austria (HR 1.70, 95% CI 1.07-2.70), and also high among women from Poland. The risk of gout was lower among men from Greece, Spain, Nordic countries (except Finland) and Latin America and among women from Southern Europe, compared to their Swedish counterparts. The increased risk of gout among several immigrant groups is likely explained by a high cardio-metabolic risk factor pattern needing attention.

  9. Multiancestry association study identifies new asthma risk loci that colocalize with immune-cell enhancer marks

    NARCIS (Netherlands)

    Demenais, Florence; Margaritte-Jeannin, Patricia; Barnes, Kathleen C; Cookson, William O C; Altmüller, Janine; Ang, Wei; Barr, R Graham; Beaty, Terri H; Becker, Allan B; Beilby, John; Bisgaard, Hans; Bjornsdottir, Unnur Steina; Bleecker, Eugene; Bønnelykke, Klaus; Boomsma, Dorret I; Bouzigon, Emmanuelle; Brightling, Christopher E; Brossard, Myriam; Brusselle, Guy G; Burchard, Esteban; Burkart, Kristin M; Bush, Andrew; Chan-Yeung, Moira; Chung, Kian Fan; Couto Alves, Alexessander; Curtin, John A; Custovic, Adnan; Daley, Denise; de Jongste, Johan C; Del-Rio-Navarro, Blanca E; Donohue, Kathleen M; Duijts, Liesbeth; Eng, Celeste; Eriksson, Johan G; Farrall, Martin; Fedorova, Yuliya; Feenstra, Bjarke; Ferreira, Manuel A; Freidin, Maxim B; Gajdos, Zofia; Gauderman, Jim; Gehring, Ulrike; Geller, Frank; Genuneit, Jon; Gharib, Sina A; Gilliland, Frank; Granell, Raquel; Graves, Penelope E; Gudbjartsson, Daniel F; Haahtela, Tari; Heckbert, Susan R; Heederik, Dick; Heinrich, Joachim; Heliövaara, Markku; Henderson, John; Himes, Blanca E; Hirose, Hiroshi; Hirschhorn, Joel N; Hofman, Albert; Holt, Patrick; Hottenga, Jouke; Hudson, Thomas J; Hui, Jennie; Imboden, Medea; Ivanov, Vladimir; Jaddoe, Vincent W V; James, Alan; Janson, Christer; Jarvelin, Marjo-Riitta; Jarvis, Deborah; Jones, Graham; Jonsdottir, Ingileif; Jousilahti, Pekka; Kabesch, Michael; Kähönen, Mika; Kantor, David B; Karunas, Alexandra S; Khusnutdinova, Elza; Koppelman, Gerard H; Kozyrskyj, Anita L; Kreiner, Eskil; Kubo, Michiaki; Kumar, Rajesh; Kumar, Ashish; Kuokkanen, Mikko; Lahousse, Lies; Laitinen, Tarja; Laprise, Catherine; Lathrop, Mark; Lau, Susanne; Lee, Young-Ae; Lehtimäki, Terho; Letort, Sébastien; Levin, Albert M; Li, Guo; Liang, Liming; Loehr, Laura R; London, Stephanie J; Loth, Daan W; Manichaikul, Ani; Marenholz, Ingo; Martinez, Fernando J; Matheson, Melanie C; Mathias, Rasika A; Matsumoto, Kenji; Mbarek, Hamdi; McArdle, Wendy L; Melbye, Mads; Melén, Erik; Meyers, Deborah; Michel, Sven; Mohamdi, Hamida; Musk, Arthur W; Myers, Rachel A; Nieuwenhuis, Maartje A E; Noguchi, Emiko; O'Connor, George T; Ogorodova, Ludmila M; Palmer, Cameron D; Palotie, Aarno; Park, Julie E; Pennell, Craig E; Pershagen, Göran; Polonikov, Alexey; Postma, Dirkje S; Probst-Hensch, Nicole; Puzyrev, Valery P; Raby, Benjamin A; Raitakari, Olli T; Ramasamy, Adaikalavan; Rich, Stephen S; Robertson, Colin F; Romieu, Isabelle; Salam, Muhammad T; Salomaa, Veikko; Schlünssen, Vivi; Scott, Robert; Selivanova, Polina A; Sigsgaard, Torben; Simpson, Angela; Siroux, Valérie; Smith, Lewis J; Solodilova, Maria; Standl, Marie; Stefansson, Kari; Strachan, David P; Stricker, Bruno H; Takahashi, Atsushi; Thompson, Philip J; Thorleifsson, Gudmar; Thorsteinsdottir, Unnur; Tiesler, Carla M T; Torgerson, Dara G; Tsunoda, Tatsuhiko; Uitterlinden, André G; van der Valk, Ralf J P; Vaysse, Amaury; Vedantam, Sailaja; von Berg, Andrea; von Mutius, Erika; Vonk, Judith M; Waage, Johannes; Wareham, Nick J; Weiss, Scott T; White, Wendy B; Wickman, Magnus; Widén, Elisabeth; Willemsen, Gonneke; Williams, L Keoki; Wouters, Inge M; Yang, James J; Zhao, Jing Hua; Moffatt, Miriam F; Ober, Carole; Nicolae, Dan L

    We examined common variation in asthma risk by conducting a meta-analysis of worldwide asthma genome-wide association studies (23,948 asthma cases, 118,538 controls) of individuals from ethnically diverse populations. We identified five new asthma loci, found two new associations at two known asthma

  10. Epidemiological study of risk factors in pediatric asthma

    African Journals Online (AJOL)

    EL-HAKIM

    Epidemiologic, physiologic, and social factors appear to be associated with an increased risk of asthma. Objective: The aim of the study was to determine the most frequent risk factors of childhood asthma exacerbation and severity in our community. Methods: This cross sectional study involved 206 asthmatic children, 5 to ...

  11. A review of epidemiological studies of asthma in Ghana | Amoah ...

    African Journals Online (AJOL)

    Results: Asthma research in Ghana has focused mainly on children between the ages of 5-16 years with one published study that included adults. Different markers for the disease have been used such as cliniciandiagnosed asthma, exercise-induced bronchospasm (EIB) as well as questionnaire-derived symptoms of ...

  12. Epidemiological study of school performance and asthma ...

    African Journals Online (AJOL)

    Ehab

    in the proportion of the world's population that is urban from 45% to 59% in 2025, there will likely be a marked increase in the number of asthmatics worldwide over the next two decades. It is estimated that there may be an additional 100 million persons with asthma by 2025. 1. It is estimated that asthma accounts for about 1.

  13. Genome-wide association studies in asthma: progress and pitfalls

    Directory of Open Access Journals (Sweden)

    March ME

    2015-01-01

    Full Text Available Michael E March,1 Patrick MA Sleiman,1,2 Hakon Hakonarson1,2 1Center for Applied Genomics, Children's Hospital of Philadelphia Research Institute, 2Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Abstract: Genetic studies of asthma have revealed that there is considerable heritability to the phenotype. An extensive history of candidate-gene studies has identified a long list of genes associated with immune function that are potentially involved in asthma pathogenesis. However, many of the results of candidate-gene studies have failed to be replicated, leaving in question the true impact of the implicated biological pathways on asthma. With the advent of genome-wide association studies, geneticists are able to examine the association of hundreds of thousands of genetic markers with a phenotype, allowing the hypothesis-free identification of variants associated with disease. Many such studies examining asthma or related phenotypes have been published, and several themes have begun to emerge regarding the biological pathways underpinning asthma. The results of many genome-wide association studies have currently not been replicated, and the large sample sizes required for this experimental strategy invoke difficulties with sample stratification and phenotypic heterogeneity. Recently, large collaborative groups of researchers have formed consortia focused on asthma, with the goals of sharing material and data and standardizing diagnosis and experimental methods. Additionally, research has begun to focus on genetic variants that affect the response to asthma medications and on the biology that generates the heterogeneity in the asthma phenotype. As this work progresses, it will move asthma patients closer to more specific, personalized medicine. Keywords: asthma, genetics, GWAS, pharmacogenetics, biomarkers

  14. The Child and Adolescent Twin Study in Sweden (CATSS).

    Science.gov (United States)

    Anckarsäter, Henrik; Lundström, Sebastian; Kollberg, Linnea; Kerekes, Nora; Palm, Camilla; Carlström, Eva; Långström, Niklas; Magnusson, Patrik K E; Halldner, Linda; Bölte, Sven; Gillberg, Christopher; Gumpert, Clara; Råstam, Maria; Lichtenstein, Paul

    2011-12-01

    The Child and Adolescent Twin Study in Sweden (CATSS) is an ongoing longitudinal twin study targeting all twins born in Sweden since July 1, 1992. Since 2004, parents of twins are interviewed regarding the children's somatic and mental health and social environment in connection with their 9th or 12th birthdays (CATSS-9/12). By January 2010, 8,610 parental interviews concerning 17,220 twins had been completed, with an overall response rate of 80%. At age 15 (CATSS-15) and 18 (CATSS-18), twins and parents complete questionnaires that, in addition to assessments of somatic and mental health, include measures of personality development and psychosocial adaptation. Twin pairs in CATSS-9/12 with one or both twins screening positive for autism spectrum disorders, attention deficit/hyperactivity disorder, tic disorders, developmental coordination disorder, learning disorders, oppositional defiant disorder, conduct disorder, obsessive-compulsive disorder, and/or eating problems have been followed with in-depth questionnaires on family, social environment and personality, and subsequently by clinical assessments at age 15 together with randomly selected population controls, including 195 clinically assessed twin pairs from the first 2 year cohorts (CATSS-15/DOGSS). This article describes the cohorts and study groups, data collection, and measures used. Prevalences, distributions, heritability estimates, ages at onset, and sex differences of mental health problems in the CATSS-9/12, that were analyzed and found to be overall comparable to those of other clinical and epidemiological studies. The CATSS study has the potential of answering important questions on the etiology of childhood mental health problems and their role in the development of later adjustment problems.

  15. Multiancestry association study identifies new asthma risk loci that colocalize with immune-cell enhancer marks

    DEFF Research Database (Denmark)

    Demenais, Florence; Margaritte-Jeannin, Patricia; Barnes, Kathleen C

    2018-01-01

    We examined common variation in asthma risk by conducting a meta-analysis of worldwide asthma genome-wide association studies (23,948 asthma cases, 118,538 controls) of individuals from ethnically diverse populations. We identified five new asthma loci, found two new associations at two known...... asthma loci, established asthma associations at two loci previously implicated in the comorbidity of asthma plus hay fever, and confirmed nine known loci. Investigation of pleiotropy showed large overlaps in genetic variants with autoimmune and inflammatory diseases. The enrichment in enhancer marks...... at asthma risk loci, especially in immune cells, suggested a major role of these loci in the regulation of immunologically related mechanisms....

  16. European birth cohort studies on asthma and atopic diseases I

    DEFF Research Database (Denmark)

    Keil, T; Kulig, M; Simpson, A

    2006-01-01

    initiated over the last two decades. AIM: One of the work packages within the Global Allergy and Asthma European Network (GA(2)LEN) project was designed to identify and compare European birth cohorts on asthma and atopic diseases. The present review (part I) describes their objectives, study settings......, outcome and exposure parameters at each time point. RESULTS: We identified and assessed 18 European birth cohorts on asthma, allergic rhinitis and eczema. Six of these studies also focused on food allergies. The birth cohorts were mostly initiated in the 1990s with predominantly urban...

  17. Asthma control and productivity loss in those with work-related asthma: A population-based study.

    Science.gov (United States)

    Wong, Alyson; Tavakoli, Hamid; Sadatsafavi, Mohsen; Carlsten, Chris; FitzGerald, J Mark

    2017-06-01

    In Canada, asthma is the third leading cause of work loss, yet little is known about the associated productivity loss. The goal of this study was to look at the relationship between asthma control and productivity loss, particularly contrasting those with work-related asthma (WRA) and non-work-related asthma (NWRA). A population-based random sample of adults with asthma in British Columbia, Canada, was prospectively recruited. Asthma control was graded according to Global Initiative for Asthma classification, while productivity loss and presence of WRA was assessed using questionnaires. Ordinal regression models were then used to associate WRA with asthma control. Generalized linear models were applied to estimate the average productivity loss associated with different levels of asthma control among those with WRA and NWRA. The study included 300 employed adults. Sixty (20%) had WRA. The odds of being controlled were significantly lower in those with WRA (OR = 0.23, 95% CI: 0.09, 0.56; P productivity loss due to presenteeism ($659.1 [95% CI: 12.9, 1581.5; P = 0.04]), but not absenteeism ($88.7 [95% CI: -86.5, 279.6; P = 0.35]), when compared to those with NWRA and uncontrolled asthma. There was no significant difference when a similar comparison was made for those with controlled or partially controlled asthma. WRA is associated with worse asthma control and increased productivity loss. Presenteeism makes a significant contribution to productivity loss and should be considered when evaluating the overall economic burden of asthma, particularly WRA.

  18. Oxidative stress biomarkers and asthma characteristics in adults of the EGEA study.

    Science.gov (United States)

    Andrianjafimasy, Miora; Zerimech, Farid; Akiki, Zeina; Huyvaert, Helene; Le Moual, Nicole; Siroux, Valérie; Matran, Régis; Dumas, Orianne; Nadif, Rachel

    2017-12-01

    Asthma is an oxidative stress related disease, but associations with asthma outcomes are poorly studied in adults. We aimed to study the associations between several biomarkers related to oxidative stress and various asthma outcomes.Cross-sectional analyses were conducted in 1388 adults (mean age 43 years, 44% with asthma) from the Epidemiological Study of the Genetics and Environment of Asthma (EGEA2). Three blood antioxidant enzyme activities (biomarkers of response to oxidative stress) and exhaled breath condensate 8-isoprostanes and plasma fluorescent oxidation products (FlOPs) levels (two biomarkers of damage) were measured. Associations between biomarkers and 1) ever asthma and 2) asthma attacks, asthma control and lung function in participants with asthma were evaluated using regression models adjusted for age, sex and smoking.Biomarkers of response were unrelated to asthma outcomes. Higher 8-isoprostane levels were significantly associated with ever asthma (odds ratio for one interquartile range increase 1.28 (95% CI 1.06-1.67). Among participants with asthma, 8-isoprostane levels were negatively associated with adult-onset asthma (0.63, 0.41-0.97) and FlOPs levels were positively associated with asthma attacks (1.33, 1.07-1.65), poor asthma control (1.30, 1.02-1.66) and poor lung function (1.34, 1.04-1.74).Our results suggest that 8-isoprostanes are involved in childhood-onset asthma and FlOPs are linked to asthma expression. Copyright ©ERS 2017.

  19. Risk factors of asthma exacerbation based on asthma severity: a nationwide population-based observational study in South Korea.

    Science.gov (United States)

    Kang, Hye-Rim; Song, Hyun Jin; Nam, Jin Hyun; Hong, Sung-Hyun; Yang, So-Young; Ju, SangEun; Lee, Sang Won; Kim, Tae-Bum; Kim, Hye-Lin; Lee, Eui-Kyung

    2018-03-22

    Asthma exacerbation, associated with many risks factors, can reflect management failure. However, little is known about how risk factors are associated with exacerbation, according to asthma severity. We aimed to investigate differences in risk factors in patients with different asthma severity and evaluate whether risk factors differed between frequent exacerbators and patients with single exacerbation. Nationwide population-based observational study. Korean National Sample Cohort database. We included 22 130 adults with asthma diagnoses more than twice (ICD-10 (International Classification of Diseases, Tenth revision) codes J45 and J46) and one prescription for asthma medication from 2010 to 2011. Asthma exacerbation was defined as having a corticosteroid (CS) burst characterised by a prescription of high-dose oral CS for ≥3 days or one systemic CS injection, hospitalisation or emergency department visit. Among severities, history of CS bursts was significantly associated with exacerbation. In mild and moderate asthma, exacerbation was significantly associated with age ≥45 years, being female, gastro-oesophageal reflux disease and chronic rhinitis. High medication possession ratio (MPR≥50%), compared with low MPR (factors in mild and moderate asthma, whereas no risk factors were significant in severe asthma. Different associations between risk factors and asthma exacerbations based on asthma severity suggest that patients with mild asthma require greater attention to their age and comorbidities, whereas those with severe asthma require greater attention to hospitalisation history and drug adherence. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. A Critical Study of Informal New Media Uses in Sweden

    Directory of Open Access Journals (Sweden)

    Yiannis Mylonas

    2014-10-01

    Full Text Available This study looks at a variety of "informal" uses of new media and ICTs. The term informal describes popular uses of digital technologies that often exist outside the norms, laws, and codes that dictate how digital technologies and networks are to be used. Such activities include what is commonly described as "piracy," but also embrace different peer-to-peer practices. Informal activities develop due to the affordances of digital technologies, which allow space for creativity and personalization of use, but are also due to broader sociocultural variables and contextual issues. In general terms, informal activities are those that concern the amateur activities of people using digital programs, tools, and networks. Media scholars see great potential in new media/ICT affordances, as related to the proliferation of grassroots participation, communication, and creativity. Nevertheless, a growing critical literature forces us to examine the actualization of such potential. This paper discusses the aforementioned issues by looking at new media/ICT uses in Sweden; it departs from critical perspectives that take into consideration the political economy of new media, and the cultural-political critiques of late-modern consumer societies.

  1. Sweden - Physics in Sweden

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    In its continual monitoring of physics in its Member States, the European Committee for Future Accelerators (ECFA) recently visited Sweden, where it met at the University of Lund in September. Physics in Sweden is flourishing, with both a long CERN tradition and excellent prospects for future collaboration. On the experimental side, about 80 researchers, including about 30 graduate students, out of a total of 110 (including 50 graduate students), concentrate on CERN for their work. The main centres of experimental activity are: Chalmers- Goteborg; Lund (particle physics and relativistic heavy ion groups), the Royal Institute of Technology - KTH - Stockholm, the University of Stockholm, and Uppsala. Engineering support staff in particle and highenergy nuclear physics number about 25. There is a strong Swedish participation (34 researchers from Lund, Stockholm, and Uppsala) in the Delphi experiment at LEP with a full commitment to higher energy running at LEP2, in the CP-LEAR experiment, JETSET studies at the LEAR low energy antiproton ring and in a LEAR hyperon experiment. Sweden is also well represented in CERN's extensive programme of nuclear and heavy ion physics, with 12 researchers active in the heavy ion programme, and a contingent in the SMC muon beam experiment. The strong Swedish interest in CERN's heavy ion programme was underlined by a special national contribution of 1.5M Swiss francs to the new lead ion injector. At lower energies, there is also good Swedish participation (mainly from the Chalmers Institute) in the Isolde online isotope separator. The national physics community has always appreciated CERN's diversified programmes and has greatly benefited as a result. For the future, there is an important involvement (some 40 physicists) in the ATLAS experiment at CERN's LHC collider. Swedish groups have been active in 11 research and development project for LHC physics. Sweden's heavy ion activity will continue at the RHIC

  2. Sweden and the NEGP: A Pilot Study of the North European Gas Pipeline and Sweden's Dependence on Russian Energy

    International Nuclear Information System (INIS)

    Larsson, Robert L.

    2006-06-01

    Developments between 2004 and 2006 indicate that a North European Gas Pipeline (NEGP) through the Baltic Sea, from Russia to Germany, may be realised in the coming decade. This would provide Europe with yet another opportunity to diversify its import channels of gas. It is however reasonable to assume that the NEGP also could change the strategic pattern and be a source of friction. The NEGP may rock the regional stability and reduce the potential of the new EU members to become security providers in Europe's northern dimension. It also gives increased leverage and influence to Russia, a state that has moved in an authoritarian direction under President Putin. The aim of this pilot study is to elucidate on the NEGP pipeline and Sweden's increasing dependence on Russian energy. A subsidiary aim is to outline a set of concerns that have bearing on the situation for the EU and Baltic Sea Region and that need to be further addressed. In conclusion, the NEGP will enhance Russia's direct leverage on Poland, Ukraine, and Belarus, as it will allow Russia to turn off gas supplies without affecting exports to other parts of Europe. Russia will also increase its leverage over the states that will or may be connected to the NEGP (Germany, and possibly Belgium, Denmark, the Netherlands and the UK). Even if Sweden is not embracing the NEGP, it is today highly sensitive as it imports most of its energy. It is increasingly dependent on Russian oil and is partly dependent on imports of electricity from Russia. Should the NEGP materialise and Sweden becomes connected in the future, it would likely be dependent also on natural gas. It is of paramount importance for the energy security of the connected states how the pipeline is constructed and operated. If there will be technical possibilities for Russia to tamper with the flow of gas to individual states without affecting supply to others, there are tangible threats to the importing states

  3. Moisture damage and asthma: a birth cohort study.

    Science.gov (United States)

    Karvonen, Anne M; Hyvärinen, Anne; Korppi, Matti; Haverinen-Shaughnessy, Ulla; Renz, Harald; Pfefferle, Petra I; Remes, Sami; Genuneit, Jon; Pekkanen, Juha

    2015-03-01

    Excess moisture and visible mold are associated with increased risk of asthma. Only a few studies have performed detailed home visits to characterize the extent and location of moisture damage and mold growth. Structured home inspections were performed in a birth cohort study when the children were 5 months old (on average). Children (N = 398) were followed up to the age of 6 years. Specific immunoglobulin E concentrations were determined at 6 years. Moisture damage and mold at an early age in the child's main living areas (but not in bathrooms or other interior spaces) were associated with the risk of developing physician-diagnosed asthma ever, persistent asthma, and respiratory symptoms during the first 6 years. Associations with asthma ever were strongest for moisture damage with visible mold in the child's bedroom (adjusted odds ratio: 4.82 [95% confidence interval: 1.29-18.02]) and in the living room (adjusted odds ratio: 7.51 [95% confidence interval: 1.49-37.83]). Associations with asthma ever were stronger in the earlier part of the follow-up and among atopic children. No consistent associations were found between moisture damage with or without visible mold and atopic sensitization. Moisture damage and mold in early infancy in the child's main living areas were associated with asthma development. Atopic children may be more susceptible to the effects of moisture damage and mold. Copyright © 2015 by the American Academy of Pediatrics.

  4. Incident asthma and Mycoplasma pneumoniae: A nationwide cohort study.

    Science.gov (United States)

    Yeh, Jun-Jun; Wang, Yu-Chiao; Hsu, Wu-Huei; Kao, Chia-Hung

    2016-04-01

    Previous studies investigating the relationship between Mycoplasma pneumoniae and incident asthma in the general population have been inconclusive. We conducted a nationwide cohort study to clarify this relationship. Using the National Health Insurance Research Database of Taiwan, we identified 1591 patients with M pneumoniae infection (International Classification of Diseases, Ninth Revision, Clinical Modification code 4830) given diagnoses between 2000 and 2008. We then frequency matched 6364 patients without M pneumoniae infection from the general population according to age, sex, and index year. Cox proportional hazards regression analysis was performed to determine the adjusted hazard ratio (aHR) of the occurrence of asthma in the M pneumoniae cohort compared with that in the non-M pneumoniae cohort. Regardless of comorbidities and the use of antibiotic or steroid therapies, patients with M pneumonia infection had a higher risk of incident asthma than those without it. The aHR of asthma was 3.35 (95% CI, 2.71-4.15) for the M pneumoniae cohort, with a significantly higher risk when patients were stratified by age, sex, follow-up time, and comorbidities, including allergic rhinitis, atopic dermatitis, or allergic conjunctivitis. Patients with M pneumoniae infection had a higher risk of having early-onset (age, incident cases of early-onset and late-onset asthma are closely related to M pneumoniae infection, even in nonatopic patients. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  5. Traffic noise and cardiovascular health in Sweden: The roadside study

    Directory of Open Access Journals (Sweden)

    Charlotta Eriksson

    2012-01-01

    Full Text Available Long-term exposure to traffic noise has been suggested to increase the risk of cardiovascular diseases (CVD. However, few studies have been performed in the general population and on railway noise. This study aimed to investigate the cardiovascular effects of living near noisy roads and railways. This cross-sectional study comprised 25,851 men and women, aged 18-80 years, who had resided in Sweden for at least 5 years. All subjects participated in a National Environmental Health Survey, performed in 2007, in which they reported on health, annoyance reactions and environmental factors. Questionnaire data on self-reported doctor′s diagnosis of hypertension and/or CVD were used as outcomes. Exposure was assessed as Traffic Load (millions of vehicle kilometres per year within 500 m around each participant′s residential address. For a sub-population (n = 2498, we also assessed road traffic and railway noise in L den at the dwelling façade. Multiple logistic regression models were used to assess Prevalence Odds Ratios (POR and 95% Confidence Intervals (CI. No statistically significant associations were found between Traffic Load and self-reported hypertension or CVD. In the sub-population, there was no association between road traffic noise and the outcomes; however, an increased risk of CVD was suggested among subjects exposed to railway noise ≥50 dB(A; POR 1.55 (95% CI 1.00-2.40. Neither Traffic Load nor road traffic noise was, in this study, associated with self-reported cardiovascular outcomes. However, there was a borderline-significant association between railway noise and CVD. The lack of association for road traffic may be due to methodological limitations.

  6. Asthma Insights and Management in India: Lessons Learnt from the Asia Pacific - Asthma Insights and Management (AP-AIM) Study.

    Science.gov (United States)

    Salvi, Sundeep S; Apte, Komalkirti K; Dhar, Raja; Shetty, Pradeep; Faruqi, Rab A; Thompson, Philip J; Guleria, Randeep

    2015-09-01

    Despite a better understanding of the pathophysiology of asthma, presence of reliable diagnostic tools, availability of a wide array of effective and affordable inhaled drugs and simplified national and international asthma management guidelines, asthma remains poorly managed in India. The Asia-Pacific Asthma Insight and Management (AP-AIM) study was aimed at understanding the characteristics of asthma, current management, level of asthma control and its impact on quality of life across Australia, China, Hong Kong, India, Malaysia, Singapore, South Korea, Taiwan and Thailand. This paper describes the results of asthma management issues in India in detail and provides a unique insight into asthma in India. The AP-AIM India study was conducted in eight urban cities in India, viz: Ajmer, Delhi, Kolkata, Rourkela, Chennai, Mangalore, Mumbai and Rajkot from February to July 2011. Face-to-face interviews were conducted in adult asthmatics and parents of asthmatic children between the ages of 12 and 17 years with a confirmed diagnosis or a treatment history of 1 year for asthma. Four hundred asthmatics (M:F::1:1.273), with a mean age of 50 ± 17.8 years, from across India were studied. 91% of the asthmatics in India perceived their asthma to be under control, however, none of the asthmatics had controlled asthma by objective measures. Asthmatics in India believed that their asthma was under control if they have up to 2 emergency doctor visits a year. The quality of life of these patients was significantly affected with 93% school/work absenteeism and a loss of 50% productivity. Seventy-five percent of the asthmatics have never had a lung function test. The common triggers for asthmatics in India were dust (49%) and air pollution (49%), while only 5% reported of pollen as triggers. Eighty-nine percent of Indian asthmatics reported an average use of oral steroids 10.5 times a year. Only 36% and 50% of Indian asthmatics used controller and rescue inhalers with a majority

  7. Changes in asthma control, work productivity, and impairment with omalizumab: 5-year EXCELS study results.

    Science.gov (United States)

    Zazzali, James L; Raimundo, Karina P; Trzaskoma, Benjamin; Rosén, Karin E; Schatz, Michael

    2015-01-01

    Asthma poses a significant disease burden worldwide. Current guidelines emphasize achieving and maintaining asthma control. To describe longitudinal changes of asthma control and asthma-related work, school, and activity impairment for patients with moderate-to-severe asthma treated with omalizumab and those who did not receive omalizumab in a real-world setting. This study used 5 years of data from patients ages ≥12 years old with moderate-to-severe persistent allergic asthma who were enrolled in the Evaluating Clinical Effectiveness and Long-term Safety in Patients with Moderate-to-Severe Asthma observational study. Asthma control was assessed with the Asthma Control Test for 5 years, and asthma-related work, school, and activity impairment was measured with the Work Productivity/Activity Impairment-Asthma questionnaire for the first 2 years. The percentage of patients treated with omalizumab (n = 4930) and with well-controlled asthma (Asthma Control Test score, >20) increased from 45% at baseline to 61% at month 60, and it was 49% (baseline) and 67% (month 60) for the non-omalizumab-treated cohort (n = 2779). For new starters to omalizumab (n = 576), the percentage with well-controlled asthma increased from 25% at baseline to 51% at month 6, and to 60% at month 60. Patients in the omalizumab-treated cohort and those in the non-omalizumab-treated cohort experienced a reduction in asthma-related work, school, and activity impairment. The amount of improvement in asthma control achieved and the reduction in asthma-related work, school, and activity impairment were similar, regardless of asthma severity. On average, patients in the Evaluating Clinical Effectiveness and Long-term Safety in Patients with Moderate-to-Severe Asthma observational study who initiated omalizumab experienced clinically significant improvement in asthma control, which was observed within 6 months and persisted for 5 years.

  8. Asthma, tobacco smoke and the indoor environment: a qualitative study of sheltered homeless families.

    Science.gov (United States)

    Buu, MyMy C; Carter, Laura; Bruce, Janine S; Baca, Elizabeth A; Greenberg, Brian; Chamberlain, Lisa J

    2014-03-01

    Asthma is common in homeless children with an incidence of 28-40%. There are few published studies investigating asthma in homeless children. This study examines the perspectives of both caregivers and shelter staff regarding challenges and opportunities of caring for children with asthma. A focus group of sheltered parents (n = 10) with children who have asthma was conducted to identify barriers to optimal asthma management. Key informant interviews (n = 6) were conducted with shelter staff to discuss the shelter systems and policies to address childhood asthma. Data were audio-recorded and transcribed. A representative analysis team performed qualitative theme analysis. Key themes across 5 domains were identified: asthma education, access to asthma medication and equipment, asthma action plans, structural barriers to asthma management and environmental triggers. Parents identified multiple asthma triggers present in the shelter environment but cited lack of control as a barrier to remediation. Shelter staff desired elimination of asthma triggers but refer to the lack of resources as the primary barrier. Shelter staff favored a smoking ban on shelter property but named challenges to policy implementation. Both parents and staff identified asthma education and increased access to medications would be helpful. Policies to reduce environmental exposures, such as a smoking ban, to asthma triggers has the potential to improve the health of sheltered children with asthma.

  9. Work stress, asthma control and asthma-specific quality of life: Initial evidence from a cross-sectional study.

    Science.gov (United States)

    Hartmann, Bettina; Leucht, Verena; Loerbroks, Adrian

    2017-03-01

    Research has suggested that psychological stress is positively associated with asthma morbidity. One major source of stress in adulthood is one's occupation. However, to date, potential links of work stress with asthma control or asthma-specific quality of life have not been examined. We aimed to address this knowledge gap. In 2014/2015, we conducted a cross-sectional study among adults with asthma in Germany (n = 362). For the current analyses that sample was restricted to participants in employment and reporting to have never been diagnosed with chronic obstructive pulmonary disease (n = 94). Work stress was operationalized by the 16-item effort-reward-imbalance (ERI) questionnaire, which measures the subcomponents "effort", "reward" and "overcommitment." Participants further completed the Asthma Control Test and the Asthma Quality of Life Questionnaire-Sydney. Multivariable associations were quantified by linear regression and logistic regression. Effort, reward and their ratio (i.e. ERI ratio) did not show meaningful associations with asthma morbidity. By contrast, increasing levels of overcommitment were associated with poorer asthma control and worse quality of life in both linear regression (ß = -0.26, p = 0.01 and ß = 0.44, p life. Longitudinal studies with larger samples are needed to confirm our findings and to disentangle the potential causality of associations.

  10. Decisional conflict in asthma patients: a cross sectional study.

    Science.gov (United States)

    Des Cormiers, Annick; Légaré, France; Simard, Serge; Boulet, Louis-Philippe

    2015-01-01

    This study aimed at determining the level of decisional conflict in asthmatic individuals facing recommendation-based decisions provided to improve asthma control. This was a cross-sectional study performed on a convenience sample of 50 adults aged between 18 and 65 years with a diagnosis of asthma. They completed a decisional conflict scale (possible range of 0-100%), asthma knowledge and control questionnaires (both 0% and 100%), and a general questionnaire on socio-demographic characteristics. A decisional conflict was considered clinically significant with a score greater than 37.5%. Simple descriptive statistics were used to investigate associations with decisional conflict. Participants were mainly women (76%) and diagnosed with mild asthma (72%). The median age (1st and 3rd quartile) was 25 years (22 and 42). The median score (1st and 3rd quartile) of decisional conflict was 33% (24 and 44). A clinically significant score (>37.5%) was obtained in 36% of subjects. A statistically significant negative correlation between the knowledge score and the decisional conflict score (r(p) = -0.38; p = 0.006) was observed. The level of knowledge was the only statistically independent variable associated with the decisional conflict score (p = 0.0043). A considerable proportion of patients with asthma have a clinically significant level of decisional conflict when facing decisions aimed at improving asthma control. Patients with poor knowledge of asthma are more at risk of clinically significant level of decisional conflict. These findings support the relevance of providing asthmatic patients with relevant information in decision aids.

  11. Economic burden of asthma in Abu Dhabi: a retrospective study.

    Science.gov (United States)

    Alzaabi, Ashraf; Alseiari, Mohammed; Mahboub, Bassam

    2014-01-01

    This study evaluates the direct costs of treating asthma in Abu Dhabi in the United Arab Emirates. Data was compiled for 2011 from health insurance claims covering all medical interventions or treatments coded as asthma. Costs were calculated from a health care perspective. The total direct cost of treating 139,092 asthma patients was estimated to be United Arab Emirates Dirhams (AED) 105 million (US$29 million), corresponding to around AED 750 per patient per annum. The total cost is principally generated by outpatient visits (>AED 85 million; 81% of the total cost). Ten point four percent of patients had made an emergency room visit. The cost per visit seems to be higher during hospital admissions (AED 7,123) compared to outpatient visits and emergency room visits. The direct cost of asthma medications was around AED 33 million (31% of the total cost). The economic burden of asthma in Abu Dhabi is high and the number of emergency visits suggests that the disease is not optimally controlled.

  12. The Copenhagen Prospective Study on Asthma in Childhood (COPSAC)

    DEFF Research Database (Denmark)

    Bisgaard, Hans

    2004-01-01

    BACKGROUND: The atopic diseases asthma, atopic dermatitis, and allergic rhinitis are the most common chronic diseases in children, and their prevalence has increased recently in industrialized nations. Little is known about the genetic-environmental interaction factors driving such proliferation....... OBJECTIVE: To investigate the relationships among genetic, environmental, and lifestyle factors in the development of atopic diseases in high-risk children with the aim of developing evidence-based prevention strategies. METHODS: The Copenhagen Prospective Study on Asthma in Childhood is a single......-center, birth cohort study of children of asthmatic mothers. Objective assessments begin at birth, with scheduled visits every 6 months and when acute symptoms manifest. Clinical outcomes comprise preasthma, asthma, atopic dermatitis, allergic rhinitis, allergy, lung function, and bronchial responsiveness...

  13. Asthma Status and Risk of Incident Myocardial Infarction: A Population-Based Case-Control Study.

    Science.gov (United States)

    Bang, Duk Won; Wi, Chung-Il; Kim, Eun Na; Hagan, John; Roger, Veronique; Manemann, Sheila; Lahr, Brian; Ryu, Euijung; Juhn, Young J

    2016-01-01

    The role of asthma status and characteristics of asthma in the risk of myocardial infarction (MI) are poorly understood. We determined whether asthma and its characteristics are associated with risk of MI. The study was designed as a population-based retrospective case-control study, which included all eligible incident MI cases between November 1, 2002, and May 31, 2006, and their matched controls. Asthma was ascertained using predetermined criteria. Active (current) asthma was defined as the occurrence of asthma-related episodes (asthma symptoms, use of asthma medications, unscheduled medical or emergency department visit, or hospitalization for asthma) within 1 year before MI index date. There were 543 eligible incident MI cases during the study period. Of the 543 MI cases, 81 (15%) had a history of asthma before index date of MI, whereas 52 of 543 controls (10%) had such a history (adjusted odds ratio [OR]: 1.68; 95% CI: 1.06-2.66) adjusting for risk factors for MI and comorbid conditions (excluding chronic obstructive lung disease). Although inactive asthma did not increase the risk of MI, individuals with active asthma had a higher odds of MI, compared with those without asthma (adjusted OR: 3.18; 95% CI: 1.57-6.44) without controlling for chronic obstructive pulmonary disease (COPD). After adjusting for COPD, although asthma overall was no longer statistically significant (adjusted OR: 1.34, 95% CI: 0.84-2.15), active asthma still was associated (adjusted OR: 2.33, 95% CI: 1.12-4.82). Active asthma is an unrecognized risk factor for MI. Further studies are needed to assess the role of asthma control and medications in the risk of MI. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  14. The Copenhagen Prospective Study on Asthma in Childhood (COPSAC)

    DEFF Research Database (Denmark)

    Bisgaard, Hans

    2004-01-01

    BACKGROUND: The atopic diseases asthma, atopic dermatitis, and allergic rhinitis are the most common chronic diseases in children, and their prevalence has increased recently in industrialized nations. Little is known about the genetic-environmental interaction factors driving such proliferation....... OBJECTIVE: To investigate the relationships among genetic, environmental, and lifestyle factors in the development of atopic diseases in high-risk children with the aim of developing evidence-based prevention strategies. METHODS: The Copenhagen Prospective Study on Asthma in Childhood is a single...

  15. Predicting asthma in preschool children with asthma symptoms: study rationale and design

    NARCIS (Netherlands)

    E.H.D. Hafkamp-De Groen (Esther); H.F. Lingsma (Hester); D. Caudri (Daan); A.H. Wijga (Alet); V.W.V. Jaddoe (Vincent); E.W. Steyerberg (Ewout); J.C. de Jongste (Johan); H. Raat (Hein)

    2012-01-01

    textabstractBackground: In well-child care it is difficult to determine whether preschool children with asthma symptoms actually have or will develop asthma at school age. The PIAMA (Prevention and Incidence of Asthma and Mite Allergy) Risk Score has been proposed as an instrument that predicts

  16. Asthma characteristics and biomarkers from the Airways Disease Endotyping for Personalized Therapeutics (ADEPT) longitudinal profiling study

    DEFF Research Database (Denmark)

    Silkoff, P E; Strambu, I; Laviolette, M

    2015-01-01

    BACKGROUND: Asthma is a heterogeneous disease and development of novel therapeutics requires an understanding of pathophysiologic phenotypes. The purpose of the ADEPT study was to correlate clinical features and biomarkers with molecular characteristics, by profiling asthma (NCT01274507). This re...

  17. A study of western red cedar-induced asthma.

    Science.gov (United States)

    Mue, S; Ise, T; Ono, Y; Akasaka, K

    1975-05-01

    Seventeen asthmatic patients who were workers dealing with Western Red Cedar in a Japanese wooden frame factory were studied. One fraction from the aqueous extract of the lumber induced a positive skin test, Prausnitz-Kustner test and the inhalation test. This confirms the existence of antigen in Western Red Cedar and its ability to produce allergic asthma in sensitive workers.

  18. Fracture and hydrology data from field studies at Stripa, Sweden

    International Nuclear Information System (INIS)

    Gale, J.E.

    1981-04-01

    The purpose of this report is to present the basic fracture and hydrology data collected as part of the joint LBL-KBS fracture hydrology program at Stripa, Sweden. A detailed description of the fracture-core logging and hydrology borehole testing procedures is included as well as a description of how the fracture and hydrology data were coded and organized. Based on this coding a series of computer data files for the fracture and hydrology borehole data have been constructed and these are described in detail. The fracture data file for one borehole is presented as an example in an appendix along with all of the raw and some partially processed and analyzed fracture hydrology data files. A detailed description of how this data will be analyzed to develop a thorough understanding of the fracture system and hydrogeologic characteristics of the Stripa site is presented

  19. Knee injuries in skiing. A prospective study from northern Sweden.

    Science.gov (United States)

    Edlund, G; Gedda, S; Hemborg, A

    1980-01-01

    This paper evaluates 420 ski injuries occurring in Northern Sweden in 1977. Our main aim was to correlate knee injuries with types of skiing and to note a change in incidence with evolution of equipment. Fifty-eight lesions (13.8%) affected the knee joint which is about the same frequency as 10 years earlier nor has introduction of high stiff boots in downhill skiing increased incidence of knee injuries. Cross-country and long-distance skiing produced more knee injuries (24.7%) than downhill skiing (11.4%). Cross-country skiers were older and more women in this group sustained knee injuries. The use of non-release type bindings is probably the main reason for this higher incidence but age and different skiing techniques seem to contribute.

  20. [Genetic and environmental factors of asthma and allergy: Results of the EGEA study].

    Science.gov (United States)

    Bouzigon, E; Nadif, R; Le Moual, N; Dizier, M-H; Aschard, H; Boudier, A; Bousquet, J; Chanoine, S; Donnay, C; Dumas, O; Gormand, F; Jacquemin, B; Just, J; Margaritte-Jeannin, P; Matran, R; Pison, C; Rage, E; Rava, M; Sarnowski, C; Smit, L A M; Temam, S; Varraso, R; Vignoud, L; Lathrop, M; Pin, I; Demenais, F; Kauffmann, F; Siroux, V

    2015-10-01

    The EGEA study (epidemiological study on the genetics and environment of asthma, bronchial hyperresponsiveness and atopy), which combines a case-control and a family-based study of asthma case (n=2120 subjects) with three surveys over 20 years, aims to identify environmental and genetic factors associated with asthma and asthma-related phenotypes. We summarize the results of the phenotypic characterization and the investigation of environmental and genetic factors of asthma and asthma-related phenotypes obtained since 2007 in the EGEA study (42 articles). Both epidemiological and genetic results confirm the heterogeneity of asthma. These results strengthen the role of the age of disease onset, the allergic status and the level of disease activity in the identification of the different phenotypes of asthma. The deleterious role of active smoking, exposure to air pollution, occupational asthmogenic agents and cleaning products on the prevalence and/or activity of asthma has been confirmed. Accounting for gene-environment interactions allowed the identification of new genetic factors underlying asthma and asthma-related traits and better understanding of their mode of action. The EGEA study is contributing to the advances in respiratory research at the international level. The new phenotypic, environmental and biological data available in EGEA study will help characterizing the long-term evolution of asthma and the factors associated to this evolution. Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  1. PVC--as flooring material--and its association with incident asthma in a Swedish child cohort study.

    Science.gov (United States)

    Larsson, M; Hägerhed-Engman, L; Kolarik, B; James, P; Lundin, F; Janson, S; Sundell, J; Bornehag, C G

    2010-12-01

    The Dampness in Buildings and Health study (DBH) started in the year 2000 in Värmland, Sweden, with a baseline questionnaire sent to all children (n = 14,077) aged 1-6. Five years later, a follow-up questionnaire was sent to the children who were 1-3 years at baseline. A total of 4779 children participated in both the baseline and the follow-up studies and constitute the study population in this cohort study. The aim of this study was to examine the association between exposure to PVC-flooring in the child's and parent's bedroom in homes of children aged 1-3 and the incidence of asthma, rhinitis, and eczema during the following 5-year period. Adjusted analyses showed that the incidence of asthma among children was associated with PVC-flooring in the child's bedroom (AOR 1.52; 95% CI 0.99-2.35) and in the parent's bedroom (1.46; 0.96-2.23). The found risks were on borderline of significance and should therefore be interpreted with caution. There was further a positive relationship between the number of rooms with PVC-flooring and the cumulative incidence of asthma. PVC-flooring was found to be a stronger risk factor for incident asthma in multifamily homes when compared with single-family houses and in smoking families compared with non-smoking families and in women. These longitudinal data from the DBH study found an association between the presence of PVC-flooring in the home and incident asthma in children. However, earlier results from the DBH study have shown that PVC-flooring is one important source for phthalates in indoor dust, and exposure to such phthalates was found to be associated with asthma and allergy among children. This emphasizes the need for prospective studies that focus on the importance of prenatal and neonatal exposure to phthalates in the development of asthma and allergy in children. © 2010 John Wiley & Sons A/S.

  2. Inhaler Errors in the CRITIKAL Study : Type, Frequency, and Association with Asthma Outcomes

    NARCIS (Netherlands)

    Price, David B; Román-Rodríguez, Miguel; McQueen, R Brett; Bosnic-Anticevich, Sinthia; Carter, Victoria; Gruffydd-Jones, Kevin; Haughney, John; Henrichsen, Svein; Hutton, Catherine; Infantino, Antonio; Lavorini, Federico; Law, Lisa M; Lisspers, Karin; Papi, Alberto; Ryan, Dermot; Ställberg, Björn; van der Molen, Thys; Chrystyn, Henry

    BACKGROUND: Poor inhaler technique has been linked to poor asthma outcomes. Training can reduce the number of inhaler errors, but it is unknown which errors have the greatest impact on asthma outcomes. OBJECTIVE: The CRITical Inhaler mistaKes and Asthma controL study investigated the association

  3. Longitudinal outcomes of different asthma phenotypes in primary care, an observational study.

    NARCIS (Netherlands)

    Khusial, R.J.; Sont, J.K.; Loijmans, R.J.B.; Snoeck-Stroband, J.B.; Assendelft, P.J.J.; Schermer, T.R.J.; Honkoop, P.J.

    2017-01-01

    While asthma presentation is heterogeneous, current asthma management guidelines in primary care are quite homogeneous. In this study we aim to cluster patients together into different phenotypes, that may aid the general practitioner in individualised asthma management. We analysed data from the

  4. Longitudinal outcomes of different asthma phenotypes in primary care, an observational study

    NARCIS (Netherlands)

    Khusial, R.J.; Sont, J.K.; Loijmans, R.J.; Snoeck-Stroband, J.B.; Assendelft, P.; Schermer, T.R.J.; Honkoop, P.J.

    2017-01-01

    While asthma presentation is heterogeneous, current asthma management guidelines in primary care are quite homogeneous. In this study we aim to cluster patients together into different phenotypes, that may aid the general practitioner in individualised asthma management. We analysed data from the

  5. Improving childcare staff management of acute asthma exacerbation - An Australian pilot study.

    Science.gov (United States)

    Soo, Yien Yien; Luckie, Kate Helen; Saini, Bandana; Kritikos, Vicky; Brannan, John D; Moles, Rebekah Jane

    2017-09-01

    This study aimed to evaluate the effectiveness of an asthma first-aid training tool for childcare staff in Australia. The effects of training on both asthma knowledge and skills were assessed. A pre/post-study design was utilised to assess changes in asthma knowledge and asthma first-aid skills in childcare staff before and after an educational intervention. Asthma first-aid skills were assessed from the participant's response to two scenarios in which a child was having a severe exacerbation of asthma. Asthma knowledge and asthma skills scores were collected at base-line and 3 weeks post the education session, which involved feedback on each individual's skills and a brief lecture on asthma delivered via PowerPoint presentation. There was a significant improvement after intervention in asthma knowledge (Z = -3.638, p < 0.001) and asthma first-aid skills for both scenario 1 (Z = -6.012, p < 0.001) and scenario 2 (Z = -6.018, p < 0.001). In scenario 1 and 2, first-aid skills improved by 65% (p < 0.001) and 57% (p < 0.001), respectively. Asthma knowledge was high at baseline (79%) and increased by 7% (p < 0.001) after the educational intervention. These asthma knowledge results were not significant when adjusted for prior knowledge. Results suggest that knowledge assessment alone may not predict the practical skills needed for asthma first-aid. Skills assessment is a useful adjunct to knowledge assessment when gauging the ability of childcare staff to manage acute asthma exacerbation. Skills assessment could be considered for incorporation into future educational interventions to improve management of acute asthma exacerbation.

  6. Factors associated with overestimation of asthma control: A cross-sectional study in Australia.

    Science.gov (United States)

    Bereznicki, Bonnie J; Chapman, Millicent P; Bereznicki, Luke R E

    2017-05-01

    To investigate actual and perceived disease control in Australians with asthma, and identify factors associated with overestimation of asthma control. This was a cross-sectional study of Australian adults with asthma, who were recruited via Facebook to complete an online survey. The survey included basic demographic questions, and validated tools assessing asthma knowledge, medication adherence, medicine beliefs, illness perception and asthma control. Items that measured symptoms and frequency of reliever medication use were compared to respondents' self-rating of their own asthma control. Predictors of overestimation of asthma control were determined using multivariate logistic regression. Of 2971 survey responses, 1950 (65.6%) were complete and eligible for inclusion. Overestimation of control was apparent in 45.9% of respondents. Factors independently associated with overestimation of asthma control included education level (OR = 0.755, 95% CI: 0.612-0.931, P = 0.009), asthma knowledge (OR = 0.942, 95% CI: 0.892-0.994, P = 0.029), total asthma control, (OR = 0.842, 95% CI: 0.818-0.867, P addictive (OR = 1.144, 95% CI: 1.017-1.287, P = 0.025), and increased feelings of control over asthma (OR = 1.261, 95% CI: 1.191-1.335), P < 0.001). Overestimation of asthma control remains a significant issue in Australians with asthma. The study highlights the importance of encouraging patients to express their feelings about asthma control and beliefs about medicines, and to be more forthcoming with their asthma symptoms. This would help to reveal any discrepancies between perceived and actual asthma control.

  7. Ambient particulate pollution and the world-wide prevalence of asthma, rhinoconjunctivitis and eczema in children: Phase One of the International Study of Asthma and Allergies in Childhood (ISAAC).

    NARCIS (Netherlands)

    Anderson, H.R.; Ruggles, R.; Pandey, K.D.; Kapetanakis, V.; Brunekreef, B.; Lai, C.K.; Strachan, D.P.; Weiland, S.K.

    2010-01-01

    OBJECTIVES: To investigate the effect of ambient particulate matter on variation in childhood prevalence of asthma, rhinoconjunctivitis and eczema. METHODS: Prevalences of asthma, rhinoconjunctivitis and eczema obtained in Phase One of the International Study of Asthma and Allergies in Childhood

  8. [Study of prevalence and association between asthma symptoms and obesity in the pediatric population of Pamplona].

    Science.gov (United States)

    Álvarez Zallo, Noelia; Guillen Grima, Francisco; Aguinaga-Ontoso, Inés; Hermoso-de-Mendoza-Cantón, Juana; Marín Fernández, Blanca; Serrano-Monzó, Inmaculada; Azcona San Julián, Cristina

    2014-09-01

    The objective of this study is to determine the prevalence of asthma symptoms and overweight-obese in children aged 6-7 years and adolescents aged 13-14 years within the metropolitan area of Pamplona, and analyse the risk of asthma within the age groups and the influences if sex on this relationship. The study is based on data of asthma symptoms and body mass index of 4,413 children and adolescents obtained from the International Study of Asthma and Allergies phase III questionnaire. Unconditional logistic regression was used to obtain adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for overweight-obesity and asthma symptoms in both groups, taking as reference the group of normal weight. Afterwards, it was stratified by sex. The prevalence of overweight-obesity in the group aged 6-7 years was 23.9% and in the group of teenagers was 11.5%. The prevalence of asthma symptoms in both age groups was lower than the Spanish average. The obese children aged 6-7 years had a higher risk of asthma symptoms. When it was stratified by sex, an increased risk in all asthma symptoms was observed only in obese girls. No relationship between obesity and asthma was observed n the adolescents group. Obesity in children is related to asthma symptoms. Obese girls have an increased risk and more severe asthma symptoms than boys. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  9. Studies on obesity in Chinese children in Beijing and Chinese adults in Sweden

    OpenAIRE

    Greiner, Ted

    2015-01-01

    Greiner T. Studies on obesity in Chinese children in Beijing and Chinese adults in Sweden. Presentation to international seminar on “Functional evaluation of food and food ingredients.” Chonbok National University Hospital and Clinical Trial Center for Functional Foods. Korea University, Seoul, February 27, 2009.

  10. Bridging Marketing Theory and Practice for Consumer Behaviour Master's Students: A Case Study from Sweden

    Science.gov (United States)

    Sundstrom, Malin; Hagberg, Johan

    2010-01-01

    This paper describes the planning, implementation and outcome of a graduate-level consumer behaviour course taught in autumn 2008 at the University of Boras in Sweden. The course was jointly developed by marketing academics and business representatives in order to combine research-oriented studies with practical experience in a retail context. The…

  11. "Gender Utopias?": U.S. Student Reflections on Studying Abroad in Norway and Sweden

    Science.gov (United States)

    Nordmeyer, Kristjane; Teig, Trisha; Bedera, Nicole

    2017-01-01

    This article describes a study abroad experience in Norway and Sweden that was designed to explore gender equality in two of the world's most gender-progressive countries. Course readings explored the work of feminist sociologists and asked students to think critically about gender equality from a cross-cultural perspective. Students met with…

  12. Young Children as Language Policy-Makers: Studies of Interaction in Preschools in Finland and Sweden

    Science.gov (United States)

    Boyd, Sally; Huss, Leena

    2017-01-01

    This special issue has as its focus the agency of young children in relation to language policy and practice in bi- and multilingual preschools in Finland and Sweden. Studies of language policy in practice in early childhood education and care (ECEC) in these two countries can be particularly relevant even to those in other contexts, because they…

  13. The sensitization pattern differs according to rhinitis and asthma multimorbidity in adults: the EGEA study.

    Science.gov (United States)

    Burte, E; Bousquet, J; Siroux, V; Just, J; Jacquemin, B; Nadif, R

    2017-04-01

    Mono- and polysensitization are different IgE-mediated allergic phenotypes in children. Allergic sensitization is associated with both allergic asthma and allergic rhinitis, however, associations between the sensitization pattern and particularly polysensitization with asthma and rhinitis remains poorly studied in adults. The aim of this study was to assess how the allergic sensitization pattern associates with asthma, rhinitis and their multimorbidity. 1199 adults from the EGEA study, with extensive phenotypic characterization and all data available on skin prick tests to 10 allergens, total IgE and blood eosinophils were included. Using questionnaires only, participants were classified into 6 groups: asymptomatic (no asthma, no rhinitis), non-allergic rhinitis alone, allergic rhinitis alone, asthma alone, asthma+non-allergic rhinitis and asthma+allergic rhinitis. Mono- and polysensitization were defined by a positive skin prick test to one or more than one allergen respectively. Asymptomatic participants and those with non-allergic rhinitis alone were mostly non-sensitized (around 72%) while around 12% were polysensitized. Between 32% and 43% of participants with allergic rhinitis alone, asthma alone and asthma+non-allergic rhinitis were non-sensitized and between 37% and 46% of them were polysensitized. 65% of the participants with asthma+allergic rhinitis were polysensitized. The level of total IgE followed a similar trend to that of allergic sensitization. Eosinophils were increased in asthma, especially when associated with rhinitis. Nasal symptoms were more severe and eczema more common in participants with both asthma and allergic rhinitis than in the other groups. Allergic sensitization and particularly polysensitization rates widely differ according to asthma and rhinitis status. This study emphasized the importance of taking into account multimorbidity between asthma and rhinitis and showed that allergic sensitization is not a dichotomic variable.

  14. A population-based prescription study of asthma drugs during pregnancy

    DEFF Research Database (Denmark)

    Olesen, Charlotte; Thrane, Nana; Nielsen, G.L.

    2001-01-01

    pregnancy, and no population-based studies concerning gestational asthma therapy exist. Objectives: To examine whether asthma drugs or changing intensity of asthma therapy during pregnancy was associated with deviations from expected values of gestational age, birth weight, length at birth, or malformations......Background: Among the goals of gestational asthma, therapy is optimisation of pulmonary function. According to the US Food and Drug Administration, no asthma drugs can be considered ‘safe’ during pregnancy. Fear of adverse fetal effects may thus lead to restrictive use of asthma drugs during....... Methods: The Birth Registry was used to identify all 15,756 primiparous women who gave birth in the County of North Jutland between 1991 and 1996. According to the North Jutland Prescription Database, 303 of these women received prescriptions for asthma drugs during pregnancy. Women who did not purchase...

  15. Back for more: a qualitative study of emergency department reattendance for asthma.

    Science.gov (United States)

    Goeman, Dianne P; Aroni, Rosalie A; Sawyer, Susan M; Stewart, Kay; Thien, Francis C K; Abramson, Michael J; Douglass, Jo A

    2004-02-02

    To explore the reasons why individuals recurrently present with asthma to hospital emergency departments. A predominantly qualitative study in which participants were interviewed in-depth about their asthma. Data on medication use, respiratory health and asthma knowledge were also collected, and asthma severity was determined from medical records. A tertiary teaching hospital and a suburban hospital emergency department (ED) from 1 March to 30 April 2000, and a rural hospital ED from 1 July to 31 August 2000. The participation rate was 32% of an initial 195 ED attendees (183 of whom were eligible) aged 18-70 years: 32 had presented to an ED for asthma care on more than one occasion over the preceding 12 months (reattendees), and 29 were non-reattendees. Two-thirds (22/32) of reattendees had chronic severe asthma and presentation to ED was deemed appropriate for 18 of these, indicated by recurrent severe asthma attacks despite seeking prior medical intervention. Reasons for re-presentation identified in a third of all reattendees included poor asthma knowledge, and financial and other barriers to medication use. We identified potentially preventable issues in about a third of patients (most of whom had mild to moderate asthma) who recurrently presented to EDs for treatment. The remainder of the participants sought emergency asthma treatment appropriately after failing to respond to medical care, and this was frequently in accordance with their asthma management plans.

  16. Industrial DSM in a deregulated European electricity market - a case study of 11 plants in Sweden

    International Nuclear Information System (INIS)

    Trygg, Louise; Karlsson, B.G.

    2005-01-01

    In 2004 Sweden will become part of a common European electricity market. This implies that the price of electricity in Swedish will adapt to a higher European electricity price due to the increase in cross-border trading. Swedish plant is characterized as more electricity-intensive than plant on the European continent, and this, in combination with a higher European electricity price will lead to a precarious scenario. This paper studies the energy use of 11 plants in the municipality of Oskarshamn in Sweden. The aim is to show how these plants can reduce their electricity use to adapt to a European level. We have found that the plants could reduce their use of electricity by 48% and their use of energy by 40%. In a European perspective, where coal-condensing power is assumed to be the marginal production that alters as the electricity demand changes, the decrease in the use of electricity in this study leads to a reduction in global emissions of carbon dioxide of 69,000 tonne a year. Electricity generated in Sweden emits very low emissions of carbon dioxide and have thus consequently very low external cost. The freed capacity in Sweden could therefore replace electricity generated with higher external cost and as a result lower the total external cost in Europe. The emissions from the saved electricity could also be valuable within the EU emissions trading scheme, if the emissions calculation is done assuming the marginal electricity is fossil fuel based

  17. Developing pictorial asthma action plans to promote self-management and health in rural youth with asthma: A qualitative study.

    Science.gov (United States)

    Duncan, Christina L; Walker, Heather A; Brabson, Laurel; Williford, Desireé N; Hynes, Lisa; Hogan, Mary Beth

    2017-09-21

    Asthma action plans (AAPs) provide asthma management instructions to families; however, AAPs typically are written at a 7th-9th grade reading level, making them less useful in lower literacy families. There is a need to develop simpler AAP formats and content to optimize their utility across all families, including those who are rural and may be at a risk for literacy concerns. Because using pictures can simplify and enhance health education, our study's aim was to develop a pictorial AAP through a series of focus groups with key stakeholders - youth with asthma, caregivers, and physicians. Fourteen caregiver/youth dyads and four physicians participated in separate focus groups where their preferences for pictorial AAP structure and content were obtained. Focus groups were audio recorded, transcribed, coded with ATLAS.ti, and analyzed for themes. Youth and their caregivers prefer that the AAPs include simple, cartoon-like pictures customized to the patient. Physicians emphasized AAP's capability to display pictures of controller medication given its importance in preventing asthma exacerbations. A stoplight format, currently used in most written AAPs, received positive reviews. Specific suggestions for pictures showing symptoms, medications, and how to take medication were suggested. Words and short phrases accompanying the pictures were thought to add clarity. Key stakeholders viewed pictorial AAPs as positive and potentially effective alternatives to standard written AAPs. It is expected that low literacy youth and caregivers would more easily understand a pictorial AAP presentation, which should facilitate better medication adherence and asthma outcomes in these children.

  18. A Low-Literacy Asthma Action Plan to Improve Provider Asthma Counseling: A Randomized Study.

    Science.gov (United States)

    Yin, H Shonna; Gupta, Ruchi S; Tomopoulos, Suzy; Mendelsohn, Alan L; Egan, Maureen; van Schaick, Linda; Wolf, Michael S; Sanchez, Dayana C; Warren, Christopher; Encalada, Karen; Dreyer, Benard P

    2016-01-01

    The use of written asthma action plans (WAAPs) has been associated with reduced asthma-related morbidity, but there are concerns about their complexity. We developed a health literacy-informed, pictogram- and photograph-based WAAP and examined whether providers who used it, with no training, would have better asthma counseling quality compared with those who used a standard plan. Physicians at 2 academic centers randomized to use a low-literacy or standard action plan (American Academy of Allergy, Asthma and Immunology) to counsel the hypothetical parent of child with moderate persistent asthma (regimen: Flovent 110 μg 2 puffs twice daily, Singulair 5 mg daily, Albuterol 2 puffs every 4 hours as needed). Two blinded raters independently reviewed counseling transcriptions. medication instructions presented with times of day (eg, morning and night vs number of times per day) and inhaler color; spacer use recommended; need for everyday medications, even when sick, addressed; and explicit symptoms used. 119 providers were randomly assigned (61 low literacy, 58 standard). Providers who used the low-literacy plan were more likely to use times of day (eg, Flovent morning and night, 96.7% vs 51.7%, P low-literacy WAAP improves the quality of asthma counseling by helping providers target key issues by using recommended clear communication principles. Copyright © 2016 by the American Academy of Pediatrics.

  19. DASH for asthma: a pilot study of the DASH diet in not-well-controlled adult asthma.

    Science.gov (United States)

    Ma, Jun; Strub, Peg; Lavori, Phillip W; Buist, A Sonia; Camargo, Carlos A; Nadeau, Kari C; Wilson, Sandra R; Xiao, Lan

    2013-07-01

    This pilot study aims to provide effect size confidence intervals, clinical trial and intervention feasibility data, and procedural materials for a full-scale randomized controlled trial that will determine the efficacy of Dietary Approaches to Stop Hypertension (DASH) as adjunct therapy to standard care for adults with uncontrolled asthma. The DASH diet encompasses foods (e.g., fresh fruit, vegetables, and nuts) and antioxidant nutrients (e.g., vitamins A, C, E, and zinc) with potential benefits for persons with asthma, but it is unknown whether the whole diet is beneficial. Participants (n = 90) will be randomized to receive usual care alone or combined with a DASH intervention consisting of 8 group and 3 individual sessions during the first 3 months, followed by at least monthly phone consultations for another 3 months. Follow-up assessments will occur at 3 and 6 months. The primary outcome measure is the 7-item Juniper Asthma Control Questionnaire, a validated composite measure of daytime and nocturnal symptoms, activity limitations, rescue medication use, and percentage predicted forced expiratory volume in 1 second. We will explore changes in inflammatory markers important to asthma pathophysiology (e.g., fractional exhaled nitric oxide) and their potential to mediate the intervention effect on disease control. We will also conduct pre-specified subgroup analyses by genotype (e.g., polymorphisms on the glutathione S transferase gene) and phenotype (e.g., atopy, obesity). By evaluating a dietary pattern approach to improving asthma control, this study could advance the evidence base for refining clinical guidelines and public health recommendations regarding the role of dietary modifications in asthma management. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Prevalence and risk factors of asthma in mainland China: The CARE study.

    Science.gov (United States)

    Lin, Jiangtao; Wang, Wenya; Chen, Ping; Zhou, Xin; Wan, Huanying; Yin, Kaisheng; Ma, Lijun; Wu, Changgui; Li, Jing; Liu, Chuntao; Su, Nan; Liu, Guoliang; Xie, Hua; Tang, Wei; Huang, Mao; Chen, Yan; Liu, Yuanhua; Song, Liqiang; Chen, Xianliang; Zhang, Yongming; Li, Wen; Sun, Lichao

    2018-04-01

    There are limited population based data on the prevalence of asthma in China. The China Asthma and Risk factors Epidemiologic (CARE) survey was designed to understand the prevalence and risk factors for asthma in mainland China. The CARE survey aims to demonstrate the prevalence and risk factors of asthma in mainland China among adolescents (age >14 years) and adults. The survey was performed between February 2010 and August 2012 in eight provinces/cities of seven areas in mainland China. The inhabitants (age, >14 years) recruited in this survey were through multi-stage cluster random sampling. Asthma diagnosis was based on medical history and lung function tests. Multivariable logistic regression was used to analyzed the risk factors for asthma. The study included 164 215 subjects (men, 79 692 [48.53%]; women, 84 523 [51.47%]). 2034 (1.24%) were asthmatic patients. Among all asthmatic patients, 521 (25.61%) were newly diagnosed. Univariable regression analysis showed that risk factors for asthma included smoking, first-degree relatives with asthma, allergic rhinitis, chronic bronchitis, COPD, pollinosis, allergic pneumonia, concomitant allergic diseases, BMI and raising pets. Multivariable logistic regression indicated that asthma risk factors included women, age stratification, smoking, first-degree relatives suffering from asthma or pollinosis, combined with allergic rhinitis, eczema or GERD. We speculated that the prevalence of asthma is increasing in mainland China among individuals aged >14 years in the past 10 years. A number of risk factors were identified. The risk factors of asthma would be further elucidated in our future work. Our CARE study highlights that asthma epidemic in mainland China should be paid more attention. Copyright © 2018. Published by Elsevier Ltd.

  1. Improving Asthma-Related Outcomes Among Children Participating in the Head-Off Environmental Asthma in Louisiana (HEAL), Phase II Study.

    Science.gov (United States)

    Rapp, Kristi Isaac; Jack, Leonard; Wilson, Candice; Hayes, Sandra Carr; Post, Robert; McKnight, Ellen; Malveaux, Floyd

    2018-03-01

    Pediatric asthma disproportionately affects low-income and minority children. The HEAL (Head-Off Environmental Asthma in Louisiana), Phase II Project was a collaborative effort with a primary focus to improve pediatric asthma management in New Orleans, Louisiana. The purpose of this article is to report clinical outcomes captured at baseline and 12-month follow-up. HEAL (Head-off Environmental Asthma in Louisiana), Phase II was a pre-post intervention study that enrolled children ages 2 to 18 years of age with a diagnosis of asthma to receive asthma education within the clinic setting. Enrollees received an asthma education intervention, an environmental evaluation, and a 12-month follow-up session. Endpoints included symptom days, level of asthma control, asthma exacerbations, emergency room visits, hospitalizations, and missed school days. The majority of participants were aged 5 years and older, male, Black, and persistent asthmatics. Emergency room visits decreased from 41% to 20% ( p < .001). Improvements in coughing (83% to 62%, p < .001), wheezing (50% to 26%, p < .001), and chest tightness (29% to 18%, p < .001) were also seen. The novel intervention was associated with improved asthma outcomes among pediatric patients receiving care at the clinical sites in the Greater New Orleans area.

  2. A community study of factors related to poorly controlled asthma among Brazilian urban children.

    Directory of Open Access Journals (Sweden)

    Silvia de Magalhães Simões

    Full Text Available Asthma constitutes a serious public health problem in many regions of the world, including the city of Salvador, State of Bahia-Brazil. The purpose of this study was to analyse the factors associated with poor asthma control.Two definitions were used for asthma: 1 wheezing in the last 12 months; 2 wheezing in the last 12 months plus other asthma symptoms or asthma diagnosis ever. The definition of poorly controlled asthma was: at least one reported hospitalisation due to asthma and/or high frequency of symptoms, in the last year. Children with poorly controlled asthma (N = 187/374 were compared with wheezing children with controlled asthma regarding age, gender, atopy, parental asthma, rhinitis, eczema, exposure to second hand tobacco smoke, presence of moulds, pets and pests in the house, helminth infections and body mass index. Crude and logistic regression adjusted odds ratios were used as measures of association. There was a higher proportion of poorly controlled asthma among children with eczema (OR = 1.55; 95% CI 1.02; 2.37. The strength of the association was greater among children with eczema and rhinitis (42.6%, 53.4% and 57.7%, respectively, in children who had no rhinitis nor eczema, had only one of those, and had both (p = 0.02 for trend test. The presence of mould in the houses was inversely associated with poorly controlled asthma (OR = 0.54; 95% CI 0.34; 0.87.Our results indicate an association between eczema and poor asthma control in this environment, but emphasize the role of various other individual and environmental factors as determinants of poor control.

  3. Sudden death in young persons with uncontrolled asthma--a nationwide cohort study in Denmark

    DEFF Research Database (Denmark)

    Gullach, Anders Juul; Risgaard, Bjarke; Lynge, Thomas Hadberg

    2015-01-01

    individuals who suffered from uncontrolled asthma. This corresponds to an incidence rate of 0.32 per 100,000 person-years. The cause of death in 31 cases (63%) was sudden cardiac death, and in 13 cases (27%), it was a fatal asthma attack. Symptoms (chest pain, dyspnea, seizures, general malaise, syncope...... asthma attack. We found that 41 (84%) of patients suffered from symptoms prior to death and that 28 (57%) sought medical advice from the emergency department and/or general practitioners.......BACKGROUND: Asthma is a common chronic disease among young adults, and several studies have reported increased mortality rates in patients with asthma. However, no study has described sudden unexpected death in a nationwide setting in patients with uncontrolled asthma. We defined uncontrolled...

  4. Adolescent Perceptions of Parenting Styles in Sweden, Italy and Greece: An Exploratory Study

    OpenAIRE

    Olivari, Maria Giulia; Hertfelt Wahn, Elisabeth; Maridaki-Kassotaki, Katerina; Antonopoulou, Katerina; Confalonieri, Emanuela

    2015-01-01

    Comparative research on parenting styles among Nordic and Mediterranean countries is still missing, despite the increasing number of studies on parenting styles in adolescence. This study explores similarities and differences in adolescents’ retrospective perceptions of parenting styles, for both parents, in Sweden, Italy and Greece, using the Parenting Styles and Dimensions Questionnaire. In particular, it examines the relation between parental role, adolescent gender, country of origin, SES...

  5. Health literacy among refugees in Sweden : a cross-sectional study

    OpenAIRE

    Wångdahl, Josefin; Lytsy, Per; Mårtensson, Lena; Westerling, Ragnar

    2014-01-01

    Background Refugees have poorer health compared to indigenous populations, which may be explained by lower health literacy, i.e. not being able to access, understand, appraise or apply health information. This study aims to determine levels of functional and comprehensive health literacy, and factors associated with inadequate health literacy, in refugees coming to Sweden. Method A cross-sectional study was performed among 455 adult refugees speaking Arabic, Dari, Somali or English. Participa...

  6. Smoking patterns among adolescents with asthma attending upper secondary schools: a community-based study

    DEFF Research Database (Denmark)

    Precht, Dorthe Hansen; Keiding, Lis; Madsen, Mette

    2003-01-01

    OBJECTIVE: Smoking among people who have asthma may be a serious health problem. We studied the prevalence of smoking and the relations between smoking and asthma, symptoms, medicine, and gender differences among adolescents with asthma. METHODS: A national cross-sectional study on health...... adjusted for age, gender, parents' job and smoking, family type, body mass index, and exercise habits. RESULTS: In total, 37.7% smoked currently and 16.5% smoked daily; more girls than boys smoked. More pupils with asthma than without smoked daily (adjusted odds ratio [OR]: 1.15; 95% confidence interval...

  7. Psychosocial factors and incident asthma hospital admissions in the EPIC-Norfolk cohort study.

    Science.gov (United States)

    Wainwright, N W J; Surtees, P G; Wareham, N J; Harrison, B D W

    2007-05-01

    Case series and case-control studies have shown high rates of psychosocial and behavioural risk factors amongst patients admitted to hospital with severe asthma. General population studies have shown associations between psychosocial factors and prevalent asthma but few have investigated incident asthma outcomes. Data on psychosocial factors and asthma hospital admissions were available for 20 854 participants, aged 41-80 years, in the Norfolk cohort of the European Prospective Investigation into Cancer study. Postal assessments included details of physical functioning, mood disorder history, social adversity and social support. A total of 686 asthma hospital admissions were recorded. Psychosocial factors present at baseline, including current mood disorders, adverse circumstances in childhood, the impact of life events experienced during adulthood and negative perceived support from a close confidant, were associated with increased rates of hospital admission independent of age, sex, indicators of socio-economic status, physical functional health, and obesity. Restricted to those participants who reported lifetime doctor-diagnosed asthma at baseline, the reported impact of adverse life events experienced in adulthood, and both confiding and negative aspects of support quality, were associated with asthma hospital admission. The magnitude of these associations was comparable to those involving indicators of socio-economic status and physical health. These results show that psychosocial factors are associated with incident asthma hospital admissions and highlight the potential importance of taking account of psychosocial factors, including availability and quality of support networks, in guiding long-term asthma management.

  8. Adolescent Perceptions of Parenting Styles in Sweden, Italy and Greece: An Exploratory Study

    Directory of Open Access Journals (Sweden)

    Maria Giulia Olivari

    2015-05-01

    Full Text Available Comparative research on parenting styles among Nordic and Mediterranean countries is still missing, despite the increasing number of studies on parenting styles in adolescence. This study explores similarities and differences in adolescents’ retrospective perceptions of parenting styles, for both parents, in Sweden, Italy and Greece, using the Parenting Styles and Dimensions Questionnaire. In particular, it examines the relation between parental role, adolescent gender, country of origin, SES and these perceptions. Swedish, Italian and Greek adolescents (N = 702; 30.9% Swedish, 39.6% Italian and 29.5% Greek participated in the study. To test the principal effects three mixed 2(parent; mother and father*2(gender; girl and boy*3(countries; Sweden, Italy and Greece*3(SES; low, medium and high ANOVAs were conducted separately for each parenting style. To verify the interaction effects, a mixed 2(parent; mother and father*3(countries; Sweden, Italy and Greece*3(SES; low, medium and high ANOVA was tested on authoritative style. Regarding authoritarian and permissive two mixed 2(parent; mother and father*2(gender; girl and boy*3(countries; Sweden, Italy and Greece ANOVAs were tested. Mothers, as compared to fathers, were perceived as more authoritative, authoritarian and permissive. Moreover, boys perceived their parents as more authoritarian and more permissive than girls. Swedish parents were perceived as significantly less authoritarian than Italian and Greek parents and more permissive than Italian parents; Greek parents were perceived as less authoritarian and more permissive than Italian parents. The study provides an interesting contribution to parenting styles literature, showing how country legislation concerning family matters and SES are related the perception of parenting behaviours.

  9. Adolescent Perceptions of Parenting Styles in Sweden, Italy and Greece: An Exploratory Study.

    Science.gov (United States)

    Olivari, Maria Giulia; Hertfelt Wahn, Elisabeth; Maridaki-Kassotaki, Katerina; Antonopoulou, Katerina; Confalonieri, Emanuela

    2015-05-01

    Comparative research on parenting styles among Nordic and Mediterranean countries is still missing, despite the increasing number of studies on parenting styles in adolescence. This study explores similarities and differences in adolescents' retrospective perceptions of parenting styles, for both parents, in Sweden, Italy and Greece, using the Parenting Styles and Dimensions Questionnaire. In particular, it examines the relation between parental role, adolescent gender, country of origin, SES and these perceptions. Swedish, Italian and Greek adolescents (N = 702; 30.9% Swedish, 39.6% Italian and 29.5% Greek) participated in the study. To test the principal effects three mixed 2(parent; mother and father)*2(gender; girl and boy)*3(countries; Sweden, Italy and Greece)*3(SES; low, medium and high) ANOVAs were conducted separately for each parenting style. To verify the interaction effects, a mixed 2(parent; mother and father)*3(countries; Sweden, Italy and Greece)*3(SES; low, medium and high) ANOVA was tested on authoritative style. Regarding authoritarian and permissive two mixed 2(parent; mother and father)*2(gender; girl and boy)*3(countries; Sweden, Italy and Greece) ANOVAs were tested. Mothers, as compared to fathers, were perceived as more authoritative, authoritarian and permissive. Moreover, boys perceived their parents as more authoritarian and more permissive than girls. Swedish parents were perceived as significantly less authoritarian than Italian and Greek parents and more permissive than Italian parents; Greek parents were perceived as less authoritarian and more permissive than Italian parents. The study provides an interesting contribution to parenting styles literature, showing how country legislation concerning family matters and SES are related the perception of parenting behaviours.

  10. Psychiatric disorders and violent reoffending: a national cohort study of convicted prisoners in Sweden

    OpenAIRE

    Chang, Zheng; Larsson, Henrik; Lichtenstein, Paul; Fazel, Seena

    2015-01-01

    Summary Background Reoffending and presence of psychiatric disorders are common in prisoners worldwide. However, whether psychiatric disorders are risk factors for reoffending is still unknown. We aimed to examine the association between psychiatric disorders, including substance use disorder, and violent reoffending. Methods We did a longitudinal cohort study of 47 326 prisoners who were imprisoned since Jan 1, 2000, and released before Dec 31, 2009, in Sweden. We obtained data for diagnosed...

  11. Adolescent Perceptions of Parenting Styles in Sweden, Italy and Greece: An Exploratory Study

    Science.gov (United States)

    Olivari, Maria Giulia; Hertfelt Wahn, Elisabeth; Maridaki-Kassotaki, Katerina; Antonopoulou, Katerina; Confalonieri, Emanuela

    2015-01-01

    Comparative research on parenting styles among Nordic and Mediterranean countries is still missing, despite the increasing number of studies on parenting styles in adolescence. This study explores similarities and differences in adolescents’ retrospective perceptions of parenting styles, for both parents, in Sweden, Italy and Greece, using the Parenting Styles and Dimensions Questionnaire. In particular, it examines the relation between parental role, adolescent gender, country of origin, SES and these perceptions. Swedish, Italian and Greek adolescents (N = 702; 30.9% Swedish, 39.6% Italian and 29.5% Greek) participated in the study. To test the principal effects three mixed 2(parent; mother and father)*2(gender; girl and boy)*3(countries; Sweden, Italy and Greece)*3(SES; low, medium and high) ANOVAs were conducted separately for each parenting style. To verify the interaction effects, a mixed 2(parent; mother and father)*3(countries; Sweden, Italy and Greece)*3(SES; low, medium and high) ANOVA was tested on authoritative style. Regarding authoritarian and permissive two mixed 2(parent; mother and father)*2(gender; girl and boy)*3(countries; Sweden, Italy and Greece) ANOVAs were tested. Mothers, as compared to fathers, were perceived as more authoritative, authoritarian and permissive. Moreover, boys perceived their parents as more authoritarian and more permissive than girls. Swedish parents were perceived as significantly less authoritarian than Italian and Greek parents and more permissive than Italian parents; Greek parents were perceived as less authoritarian and more permissive than Italian parents. The study provides an interesting contribution to parenting styles literature, showing how country legislation concerning family matters and SES are related the perception of parenting behaviours. PMID:27247655

  12. The Urban Environment and Childhood Asthma (URECA birth cohort study: design, methods, and study population

    Directory of Open Access Journals (Sweden)

    Sandel Megan T

    2009-05-01

    Full Text Available Abstract Background The incidence and morbidity of wheezing illnesses and childhood asthma is especially high in poor urban areas. This paper describes the study design, methods, and population of the Urban Environment and Childhood Asthma (URECA study, which was established to investigate the immunologic causes of asthma among inner-city children. Methods and Results URECA is an observational prospective study that enrolled pregnant women in central urban areas of Baltimore, Boston, New York City, and St. Louis and is following their offspring from birth through age 7 years. The birth cohort consists of 560 inner-city children who have at least one parent with an allergic disease or asthma, and all families live in areas in which at least 20% of the population has incomes below the poverty line. In addition, 49 inner-city children with no parental history of allergies or asthma were enrolled. The primary hypothesis is that specific urban exposures in early life promote a unique pattern of immune development (impaired antiviral and increased Th2 responses that increases the risk of recurrent wheezing and allergic sensitization in early childhood, and of asthma by age 7 years. To track immune development, cytokine responses of blood mononuclear cells stimulated ex vivo are measured at birth and then annually. Environmental assessments include allergen and endotoxin levels in house dust, pre- and postnatal maternal stress, and indoor air nicotine and nitrogen dioxide. Nasal mucous samples are collected from the children during respiratory illnesses and analyzed for respiratory viruses. The complex interactions between environmental exposures and immune development will be assessed with respect to recurrent wheeze at age 3 years and asthma at age 7 years. Conclusion The overall goal of the URECA study is to develop a better understanding of how specific urban exposures affect immune development to promote wheezing illnesses and asthma.

  13. Bidirectionality in the relationship between asthma and smoking in adolescents : A population-based cohort study

    NARCIS (Netherlands)

    De Ven, Monique O. M. Van; Engels, Rutger C. M. E.; Kerstjens, Huib A. M.; Van Den Eijnden, Regina J. J. M.

    2007-01-01

    Purpose: Several cross-sectional studies have showed higher smoking rates among adolescents with asthma, but hardly any study has investigated this relation longitudinally. This study examines whether these cross-sectional results are caused by higher smoking onset among adolescents with asthma, or

  14. Bladder pain syndrome/interstitial cystitis is associated with asthma: A case-control study.

    Science.gov (United States)

    Chung, Shiu-Dong; Huang, Chung-Chien; Lin, Herng-Ching; Kao, Li-Ting

    2018-02-14

    Although asthma and bladder pain syndrome/interstitial cystitis (BPS/IC) are considered to share similar pathophysiological pathways, the relationship between asthma and BPS/IC is uncertain. This case-control study aimed to investigate the relationship between prior asthma and BPS/IC using a large database in Taiwan. This study used data from the Taiwan Longitudinal Health Insurance Database 2005. We identified 500 female patients with BPS/IC as cases and 500 propensity score-matched females without BPS/IC as controls. We conducted logistic regressions to estimate the odds ratio (OR) and 95% confidence interval (CI) for prior asthma between cases and controls. Results indicated that 143 (14.30%) of the total sampled patients had received a prior diagnosis of asthma. Moreover, prior asthma was found in 86 (17.20%) cases and 57 (11.40%) controls. The OR of prior asthma for cases was 1.61 (95%CI: 1.13-2.32) compared to propensity score-matched controls. Additionally, the ORs of prior asthma for females with BPS/IC aged 18-59 and ≥60 years were 1.72 (95%CI: 1.11-2.69) and 1.40 (95%CI: 0.74-2.62), respectively, compared to controls. We concluded that prior asthma was significantly associated with BPS/IC in a female Taiwanese population. © 2018 Wiley Periodicals, Inc.

  15. Lone mothers in Sweden

    DEFF Research Database (Denmark)

    Burström, B; Diderichsen, Finn; Shouls, S

    1999-01-01

    To study trends in the health and socioeconomic circumstances of lone mothers in Sweden over the years 1979-1995, and to make comparisons with couple mothers over the same period.......To study trends in the health and socioeconomic circumstances of lone mothers in Sweden over the years 1979-1995, and to make comparisons with couple mothers over the same period....

  16. Differences in sickness absence in Sweden and Denmark: the cross national HAKNAK study

    DEFF Research Database (Denmark)

    Lund, Thomas; Christensen, Karl Bang; Vaez, Marjan

    2009-01-01

    AIM: To investigate potential differences in sickness absence among public sector employees in Sweden and Denmark, and to what extent a difference was associated with age, gender, physical and psychosocial work environment exposures, lifestyle factors, self-rated health or work ability. METHODS......, lifestyle, psychosocial or physical work environment, musculoskeletal symptoms or self-rated health, whereas work ability score decreased the difference in sickness absence level. CONCLUSION: The results could indicate an increased retention of employees with health problems in the Swedish labour market......: In 2000, two cross-sectional samples of 8562 public sector employees in Sweden and Denmark were surveyed. The study outcome, self-reported number of sick-leave days the year preceding interview, was dichotomized into 7 days or less, and more than 7 days. Chi square test was used to analyse distribution...

  17. Associations between asthma, overweight and physical activity in children: a cross-sectional study.

    Science.gov (United States)

    Willeboordse, Maartje; van de Kant, Kim D G; van der Velden, Charlotte A; van Schayck, Constant P; Dompeling, Edward

    2016-09-01

    Asthma and obesity are highly prevalent in children, and are interrelated resulting in a difficult-to-treat asthma-obesity phenotype. The exact underlying mechanisms of this phenotype remain unclear, but decreased physical activity (PA) could be an important lifestyle factor. We hypothesize that both asthma and overweight/obesity decrease PA levels and interact on PA levels in asthmatic children with overweight/obesity. School-aged children (n = 122) were divided in 4 groups (healthy control, asthma, overweight/obesity and asthma, and overweight/obesity). Children were asked to perform lung function tests and wear an activity monitor for 7 days. PA was determined by: step count, active time, screen time, time spent in organized sports and active transport forms. We used multiple linear regression techniques to investigate whether asthma, body mass index-standard deviation score (BMI-SDS), or the interaction term asthma x BMI-SDS were associated with PA. Additionally, we tested if asthma features (including lung function and medication) were related to PA levels in asthmatic children. Asthma, BMI-SDS and the interaction between asthma x BMI-SDS were not related to any of the PA variables (p ≥ 0.05). None of the asthma features could predict PA levels (p ≥ 0.05). Less than 1 in 5 children reached the recommended daily step count guidelines of 12,000 steps/day. We found no significant associations between asthma, overweight and PA levels in school-aged children in this study. However, as PA levels were worryingly low, effective PA promotion in school-aged children is necessary.

  18. Dietary differences between elderly Iranians living in Sweden and Iran a cross-sectional comparative study

    Directory of Open Access Journals (Sweden)

    Johansson Sven-Erik

    2011-05-01

    Full Text Available Abstract Background During the last decades, global migration has increased and many immigrant groups have a higher prevalence than the native born population of several cardiovascular disease risk factors, including poor dietary habits. However, it is uncertain if dietary habits in immigrant populations reflect dietary habits in their country of origin or if the current diet is a consequence of the migration and possible change of dietary habits. The aim of this study was to examine possible dietary differences between elderly Iranians living in Stockholm, Sweden with elderly Iranians living in Tehran, Iran, taking into account sex, age, marital status, and education. Methods Dietary intakes were assessed by semi - quantitative food frequency questionnaire in a cross-sectional study of 121 Iranians living in Stockholm and 52 Iranians living in Tehran, aged 60-80. Differences in dietary habits between the two groups was analysed by bootstrapped regression analyses with 1000 replications. Results Iranians living in Sweden had significantly higher intake of protein, total fat, fiber than Iranians living in Iran, but lower consumption of carbohydrates. The observed differences in intake of macronutrients were reflected in consumed amount of all food items, which were higher among Iranians living in Iran with the exception of bread and grain consumption which was lower. Conclusions There are general differences in dietary habits between Iranians living in Iran and Iranians living in Sweden. Parts of observed differences in dietary habits may reflect a favourable adoption process to the Swedish dietary habits after migration. Meanwhile other differences are point of concern in light of the high prevalence of overweight, among Iranians living in Sweden and can have unfavourable impact in particular in the context of cardiovascular health.

  19. Neighborhood deprivation and childhood autism: a nationwide study from Sweden.

    Science.gov (United States)

    Li, Xinjun; Sjöstedt, Cecilia; Sundquist, Kristina; Zöller, Bengt; Sundquist, Jan

    2014-06-01

    To examine whether there is an association between neighborhood deprivation and childhood autism, after accounting for family- and individual-level sociodemographic characteristics. An open cohort of all children aged 2-11 years was followed between January 1, 2000 and December 31, 2010. Childhood residential locations were geocoded and classified according to neighborhood deprivation (an index of low education, low income, unemployment, and receipt of welfare assistance). Data were analyzed by multilevel logistic regression, with family- and individual-level characteristics at the first level and level of neighborhood deprivation at the second level. During the study period, among a total of 643,456 children, 1699 (0.3%) were diagnosed with childhood autism. Age-standardized cumulative incidence, defined as first registration for childhood autism during the study period, increased with increasing level of neighborhood deprivation. In the study population, 2.2 per 1000 and 3.6 per 1000 children in the least and most deprived neighborhoods, respectively, were diagnosed with childhood autism. Incidence of childhood autism increased with increasing neighborhood-level deprivation across all family and individual-level sociodemographic categories. The odds ratio (OR) for childhood autism for those living in high-deprivation neighborhoods versus those living in low-deprivation neighborhoods was 1.59 (95% confidence interval = 1.35-1.88). High neighborhood deprivation remained significantly associated with odds of childhood autism after adjustment for family- and individual-level sociodemographic characteristics (OR = 1.28, 95% confidence interval = 1.07-1.53, P = 0.007). This study is the largest so far on potential neighborhood influences on childhood autism. Our results show that neighborhood deprivation is associated with childhood autism, independently of family- and individual-level sociodemographic characteristics. Copyright © 2014 Elsevier Ltd. All rights

  20. Epidemiology of Massive Transfusion: A Binational Study From Sweden and Denmark.

    Science.gov (United States)

    Halmin, Märit; Chiesa, Flaminia; Vasan, Senthil K; Wikman, Agneta; Norda, Rut; Rostgaard, Klaus; Vesterager Pedersen, Ole Birger; Erikstrup, Christian; Nielsen, Kaspar René; Titlestad, Kjell; Ullum, Henrik; Hjalgrim, Henrik; Edgren, Gustaf

    2016-03-01

    There is an increasing focus on massive transfusion, but there is a paucity of comprehensive descriptions of the massively transfused patients and their outcomes. The objective of this study is to describe the incidence rate of massive transfusion, patient characteristics, and the mortality of massively transfused patients. Descriptive cohort study. Nationwide study with data from Sweden and Denmark. The study was based on the Scandinavian Donations and Transfusions database, including all patients receiving 10 or more red cell concentrate transfusions in Sweden from 1987 and in Denmark from 1996. A total of 92,057 patients were included. Patients were followed until the end of 2012. Descriptive statistics were used to characterize the patients and indications. Post transfusion mortality was expressed as crude 30-day mortality and as long-term mortality using the Kaplan-Meier method and using standardized mortality ratios. The incidence of massive transfusion was higher in Denmark (4.5 per 10,000) than in Sweden (2.5 per 10,000). The most common indication for massive transfusion was major surgery (61.2%) followed by trauma (15.4%). Massive transfusion due to obstetrical bleeding constituted only 1.8%. The overall 5-year mortality was very high (54.6%), however with large differences between indication groups, ranging from 91.1% among those transfused for a malignant disease without surgery to 1.7% among patients transfused for obstetrical bleeding. The early standardized mortality ratios were high and decreased thereafter, but remained elevated throughout the time period. This large-scale study based on nationwide data from Sweden and Denmark describes the complete range of massive transfusion. We report a nonnegligible incidence and both a high absolute mortality and high standardized mortality ratio. The general pattern was similar for Sweden and Denmark, and we believe that similar patterns may be found in other high-resource countries. The study provides a

  1. New Geographies of Work: A Case Study from Sweden

    Directory of Open Access Journals (Sweden)

    Brita Hermelin

    2012-01-01

    Full Text Available This paper describes and analyses the geography of work, i.e., the spatial patterns in where paid work is done. The geography of work may diverge from the geography of employment when paid work is done at the premises of client organizations, during commuting, on business trips, on external meetings, at home or at other places. The particular patterns in the geography of work depend on a number of factors, possibilities and constraints. The paper takes its point of departure from the debate about how structural economic changes resulting from evolving service industries and the development of Information and Communication Technology (ICT entail new forms for the organization of paid work. Flexibility, reflexivity, flows and places are key concepts. The paper presents a case study from Stockholm that takes a workplace perspective and looks at knowledge-intensive work in a public sector organization. The empirical study analyses data from interviews, time diaries and a questionnaire. We analyse how the geography of work is the result of negotiations between different parties and in different arenas, and how this spatial pattern is the result of the character of work tasks and accessibility of ICT support. The discussion illustrates a complex picture of the coexistence of spatial fix and spatial flexibility, and how this may cause tensions but also convenient solutions for organizing and conducting paid work.

  2. Validated and longitudinally stable asthma phenotypes based on cluster analysis of the ADEPT study

    NARCIS (Netherlands)

    Loza, Matthew J.; Djukanovic, Ratko; Chung, Kian Fan; Horowitz, Daniel; Ma, Keying; Branigan, Patrick; Barnathan, Elliot S.; Susulic, Vedrana S.; Silkoff, Philip E.; Sterk, Peter J.; Baribaud, Frédéric; Adcock, Ian; Adriaens, Nora; Ahmed, Hassan; Aliprantis, Antonios; Alving, Kjell; Auffray, Charles; Badorrek, Philipp; Bakke, Per; Balgoma, David; Bansal, Aruna T.; Barber, Clair; Bautmans, An; Behndig, Annelie F.; Bel, Elisabeth; Beleta, Jorge; Berglind, Ann; Berton, Alix; Bigler, Jeannette; Bisgaard, Hans; Bochenek, Grazyna; Boedigheimer, Michel J.; Bøonnelykke, Klaus; Brandsma, Joost; Braun, Armin; Brinkman, Paul; Burg, Dominic; Campagna, Davide; Carayannopoulos, Leon; Caruso, Massimo; da Purificação, Rocha João Pedro Carvalho; Chaiboonchoe, Amphun; Chaleckis, Romanas; Chanez, Pascal; Chung, Kian F.; Coleman, Courtney; Compton, Chris; Corfield, Julie; D'Amico, Arnaldo; Dahlen, Barbro; Dahlén, Sven-Erik; de Alba, Jorge; de Boer, Pim; de Lepeleire, Inge; de Meulder, Betrand; Dekker, Tamara; Delin, Ingrid; Dennison, Patrick; Dijkhuis, Annemiek; Draper, Aleksandra; Edwards, Jessica; Emma, Rosalia; Ericsson, Magnus; Erpenbeck, Veit; Erzen, Damijan; Fichtner, Klaus; Fitch, Neil; Fleming, Louis J.; Flood, Breda; Fowler, Stephen J.; Frey, Urs; Gahlemann, Martina; Galffy, Gabriella; Gallart, Hector; Garrett, Trevor; Geiser, Thomas; Gent, Julaiha; Gerhardsson, de Verdier Maria; Gibeon, David; Gomez, Cristina; Gove, Kerry; Gozzard, Neil; Guo, Yi-Ke; Hashimoto, Simone; Haughney, John; Hedlin, Gunilla; Hekking, Pieter-Paul; Henriksson, Elisabeth; Hewitt, Lorraine; Higgenbottam, Tim; Hoda, Uruj; Hohlfeld, Jens; Holweg, Cecile; Horvath, Ildiko; Howarth, Peter; Hu, Richard; Hu, Sile; Hu, Xugang; Hudson, Val; James, Anna J.; Kamphuis, Juliette; Kennington, Erika J.; Kerry, Dyson; Klüglich, Matthias; Knobel, Hugo; Knowles, Richard; Knox, Alan; Kolmert, Johan; Konradsen, Jon; Kots, Maxim; Krueger, Linn; Krug, Norbert; Kuo, Scott; Kupczyk, Maciej; Lambrecht, Bart; Lantz, Ann-Sofie; Larsson, Lars; Lazarinis, Nikos; Lefaudeux, Diane; Lone-Latif, Saeeda; Lutter, Rene; Marouzet, Lisa; Martin, Jane; Masefield, Sarah; Mathon, Caroline; Matthews, John G.; Mazein, Alexander; Meah, Sally; Meiser, Andrea; Menzies-Gow, Andrew; Metcalf, Leanne; Middelveld, Roelinde; Mikus, Maria; Miralpeix, Montse; Monk, Philip; Montuschi, Paolo; Mores, Nadia; Murray, Clare S.; Musial, Jacek; Myles, David; Naz, Shama; Nething, Katja; Nicholas, Ben; Nihlen, Ulf; Nilsson, Peter; Nordlund, Björn; Östling, Jörgen; Pacino, Antonio; Pahus, Laurie; Palkonen, Susanna; Pandis, Ioannis; Pavlidis, Stelios; Pennazza, Giorgio; Petrén, Anne; Pink, Sandy; Postle, Anthony; Powel, Pippa; Rahman-Amin, Malayka; Rao, Navin; Ravanetti, Lara; Ray, Emma; Reinke, Stacey; Reynolds, Leanne; Riemann, Kathrin; Riley, John; Robberechts, Martine; Roberts, Amanda; Roberts, Graham; Rossios, Christos; Rowe, Anthony; Russell, Kirsty; Rutgers, Michael; Sandström, Thomas; Santini, Giuseppe; Santoninco, Marco; Schoelch, Corinna; Schofield, James P. R.; Seibold, Wolfgang; Shaw, Dominick E.; Sigmund, Ralf; Singer, Florian; Sjödin, Marcus; Skipp, Paul J.; Smids, Barbara; Smith, Caroline; Smith, Jessica; Smith, Katherine M.; Söderman, Päivi; Sogbesan, Adesimbo; Sousa, Ana R.; Staykova, Doroteya; Strandberg, Karin; Sun, Kai; Supple, David; Szentkereszty, Marton; Tamasi, Lilla; Tariq, Kamran; Thörngren, John-Olof; Thornton, Bob; Thorsen, Jonathan; Valente, Salvatore; van, Aalderen Wim; van de Pol, Marianne; van, Drunen Kees; van, Geest Marleen; Versnel, Jenny; Vestbo, Jorgen; Vink, Anton; Vissing, Nadja; von, Garnier Christophe; Wagener, Ariane; Wagers, Scott; Wald, Frans; Walker, Samantha; Ward, Jonathan; Weiszhart, Zsoka; Wetzel, Kristiane; Wheelock, Craig E.; Wiegman, Coen; Williams, Siân; Wilson, Susan J.; Woodcock, Ashley; Yang, Xian; Yeyasingham, Elizabeth; Yu, Wen; Zetterquist, Wilhelm; Zwinderman, Koos

    2016-01-01

    Asthma is a disease of varying severity and differing disease mechanisms. To date, studies aimed at stratifying asthma into clinically useful phenotypes have produced a number of phenotypes that have yet to be assessed for stability and to be validated in independent cohorts. The aim of this study

  3. Asthma and Attention-Deficit/Hyperactivity Disorder: A Nationwide Population-Based Prospective Cohort Study

    Science.gov (United States)

    Chen, Mu-Hong; Su, Tung-Ping; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

    2013-01-01

    Background: Previous cross-sectional studies have suggested an association between asthma and attention-deficit/hyperactivity disorder (ADHD), but the temporal relationship was not determined. Using a nationwide population-based prospective case-control cohort study (1:4, age-/gender-matched), we hypothesized that asthma in infanthood or early…

  4. Self-Reported Stressful Life Events During Adolescence and Subsequent Asthma: A Longitudinal Study.

    Science.gov (United States)

    Oren, Eyal; Gerald, Lynn; Stern, Debra A; Martinez, Fernando D; Wright, Anne L

    Although exposure to stressful life events in adolescence has been associated with poor health as measured by number of physicians' visits and symptom scores, little is known regarding stress in adolescence and either concurrent or subsequent asthma. The objective of this study was to explore whether life events in adolescence are associated with either concurrent or new active asthma. The Tucson Children's Respiratory Study, a prospective population-based birth cohort, surveyed participants at 10 ages between 6 and 29 years regarding respiratory health. Asthma was defined as a physician-diagnosis of asthma with symptoms during the previous year. At age 16, participants (n = 318) were queried regarding stressful life events using the 67-item Life Events Questionnaire for Adolescents (LEQA). LEQA scores were examined in relation to both concurrent and new active asthma. Estimates were obtained with logistic regression and mixed models. There was no relation between asthma prevalence at age 16 and LEQA scores in the overall sample, although males with high LEQA scores had higher prevalence of asthma compared with males with low scores (relative risk [RR]: 3.03; 95% confidence interval [CI]: 1.37, 6.69; P = .006). Among adolescents with no asthma through age 16, risk of new asthma was greater for those with high LEQA scores (adjRR: 4.07; 95% CI: 1.33, 12.43; P = .014), after adjustment for potential confounders including smoking. Emotional support from family and friends slightly diminished the relation of stress to new asthma. Stressful life events during adolescence are associated with subsequent new asthma. Additional biological and psychological measures of stress would complement these findings. Published by Elsevier Inc.

  5. Prenatal and infant paracetamol exposure and development of asthma: the Norwegian Mother and Child Cohort Study.

    Science.gov (United States)

    Magnus, Maria C; Karlstad, Øystein; Håberg, Siri E; Nafstad, Per; Davey Smith, George; Nystad, Wenche

    2016-04-01

    Paracetamol exposure has been positively associated with asthma development. The relative importance of prenatal vs infant exposure and confounding by indication remains elusive. We examined the association of prenatal and infant (first 6 months) paracetamol exposure with asthma development while addressing confounding by indication. We used information from the Norwegian Mother and Child Cohort Study, including 53169 children for evaluation of current asthma at 3 years, 25394 for current asthma at 7 years and 45607 for dispensed asthma medications at 7 years in the Norwegian Prescription Database. We calculated adjusted relative risks (adj. RR) and 95% confidence intervals (CI) using log-binomial regression. There were independent modest associations between asthma at 3 years with prenatal paracetamol exposure (adj. RR 1.13; 95% CI: 1.02-1.25) and use of paracetamol during infancy (adj. RR 1.29; 95% CI: 1.16-1.45). The results were consistent for asthma at 7 years. The associations with prenatal paracetamol exposure were seen for different indications (pain, respiratory tract infections/influenza and fever). Maternal pain during pregnancy was the only indication that showed an association both with and without paracetamol use. Maternal paracetamol use outside pregnancy and paternal paracetamol use were not associated with asthma development. In a secondary analysis, prenatal ibuprofen exposure was positively associated with asthma at 3 years but not asthma at 7 years. This study provides evidence that prenatal and infant paracetamol exposure have independent associations with asthma development. Our findings suggest that the associations could not be fully explained by confounding by indication. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  6. Effects of pets on asthma development up to 8 years of age: the PIAMA study.

    NARCIS (Netherlands)

    Kerkhof, M.; Wijga, A.H.; Brunekreef, B.|info:eu-repo/dai/nl/067548180; Smit, H.A.; de Jongste, J.C.; Aalberse, R.C.; Hoekstra, M.O.; Gerritsen, J.|info:eu-repo/dai/nl/336510160; Postma, D.S.

    2009-01-01

    BACKGROUND: Recall bias may provide discrepant relationships of pet exposure with sensitization and asthma development. We studied prospectively effects of pets at home on development of sensitization, asthma and respiratory symptoms from birth up to age 8 years. METHODS: Event history analysis was

  7. Effects of pets on asthma development up to 8 years of age: the PIAMA study

    NARCIS (Netherlands)

    Kerkhof, M.; Wijga, A. H.; Brunekreef, B.; Smit, H. A.; de Jongste, J. C.; Aalberse, R. C.; Hoekstra, M. O.; Gerritsen, J.; Postma, D. S.

    2009-01-01

    BACKGROUND: Recall bias may provide discrepant relationships of pet exposure with sensitization and asthma development. We studied prospectively effects of pets at home on development of sensitization, asthma and respiratory symptoms from birth up to age 8 years. METHODS: Event history analysis was

  8. Effects of pets on asthma development up to 8 years of age : the PIAMA study

    NARCIS (Netherlands)

    Kerkhof, M.; Wijga, A. H.; Brunekreef, B.; Smit, H. A.; de Jongste, J. C.; Aalberse, R. C.; Hoekstra, M. O.; Gerritsen, J.; Postma, D. S.

    Background: Recall bias may provide discrepant relationships of pet exposure with sensitization and asthma development. We studied prospectively effects of pets at home on development of sensitization, asthma and respiratory symptoms from birth up to age 8 years. Methods: Event history analysis was

  9. Secular trends of allergic asthma in Danish adults. The Copenhagen Allergy Study

    DEFF Research Database (Denmark)

    Linneberg, A; Nielsen, N H; Madsen, F

    2001-01-01

    Numerous studies have reported increases in asthma prevalence among children world-wide. Less is known about similar trends in adults. We aimed to investigate whether the prevalence of allergic asthma symptoms had increased in an adult general population. Two cross-sectional surveys using identic...

  10. Childhood Asthma: A Clinical Study in Southern Nigeria | Okoh ...

    African Journals Online (AJOL)

    The most common recognized trigger factor for exacerbation of asthmatic symptoms was extreme cold seen in 29 (72.5%) patients, while the most common identified early childhood risk factor for development of asthma was a positive family history of asthma in 21 (52.5%) patients. Thirty five of the subjects (87.5%) had mild ...

  11. Comorbidities of asthma during childhood : possibly important, yet poorly studied

    NARCIS (Netherlands)

    de Groot, E. P.; Duiverman, E. J.; Brand, P. L. P.

    Asthma in adults is associated with comorbidities such as obesity, gastro-oesophageal reflux, dysfunctional breathing and mental disorders. Herein, we provide an overview of the current state of evidence on these comorbidities in childhood asthma. The prevalence, known mechanisms and possible

  12. Long-term exposure to air pollution and asthma hospitalisations in older adults: a cohort study.

    Science.gov (United States)

    Andersen, Zorana Jovanovic; Bønnelykke, Klaus; Hvidberg, Martin; Jensen, Steen S; Ketzel, Matthias; Loft, Steffen; Sørensen, Mette; Tjønneland, Anne; Overvad, Kim; Raaschou-Nielsen, Ole

    2012-01-01

    Exposure to air pollution in early life contributes to the burden of childhood asthma, but it is not clear whether long-term exposure to air pollution can lead to asthma onset or progression in adulthood. The authors studied the effect of exposure to traffic-related air pollution over 35 years on the risk for asthma hospitalisation in older people. 57 053 participants in the Danish Diet, Cancer and Health cohort, aged 50-65 years at baseline (1993-1997), were followed up for first hospital admission for asthma until 2006, and the annual nitrogen dioxide (NO(2)) levels were estimated as a proxy of the exposure to traffic-related air pollution at the residential addresses of the participants since 1971. The association between NO(2) and hospitalisation for asthma was modelled using Cox regression, for the full cohort and in people with and without previous hospitalisations for asthma, and the effect modification by comorbid conditions was assessed. During 10.2 years' median follow-up, 977 (1.9%) of 53 695 eligible people were admitted to hospital for asthma: 821 were first-ever admissions and 176 were readmissions. NO(2) levels were associated with risk for asthma hospitalisation in the full cohort (HR and 95% CI per IQR, 5.8 μg/m(3): 1.12; 1.04-1.22), and for first-ever admissions (1.10; 1.01-1.20), with the highest risk in people with a history of asthma (1.41; 1.15-2.07) or chronic obstructive pulmonary disease (COPD) (1.30; 1.07-1.52) hospitalisation. Long-term exposure to traffic-related air pollution increases the risk for asthma hospitalisation in older people. People with previous asthma or COPD hospitalisations are most susceptible.

  13. Asthma during pregnancy in a population-based study--pregnancy complications and adverse perinatal outcomes.

    Directory of Open Access Journals (Sweden)

    Gustaf Rejnö

    Full Text Available BACKGROUND: Asthma is one of the most common chronic diseases, and prevalence, severity and medication may have an effect on pregnancy. We examined maternal asthma, asthma severity and control in relation to pregnancy complications, labour characteristics and perinatal outcomes. METHODS: We retrieved data on all singleton births from July 1, 2006 to December 31, 2009, and prescribed drugs and physician-diagnosed asthma on the same women from multiple Swedish registers. The associations were estimated with logistic regression. RESULTS: In total, 266 045 women gave birth to 284 214 singletons during the study period. Maternal asthma was noted in 26 586 (9.4% pregnancies. There was an association between maternal asthma and increased risks of pregnancy complications including preeclampsia or eclampsia (adjusted OR 1.15; 95% CI 1.06-1.24 and premature contractions (adj OR 1.52; 95% CI 1.29-1.80. There was also a significant association between maternal asthma and emergency caesarean section (adj OR 1.29; 95% CI 1.23-1.34, low birth weight, and small for gestational age (adj OR 1.23; 95% CI 1.13-1.33. The risk of adverse outcomes such as low birth weight increased with increasing asthma severity. For women with uncontrolled compared to those with controlled asthma the results for adverse outcomes were inconsistent displaying both increased and decreased OR for some outcomes. CONCLUSION: Maternal asthma is associated with a number of serious pregnancy complications and adverse perinatal outcomes. Some complications are even more likely with increased asthma severity. With greater awareness and proper management, outcomes would most likely improve.

  14. The Inhaled Steroid Treatment As Regular Therapy in Early Asthma (START) study 5-year follow-up: effectiveness of early intervention with budesonide in mild persistent asthma

    DEFF Research Database (Denmark)

    Busse, William W; Pedersen, Søren; Pauwels, Romain A

    2008-01-01

    BACKGROUND: The Inhaled Steroid Treatment as Regular Therapy in Early Asthma (START) study enrolled 7241 patients aged 5 to 66 years with recent-onset, mild persistent asthma to assess early intervention with the inhaled corticosteroid budesonide on long-term asthma control. OBJECTIVE: The open......-label phase of the START study was included to determine the effect on lung function and asthma control of adding budesonide to the reference group patients who had not initially received inhaled corticosteroids. METHODS: Patients were randomized to double-blind treatment with budesonide, 200 mug (those aged...... asthma therapy for 3 years, after which all patients received 2 years of open-label treatment with budesonide once daily. RESULTS: During the full 5-year study period, postbronchodilator FEV(1) percent predicted decreased, irrespective...

  15. Antibiotic sales and the prevalence of symptoms of asthma, rhinitis, and eczema: The International Study of Asthma and Allergies in Childhood (ISAAC).

    Science.gov (United States)

    Foliaki, Sunia; Nielsen, Sandy Kildegaard; Björkstén, Bengt; Von Mutius, Erika; Cheng, Soo; Pearce, Neil

    2004-06-01

    It has been hypothesized that antibiotic use early in life may increase the subsequent risk of asthma. We have conducted an ecologic analysis of the relationship between antibiotics sales and the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema in 99 centres from 28 countries. Data for antibiotics sales for 28 countries were obtained from the Institute for Medical Statistics (IMS), Health Global Services, UK and converted to defined daily doses (DDD). Data on the prevalence of symptoms of asthma, rhinitis, and eczema in 13-14 year olds were based on the responses to the written and video questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC). The analysis was adjusted for gross national product (GNP) as an estimate of the level of affluence. In general, there was a positive association between per capita antibiotics sales and the prevalence of symptoms for asthma, rhinitis, and eczema, but the associations generally became negative once the analyses had been adjusted for GNP. In particular, there were non-significant negative associations between total antibiotics sales and the prevalence of wheeze ever, wheeze in the last 12 months, nose problems with itchy-watery eyes, itchy rash in the last 12 months, and eczema ever. On the other hand there were weak non-significant positive associations for asthma ever, nose problems ever, nose problems in the last 12 months, and itchy rash ever. There was a statistically significant positive association with wheeze at rest as measured by the asthma video questionnaire; however, even this association was weak and would not account for more than a 1% difference in asthma prevalence between countries. These findings are generally not consistent with the hypothesis that antibiotic use increases the risk of asthma, rhinitis, or eczema. If there is a causal association of antibiotic use with asthma risk, it does not appear to explain the international differences in

  16. Young People's Preferences for an Asthma Self-Management App Highlight Psychological Needs: A Participatory Study.

    Science.gov (United States)

    Peters, Dorian; Davis, Sharon; Calvo, Rafael Alejandro; Sawyer, Susan M; Smith, Lorraine; Foster, Juliet M

    2017-04-11

    Although the prevalence of mental illness among young people with asthma is known to be twice the rate of the wider population, none of the asthma apps reported have acknowledged or attempted to include psychological support features. This is perhaps because user involvement in the development of asthma apps has been scarce. User involvement, facilitated by participatory design methods, can begin to address these issues while contributing insights to our understanding of the psychological experience associated with asthma and how technology might improve quality of life. The goal of this participatory user research study was to explore the experience, needs, and ideas of young people with asthma while allowing them to define requirements for an asthma app that would be engaging and effective at improving their well-being. Young people aged 15-24 years with doctor-diagnosed asthma were invited to participate in a participatory workshop and to complete a workbook designed to elicit their thoughts and ideas about living with asthma, technology use, and the design of an app. Participants generated a number of artifacts (including collages, concept maps, and paper prototypes) designed to reify their ideas, tacit knowledge, and experience. A total of 20 participants (mean age 17.8 years; 60%, 12/20 female) representing a range from inadequately to well-controlled asthma completed a workbook and 13 of these also took part in a workshop (four workshops were held in total), resulting in 102 participant-generated artifacts. Theoretical thematic analysis resulted in a set of personal needs, feature ideas, and app characteristics considered relevant by young people for an asthma support app. The data revealed that psychological factors such as anxiety, and impediments to autonomy, competence, and relatedness (as consistent with self-determination theory [SDT]), were considered major influences on quality of life by young people with asthma. Furthermore, the incorporation of

  17. Omalizumab treats chronic rhinosinusitis with nasal polyps and asthma together-a real life study.

    Science.gov (United States)

    Bidder, T; Sahota, J; Rennie, C; Lund, V J; Robinson, D S; Kariyawasam, H H

    2018-03-01

    Chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma often coexist and thus treating both with one intervention is an attractive strategy. To prospectively evaluate whether treatment with the monoclonal antibody against IgE Omalizumab for severe allergic asthma also effectively treats co-existent CRSwNP. SNOT-22 and the ACQ-7 scores were recorded at 4 and 16 weeks of treatment in a cohort of patients with both CRSwNP and severe refractory allergic asthma treated with Omalizumab (n=13) according to UK guidelines for their severe asthma. SNOT-22 in a surgery only treated CRSwNP with asthma group (n=24) was compared. Rapid improvement was seen at 4 weeks and 16 weeks of treatment in both CRSwNP and asthma control. The improvement in CRSwNP with Omalizumab was similar to that seen in a group of patients who received upper airway surgery. Omalizumab treatment for severe allergic asthma also improves co-existent CRSwNP. Further clinical studies of current and emerging biological agents for severe asthma should include upper airway outcomes. These agents may be effective for severe CRSwNP and comparative studies with surgery are warranted.

  18. Accuracy of spirometry for detection of asthma: a cross-sectional study.

    Science.gov (United States)

    Meneghini, Andréa Cristina; Paulino, Ana Carolina Botto; Pereira, Luciano Penha; Vianna, Elcio Oliveira

    2017-01-01

    Asthma is a chronic inflammatory disease with airway hyperresponsiveness. Spirometry is the most commonly used test among asthmatic patients. Another functional test used for diagnosing asthma is the bronchial challenge test. The aim of this study was to analyze the accuracy of spirometry for detecting asthma in the general population. Cross-sectional study with data analysis to evaluate the accuracy of spirometry through calculating sensitivity, specificity and predictive values and through the kappa agreement test. Subjects who constituted a birth cohort were enrolled at the age of 23 to 25 years. Spirometric abnormality was defined as reduced forced expiratory volume in one second, i.e. lower than 80% of the predicted value. Measurement of bronchial responsiveness was performed by means of the bronchial challenge test with methacholine. The gold-standard diagnosis of asthma was defined as the presence of bronchial hyperresponsiveness in association with respiratory symptoms. Asthma was detected in 200 subjects (10.4%) out of the sample of 1922 individuals. Spirometric abnormality was detected in 208 subjects (10.9%) of the sample. The specificity of spirometric abnormality for detecting asthma was 90%, sensitivity was 23%, positive predictive value was 22%, and negative predictive value was 91%. The kappa test revealed weak agreement of 0.13 (95% confidence interval, CI: 0.07-0.19) between spirometry and the diagnosis of asthma. Spirometry, as a single test, has limitations for detecting asthma in the general population.

  19. Risk factors for asthma in young adults: a co-twin control study

    DEFF Research Database (Denmark)

    Thomsen, S F; Ulrik, C S; Kyvik, K O

    2006-01-01

    and females = 0.54, 95% CI: 0.36-0.80, P = 0.002), and increasing levels of body mass index (BMI; OR per unit = 1.11, 95% CI: 1.02-1.20, P = 0.009) were significant predictors of asthma. CONCLUSIONS: Hay fever, eczema, female sex, exercise and increasing levels of BMI were risk factors for asthma in young...... who were initially unaffected with respect to asthma at a nationwide questionnaire-based study in 1994 participated in a similar follow-up study in 2002. Subjects were regarded incident asthma cases when responding affirmatively to the question 'Do you have, or have you ever had asthma'? in 2002...

  20. Clinical documentation variations and NLP system portability: a case study in asthma birth cohorts across institutions.

    Science.gov (United States)

    Sohn, Sunghwan; Wang, Yanshan; Wi, Chung-Il; Krusemark, Elizabeth A; Ryu, Euijung; Ali, Mir H; Juhn, Young J; Liu, Hongfang

    2017-11-30

    To assess clinical documentation variations across health care institutions using different electronic medical record systems and investigate how they affect natural language processing (NLP) system portability. Birth cohorts from Mayo Clinic and Sanford Children's Hospital (SCH) were used in this study (n = 298 for each). Documentation variations regarding asthma between the 2 cohorts were examined in various aspects: (1) overall corpus at the word level (ie, lexical variation), (2) topics and asthma-related concepts (ie, semantic variation), and (3) clinical note types (ie, process variation). We compared those statistics and explored NLP system portability for asthma ascertainment in 2 stages: prototype and refinement. There exist notable lexical variations (word-level similarity = 0.669) and process variations (differences in major note types containing asthma-related concepts). However, semantic-level corpora were relatively homogeneous (topic similarity = 0.944, asthma-related concept similarity = 0.971). The NLP system for asthma ascertainment had an F-score of 0.937 at Mayo, and produced 0.813 (prototype) and 0.908 (refinement) when applied at SCH. The criteria for asthma ascertainment are largely dependent on asthma-related concepts. Therefore, we believe that semantic similarity is important to estimate NLP system portability. As the Mayo Clinic and SCH corpora were relatively homogeneous at a semantic level, the NLP system, developed at Mayo Clinic, was imported to SCH successfully with proper adjustments to deal with the intrinsic corpus heterogeneity.

  1. Sunny hours and variations in the prevalence of asthma in schoolchildren according to the International Study of Asthma and Allergies (ISAAC) Phase III in Spain

    Science.gov (United States)

    Arnedo-Pena, Alberto; García-Marcos, Luis; Fernández-Espinar, Jorge Fuertes; Bercedo-Sanz, Alberto; Aguinaga-Ontoso, Ines; González-Díaz, Carlos; Carvajal-Urueña, Ignacio; Busquet-Monge, Rosa; Suárez-Varela, Maria Morales; de Andoin, Nagore García; Batlles-Garrido, Juan; Blanco-Quirós, Alfredo; Varela, Angel López-Silvarrey; García-Hernández, Gloria

    2011-05-01

    The objective of this study was to estimate the relationship between the prevalence of asthma in schoolchildren aged 6-7 years and 13-14 years and the mean annual sunny hours (MASH) in Spain, and to explore predictive models for asthma prevalence. The prevalence of asthma was obtained from the International Study of Asthma and Allergies (ISAAC) Phase III 2002-2003, and climate and socio-economic variables from official sources. Nine centres were studied and a further four centres, two of which are in ISAAC, to test the predictive models. Logistic regression was used to estimate adjusted prevalence rates of asthma for each centre, and multiple regression models to study the effects of MASH and other meteorological and socio-economic variables. The adjusted prevalence rate of asthma decreased 0.6% [95% confidence interval (CI) 0.4-0.8%] for the 6-7 years group and 1.1% (95% CI 0.8-1.3%) for the 13-14 years group with an increase in the MASH of 100 h. Relative humidity was negatively associated with asthma in the older age group, and gross province product per capita (GPP) was positively associated with asthma in the younger age group. The predictive models, which included MASH, gender, relative humidity, and GPP, anticipated prevalence rates of asthma without significant differences between the levels observed and those expected in 9 of the11 measurements carried out. The results indicate that sunny hours have a protective effect on the prevalence of asthma in schoolchildren.

  2. Long-term prognosis of asthma, chronic obstructive pulmonary disease, and asthma-chronic obstructive pulmonary disease overlap in the Copenhagen City Heart study

    DEFF Research Database (Denmark)

    Lange, Peter; Çolak, Yunus; Ingebrigtsen, Truls Sylvan

    2016-01-01

    were 39·48 (95% CI 25·93-60·11) in asthma-COPD overlap with early-onset asthma, 83·47 (61·67-112·98) in asthma-COPD overlap with late-onset asthma, 23·80 (17·43-33·50) in COPD, and 14·74 (10·06-21·59) in asthma compared with never-smokers without lung disease (all pLife expectancy was 9...... focus on individuals with asthma-COPD overlap. METHODS: We assigned participants from the Copenhagen City Heart Study into six subgroups: healthy never-smokers, ever-smokers without asthma and COPD, those with asthma with low cumulated smoking exposure and no airflow limitation, those with COPD, those...... ratio of less than 0·7, without any restrictions regarding smoking. We investigated the course of FEV1 decline for 18 years and risk of admission to hospital due to exacerbations or pneumonias and respiratory and all-cause mortality for 22 years. We analysed FEV1 decline in the six groups using a linear...

  3. Blood granulocyte patterns as predictors of asthma phenotypes in adults from the EGEA study.

    Science.gov (United States)

    Nadif, Rachel; Siroux, Valérie; Boudier, Anne; le Moual, Nicole; Just, Jocelyne; Gormand, Frederic; Pison, Christophe; Matran, Regis; Pin, Isabelle

    2016-10-01

    To what extent blood granulocyte patterns may predict asthma control remains under-studied. Our aim was to study associations between blood neutrophilia and eosinophilia and asthma control outcomes in adults.Analyses were conducted in 474 asthmatics from the first follow-up of the Epidemiological Study on the Genetics and Environment of Asthma (EGEA2), including 242 asthmatics who were adults a decade earlier (EGEA1). At EGEA2, asthma control was assessed using the Global Initiative for Asthma definition (2015), and asthma exacerbations by use of urgent care or courses of oral corticosteroids in the past year. Blood EOS lo /EOS hi was defined as EGEA2, NEU hi was associated with asthma exacerbations and poor asthma control (OR >2.10). EOS hi was associated with higher bronchial hyperresponsiveness (BHR) (OR (95% CI) 2.21 (1.24-3.97)), poor lung function (p=0.02) and higher total IgE level (p=0.002). Almost 50% of asthmatics had a persistent pattern between surveys. Persistent NEU hi was associated with poor asthma control at EGEA2 (OR (95% CI) 3.09 (1.18-7.05)). EOS hi at EGEA1 and persistent EOS hi were associated with higher BHR (OR (95% CI) 2.36 (1.10-5.07) and 3.85 (1.11-13.34), respectively), poor lung function (pEGEA2.Granulocyte patterns were differently associated with asthma outcomes, suggesting specific roles for each one, which could be tested as predictive signatures. Copyright ©ERS 2016.

  4. TOURISM STUDIES IN THE HIGHER EDUCATION IN SWEDEN: FOCUSING ON SUSTAINABILITY

    Directory of Open Access Journals (Sweden)

    Olga Milinchuk

    2017-11-01

    Full Text Available In this paper the Swedish higher tourism education is presented by analyzing the development of tourism education. Descriptive information of English taught University programs has been collected with a purpose to gain a deeper understanding of the general features of tourism higher education in Sweden. Methodology. The paper is based on a web-based content analysis of Swedish universities’ web-sites. In total six master degree programs at five universities were analyzed. Results of the analysis showed that the first Swedish academic program in tourism was opened in 1978 and from its inception tourism education is of growing significance. Instead of the higher number of degree programs in tourism, which are taught in Swedish, there is a limited number of those taught in English. Just one Bachelor Programme is taught in English in International Tourism is developed at Dalarna University and one Ph.D. Programme in Tourism is developed at Mid Sweden University. Master programs related to tourism are offered at Dalarna University, Linnaeus University, Lund University, Mid Sweden University, and Umeå University. Based on the curricula analysis of these programs, five main themes are identified: 1 tourism as a social phenomenon; 2 sustainable development of tourism; 3 tourism destination development; 4 economics of tourism, and 5 tourism through service studies. The findings show that the major university programs in tourism adopt an interdisciplinary approach, which combines elements of social sciences, humanities, and business administration. According to the observed curricula, the view on tourism as on social phenomenon prevails. In the studying process, the concept of sustainable development and classical social concepts such as ethnicity, gender, class, culture, and power relations are widely integrated into different tourism courses, making the programs comprehensive, and attractive for international students. The recognition of the tourism

  5. Siblings, asthma, rhinoconjunctivitis and eczema: a worldwide perspective from the International Study of Asthma and Allergies in Childhood.

    Science.gov (United States)

    Strachan, D P; Aït-Khaled, N; Foliaki, S; Mallol, J; Odhiambo, J; Pearce, N; Williams, H C

    2015-01-01

    Associations of larger families with lower prevalences of hay fever, eczema and objective markers of allergic sensitization have been found fairly consistently in affluent countries, but little is known about these relationships in less affluent countries. Questionnaire data for 210,200 children aged 6-7 years from 31 countries, and 337,226 children aged 13-14 years from 52 countries, were collected by Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC). Associations of disease symptoms and labels of asthma, rhinoconjunctivitis and eczema were analysed by numbers of total, older and younger siblings, using mixed (multi-level) logistic regression models to adjust for individual covariates and at the centre level for region, language and national affluence. In both age groups, inverse trends (P national GNI per capita. These global findings on sibship size and childhood asthma, rhinoconjunctivitis and eczema suggest at least two distinct trends. Inverse associations with older siblings (observations which prompted the 'hygiene hypothesis' for allergic disease) are mainly a phenomenon of more affluent countries, whereas greater severity of symptoms in larger families is globally more widespread. © 2014 The Authors. Clinical & Experimental Allergy Published by John Wiley & Sons Ltd.

  6. A population-level study of place of death and associated factors in Sweden.

    Science.gov (United States)

    Håkanson, Cecilia; Öhlén, Joakim; Morin, Lucas; Cohen, Joachim

    2015-11-01

    The aims of this study were to examine, on a population level, where people die in Sweden, and to investigate associations between place of death and underlying cause of death, socioeconomic and environmental characteristics, with a particular interest in people dying from life-limiting conditions typically in need of palliative care. This population-level study is based on death certificate data for all deceased individuals in Sweden in 2012, with a registered place of death (n=83,712). Multivariable logistic regression was performed to investigate associations between place of death and individual, socioeconomic and environmental characteristics. The results show that, in 2012, 42.1% of all deaths occurred in hospitals, 17.8% occurred at home and 38.1% in nursing home facilities. Individuals dying of conditions indicative of potential palliative care needs were less likely to die in hospital than those dying of other conditions (OR = 0.73; 95% CI = 0.70-0.77). Living at home in urban areas was associated with higher likelihood of dying in hospital or in a nursing home (OR = 1.04 and 1.09 respectively). Educational attainment and marital status were found to be somewhat associated with the place of death. The majority of deaths in Sweden occur in institutional settings, with comparatively larger proportions of nursing home deaths than most countries. Associations between place of death and other variables point to inequalities in availability and/or utilization of health services at the end of life. © 2015 the Nordic Societies of Public Health.

  7. Arachidonic acid intake and asthma risk in children and adults: a systematic review of observational studies.

    Science.gov (United States)

    Kakutani, Saki; Egawa, Kahori; Saito, Kayo; Suzuki, Toshihide; Horikawa, Chika; Rogi, Tomohiro; Kawashima, Hiroshi; Shibata, Hiroshi; Sasaki, Satoshi

    2014-01-01

    The effect of arachidonic acid (ARA) intake on asthma risk is unclear. The objective of the present review was to systematically evaluate available observational studies on the relationship between ARA exposure and asthma risk in children and adults. A PubMed search was conducted on 22 October 2013 and seventy-three publications were checked against predefined criteria for eligibility. To identify additional eligible publications, potentially relevant articles were searched from bibliographies of articles on ARA and asthma. A total of 2924 citations were scrutinised. Finally, fourteen articles were included. A quality assessment was conducted based on the reporting and methodological quality. A meta-analysis was not conducted; therefore, a qualitative assessment is presented. Three high-, two medium- and ten low-quality studies were reviewed. Eleven studies, including two high- and two medium-quality studies, did not find a significant association between ARA exposure and asthma risk. In contrast, one high-quality study indicated a significant trend toward reducing asthma risk in children with decreasing maternal ARA intake (P trend = 0·025), and one low-quality study reported a significant trend of increasing asthma risk with higher blood ARA levels (P trend = 0·007). In two low-quality studies, asthma patients had significantly lower blood ARA levels than controls (both P studies did not sufficiently demonstrate any relationships between ARA exposure and asthma risk because of the limited number of studies and their methodological limitations. They seem to suggest that ARA exposure is not consistently associated with asthma risk. Nevertheless, further evidence is required to prove or disprove the association.

  8. Burden of asthma among patients adherent to ICS/LABA: A real-world study.

    Science.gov (United States)

    Davis, Jill; Trudo, Frank; Siddall, James; Small, Mark

    2018-04-06

    Asthma is a chronic respiratory condition with a U.S. prevalence of 7.4%. Despite numerous treatment options, asthma remains poorly controlled in some patients. Uncontrolled asthma is associated with high healthcare resource utilization (HCRU) and reduced productivity. This study assessed symptoms, productivity, and HCRU of patients adherent to medium/high-dosage inhaled corticosteroid/long-acting beta2-agonist (ICS/LABA) treatment, and the relationship of asthma control with these parameters. Data were collected in the U.S. in 2013-2016 in the Adelphi Respiratory Disease Specific Programme, a cross-sectional survey. Participating physicians (n = 258) each completed a record form for eligible patients, who were receiving medium/high-dosage ICS/LABA treatment with self-reported moderate/high adherence, completed the Asthma Control Test (ACT) and the Work Productivity and Activity Impairment (WPAI) questionnaire, and were included in the analyses. Patients (n = 428) had a mean of 59% symptom-free days in the past month. Wheezing was the most troublesome symptom for 25% of patients. In the previous 12 months, the mean number of exacerbations was 1.3; 15% of exacerbations required emergency room treatment and/or hospitalization. Mean physician visits for asthma was 5.7. Asthma impacted leisure/personal time frequently/constantly for 11% of patients, with 20% overall work impairment. Asthma was poorly controlled (ACT score ≤15) in 18% of patients; poorer asthma control was associated with higher rates of exacerbations, work impairment, and HCRU. Given the substantial burden described, greater attention to asthma monitoring and management is necessary. Identification of novel treatments may be important for patients not responding to medium/high-dosage ICS/LABA treatment.

  9. Economic burden associated with chronic constipation in Sweden: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Bruce Wirta S

    2014-08-01

    Full Text Available Sara Bruce Wirta,1 Paul Hodgkins,2 Alain Joseph3 1IMS Health, Stockholm, Sweden; 2Shire, Wayne, PA, USA; 3Shire, Eysins, Switzerland Background: Chronic constipation is a common condition, but few studies have assessed its cost and impact on resource use. The purpose of this cohort study was to assess the health care utilization and costs of chronic constipation in a Swedish population using health care claims data. Methods: Data were compiled on health care costs, drug costs, and mortality for Västra Götaland, Sweden (2005–2009. These data were used to identify patients aged 18 years or older with chronic constipation, defined as: at least two health care contacts with a primary diagnosis of constipation within 12 months or at least one care contact with a primary diagnosis of constipation and two dispatches of laxatives 6 months before and 12 months after the index date. Patients with irritable bowel syndrome or taking opioids, both of which can cause constipation, were excluded. Costs, resource use, comorbidities, and laxative use were assessed during a 12-month follow-up period. Results: In total, 4,043 patients with chronic constipation were identified. They had a mean (SD age of 67±18 years. Mortality was 7% during the 12-month follow-up period and the most common comorbidity was hypertension (22%. In the 12-month follow-up period, patients with chronic constipation had a mean (SD of 2.3±7.5 constipation-related health care contacts and a mean (SD of 15.2±19.5 other health care contacts. Annual costs, adjusted for sex, age group, mortality, and comorbidities, were €5,388, of which €951 were for constipation-related care. Conclusion: Patients with chronic constipation constituted an elderly population with a high disease burden in Sweden between 2005 and 2009. Mean annual constipation-related health care costs, adjusted for potentially confounding factors, were €951 per patient. Keywords: cohort study, chronic constipation

  10. Effect of Education on Asthma Control in Children: A Quasi- Experimental Study

    Directory of Open Access Journals (Sweden)

    Arash Kalantari

    2017-12-01

    Full Text Available Introduction: The prevalence of asthma has increased significantly in recent decades1 especially in lower socioeconomic groups and in minority populations. Because of the increasing prevalence of asthma among children in worldwide and Iran, the importance of timely control of the disease after its diagnosis and few studies on the effect of education on asthma control in Iran, the aim of this study was to investigate the effect of education on asthma control in children. Methods: In this quasi-experimental study, 104 Iranian children (6-14 years old with asthma referred to asthma and allergy clinic of Children's Medical Center in Tehran were studied via convenience sampling method. Recruitment was occurred between 2011 to 2014. Subjects randomly were divided into two equal groups of intervention and control. For intervention group, common education as well as special education in format of booklet, pamphlets, CD and group training sessions were applied every two weeks within the first two months of follow up and every two months then after. While, the control group received usual careResults: The means of FEV1/ FVC change, frequency of admission to the ED, hospitalization and absence from school and use of steroids were significantly different before and after education in the intervention group. While changes among measured parameters in the control group were not significantly different.Conclusion: The results of this study showed that specific education has significant helpful effect on asthma attack control in children.

  11. Study on a hypothetical replacement of nuclear electricity by wind power in Sweden

    Science.gov (United States)

    Wagner, F.; Rachlew, E.

    2016-05-01

    The Swedish electricity supply system benefits strongly from the natural conditions which allow a high share of hydroelectricity. A complete supply is, however, not possible. Up to now, nuclear power is the other workhorse to serve the country with electricity. Thus, electricity production of Sweden is basically CO2 -free and Sweden has reached an environmental status which others in Europe plan to reach in 2050. Furthermore, there is an efficient exchange within the Nordic countries, Nordpol, which can ease possible capacity problems during dry cold years. In this study we investigate to what extent and with what consequences the base load supply of nuclear power can be replaced by intermittent wind power. Such a scenario leads unavoidably to high wind power installations. It is shown that hydroelectricity cannot completely smooth out the fluctuations of wind power and an additional back-up system using fossil fuel is necessary. From the operational dynamics, this system has to be based on gas. The back-up system cannot be replaced by a storage using surplus electricity from wind power. The surplus is too little. To overcome this, further strong extension of wind power is necessary which leads, however, to a reduction of the use of hydroelectricity if the annual consumption is kept constant. In this case one fossil-free energy form is replaced by another, however, more complex one. A mix of wind power at 22.3GW plus a gas based back-up system with 8.6GW producing together 64.8TWh would replace the present infrastructure with 9GW nuclear power producing 63.8TWh electricity. The specific CO2 -emission increases to the double in this case. Pumped storage for the exclusive supply of Sweden does not seem to be a meaningful investment.-1

  12. Change in child mortality patterns after injuries in Sweden: a nationwide 14-year study.

    Science.gov (United States)

    Bäckström, D; Steinvall, I; Sjöberg, F

    2017-06-01

    Sweden has one of the world's lowest child injury mortality rates, but injuries are still the leading cause of death among children. Child injury mortality in the country has been declining, but this decline seems to decrease recently. Our objective was therefore to further examine changes in the mortality of children's death from injury over time and to assess the contribution of various effects on mortality. The underlying hypothesis for this investigation is that the incidence of lethal injuries in children, still is decreasing and that this may be sex specific. We studied all deaths from injury in Sweden under-18-year-olds during the 14 years 1999-2012. We identified those aged under 18 whose underlying cause of death was recorded as International Classification of Diseases, 10th Revision (ICD-10) diagnosis from V01 to X39 in the Swedish cause of death, where all dead citizens are registered. From the 1 January 1999 to 31 December 2012, 1213 children under the age of 18 died of injuries in Sweden. The incidence declined during this period (r = -0.606, p = 0.02) to 3.3 deaths/100,000 children-years (95 % CI 2.6-4.2). Death from unintentional injury was more common than that after intentional injury (p injuries during the study period (r = -0.757, p = 0.03). The most common causes of death were injury to the brain (n = 337, 41 %), followed by drowning (n = 109, 13 %). The number of deaths after intentional injury increased (r = 0.585, p = 0.03) and at the end of the period was 1.5 deaths/100,000 children-years. The most common causes of death after intentional injuries were asphyxia (n = 177, 45 %), followed by injury to the brain (n = 76, 19 %). Mortality patterns in injured children in Sweden have changed from being dominated by unintentional injuries to a more equal distribution between unintentional and intentional injuries as well as between sexes and the overall rate has declined further. These findings are important as they might

  13. Menopause as a predictor of new-onset asthma: A longitudinal Northern European population study.

    Science.gov (United States)

    Triebner, Kai; Johannessen, Ane; Puggini, Luca; Benediktsdóttir, Bryndís; Bertelsen, Randi J; Bifulco, Ersilia; Dharmage, Shyamali C; Dratva, Julia; Franklin, Karl A; Gíslason, Thórarinn; Holm, Mathias; Jarvis, Deborah; Leynaert, Bénédicte; Lindberg, Eva; Malinovschi, Andrei; Macsali, Ferenc; Norbäck, Dan; Omenaas, Ernst R; Rodríguez, Francisco J; Saure, Eirunn; Schlünssen, Vivi; Sigsgaard, Torben; Skorge, Trude D; Wieslander, Gunilla; Zemp, Elisabeth; Svanes, Cecilie; Hustad, Steinar; Gómez Real, Francisco

    2016-01-01

    There is limited and conflicting evidence on the effect of menopause on asthma. We sought to study whether the incidence of asthma and respiratory symptoms differ by menopausal status in a longitudinal population-based study with an average follow-up of 12 years. The Respiratory Health in Northern Europe study provided questionnaire data pertaining to respiratory and reproductive health at baseline (1999-2001) and follow-up (2010-2012). The study cohort included women aged 45 to 65 years at follow-up, without asthma at baseline, and not using exogenous hormones (n = 2322). Menopausal status was defined as nonmenopausal, transitional, early postmenopausal, and late postmenopausal. Associations with asthma (defined by the use of asthma medication, having asthma attacks, or both) and respiratory symptoms scores were analyzed by using logistic (asthma) and negative binomial (respiratory symptoms) regressions, adjusting for age, body mass index, physical activity, smoking, education, and study center. The odds of new-onset asthma were increased in women who were transitional (odds ratio, 2.40; 95% CI, 1.09-5.30), early postmenopausal (odds ratio, 2.11; 95% CI, 1.06-4.20), and late postmenopausal (odds ratio, 3.44; 95% CI, 1.31-9.05) at follow-up compared with nonmenopausal women. The risk of respiratory symptoms increased in early postmenopausal (coefficient, 0.40; 95% CI, 0.06-0.75) and late postmenopausal (coefficient, 0.69; 95% CI, 0.15-1.23) women. These findings were consistent irrespective of smoking status and across study centers. New-onset asthma and respiratory symptoms increased in women becoming postmenopausal in a longitudinal population-based study. Clinicians should be aware that respiratory health might deteriorate in women during reproductive aging. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  14. ALLERGIC ASTHMA AND THE DEVELOPING IMMUNE SYSTEM: A PILOT STUDY

    Science.gov (United States)

    Rationale: The predisposition towards atopic disease begins early in life, and that the risk of developing asthma is heightened following prenatal exposure to some compounds. Nonetheless, the effect of gestational aeroallergen exposure on the developing immune system is unclear....

  15. Asthma Basics

    Science.gov (United States)

    ... asthma diary is another way to help manage asthma. Tracking your child's symptoms and medicines will help you know when ... When to Go to the ER if Your Child Has Asthma Do Allergies Cause Asthma? Allergy Shots Asthma Center ...

  16. Determinants of the incidence of childhood asthma: a two-stage case-control study.

    Science.gov (United States)

    Martel, Marie-Josée; Rey, Evelyne; Malo, Jean-Luc; Perreault, Sylvie; Beauchesne, Marie-France; Forget, Amélie; Blais, Lucie

    2009-01-15

    Extensive literature exists on potential risk factors for childhood asthma. To the authors' knowledge, no investigators have yet attempted to disentangle the effects of those determinants within a single study setting. The authors aimed to evaluate the independent effects of 47 potential determinants (from the prenatal, perinatal, and childhood periods) of asthma development in children within the first 10 years of life. From a Canadian birth cohort of 26,265 children (1990-2002), a 2-stage case-control study was conducted. In the first stage, 20 controls per case were selected from 3 administrative databases. In the second stage, selected mothers were mailed questionnaires for assessment of additional determinants. Increased risks of childhood asthma were found for > or =1 previous diagnosis of bronchopulmonary disease and atopic dermatitis in the child, oxygen administration after birth, prescription of antibiotics within the first 6 months of life, male gender, asthma during pregnancy, use of antibiotics during pregnancy, maternal receipt of social aid, paternal asthma, and asthma in siblings. Protective effects included use of intranasal corticosteroids during pregnancy, having a wood-burning fireplace, having pets in the home prior to the index date, breastfeeding, and day-care attendance. This study allowed the authors to identify, within a single setting, the most influential determinants of childhood asthma among 47 predictors assessed for the prenatal, perinatal, and childhood periods.

  17. Relationship between obesity and asthma symptoms among children in Ahvaz, Iran: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Alipoor Mohammad

    2011-01-01

    Full Text Available Abstract Background Obesity has been identified as a risk factor for higher prevalence of asthma and asthma-related symptoms in children. The objective of this study was to evaluate the relationship between the prevalence of asthma symptoms and obesity among school-age children in the city of Ahvaz, Iran. Methods A total of 903 children, 7 to 11 years of age, were enrolled in this study through cluster sampling. The International Study of Asthma and Allergies in Childhood (ISAAC questionnaire was used to identify the children who were currently suffering from asthma. Height and weight were measured and body mass index (BMI was calculated in kg/m2. Overweight was defined as BMI greater than the age- and sex-specific 85th percentile, and obesity as BMI greater than the 95th percentile. We determined the relationship between obesity and asthma symptoms by chi-square tests. Results The prevalence of wheeze ever, current wheezing, obesity, and overweight was 21.56%, 8.7%, 6.87%, and 9.5%, respectively. The current prevalence of wheezing among obese and overweight children was 68.75% and 37%, respectively, and there was a statistical association between obesity and the prevalence of current wheezing (p Conclusion There is a strong association between asthma symptoms and both overweight and obesity in both sexes among school-age children.

  18. Fine particulate air pollution and hospital admissions for asthma: a case-crossover study in Taipei.

    Science.gov (United States)

    Cheng, Meng-Hsuan; Chen, Chih-Cheng; Chiu, Hui-Fen; Yang, Chun-Yuh

    2014-01-01

    This study was undertaken to determine whether there was a correlation between fine particles (PM2.5) levels and hospital admissions for asthma in Taipei, Taiwan. Hospital admissions for asthma and ambient air pollution data for Taipei were obtained for the period of 2006-2010. The relative risk of hospital admissions for asthma was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single-pollutant model (without adjustment for other pollutants), increased asthma admissions were significantly associated with PM2.5 levels both on warm days (>23°C) and cool days (<23°C), with an interquartile range rise associated with a 12% (95% CI = 6-18%) and 3% (95% CI = 0-8%) elevation in admissions for asthma, respectively. In the two-pollutant models, PM2.5 levels remained significant for increased asthma admissions after inclusion of SO2 or O3 both on warm and cool days. This study provides evidence that higher levels of PM2.5 elevate the risk of hospital admissions for asthma in Taiwan.

  19. Cholecystectomy in Sweden 2000 – 2003: a nationwide study on procedures, patient characteristics, and mortality

    Directory of Open Access Journals (Sweden)

    Stenlund Hans

    2007-08-01

    Full Text Available Abstract Background Epidemiological data on characteristics of patients undergoing open or laparoscopic cholecystectomy are limited. In this register study we examined characteristics and mortality of patients who underwent cholecystectomy during hospital stay in Sweden 2000 – 2003. Methods Hospital discharge and death certificate data were linked for all patients undergoing cholecystectomy in Sweden from January 1st 2000 through December 31st 2003. Mortality risk was calculated as standardised mortality ratio (SMR i.e. observed over expected deaths considering age and gender of the background population. Results During the four years of the study 43072 patients underwent cholecystectomy for benign biliary disease, 31144 (72% using a laparoscopic technique and 11928 patients (28% an open procedure (including conversion from laparoscopy. Patients with open cholecystectomy were older than patients with laparoscopic cholecystectomy (59 vs 49 years, p Conclusion Laparoscopic cholecystectomy is performed on patients having a lower mortality risk than the general Swedish population. Patients with open cholecystectomy are more sick than patients with laparoscopic cholecystectomy, and they have a mortality risk within 90 days of admission for cholecystectomy, which is four times that of the general population. Further efforts to reduce surgical trauma in open biliary surgery are motivated.

  20. Stillbirth is no longer managed as a nonevent: a nationwide study in Sweden.

    Science.gov (United States)

    Rådestad, I; Nordin, C; Steineck, G; Sjögren, B

    1996-12-01

    Giving birth to a stillborn child is a tragedy. The aim of this study is to investigate the meeting of mothers with their stillborn children and the women's experiences of support during and after the delivery. In a nationwide study in Sweden, data from 636 women who gave birth to a stillborn or live baby were collected by means of an anonymous postal questionnaire in 1994. Among the 314 women who gave birth to a stillborn child, nearly every mother had seen her child, and 80 percent had carressed her baby. More than 90 percent of the mothers stated that the medical staff showed respect, and about 80 percent of the mothers stated that staff exhibited tenderness toward their dead children. The mother's assessment of respect and tenderness to her child by medical staff was almost identical between stillbirths and live births. Nearly 70 percent of the women reported that the hospital had good routines to support mothers of stillborn children. Feelings of sadness and having been deeply hurt or angered by the medical staff's behavior were reported by 37 percent of the women. A difficult balance is still to be achieved between women being forced to encounter the baby when not yet ready versus others who wish the staff had given more encouragement. The value of properly taken photographs is described. Treating stillbirth as a nonevent has been largely, if not entirely, abandoned in Sweden. Most mothers of a stillborn child experience that the medical staff treat their dead children appropriately.

  1. REFUGEE CRISIS IN EUROPE: THE CASE STUDIES OF SWEDEN AND SLOVAKIA

    Directory of Open Access Journals (Sweden)

    Bedrudin Brljavac

    2017-07-01

    Full Text Available Europe as a continent has throughout its history been one of the most popular destinations for migrants and foreigners who have viewed the Old continent as a place of better social and economic possibilities. However, recently most European states and its publics have not been so willing to accept the refugees fleeing the wars and violence. For instance, there have been only a few countries such as Sweden and Germany which have openly welcomed the migrants over the past years. On the other hand, some EU states such as Slovakia have openly rejected to accept the refugees just because they do not want the Brussels to impose immigration policies on them or because they simply do not want Muslims or non-Europeans in their communities. The migrant crisis has thus become a real litmus test for the EU coherence and unity. Thus, in this paper I study the cases of Sweden and Slovakia in terms of their immigration policies since they have applied completely different responses towards the migrants. Through this comparative study I hope that it will be much clearer whether the last migrant crisis can be an end to a united Europe in a global world or is this just one of the several crises the EU has faced throughout its history. Probably the biggest problem in this sense is that only a few EU states have proved their democratic and humanistic matureness to accommodate the migrants and accept them as equal citizens.

  2. Risks of small-for-gestational-age births in immigrants: a nationwide epidemiological study in Sweden.

    Science.gov (United States)

    Li, Xinjun; Sundquist, Kristina; Sundquist, Jan

    2012-11-01

    To examine if there is an association between country of birth in parents and small-for-gestational-age (defined as a birthweight of more than two standard deviations (SDs) below the mean) in first singletons births. In this follow-up study, national population and healthcare registers were used to identify small-for-gestational-age births in all first singleton births in Sweden between 1 January 1982 and 31 December 2006. Odds ratios, standardised with regard to maternal age at birth, period of birth, marital status, family income, geographical region, employment, maternal height, and smoking history, were estimated by maternal and paternal country of birth. Singletons with both parents born in Sweden were used as reference group. There were 1,060,467 records for first singletons births over the study period, of whom 3.5% were small-for-gestational-age. The rate was higher in newborns with non-Swedish born than in those with Swedish born mothers (4.1 and 3.3%, respectively). Immigrants from Southern European countries, Africa, and Asia had higher risks of small-for-gestational-age in than those in the reference group, and the risks were even higher in compatriot parents. Country of birth affected the risk of small-for-gestational-age. Maternity care should pay a special attention to pregnancies in certain population groups.

  3. Physical activity and asthma: A longitudinal and multi-country study.

    Science.gov (United States)

    Russell, Melissa A; Janson, Christer; Real, Francisco Gómez; Johannessen, Ane; Waatevik, Marie; Benediktsdóttir, Bryndis; Holm, Mathias; Lindberg, Eva; Schlünssen, Vivi; Raza, Wasif; Dharmage, Shyamali C; Svanes, Cecilie

    2017-11-01

    To investigate the impact of physical activity on asthma in middle-aged adults, in one longitudinal analysis, and one multi-centre cross-sectional analysis. The Respiratory Health in Northern Europe (RHINE) is a population-based postal questionnaire cohort study. Physical activity, height and weight were self-reported in Bergen, Norway, at RHINE II (1999-2001) and all centres at RHINE III (2010-2012). A longitudinal analysis of Bergen data investigated the association of baseline physical activity with follow-up asthma, incident asthma and symptoms, using logistic and zero-inflated Poisson regression (n = 1782). A cross-sectional analysis of all RHINE III centres investigated the association of physical activity with concurrent asthma and symptoms (n = 13,542) using mixed-effects models. Body mass index (BMI) was categorised (asthma (odds ratio [OR] 0.44, 95% confidence interval [CI] 0.22, 0.89), whilst an effect from undertaking vigorous activity 3+ times/week was not detected (OR 1.22, 95% CI 0.44, 2.76). The associations were attenuated with BMI adjustment. In the all-centre cross-sectional analysis an interaction was found, with the association between physical activity and asthma varying across BMI categories. These findings suggest potential longer-term benefit from lighter physical activity, whilst improvement in asthma outcomes from increasing activity intensity was not evident. Additionally, it appears the benefit from physical activity may differ according to BMI.

  4. A Population-based Clinical Study of Allergic and Non-allergic Asthma

    DEFF Research Database (Denmark)

    Knudsen, T.B.; Thomsen, S.F.; Nolte, H.

    2009-01-01

    to have AHR, OR = 0.40, (0.24-0.66), p 0.001, food allergy, OR = 0.28, (0.11-0.73), p = 0.009, and symptoms of rhinitis, OR = 0.08 (0.05-0.14) compared with subjects with allergic asthma. Subjects with non-allergic asthma had had persistent symptoms within the last 4 weeks more often than subjects......Background. The aim of this study was to describe differences between allergic and non-allergic asthma in a large community-based sample of Danish adolescents and adults. Methods. A total of 1,186 subjects, 14 to 44 years of age, who in a screening questionnaire had reported a history of airway...... individuals had clinical asthma of whom 61% had allergic asthma, whereas 39% had non-allergic asthma. Subjects with non-allergic asthma were more likely to be females, OR = 2.24 (1.32-3.72), p = 0.003, and to have cough as the predominant symptom, OR = 1.96, (1.19-3.23), p = 0.008, but were less likely...

  5. Role of sulfite additives in wine induced asthma: single dose and cumulative dose studies

    OpenAIRE

    Vally, H; Thompson, P

    2001-01-01

    BACKGROUND—Wine appears to be a significant trigger for asthma. Although sulfite additives have been implicated as a major cause of wine induced asthma, direct evidence is limited. Two studies were undertaken to assess sulfite reactivity in wine sensitive asthmatics. The first study assessed sensitivity to sulfites in wine using a single dose sulfited wine challenge protocol followed by a double blind, placebo controlled challenge. In the second study a cumulative dose su...

  6. Working conditions and effort-reward imbalance of German physicians in Sweden respective Germany: a comparative study.

    Science.gov (United States)

    Ohlander, Johan; Weigl, Matthias; Petru, Raluca; Angerer, Peter; Radon, Katja

    2015-05-01

    Work stress among physicians is a growing concern in various countries and has led to migration. We compared the working conditions and the work stress between a migrated population of German physicians in Sweden and a population of physicians based in Germany. Additionally, specific risk factors for work stress were examined country wise. Using a cross-sectional design, 85 German physicians employed in Sweden were surveyed on working conditions and effort-reward imbalance and compared with corresponding data on 561 physicians working in Germany. Multiple linear regression analyses were applied on both populations separately to model the associations between working conditions and effort-reward ratio (ERR), adjusted for a priori confounders. German physicians in Sweden had a significantly lower ERR than physicians in Germany: mean (M) = 0.47, standard deviation (SD) = 0.24 vs. M = 0.80, SD = 0.35. Physicians in Sweden worked on average 8 h less per week and reported higher work support and responsibility. Multivariate analyses showed in both populations a negative association between work support and the ERR (β = -0.148, 95% CI -0.215 to (-0.081) for physicians in Sweden and β = -0.174, 95% CI -0.240 to (-0.106) for physicians in Germany). Further significant associations with the ERR were found among physicians in Sweden for daily breaks (β = -0.002, 95% CI -0.004 to (-0.001)) and among physicians in Germany for working hours per week (β = 0.006, 95% CI 0.002-0.009). Our findings show substantial differences in work stress and working conditions in favor of migrated German physicians in Sweden. To confirm our results and to explain demonstrated differences in physicians' work stress, longitudinal studies are recommended.

  7. Everyday technology use among older adults in Sweden and Japan: A comparative study.

    Science.gov (United States)

    Malinowsky, Camilla; Nygård, Louise; Tanemura, Rumi; Nagao, Toru; Noda, Kazue; Nakata, Osamu; Sagara, Jiro; Rosenberg, Lena; Asaba, Eric; Kottorp, Anders

    2017-04-27

    As context may impact everyday technology (ET) use it is relevant to study this within different contexts. To examine the usefulness of the Everyday Technology Use Questionnaire (ETUQ) in different contexts by investigating and comparing (1) the level of challenge of ETs in the ETUQ and (2) the relevance of and perceived ability to use ET in samples of Swedish and Japanese older adults. The Swedish and the Japanese samples (n = 86/86) were interviewed using the ETUQ about relevance of and perceived ability to use ET. Data were analyzed using Rasch analysis, chi square and a general linear model. Moreover, Differential Item Functioning (DIF) was investigated. The hierarchy of ETs' level of challenge was generally stable in the two contexts. On group-level, the relevance was somewhat higher and the perceived ability to use ET significantly higher in the Swedish sample than in the Japanese. The similarities and differences between the technological landscapes of Sweden and Japan could be detected by ETUQ, demonstrating its usefulness in both countries. The potential causes to the differences in relevance of and perceived ability to use ET between older adults in Sweden and Japan need further exploration.

  8. Ethnobotanical study of plants used to treat asthma in the maritime ...

    African Journals Online (AJOL)

    Ethnobotanical study of plants used to treat asthma in the maritime region in Togo. Holaly E. Gbekley, Gnatoulma Katawa, Simplice D. Karou, Kokou Anani, Tchacondo Tchadjobo, Yaovi Ameyapoh, Komlan Batawila, Jacques Simpore ...

  9. The Shanghai Women's Asthma and Allergy Study: objectives, design, and recruitment results.

    Science.gov (United States)

    Hartert, Tina V; Deng, Xinqing; Hartman, Terryl J; Wen, Wanqing; Yang, Gong; Gao, Yu-Tang; Jin, Meiling; Bai, Chunxue; Gross, Myron; Roberts, L Jackson; Sheller, James R; Christman, John; Dupont, William; Griffin, Marie; Shu, Xiao Ou

    2008-06-01

    The Shanghai Women's Asthma and Allergy Study is the first population-based incidence study designed to assess the associations of dietary antioxidant intake and measures of oxidative stress and antioxidant enzyme activity with development of adult-onset asthma and allergic rhinitis. A total of 65,732 participants in the Shanghai Women's Health Study, an ongoing cohort study in seven districts of Shanghai, People's Republic of China, were recruited to the Shanghai Women's Asthma and Allergy Study from 2003 to 2007. Dietary intake was assessed in the parent study by using a validated and quantitative food frequency questionnaire at baseline recruitment and at the first biennial follow-up survey. Blood and urine samples were collected to measure baseline oxidative stress, antioxidant enzyme activity, and nutrient levels at the baseline survey. Incident asthma and allergic rhinitis were assessed by using a modification of the International Study of Asthma and Allergies in Childhood questionnaire during the biennial in-person survey of the Shanghai Women's Health Study. Diagnosis of asthma was confirmed by either methacholine challenge testing or test of reversibility to beta-agonists. Dietary antioxidant intake, plasma antioxidants, antioxidant enzymes, and urinary isoprostanes, a marker of oxidative stress, were measured prior to disease onset. This paper describes the study objectives, design, population demographics, and recruitment results.

  10. Impact of Asthma on the Sexual Functioning of Patients. A Case-Control Study.

    Science.gov (United States)

    Soto Campos, José Gregorio; Rojas Villegas, Josefa; Padilla Galo, Alicia; Marina Malanda, Nuria; Garcia Rivero, Juan Luis; Pinedo Sierra, Celia; Garcia Salmones, Mercedes; Cabrera Galán, Carmen; Segura Molina, Esperanza; Plaza, Vicente; Pascual Erquicia, Silvia

    2017-12-01

    Sexual limitations play an important role in the quality of life of patients with chronic diseases. Very limited information is available on the impact of asthma on the sexual functioning of these individuals. Cross-sectional, observational, multicenter study. Asthma patients and healthy individuals were recruited. All subjects participated in an interview in which demographic and clinical data were recorded, and completed the Goldberg Anxiety-Depression Scale (GADS) to evaluate the presence of concomitant psychiatric disease. Men also completed the International Index of Erectile Function (IIEF), and women, the Female Sexual Function Index (FSFI). A total of 276cases were included, comprising 172asthma patients (63 men and 109 women) with a mean age of 42 (±14) years, and 104 controls (52men and 51women) with a mean age of 39 (±12) years. Time since onset of asthma was 15 years and severity distribution was: 6.4% intermittent, 17.9% mild persistent, 47.4% moderate, and 28.2% severe. Disease was considered controlled in 57.7%, partially controlled in 28.2%, and uncontrolled in 14.1%. Women with asthma had greater sexual limitations than women in the control group, with a total FSFI score of 22.1 (±9) compared to 26.5 (±6.8), respectively (P<.005). Men with asthma had significantly more severe erectile dysfunction with a total IIEF score of 59.5 (±12.5) compared to 64.3 (±8.2) in male controls (P<.05). An association was also observed between sexual problems and poorer asthma control. Asthma is associated with a poorer sexual quality of life among patients. These results should arouse the interest of healthcare professionals in detecting and alleviating possible sexual limitations among their asthma patients in routine clinical practice. Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Active play exercise intervention in children with asthma: a PILOT STUDY.

    Science.gov (United States)

    Westergren, Thomas; Fegran, Liv; Nilsen, Tonje; Haraldstad, Kristin; Kittang, Ole Bjørn; Berntsen, Sveinung

    2016-01-05

    Increased physical activity (PA) may be beneficial for children with asthma. Knowledge about how to intervene and encourage children with asthma to be physically active is required. In the present study, we aimed to pilot a 6-week exercise intervention designed as active play and examine attendance rate, exercise intensity and children's perceptions of participating. 6 children with asthma (4 boys, 2 girls) aged 10-12 years, participated in 60 min of active play exercise twice weekly. A mixed-methods design was applied. The data analysed included attendance rate, exercise intensity assessed by heart rate (HR) monitoring during exercise sessions, registration and description of the active play exercise programme, 3 semistructured focus groups, field observations of 5 exercise sessions, and preintervention and postintervention testing. The average attendance rate was 90%. Intensity ≥ 80% of maximal HR (HRmax) was recorded for a median (IQR) time of 22 (8) out of 60 min per session. Median (IQR) HR during the sessions was 146 (9; 74% of HRmax) bpm. Children reported increased health-related quality of life (HRQoL) post-test compared with baseline. Children enjoyed participating and reported no limitations by asthma or serious asthma attacks. Instead, they perceived that their asthma and fitness had improved after the programme. The instructors created an inclusive atmosphere that was characterised by easy-to-master games, fair competition, humour and mutual participation. The exercise intervention pilot focusing on active play had a high attendance rate, relatively high exercise intensity, and satisfaction; the children perceived that their fitness and asthma had improved, and reported increased HRQoL. A randomised controlled trial of active play exercise including children with asthma should be conducted to evaluate effect on PA level, physical fitness, asthma control and HRQoL. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  12. 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...

  13. Anthroposophic therapy for asthma: A two-year prospective cohort study in routine outpatient settings

    Directory of Open Access Journals (Sweden)

    Harald J Hamre

    2009-11-01

    Full Text Available Harald J Hamre1, Claudia M Witt2, Gunver S Kienle1, Christof Schnürer3, Anja Glockmann1, Renatus Ziegler4, Stefan N Willich2, Helmut Kiene11Institute for Applied Epistemology and Medical Methodology, Freiburg, Germany; 2Institute of Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany; 3Internal Medicine Practice, A Fraenkel Centrum, Badenweiler, Germany; 4Society for Cancer Research, Arlesheim, SwitzerlandBackground: Anthroposophic treatment for asthma includes special artistic and physical therapies and special medications.Methods: We studied consecutive outpatients starting anthroposophic treatment for asthma under routine conditions in Germany. Main outcomes were average asthma severity (0–10, primary outcome; symptoms (1–4; and asthma-related quality of life at 12-month follow-up (Asthma Quality of Life Questionnaire [AQLQ] overall score, 1–7, for adults; KINDL Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, asthma module, 0–100, for children at 12-month follow-up.Results: Ninety patients (54 adults, 36 children were included. Anthroposophic treatment modalities used were medications (88% of patients, n = 79/90; eurythmy therapy (22%; art therapy (10%; and rhythmical massage therapy (1%. Median number of eurythmy/art/massage sessions was 12 (interquartile range 10–20, median therapy duration was 120 days (84–184. From baseline to 12-month follow-up, all outcomes improved significantly (P < 0.001 for all comparisons. Average improvements were: average asthma severity 2.61 points (95% confidence interval CI: 1.90–3.32; cough 0.93 (95% CI: 0.60–1.25; dyspnea 0.92 (95% CI: 0.56–1.28; exertion-induced symptoms 0.95 (95% CI: 0.64–1.25; frequency of asthma attacks 0.78 (95% CI:0.41–1.14; awakening from asthma 0.90 (95% CI: 0.58–1.21; AQLQ overall score 1.44 (95% CI:0.97–1.92; and KINDL asthma module 14.74 (95% CI: 9.70–19

  14. Bidirectional Association between Asthma and Irritable Bowel Syndrome: Two Population-Based Retrospective Cohort Studies.

    Directory of Open Access Journals (Sweden)

    Te-Chun Shen

    Full Text Available There is a demonstrated association between asthma and irritable bowel syndrome (IBS. In this study, we examined the bidirectional association between asthma and IBS using a nationwide database.We conducted two retrospective cohort studies using data obtained from the National Health Insurance of Taiwan. Study 1 included 29,648 asthma patients newly diagnosed between 2000 and 2010. Study 2 included 29,875 IBS patient newly diagnosed between 2000 and 2010. For each study, four subjects without asthma and IBS were selected, respectively, frequency-matched by sex, age, and the diagnosis date. All four cohorts were followed up until the end of 2011 to estimate incident IBS for Study 1 and incident asthma for study 2. Adjusted hazard ratios (aHRs were estimated using the Cox proportional hazards model after controlling for sex, age and comorbidities.The incidence of IBS was 1.89 times higher in the asthma cohort than in the comparison cohort (8.26 vs. 4.36 per 1,000 person-years, with an aHR of 1.57 [95% confidence interval (CI = 1.47-1.68]. The aHRs remained significant in all subgroups measured by sex, age and the presence of comorbidities. In contrast, the incidence of asthma was 1.76 times higher in the IBS cohort than the comparison cohort (7.09 vs. 4.03 per 1,000 person-years, with an aHR of 1.54 (95% CI = 1.44-1.64. Similarly, aHRs remained significant in all subgroups measured by sex, age and the presence of comorbidities.The present study suggests a bidirectional association between asthma and IBS. Atopy could be a shared pathophysiology underlying this association, deserving a further investigation.

  15. Does migration affect asthma, rhinoconjunctivitis and eczema prevalence? Global findings from the international study of asthma and allergies in childhood.

    Science.gov (United States)

    Garcia-Marcos, Luis; Robertson, Colin F; Ross Anderson, H; Ellwood, Philippa; Williams, Hywel C; Wong, Gary Wk

    2014-12-01

    Immigrants to Westernized countries adopt the prevalence of allergic diseases of native populations, yet no data are available on immigrants to low-income or low-disease prevalence countries. We investigated these questions using data from the International Study of Asthma and Allergies in Childhood. Standardized questionnaires were completed by 13-14-year-old adolescents and by the parent/guardians of 6-7-year-old children. Questions on the symptom prevalence of asthma, rhinoconjunctivitis and eczema, and a wide range of factors postulated to be associated with these conditions, including birth in or not in the country and age at immigration, were asked. Odds ratios for risk of the three diseases according to immigration status were calculated using generalized linear mixed models. These were adjusted for: world region; language and gross national income; and individual risk factors including gender, maternal education, antibiotic and paracetamol use, maternal smoking, and diet. Effect modification by gross national income and by prevalence was examined. There were 326 691 adolescents from 48 countries and 208 523 children from 31 countries. Immigration was associated with a lower prevalence of asthma, rhinoconjunctivitis and eczema in both age groups than among those born in the country studied, and this association was mainly confined to high-prevalence/affluent countries. This reduced risk was greater in those who had lived fewer years in the host country. Recent migration to high prevalence/affluent countries is associated with a lower prevalence of allergic diseases. The protective pre-migration environment quickly decreases with increasing time in the host country. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  16. Sweden and the NEGP: A Pilot Study of the North European Gas Pipeline and Sweden's Dependence on Russian Energy

    Energy Technology Data Exchange (ETDEWEB)

    Larsson, Robert L.

    2006-06-15

    Developments between 2004 and 2006 indicate that a North European Gas Pipeline (NEGP) through the Baltic Sea, from Russia to Germany, may be realised in the coming decade. This would provide Europe with yet another opportunity to diversify its import channels of gas. It is however reasonable to assume that the NEGP also could change the strategic pattern and be a source of friction. The NEGP may rock the regional stability and reduce the potential of the new EU members to become security providers in Europe's northern dimension. It also gives increased leverage and influence to Russia, a state that has moved in an authoritarian direction under President Putin. The aim of this pilot study is to elucidate on the NEGP pipeline and Sweden's increasing dependence on Russian energy. A subsidiary aim is to outline a set of concerns that have bearing on the situation for the EU and Baltic Sea Region and that need to be further addressed. In conclusion, the NEGP will enhance Russia's direct leverage on Poland, Ukraine, and Belarus, as it will allow Russia to turn off gas supplies without affecting exports to other parts of Europe. Russia will also increase its leverage over the states that will or may be connected to the NEGP (Germany, and possibly Belgium, Denmark, the Netherlands and the UK). Even if Sweden is not embracing the NEGP, it is today highly sensitive as it imports most of its energy. It is increasingly dependent on Russian oil and is partly dependent on imports of electricity from Russia. Should the NEGP materialise and Sweden becomes connected in the future, it would likely be dependent also on natural gas. It is of paramount importance for the energy security of the connected states how the pipeline is constructed and operated. If there will be technical possibilities for Russia to tamper with the flow of gas to individual states without affecting supply to others, there are tangible threats to the importing states.

  17. Prevalence and sensitization of atopic allergy and coeliac disease in the Northern Sweden Population Health Study

    Directory of Open Access Journals (Sweden)

    Stefan Enroth

    2013-08-01

    Full Text Available Background. Atopic allergy is effected by a number of environmental exposures, such as dry air and time spent outdoors, but there are few estimates of the prevalence in populations from sub-arctic areas. Objective. To determine the prevalence and severity of symptoms of food, inhalation and skin-related allergens and coeliac disease (CD in the sub-arctic region of Sweden. To study the correlation between self-reported allergy and allergy test results. To estimate the heritability of these estimates. Study design. The study was conducted in Karesuando and Soppero in Northern Sweden as part of the Northern Sweden Population Health Study (n=1,068. We used a questionnaire for self-reported allergy and CD status and measured inhalation-related allergens using Phadiatop, food-related allergens using the F×5 assay and IgA and IgG antibodies against tissue transglutaminase (anti-tTG to indicate prevalence of CD. Results. The prevalence of self-reported allergy was very high, with 42.3% reporting mild to severe allergy. Inhalation-related allergy was reported in 26.7%, food-related allergy in 24.9% and skin-related allergy in 2.4% of the participants. Of inhalation-related allergy, 11.0% reported reactions against fur and 14.6% against pollen/grass. Among food-related reactions, 14.9% reported milk (protein and lactose as the cause. The IgE measurements showed that 18.4% had elevated values for inhalation allergens and 11.7% for food allergens. Self-reported allergies and symptoms were positively correlated (p<0.01 with age- and sex-corrected inhalation allergens. Allergy prevalence was inversely correlated with age and number of hours spent outdoors. High levels of IgA and IgG anti-tTG antibodies, CD-related allergens, were found in 1.4 and 0.6% of participants, respectively. All allergens were found to be significantly (p<3e–10 heritable, with estimated heritabilities ranging from 0.34 (F×5 to 0.65 (IgA. Conclusions. Self-reported allergy

  18. Personality and risk of adult asthma in a prospective cohort study.

    Science.gov (United States)

    Loerbroks, Adrian; Li, Jian; Bosch, Jos A; Herr, Raphael M; Angerer, Peter

    2015-07-01

    Traits conceptualized according to the five-factor model of personality have been found to predict numerous health outcomes and may also be predictive of asthma. Prior longitudinal studies on personality and asthma remain however sparse, have been restricted to only two traits (i.e., neuroticism and extraversion), and yielded inconsistent results. We therefore aimed to examine the potential relationships of all five-factor personality traits with incident asthma. We combined the 2009 and 2011 data from the population-based German Socio-Economic Panel study for longitudinal analyses (n=12,202). Personality traits were measured by an established 15-item version of the Big Five Inventory. Asthma was measured by participant-reports of having ever received such a diagnosis by a physician. We estimated multivariable risk ratios (RRs) and corresponding 95% confidence intervals (CIs) of trait-specific scores (continuous or categorized by tertiles) and incident asthma by Poisson regression. Neuroticism was the only trait which was predictive of asthma (RR for the z-score=1.17, 95% CI=1.02-1.34; RR for the highest versus the lowest tertile=1.59, 95% CI=1.12-2.25). Associations between personality traits and asthma risk did not differ by sex (p-values for interaction ≥0.07). There were no two-way interactions between personality traits when we tested all potential combinations (all p-values for interaction ≥0.20). The present study suggests that high levels of neuroticism may predispose adults to develop asthma. Future longitudinal studies are needed to confirm our findings and to shed light on the potential psychophysiological processes underlying the observed association. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Evaluation of CHESS: Utah asthma study, 1971-1972. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, A.R.; Tolley, H.D.; Simpson, J.C.; Namekata, T.; Woods, J.S.

    1983-02-01

    This report is divided into five main sections. The first reviews the use of asthma as a health indicator in environmental epidemiology, including a review of selected asthma panel studies. The next two sections consider the impact of the data quality: the limitations and characteristics of the aerometric data and of the panelists' data, respectively. The last two sections contain statistical analyses: analyses correcting for variation among panelists and analyses based on person-days.

  20. Pulmonary function, exhaled nitric oxide and symptoms in asthma patients with obesity: a cross-sectional study.

    Science.gov (United States)

    Kasteleyn, Marise J; Bonten, Tobias N; de Mutsert, Renée; Thijs, Willemien; Hiemstra, Pieter S; le Cessie, Saskia; Rosendaal, Frits R; Chavannes, Niels H; Taube, Christian

    2017-12-07

    Obesity is a risk factor for the development of asthma. In patients with obesity the diagnosis of asthma is often based on symptoms, but without objective measurements. Nevertheless, obesity-associated asthma is recognized as a distinct asthma phenotype. Therefore, this study explores lung function and symptoms in asthma patients with and without obesity. The Netherlands Epidemiology of Obesity (NEO) study is a population-based cohort study with 6671 participants (aged 45-65 years) of whom 472 had asthma. Of this latter group, linear regression analysis was used to examine differences in lung function and symptoms between asthma patients with (n = 248) and without obesity (n = 224), and between asthma patients with and without increased Fe NO . Analyses were adjusted for confounders. Asthma patients with obesity had lower predicted FEV 1 and FVC values than patients without obesity [adjusted mean difference (MD) -3.3% predicted, 95% CI -6.5, -0.2; adjusted MD -5.0% predicted, 95% CI -7.8, -2.1]. The prevalence of symptoms was higher in patients with obesity. Asthma patients with obesity and with increased Fe NO had lower FEV 1 and FEV 1 /FVC values compared with those with low Fe NO (adjusted MD -6.9% predicted, 95% CI -11.7, -2.0; -2.4%, 95% CI -4.6, -0.2). Asthma patients with obesity had lower FEV 1 and FVC values than patients without obesity. This suggests that patients with obesity have restrictive lung function changes, rather than obstructive changes. Asthma patients with obesity and increased Fe NO showed more obstructive changes. Fe NO might help to identify patients with eosinophilic inflammation-driven asthma, whereas patients with low Fe NO might have an obesity-associated asthma phenotype in which symptoms are partly caused by the obesity.

  1. Experiences of a Mental Health First Aid training program in Sweden: a descriptive qualitative study.

    Science.gov (United States)

    Svensson, Bengt; Hansson, Lars; Stjernswärd, Sigrid

    2015-05-01

    Restricted mental health literacy and stigma are barriers to treatment of mental disorders. A Mental Health First Aid training program was tested for implementation in Sweden among employees in the public sector. The aim of the present qualitative study was to explore participants' experiences of the program in more depth, in conjunction with a randomized controlled study. Twenty four persons participated in a total of six focus groups 6-8 months after program participation. Data were analyzed using content analysis. The analysis resulted in five categories illustrating the participants' experiences of the course: increased awareness, knowledge and understanding; influence on attitude and approach; tool box and confidence; feedback on content and layout; and tangible examples of applied knowledge. The most central finding is the fruitfulness of the program's practical focus and use, the increased confidence and inclination to act following program participation, and the importance of experienced instructors.

  2. Prevalence of asthma symptoms in schoolchildren, and climate in west European countries: an ecologic study

    Science.gov (United States)

    Arnedo-Pena, Alberto; García-Marcos, Luis; Bercedo-Sanz, Alberto; Aguinaga-Ontoso, Inés; González-Díaz, Carlos; García-Merino, Águeda; Busquets-Monge, Rosa; Suárez-Varela, Maria Morales; Batlles-Garrido, Juan; Blanco-Quirós, Alfredo A.; López-Silvarrey, Angel; García-Hernández, Gloria; Fuertes, Jorge

    2013-09-01

    The aim of the present study was to estimate the associations between the prevalence of asthma symptoms in schoolchildren and meteorological variables in west European countries that participated in the International Study of Asthma and Allergies in Children (ISAAC), Phase III 1997-2003. An ecologic study was carried out. The prevalence of asthma was obtained from this study from 48 centers in 14 countries, and meteorological variables from those stations closest to ISAAC centers, together with other socioeconomic and health care variables. Multilevel mixed-effects linear regression models were used. For schoolchildren aged 6-7 years, the prevalence rate of asthma decreased with an increase in mean annual sunshine hours, showed a positive association with rainy weather, and warm temperature, and a negative one with relative humidity and physician density (PD). Current wheeze prevalence was stronger in autumn/winter seasons and decreased with increasing PD. Severe current wheeze decreased with PD. For schoolchildren aged 13-14 years, the prevalence rates of asthma and current wheeze increased with rainy weather, and these rates decreased with increased PD. Current wheeze, as measured by a video questionnaire, was inversely associated with sunny weather, and nurse density. Severe current wheeze prevalence was stronger during autumn/winter seasons, decreased with PD, and indoor chlorinated public swimming pool density, and increased with rainy weather. Meteorological factors, including sunny and rainy weather, and PD may have some effect on the prevalence rates of asthma symptoms in children from west European countries.

  3. Clinical and socioeconomic features of subjects with red cedar asthma. A follow-up study.

    Science.gov (United States)

    Marabini, A; Dimich-Ward, H; Kwan, S Y; Kennedy, S M; Waxler-Morrison, N; Chan-Yeung, M

    1993-09-01

    A follow-up study of 128 subjects with red cedar asthma was conducted to evaluate the clinical and socioeconomic impact of the disease in determining the working status of the subjects after the diagnosis was made. The results suggest that the severity of asthma is not the main determinant of working status. Comparing the data at diagnosis and at follow-up examination, we found that the persistence of exposure resulted in a deterioration in the asthma despite the use of more medications. Subjects who were working were younger and had a larger number of dependents than the subjects who were not working at the time of the follow-up examination. We conclude that the socioeconomic factors are important in determining the working status of subjects with red cedar asthma. To prevent severe impairment and disability, there should be more economic incentives for these subjects to choose other jobs.

  4. Fragrance materials in asthma: a pilot study using a surrogate aerosol product.

    Science.gov (United States)

    Vethanayagam, Dilini; Vliagoftis, Harissios; Mah, Dennell; Beach, Jeremy; Smith, Ladd; Moqbel, Redwan

    2013-11-01

    Many household products contain fragrances. Little is known about exposure to fragrances on human health, particularly within the airways. This study aimed to evaluate how common household fragrance products (i.e. air fresheners, cleaning products) affect people with asthma, who frequently report sensitivity to these products. Many of these products have volatile organic compounds or semi-volatile organic compounds. This study evaluated nine fragrance materials in an aerosol formulation to assess effects on airway physiology, airway inflammation and symptom perception in normal controls and those with asthma. The effects of fragrances were evaluated in people without asthma, people with mild asthma and people with moderate asthma in a four-way crossover placebo-controlled study. Subjects were exposed twice to a fragranced aerosol and twice to a placebo aerosol (15 and 30 min each). Subjects completed a questionnaire for 29 symptoms during and up to 3 h after each exposure scenario. Spirometry was performed prior to and 3 h post-exposure; sputum induction was conducted 3 h post-exposure. Nasal symptoms showed the greatest frequency of response in all three subject groups, and moderate asthmatics reported the greatest symptom severity and symptom types. No significant differences were noted in physiology or cellular inflammation. A trend for increased symptoms was noted in moderate asthmatics, suggesting that asthma severity may play a factor in fragrance sensitivity.

  5. The link between allergic rhinitis and allergic asthma: a prospective population-based study. The Copenhagen Allergy Study.

    Science.gov (United States)

    Linneberg, A; Henrik Nielsen, N; Frølund, L; Madsen, F; Dirksen, A; Jørgensen, T

    2002-11-01

    It has been hypothesized that allergic rhinitis and allergic asthma are manifestations of the same disease entity. We aimed to investigate the relationship between allergic rhinitis and allergic asthma. Participants in a population-based study of 15-69-year-olds in 1990 were invited to a follow-up in 1998. A total of 734 subjects were examined on two occasions eight years apart. Allergic rhinitis to pollen was defined as a history of nasal symptoms on exposure to pollens and IgE specific to pollen. Allergic asthma to pollen was defined as a history of lower airway symptoms on exposure to pollens and IgE specific to pollen. Similarly, diagnoses of allergic rhinitis and allergic asthma to animals or mite were defined. At follow-up, all subjects with allergic asthma to pollen (n = 52) had in addition allergic rhinitis to pollen. In the longitudinal analysis, there were a total of 28 new (incident) cases of allergic asthma to pollen. They all had allergic rhinitis to pollen at baseline, or had developed allergic rhinitis to pollen at follow-up. Accordingly, allergic rhinitis to animals and mite were ubiquitous in subjects with allergic asthma to animals and mite, respectively. The results support the hypothesis that allergic rhinitis and allergic asthma are manifestations of the same disease entity.

  6. The Benefits and Challenges of Managing Asthma in Hispanic Families in South Texas: A Mixed-Methods Study

    Directory of Open Access Journals (Sweden)

    Genny Carrillo

    2017-06-01

    Full Text Available BackgroundUnderstanding the experience of Hispanic parents of children diagnosed with asthma can be useful in the delivery of effective and meaningful asthma education. In order to assess the needs of Hispanic families with asthmatic children in South Texas, investigators utilized a combination of qualitative and quantitative research methods.ObjectivesThis study aimed (1 to assess the impact of asthma in the quality of life of Hispanic children and their families and (2 to identify barriers and challenges to asthma management as perceived by parents of children diagnosed with asthma.MethodsA mixed-methods study included a quality-of-life survey and focus group discussions. The Children’s Health Survey for Asthma (CHSA was completed by 90 parents of children with asthma. Three focus groups were conducted with 15 low-income, Hispanic parents of asthmatic children to assess their needs and experience in managing the disease.ResultsResults from the CHSA showed that asthma significantly affects the quality of life of children with asthma and their families, particularly the emotional dimensions and the child’s physical health. Fifty-three percent of the children had visited the emergency room, and 51% had been hospitalized due to asthma. One out of five parents had missed work, and 27% of children had missed school in the past 2 weeks due to the child’s asthma. In the focus group discussions, the key themes emerging included lack of asthma knowledge, the burden of disease for asthmatic children and their families, and the importance of asthma education and self-management behaviors for asthma control.ConclusionOne of the main challenges faced by Hispanic families with asthmatic children is the lack of asthma-related knowledge to help understand and control their children’s disease. Lack of knowledge and self-management skills lead to significant stress and anxiety among children with asthma and their parents. Results highlight that while

  7. Proceedings of a study tour, conference and workshop in Sweden, 5-10 June 1994

    Energy Technology Data Exchange (ETDEWEB)

    Aronsson, P.; Perttu, K. [eds.

    1994-12-31

    The present proceedings are the result of an international meeting within the frame of the International Energy Agency/Biomass Agreement (IEA/BA)/Task VIII through the activities on `Biological disposal of waste waters and sludges` and `Ecological/biological balances and conservation` organized by the Swedish University of Agricultural Sciences, Uppsala. The meeting was divided into a 2-day study tour, starting from southernmost Sweden and ending in Uppsala, during which visits were made to different vegetation filter experiments, and a 1-day conference with paper and poster presentations. In connection with the IEA meeting, a joint Swedish-Polish workshop was organized, mainly devoted to presentations of results from Polish investigations on large-scale vegetation filter use. Separate abstracts have been prepared for 29 of the 34 papers

  8. Physical, psychosocial, and organisational factors relative to sickness absence: a study based on Sweden Post

    DEFF Research Database (Denmark)

    Voss, M; Floderus, B; Diderichsen, F

    2001-01-01

    OBJECTIVE: To analyse incidence of sickness for women and men relative to potential aetiological factors at work-physical, psychosocial, and organisational. METHODS: The study group comprised 1557 female and 1913 male employees of Sweden Post. Sickness absence was measured by incidence of sickness...... (sick leave events and person-days at risk). Information on explanatory factors was obtained by a postal questionnaire, and incidence of sickness was based on administrative files of the company. RESULTS: Complaints about heavy lifting and monotonous movements were associated with increased risk of high...... and men. Among women, 16% reported bullying at the workplace, which was linked with a doubled risk of high incidence of sickness (OR 1.91 (1.31 to 2.77)). For men, the strongest association was found for those reporting anxiety about reorganisation of the workplace (OR 1.93 (1.34 to 2.77)). CONCLUSIONS...

  9. Meteorological factors, aeroallergens and asthma-related visits inKuwait: a 12-month retrospective study

    International Nuclear Information System (INIS)

    Qasem, Jafar A.; Al-Sherfyee, A.; Al-Mathkouri, Samirah A.; Nasrallah, H.; Al-Khalaf, Bader N.; Al-Sharifi, F.; Al-Saraf, H.

    2008-01-01

    The increasing prevalence of asthma in many countries has been related toweather factors and aerllergen concentrations, but this has not been studiedin Kuwait. We evaluated the effect of meteorological factors and theoccurrence of aerobiologicals on the number of asthma cases in Kuwait. Thenumber of daily asthma visits to the allergy center and emergency departmentat Al-Sabha Hospital for 1 year were examined on a monthly basis forcorrelation with major meteorological factors (temperature, relativehumidity, rain, wind speed and direction). Spore and pollen counts werecollected hourly. A total of 4353 patients received asthma treatment duringthe year. The highest pollen count was in the month of September with amaximum relative humidity of 47% and no precipitation, but with a high meantemperature of 39.7C. Pollen counts were higher in the late summer(September) and occurred with a high patient visit to the allergy center.Fungal spore counts were significantly higher in early winter (December). Thehigh fungal spore count seemed related to with high relative humidity andhigh precipitation with a low mean average temperature of 19.7C. The increasenumber of patients with bronchial asthma visiting an emergency clinic duringDecember was significantly associated with high aerial counts for fungalspores (P<0.3) and the months of September and October were more significantfor pollen. This study indicates that meteorological factors, aeroallergenconcentrations and asthma-related visits were interrelated. The results mayprove useful in the generation of hypotheses and development of designs formore comprehensive, individual-based epidemiological studies. (author)

  10. Serum 25-hydroxyvitamin D levels and incident asthma in adults: the HUNT Study.

    Science.gov (United States)

    Mai, Xiao-Mei; Langhammer, Arnulf; Camargo, Carlos A; Chen, Yue

    2012-12-15

    The impact of low vitamin D status on asthma development is unclear. The authors investigated the relation between the baseline serum 25-hydroxyvitamin D (25(OH)D) level and incident asthma in adults, including possible effect modification by allergy status, using allergic rhinitis as a proxy measure. A cohort of 25,616 Norwegian adults aged 19-55 years participated in 2 surveys of the Nord-Trøndelag Health Study known as HUNT 2 (1995-1997) and HUNT 3 (2006-2008). Of this cohort, a nested case-control study included 584 new-onset asthma cases and 1,958 nonasthma controls whose baseline serum 25(OH)D levels were measured. After adjustment for potential asthma risk factors, the baseline serum level of 25(OH)D (incident asthma in women, regardless of allergy status. Low vitamin D status was not significantly associated with incident asthma in most adults, but it may have increased risk among men without allergy.

  11. Exercise-induced bronchoconstriction : clinical studies in childhood asthma

    NARCIS (Netherlands)

    W.B. Hofstra (Winfried)

    1997-01-01

    textabstractAt present, astluna is regarded as a chronic inflammatory disorder of the airways, In susceptible individuals, asthma causes symptoms, that are usually associated with variable, but often reversible airflow obstmction. Astlulla is the most conunon lung disease in childhood, with

  12. Alcohol consumption among partners of pregnant women in Sweden: a cross sectional study.

    Science.gov (United States)

    Högberg, Hjördis; Skagerström, Janna; Spak, Fredrik; Nilsen, Per; Larsson, Margareta

    2016-08-02

    Antenatal care in Sweden involves a visit in pregnancy week 6-7 for counseling about lifestyle issues, including alcohol. The aim of this study was to investigate alcohol consumption among partners of pregnant women, their motives for changing drinking patterns when becoming a parent and their perceptions of the midwife's counseling about alcohol. The study was conducted at 30 antenatal care centers across Sweden in 2009-2010. All partners who accompanied a pregnant women in pregnancy week >17 were asked to participate. The questionnaire included questions on alcohol consumption. Questionnaires from 444 partners were analyzed. Most, 95 %, of the partners reported alcohol consumption before pregnancy; 18 % were binge drinking (6 standard drinks or more per occasion, each drink containing 12 grams of pure alcohol) at least once every month during the last year. More than half, 58 %, of all partners had decreased their alcohol consumption following pregnancy recognition and a higher proportion of binge drinkers decreased their consumption compared to non-frequent binge drinkers (p = 0.025). Their motives varied; the pregnancy itself, fewer social gatherings (potentially involving alcohol consumption) and a sense of responsibility for the pregnant partner were reported. Of the partners, 37 % reported support for decreased drinking from others (pregnant partner, parents, friend or workmates). Further, most partners appreciated the midwife's counseling on alcohol. A majority of partners decreased their alcohol consumption in transition to parenthood, which also appears to be a crucial time for changing alcohol-drinking patterns. The partners with higher AUDIT-C scores reported more support for decreased drinking. Most partners appreciated the midwife's talk about alcohol and pregnancy and those who filled out AUDIT in early pregnancy reported that the counseling was more engaging. During pregnancy it is possible to detect partners with high alcohol consumption

  13. Prevalence and Characteristics of Hyperhidrosis in Sweden: A Cross-Sectional Study in the General Population.

    Science.gov (United States)

    Shayesteh, Alexander; Janlert, Urban; Brulin, Christine; Boman, Jens; Nylander, Elisabet

    2016-01-01

    Hyperhidrosis is defined as excessive sweating which can be primary or secondary. Data about the prevalence of primary hyperhidrosis are scarce for northern Europe. Our aim was to investigate the prevalence of hyperhidrosis focusing on its primary form and describe the quality of life impairments for the affected individuals. Five thousand random individuals aged 18-60 years in Sweden were investigated. The individuals' addresses were obtained from Statens personadressregister, SPAR, which includes all persons who are registered as resident in Sweden. A validated questionnaire regarding hyperhidrosis including the Hyperhidrosis Disease Severity Scale (HDSS) and 36-item Short Form (SF-36) health survey was sent to each individual. The participants were asked to return the coded questionnaire within 1 week. A total of 1,353 individuals (564 male, 747 female and 42 with unspecified gender) with a mean age of 43.1 ± 11.2 years responded. The prevalence of primary hyperhidrosis was 5.5%, and severe primary hyperhidrosis (HDSS 3-4 points) occurred in 1.4%. Secondary hyperhidrosis was observed in 14.8% of the participants. Our SF-36 results showed that secondary hyperhidrosis causes a significant (p hyperhidrosis impairs primarily the mental health (p Hyperhidrosis affects individuals in adolescence as a focal form while occurring as a generalised form with increasing age. Further, the prevalence of primary hyperhidrosis described in our study is comparable to other studies from the western hemisphere. While secondary, generalised hyperhidrosis impairs both physical and mental aspects of life, primary hyperhidrosis, with the exception of severe cases, mainly affects the mental health. © 2016 S. Karger AG, Basel.

  14. Relative exposure to controller therapy and asthma exacerbations: a validation study in community pharmacies.

    Science.gov (United States)

    Laforest, Laurent; Licaj, Idlir; Devouassoux, Gilles; Chatté, Gérard; Belhassen, Manon; Van Ganse, Eric; Chamba, Geneviève

    2014-09-01

    "Controllers-to-total asthma drug" ratios computed from claims data identify asthmatics at risk of exacerbations. Direct link of ratios to data obtained from patients, such as control and recent outcomes, would facilitate their interpretation. We studied the relationship between R1 ratio (inhaled corticosteroids (ICS)/total anti-asthma drug ratio) and the Asthma Control Test. Comparisons were also conducted for secondary outcomes (asthma-related hospital contacts, monthly medical contacts, use of oral corticosteroids, and perception of disease burden). Results with R1 ratio were compared with those obtained with a second ratio, "ICS-plus-leukotriene receptor antagonist/total asthma drug" (R2 = ICS + leukotriene receptor antagonist/total anti-asthma drugs). A survey was conducted in community pharmacies. Patients visiting with a prescription of anti-asthma drug and ≥12 months of drug dispensing recorded in the pharmacy were consecutively recruited. Dispensing data were linked to patient-reported outcomes. Asthma control and secondary outcomes were compared for both ratios between low-controller-ratio (R controller-ratio groups (R ≥ 50%), after excluding null values. Of the 919 eligible patients (mean age 37 years, 55% women), 90.2% and 92.4% had non-null values for R1 and R2, respectively. Compared with the low-controller-ratio groups, adjusted risks of being uncontrolled were significantly lower in the high-controller-ratio groups (RR = 0.64, 95%CI [0.54, 0.77] and RR = 0.57, 95%CI [0.47, 0.70], for R1 and R2 ratios, respectively). Likewise, fewer patients with secondary outcomes were observed in the high-controller-ratio groups, for both ratios. Asthma was better controlled among patients with high controller ratios, along with fewer asthma-related outcomes, for both R1 and R2 ratios. This confirms the utility of asthma/drug ratios in identifying patients at risk of exacerbations, notably in claims data. Copyright © 2014 John Wiley

  15. Estimated cost of asthma in outpatient treatment: a real-world study

    Science.gov (United States)

    Costa, Eduardo; Caetano, Rosangela; Werneck, Guilherme Loureiro; Bregman, Maurício; Araújo, Denizar Vianna; Rufino, Rogério

    2018-01-01

    ABSTRACT OBJECTIVE To estimate the cost of diagnosis and treatment of asthma. METHODS We used the perspective of society. We sequentially included for 12 months, in 2011-2012, 117 individuals over five years of age who were treated for asthma in the Pneumology and Allergy-Immunology Services of the Piquet Carneiro Polyclinic, Universidade do Estado do Rio de Janeiro. All of them were interviewed twice with a six-month interval for data collection, covering 12 months. The cost units were identified and valued according to defined methods. We carried out a sensitivity analysis and applied statistical methods with a significance level of 5% for cost comparisons between subgroups. RESULTS The study consisted of 108 patients, and 73.8% of them were women. Median age was 49.5 years. Rhinitis was present in 83.3% of the individuals, and more than half were overweight or obese. Mean family income was U$915.90/month (SD = 879.12). Most workers and students had absenteeism related to asthma. Total annual mean cost was U$1,291.20/patient (SD = 1,298.57). The cost related to isolated asthma was U$1,155.43/patient-year (SD = 1,305.58). Obese, severe, and uncontrolled asthmatic patients had higher costs than non-obese, non-severe, and controlled asthmatics, respectively. Severity and control level were independently associated with higher cost (p = 0.001 and 0.000, respectively). The direct cost accounted for 82.3% of the estimated total cost. The cost of medications for asthma accounted for 62.2% of the direct costs of asthma. CONCLUSIONS Asthma medications, environmental control measures, and long-term health leaves had the greatest potential impact on total cost variation. The results are an estimate of the cost of treating asthma at a secondary level in the Brazilian Unified Health System, assuming that the treatment used represents the ideal approach to the disease. PMID:29641652

  16. Estimated cost of asthma in outpatient treatment: a real-world study.

    Science.gov (United States)

    Costa, Eduardo; Caetano, Rosangela; Werneck, Guilherme Loureiro; Bregman, Maurício; Araújo, Denizar Vianna; Rufino, Rogério

    2018-04-09

    To estimate the cost of diagnosis and treatment of asthma. We used the perspective of society. We sequentially included for 12 months, in 2011-2012, 117 individuals over five years of age who were treated for asthma in the Pneumology and Allergy-Immunology Services of the Piquet Carneiro Polyclinic, Universidade do Estado do Rio de Janeiro. All of them were interviewed twice with a six-month interval for data collection, covering 12 months. The cost units were identified and valued according to defined methods. We carried out a sensitivity analysis and applied statistical methods with a significance level of 5% for cost comparisons between subgroups. The study consisted of 108 patients, and 73.8% of them were women. Median age was 49.5 years. Rhinitis was present in 83.3% of the individuals, and more than half were overweight or obese. Mean family income was U$915.90/month (SD = 879.12). Most workers and students had absenteeism related to asthma. Total annual mean cost was U$1,291.20/patient (SD = 1,298.57). The cost related to isolated asthma was U$1,155.43/patient-year (SD = 1,305.58). Obese, severe, and uncontrolled asthmatic patients had higher costs than non-obese, non-severe, and controlled asthmatics, respectively. Severity and control level were independently associated with higher cost (p = 0.001 and 0.000, respectively). The direct cost accounted for 82.3% of the estimated total cost. The cost of medications for asthma accounted for 62.2% of the direct costs of asthma. Asthma medications, environmental control measures, and long-term health leaves had the greatest potential impact on total cost variation. The results are an estimate of the cost of treating asthma at a secondary level in the Brazilian Unified Health System, assuming that the treatment used represents the ideal approach to the disease.

  17. Exposure to Mobile Source Air Pollution in Early-life and Childhood Asthma Incidence: The Kaiser Air Pollution and Pediatric Asthma Study.

    Science.gov (United States)

    Pennington, Audrey Flak; Strickland, Matthew J; Klein, Mitchel; Zhai, Xinxin; Bates, Josephine T; Drews-Botsch, Carolyn; Hansen, Craig; Russell, Armistead G; Tolbert, Paige E; Darrow, Lyndsey A

    2018-01-01

    Early-life exposure to traffic-related air pollution exacerbates childhood asthma, but it is unclear what role it plays in asthma development. The association between exposure to primary mobile source pollutants during pregnancy and during infancy and asthma incidence by ages 2 through 6 was examined in the Kaiser Air Pollution and Pediatric Asthma Study, a racially diverse birth cohort of 24,608 children born between 2000 and 2010 and insured by Kaiser Permanente Georgia. We estimated concentrations of mobile source fine particulate matter (PM2.5, µg/m), nitrogen oxides (NOX, ppb), and carbon monoxide (CO, ppm) at the maternal and child residence using a Research LINE source dispersion model for near-surface releases. Asthma was defined using diagnoses and medication dispensings from medical records. We used binomial generalized linear regression to model the impact of exposure continuously and by quintiles on asthma risk. Controlling for covariates and modeling log-transformed exposure, a 2.7-fold increase in first year of life PM2.5 was associated with an absolute 4.1% (95% confidence interval, 1.6%, 6.6%) increase in risk of asthma by age 5. Quintile analysis showed an increase in risk from the first to second quintile, but similar risk across quintiles 2-5. Risk differences increased with follow-up age. Results were similar for NOX and CO and for exposure during pregnancy and the first year of life owing to high correlation. Results provide limited evidence for an association of early-life mobile source air pollution with childhood asthma incidence with a steeper concentration-response relationship observed at lower levels of exposure.

  18. A case-control study of the relation between plasma selenium and asthma in European populations

    DEFF Research Database (Denmark)

    Burney, P; Potts, J; Makowska, J

    2008-01-01

    BACKGROUND: There is evidence that selenium levels are relatively low in Europe and may be falling. Low levels of selenium or low activity of some of the enzymes dependent on selenium have been associated with asthma. METHODS: The GA(2)LEN network has organized a multicentre case-control study...... in Europe to assess the relation of plasma selenium to asthma. The network compared 569 cases in 14 European centres with a diagnosis of asthma and reporting asthma symptoms in the last 12 months with 576 controls from the same centres with no diagnosis of asthma and no asthmatic symptoms in the last 12......-analysis of the results from the centres showed no overall association between asthma and plasma selenium [odds ratio (OR)/10 microg/l increase in plasma selenium: 1.04; 95% confidence interval (CI): 0.89-1.21] though there was a significantly protective effect in Lodz (OR: 0.48; 95% CI: 0.29-0.78) and a marginally...

  19. A Population-based Clinical Study of Allergic and Non-allergic Asthma

    DEFF Research Database (Denmark)

    Knudsen, T.B.; Thomsen, S.F.; Nolte, H.

    2009-01-01

    Background. The aim of this study was to describe differences between allergic and non-allergic asthma in a large community-based sample of Danish adolescents and adults. Methods. A total of 1,186 subjects, 14 to 44 years of age, who in a screening questionnaire had reported a history of airway...... symptoms suggestive of asthma and/or allergy, or who were taking any medication for these conditions were clinically examined. All participants were interviewed about respiratory symptoms, and furthermore skin test reactivity, lung function, and airway responsiveness were measured. Results. A total of 489...... individuals had clinical asthma of whom 61% had allergic asthma, whereas 39% had non-allergic asthma. Subjects with non-allergic asthma were more likely to be females, OR = 2.24 (1.32-3.72), p = 0.003, and to have cough as the predominant symptom, OR = 1.96, (1.19-3.23), p = 0.008, but were less likely...

  20. The risk of asthma in patients with ankylosing spondylitis: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Te-Chun Shen

    Full Text Available The relationship between asthma and ankylosing spondylitis (AS is controversial. We examined the risk of asthma among AS patients in a nationwide population.We conducted a retrospective cohort study using data from the National Health Insurance (NHI system of Taiwan. The cohort included 5,974 patients newly diagnosed with AS from 2000 to 2010. The date of diagnosis was defined as the index date. A 4-fold of general population without AS was randomly selected frequency matched by age, gender and the index year. The occurrence and hazard ratio (HR of asthma were estimated by the end of 2011.The overall incidence of asthma was 1.74 folds greater in the AS cohort than in the non-AS cohort (8.26 versus 4.74 per 1000 person-years with a multivariable Cox method measured adjusted HR of 1.54 (95% confidence interval (CI, 1.34-1.76. The adjusted HR of asthma associated with AS was higher in women (1.59; 95% CI, 1.33-1.90, those aged 50-64 years (1.66; 95% CI, 1.31-2.09, or those without comorbidities (1.82; 95% CI, 1.54-2.13.Patients with AS are at a higher risk of developing asthma than the general population, regardless of gender and age. The pathophysiology needs further investigation.

  1. Suicide after release from prison - a population-based cohort study from Sweden

    Science.gov (United States)

    Haglund, Axel; Tidemalm, Dag; Jokinen, Jussi; Långström, Niklas; Liechtenstein, Paul; Fazel, Seena; Runeson, Bo

    2015-01-01

    Objective Released prisoners have high suicide rates compared with the general population, but little is known about risk factors and possible causal pathways. We conducted a population-based cohort study to investigate rates and risk factors for suicide in people previously imprisoned. Methods We identified individuals released from prison in Sweden between January 1, 2005 and December 31, 2009 through linkage of national population-based registers. Released prisoners were followed from the day of release until death, emigration, new incarceration, or December 31, 2009. Survival analyses were conducted to compare incidence rates and psychiatric morbidity with non-convicted population controls matched on gender and year of birth. Results We identified 38,995 releases among 26,953 prisoners (7.6% females) during 2005-2009. Overall, 127 suicides occurred, accounting for 14% of all deaths after release (n=920). The mean suicide rate was 204 per 100,000 person years yielding an incidence rate ratio of 18.2 (95% CI 13.9-23.8) compared with general population controls. Previous substance use disorder (Hazard Ratio [HR]=2.1, 1.4-3.2), suicide attempt (HR=2.5, 1.7-3.7), and being born in Sweden vs. abroad (HR=2.1, 1.2-3.6) were independent risk factors for suicide after release. Conclusions Released prisoners are at high suicide risk and with a slightly different pattern of psychiatric risk factors for suicide compared with the general population. Results suggest appropriate allocation of resources to facilitate transition to life outside prison and increased attention to prisoners with both a previous suicide attempt and substance use disorder. PMID:25373114

  2. Suicide after release from prison: a population-based cohort study from Sweden.

    Science.gov (United States)

    Haglund, Axel; Tidemalm, Dag; Jokinen, Jussi; Långström, Niklas; Lichtenstein, Paul; Fazel, Seena; Runeson, Bo

    2014-10-01

    Released prisoners have high suicide rates compared with the general population, but little is known about risk factors and possible causal pathways. We conducted a population-based cohort study to investigate rates and risk factors for suicide in people previously imprisoned. We identified individuals released from prison in Sweden between January 1, 2005, and December 31, 2009, through linkage of national population-based registers. Released prisoners were followed from the day of release until death, emigration, new incarceration, or December 31, 2009. Survival analyses were conducted to compare incidence rates and psychiatric morbidity with nonconvicted population controls matched on gender and year of birth. We identified 38,995 releases among 26,985 prisoners (7.6% female) during 2005-2009. Overall, 127 suicides occurred, accounting for 14% of all deaths after release (n = 920). The mean suicide rate was 204 per 100,000 person-years, yielding an incidence rate ratio of 18.2 (95% CI, 13.9-23.8) compared with general population controls. Previous substance use disorder (hazard ratio [HR] = 2.1; 95% CI, 1.4-3.2), suicide attempt (HR = 2.5; 95% CI, 1.7-3.7), and being born in Sweden versus abroad (HR = 2.1; 95% CI, 1.2-3.6) were independent risk factors for suicide after release. Released prisoners are at high suicide risk and have a slightly different pattern of psychiatric risk factors for suicide compared with the general population. Results suggest appropriate allocation of resources to facilitate transition to life outside prison and increased attention to prisoners with both a previous suicide attempt and substance use disorder. © Copyright 2014 Physicians Postgraduate Press, Inc.

  3. Childhood Asthma

    Science.gov (United States)

    ... for long periods of time before having an asthma attack. The symptoms of asthma can be confused with ... pollen and other environmental allergens can trigger an asthma attack. In some children, asthma can be caused by ...

  4. Pediatric Asthma

    Science.gov (United States)

    ... Science Education & Training Home Conditions Asthma (Pediatric) Asthma (Pediatric) Make an Appointment Refer a Patient Ask a ... meet the rising demand for asthma care. Our pediatric asthma team brings together physicians, nurses, dietitians, physical ...

  5. Meta-analysis of genome-wide linkage studies of asthma and related traits

    Directory of Open Access Journals (Sweden)

    Ferreira Manuel A

    2008-04-01

    Full Text Available Abstract Background Asthma and allergy are complex multifactorial disorders, with both genetic and environmental components determining disease expression. The use of molecular genetics holds great promise for the identification of novel drug targets for the treatment of asthma and allergy. Genome-wide linkage studies have identified a number of potential disease susceptibility loci but replication remains inconsistent. The aim of the current study was to complete a meta-analysis of data from genome-wide linkage studies of asthma and related phenotypes and provide inferences about the consistency of results and to identify novel regions for future gene discovery. Methods The rank based genome-scan meta-analysis (GSMA method was used to combine linkage data for asthma and related traits; bronchial hyper-responsiveness (BHR, allergen positive skin prick test (SPT and total serum Immunoglobulin E (IgE from nine Caucasian asthma populations. Results Significant evidence for susceptibility loci was identified for quantitative traits including; BHR (989 pedigrees, n = 4,294 2p12-q22.1, 6p22.3-p21.1 and 11q24.1-qter, allergen SPT (1,093 pedigrees, n = 4,746 3p22.1-q22.1, 17p12-q24.3 and total IgE (729 pedigrees, n = 3,224 5q11.2-q14.3 and 6pter-p22.3. Analysis of the asthma phenotype (1,267 pedigrees, n = 5,832 did not identify any region showing genome-wide significance. Conclusion This study represents the first linkage meta-analysis to determine the relative contribution of chromosomal regions to the risk of developing asthma and atopy. Several significant results were obtained for quantitative traits but not for asthma confirming the increased phenotype and genetic heterogeneity in asthma. These analyses support the contribution of regions that contain previously identified asthma susceptibility genes and provide the first evidence for susceptibility loci on 5q11.2-q14.3 and 11q24.1-qter.

  6. Why Do Student Teachers Enrol for a Teaching Degree? A Study of Teacher Recruitment in Portugal and Sweden

    Science.gov (United States)

    Flores, Maria Assunção; Niklasson, Laila

    2014-01-01

    This paper reports on findings from an exploratory study carried out in Portugal and Sweden, concerning student teacher recruitment to Initial Teacher Education (ITE) programmes. It addresses issues such as the motivations and expectations of the student teachers regarding the teaching profession. Drawing upon existing related literature, a…

  7. Adult asthma disease management: an analysis of studies, approaches, outcomes, and methods.

    Science.gov (United States)

    Maciejewski, Matthew L; Chen, Shih-Yin; Au, David H

    2009-07-01

    Disease management has been implemented for patients with asthma in various ways. We describe the approaches to and components of adult asthma disease-management interventions, examine the outcomes evaluated, and assess the quality of published studies. We searched the MEDLINE, EMBASE, CINAHL, PsychInfo, and Cochrane databases for studies published in 1986 through 2008, on adult asthma management. With the studies that met our inclusion criteria, we examined the clinical, process, medication, economic, and patient-reported outcomes reported, and the study designs, provider collaboration during the studies, and statistical methods. Twenty-nine articles describing 27 studies satisfied our inclusion criteria. There was great variation in the content, extent of collaboration between physician and non-physician providers responsible for intervention delivery, and outcomes examined across the 27 studies. Because of limitations in the design of 22 of the 27 studies, the differences in outcomes assessed, and the lack of rigorous statistical adjustment, we could not draw definitive conclusions about the effectiveness or cost-effectiveness of the asthma disease-management programs or which approach was most effective. Few well-designed studies with rigorous evaluations have been conducted to evaluate disease-management interventions for adults with asthma. Current evidence is insufficient to recommend any particular intervention.

  8. Adult asthma is associated with an increased risk of herpes zoster: A population-based cohort study.

    Science.gov (United States)

    Peng, Yi-Hao; Fang, Hsin-Yu; Wu, Biing-Ru; Kao, Chia-Hung; Chen, Hsuan-Ju; Hsia, Te-Chun; Liao, Wei-Chih

    2017-04-01

    The objective of this study was to determine whether a new diagnosis of asthma is associated with a later diagnosis of herpes zoster (HZ) in a nationwide, retrospective, non-age limited, population-based cohort. We used data from the National Health Insurance Research Database in Taiwan. The asthma group consisted of all 40 069 patients in the database with newly diagnosed asthma and using asthma medications from 2000 through 2005. The nonasthma group comprised 40 069 age- and sex-matched patients without any asthma diagnosis. Cox proportional hazards regression analysis was applied to calculate the hazard ratio of HZ in the patients with asthma relative to those without asthma. During a mean follow-up period of 8.77 years, the risk of HZ was 1.48-fold higher in the asthma group compared with that in the nonasthma group after adjustment for sex, age, comorbidities, inhaled and systemic corticosteroid use, and annual outpatient department visits to dermatologists. Additional stratified analyses revealed that the risk of HZ was significantly higher in patients of both sexes and those aged older than 21 years. Newly diagnosed adult patients with asthma have a significantly higher risk of developing HZ than do those without asthma.

  9. A pilot feeding study for adults with asthma: The healthy eating better breathing trial.

    Directory of Open Access Journals (Sweden)

    Emily P Brigham

    Full Text Available Evidence from observational studies and to a lesser extent clinical trials suggest that a healthy diet may improve symptoms and lung function in patients with asthma. We conducted a pilot study to determine the feasibility of conducting a larger scale dietary trial and to provide preliminary evidence on the impact of a healthy diet on asthma outcomes.In a randomized, two period cross-over trial, participants with asthma received a 4-week dietary intervention followed by a usual diet (or vice versa, separated by a 4-week washout. The dietary intervention was a healthy diet rich in unsaturated fat. During the dietary intervention, participants ate three meals per week on site at the Johns Hopkins ProHealth Research Center. All remaining meals and snacks were provided for participants to consume off-site. During the control diet, participants were instructed to continue their usual dietary intake. Relevant biomarkers and asthma clinical outcomes were assessed at 0, 2, and 4 weeks after starting each arm of the study.Eleven participants were randomized, and seven completed the full study protocol. Among these seven participants, average age was 42 years, six were female, and six were African American. Participant self-report of dietary intake revealed significant increases in fruit, vegetable, and omega-3 fatty acid intake with the dietary intervention compared to usual diet. Serum carotenoids (eg. lutein and beta-cryptoxanthin increased in the intervention versus control. Total cholesterol decreased in the intervention versus control diet. There was no consistent effect on asthma outcomes.The findings suggest that a feeding trial in participants with asthma is feasible. Larger trials are needed to definitively assess the potential benefits of dietary interventions on pulmonary symptoms and function in patients with asthma.

  10. Pet ownership and risk of asthma: a case-controlled study

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    Sharifi

    2008-08-01

    Full Text Available Background: In the treatment of bronchial asthma, the identification, isolation, and elimination of causative allergens is the most effective part of treatment. With the recent diversification within the pet industry, pet owner exposure to many unknown antigens is on the rise. The results of population studies have been contradictory and some epidemiological studies have failed to confirm this, some indicating that keeping pets might actually reduce the risk of sensitization and asthma. The purpose of this study was to determine the association between pet ownership and asthma. Methods: This case-control study included 300 asthmatic participants referred to the Children's Medical Center over a two-year period. Participants were asked to fill out a questionnaire regarding pet ownership, pet gender and puberty, the place it was kept, how long the pet was kept and the reason for keeping the pet. The same questions were asked from 300 age- and gender-matched nonasthmatic individuals as the control group. Statistical analysis was performed to calculate odds ratios (OR of asthma morbidity in individuals who kept pets. Results: The OR for asthma morbidity in patients who kept pets was 2.59 (CI=1.60-4.21 and p>0.001. Financial aim was the most common reason for keeping a pet and most pets were mature and kept outdoors. No significant correlations for pet genders were observed. Conclusion: This survey provides evidence that pet ownership is an important risk factor for asthma, therefore we suggest that individuals at risk for asthma (atopic individuals must avoid contact with pets. However, more research in this field in Iran is necessary.

  11. Effects of BMI, Fat Mass, and Lean Mass on Asthma in Childhood: A Mendelian Randomization Study

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    Granell, Raquel; Henderson, A. John; Evans, David M.; Smith, George Davey; Ness, Andrew R.; Lewis, Sarah; Palmer, Tom M.; Sterne, Jonathan A. C.

    2014-01-01

    Background Observational studies have reported associations between body mass index (BMI) and asthma, but confounding and reverse causality remain plausible explanations. We aim to investigate evidence for a causal effect of BMI on asthma using a Mendelian randomization approach. Methods and Findings We used Mendelian randomization to investigate causal effects of BMI, fat mass, and lean mass on current asthma at age 7½ y in the Avon Longitudinal Study of Parents and Children (ALSPAC). A weighted allele score based on 32 independent BMI-related single nucleotide polymorphisms (SNPs) was derived from external data, and associations with BMI, fat mass, lean mass, and asthma were estimated. We derived instrumental variable (IV) estimates of causal risk ratios (RRs). 4,835 children had available data on BMI-associated SNPs, asthma, and BMI. The weighted allele score was strongly associated with BMI, fat mass, and lean mass (all p-valuesBMI on asthma was 1.55 (95% CI 1.16–2.07) per kg/m2, p = 0.003. This effect appeared stronger for non-atopic (1.90, 95% CI 1.19–3.03) than for atopic asthma (1.37, 95% CI 0.89–2.11) though there was little evidence of heterogeneity (p = 0.31). The estimated causal RRs for the effects of fat mass and lean mass on asthma were 1.41 (95% CI 1.11–1.79) per 0.5 kg and 2.25 (95% CI 1.23–4.11) per kg, respectively. The possibility of genetic pleiotropy could not be discounted completely; however, additional IV analyses using FTO variant rs1558902 and the other BMI-related SNPs separately provided similar causal effects with wider confidence intervals. Loss of follow-up was unlikely to bias the estimated effects. Conclusions Higher BMI increases the risk of asthma in mid-childhood. Higher BMI may have contributed to the increase in asthma risk toward the end of the 20th century. Please see later in the article for the Editors' Summary PMID:24983943

  12. Serum cytokine profiles as predictors of asthma control in adults from the EGEA study.

    Science.gov (United States)

    Akiki, Zeina; Rava, Marta; Diaz Gil, Oscar; Pin, Isabelle; le Moual, Nicole; Siroux, Valérie; Guerra, Stefano; Chamat, Soulaima; Matran, Regis; Fitó, Montserrat; Salameh, Pascale; Nadif, Rachel

    2017-04-01

    To which extent serum cytokines may predict asthma control in adults remains understudied. We investigated cross-sectional and longitudinal associations between cytokine profiles and asthma outcomes. Serum interleukin (IL)-1Ra, IL-5, IL-7, IL-8, IL-10, IL-13 and TNF-α levels were determined in 283 adults with current asthma from the 2nd survey of the Epidemiological Study on the Genetics and Environment of Asthma (EGEA2). Participants were followed-up seven years later. Asthma symptom control was assessed according to GINA 2015 guidelines. Cytokine profiles were identified by principal component (PC) analyses, and expressed as above/below the median. The first two PCs captured 82.5% of the variability. While all seven cytokines scored high on PC1, only IL-1Ra and IL-10 scored high on PC2. At EGEA2, neither PC1 nor PC2 were related to exacerbations, asthma attacks, asthma symptom control, lung function, or allergic diseases. High level of PC1 (above the median) was associated with higher blood neutrophil counts (P = 0.02), while high level of PC2 was associated with lower IgE levels (P = 0.04). High level of PC2 at EGEA2 was associated with lower bronchial hyperresponsiveness (adjusted(a) OR[95%CI] = 0.46[0.23; 0.91]) and with subsequent lower risk of worsening asthma control and attacks (aOR[95%CI] = 0.24[0.09; 0.60]; 0.31[0.11; 0.85] respectively). Serum cytokine profiles with high levels of IL-1Ra and IL-10 were associated with lower subsequent risks of worsening asthma control and attacks in adults. This study adds new findings for the role of serum cytokine profiles to help identifying adults with subsequent risk of asthma burden that could be targeted for specific therapies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. The Use of Religious Coping Methods in a Secular Society: A Survey Study Among Cancer Patients in Sweden.

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    Ahmadi, Nader; Ahmadi, Fereshteh

    2017-07-01

    In the present article, based on results from a survey study in Sweden among 2,355 cancer patients, the role of religion in coping is discussed. The survey study, in turn, was based on earlier findings from a qualitative study of cancer patients in Sweden. The purpose of the present survey study was to determine to what extent results obtained in the qualitative study can be applied to a wider population of cancer patients in Sweden. The present study shows that use of religious coping methods is infrequent among cancer patients in Sweden. Besides the two methods that are ranked in 12th and 13th place, that is, in the middle (Listening to religious music and Praying to God to make things better), the other religious coping methods receive the lowest rankings, showing how nonsignificant such methods are in coping with cancer in Sweden. However, the question of who turns to God and who is self-reliant in a critical situation is too complicated to be resolved solely in terms of the strength of individuals' religious commitments. In addition to background and situational factors, the culture in which the individual was socialized is an important factor. Regarding the influence of background variables, the present results show that gender, age , and area of upbringing played an important role in almost all of the religious coping methods our respondents used. In general, people in the oldest age-group, women, and people raised in places with 20,000 or fewer residents had a higher average use of religious coping methods than did younger people, men, and those raised in larger towns.

  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. Details of development of the resource for adults with asthma in the RAISIN (randomized trial of an asthma internet self-management intervention) study.

    Science.gov (United States)

    Morrison, Deborah; Mair, Frances S; Chaudhuri, Rekha; McGee-Lennon, Marilyn; Thomas, Mike; Thomson, Neil C; Yardley, Lucy; Wyke, Sally

    2015-07-28

    Around 300 million people worldwide have asthma and prevalence is increasing. Self-management can be effective in improving a range of outcomes and is cost effective, but is underutilised as a treatment strategy. Supporting optimum self-management using digital technology shows promise, but how best to do this is not clear. We aimed to develop an evidence based, theory informed, online resource to support self-management in adults with asthma, called 'Living well with Asthma', as part of the RAISIN (Randomized Trial of an Asthma Internet Self-Management Intervention) study. We developed Living well with Asthma in two phases. Phase 1: A low fidelity prototype (paper-based) version of the website was developed iteratively through input from a multidisciplinary expert panel, empirical evidence from the literature, and potential end users via focus groups (adults with asthma and practice nurses). Implementation and behaviour change theories informed this process. Phase 2: The paper-based designs were converted to a website through an iterative user centred process. Adults with asthma (n = 10) took part in think aloud studies, discussing the paper based version, then the web-based version. Participants considered contents, layout, and navigation. Development was agile using feedback from the think aloud sessions immediately to inform design and subsequent think aloud sessions. Think aloud transcripts were also thematically analysed, further informing resource development. The website asked users to aim to be symptom free. Key behaviours targeted to achieve this include: optimising medication use (including inhaler technique); attending primary care asthma reviews; using asthma action plans; increasing physical activity levels; and stopping smoking. The website had 11 sections, plus email reminders, which promoted these behaviours. Feedback on the contents of the resource was mainly positive with most changes focussing on clarification of language, order of pages and

  16. Allergy in severe asthma.

    Science.gov (United States)

    Del Giacco, S R; Bakirtas, A; Bel, E; Custovic, A; Diamant, Z; Hamelmann, E; Heffler, E; Kalayci, Ö; Saglani, S; Sergejeva, S; Seys, S; Simpson, A; Bjermer, L

    2017-02-01

    It is well recognized that atopic sensitization is an important risk factor for asthma, both in adults and in children. However, the role of allergy in severe asthma is still under debate. The term 'Severe Asthma' encompasses a highly heterogeneous group of patients who require treatment on steps 4-5 of GINA guidelines to prevent their asthma from becoming 'uncontrolled', or whose disease remains 'uncontrolled' despite this therapy. Epidemiological studies on emergency room visits and hospital admissions for asthma suggest the important role of allergy in asthma exacerbations. In addition, allergic asthma in childhood is often associated with severe asthma in adulthood. A strong association exists between asthma exacerbations and respiratory viral infections, and interaction between viruses and allergy further increases the risk of asthma exacerbations. Furthermore, fungal allergy has been shown to play an important role in severe asthma. Other contributing factors include smoking, pollution and work-related exposures. The 'Allergy and Asthma Severity' EAACI Task Force examined the current evidence and produced this position document on the role of allergy in severe asthma. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Dietary patterns and adult asthma: population-based case-control study.

    Science.gov (United States)

    Bakolis, I; Hooper, R; Thompson, R L; Shaheen, S O

    2010-05-01

    Epidemiological studies of diet and asthma have focused on relations with intakes of individual nutrients and foods and evidence has been conflicting. Few studies have examined associations with dietary patterns. We carried out a population-based case-control study of asthma in adults aged between 16 and 50 in South London, UK. Information about usual diet was obtained by food frequency questionnaire and we used principal components analysis to define five dietary patterns in controls. We used logistic and linear regression, controlling for confounders, to relate these patterns to asthma, asthma severity, rhinitis and chronic bronchitis in 599 cases and 854 controls. Overall, there was weak evidence that a 'vegetarian' dietary pattern was positively associated with asthma [adjusted odds ratio comparing top vs bottom quintile of pattern score 1.43 (95% CI: 0.93-2.20), P trend 0.075], and a 'traditional' pattern (meat and vegetables) was negatively associated [OR 0.68 (0.45-1.03), P trend 0.071]. These associations were stronger amongst nonsupplement users (P trend 0.030 and 0.001, respectively), and the association with the 'vegetarian' pattern was stronger amongst whites (P trend 0.008). No associations were observed with asthma severity. A 'prudent' dietary pattern (wholemeal bread, fish and vegetables) was positively associated with chronic bronchitis [OR 2.61 (1.13-6.05), P trend 0.025], especially amongst nonsupplement users (P trend 0.002). Overall there were no clear relations between dietary patterns and adult asthma; associations in nonsupplement users and whites require confirmation. The finding for chronic bronchitis was unexpected and also requires replication.

  18. Association between protozoa in sputum and asthma: a case-control study.

    Science.gov (United States)

    van Woerden, Hugo C; Ratier-Cruz, Adriana; Aleshinloye, Olabode B; Martinez-Giron, Rafael; Gregory, Clive; Matthews, Ian P

    2011-06-01

    Atypical infectious agents have been proposed as potential contributors to asthma. A novel set of morphological and staining criteria permit the identification of flagellated protozoa in sputum. This case-control study was designed to use this novel method and to assess: (1) are protozoa more common in asthmatics than in non-asthmatics; (2) is the presence of protozoa associated with the use of steroid inhalers; and (3) is the presence of protozoa associated with living in damp housing? Induced sputum samples were collected from asthma patients and local non-atopic, non-smoking controls. Questionnaires assessed asthma severity and housing conditions. Sputum was examined for flagellated protozoa using a previously described staining technique. 96 participants were recruited for this study; 54 asthma patients and 42 controls, age range 21-62 years, 70% female participants. Limiting results to those who were clearly positive or negative for flagellated protozoa, 66.7% (20/30) of asthmatics and 30.8% (4/13) of controls had protozoa (p = 0.046). Among the asthma patients, prevalence of protozoa was not significantly different between those who had (10/18), and those who had not (10/12), used steroid inhaler in the preceding two weeks (p = 0.11). Similarly, the prevalence of protozoa was not significantly different between those who did (6/11) and those who did not (18/32), live in damp homes (p = 0.92). This case-control study demonstrates an association between flagellated protozoa in sputum and asthma. It is now necessary to confirm and characterise the protozoa using genetic techniques based on 18S ribosomal RNA. Once tis is established it would be worthwhile to determine if asthma symptoms improve when treated by anti-protozoal agents. Copyright © 2010 Elsevier Ltd. All rights reserved.

  19. Common variants of the neuropeptide expressing tachykinin genes and susceptibility to asthma: a case-control study.

    Science.gov (United States)

    Klassert, Tilman E; Sánchez, Juan J; Almeida, Teresa A; Candenas, Luz; Pinto, Francisco; Acosta, Orlando; Hernández, Mariano

    2010-10-08

    Since tachykinins appear to be involved in the pathogenesis of allergic asthma, we investigated a possible association between 28 single nucleotide polymorphisms of the tachykinin genes TAC1, TAC3 and TAC4, and asthma susceptibility. A case-control study was conducted on 102 patients and 100 healthy subjects from the Canary Islands (Spain). A significant association with asthma was observed for two SNPs: rs2291855 in the TAC3 gene conferring asthma protection (Odds ratio [OR]: 0.46; 95% Confidence Interval [CI]: 0.22-0.97; P=0.038), and rs4794068 in the TAC4 gene associated with an increased risk for asthma (OR: 1.94; 95% CI: 1.06-3.54; P=0.03). The present study represents a preliminary step in elucidating the association between tachykinin gene polymorphisms and asthma susceptibility. Copyright © 2010 Elsevier B.V. All rights reserved.

  20. Mother's education and offspring asthma risk in 10 European cohort studies.

    Science.gov (United States)

    Lewis, Kate Marie; Ruiz, Milagros; Goldblatt, Peter; Morrison, Joana; Porta, Daniela; Forastiere, Francesco; Hryhorczuk, Daniel; Zvinchuk, Oleksandr; Saurel-Cubizolles, Marie-Josephe; Lioret, Sandrine; Annesi-Maesano, Isabella; Vrijheid, Martine; Torrent, Maties; Iniguez, Carmen; Larranaga, Isabel; Harskamp-van Ginkel, Margreet W; Vrijkotte, Tanja G M; Klanova, Jana; Svancara, Jan; Barross, Henrique; Correia, Sofia; Jarvelin, Marjo-Riitta; Taanila, Anja; Ludvigsson, Johnny; Faresjo, Tomas; Marmot, Michael; Pikhart, Hynek

    2017-09-01

    Highly prevalent and typically beginning in childhood, asthma is a burdensome disease, yet the risk factors for this condition are not clarified. To enhance understanding, this study assessed the cohort-specific and pooled risk of maternal education on asthma in children aged 3-8 across 10 European countries. Data on 47,099 children were obtained from prospective birth cohort studies across 10 European countries. We calculated cohort-specific prevalence difference in asthma outcomes using the relative index of inequality (RII) and slope index of inequality (SII). Results from all countries were pooled using random-effects meta-analysis procedures to obtain mean RII and SII scores at the European level. Final models were adjusted for child sex, smoking during pregnancy, parity, mother's age and ethnicity. The higher the score the greater the magnitude of relative (RII, reference 1) and absolute (SII, reference 0) inequity. The pooled RII estimate for asthma risk across all cohorts was 1.46 (95% CI 1.26, 1.71) and the pooled SII estimate was 1.90 (95% CI 0.26, 3.54). Of the countries examined, France, the United Kingdom and the Netherlands had the highest prevalence's of childhood asthma and the largest inequity in asthma risk. Smaller inverse associations were noted for all other countries except Italy, which presented contradictory scores, but with small effect sizes. Tests for heterogeneity yielded significant results for SII scores. Overall, offspring of mothers with a low level of education had an increased relative and absolute risk of asthma compared to offspring of high-educated mothers.

  1. Suboptimal asthma care for immigrant children: results of an audit study

    Directory of Open Access Journals (Sweden)

    Klazinga Niek S

    2008-01-01

    Full Text Available Abstract Background Little is known on the scope and nature of ethnic inequalities in suboptimal asthma care for children. This study aimed to assess (1 ethnic differences in suboptimal asthma care for children with an asthma exacerbation who consulted a physician, and (2 ethnic differences in the nature of suboptimal care. Methods All children aged 6–16 years who during a period of six months consulted the paediatric department of the Academic Medical Centre-University of Amsterdam or one of the six regional primary care centres with an asthma exacerbation were included. Clinical guidelines were systematically converted to review criteria following the strategy as proposed by the Agency for Health Care Policy and Research. Based upon these review criteria and their experience experts of two multidisciplinary panels retrospectively assessed the quality of care and its (possible failure to prevent the occurrence of asthma exacerbation. Results Only a small number of children (n = 35 were included in the analysis as a result of which the ethnic differences in suboptimal care were not significant. However, the results do indicate immigrant children, in particular 'other non-Western' children (n = 11, more frequently to receive suboptimal care related to the asthma exacerbation when compared to ethnic Dutch children. Furthermore, we found the nature of suboptimal care to differ with under-prescribing in the 'other non-Western' group (n = 11, lack of information exchange between physicians in the Surinamese/Antillean group (n = 12 and lack of education, and counselling of patients and parents in the ethnic Dutch (n = 12 as the most relevant factor. Conclusion Ethnic inequalities in the scope and nature of suboptimal asthma care for children in the Netherlands seem to exist. For the non-western immigrant groups the results indicate the importance of the prescription behaviour of the medical doctor, as well as the supervision by one health care

  2. Effectiveness of voriconazole in the treatment of Aspergillus fumigatus-associated asthma (EVITA3 study).

    Science.gov (United States)

    Agbetile, Joshua; Bourne, Michelle; Fairs, Abbie; Hargadon, Beverley; Desai, Dhananjay; Broad, Clare; Morley, Joseph; Bradding, Peter; Brightling, Christopher E; Green, Ruth H; Haldar, Pranabashis; Pashley, Catherine H; Pavord, Ian D; Wardlaw, Andrew J

    2014-07-01

    IgE sensitization to Aspergillus fumigatus and a positive sputum fungal culture result are common in patients with refractory asthma. It is not clear whether these patients would benefit from antifungal treatment. We sought to determine whether a 3-month course of voriconazole improved asthma-related outcomes in patients with asthma who are IgE sensitized to A fumigatus. Asthmatic patients who were IgE sensitized to A fumigatus with a history of at least 2 severe exacerbations in the previous 12 months were treated for 3 months with 200 mg of voriconazole twice daily, followed by observation for 9 months, in a double-blind, placebo-controlled, randomized design. Primary outcomes were improvement in quality of life at the end of the treatment period and a reduction in the number of severe exacerbations over the 12 months of the study. Sixty-five patients were randomized. Fifty-nine patients started treatment (32 receiving voriconazole and 27 receiving placebo) and were included in an intention-to-treat analysis. Fifty-six patients took the full 3 months of medication. Between the voriconazole and placebo groups, there were no significant differences in the number of severe exacerbations (1.16 vs 1.41 per patient per year, respectively; mean difference, 0.25; 95% CI, 0.19-0.31), quality of life (change in Asthma Quality of Life Questionnaire score, 0.68 vs 0.88; mean difference between groups, 0.2; 95% CI, -0.05 to -0.11), or any of our secondary outcome measures. We were unable to show a beneficial effect of 3 months of treatment with voriconazole in patients with moderate-to-severe asthma who were IgE sensitized to A fumigatus on either the rate of severe exacerbations, quality of life, or other markers of asthma control. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  3. A quality improvement study using fishbone analysis and an electronic medical records intervention to improve care for children with asthma.

    Science.gov (United States)

    Gold, Jonathan; Reyes-Gastelum, David; Turner, Jane; Davies, H Dele

    2014-01-01

    Despite expert guidelines, gaps persist in quality of care for children with asthma. This study sought to identify barriers and potential interventions to improve compliance to national asthma prevention guidelines at a single academic pediatric primary care clinic. Using the plan-do-check-act (PDCA) quality improvement framework and fishbone analysis, several barriers to consistent asthma processes and possible interventions were identified by a group of key stakeholders. Two interventions were implemented using the electronic medical record (EMR). Physician documentation of asthma quality measures were analyzed before intervention and during 2 subsequent time points over 16 months. Documentation of asthma action plans (core group P PDCA and fishbone analysis in conjunction with embedded EMR tools can improve asthma care in a pediatric primary care setting.

  4. Characterization of Rhinitis According to the Asthma Status in Adults Using an Unsupervised Approach in the EGEA Study.

    Science.gov (United States)

    Burte, Emilie; Bousquet, Jean; Varraso, Raphaëlle; Gormand, Frédéric; Just, Jocelyne; Matran, Régis; Pin, Isabelle; Siroux, Valérie; Jacquemin, Bénédicte; Nadif, Rachel

    2015-01-01

    The classification of rhinitis in adults is missing in epidemiological studies. To identify phenotypes of adult rhinitis using an unsupervised approach (data-driven) compared with a classical hypothesis-driven approach. 983 adults of the French Epidemiological Study on the Genetics and Environment of Asthma (EGEA) were studied. Self-reported symptoms related to rhinitis such as nasal symptoms, hay fever, sinusitis, conjunctivitis, and sensitivities to different triggers (dust, animals, hay/flowers, cold air…) were used. Allergic sensitization was defined by at least one positive skin prick test to 12 aeroallergens. Mixture model was used to cluster participants, independently in those without (Asthma-, n = 582) and with asthma (Asthma+, n = 401). Three clusters were identified in both groups: 1) Cluster A (55% in Asthma-, and 22% in Asthma+) mainly characterized by the absence of nasal symptoms, 2) Cluster B (23% in Asthma-, 36% in Asthma+) mainly characterized by nasal symptoms all over the year, sinusitis and a low prevalence of positive skin prick tests, and 3) Cluster C (22% in Asthma-, 42% in Asthma+) mainly characterized by a peak of nasal symptoms during spring, a high prevalence of positive skin prick tests and a high report of hay fever, allergic rhinitis and conjunctivitis. The highest rate of polysensitization (80%) was found in participants with comorbid asthma and allergic rhinitis. This cluster analysis highlighted three clusters of rhinitis with similar characteristics than those known by clinicians but differing according to allergic sensitization, and this whatever the asthma status. These clusters could be easily rebuilt using a small number of variables.

  5. Higher body mass index may induce asthma among adolescents with pre-asthmatic symptoms: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Myers Leann

    2011-07-01

    Full Text Available Abstract Background Limited studies have prospectively examined the role of body mass index (BMI as a major risk factor for asthma during adolescence. This study investigates whether BMI is associated with increased risk of developing physician-diagnosed asthma during 12-month follow-up among adolescents with undiagnosed asthma-like symptoms at baseline. Methods A total of 4,052 adolescents with undiagnosed asthma-like symptoms at baseline were re-examined after a 12-month follow-up. Asthma cases were considered confirmed only after diagnosis by a physician based on the New England core and International Study of Asthma and Allergies in Childhood (ISAAC criteria video questionnaires, and accompanying pulmonary function tests. Logistic regression analyses were used to evaluate the relationship of BMI and the risk of acquiring asthma. Results The results indicated that girls with higher BMI were at an increased risk of developing asthma during the 12-month follow-up. The odds ratios for girls developing physician-diagnosed asthma were 1.75 (95% CI = 1.18-2.61 and 1.12 (95% CI = 0.76-1.67, respectively, for overweight and obesity as compared to the normal weight reference group after adjustment for other covariates. A similar relationship was not observed for overweight and obese boys who were also significantly more active than their female counterparts. Conclusions Increased BMI exaggerates the risk of acquiring asthma in symptomatic adolescent females but not in adolescent males. Thus, gender is an important modifier of BMI-related asthma risk. Additional research will be required to determine whether the increased asthma risk results from genetic, physiological or behavioural differences.

  6. Outdoor air pollution, exhaled 8-isoprostane and current asthma in adults: the EGEA study.

    Science.gov (United States)

    Havet, Anaïs; Zerimech, Farid; Sanchez, Margaux; Siroux, Valérie; Le Moual, Nicole; Brunekreef, Bert; Stempfelet, Morgane; Künzli, Nino; Jacquemin, Bénédicte; Matran, Régis; Nadif, Rachel

    2018-04-01

    Associations between outdoor air pollution and asthma in adults are still scarce, and the underlying biological mechanisms are poorly understood. Our aim was to study the associations between 1) long-term exposure to outdoor air pollution and current asthma, 2) exhaled 8-isoprostane (8-iso; a biomarker related to oxidative stress) and current asthma, and 3) outdoor air pollution and exhaled 8-iso.Cross-sectional analyses were conducted in 608 adults (39% with current asthma) from the first follow-up of the French case-control and family study on asthma (EGEA; the Epidemiological study of the Genetic and Environmental factors of Asthma). Data on nitrogen dioxide, nitrogen oxides, particulate matter with a diameter ≤10 and ≤2.5 µm (PM 10 and PM 2.5 ), road traffic, and ozone (O 3 ) were from ESCAPE (European Study of Cohorts for Air Pollution Effects) and IFEN (French Institute for the Environment) assessments. Models took account of city and familial dependence.The risk of current asthma increased with traffic intensity (adjusted (a)OR 1.09 (95% CI 1.00-1.18) per 5000 vehicles per day), with O 3 exposure (aOR 2.04 (95% CI 1.27-3.29) per 10 µg·m -3 ) and with exhaled 8-iso concentration (aOR 1.50 (95% CI 1.06-2.12) per 1 pg·mL -1 ). Among participants without asthma, exhaled 8-iso concentration increased with PM 2.5 exposure (adjusted (a)β 0.23 (95% CI 0.005-0.46) per 5 µg·m -3 ), and decreased with O 3 and O 3-summer exposures (aβ -0.20 (95% CI -0.39- -0.01) and aβ -0.52 (95% CI -0.77- -0.26) per 10 µg·m -3 , respectively).Our results add new insights into a potential role of oxidative stress in the associations between outdoor air pollution and asthma in adults. Copyright ©ERS 2018.

  7. Electronic Adherence Monitoring in a High-Utilizing Pediatric Asthma Cohort: A Feasibility Study.

    Science.gov (United States)

    Kenyon, Chén Collin; Chang, Joyce; Wynter, Sheri-Ann; Fowler, Jessica C; Long, Jin; Bryant-Stephens, Tyra C

    2016-06-22

    Inner-city, minority children with asthma have the highest rates of morbidity and death from asthma and the lowest rates of asthma controller medication adherence. Some recent electronic medication monitoring interventions demonstrated dramatic improvements in adherence in lower-risk populations. The feasibility and acceptability of such an intervention in the highest-risk children with asthma has not been studied. Our objective was to assess the feasibility and acceptability of a community health worker-delivered electronic adherence monitoring intervention among the highest utilizers of acute asthma care in an inner-city practice. This was a prospective cohort pilot study targeting children with the highest frequency of asthma-related emergency department and hospital care within a local managed care Medicaid plan. The 3-month intervention included motivational interviewing, electronic monitoring of controller and rescue inhaler use, and outreach by a community health worker for predefined medication alerts. We measured acceptability by using a modified technology acceptability model and changes in asthma control using the Asthma Control Test (ACT). Given prominent feasibility issues, we describe qualitative patterns of medication use at baseline only. We enrolled 14 non-Hispanic black children with a median age of 3.5 years. Participants averaged 7.8 emergency or hospital visits in the year preceding enrollment. We observed three distinct patterns of baseline controller use: 4 patients demonstrated sustained use, 5 patients had periodic use, and 5 patients lapsed within 2 weeks. All participants initiated use of the electronic devices; however, no modem signal was transmitted for 5 or the 14 participants after a mean of 45 days. Of the 9 (64% of total) caregivers who completed the final study visit, all viewed the electronic monitoring device favorably and would recommend it to friends, and 5 (56%) believed that the device helped to improve asthma control. ACT

  8. [Does Ecuadorians with asthma has preferences in the use of information and communication technologies? Pilot study].

    Science.gov (United States)

    Chérrez-Ojeda, Iván; Plaza, Karin; Cano, José A; Calderón, Juan Carlos; Chérrez, Annia; Baptist, Alan; Calero, Erick; Hoyos, Rodrigo; Beltrán, Patricio; Cruz, Víctor; Ramón, Germán; Simancas, Daniel

    2017-01-01

    Inadequate communication between asthmatic patients and their physicians may interfere directly with asthma control. In the last years, the use of information and communication technologies (ICTs) it has increased in Latin-America. This technology seems to be a good tool to improve communication and management of the asthmatic patient. We evaluated the frequency and preference patterns of communication and information technologies in Ecuadorian patients with bronchial asthma. We conducted a pilot cross-sectional study to identify the frequency and preferences of ICT in patients with asthma. The Spanish version of the Michigan questionnaire was used. Age and educational level were categorized into 3 groups. We used logistic regression between these groups regarding the frequency of use, interest in seeking and receiving information related to their asthma for the age and educational level of the patients. A total of 222 patients participated in our study. The mean age was 45.6 years (SD 17.4), the most common sex was female with 89.25 %. Almost all patients had a cell phone (87.5 %) and internet access (62.7 %). The three ICTs most likely to be used to search for or receive information about their illness were WhatsApp, Facebook and email (p ICT among patients however WhatsApp and Facebook may be appropriate for certain ages especially young asthmatic. Knowledge of preferences can help the development of ICT in a personalized way and improve the outcomes in patients with asthma.

  9. MICROBIOLOGICAL STUDY ON CANDIDA PRESENCE IN SALIVA OF CHILDREN WITH ASTHMA.

    Directory of Open Access Journals (Sweden)

    Mariela Georgieva

    2015-11-01

    Full Text Available Asthma is a chronic disease with increasing frequency that can affect medical and oral health. During the prolonged treatment mainly with corticosteroids and anticholinergic drugs, changes in the oral environment may occur. The aim of this study is to investigate Candida presence in saliva collected from children with asthma and healthy coevals. The study is comprised of 52 children with asthma and 37 controls. Saliva specimens from all the children were prepared and inoculated into selective chromogenic medium to establish colonies growth. Microbial counts determination-followed inoculation. Medium-sized plates were cultured under aerobic conditions. Colony forming units (CFU were counted and biochemical identification was performed. Nearly one third of the examined children were colonized with yeasts on their oral mucosa without significant difference between the asthmatic and controls (26.9% of asthmatic patients and 29.7% of the controls. Children with asthma had higher microbial counts of Candida (104-105, whereas healthy children demonstrated mono infestation and lower microbial counts – fewer than103. C. albicans was the most frequently isolated fungal species from the oral cavity in children with asthma (in 69% of the samples and in healthy children (in 46% of the samples. Some non-albicans species were also isolated in both groups

  10. Joint effect of obesity and TNFA variability on asthma: two international cohort studies.

    Science.gov (United States)

    Castro-Giner, F; Kogevinas, M; Imboden, M; de Cid, R; Jarvis, D; Mächler, M; Berger, W; Burney, P; Franklin, K A; Gonzalez, J R; Heinrich, J; Janson, C; Omenaas, E; Pin, I; Rochat, T; Sunyer, J; Wjst, M; Antó, J-M; Estivill, X; Probst-Hensch, N M

    2009-05-01

    Obesity is a risk factor for asthma. Adipose tissue expresses pro-inflammatory molecules including tumour necrosis factor (TNF), and levels of TNF are also related to polymorphisms in the TNF-alpha (TNFA) gene. The current authors examined the joint effect of obesity and TNFA variability on asthma in adults by combining two population-based studies. The European Community Respiratory Health Survey and the Swiss Cohort Study on Air Pollution and Lung and Heart Disease in Adults used comparable protocols, questionnaires and measures of lung function and atopy. DNA samples from 9,167 participants were genotyped for TNFA -308 and lymphotoxin-alpha (LTA) +252 gene variants. Obesity and TNFA were associated with asthma when mutually adjusting for their independent effects (odds ratio (OR) for obesity 2.4, 95% confidence interval (CI) 1.7-3.2; OR for TNFA -308 polymorphism 1.3, 95% CI 1.1-1.6). The association of obesity with asthma was stronger for subjects carrying the G/A and A/A TNFA -308 genotypes compared with the more common G/G genotype, particularly among nonatopics (OR for G/A and A/A genotypes 6.1, 95% CI 2.5-14.4; OR for G/G genotype 1.7, 95% CI 0.8-3.3). The present findings provide, for the first time, evidence for a complex pattern of interaction between obesity, a pro-inflammatory genetic factor and asthma.

  11. Use of Laparoscopy in Gastrointestinal Surgery in Sweden 1998-2014: A Nationwide Study.

    Science.gov (United States)

    Sundbom, M; Hedberg, J

    2017-03-01

    One by one, minimally invasive alternatives to established gastrointestinal procedures have become clinical routine. We have studied the use of laparoscopy in four common procedures-cholecystectomy, appendectomy, reflux surgery, and bariatric surgery-as well as in major resectional gastrointestinal surgery in Sweden. The National Patient Registry was used to identify all in-hospital procedures performed in patients above the age of 15 during 1998-2014, meeting our inclusion criteria. For each group, the annual number of procedures and proportion of laparoscopic surgery were studied, as well as applicable subgroups. Differences in age, gender, as well as geographical differences were evaluated in the most recent 3-year period (2012-2014). In total, 537,817 procedures were studied, 43% by laparoscopic approach. In 2012-2014, the proportion of laparoscopic surgery ranged from high rates in the four common procedures (cholecystectomy 81%, appendectomy 47%, reflux surgery 72%, and bariatric surgery 97%) to rather low numbers in resectional surgery (4%-10%), however, increasing in the last years. In appendectomy and cholecystectomy, men were less likely to have laparoscopic surgery (42% versus 51% and 74% versus 85%, respectively, p laparoscopy were also noted, for example, the proportion of laparoscopic appendectomy varied from 11% to 76% among the 21 different Swedish counties. The proportion of laparoscopy was high in the four common procedures and low, but rising, in major resectional surgery. A large variation in the proportion of laparoscopic surgery by age, gender, and place of residence was noted.

  12. Plug-in hybrid electric vehicles as regulating power providers: Case studies of Sweden and Germany

    International Nuclear Information System (INIS)

    Andersson, S.-L.; Elofsson, A.K.; Galus, M.D.; Goeransson, L.; Karlsson, S.; Johnsson, F.; Andersson, G.

    2010-01-01

    This study investigates plug-in hybrid electric vehicles (PHEVs) as providers of regulating power in the form of primary, secondary and tertiary frequency control. Previous studies have shown that PHEVs could generate substantial profits while providing ancillary services. This study investigates under what conditions PHEVs can generate revenues using actual market data, i.e. prices and activations of regulating power, from Sweden and Germany from four months in 2008. PHEV market participation is modelled for individual vehicles in a fleet subject to a simulated movement pattern. Costs for infrastructure and vehicle-to-grid equipment are not included in the analysis. The simulation results indicate that maximum average profits generated on the German markets are in the range 30-80 Euro per vehicle and month whereas the Swedish regulating power markets give no profit. In addition, an analysis is performed to identify strengths, weaknesses, opportunities, and threats (SWOT) of PHEVs as regulating power providers. Based on the simulation results and the SWOT analysis, characteristics for an ideal regulating power market for PHEVs are presented.

  13. Fate of occupational asthma. A follow-up study of patients with occupational asthma due to Western Red Cedar (Thuja plicata).

    Science.gov (United States)

    Chan-Yeung, M

    1977-12-01

    Thirty-eight patients with red cedar asthma proved by inhalation provocation test were studied after they had left exposure for more than 6 months. Twenty-seven patients became asymptomatic, with normal lung function (group A). Three patients had persistent chronic bronchitis with a moderate degree of airway obstruction, probably as a result of cigarette smoking (group B1). Eight patients continued to have recurrent attacks of asthma that decreased in severity after cessation of exposure, and their symptoms were probably due to previous exposure (group B2). The effect of breathing helium on maximal expiratory flow at 50 per cent of the vital capacity was studied. All except one patient in group A were responders (change in maximal expiratory flow at 50 per cent of vital capacity greater than 30 per cent). Two patients in group B1 and 2 in group B2 were nonresponders, suggesting obstruction in the small airways. All patients with red cedar asthma demonstrated bronchial hyperreactivity to methacholine to the same extent as patients with nonoccupational asthma. This hyperreactivity persisted after they left exposure, irrespective of symptoms. It is not known at present whether bronchial hyperreactivity is the predisposing factor in occupational asthma or is the result of the disease.

  14. Vitamin D as an adjunctive therapy in asthma. Part 2: A review of human studies.

    LENUS (Irish Health Repository)

    Kerley, Conor P

    2015-03-05

    Vitamin D deficiency (VDD) is highly prevalent worldwide, with adverse effects on bone health but also potentially other unfavorable consequences. VDD and asthma-incidence\\/severity share many common risk factors, including winter season, industrialization, poor diet, obesity, dark skin pigmentation, and high latitude. Multiple anatomical areas relevant to asthma contain both the enzyme responsible for producing activated vitamin D and the vitamin D receptor suggesting that activated vitamin D (1,25-dihydroxyvitamin D) may have important local effects at these sites. Emerging evidence suggests that VDD is associated with increased airway hyperresponsiveness, decreased pulmonary function, worse asthma control, and possibly decreased response to standard anti-asthma therapy. However the effect is inconsistent with preliminary evidence from different studies suggesting vitamin D is both beneficial and detrimental to asthma genesis and severity. Current evidence suggests that supplementation with moderate doses of vitamin D may be appropriate for maintenance of bone health in asthmatics, particularly steroid users. However emerging data from an increasing number of randomized, controlled, intervention studies of vitamin D supplementation in pediatric and adult asthma are becoming available and should help determine the importance, if any of vitamin D for asthma pathogenesis. The purpose of this second of a two-part review is to review the current human literature on vitamin D and asthma, discussing the possible consequences of VDD for asthma and the potential for vitamin D repletion as adjunct therapy.

  15. Age-specific familial risks of depression: a nation-wide epidemiological study from Sweden.

    Science.gov (United States)

    Li, Xinjun; Sundquist, Jan; Sundquist, Kristina

    2008-08-01

    Familial risks of depression have been assessed in small case-control studies, usually based on reported, but not medically verified, depressions in family members; thus the degree of familial clustering of these diseases remains to be established. The Multigeneration Register, in which all men and women born in Sweden from 1932 onward are registered together with their parents, was linked to hospital admission data. Standardized incidence ratios (SIRs) were calculated as the ratio of the observed to the expected number of cases in men and women with mothers or fathers affected by depression, compared with men and women whose mothers or fathers were not affected by depression. A total of respectively 60,477 and 79,969 depressions were recorded in offspring and parents. In 6.44% of all families, an offspring and a parent were affected, giving a population-attributable proportion of 4.04% and a familial SIR of 2.68. The parental transmission of depression was similar for both men and women (2.72 and 2.66). This study has provided the first data on age-specific familial clustering of depressions, based on medically confirmed records. The risks were so high that hereditary factors were considered to be likely to contribute to depression, possibly modified by environmental factors. Age-specific risk tables would be helpful for clinical counseling.

  16. Linking clinical quality indicators to research evidence - a case study in asthma management for children.

    Science.gov (United States)

    Choong, Miew Keen; Tsafnat, Guy; Hibbert, Peter; Runciman, William B; Coiera, Enrico

    2017-07-21

    Clinical quality indicators are used to monitor the performance of healthcare services and should wherever possible be based on research evidence. Little is known however about the extent to which indicators in common use are based on research. The objective of this study is to measure the extent to which clinical quality indicators used in asthma management in children with outcome measurements can be linked to results in randomised controlled clinical trial (RCT) reports. This work is part of a broader research program to trial methods that improve the efficiency and accuracy of indicator development. National-level indicators for asthma management in children were extracted from the National Quality Measures Clearinghouse database and the National Institute for Health and Care Excellence quality standards by two independent appraisers. Outcome measures were extracted from all published English language RCT reports for asthma management in children below the age of 12 published between 2005 and 2014. The two sets were then linked by manually mapping both to a common set of Unified Medical Language System (UMLS) concepts. The analysis identified 39 indicators and 562 full text RCTs dealing with asthma management in children. About 95% (37/39) of the indicators could be linked to RCT outcome measures. It is possible to identify relevant RCT reports for the majority of indicators used to assess the quality of asthma management in childhood. The methods reported here could be automated to more generally support assessment of candidate indicators against the research evidence.

  17. Risk factors for asthma in young adults: a co-twin control study

    DEFF Research Database (Denmark)

    Thomsen, SF; Ulrik, Charlotte Suppli; Kyvik, KO

    2006-01-01

    BACKGROUND: The liability to asthma is influenced both by genetic and environmental factors. The objective of this study was to identify risk factors for asthma in young adult twin pairs during an 8-year period. METHODS: From the birth cohorts 1953-1982 of the Danish Twin Registry, 6,090 twin pairs....... Pairs in which only one twin developed asthma -- discordant pairs -- were identified and conditional logistic regression was applied to detect effects of risk factors. RESULTS: A total of 126 monozygotic (MZ) and 273 dizygotic (DZ) discordant twin pairs were identified. In MZ twins hay fever (OR = 3...... and females = 0.54, 95% CI: 0.36-0.80, P = 0.002), and increasing levels of body mass index (BMI; OR per unit = 1.11, 95% CI: 1.02-1.20, P = 0.009) were significant predictors of asthma. CONCLUSIONS: Hay fever, eczema, female sex, exercise and increasing levels of BMI were risk factors for asthma in young...

  18. Risk factors for asthma in young adults: a co-twin control study

    DEFF Research Database (Denmark)

    Thomsen, SF; Ulrik, Charlotte Suppli; Kyvik, KO

    2006-01-01

    and females = 0.54, 95% CI: 0.36-0.80, P = 0.002), and increasing levels of body mass index (BMI; OR per unit = 1.11, 95% CI: 1.02-1.20, P = 0.009) were significant predictors of asthma. CONCLUSIONS: Hay fever, eczema, female sex, exercise and increasing levels of BMI were risk factors for asthma in young......BACKGROUND: The liability to asthma is influenced both by genetic and environmental factors. The objective of this study was to identify risk factors for asthma in young adult twin pairs during an 8-year period. METHODS: From the birth cohorts 1953-1982 of the Danish Twin Registry, 6,090 twin pairs.......16, 95% CI: 1.29-7.73, P = 0.007) and exercise (OR for inactivity = 0.35, 95% CI: 0.13-0.91, P = 0.023) were significantly associated with asthma, whereas in DZ twins, hay fever (OR = 2.44, 95% CI: 1.44-4.13, P = 0.001), eczema (OR = 1.96, 95% CI: 1.02-3.78, P = 0.040), female sex (OR between males...

  19. Risk factors for asthma in young adults: a co-twin control study

    DEFF Research Database (Denmark)

    Thomsen, SF; Ulrik, Charlotte Suppli; Kyvik, KO

    2006-01-01

    .16, 95% CI: 1.29-7.73, P = 0.007) and exercise (OR for inactivity = 0.35, 95% CI: 0.13-0.91, P = 0.023) were significantly associated with asthma, whereas in DZ twins, hay fever (OR = 2.44, 95% CI: 1.44-4.13, P = 0.001), eczema (OR = 1.96, 95% CI: 1.02-3.78, P = 0.040), female sex (OR between males...... and females = 0.54, 95% CI: 0.36-0.80, P = 0.002), and increasing levels of body mass index (BMI; OR per unit = 1.11, 95% CI: 1.02-1.20, P = 0.009) were significant predictors of asthma. CONCLUSIONS: Hay fever, eczema, female sex, exercise and increasing levels of BMI were risk factors for asthma in young......BACKGROUND: The liability to asthma is influenced both by genetic and environmental factors. The objective of this study was to identify risk factors for asthma in young adult twin pairs during an 8-year period. METHODS: From the birth cohorts 1953-1982 of the Danish Twin Registry, 6,090 twin pairs...

  20. Consequences of occupational asthma on employment and financial status: a follow-up study.

    Science.gov (United States)

    Ameille, J; Pairon, J C; Bayeux, M C; Brochard, P; Choudat, D; Conso, F; Devienne, A; Garnier, R; Iwatsubo, Y

    1997-01-01

    The aim of this study was to describe changes in employment and income following a diagnosis of occupational asthma, and to determine what factors might affect these changes. Two hundred and nine patients with occupational asthma were reviewed on average 3.1 yrs after the diagnosis had been made. They were contacted by telephone or were sent a self-administered questionnaire by post. Multiple logistic regression models were constructed to determine which variables were associated with loss of employment after the diagnosis. At the time of review, 44% of patients had left their previous job and 25% were currently unemployed. Remarkably, 32% remained exposed to the offending agents in the same job. Forty six percent of the patients had suffered a reduction of income (84% of those who had left their employer versus 19% of those still employed in the same company (p company, level of education, and age at the time of diagnosis were significantly associated with a risk for becoming unemployed or having a new employer after the diagnosis of occupational asthma. Occupational asthma results in severe socioeconomic consequences. The French compensation system for occupational asthma should be revised, as the criteria currently used to determine compensation for this disease largely underestimate the social and occupational damages.

  1. Smoking and the risk of hospitalization for symptomatic diverticular disease: a population-based cohort study from Sweden

    OpenAIRE

    Humes, David; Ludvigsson, Jonas F.; Jarvholm, Bengt

    2016-01-01

    BACKGROUND: Current studies reporting on the risk of smoking and development of symptomatic diverticular disease have reported conflicting results. \\ud \\ud OBJECTIVE: The aim of this study was to investigate the association between smoking and symptomatic diverticular disease. \\ud \\ud DESIGN: This is a cohort study.\\ud \\ud SETTINGS: : Information was derived from the Swedish Construction Workers Cohort 1971-1993. \\ud \\ud PATIENTS: Patients were selected from construction workers in Sweden. \\u...

  2. Risk factors for onset of asthma: a 12-year prospective follow-up study

    DEFF Research Database (Denmark)

    Porsbjerg, C; von Linstow, Marie-Louise; Ulrik, Charlotte Suppli

    2006-01-01

    BACKGROUND: Studies of the clinical outcome in adulthood of asymptomatic airway hyperresponsiveness (AHR) to histamine or exercise-induced bronchospasm (EIB) detected in childhood in general population samples are sparse and have produced conflicting results. OBJECTIVE: To describe the outcome...... of asymptomatic AHR to histamine and EIB. METHODS: Data from a 12-year follow-up study of a random population sample of individuals aged 7 to 17 years at enrollment were analyzed; only individuals without asthma at enrollment were included in the analysis. AHR to inhaled histamine, EIB, lung function...... asthma, compared with only 5% of individuals in whom these test results were negative. In patients with AHR to histamine, parental asthma (odds ratio [OR], 12.6; 95% confidence interval [CI], 1.5-108.5), furred pets ownership (OR, 6.0; 95% CI, 1.2-19.6), and dermatitis and/or rhinitis in childhood (OR, 2...

  3. Long-term studies of the natural history of asthma in childhood

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Bønnelykke, Klaus

    2010-01-01

    limitation associated with asthma already existed at birth or developed along with symptoms. Likewise, the association between the infant's bronchial responsiveness and development of asthma and other wheezy disorders is unclear. Neither primary prevention through manipulation of environmental factors nor...... secondary prevention through the use of inhaled corticosteroids can effectively halt the long-term disease progression in childhood. In conclusion, the natural history of asthma and the associated airway changes is still poorly understood, and we have not managed to translate findings from long-term studies...... into a deeper understanding of the underlying endophenotypes or improved disease management. We propose the need for a translational research approach based on long-term clinical studies of birth cohorts with comprehensive and objective assessments of intermediate phenotypes and environmental exposures combined...

  4. A randomized trial of citalopram versus placebo in outpatients with asthma and major depressive disorder: a proof of concept study.

    Science.gov (United States)

    Brown, E Sherwood; Vigil, Luis; Khan, David A; Liggin, Joshua D M; Carmody, Thomas J; Rush, A John

    2005-12-01

    The prevalence of asthma has increased in recent years and depression is common in this population. Minimal data are available on the treatment of depressed asthma patients. Ninety adults with asthma and current major depressive disorder were randomized to receive citalopram or placebo for 12 weeks. At each visit, the Hamilton Rating Scale for Depression (HRSD), Inventory of Depressive Symptomatology - Self-Report, Asthma Control Questionnaire, and Asthma Quality of Life Questionnaire were administered, and oral corticosteroid use assessed. In the evaluable sample (n = 82), the primary outcome, a random regression analysis of HRSD scores, revealed no significant between-group differences. Bonferroni corrected secondary outcomes revealed HRSD scores decreased significantly in both groups with a significantly greater decrease in the citalopram group at week 6. Changes in asthma symptoms were similar between groups. The groups had similar rates of oral corticosteroid use at baseline, but the citalopram group had less corticosteroid use during the study. Changes in asthma symptom severity correlated with changes in depressive symptom severity. A reduction in depressive symptoms was associated with improvement in asthma. Corticosteroid use, an important measure of severe asthma exacerbations, was lower in the citalopram group. Larger clinical trials in this population are warranted.

  5. Asthma - control drugs

    Science.gov (United States)

    ... Asthma - children Wheezing Patient Instructions Asthma and school Asthma - child - discharge Asthma - quick-relief drugs Asthma - what to ask the doctor - adult Asthma - what to ask your doctor - child Bronchiolitis - discharge Exercise-induced asthma Exercising and asthma ...

  6. Communication ability in cerebral palsy: a study from the CP register of western Sweden.

    Science.gov (United States)

    Himmelmann, Kate; Lindh, Karin; Hidecker, Mary Jo Cooley

    2013-11-01

    Communication is often impaired in cerebral palsy (CP). Tools are needed to describe this complex function, in order to provide effective support. To study communication ability and the relationship between the Communication Function Classification System (CFCS) and CP subtype, gross motor function, manual ability, cognitive function and neuroimaging findings in the CP register of western Sweden. Sixty-eight children (29 girls), 14 with unilateral spastic CP, 35 with bilateral spastic CP and 19 with dyskinetic CP, participated. The CFCS, Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) levels, cognitive impairment and neuroimaging findings were recorded. Half the children used speech, 32% used communication boards/books and 16% relied on body movements, eye gaze and sounds. Twenty-eight per cent were at the most functional CFCS level I, 13% at level II, 21% at level III, 10% at level IV and 28% at level V. CFCS levels I-II were found in 71% of children with unilateral spastic CP, 46% in bilateral spastic CP and 11% in dyskinetic CP (p = 0.03). CFCS correlated with the GMFCS, MACS and cognitive function (p CP can be derived from the CFCS, which correlates to gross and fine motor and cognitive function. Good communication ability is associated with lesions acquired early, rather than late, in the third trimester. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  7. Health Utilities of Type 2 Diabetes-Related Complications: A Cross-Sectional Study in Sweden

    Directory of Open Access Journals (Sweden)

    Aliasghar A. Kiadaliri

    2014-05-01

    Full Text Available This study estimates health utilities (HU in Sweden for a range of type 2 diabetes-related complications using EQ-5D and two alternative tariffs (UK and Swedish from 1757 patients with type 2 diabetes from the Swedish National Diabetes Register (NDR. Ordinary least squares were used for statistical analysis. Lower HU was found for female gender, younger age at diagnosis, higher BMI, and history of complications. Microvascular and macrovascular complications had the most negative effect on HU among women and men, respectively. The greatest decline in HU was associated with kidney disorders (−0.114 using the UK tariff and stroke (−0.059 using the Swedish tariff. Multiple stroke and non-acute ischaemic heart disease had higher negative effect than a single event. With the UK tariff, each year elapsed since the last microvascular/macrovascular complication was associated with 0.013 and 0.007 units higher HU, respectively. We found important heterogeneities in effects of complications on HU in terms of gender, multiple event, and time. The Swedish tariff gave smaller estimates and so may result in less cost-effective interventions than the UK tariff. These results suggest that incorporating subgroup-specific HU in cost-utility analyses might provide more insight for informed decision-making.

  8. Conventional and New Ways of Governing Forest Threats: A Study of Stakeholder Coherence in Sweden

    Science.gov (United States)

    Eriksson, Louise

    2018-01-01

    Based on a framework for analyzing stakeholder coherence horizontally and vertically, the present study examined the governance of forest threats in Sweden. Opinions of forest risk governance in stakeholder groups with and without a connection to private forestry were compared ( n = 2496) and the opinions were analyzed in relation to current governance practices. More specifically, forest threat appraisals, trust in the Swedish Forest Agency (SFA), and the acceptability of forest risk policy measures directed at private forest owners were assessed. Results revealed an overall coherence between different stakeholders in this context. However, the groups differed in, for example, the acceptability of the hypothetical regulative measure aiming to reduce damages threatening the forest long-term (e.g., climate change). Furthermore, an extensive use of advice for a fee may challenge particularly the internal, but also the external, legitimacy of forest risk governance. The forest owner stakeholder group showed lower threat appraisals when evaluating threat to one's own forest rather than to the Swedish forest, except regarding browsing by animals. Regulations were not disapproved of in any of the stakeholder groups, although the forest owner group generally displayed higher acceptability of encouraging measures compared to the general public. Trust in the SFA was furthermore confirmed as an important driver of policy acceptability, and higher threat appraisals of novel threats, such as climate change and fire, resulted in a higher acceptability of measures less central or new in this context. The value of analyzing stakeholder coherence for natural resource management and governance is discussed.

  9. Physical, psychosocial, and organisational factors relative to sickness absence: a study based on Sweden Post

    DEFF Research Database (Denmark)

    Voss, M; Floderus, B; Diderichsen, F

    2001-01-01

    OBJECTIVE: To analyse incidence of sickness for women and men relative to potential aetiological factors at work-physical, psychosocial, and organisational. METHODS: The study group comprised 1557 female and 1913 male employees of Sweden Post. Sickness absence was measured by incidence of sickness...... (sick leave events and person-days at risk). Information on explanatory factors was obtained by a postal questionnaire, and incidence of sickness was based on administrative files of the company. RESULTS: Complaints about heavy lifting and monotonous movements were associated with increased risk of high...... incidence of sickness among both women and men. For heavy lifting, an odds ratio (OR) of 1.70 (95% confidence interval (95% CI) 1.22 to 2.39) among women, and OR 1.70 (1.20 to 2.41) among men was found. For monotonous movements the risk estimates were OR 1.42 (1.03 to 1.97) and OR 1.45 (1.08 to 1...

  10. A methodology to establish a database to study gene environment interactions for childhood asthma

    Directory of Open Access Journals (Sweden)

    McCormick Jonathan

    2010-12-01

    Full Text Available Abstract Background Gene-environment interactions are likely to explain some of the heterogeneity in childhood asthma. Here, we describe the methodology and experiences in establishing a database for childhood asthma designed to study gene-environment interactions (PAGES - Paediatric Asthma Gene Environment Study. Methods Children with asthma and under the care of a respiratory paediatrician are being recruited from 15 hospitals between 2008 and 2011. An asthma questionnaire is completed and returned by post. At a routine clinic visit saliva is collected for DNA extraction. Detailed phenotyping in a proportion of children includes spirometry, bronchodilator response (BDR, skin prick reactivity, exhaled nitric oxide and salivary cotinine. Dietary and quality of life questionnaires are completed. Data are entered onto a purpose-built database. Results To date 1045 children have been invited to participate and data collected in 501 (48%. The mean age (SD of participants is 8.6 (3.9 years, 57% male. DNA has been collected in 436 children. Spirometry has been obtained in 172 children, mean % predicted (SD FEV1 97% (15 and median (IQR BDR is 5% (2, 9. There were differences in age, socioeconomic status, severity and %FEV1 between the different centres (p≤0.024. Reasons for non-participation included parents not having time to take part, children not attending clinics and, in a small proportion, refusal to take part. Conclusions It is feasible to establish a national database to study gene-environment interactions within an asthmatic paediatric population; there are barriers to participation and some different characteristics in individuals recruited from different centres. Recruitment to our study continues and is anticipated to extend current understanding of asthma heterogeneity.

  11. Development and pilot testing of a mobile health solution for asthma self-management: asthma action plan smartphone application pilot study.

    Science.gov (United States)

    Licskai, Christopher; Sands, Todd W; Ferrone, Madonna

    2013-01-01

    Collaborative self-management is a core recommendation of national asthma guidelines; the written action plan is the knowledge tool that supports this objective. Mobile health technologies have the potential to enhance the effectiveness of the action plan as a knowledge translation tool. To design, develop and pilot a mobile health system to support asthma self-management. The present study was a prospective, single-centre, nonrandomized, pilot preintervention-postintervention analysis. System design and development were guided by an expert steering committee. The network included an agnostic web browser-based asthma action plan smartphone application (SPA). Subjects securely transmitted symptoms and peak flow data daily, and received automated control assessment, treatment advice and environmental alerts. Twenty-two adult subjects (mean age 47 years, 82% women) completed the study. Biophysical data were received on 84% of subject days (subject day = 1 subject × 1 day). Subjects viewed their action plan current zone of control on 54% and current air quality on 61% of subject days, 86% followed self-management advice and 50% acted to reduce exposure risks. A large majority affirmed ease of use, clarity and timeliness, and 95% desired SPA use after the study. At baseline, 91% had at least one symptom criterion for uncontrolled asthma and 64% had ≥2, compared with 45% (P=0.006) and 27% (P=0.022) at study close. Mean Asthma Quality of Life Questionnaire score improved from 4.3 to 4.8 (P=0.047). A dynamic, real-time, interactive, mobile health system with an integrated asthma action plan SPA can support knowledge translation at the patient and provider levels.

  12. Early-life farm exposures and adult asthma and atopy in the Agricultural Lung Health Study.

    Science.gov (United States)

    House, John S; Wyss, Annah B; Hoppin, Jane A; Richards, Marie; Long, Stuart; Umbach, David M; Henneberger, Paul K; Beane Freeman, Laura E; Sandler, Dale P; Long O'Connell, Elizabeth; Barker-Cummings, Christie; London, Stephanie J

    2017-07-01

    Previous studies, mostly from Europe, suggest that early-life farming exposures protect against childhood asthma and allergy; few data exist on asthma and allergy in adults. We sought to examine associations between early-life farming exposures and current asthma and atopy in an older adult US farming population. We analyzed data from 1746 farmers and 1555 spouses (mean age, 63) from a case-control study nested within the Agricultural Health Study. Current asthma and early-life farming exposures were assessed via questionnaires. We defined atopy based on specific IgE > 0.70 IU/mL to at least 1 of 10 allergens measured in blood. We used logistic regression, adjusted for age, sex, race, state (Iowa or North Carolina), and smoking (pack years), to estimate associations between early-life exposures and asthma (1198 cases and 2031 noncases) or atopy (578 cases and 2526 noncases). Exposure to the farming environment in utero and in early childhood had little or no association with asthma but was associated with reduced odds of atopy. The strongest association was seen for having a mother who performed farm activities while pregnant (odds ratio, 0.60; 95% CI, 0.48-0.74) and remained significant in models with correlated early-life exposures including early childhood farm animal contact and raw milk consumption. In a large US farming population, early-life farm exposures, particularly maternal farming activities while pregnant, were strongly associated with reduced risk of atopy in adults. These results extend previous work done primarily on childhood outcomes and suggest that protective associations of early-life farming exposures on atopy endure across the life course. Published by Elsevier Inc.

  13. Immunologic studies of the mechanisms of occupational asthma caused by western red cedar.

    Science.gov (United States)

    Frew, A; Chan, H; Dryden, P; Salari, H; Lam, S; Chan-Yeung, M

    1993-09-01

    Occupational asthma caused by western red cedar (Thuja plicata) is a common problem in sawmill industries. The objective of this study was to examine the cellular and immunologic mechanisms of western red cedar asthma (WRCA) more closely. Bronchial biopsy specimens, bronchoalveolar lavage (BAL) mast cells and peripheral blood basophils from patients with WRCA, patients with atopic asthma, and nonatopic control subjects were challenged in vitro with plicatic acid (PA), PA-human serum albumin conjugate (PA-HSA), grass pollen, or calcium ionophore. PA (100 micrograms/ml) released histamine from the basophils of 9 of 11 patients with WRCA, 1 of 7 patients with atopic asthma, and 2 of 7 normal subjects. PA triggered histamine release from 10 of 11 bronchial biopsy specimens and 8 of 8 BAL samples from patients with WRCA. Interestingly, PA released histamine from BAL cells and bronchial biopsy specimens from 3 of 7 normal subjects but in none of the patients with atopic asthma. PA-HSA-induced histamine release from basophils and biopsy specimens was confined to patients with WRCA. PA-specific IgE was not detectable in serum from most patients with WRCA, and their serum did not transfer PA sensitivity to human lung fragments or lactate-stripped basophils. After pretreatment with anti-IgE in the absence of calcium, basophils from 14 subjects with WRCA still responded to PA (mean 64% to 67% of pretreatment response), whereas responses to grass pollen or anti-IgE were abolished. This study confirms that PA releases histamine from bronchial mast cells of most patients with WRCA but not from those of patients with atopic asthma. The PA response of some normal subjects suggests that PA may have both specific and nonspecific actions on mast cells and basophils, whereas the serologic studies indicate histamine release in WRCA cannot simply be attributed to PA-specific IgE.

  14. Work stress, family stress and asthma: a cross-sectional study among women in China.

    Science.gov (United States)

    Loerbroks, Adrian; Ding, Hui; Han, Wei; Wang, Hong; Wu, Jiang-Ping; Yang, Liu; Angerer, Peter; Li, Jian

    2017-05-01

    Research addressing links of work stress or family stress with asthma is constrained by (1) inconsistent evidence, (2) failure to consider the combined exposure to work stress and family stress, and (3) its primary focus on Western study populations. We aimed to address these knowledge gaps. We used cross-sectional data collected in 2015 among 7816 women from five professional groups in five Chinese cities. Work stress was measured by the 10-item effort-reward imbalance (ERI) questionnaire. Family stress was assessed by a psychometrically evaluated instrument comprising five items on, e.g., familial conflicts or domestic workload. Asthma was operationalized by self-reports of a physician diagnosis. Associations were examined by multivariable logistic regression estimating odds ratios (ORs) and 95% confidence intervals (CIs). Both high work stress (i.e., ERI score >1) and high family stress (i.e., score above the median) were associated with asthma (OR 1.66, 95% CI 1.22-2.27 and OR 1.48, 95% CI 1.10-1.99, respectively). Women with combined exposure (versus none) had somewhat higher odds of asthma (OR 2.13, 95% CI 1.42-3.19) than those with sole exposure to either work stress (OR 1.89, 95% CI 1.20-2.96) or family stress (OR 1.71, 95% CI 1.03-2.84). Interaction terms were significant for continuous variables (p = 0.046), but not for dichotomized variables (p = 0.199). The present study suggests that both work stress and family stress are positively associated with asthma in women in China. Further, the combined exposure may be associated with a further excess of asthma occurrence. Longitudinal studies are needed to confirm our findings and to explore potential temporal relationships.

  15. Meteorological factors, aeroallergens and asthma-related visits in Kuwait : A 12-month retrospective study

    International Nuclear Information System (INIS)

    Jafar A Qasem

    2010-01-01

    The increasing prevalence of asthma in many countries has been related to weather factors and aeroallergen concentrations , but this has not been studied in Kuwait. We evaluated the effect of meteorological factors and the occurrence of aerobiologicals on the number of asthma cases in Kuwait.The number of daily asthma visits to the allergy center and emergency department at Al-Sabha Hospital for 1 year were examined on a monthly basis for correlation with major metereological factors (temperature , relative humidity , rain , wind speed and direction). Spore and pollen counts were collected hourly. Results: A total of 4353 patients received asthma treatment during the year. The highest pollen count was in the month of September with a maximum relative humidity of 47% and no precipitation , but with a high mean temperature of 39.7 0 C. . Pollen counts were higher in the late summer (September) and occurred with a high patient visit to the allergy center. Fungal spore counts were significantly higher in early winter (December). The high fungal spore count seemed related to with high relative humidity and high precipitation with a low mean average temperature of 19.7 0 C. The increase number of patients with bronchial asthma visiting an emergency clinic during December was significantly associated with high aerial counts for fungal spores (P<.03) , and the months of September and October were more significant for pollen.This study indicates that meteorological factors , aeroallergen concentrations and asthma related visits are interrelated. The results may prove useful in the generation of hypotheses and development of designs for more comprehensive , individual-based epidemiological studies (Author).

  16. Identifying environmental risk factors for asthma emergency care" a multilevel approach for ecological study.

    Science.gov (United States)

    Allacci, MaryAnn Sorensen

    2005-01-01

    This ongoing empirical study suggests a model for evaluating a combination of environmental risk factors to explain neighborhood differences in adult use of Harlem Hospital's Asthma Emergency Department services. A multilevel or "nested" model incorporates methods for hypothesis testing using geographic information systems (GIS) and existing data from Harlem Hospital Center, city agencies, and other sources to measure variables on both building and street segment levels. Selection of the best geographic scale by which to measure housing conditions, neighborhood physical quality, income indicators, and access to healthcare is an important strategy toward identifying neighborhood socioenvironmental patterns contributing to geographic clustering of asthma emergencies. Specific community interventions may then be defined to improve the health outcomes of residents with asthma.

  17. Indoor environmental factors associated with wheezing illness and asthma in South Korean children: phase III of the International Study of Asthma and Allergies in Childhood.

    Science.gov (United States)

    Chae, Yoomi; Hahm, Myung-Il; Ahn, Kangmo; Kim, Jihyun; Kim, Woo Kyung; Lee, So-Yeon; Park, Yong Mean; Han, Man Yong; Lee, Kee-Jae; Kwon, Ho-Jang

    2014-11-01

    The relationship between exposure to indoor environmental pollutants and incidence of asthma and wheezing illness in children is unclear. This study aimed to clarify this relationship by identifying the risk factors associated with these conditions in South Korean children aged 6-7 years. The parents or guardians of 3810 children aged 6-7 years who had participated in the International Study of Asthma and Allergies in Childhood and met the study criteria completed validated questionnaires regarding their children's asthma and wheezing illness, risk factors and exposure to indoor pollutants. The data were subjected to chi-square and multivariate logistic regression analysis to identify the factors significantly associated with asthma and wheezing illness. Parental history of allergic disease (odds ratio [OR]: 1.729; 95% confidence interval [CI]: 1.447-2.066), living on the basement or semi-basement floor (OR: 1.891; 95% CI: 1.194-2.996) and living in housing that had been remodeled within the last 12 months (OR: 1.376; 95% CI: 1.101-1.720) were found to be significantly associated with wheezing illness. Parental history of allergic disease (OR: 2.189; 95% CI: 1.483-3.231), male sex (OR: 1.971; 95% CI: 1.369-2.838) and positive skin prick test (SPT) result (OR: 1.583; 95% CI: 1.804-3.698) were found to be significantly associated with current asthma. Although the risk factors for current asthma appear to be more related to the non-modifiable risk factors like sex, parental history of allergic diseases, SPT, the two groups are associated with exposure to modifiable indoor environmental factors.

  18. mHealth intervention to support asthma self-management in adolescents: the ADAPT study

    Directory of Open Access Journals (Sweden)

    Kosse RC

    2017-03-01

    Full Text Available Richelle C Kosse,1 Marcel L Bouvy,1 Tjalling W de Vries,2 Ad A Kaptein,3 Harm CJ Geers,1 Liset van Dijk,4 Ellen S Koster1 1Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, 2Department of Paediatrics, Medical Center Leeuwarden, Leeuwarden, 3Medical Psychology, Leiden University Medical Center, Leiden, 4NIVEL, the Netherlands Institute for Health Services Research, Utrecht, the Netherlands Purpose: Poor medication adherence in adolescents with asthma results in poorly controlled disease and increased morbidity. The aim of the ADolescent Adherence Patient Tool (ADAPT study is to develop an mHealth intervention to support self-management and to evaluate the effectiveness in improving medication adherence and asthma control. Intervention: The ADAPT intervention consists of an interactive smartphone application (app connected to a desktop application for health care providers, in this study, the community pharmacist. The app contains several functions to improve adherence as follows: 1 a questionnaire function to rate asthma symptoms and monitor these over time; 2 short movie clips with medication and disease information; 3 a medication reminder; 4 a chat function with peers; and 5 a chat function with the pharmacist. The pharmacist receives data from the patient’s app through the desktop application, which enables the pharmacist to send information and feedback to the patient. Study design: The ADAPT intervention is tested in a community pharmacy-based cluster randomized controlled trial in the Netherlands, aiming to include 352 adolescents with asthma. The main outcome is adherence, measured by patient’s self-report and refill adherence calculated from pharmacy dispensing records. In addition, asthma control, illness perceptions, medication beliefs, and asthma-related quality of life are measured. Conclusion: This study will provide in

  19. SDS-Polyacrylamide Electrophoresis and Western Blotting Applied to the Study of Asthma.

    Science.gov (United States)

    García-Solaesa, Virginia; Abad, Sara Ciria

    2016-01-01

    Western blotting is used to analyze proteins after being separated by electrophoresis and subsequently electro-transferred to a membrane. Once immobilized, a specific protein can be identified through its reaction with a labeled antibody or antigen. It is a methodology commonly used in biomedical research such as asthma studies, to assess the pathways of inflammatory mediators involved in the disease.Here, we describe an example of western blotting to determine the factors involved in asthma. In this chapter, the methodology of western blotting is reviewed, paying attention on potential problems and giving interesting recommendations.

  20. Serum 25-Hydroxyvitamin D levels and incident asthma in adults; the HUNT study

    OpenAIRE

    Mai, Xiao-Mei; Langhammer, Arnulf; Camargo, Carlos Arthuro; Chen, Yue

    2012-01-01

    The impact of low vitamin D status on asthma development is unclear. The authors investigated the relation between the baseline serum 25-hydroxyvitamin D (25(OH)D) level and incident asthma in adults, including possible effect modification by allergy status, using allergic rhinitis as a proxy measure. A cohort of 25,616 Norwegian adults aged 19–55 years participated in 2 surveys of the Nord-Trøndelag Health Study known as HUNT 2 (1995–1997) and HUNT 3 (2006–2008). Of this cohort, a nested cas...

  1. 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

    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

  2. Homeopathy for Perennial Asthma in Adolescents: Pilot Feasibility Study Testing a Randomised Withdrawal Design.

    Science.gov (United States)

    Mitchiguian Hotta, Livia; Cardinalli Adler, Ubiratan; de Toledo Cesar, Amarilys; Martinez, Edson Zangiacomi; Demarzo, Marcelo Marcos Piva

    2018-03-26

     Previous findings from a pragmatic trial suggest that usual care compared with usual care plus individualised homeopathy is not a feasible design to address homeopathic interventions for asthma.  The main purpose of this article was to investigate the feasibility of the randomised withdrawal design as a strategy to assess the effectiveness of a standardised clinical-pharmaceutical homeopathic protocol ( Organon.modus ) on perennial asthma in adolescents.  Randomised withdrawal, double-blind, parallel, placebo-controlled, 12-week study. 12 to 17 years old adolescents, with the diagnosis of perennial asthma, using inhalatory beclomethasone (plus fenoterol for wheezing episodes), who achieved 3 months of well-controlled asthma, after a variable period of individualised homeopathic treatment according to Organon.modus protocol. a secondary care medical specialist centre. continuation with the individualised homeopathic medicine or with indistinguishable placebo during 12 weeks of beclomethasone step-down. number of days of well-controlled asthma. Secondary measures: number of days of fenoterol use, number of visits to an emergency service (without hospitalisation) and percentage of patients excluded due to an exacerbation characterising a partly controlled asthma. Tolerability was assessed by Adverse Events, registered at every visit.  Nineteen patients were randomised to continue treatment with homeopathy and 21 with placebo. Effectiveness measures for the homeopathy and placebo groups respectively were median number of days of good clinical control: 84 versus 30 ( p  = 0.18); median number of days of fenoterol use per patient: 3 versus 5 ( p  = 0.41); visits to an emergency room: 1 versus 6 ( p  = 0.35); percentage of exclusion due to partly controlled asthma: 36.8% versus 71.4% ( p  = 0.05). Few Adverse Events were reported.  This pilot study supports the feasibility of the double-blind randomised withdrawal design in studies investigating

  3. A nested case-control study: personal, social and environmental correlates of vigorous physical activity in adolescents with asthma.

    Science.gov (United States)

    Westergren, Thomas; Ommundsen, Yngvar; Lødrup Carlsen, Karin C; Carlsen, Kai-Håkon; Mowinckel, Petter; Fegran, Liv; Berntsen, Sveinung

    2015-03-01

    Physical activity (PA) is associated with health benefits. Children and adolescents with asthma may be limited in their PA, particularly at vigorous intensity due to asthma symptoms or poor psychological adjustment to asthma. We aimed to investigate if self-perceived competence, enjoyment, support from others and social-physical environment were associated with vigorous physical activity (VPA) and secondarily to assess if such associations were modified by asthma and asthma severity. Data from a nested case-control study at 13 years of age within the birth-cohort Environment and Childhood Asthma Study were compiled from 95 participants with and 79 without asthma. The participants completed a questionnaire designed to capture self-perceived competence, enjoyment, support from others and social-physical environment. VPA, defined as ≥ 6 Metabolic Equivalents, was recorded objectively by SenseWear™ Pro2 Armband. Asthma severity was assessed pragmatically by lung function and use of inhaled glucocorticosteroids and β2-agonists and incidence of exacerbations in the last 14 days. Data were analysed using linear regression analysis. No significant differences between adolescents with and without asthma were identified in terms of VPA, competence-enjoyment, support from others and social-physical environment. Peer support (b = 0.29 (0.05-0.52)) and competence-enjoyment (b = 0.23 (0.01-0.44)) were significantly and positively associated with VPA, and teacher support (b = -0.26 (-0.50 to -0.02)) were inversely associated. The model explained 25% of the variance in VPA. Peer support and competence-enjoyment were positively associated with increased VPN in adolescents irrespectively of asthma and asthma severity.

  4. Greater risk of incident asthma cases in adults with Allergic Rhinitis and Effect of Allergen Immunotherapy: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Piccillo Giovita

    2005-12-01

    Full Text Available Abstract Asthma and rhinitis are often co-morbid conditions. As rhinitis often precedes asthma it is possible that effective treatment of allergic rhinitis may reduce asthma progression. The aim of our study is to investigate history of allergic rhinitis as a risk factor for asthma and the potential effect of allergen immunotherapy in attenuating the incidence of asthma. Hospital-referred non-asthmatic adults, aged 18–40 years between 1990 and 1991, were retrospectively followed up until January and April 2000. At the end of follow up, available subjects were clinically examined for asthma diagnosis and history of allergen specific immunotherapy, second-hand smoking and the presence of pets in the household. A total of 436 non-asthmatic adults (332 subjects with allergic rhinitis and 104 with no allergic rhinitis nor history of atopy were available for final analyses. The highest OR (odds ratio associated with a diagnosis of asthma at the end of follow-up was for the diagnosis of allergic rhinitis at baseline (OR, 7.8; 95%CI, 3.1–20.0 in the model containing the covariates of rhinitis diagnosis, sex, second-hand smoke exposure, presence of pets at home, family history of allergic disorders, sensitization to Parietaria judaica; grass pollen; house dust mites; Olea europea: orchard; perennial rye; and cat allergens. Female sex, sensitization to Parietaria judaica and the presence of pets in the home were also significantly predictive of new onset asthma in the same model. Treatment with allergen immunotherapy was significantly and inversely related to the development of new onset asthma (OR, 0.53; 95%CI, 0.32–0.86. In the present study we found that allergic rhinitis is an important independent risk factor for asthma. Moreover, treatment with allergen immunotherapy lowers the risk of the development of new asthma cases in adults with allergic rhinitis.

  5. Greater risk of incident asthma cases in adults with Allergic Rhinitis and Effect of Allergen Immunotherapy: A Retrospective Cohort Study

    Science.gov (United States)

    Polosa, Riccardo; Al-Delaimy, Wael K; Russo, Cristina; Piccillo, Giovita; Sarvà, Maria

    2005-01-01

    Asthma and rhinitis are often co-morbid conditions. As rhinitis often precedes asthma it is possible that effective treatment of allergic rhinitis may reduce asthma progression. The aim of our study is to investigate history of allergic rhinitis as a risk factor for asthma and the potential effect of allergen immunotherapy in attenuating the incidence of asthma. Hospital-referred non-asthmatic adults, aged 18–40 years between 1990 and 1991, were retrospectively followed up until January and April 2000. At the end of follow up, available subjects were clinically examined for asthma diagnosis and history of allergen specific immunotherapy, second-hand smoking and the presence of pets in the household. A total of 436 non-asthmatic adults (332 subjects with allergic rhinitis and 104 with no allergic rhinitis nor history of atopy) were available for final analyses. The highest OR (odds ratio) associated with a diagnosis of asthma at the end of follow-up was for the diagnosis of allergic rhinitis at baseline (OR, 7.8; 95%CI, 3.1–20.0 in the model containing the covariates of rhinitis diagnosis, sex, second-hand smoke exposure, presence of pets at home, family history of allergic disorders, sensitization to Parietaria judaica; grass pollen; house dust mites; Olea europea: orchard; perennial rye; and cat allergens). Female sex, sensitization to Parietaria judaica and the presence of pets in the home were also significantly predictive of new onset asthma in the same model. Treatment with allergen immunotherapy was significantly and inversely related to the development of new onset asthma (OR, 0.53; 95%CI, 0.32–0.86). In the present study we found that allergic rhinitis is an important independent risk factor for asthma. Moreover, treatment with allergen immunotherapy lowers the risk of the development of new asthma cases in adults with allergic rhinitis. PMID:16381607

  6. Gender differences in effects of obesity and asthma on adolescent lung function: Results from a population-based study.

    Science.gov (United States)

    Chen, Yi-Chun; Huang, Yu-Li; Ho, Wen-Chao; Wang, Yu-Chun; Yu, Yang-Hao

    2017-04-01

    To investigate lung function associated with asthma and body mass index (BMI) among adolescents at 96 northern Taiwan junior high schools participating in an asthma screening program. The questionnaires and lung function test results measured for 3669 boys and 3523 girls were included in this study for data analysis. Measures of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1 ) and FEV 1 /FVC ratio were compared by sex, asthma status and BMI. Overall mean FVC levels were similar between students with and without asthma, 3.71 L vs. 3.71 L for boys (p = 0.991) and 2.79 vs. 2.78 for girls (p = 0.517). The overall mean FEV 1 levels were also similar between girls with and without asthma. Asthmatic boys had lower FEV 1 than non-asthmatic boys. Mean FEV 1 /FVC was significantly lower in students with asthma than those without asthma. Mean FVC and FEV 1 increased with BMI in both sexes. A lower mean FEV 1 /FVC was observed among students with asthma and high BMI, and was more pronounced in boys than in girls. Multivariable regression analysis also showed that FEV 1 /FVC ratios were negatively associated with asthma and high BMI, stronger in boys than in girls for asthma (β = -2.176 (standard errors (SE) = 0.268) vs. -1.085 (SE = 0.258) and for BMI (β = -0.309 (SE = 0.025) vs. -0.218 (SE = 0.029)). This northern Taiwan study suggests that FEV 1 /FVC is negatively associated with asthma and high BMI in adolescents, stronger for boys than for girls.

  7. Higher education and psychological distress: a 27-year prospective cohort study in Sweden.

    Science.gov (United States)

    Brännlund, Annica; Hammarström, Anne

    2014-03-01

    Research identifies a positive link between education and a reduction of psychological distress, but few studies have analysed the long-term impact of education on psychological distress. This study followed the same cohort for 27 years, investigating the association between education and adult psychological distress. Further, it discuss whether the link can be understood through the mediating mechanisms of social and labour-market resources, furthermore, if the mechanisms operate differently for men and women. A 27-year prospective cohort study was performed at ages 16, 18, 21, 30 and 43. The cohort consisted of all students (n = 1083, of which 1001 are included in this study) in their final year of compulsory school in Sweden. Data were collected through comprehensive questionnaires (response rate 96.4%), and analysed with OLS regression, with psychological distress at age 21, 30 and 43 as dependent variable. Baseline psychological distress, measures of social and labour-market resources, and possible educational selection factors were used as independent variables. To compare the overall magnitude of educational differences, a kappa index was calculated. A positive relation between higher education and less psychological distress was found. When becoming older this relation weakens and a link between social and labour-market resources and psychological distress is observed, indicating that education in a long-term perspective operates through the suggested mechanisms. Additionally, the mechanisms work somewhat differently for men than for women: labour-market resources were significant for men and social resources were important for women. higher education is positively linked to less psychological distress, and the link can somewhat be understood through the mechanisms of social and labour-market resources.

  8. Month of birth and mortality in Sweden: a nation-wide population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Peter Ueda

    Full Text Available BACKGROUND: Month of birth--an indicator for a variety of prenatal and early postnatal exposures--has been associated with life expectancy in adulthood. On the northern hemisphere, people born in the autumn live longer than those born during the spring. Only one study has followed a population longitudinally and no study has investigated the relation between month of birth and mortality risk below 50 years. METHODS AND RESULTS: In this nation-wide Swedish study, we included 6,194,745 subjects, using data from population-based health and administrative registries. The relation between month of birth (January-December and mortality risk was assessed by fitting Cox proportional hazard regression models using attained age as the underlying time scale. Analyses were made for ages >30, >30 to 50, >50 to 80 and >80 years. Month of birth was a significant predictor of mortality in the age-spans >30, >50 to 80, and >80 years. In models adjusted for gender and education for ages >30 and >50 to 80 years, the lowest mortality was seen for people born in November and the highest mortality in those born in the spring/summer, peaking in May for mortality >30 years (25‰ excess hazard ratio compared to November, [95% confidence interval = 16-34 ] and in April for mortality >50 to 80 years (42‰ excess hazard ratio compared to November, [95% confidence interval = 30-55]. In the ages >80 years the pattern was similar but the differences in mortality between birth months were smaller. For mortality within the age-span >30 to 50 years, results were inconclusive. CONCLUSION: Month of birth is associated to risk of mortality in ages above 50 years in Sweden. Further studies should aim at clarifying the mechanisms behind this association.

  9. 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...

  10. Characteristics and severity of asthma in children with and without atopic conditions : a cross-sectional study

    NARCIS (Netherlands)

    Arabkhazaeli, Ali; Vijverberg, Susanne J H; van Erp, Francine C; Raaijmakers, Jan A M; van der Ent, Cornelis K.; Maitland van der Zee, Anke H

    2015-01-01

    BACKGROUND: Childhood allergic diseases have a major impact on a child's quality of life, as well as that of their parents. We studied the coexistence of reported allergies in children who use asthma medication. Additionally, we tested the hypothesis that asthma severity is greater among children

  11. Characteristics and severity of asthma in children with and without atopic conditions: A cross-sectional study

    NARCIS (Netherlands)

    Arabkhazaeli, Ali; Vijverberg, Susanne J. H.; van Erp, Francine C.; Raaijmakers, Jan A. M.; van der Ent, Cornelis K.; Maitland van der Zee, Anke H.

    2015-01-01

    Background: Childhood allergic diseases have a major impact on a child's quality of life, as well as that of their parents. We studied the coexistence of reported allergies in children who use asthma medication. Additionally, we tested the hypothesis that asthma severity is greater among children

  12. A daily SMS reminder increases adherence to asthma treatment: a three-month follow-up study

    DEFF Research Database (Denmark)

    Strandbygaard, Ulla; Thomsen, Simon Francis; Backer, Vibeke

    2010-01-01

    Poor adherence to asthma treatment is a well-recognised challenge and is associated with increased morbidity, mortality and consumption of health care resources. This study examined the impact of receiving a daily text message reminder on one's cell phone on adherence to asthma treatment....

  13. Self-rated health and social capital in Iraqi immigrants to Sweden: The MEDIM population-based study.

    Science.gov (United States)

    Bennet, Louise; Lindström, Martin

    2018-03-01

    Poor self-rated health is an estimator of quality of life and a predictor of mortality seldom studied in immigrant populations. This work aimed to study self-rated health in relation to social capital, socioeconomic status, lifestyle and comorbidity in immigrants from Iraq - one of the largest non-European immigrant group in Sweden today - and to compare it with the self-rated health of native Swedes. The study was a cross-sectional population-based study conducted from 2010 to 2012 among citizens of Malmö, Sweden, aged 30-65 years and born in Iraq or Sweden. All participants underwent a health examination and answered questionnaires on self-rated health, social capital, comorbidity, lifestyle and socioeconomic status. In total, 1348 Iraqis and 677 Swedes participated. Poor self-rated health was identified in 43.9% of Iraqis and 21.9% of native Swedes ( pcapital was highly prevalent in the immigrants. Female gender showed higher odds of poor self-rated health in Iraqis than in Swedes (OR 1.8, 95% CI 1.4-2.5, p interaction =0.024), independent of other risk factors connected to social capital, socioeconomic status, lifestyle or comorbidity. Although public health initiatives promoting social capital, socioeconomic status and comorbidity in immigrants are crucial, the excess risk of poor self-rated health in Iraqi women is not fully attributed to known risk factors for self-rated health, but remains to be further explored.

  14. Do fast foods cause asthma, rhinoconjunctivitis and eczema? Global findings from the International Study of Asthma and Allergies in Childhood (ISAAC) phase three.

    Science.gov (United States)

    Ellwood, Philippa; Asher, M Innes; García-Marcos, Luis; Williams, Hywel; Keil, Ulrich; Robertson, Colin; Nagel, Gabriele

    2013-04-01

    Certain foods may increase or decrease the risk of developing asthma, rhinoconjunctivitis and eczema. We explored the impact of the intake of types of food on these diseases in Phase Three of the International Study of Asthma and Allergies in Childhood. Written questionnaires on the symptom prevalence of asthma, rhinoconjunctivitis and eczema and types and frequency of food intake over the past 12 months were completed by 13-14-year-old adolescents and by the parents/guardians of 6-7-year-old children. Prevalence ORs were estimated using logistic regression, adjusting for confounders, and using a random (mixed) effects model. For adolescents and children, a potential protective effect on severe asthma was associated with consumption of fruit ≥3 times per week (OR 0.89, 95% CI 0.82 to 0.97; OR 0.86, 95% CI 0.76 to 0.97, respectively). An increased risk of severe asthma in adolescents and children was associated with the consumption of fast food ≥3 times per week (OR 1.39, 95% CI 1.30 to 1.49; OR 1.27, 95% CI 1.13 to 1.42, respectively), as well as an increased risk of severe rhinoconjunctivitis and severe eczema. Similar patterns for both ages were observed for regional analyses, and were consistent with gender and affluence categories and with current symptoms of all three conditions. If the association between fast foods and the symptom prevalence of asthma, rhinoconjunctivitis and eczema is causal, then the findings have major public health significance owing to the rising consumption of fast foods globally.

  15. Biological studies on the effect of estrogen on experimentally induced asthma in mice.

    Science.gov (United States)

    El-Desouki, Nabila I; Tabl, Ghada A; Elkhodary, Yasmin A A

    2016-01-01

    This study evaluates the influence of estrogen hormone on the experimentally induced asthma in male mice. The animals were divided into four groups, with 20 mice in each group; group I (control mice) included mice that received no treatment, group II included mice that received intraperitoneal estrogen injection (0.25 mg/kg body weight (bw), twice on day 28 of the experiment), group III (asthmatic mice) included asthmatic mice that received intraperitoneal injection of two doses of ovalbumin (OVA; 2 µg of OVA mixed with 100 µg of aluminum potassium sulfate) on days 1 and 14 of the experiment and then challenged intranasally with a single dose of OVA (50 µg dissolved in 0.05 ml phosphate-buffered saline; PBS) on day 28 of the experiment, and group IV (asthmatic mice treated with estrogen) included asthma model male mice that received the estrogen (0.5 mg/kg bw in 40 ml PBS, twice on the day 28 of the experiment). The immunohistochemical studies observed a marked intensity of CD15 immunoreactivity in the lung tissues of asthma model mice. Physiological results recorded that the total and differential count of leukocytes in bronchoalveolar lavage fluid (BALF) of asthma model mice recorded a significant increase in the number of leukocytes especially in the number of eosinophil cells. The BALF of asthma model mice showed high levels of interleukins 4 and 5 (IL-4 and IL-5), and there was a significant decrease in both the levels of IL-4 and IL-5 in BALF of asthma model mice treated with estrogen. In conclusion, the obtained results indicated that the asthma is responsible for certain immunohistochemical and physiological alterations induced in lung tissues of mice. The administration of estrogen to asthmatic male mice could improve these changes. For this reason, the present findings support the possible role of estrogen in modulating the inflammatory effects caused by asthma in male mice and may be helpful to cure many asthmatic progressions. © The Author

  16. Using fathers as a negative control exposure to test the Developmental Origins of Health and Disease Hypothesis: A case study on maternal distress and offspring asthma using Swedish register data.

    Science.gov (United States)

    Brew, Bronwyn K; Gong, Tong; Williams, Dylan M; Larsson, Henrik; Almqvist, Catarina

    2017-07-01

    Developmental Origins of Health and Disease Hypothesis (DOHaD) studies are often observational in nature and are therefore prone to biases from loss to follow-up and unmeasured confounding. Register-based studies can reduce these issues since they allow almost complete follow-up and provide information on fathers that can be used in a negative control analysis to assess the impact of unmeasured confounding. The aim of this study was to propose a causal model for testing DOHaD using paternal exposure as a negative control, and its application to maternal distress in pregnancy and offspring asthma. A causal diagram including shared and parent-specific measured and unmeasured confounders for maternal (fetal) and paternal exposures is proposed. The case study consisted of all children born in Sweden from July 2006 to December 2008 ( n=254,150). Information about childhood asthma, parental distress and covariates was obtained from the Swedish national health registers. Associations between maternal and paternal distress during pregnancy and offspring asthma at age five years were assessed separately and with mutual adjustment for the other parent's distress measure, as well as for shared confounders. Maternal distress during pregnancy was associated with offspring asthma risk; mutually adjusted odds ratio (OR) (OR 1.32, 95% CI 1.23, 1.43). The mutually adjusted paternal distress-offspring asthma analysis (OR 1.05, 95% CI 0.97, 1.13) indicated no evidence for unmeasured confounding shared by the mother and father. Using paternal exposure in a negative control model to test the robustness of fetal programming hypotheses can be a relatively simple extension of conventional observational studies but limitations need to be considered.

  17. Two tales of cardiovascular risks—middle-aged women living in Sweden and Scotland: a cross-sectional comparative study

    Science.gov (United States)

    Wennerholm, Carina; Bromley, Catherine; Johansson, AnnaKarin; Nilsson, Staffan; Frank, John; Faresjö, Tomas

    2017-01-01

    Objectives To compare cardiovascular risk factors as well as rates of cardiovascular diseases in middle-aged women from urban areas in Scotland and Sweden. Design Comparative cross-sectional study. Setting Data from the general population in urban areas of Scotland and the general population in two major Swedish cities in southeast Sweden, south of Stockholm. Participants Comparable data of middle-aged women (40–65 years) from the Scottish Health Survey (n=6250) and the Swedish QWIN study (n=741) were merged together into a new dataset (n=6991 participants). Main outcome measure We compared middle-aged women in urban areas in Sweden and Scotland regarding risk factors for cardiovascular disease (CVD), CVD diagnosis, anthropometrics, psychological distress and lifestyle. Results In almost all measurements, there were significant differences between the countries, favouring the Swedish women. Scottish women demonstrated a higher frequency of alcohol consumption, smoking, obesity, low vegetable consumption, a sedentary lifestyle and also more psychological distress. For doctor-diagnosed coronary heart disease, there were also significant differences, with a higher prevalence among the Scottish women. Conclusions This is one of the first studies that clearly shows that Scottish middle-aged women are particularly affected by a worse profile of CVD risks. The profound differences in CVD risk and outcome frequency in the two populations are likely to have arisen from differences in the two groups of women's social, cultural, political and economic environments. PMID:28790040

  18. Understanding reasons for asthma outpatient (non)-attendance and exploring the role of telephone and e-consulting in facilitating access to care: exploratory qualitative study.

    NARCIS (Netherlands)

    Baar, J.D. van; Joosten, H.; Car, J.; Freeman, G.; Partridge, M.R.; Weel, C. van; Sheikh, A.

    2006-01-01

    OBJECTIVE: To understand factors influencing patients' decisions to attend for outpatient follow up consultations for asthma and to explore patients' attitudes to telephone and email consultations in facilitating access to asthma care. DESIGN: Exploratory qualitative study using in depth interviews.

  19. Nutrient loadings from urban catchments under climate change scenarios: case studies in Stockholm, Sweden.

    Science.gov (United States)

    Wu, Jiechen; Malmström, Maria E

    2015-06-15

    Anthropogenic nutrient emissions and associated eutrophication of urban lakes are a global problem. Future changes in temperature and precipitation may influence nutrient loadings in lake catchments. A coupling method, where the Generalized Watershed Loading Functions method was tested in combination with source quantification in a Substance Flow Analysis structure, was suggested to investigate diffuse nutrient sources and pathways and climate change effects on the loadings to streamflow in urban catchments. This method may, with an acceptable level of uncertainty, be applied to urban catchments for first-hand estimations of nutrient loadings in the projected future and to highlight the need for further study and monitoring. Five lake catchments in Stockholm, Sweden (Råcksta Träsk, Judarn, Trekanten, Långsjön and Laduviken) were employed as case studies and potential climate change effects were explored by comparing loading scenarios in two periods (2000-2009 and 2021-2030). For the selected cases, the dominant diffuse sources of nutrients to urban streamflow were found to be background atmospheric concentration and vehicular traffic. The major pathways of the nitrogen loading were suggested to be from both developed areas and natural areas in the control period, while phosphorus was indicated to be largely transported through surface runoff from natural areas. Furthermore, for nitrogen, a modest redistribution of loadings from surface runoff and stormwater between seasons and an increase in the annual loading were suggested for the projected future climate scenarios as compared to the control period. The model was, due to poor monitoring data availability, only able to set an upper limit to nutrient transport by groundwater both in the control period and the future scenarios. However, for nitrogen, groundwater appeared to be the pathway most sensitive to climate change, with a considerable increase and seasonal redistribution of loadings. For phosphorus

  20. Traffic-Related Air Pollution and Dementia Incidence in Northern Sweden: A Longitudinal Study.

    Science.gov (United States)

    Oudin, Anna; Forsberg, Bertil; Adolfsson, Annelie Nordin; Lind, Nina; Modig, Lars; Nordin, Maria; Nordin, Steven; Adolfsson, Rolf; Nilsson, Lars-Göran

    2016-03-01

    Exposure to ambient air pollution is suspected to cause cognitive effects, but a prospective cohort is needed to study exposure to air pollution at the home address and the incidence of dementia. We aimed to assess the association between long-term exposure to traffic-related air pollution and dementia incidence in a major city in northern Sweden. Data on dementia incidence over a 15-year period were obtained from the longitudinal Betula study. Traffic air pollution exposure was assessed using a land-use regression model with a spatial resolution of 50 m × 50 m. Annual mean nitrogen oxide levels at the residential address of the participants at baseline (the start of follow-up) were used as markers for long-term exposure to air pollution. Out of 1,806 participants at baseline, 191 were diagnosed with Alzheimer's disease during follow-up, and 111 were diagnosed with vascular dementia. Participants in the group with the highest exposure were more likely than those in the group with the lowest exposure to be diagnosed with dementia (Alzheimer's disease or vascular dementia), with a hazard ratio (HR) of 1.43 (95% CI: 0.998, 2.05 for the highest vs. the lowest quartile). The estimates were similar for Alzheimer's disease (HR 1.38) and vascular dementia (HR 1.47). The HR for dementia associated with the third quartile versus the lowest quartile was 1.48 (95% CI: 1.03, 2.11). A subanalysis that excluded a younger sample that had been retested after only 5 years of follow-up suggested stronger associations with exposure than were present in the full cohort (HR = 1.71; 95% CI: 1.08, 2.73 for the highest vs. the lowest quartile). If the associations we observed are causal, then air pollution from traffic might be an important risk factor for vascular dementia and Alzheimer's disease.

  1. The Roots of Autism and ADHD Twin Study in Sweden (RATSS).

    Science.gov (United States)

    Bölte, Sven; Willfors, Charlotte; Berggren, Steve; Norberg, Joakim; Poltrago, Lina; Mevel, Katell; Coco, Christina; Fransson, Peter; Borg, Jacqueline; Sitnikov, Rouslan; Toro, Roberto; Tammimies, Kristiina; Anderlid, Britt-Marie; Nordgren, Ann; Falk, Anna; Meyer, Urs; Kere, Juha; Landén, Mikael; Dalman, Christina; Ronald, Angelica; Anckarsäter, Henrik; Lichtenstein, Paul

    2014-06-01

    Neurodevelopmental disorders affect a substantial minority of the general population. Their origins are still largely unknown, but a complex interplay of genetic and environmental factors causing disturbances of the central nervous system's maturation and a variety of higher cognitive skills is presumed. Only limited research of rather small sample size and narrow scope has been conducted in neurodevelopmental disorders using a twin-differences design. The Roots of Autism and ADHD Twin Study in Sweden (RATSS) is an ongoing project targeting monozygotic twins discordant for categorical or dimensional autistic and inattentive/hyperactive-impulsive phenotypes as well as other neurodevelopmental disorders, and typically developing twin controls. Included pairs are 9 years of age or older, and comprehensively assessed for psychopathology, medical history, neuropsychology, and dysmorphology, as well as structural, functional, and molecular brain imaging. Specimens are collected for induced pluripotent (iPS) and neuroepithelial stem cells, genetic, gut bacteria, protein-/monoamine, and electron microscopy analyses. RATSS's objective is to generate a launch pad for novel surveys to understand the complexity of genotype-environment-phenotype interactions in autism spectrum disorder and attention-deficit hyperactivity disorder (ADHD). By October 2013, RATSS had collected data from 55 twin pairs, among them 10 monozygotic pairs discordant for autism spectrum disorder, seven for ADHD, and four for other neurodevelopmental disorders. This article describes the design, recruitment, data collection, measures, collected pairs' characteristics, as well as ongoing and planned analyses in RATSS. Potential gains of the study comprise the identification of environmentally mediated biomarkers, the emergence of candidates for drug development, translational modeling, and new leads for prevention of incapacitating outcomes.

  2. Goods in the Anthroposphere as a Metal Emission Source A Case Study of Stockholm, Sweden

    International Nuclear Information System (INIS)

    Soerme, L.; Bergbaeck, B.; Lohm, U.

    2001-01-01

    The aim of this study was to quantify the diffuse emissions during use of metal containing goods in the capital of Sweden,Stockholm. The following metals were studied: Cadmium (Cd), Chromium (Cr), Copper (Cu), Lead (Pb), Mercury (Hg), Nickel (Ni) and Zinc (Zn).A major part of the metals are found in a protected environment where degrading processes like corrosion are most limited. However, during the lifetime of some goods the metal release to the environment is significant. The quantitatively most dominant emissions were found for Cu and Zn. The tap water system and roofs/fronts (Cu) represent goods with large exposed areas but with relatively small release rates per unit. In contrast, brake linings, aerial lines and electrical grounding (Cu) and tyres, brake linings and chemicals (Zn) are all goods with high release rates but mostly limited exposed stocks.High yearly emissions are also found for Pb, ammunition and sinkers dominate the calculated emissions totally. For Cr and Ni, stainless steel represent the major part of the stocks, but corrosion was estimated to give only a minor contribution to the emissions. Potential emission sources, i.e. stabilisers,pigments and plated goods dominate the exposed Cd stock. These emissions were not quantified due to lack of data. Hg is currently phased out, but one major source of emission, i.e. the use of amalgam, will be continuously significant for several decades. The importance of the traffic sector is obvious. The emissions from brake linings (Cu, Zn and Pb), tyres (Zn, Pb, Cr and Ni)and asphalt wear (Cu, Zn, Cr, Ni and Pb) are all of large importance for the total emission from respectively metal

  3. Asthma - children

    Science.gov (United States)

    ... control drugs are taken every day to prevent asthma symptoms. Your child should take these medicines even if no symptoms ... you think your child has new symptoms of asthma. If your child has been diagnosed with asthma, call the provider: ...

  4. Asthma Quiz

    Science.gov (United States)

    ... plan, and environmental control measures to avoid your child's asthma triggers. By working together with your daughter's health ... which can diminish your allergies' effect on your asthma. Question 5 Once my child reaches puberty, he will outgrow his asthma. True ...

  5. Asthma and rhinitis in cleaning workers: a systematic review of epidemiological studies.

    NARCIS (Netherlands)

    Folletti, I.; Zock, J.P.; Moscato, G.; Siracusa, A.

    2014-01-01

    Objective: This article presents a systematic review of epidemiological studies linking cleaning work and risk of asthma and rhinitis. Methods: Published reports were identified from PubMed covering the years from 1976 through June 30, 2012. In total, we identified 24 papers for inclusion in the

  6. mHealth intervention to support asthma self-management in adolescents: the ADAPT study.

    NARCIS (Netherlands)

    Kosse, R.C.; Bouvy, M.L.; Vries, T.W. de; Kaptein, A.A.; Geers, H.C.J.; Dijk, L. van; Koster, E.S.

    2017-01-01

    Purpose: Poor medication adherence in adolescents with asthma results in poorly controlled disease and increased morbidity. The aim of the ADolescent Adherence Patient Tool (ADAPT) study is to develop an mHealth intervention to support self-management and to evaluate the effectiveness in improving

  7. Protection from childhood asthma and allergy in Alpine farm environments-the GABRIEL Advanced Studies

    NARCIS (Netherlands)

    Illi, S.; Depner, M.; Genuneit, J.; Horak, E.; Loss, G.; Strunz-Lehner, C.; Büchele, G.; Boznanski, A.; Danielewicz, H.; Cullinan, P.; Heederik, D.|info:eu-repo/dai/nl/072910542; Braun-Fahrländer, C.; von Mutius, E.

    2012-01-01

    BACKGROUND Studies on the association of farm environments with asthma and atopy have repeatedly observed a protective effect of farming. However, no single specific farm-related exposure explaining this protective farm effect has consistently been identified. OBJECTIVE We sought to determine

  8. Study of the level of stem cell factor in patients with bronchial asthma

    Directory of Open Access Journals (Sweden)

    Ahmad Gouda El-Gazzar

    2016-01-01

    Conclusion: This study demonstrated that the serum level of SCF was higher in asthmatic patients especially among eosinophilic phenotype than among healthy control subjects. Also there was a significant association between higher SCF and higher levels of asthma severity, sputum and blood eosinophil%.

  9. Maternal suicide - Register based study of all suicides occurring after delivery in Sweden 1974-2009.

    Science.gov (United States)

    Lysell, Henrik; Dahlin, Marie; Viktorin, Alexander; Ljungberg, Elsa; D'Onofrio, Brian M; Dickman, Paul; Runeson, Bo

    2018-01-01

    Recent research suggests that having a newborn child is associated with substantially reduced risk for maternal suicide. We studied postpartum suicides in a national cohort of mothers and the role of mental disorder, self-harm and delivery related factors. We used a nested case-control design with data from Swedish registries. The cohort consisted of all women given birth in Sweden 1974-2009. Mothers who died by suicide during follow-up were considered cases (n = 1,786) and risk of suicide was estimated with proximity to delivery as the explanatory variable. In a second step, association between suicide during the first year following delivery (n = 145) and mental disorder, self-harm and delivery related variables risk factors were analyzed. The first postpartum year was associated with a lower risk of suicide, compared to later (RR 0.80, 95%CI 0.66-0.96), which was unaltered after adjustment for socio-economic status and history of self-harm (aRR 0.82, 95%CI 0.68-0.99). Compared to living mothers, suicide victims of the postpartum year more often had affective disorders (aRR 133.94, 95%CI 45.93-390.61), psychotic disorders (aRR 83.69, 95%CI 36.99-189.31) and history of self-harm (aRR 47.56, 95%CI 18.24-124.02). The aRR of stillbirth was 2.66 (95%CI 0.63-11.30). We found only a weak negative association between childbirth during the preceding year and suicide, when using mothers as controls. A severe mental disorder after delivery and a history of self-harm was strongly associated with increased risk of suicide in the postpartum year and may inform the clinical assessment postpartum.

  10. Influence of urban vegetation on air pollution and noise exposure - A case study in Gothenburg, Sweden.

    Science.gov (United States)

    Klingberg, Jenny; Broberg, Malin; Strandberg, Bo; Thorsson, Pontus; Pleijel, Håkan

    2017-12-01

    Air pollution levels (NO 2 , PAHs, O 3 ) were investigated, before (BLE) and after (ALE) leaf emergence, in the urban landscape of Gothenburg, Sweden. The aims were to study the 1) spatial and temporal variation in pollution levels between urban green areas, 2) effect of urban vegetation on air pollution levels at the same distance from a major emission source (traffic route), 3) improvement of urban air quality in urban parks compared to adjacent sites near traffic, 4) correlation between air pollution and noise in a park. O 3 varied little over the urban landscape. NO 2 varied strongly and was higher in situations strongly influenced by traffic. Four PAH variables were included: total PAH, total particle-bound PAH, the quantitatively important gaseous phenanthrene and the highly toxic particle-bound benzo(a)pyrene. The variation of PAHs was similar to NO 2 , but for certain PAHs the difference between highly and less polluted sites was larger than for NO 2 . At a vegetated site, NO 2 and particulate PAH levels were lower than at a non-vegetated site at a certain distance from a busy traffic route. This effect was significantly larger ALE compared to BLE for NO 2 , indicating green leaf area to be highly significant factor for air quality improvement. For particulate PAHs, the effect was similar BLE and ALE, indicating that tree bark and branches also could be an important factor in reducing air pollution. Parks represented considerably cleaner local environments (park effect), which is likely to be a consequence of both a dilution (distance effect) and deposition. Noise and air pollution (NO 2 and PAH) levels were strongly correlated. Comparison of noise levels BLE and ALE also showed that the presence of leaves significantly reduced noise levels. Our results are evidence that urban green spaces are beneficial for urban environmental quality, which is important to consider in urban planning. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Spatio-temporal precipitation error propagation in runoff modelling: a case study in central Sweden

    Directory of Open Access Journals (Sweden)

    J. Olsson

    2006-01-01

    Full Text Available The propagation of spatio-temporal errors in precipitation estimates to runoff errors in the output from the conceptual hydrological HBV model was investigated. The study region was the Gimån catchment in central Sweden, and the period year 2002. Five precipitation sources were considered: NWP model (H22, weather radar (RAD, precipitation gauges (PTH, and two versions of a mesoscale analysis system (M11, M22. To define the baseline estimates of precipitation and runoff, used to define seasonal precipitation and runoff biases, the mesoscale climate analysis M11 was used. The main precipitation biases were a systematic overestimation of precipitation by H22, in particular during winter and early spring, and a pronounced local overestimation by RAD during autumn, in the western part of the catchment. These overestimations in some cases exceeded 50% in terms of seasonal subcatchment relative accumulated volume bias, but generally the bias was within ±20%. The precipitation data from the different sources were used to drive the HBV model, set up and calibrated for two stations in Gimån, both for continuous simulation during 2002 and for forecasting of the spring flood peak. In summer, autumn and winter all sources agreed well. In spring H22 overestimated the accumulated runoff volume by ~50% and peak discharge by almost 100%, owing to both overestimated snow depth and precipitation during the spring flood. PTH overestimated spring runoff volumes by ~15% owing to overestimated winter precipitation. The results demonstrate how biases in precipitation estimates may exhibit a substantial space-time variability, and may further become either magnified or reduced when applied for hydrological purposes, depending on both temporal and spatial variations in the catchment. Thus, the uncertainty in precipitation estimates should preferably be specified as a function of both time and space.

  12. Risk of Periodontal Disease in Patients With Asthma: A Nationwide Population-Based Retrospective Cohort Study.

    Science.gov (United States)

    Shen, Te-Chun; Chang, Pei-Ying; Lin, Cheng-Li; Wei, Chang-Ching; Tu, Chih-Yen; Hsia, Te-Chun; Shih, Chuen-Ming; Hsu, Wu-Huei; Sung, Fung-Chang; Kao, Chia-Hung

    2017-08-01

    Studies have reported an association between asthma and oral diseases, including periodontal diseases. The aim of this retrospective study is to investigate risk of periodontal diseases for patients with asthma. Using the claims data of National Health Insurance of Taiwan and patients without a history of periodontal diseases, 19,206 asthmatic patients, who were newly diagnosed from 2000 through 2010, were identified. For each case, four comparison individuals without history of asthma and periodontal disease were randomly selected from the general population and frequency matched (categorical matched) by sex, age, and year of diagnosis (n = 76,824). Both cohorts were followed to the end of 2011 to monitor occurrence of periodontal diseases. Adjusted hazard ratios (aHRs) of periodontal disease were estimated using Cox proportional hazards regression analysis. Overall incidence of periodontal diseases was 1.18-fold greater in the asthma cohort than in the comparison cohort (P periodontal diseases compared with those with a mean of less than one visit. Patients with at least three admissions annually also had a similar aHR (51.8) for periodontal disease. In addition, asthmatic patients on inhaled corticosteroid (ICS) therapy had greater aHRs than non-users (aHR = 1.12; 95% CI = 1.03 to 1.23). In the studied population, asthmatic patients are at an elevated risk of developing periodontal diseases. The risk is much greater for those with emergency medical demands or hospital admissions and those on ICS treatment.

  13. Cooking fuels and prevalence of asthma: a global analysis of phase three of the International Study of Asthma and Allergies in Childhood (ISAAC).

    Science.gov (United States)

    Wong, Gary W K; Brunekreef, Bert; Ellwood, Philippa; Anderson, H Ross; Asher, M Innes; Crane, Julian; Lai, Christopher K W

    2013-07-01

    Indoor air pollution from a range of household cooking fuels has been implicated in the development and exacerbation of respiratory diseases. In both rich and poor countries, the effects of cooking fuels on asthma and allergies in childhood are unclear. We investigated the association between asthma and the use of a range of cooking fuels around the world. For phase three of the International Study of Asthma and Allergies in Childhood (ISAAC), written questionnaires were self-completed at school by secondary school students aged 13-14 years, 244,734 (78%) of whom were then shown a video questionnaire on wheezing symptoms. Parents of children aged 6-7 years completed the written questionnaire at home. We investigated the association between types of cooking fuels and symptoms of asthma using logistic regression. Adjustments were made for sex, region of the world, language, gross national income, maternal education, parental smoking, and six other subject-specific covariates. The ISAAC study is now closed, but researchers can continue to use the instruments for further research. Data were collected between 1999 and 2004. 512,707 primary and secondary school children from 108 centres in 47 countries were included in the analysis. The use of an open fire for cooking was associated with an increased risk of symptoms of asthma and reported asthma in both children aged 6-7 years (odds ratio [OR] for wheeze in the past year, 1·78, 95% CI 1·51-2·10) and those aged 13-14 years (OR 1·20, 95% CI 1·06-1·37). In the final multivariate analyses, ORs for wheeze in the past year and the use of solely an open fire for cooking were 2·17 (95% CI 1·64-2·87) for children aged 6-7 years and 1·35 (1·11-1·64) for children aged 13-14 years. Odds ratios for wheeze in the past year and the use of open fire in combination with other fuels for cooking were 1·51 (1·25-1·81 for children aged 6-7 years and 1·35 (1·15-1·58) for those aged 13-14 years. In both age groups, we

  14. Breast cancer diagnosis and mortality by tumor stage and migration background in a nationwide cohort study in Sweden.

    Science.gov (United States)

    Abdoli, Gholamreza; Bottai, Matteo; Sandelin, Kerstin; Moradi, Tahereh

    2017-02-01

    Survival in breast cancer patients has steadily increased over the years, but with considerable disparities between individuals with different migration background and social position. We explored differences in diagnosis and all-cause mortality in breast cancer patients by stage of disease at the time of diagnosis and by country of birth, while considering the effect of comorbidity, regional and socio-demographic factors. We used Swedish national registers to follow a cohort of 35,268 patients (4232 foreign-born) with breast cancer between 2004 and 2009 in Sweden. We estimated relative risk ratio (RRR) for diagnosis, hazard ratio (HR) for all-cause mortality and relative excess rate (RER) for breast cancer mortality using multinomial logistic regression models, multivariable Cox proportional hazard, and Poisson regression, respectively. We observed 4178 deaths due to any causes. Among them 418 women were born abroad. Foreign-born patients were on average 3 years younger at the time of breast cancer diagnosis and had higher risk of stage II tumors compared with Sweden-born women (RRR = 1.09, 95% CI 1.00-1.19). Risk of dying was 20% higher in foreign-born compared with Sweden-born breast cancer patients, if the tumor was diagnosed at stages III-IV after adjustment for age at diagnosis, education, county of residence and Charlson's comorbidity index (HR = 1.20, 95% CI 0.95-1.51 and RER = 1.21, 95% CI 0.95-1.55). The worse prognosis in foreign-born patients with advanced tumors compared with Sweden-born patients is not explained by educational level or comorbidity. The reasons behind the observed disparities should be further studied. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Sickness Absence and Precarious Employment: A Comparative Cross-National Study of Denmark, Finland, Sweden, and Norway

    Directory of Open Access Journals (Sweden)

    A Oke

    2016-07-01

    Full Text Available Background: Precarious employment is a major social determinant of health and health inequalities with effects beyond the health of workers. Objective: To investigate the association between precarious employment and sickness absence in 4 Nordic countries, Denmark, Finland, Norway, and Sweden. Methods: Logistic regression analyses were conducted separately for each country on data from 4186 respondents aged 15–65 years in Denmark, Finland, Norway, and Sweden derived from the 2010 European Working Conditions Survey. Sickness absence was based on self-reports and defined as absence of seven or more day per year. Precarious employment was operationalized as a multidimensional construct of indicators. Analyses were also conducted separately for men and women. Results: The prevalence of sickness absence was lowest in Sweden (18%, and highest in Finland (28%. 3 precarious employment indicators were positively associated with sickness absence; the pattern being largely similar in the total sample. In the sex-disaggregated sample, 5 precarious employment indicators increased the likelihood of sickness absence; the pattern was heterogeneous, with women generally having significantly higher odds of sickness absence than men. “Low household income” and “sickness presenteeism” were strong predictors of sickness absence among both sexes in most of the 4 studied countries. Sickness absence varied between the Nordic countries in the sex-disaggregated analyses. Conclusion: Precarious employment indicators predicted sickness absence in the Nordic countries. Findings emphasize the need to prioritize informed and monitored collective bargaining for all workers, increase working time flexibility, and improving work conditions.

  16. Genome-wide association study of lung function decline in adults with and without asthma

    Science.gov (United States)

    Imboden, Medea; Bouzigon, Emmanuelle; Curjuric, Ivan; Ramasamy, Adaikalavan; Kumar, Ashish; Hancock, Dana B; Wilk, Jemma B; Vonk, Judith M; Thun, Gian A; Siroux, Valerie; Nadif, Rachel; Monier, Florent; Gonzalez, Juan R; Wjst, Matthias; Heinrich, Joachim; Loehr, Laura R; Franceschini, Nora; North, Kari E; Altmüller, Janine; Koppelman, Gerard H.; Guerra, Stefano; Kronenberg, Florian; Lathrop, Mark; Moffatt, Miriam F; O’Connor, George T; Strachan, David P; Postma, Dirkje S; London, Stephanie J; Schindler, Christian; Kogevinas, Manolis; Kauffmann, Francine; Jarvis, Debbie L; Demenais, Florence; Probst-Hensch, Nicole M

    2012-01-01

    Background Genome-wide association studies (GWAS) have identified determinants of chronic obstructive pulmonary disease, asthma and lung function level, however none addressed decline in lung function. Aim We conducted the first GWAS on age-related decline in forced expiratory volume in the first second (FEV1) and in its ratio to forced vital capacity (FVC) stratified a priori by asthma status. Methods Discovery cohorts included adults of European ancestry (1441 asthmatics, 2677 non-asthmatics; Epidemiological Study on the Genetics and Environment of Asthma (EGEA); Swiss Cohort Study on Air Pollution And Lung And Heart Disease In Adults (SAPALDIA); European Community Respiratory Health Survey (ECRHS)). The associations of FEV1 and FEV1/FVC decline with 2.5 million single nucleotide polymorphisms (SNPs) were estimated. Thirty loci were followed-up by in silico replication (1160 asthmatics, 10858 non-asthmatics: Atherosclerosis Risk in Communities (ARIC); Framingham Heart Study (FHS); British 1958 Birth Cohort (B58C); Dutch asthma study). Results Main signals identified differed between asthmatics and non-asthmatics. None of the SNPs reached genome-wide significance. The association between the height related gene DLEU7 and FEV1 decline suggested for non-asthmatics in the discovery phase was replicated (discovery P=4.8×10−6; replication P=0.03) and additional sensitivity analyses point to a relation to growth. The top ranking signal, TUSC3, associated with FEV1/FVC decline in asthmatics (P=5.3×10−8) did not replicate. SNPs previously associated with cross-sectional lung function were not prominently associated with decline. Conclusions Genetic heterogeneity of lung function may be extensive. Our results suggest that genetic determinants of longitudinal and cross-sectional lung function differ and vary by asthma status. PMID:22424883

  17. Asthma and Allergies in Children With Autism Spectrum Disorders: Results From the CHARGE Study.

    Science.gov (United States)

    Lyall, Kristen; Van de Water, Judy; Ashwood, Paul; Hertz-Picciotto, Irva

    2015-10-01

    Immune aberrations are often noted in children with autism spectrum disorder (ASD), but whether asthma and allergy are related to ASD is not well defined. This study examined asthma and allergies in association with ASD and phenotypic subsets. Participants were 560 children with confirmed ASD and 391 typically developing children from the CHildhood Autism Risks from Genetics and the Environment study. Maternally reported child asthma and allergy was compared between cases and controls, and in association with cognitive and behavioral test scores. Prevalence of asthma and overall allergies did not differ between cases and controls, but overall allergy in children with ASD was associated with higher stereotypy scores as measured by the Aberrant Behavior Checklist. In addition, reported food allergies were significantly associated with ASD (adjusted odds ratio = 2.23, 95% confidence interval 1.28, 3.89). Our results suggest food allergies and sensitivities may be more common in children with ASD, and that these issues may correlate with other behaviors. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

  18. Study of depressed mood and quality of life in asthma patients in Tehran using the 28-item general health questionnaire.

    Science.gov (United States)

    Tafti, S F; Cheraghvandi, A; Safa, M; Eragh, D F; Mokri, B; Talischi, F

    2011-11-01

    The prevalence of depression among the general population has been estimated as up to 50% and even higher among asthmatics. The aim of this cross-sectional study was to evaluate the prevalence of depressed mood among asthma patients (n = 280) attending a pulmonary clinic in Tehran and compare it with measures of severity of asthma and of health and well-being. The prevalence of depression symptoms on the 28-item general health questionnaire (GHQ-28) was 65.4%. Patients' individual scores on the GHQ-28 were significantly correlated with the number of asthma medications used, frequency of visits to the pulmonary clinic and frequency of hospitalizations for asthma, but not with FEV1. A significant correlation was found between patients' total scores on the GHQ-28 and total and subscale scores on the Saint George respiratory questionnaire. The GHQ-28 may be useful for screening for asthma patients who need more attention and therapeutic intervention for psychiatric disorders.

  19. Pre-natal exposure to paracetamol and risk of wheezing and asthma in children: A birth cohort study

    DEFF Research Database (Denmark)

    Rebordosa, Cristina; Kogevinas, Manolis; Sørensen, Henrik T

    2008-01-01

    BACKGROUND: Paracetamol use has been associated with increased prevalence of asthma in children and adults, and one study reported an association between pre-natal exposure to paracetamol and asthma in early childhood. METHODS: To examine if pre-natal exposure to paracetamol is associated...... with the risk of asthma or wheezing in early childhood, we selected 66 445 women from the Danish National Birth Cohort for whom we had information on paracetamol use during pregnancy and who participated in an interview when their children were 18-months-old and 12 733 women whose children had reached the age...... of 7 and estimated the prevalence of physician-diagnosed asthma and wheezing at the ages of 18 months and 7 years. We also linked our population to the Danish National Hospital Registry to record all hospitalizations due to asthma up to age of 18 months. RESULTS: Paracetamol use during any time...

  20. Association of Blood Eosinophil and Blood Neutrophil Counts with Asthma Exacerbations in the Copenhagen General Population Study

    DEFF Research Database (Denmark)

    Vedel-Krogh, Signe; Nielsen, Sune Fallgaard; Lange, Peter

    2017-01-01

    BACKGROUND: Blood eosinophil count is a marker of eosinophilic airway inflammation and disease severity in asthma. However, blood neutrophil count might also be associated with disease severity. We tested the hypothesis that high blood eosinophil and neutrophil counts are both associated...... with the risk of asthma exacerbations among individuals with asthma from the general population. METHODS: From the Copenhagen General Population Study with 81351 participants, we included 4838 with self-reported asthma. We recorded baseline blood eosinophil and neutrophil counts, and asthma exacerbations during...... with blood eosinophil counts >0.29 × 10(9)/L (highest tertile) vs individuals with blood eosinophil counts neutrophils, the multivariable-adjusted IRRs were 2.14 (1.74-2.63) for moderate exacerbations and 1.18 (0.89-1.55) for severe exacerbations for individuals...

  1. Genome Wide Association Study to predict severe asthma exacerbations in children using random forests classifiers

    Directory of Open Access Journals (Sweden)

    Litonjua Augusto A

    2011-06-01

    Full Text Available Abstract Background Personalized health-care promises tailored health-care solutions to individual patients based on their genetic background and/or environmental exposure history. To date, disease prediction has been based on a few environmental factors and/or single nucleotide polymorphisms (SNPs, while complex diseases are usually affected by many genetic and environmental factors with each factor contributing a small portion to the outcome. We hypothesized that the use of random forests classifiers to select SNPs would result in an improved predictive model of asthma exacerbations. We tested this hypothesis in a population of childhood asthmatics. Methods In this study, using emergency room visits or hospitalizations as the definition of a severe asthma exacerbation, we first identified a list of top Genome Wide Association Study (GWAS SNPs ranked by Random Forests (RF importance score for the CAMP (Childhood Asthma Management Program population of 127 exacerbation cases and 290 non-exacerbation controls. We predict severe asthma exacerbations using the top 10 to 320 SNPs together with age, sex, pre-bronchodilator FEV1 percentage predicted, and treatment group. Results Testing in an independent set of the CAMP population shows that severe asthma exacerbations can be predicted with an Area Under the Curve (AUC = 0.66 with 160-320 SNPs in comparison to an AUC score of 0.57 with 10 SNPs. Using the clinical traits alone yielded AUC score of 0.54, suggesting the phenotype is affected by genetic as well as environmental factors. Conclusions Our study shows that a random forests algorithm can effectively extract and use the information contained in a small number of samples. Random forests, and other machine learning tools, can be used with GWAS studies to integrate large numbers of predictors simultaneously.

  2. The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three: a global synthesis.

    Science.gov (United States)

    Mallol, J; Crane, J; von Mutius, E; Odhiambo, J; Keil, U; Stewart, A

    2013-01-01

    This ISAAC Phase Three synthesis provides summarised information on the main findings of the study, regional tables and figures related to the prevalence and severity of current symptoms of asthma, rhinoconjunctivitis and eczema in the main regions of the world. The large number of surveyed children (≈1,200,000), the large number of centres (233) and countries (98) that participated in ISAAC Phase Three makes this study the most comprehensive survey of these diseases ever undertaken. Globally, the prevalence for current asthma, rhinoconjunctivitis and eczema in the 13-14-year age group was 14.1%, 14.6% and 7.3%, respectively. In the 6-7-year age group the prevalence for current asthma, rhinoconjunctivitis and eczema was 11.7%, 8.5% and 7.9%, respectively. The study shows a wide variability in the prevalence and severity of asthma, rhinoconjunctivitis and eczema which occurs not just between regions and countries but between centres in the same country and centres in the same city. This study definitively establishes that the prevalence of those diseases can be very high in non-affluent centres with low socioeconomic conditions. The large variability also suggests a crucial role of local environment characteristics to determine the differences in prevalence between one place and another. Thus, ISAAC Phase Three has provided a large body of epidemiological information on asthma, rhinoconjunctivitis and eczema in childhood from contrasting environments which is expected to yield new clues about the aetiology of those conditions and reasons for their marked global variability. Copyright © 2012 SEICAP. Published by Elsevier Espana. All rights reserved.

  3. Cross-prediction of the groundwater chemistry at the SKB sites in Sweden. Pilot study

    International Nuclear Information System (INIS)

    Skaarman, C.; Laaksoharju, M.

    1997-08-01

    The possibility to perform a large scale prediction throughout Sweden was tested. The aim of the work was: to collect data and create a groundwater database for current and future use; to see if there is any correlation between data at different sites; to perform a modelling where the groundwater composition at different regions in Sweden is predicted. The outcome of the predictions were compared with the measured data at different sites. The results show that it is possible but more work needs to be done to improve the prediction models. More measurements at depth are needed to enable the use of 3D models. It is also important to include hydrogeological parameters in the groundwater chemical prediction models that are used

  4. 'Real-life' effectiveness studies of omalizumab in adult patients with severe allergic asthma: systematic review.

    Science.gov (United States)

    Abraham, I; Alhossan, A; Lee, C S; Kutbi, H; MacDonald, K

    2016-05-01

    We reviewed 24 'real-life' effectiveness studies of omalizumab in the treatment of severe allergic asthma that included 4117 unique patients from 32 countries with significant heterogeneity in patients, clinicians and settings. The evidence underscores the short- and long-term benefit of anti-IgE therapy in terms of the following: improving lung function; achieving asthma control and reducing symptomatology, severe exacerbations and associated work/school days lost; reducing healthcare resource utilizations, in particular hospitalizations, hospital lengths of stay and accident specialist or emergency department visits; reducing or discontinuing other asthma medications; and improving quality of life - thus confirming, complementing and extending evidence from randomized trials. Thus, omalizumab therapy is associated with signal improvements across the full objective and subjective burden of illness chain of severe allergic asthma. Benefits of omalizumab may extend up to 2-4 years, and the majority of omalizumab-treated patients may benefit for many years. Omalizumab has positive short- and long-term safety profiles similar to what is known from randomized clinical trials. Initiated patients should be monitored for treatment response at 16 weeks. Those showing positive response at that time are highly likely to show sustained treatment response and benefit in terms of clinical, quality of life and health resource utilization outcomes. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Longterm clinical outcomes of omalizumab therapy in severe allergic asthma: Study of efficacy and safety.

    Science.gov (United States)

    Mansur, Adel H; Srivastava, Sapna; Mitchell, Verity; Sullivan, Julie; Kasujee, Ismail

    2017-03-01

    Omalizumab has been shown to be an effective add-on therapy for patients with uncontrolled severe persistent allergic asthma. There has been a steady accumulation of evidence on the long-term effectiveness of omalizumab; however, data on real-life outcomes beyond one year of treatment is limited. In this study, we report on long-term outcomes of omalizumab treatment. We collected data from our severe asthma registry on hospitalisations, exacerbations, corticosteroid sparing, asthma control, lung function, biomarkers and side effects, to determine if the benefit was sustained and treatment was safe on the long term. Forty-five patients [mean age 44.9 years (range 19-69), females 37/45 (82%), mean duration of omalizumab treatment = 60.7 ± 30.9 months (range 23-121) were included in the analysis. We observed a reduction in the annual acute asthma related hospital admissions for the total population from 207 at baseline to 40 on treatment (80.7% reduction), whilst the per patient annual hospitalisations were reduced from a mean of 4.8 to 0.89 post-omalizumab treatment (p omalizumab therapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Asthma and Wheeze Prevalence among Nursing Professionals in Western Japan: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Jun Kurai

    2015-12-01

    Full Text Available Although adult asthma is attributable to occupational factors, few reports are available on asthma prevalence among health care workers in Japan. The objective of this study was to estimate the prevalence of asthma and wheeze among Japanese nursing professionals. A cross-sectional study was conducted by postal survey using a translated version of the European Community Respiratory Health Survey questionnaire from April to June 2013. The analysis included 4634 nursing professionals (257 men and 4377 women and the overall response rate was 84.8%. The prevalence of current asthma and wheeze were 10.7% (95% confidence interval (CI, 9.9%–11.7% and 15.6% (95% CI, 14.5%–16.6%, respectively. More than one year of work experience as a nursing professional and more than one year of experience with bed-making tasks were associated with odds ratios (ORs of 1.95 (95% CI, 1.12–3.39 and 1.64 (95% CI, 1.15–2.23 for wheeze, respectively. Current smoking was significantly associated with the presence of wheeze, with ORs of 2.27 for men (95% CI, 1.11–4.64 and 2.01 for women (95% CI, 1.54–2.64. Among female nurses, latex allergy was associated with wheeze (OR, 1.87; 95% CI, 1.56–2.23, as was body mass index ≥30 (OR, 2.76; 95% CI, 1.65–4.62. This study has provided the prevalence of asthma and wheeze among Japanese nursing professionals. Employment period, bed-making tasks, latex allergy, obesity, and smoking may be risk factors for prevalent wheeze among nursing professionals.

  7. Institutional prerequisites for affordable housing development : A comparative study of Germany and Sweden

    OpenAIRE

    Granath Hansson, Anna

    2017-01-01

    This thesis was written against the background of intense public debate on increasing housing shortages and housing policy reform in Germany and Sweden. Potential reforms to increase housing development volumes, especially in the affordable segment, are analysed using theories of institutional change with focus on urban planning, building law and housing policy. The instruments analysed are divided into measures intended to increase housing supply elasticity and targeted affordable housing me...

  8. Does the Breast Cancer Age at Diagnosis Differ by Ethnicity? A Study on Immigrants to Sweden

    Science.gov (United States)

    Hemminki, Kari; Sundquist, Jan; Brandt, Andreas

    2011-01-01

    Background. Age-specific incidence rates for breast cancer in low-risk and high-risk ethnic populations differ by age at which the incidence maximum is reached: around 50 years in low-risk populations and over 60 years in high-risk populations. The interpretation of these differences remains unsettled, one line primarily referring to biological differences, the second one to cohort effects of rapidly increasing rates in young populations, and the third one to incomplete registration of cancer in the elderly. Methods. The nationwide Family-Cancer Database was used to analyze standardized incidence ratios (SIRs) and age at diagnosis of breast cancer in female immigrants to Sweden by their region of origin compared with women native to Sweden matched on birth year and other relevant factors. Results. We showed first that the SIRs for breast cancer were lower in many immigrant groups compared with natives of Sweden; women from Turkey had the lowest SIR of 0.45, followed by those from Chile (0.54) and Southeast Asia (0.57). Women from nine regions showed an earlier mean age at diagnosis than their matched Swedish controls, the largest differences being 5.5 years for women from Turkey, 5.1 years for those from Asian Arab and “Other African” countries, 4.3 years for those from Iran, and 4.0 years for those from Iraq. Conclusions. The results show that in many immigrant groups, the diagnostic age is earlier (Sweden (>50 years), suggesting that true biological factors underlie the differences. These factors may explain much of the international variation in breast cancer incidence. Identifying these factors should advance understanding of breast cancer etiology and prevention. PMID:21266400

  9. Exposure to toxics during pregnancy and childhood and asthma in children: A pilot study

    Directory of Open Access Journals (Sweden)

    Souheil Hallit

    2017-09-01

    Full Text Available Environmental factors, pesticides, alcohol and smoking are linked to asthma in children. The association of toxic substances exposure with asthma has not been evaluated. Our objective is to assess such associations among children aged less than 16 years old. This is a cross-sectional study, conducted between January and May 2015, using a sample of Lebanese students from private schools in Beirut and Mount Lebanon. Out of 700 distributed questionnaires, 527 (75.2% were returned to us. Verbal informed consent was also obtained from all parents prior to participating in the study. A significant association was found between waterpipe smoking and diagnosed asthma (p = 0.003; ORa = 13.25; 95% CI 2.472–71.026. Alcohol during pregnancy, waterpipe smoking during pregnancy and parents respiratory problems significantly increased the risk of respiratory problems by approximately 5 times, 6 times and 2 times respectively (p = 0.016; ORa = 4.889; 95% CI 1.339–17.844, p = 0.021; ORa = 6.083; 95% CI 1.314–28.172, p = 0.004; ORa = 1.748; 95% CI 1.197–2.554 respectively. Waterpipe smoking, alcohol during pregnancy, recurrent otitis and humidity at home seem to be significantly correlated with asthma in children. Spreading awareness by health care professionals is needed to permit a reduction of the prevalence of these allergic diseases, especially asthma, in children.

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

    Science.gov (United States)

    Salam, Muhammad T; Avoundjian, Tigran; Knight, Wendy M; Gilliland, Frank D

    2015-01-01

    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 contribution from

  11. Grandmother's smoking when pregnant with the mother and asthma in the grandchild: the Norwegian Mother and Child Cohort Study.

    Science.gov (United States)

    Magnus, Maria C; Håberg, Siri E; Karlstad, Øystein; Nafstad, Per; London, Stephanie J; Nystad, Wenche

    2015-03-01

    A trans-generational influence of prenatal tobacco smoke exposure on asthma development has been proposed but the evidence remains sparse. We examined the grandmother's smoking when pregnant with the mother in relation to asthma outcomes in the grandchild (current asthma at 36 months (N=53 169, cases=3013), current asthma at 7 years (N=25 394, cases=1265) and dispensed asthma medications at 7 years in the Norwegian Prescription Database (N=45 607, cases=1787)) within the Norwegian Mother and Child Cohort Study (MoBa). We calculated adjusted RR (adj. RR) and 95% CIs using log binomial regression. A total of 23.5% of mothers reported that their mother smoked when pregnant with them. The grandmother's smoking when pregnant with the mother was positively associated with asthma at 36 months (adj. RR 1.15 (95% CI 1.06 to 1.24)), asthma at 7 years (adj. RR 1.21 (95% CI 1.07 to 1.37)) and dispensed asthma medications at 7 years (adj. RR 1.15 (95% CI 1.04 to 1.26)). This positive association did not differ significantly by the mother's smoking status when pregnant with the child (p values for multiplicative interaction >0.1). The grandmother's smoking when pregnant with the mother increased the risk of asthma in the grandchild independent of the mother's smoking status. However, given limited information on the grandmother's socioeconomic status, asthma status and other factors, unmeasured confounding may be present. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Determinants of longitudinal health-related quality-of-life change in children with asthma from low-income families: a report from the PROMIS®Pediatric Asthma Study.

    Science.gov (United States)

    Li, Z; Leite, W L; Thompson, L A; Gross, H E; Shenkman, E A; Reeve, B B; DeWalt, D A; Huang, I-C

    2017-03-01

    How the longitudinal asthma control status and other socio-demographic factors influence the changes of health-related quality of life (HRQOL) among asthmatic children, especially from low-income families, has not been fully investigated. This study aimed to describe the trajectories of asthma-specific HRQOL over 15 months and examine the effect of asthma control status on HRQOL by taking socio-demographic factors into consideration. A total of 229 dyads of asthmatic children and their parents enroled in public insurance programs were recruited for assessing asthma control status and HRQOL over four time points of assessment. Asthma control status was measured using the Asthma Control and Communication Instrument, and asthma-specific HRQOL was assessed using the Patient-Reported Outcomes Measurement Information System's Pediatric Asthma Impact Scale. Latent growth models (LGMs) were applied to examine the trajectory of HRQOL and the factors contributing to the changes of HRQOL. Unconditional LGM revealed that HRQOL was improved over time. Conditional LGM suggested that accounting for asthma control and participants' socio-demographic factors, the variation in the initial level of HRQOL was significant, yet the rate of change was not. Conditional LGM also revealed that poorly controlled asthma status was associated with poor HRQOL at each time point (P's < 0.05). Lower parental education was associated with lower baseline HRQOL (P < 0.05). Hispanic children had a larger increase in HRQOL over time (P < 0.01) than non-Hispanic White children. Vulnerable socio-demographic characteristics and poorly controlled asthma status affect HRQOL in children. This finding encourages interventions to improve asthma control status and HRQOL in minority children. © 2016 John Wiley & Sons Ltd.

  13. Dementia and cognitive disorder identified at a forensic psychiatric examination - a study from Sweden.

    Science.gov (United States)

    Ekström, Anette; Kristiansson, Marianne; Björkstén, Karin Sparring

    2017-09-18

    Few studies have addressed the relationship between dementia and crime. We conducted a study of persons who got a primary or secondary diagnosis of dementia or cognitive disorder in a forensic psychiatric examination. In Sweden, annually about 500 forensic psychiatric examinations are carried out. All cases from 2008 to 2010 with the diagnoses dementia or cognitive disorder were selected from the database of the Swedish National Board of Forensic Medicine. Out of 1471 cases, there were 54 cases of dementia or cognitive disorder. Case files were scrutinized and 17 cases of dementia and 4 cases of cognitive disorder likely to get a dementia diagnosis in a clinical setting were identified and further studied. There were 18 men and 3 women; Median age 66 (n = 21; Range 35-77) years of age. Eleven men but no women had a previous criminal record. There were a total of 38 crimes, mostly violent, committed by the 21 persons. The crimes were of impulsive rather that pre-meditated character. According to the forensic psychiatric diagnoses, dementia was caused by cerebrovascular disorder (n = 4), alcohol or substance abuse (n = 3), cerebral haemorrhage and alcohol (n = 1), head trauma and alcohol (n = 2), Alzheimer's disease (n = 2), Parkinson's disease (n = 1), herpes encephalitis (n = 1) and unspecified (3). Out of four persons diagnosed with cognitive disorder, one also had delusional disorder and another one psychotic disorder and alcohol dependence. An alcohol-related diagnosis was established in ten cases. There were only two cases of Dementia of Alzheimer's type, one of whom also had alcohol intoxication. None was diagnosed with a personality disorder. All but one had a history of somatic or psychiatric comorbidity like head traumas, stroke, other cardio-vascular disorders, epilepsy, depression, psychotic disorders and suicide attempts. In this very ill group, the suggested verdict was probation in one case and different forms of care in the remaining

  14. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Controlling Tools for Control Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers ... Case Studies Open Airways for Schools Asthma Care Training Wee Wheezers Adventures of Puff Inner City Asthma ...

  15. An ADAM33 polymorphism associates with progression of preschool wheeze into childhood asthma: a prospective case-control study with replication in a birth cohort study.

    Directory of Open Access Journals (Sweden)

    Ester M M Klaassen

    Full Text Available The influence of asthma candidate genes on the development from wheeze to asthma in young children still needs to be defined.To link genetic variants in asthma candidate genes to progression of wheeze to persistent wheeze into childhood asthma.In a prospective study, children with recurrent wheeze from the ADEM (Asthma DEtection and Monitoring study were followed until the age of six. At that age a classification (transient wheeze or asthma was based on symptoms, lung function and medication use. In 198 children the relationship between this classification and 30 polymorphisms in 16 asthma candidate genes was assessed by logistic regression. In case of an association based on a p<0.10, replication analysis was performed in an independent birth cohort study (KOALA study, n = 248 included for the present analysis.In the ADEM study, the minor alleles of ADAM33 rs511898 and rs528557 and the ORMDL3/GSDMB rs7216389 polymorphisms were negatively associated, whereas the minor alleles of IL4 rs2243250 and rs2070874 polymorphisms were positively associated with childhood asthma. When replicated in the KOALA study, ADAM33 rs528557 showed a negative association of the CG/GG-genotype with progression of recurrent wheeze into childhood asthma (0.50 (0.26-0.97 p = 0.04 and no association with preschool wheeze.Polymorphisms in ADAM33, ORMDL3/GSDMB and IL4 were associated with childhood asthma in a group of children with recurrent wheeze. The replication of the negative association of the CG/GG-genotype of rs528557 ADAM33 with childhood asthma in an independent birth cohort study confirms that a compromised ADAM33 gene may be implicated in the progression of wheeze into childhood asthma.

  16. Gender Equality a case study of Sweden : Gender Equality Gender Equity and policies of combating inequality at workplace to make the society equal.

    OpenAIRE

    Sultan, Tipu

    2010-01-01

    The paper analyses Gender Equality, Gender Equity and policies of combating inequality at workplace to make the society equal as a case study of Sweden. The aim of paper is see the gender equality, gender equity, discrimination against women at workplace and to describe the policies combating inequality in the welfare state of Sweden. This work highlights the gender equality in terms of institutionalizing gender equality, gender equity, gender and pay gap, parental leave, gender and the pensi...

  17. Towards evidence-based palliative care in nursing homes in Sweden: a qualitative study informed by the organizational readiness to change theory

    OpenAIRE

    Nilsen, Per; Wallerstedt, Birgitta; Behm, Lina; Ahlstroem, Gerd

    2018-01-01

    Background: Sweden has a policy of supporting older people to live a normal life at home for as long as possible. Therefore, it is often the oldest, most frail people who move into nursing homes. Nursing home staff are expected to meet the existential needs of the residents, yet conversations about death and dying tend to cause emotional strain. This study explores organizational readiness to implement palliative care based on evidence-based guidelines in nursing homes in Sweden. The aim was ...

  18. Statistics available for site studies in registers and surveys at Statistics Sweden

    International Nuclear Information System (INIS)

    Haldorson, Marie

    2000-03-01

    Statistics Sweden (SCB) has produced this report on behalf of the Swedish Nuclear Fuel and Waste Management Company (SKB), as part of the data to be used by SKB in conducting studies of potential sites. The report goes over the statistics obtainable from SCB in the form of registers and surveys. The purpose is to identify the variables that are available, and to specify their degree of geographical detail and the time series that are available. Chapter two describes the statistical registers available at SCB, registers that share the common feature that they provide total coverage, i.e. they contain all 'objects' of a given type, such as population, economic activities (e.g. from statements of employees' earnings provided to the tax authorities), vehicles, enterprises or real estate. SCB has exclusive responsibility for seven of the nine registers included in the chapter, while two registers are ordered by public authorities with statistical responsibilities. Chapter three describes statistical surveys that are conducted by SCB, with the exception of the National Forest Inventory, which is carried out by the Swedish University of Agricultural Sciences. In terms of geographical breakdown, the degree of detail in the surveys varies, but all provide some possibility of reporting data at lower than the national level. The level involved may be county, municipality, yield district, coastal district or category of enterprises, e.g. aquaculture. Six of the nine surveys included in the chapter have been ordered by public authorities with statistical responsibilities, while SCB has exclusive responsibility for the others. Chapter four presents an overview of the statistics on land use maintained by SCB. This chapter does not follow the same pattern as chapters two and three but instead gives a more general account. The conclusion can be drawn that there are good prospects that SKB can make use of SCB's data as background information or in other ways when undertaking future

  19. Statistics available for site studies in registers and surveys at Statistics Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Haldorson, Marie [Statistics Sweden, Oerebro (Sweden)

    2000-03-01

    Statistics Sweden (SCB) has produced this report on behalf of the Swedish Nuclear Fuel and Waste Management Company (SKB), as part of the data to be used by SKB in conducting studies of potential sites. The report goes over the statistics obtainable from SCB in the form of registers and surveys. The purpose is to identify the variables that are available, and to specify their degree of geographical detail and the time series that are available. Chapter two describes the statistical registers available at SCB, registers that share the common feature that they provide total coverage, i.e. they contain all 'objects' of a given type, such as population, economic activities (e.g. from statements of employees' earnings provided to the tax authorities), vehicles, enterprises or real estate. SCB has exclusive responsibility for seven of the nine registers included in the chapter, while two registers are ordered by public authorities with statistical responsibilities. Chapter three describes statistical surveys that are conducted by SCB, with the exception of the National Forest Inventory, which is carried out by the Swedish University of Agricultural Sciences. In terms of geographical breakdown, the degree of detail in the surveys varies, but all provide some possibility of reporting data at lower than the national level. The level involved may be county, municipality, yield district, coastal district or category of enterprises, e.g. aquaculture. Six of the nine surveys included in the chapter have been ordered by public authorities with statistical responsibilities, while SCB has exclusive responsibility for the others. Chapter four presents an overview of the statistics on land use maintained by SCB. This chapter does not follow the same pattern as chapters two and three but instead gives a more general account. The conclusion can be drawn that there are good prospects that SKB can make use of SCB's data as background information or in other ways when

  20. Correlation between Bronchovascular and Cardiovascular Disorders in Children with Bronchial Asthma: Multifacetedness and Inexhaustibility of Problem Study

    Directory of Open Access Journals (Sweden)

    T.Ye. Shumna

    2014-11-01

    Full Text Available Due to tight functional interrelation between respiratory apparatus and blood circulation, exacerbation of bronchial asthma in children is associated with changes of cardiovascular system. Multifacetedness of this problem determines comprehensive approach to examination of children with bronchial asthma, involving most available methods of heart function evaluation: echocardiographic heart study with Doppler sonography and electrocardiography. Of great importance is investigation of systemic and pulmonary hemodynamics and microcirculation in bronchial asthma depending on its clinical course. It was found that children with exacerbation of bronchial asthma were detected with pulmonary hypertension, which had gradual regression after attack alleviation. During the remission stage, hemodynamics disturbances in lesser circulation were present in long-lasting and severe course of disease. However, the increase in the pulmonary blood flow parameters in patients only in the early period after attack can be regarded as a compensatory response from the lesser circulation to the decline in respiratory function indices. Therefore, despite the great achievements of science in the study of pathophysiological mechanisms and clinical features of bronchial asthma at different ages, it is necessary to continue further study of all aspects of bronchial asthma in children, because it is not as well studied as asthma in adults.

  1. Association between high school students’ cigarette smoking, asthma and related beliefs: a population-based study

    Directory of Open Access Journals (Sweden)

    Resa M. Jones

    2016-09-01

    Full Text Available Abstract Background Smoking has a detrimental effect on the symptoms and severity of asthma, a common chronic disease among adolescents. The purpose of this study was to examine the association between asthma and smoking among high school students and assess provider-patient communication with asthmatic adolescents regarding smoking and adolescents’ beliefs about the harms of smoking. Methods In fall 2014, data from high school students, ages 14–18 years, completing the 2009-2010 Virginia Youth Tobacco Survey (N = 1796 were used in descriptive analyses and multivariable logistic regression models adjusting for model-specific confounders as appropriate. Results Overall, an estimated 19 % of high school students in Virginia smoked and 16 % had asthma. Odds of smoking did not differ by asthma status; however, asthmatics had 1.5 times higher odds of being asked if they smoke (95 % CI 1.06–2.13 and being advised not to smoke by a health professional (95 % CI 1.10–2.14 compared to non-asthmatics. Asthmatics who believed second-hand smoke or smoking 1–5 cigarettes/day was not harmful had respectively 4.2 and 2.8 times higher odds of smoking than those who thought each was harmful. Further, asthmatics who thought smoking 1−2 years is safe had 3.4 times higher odds of smoking than those who did not (95 % CI 1.57–10.1. Conclusions While asthmatic adolescents are just as likely to smoke as non-asthmatics, less healthy beliefs about the risks of smoking increase the odds of smoking among asthmatics. Thus, targeted asthma-specific smoking prevention and education to change attitudes and beliefs could be an effective tool for adolescents.

  2. Exercise-induced bronchoconstriction in children with asthma: An observational cohort study.

    Science.gov (United States)

    Lin, Li-Lun; Huang, Shu-Jung; Ou, Liang-Shiou; Yao, Tsung-Chieh; Tsao, Kuo-Chieh; Yeh, Kuo-Wei; Huang, Jing-Long

    2017-09-06

    The diagnosis of exercise-induced bronchoconstriction (EIB) was established by changes in lung function after exercise challenge. The prevalence of EIB and factors related to EIB were not fully described in children with asthma. The aim of this study was to investigate the prevalence and predictors of EIB in children with asthma. A total of 149 children with physician-diagnosed asthma above 5 years of age underwent standardized treadmill exercise challenge for EIB and methacholine challenge for airway hyper-responsiveness from October 2015 to December 2016. EIB presented in 52.5% of children with asthma. Compared with children without EIB, there were more patients with atopic dermatitis in children with EIB (p = 0.038). Allergic to Dermatohagoides pteronyssinus and Dermatophagoides farinae were also found more in children with EIB (p = 0.045 and 0.048 respectively). Maximal decrease in forced expiratory volume in 1 s (FEV 1 ) were highest in patients who were most sensitive to methacholine provocation (provocation concentration causing 20% fall in FEV1 [PC 20 ] ≤ 1 mg/mL). Patients, who were more sensitive to methacholine challenge (with lower PC 20 levels), develop EIB with more decline in FEV 1 after exercise challenge (p = 0.038). Among patients with EIB, airflow limitation development in patient with methacholine-induced airway hyper-responsiveness was more abrupt and severe compared with patients without airway hyper-responsiveness (p = 0.045 and 0.033 respectively). EIB presented in 52.5% of children with asthma. The more severe methacholine-induced hyper-responsiveness, the higher prevalence of EIB as well as the severity. Copyright © 2017. Published by Elsevier B.V.

  3. Psychiatric disorders and violent reoffending: a national cohort study of convicted prisoners in Sweden.

    Science.gov (United States)

    Chang, Zheng; Larsson, Henrik; Lichtenstein, Paul; Fazel, Seena

    2015-10-01

    Reoffending and presence of psychiatric disorders are common in prisoners worldwide. However, whether psychiatric disorders are risk factors for reoffending is still unknown. We aimed to examine the association between psychiatric disorders, including substance use disorder, and violent reoffending. We did a longitudinal cohort study of 47,326 prisoners who were imprisoned since Jan 1, 2000, and released before Dec 31, 2009, in Sweden. We obtained data for diagnosed psychiatric disorders from both inpatient and outpatient registers, and sociodemographic and criminological factors from other population-based registers. We calculated hazard ratios (HRs) for violent reoffending with Cox regression. To control for potential familial confounding, we compared sibling prisoners with and without psychiatric disorders. We calculated population attributable fraction to assess the population effect. Diagnosed psychiatric disorders were associated with an increased hazard of violent reoffending in male (adjusted HR 1·63 [95% CI 1·57-1·70]) and female (2·02 [1·54-2·63]) prisoners, and these associations were independent of measured sociodemographic and criminological factors, and, in men, remained substantial after adjustment for unmeasured familial factors (2·01 [1·66-2·43]). However, findings differed between individual diagnoses and sex. We found some evidence of stronger effects on violent reoffending of alcohol and drug use disorders and bipolar disorder than of other psychiatric disorders. Alcohol use disorder seemed to have a greater effect in women than in men (women 2·08 [1·66-2·60]; men 1·63 [1·56-1·71]). The overall effects of psychiatric disorders did not differ with severity of crime. The hazard of violent reoffending increased in a stepwise way with the number of diagnosed psychiatric disorders. Assuming causality, up to 20% (95% CI 19-22) of violent reoffending in men and 40% (27-52) in women was attributable to the diagnosed psychiatric disorders

  4. Psychiatric disorders and violent reoffending: a national cohort study of convicted prisoners in Sweden

    Science.gov (United States)

    Chang, Zheng; Larsson, Henrik; Lichtenstein, Paul; Fazel, Seena

    2015-01-01

    Summary Background Reoffending and presence of psychiatric disorders are common in prisoners worldwide. However, whether psychiatric disorders are risk factors for reoffending is still unknown. We aimed to examine the association between psychiatric disorders, including substance use disorder, and violent reoffending. Methods We did a longitudinal cohort study of 47 326 prisoners who were imprisoned since Jan 1, 2000, and released before Dec 31, 2009, in Sweden. We obtained data for diagnosed psychiatric disorders from both inpatient and outpatient registers, and sociodemographic and criminological factors from other population-based registers. We calculated hazard ratios (HRs) for violent reoffending with Cox regression. To control for potential familial confounding, we compared sibling prisoners with and without psychiatric disorders. We calculated population attributable fraction to assess the population effect. Findings Diagnosed psychiatric disorders were associated with an increased hazard of violent reoffending in male (adjusted HR 1·63 [95% CI 1·57–1·70]) and female (2·02 [1·54–2·63]) prisoners, and these associations were independent of measured sociodemographic and criminological factors, and, in men, remained substantial after adjustment for unmeasured familial factors (2·01 [1·66–2·43]). However, findings differed between individual diagnoses and sex. We found some evidence of stronger effects on violent reoffending of alcohol and drug use disorders and bipolar disorder than of other psychiatric disorders. Alcohol use disorder seemed to have a greater effect in women than in men (women 2·08 [1·66–2·60]; men 1·63 [1·56–1·71]). The overall effects of psychiatric disorders did not differ with severity of crime. The hazard of violent reoffending increased in a stepwise way with the number of diagnosed psychiatric disorders. Assuming causality, up to 20% (95% CI 19–22) of violent reoffending in men and 40% (27–52) in women was

  5. 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....

  6. Prescription of respiratory medication without an asthma diagnosis in children: a population based study.

    NARCIS (Netherlands)

    Zuidgeest, M.G.P.; Dijk, L. van; Smit, H.A.; Wouden, J.C. van der; Brunekreef, B.; Leufkens, H.G.M.; Bracke, M.

    2008-01-01

    BACKGROUND: In pre-school children a diagnosis of asthma is not easily made and only a minority of wheezing children will develop persistent atopic asthma. According to the general consensus a diagnosis of asthma becomes more certain with increasing age. Therefore the congruence between asthma

  7. Breathing retraining for African-American adolescents with asthma: a pilot study of a school-based randomized controlled trial.

    Science.gov (United States)

    Bignall, Whitney Janee Raglin; Luberto, Christina Marie; Cornette, Adrianne Falkenberg; Haj-Hamed, Monzer; Cotton, Sian

    2015-01-01

    Asthma affects approximately seven million children/adolescents in the USA, with African-American children disproportionately affected. Breathing retraining techniques have been shown to improve asthma outcomes in adults, though research in youth is limited. The purpose of this pilot study was to test the feasibility and preliminary efficacy of a school-based randomized controlled trial of breathing retraining for asthma outcomes and anxiety symptoms in a sample of urban, African-American adolescents. Adolescents were randomized into either the intervention group (20-min breathing retraining plus education) or control group (20-min standard education). Participants completed two study visits, one month apart. Asthma control, asthma quality of life and lung functioning (FEV1 and peak flow) were the primary outcomes, and state anxiety (pre-post the intervention) and trait anxiety (over the one-month period) were the secondary outcomes. Thirty-three African-American adolescents participated in the study, with a 90% retention rate between visit 1 and visit 2. Asthma control and asthma quality of life, significantly improved over time (p ≤ 0.01) with no differences between intervention and control groups. State anxiety significantly decreased (p ≤ 0.01) immediately post intervention at both time points with no differences between groups. There were no significant differences found in lung functioning or trait anxiety over the one-month time period. These preliminary results suggest that breathing retraining is a feasible, acceptable and potentially efficacious intervention (although no significant differences between groups were found) for improving asthma symptoms in urban adolescents with asthma in a school-based setting.

  8. Gun Violence, African Ancestry, and Asthma: A Case-Control Study in Puerto Rican Children.

    Science.gov (United States)

    Rosas-Salazar, Christian; Han, Yueh-Ying; Brehm, John M; Forno, Erick; Acosta-Pérez, Edna; Cloutier, Michelle M; Alvarez, María; Colón-Semidey, Angel; Canino, Glorisa; Celedón, Juan C

    2016-06-01

    Exposure to gun violence and African ancestry have been separately associated with increased risk of asthma in Puerto Rican children. The objective of this study was to examine whether African ancestry and gun violence interact on asthma and total IgE in school-aged Puerto Rican children. This is a case-control study of 747 Puerto Rican children aged 9 to 14 years living in San Juan, Puerto Rico (n = 472), and Hartford, Connecticut (n = 275). Exposure to gun violence was defined as the child's report of hearing gunshots more than once, and the percentage of African ancestry was estimated using genome-wide genotypic data. Asthma was defined as parental report of physician-diagnosed asthma and wheeze in the previous year. Serum total IgE (IU/mL) was measured in study participants. Multivariate logistic and linear regressions were used for the analysis of asthma and total IgE, respectively. In multivariate analyses, there was a significant interaction between exposure to gun violence and African ancestry on asthma (P = .001) and serum total IgE (P = .04). Among children exposed to gun violence, each quartile increase in the percentage of African ancestry was associated with approximately 45% higher odds of asthma (95% CI, 1.15-1.84; P = .002) and an approximately 19% increment in total IgE (95% , 0.60-40.65, P = .04). In contrast, there was no significant association between African ancestry and asthma or total IgE in children not exposed to gun violence. Our results suggest that exposure to gun violence modifies the estimated effect of African ancestry on asthma and atopy in Puerto Rican children. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  9. Asthma and asthma related symptoms in 23,326 Chinese children in relation to indoor and outdoor environmental factors: The Seven Northeastern Cities (SNEC) Study

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Fan, E-mail: liufan-sky@163.com [Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, Liaoning Province 110001 (China); Zhao, Yang, E-mail: zhaoyang_cmu@126.com [Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001 (China); Liu, Yu-Qin, E-mail: xinxin_lyq@163.com [Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001 (China); Liu, Yang, E-mail: liuyang071506@126.com [Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001 (China); Sun, Jing, E-mail: sunjingjl_2007@126.com [Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001 (China); Huang, Mei-Meng, E-mail: gghuangmeimeng@163.com [Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001 (China); Liu, Yi, E-mail: liuyi256@126.com [Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, Liaoning Province 110001 (China); Dong, Guang-Hui, E-mail: donggh5@mail.sysu.edu.cn [Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province 510080 (China)

    2014-11-01

    Background: Both the levels and patterns of outdoor and indoor air pollutants have changed dramatically during the last decade in China. However, few studies have evaluated the effects of the present air pollution on the health of Chinese children. This study examines the association between outdoor and indoor air pollution and respiratory diseases among children living in Liaoning, a heavy industrial province of China. Methods: A cross-sectional study of 23,326 Chinese children aged 6 to 13 years was conducted in 25 districts of 7 cities in Northeast China during 2009. Three-year (2006–2008) average concentrations of particles with an aerodynamic diameter of ≤ 10 μm (PM{sub 10}), sulfur dioxide (SO{sub 2}), nitrogen dioxides (NO{sub 2}), and ozone (O{sub 3}) were calculated from monitoring stations in each of the 25 districts. We used two-level logistic regression models to examine the effects of yearly variations in exposure to each pollutant, controlling for important covariates. Results: The prevalence of respiratory symptoms was higher for those dwelling close to a busy road, those living near smokestacks or factories, those living with smokers, those living in one-story houses typically with small yards, and those with home renovation, bedroom carpet or pets. Ventilation device use was associated with decreased odds of asthma in children. The adjusted odds ratio for diagnosed-asthma was 1.34 (95% confidence interval [CI], 1.24–1.45) per 31 μg/m{sup 3} increase in PM{sub 10}, 1.23 (95%CI, 1.14–1.32) per 21 μg/m{sup 3} increase in SO{sub 2}, 1.25 (95%CI, 1.16–1.36) per 10 μg/m{sup 3} increase in NO{sub 2}, and 1.31 (95%CI, 1.21–1.41) per 23 μg/m{sup 3} increase in O{sub 3}, respectively. Conclusion: Outdoor and indoor air pollution was associated with an increased likelihood of respiratory morbidity among Chinese children. - Highlights: • We studied air pollution and respiratory health in 23,326 Chinese children. • Home renovation, carpet

  10. Natural radioactivity in selected waterworks and private wells in Sweden. A pilot study

    International Nuclear Information System (INIS)

    Oestergren, I.; Falk, R.; Mjoenes, L.; Ek, B.M.

    2003-01-01

    Naturally occurring radioactive elements are present in all ground waters. Groundwater from rock aquifers can contain relatively high concentrations of natural radionuclides, especially in areas with uranium-rich granites and pegmatite. Sweden has relatively high levels of natural radioactive elements in the groundwater. In this investigation we have carried out measurements in order to estimate alpha- and beta-emitting natural radionuclides. The alphaemitting nuclides are primarily 238 U, 234 U, 226 Ra and 210 Po. The most important beta-emitting nuclides are 210 Pb and 228 Ra. In the European Drinking Water Directive, 98/83/EC, a reference value of 0.1 millisievert, mSv, per year for Total Indicative Dose, TID, from consumption of drinking water is given. TID includes all radionuclides in drinking water, both artificial and natural, with the exception of radon, radon progeny, 40 K and tritium. A first indication of that TID might exceed 0.1 mSv is that the gross alpha activity concentration exceeds 0.1 Bq/l or that the gross beta activity concentration exceeds 1 Bq/l. A new Swedish Drinking Water Ordinance implementing the new directive has come into force but will not be put into practice until December 2003 (SLV FS 2001:30). Sweden has had action levels for radon in drinking water since 1997 (SLV FS 1997:32). The action level for radon in water from public water supplies is 100 Bq/l. For private wells the recommended maximum level is 1,000 Bq/l. Sweden has about 2,100 public water supplies and 200,000 private drilled wells used permanently and another 100,000 used in summerhouses. Altogether about 1.2 million of the Swedish population rely on private water supplies. (orig.)

  11. Computer-assisted school-based asthma management: a pilot study.

    Science.gov (United States)

    Arnold, Renée Jg; Stingone, Jeanette A; Claudio, Luz

    2012-11-13

    The high prevalence of asthma among children continues to be a major public health issue. In particular, low-income African-American and Hispanic children often receive asthma care in the emergency department and lack access to continuity of care. The aim of the current study was to test the feasibility of implementing a computerized program for empowering low-income children with asthma to manage their own disease. This pilot program consisted of a guided, personalized, Web-based computer program as the main component of a school-based asthma intervention. The Automated Live E-Health Response Tracking System (ALERTS), a computer-assisted, Web-based tracking program, was tested for implementation in a school in East Harlem, New York. The program required children with asthma, assisted by trained researchers, to routinely measure their peak flow meter readings and answer a symptom questionnaire. The program provided individualized feedback on their disease status based on peak flow meter input. The computer program sent reports to the child's physician and the nurse practitioner at the on-site school health center. The children were also encouraged to bring the reports home to their parents. A pre/post study design was employed such that each participant acted as his/her own control. Comparisons of preintervention and postintervention outcomes were calculated using the paired t-test and the McNemar test for dichotomous data. Twenty-four children (6 to 12 years) participated in the program over 2 to 15 months. Improvements in health outcomes showed the greatest significance among the group of participants who were enrolled for 8 months or longer. Statistically significant improvements were seen in the average physical health score of the children (from 65.64 preintervention to 76.28 postintervention, P = .045). There was a significant decrease in the number of participants experiencing wheezing episodes (n = 9 to n = 2, P = .03), and in the average number of

  12. Prevalence of asthma and allergic diseases in adolescents: nine-year follow-up study (2003-2012).

    Science.gov (United States)

    Solé, Dirceu; Rosário Filho, Nelson A; Sarinho, Emanuel S; Camelo-Nunes, Inês C; Barreto, Bruno A Paes; Medeiros, Mércia L; Franco, Jackeline Motta; Camargos, Paulo A; Mallol, Javier; Gurgel, Ricardo; Andrade, Djanira M de; Furlan, Fernanda P; Silva, Almerinda R; Cardozo, Cristina; Andrade, Cláudia

    2015-01-01

    To determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema in adolescents (AD; 13-14 years) living in seven Brazilian cities, by applying the standardized written questionnaire (WQ) of the International Study of Asthma and Allergies in Childhood (ISAAC), and to evaluate the time trend nine years after the last assessment of ISAAC phase 3 (ISP3). The ISAAC-WQ was answered by 20,099 AD from the Northern, Northeastern, Southeastern, and Southern Brazilian regions. Values obtained were compared to those observed in ISP3 using nonparametric (chi-squared or Fisher) tests, and the ratio of annual increment/decrement was established for each of the centers, according to the symptom assessed. Considering the national data and comparing to values of ISP3, there was a decrease in the mean prevalence of active asthma (18.5% vs. 17.5%) and an increase in the frequency of severe asthma (4.5% vs. 4.7%) and physician-diagnosed asthma (14.3% vs. 17.6%). An increase in prevalence of rhinitis, rhinoconjunctivitis, and atopic eczema was also observed. The prevalence of asthma, rhinitis, and atopic eczema in Brazil was variable; higher prevalence values, especially of asthma and eczema, were observed in regions located closer to the Equator. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  13. Prevalence of asthma and allergic diseases in adolescents: nine-year follow-up study (2003-2012

    Directory of Open Access Journals (Sweden)

    Dirceu Solé

    2015-02-01

    Full Text Available OBJECTIVE: To determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema in adolescents (AD; 13-14 years living in seven Brazilian cities, by applying the standardized written questionnaire (WQ of the International Study of Asthma and Allergies in Childhood (ISAAC, and to evaluate the time trend nine years after the last assessment of ISAAC phase 3 (ISP3. METHODS: The ISAAC-WQ was answered by 20,099 AD from the Northern, Northeastern, Southeastern, and Southern Brazilian regions. Values obtained were compared to those observed in ISP3 using nonparametric (chi-squared or Fisher tests, and the ratio of annual increment/decrement was established for each of the centers, according to the symptom assessed. RESULTS: Considering the national data and comparing to values of ISP3, there was a decrease in the mean prevalence of active asthma (18.5% vs. 17.5% and an increase in the frequency of severe asthma (4.5% vs. 4.7% and physician-diagnosed asthma (14.3% vs. 17.6%. An increase in prevalence of rhinitis, rhinoconjunctivitis, and atopic eczema was also observed. CONCLUSIONS: The prevalence of asthma, rhinitis, and atopic eczema in Brazil was variable; higher prevalence values, especially of asthma and eczema, were observed in regions located closer to the Equator.

  14. Risk of Obstructive Sleep Apnea in Adult Patients with Asthma: A Population-Based Cohort Study in Taiwan.

    Directory of Open Access Journals (Sweden)

    Te-Chun Shen

    Full Text Available There are several publications reported that obstructive sleep apnea (OSA was associated with asthma. However, large-scaled, population-based cohort study has been limited. We aimed to examine the risk of OSA among adult patients with asthma in an Asian population.We conducted a retrospective cohort study using data from the National Health Insurance (NHI of Taiwan. The asthma cohort included 38,840 newly diagnosed patients between 2000 and 2010. The date of diagnosis was defined as the index date. Each patient was randomly matched with four people without asthma according to gender, age, and the index year as the comparison cohort. The occurrence of OSA was followed up until the end of 2011. The risk of OSA was estimated using the Cox proportional hazard model after adjusting for gender, age, and comorbidities.The overall incidence of OSA was 2.51-fold greater in the asthma cohort than in the comparison cohort (12.1 versus 4.84 per 1000 person-years. Compared to non-asthma subjects, the adjusted hazard ratio (aHR of OSA increased to 1.78 for asthma patients with one or less annual emergency room (ER visit, and 23.8 for those who visited ER more than once per year. In addition, aHR in patients with inhaled steroid treatment compared to those without steroid treatment was 1.33 (95% CI = 1.01-1.76.Patients with asthma have a significantly higher risk of developing OSA than the general population. The results suggest that the risk of OSA is proportional to asthma control and patients with inhaled steroid treatment have a higher risk for OSA than those without steroid treatment.

  15. Two tales of cardiovascular risks-middle-aged women living in Sweden and Scotland: a cross-sectional comparative study.

    Science.gov (United States)

    Wennerholm, Carina; Bromley, Catherine; Johansson, AnnaKarin; Nilsson, Staffan; Frank, John; Faresjö, Tomas

    2017-08-07

    To compare cardiovascular risk factors as well as rates of cardiovascular diseases in middle-aged women from urban areas in Scotland and Sweden. Comparative cross-sectional study. Data from the general population in urban areas of Scotland and the general population in two major Swedish cities in southeast Sweden, south of Stockholm. Comparable data of middle-aged women (40-65 years) from the Scottish Health Survey (n=6250) and the Swedish QWIN study (n=741) were merged together into a new dataset (n=6991 participants). We compared middle-aged women in urban areas in Sweden and Scotland regarding risk factors for cardiovascular disease (CVD), CVD diagnosis, anthropometrics, psychological distress and lifestyle. In almost all measurements, there were significant differences between the countries, favouring the Swedish women. Scottish women demonstrated a higher frequency of alcohol consumption, smoking, obesity, low vegetable consumption, a sedentary lifestyle and also more psychological distress. For doctor-diagnosed coronary heart disease, there were also significant differences, with a higher prevalence among the Scottish women. This is one of the first studies that clearly shows that Scottish middle-aged women are particularly affected by a worse profile of CVD risks. The profound differences in CVD risk and outcome frequency in the two populations are likely to have arisen from differences in the two groups of women's social, cultural, political and economic environments. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Work-related health factors among female immigrants in Sweden - A qualitative study on a sample of twenty workers

    Directory of Open Access Journals (Sweden)

    Sharareh Akhavan

    2006-03-01

    Full Text Available

    Aims: The purpose of this study was to explore work-related health factors amongst female immigrants in Sweden.

    Methods: Qualitative methods were used in order to get the broadest possible picture of female immigrants’ perceptions on work-related health factors. Semi-structured interviews were conducted with twenty female immigrants who worked in different departments of a municipality adjacent to a large city in Sweden. Most of the interviewed women came from the Middle East, Africa and Latin America, while some came from eastern and southern Europe as well as Finland. The women had lived in Sweden for 5-27 years. Content analysis, which is based on analysis by topic, was used to analyse the data.

    Results: Results from the interviews show that female immigrants perceived that work-related health is strongly associated with class. The three aspects of class that arose from this study were wage, professional status and their position within the organisations hierarchy. Other factors that were identified as being associated to work-related health were discrimination due to ethnicity and gender, unfavourable physical and psychosocial work environment and lack of training opportunities for upgrading their skills.

    Conclusions: The public health implications of the findings in this study suggest that measures that ought to be taken to improve female immigrants working conditions and health are primarily systematic efforts to counteract discrimination because of gender and ethnicity in areas such as wage setting and opportunities for skill up-grade training. This should result in improved employment opportunities for female immigrants, particularly those who work in low status and low-paid jobs.

  17. Work-site wellness programmes in Sweden: a cross-sectional study of physical activity, self-efficacy, and health.

    Science.gov (United States)

    Gånedahl, H; Zsaludek Viklund, P; Carlén, K; Kylberg, E; Ekberg, J

    2015-05-01

    In Sweden, a work-site wellness programme implies reimbursing some of the expenses for health-promoting activities. Although work-site wellness programmes are readily available in Sweden, a large number of employees elect not to participate. The aim of this study was to investigate the association of physical activity, self-reported general health assessment and self-efficacy with participation in a work-site wellness programme. A cross-sectional study design was used. An online questionnaire was distributed to employees of a manufacturing company with 2500 employees in southwest Sweden. Those who took advantage of the work-site wellness programme assessed their general health as better and had higher assessment of physical activity. The study showed that being enlisted also implies a higher level of physical activity and general health; however, the effect sizes of these correlations were small. Self-efficacy, i.e. perceived behavioural control, was not associated with participation in the work-site wellness programme. However, self-efficacy was correlated with both general health assessment and physical activity. A regression analysis to determine explanatory contributions to the general health assessment score showed no significant contribution from participation in a work-site wellness programme, but was instead explained by perceived behavioural control and physical activity. Given the small effect size of the difference in physical activity between participators and non-participators in the work-site wellness programme, it is probable that only a small proportion of participators changed their health-promoting activities as a result of the work-site wellness programme. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  18. Alport syndrome in southern Sweden

    DEFF Research Database (Denmark)

    Persson, U; Hertz, Jens Michael; Wieslander, J

    2005-01-01

    The aim of the present investigation is to study the epidemiology of Alport syndrome in southern Sweden, to search for mutations in the COL4A5 gene and to estimate the mutation frequency.......The aim of the present investigation is to study the epidemiology of Alport syndrome in southern Sweden, to search for mutations in the COL4A5 gene and to estimate the mutation frequency....

  19. Gendered experiences of work environment : A study of stress and ambiguity among dental students in Sweden

    OpenAIRE

    Schéle, Ingrid

    2011-01-01

    This thesis explores how dental students experience their education. We aim to generate ways to understand which elements relate to the students’ experience based on current theories and models regarding the quality of working life and gender (and) power relations.   Methods Twelve interviews with Umeå dental students in their clinical semesters were analysed with a Grounded Theory (GT) as well as a content analysis approach. A web-survey was sent to all clinical dental students in Sweden (P ...

  20. The function of medication beliefs as mediators between personality traits and adherence behavior in people with asthma

    Directory of Open Access Journals (Sweden)

    Axelsson M

    2013-10-01

    Full Text Available Malin Axelsson,1,2 Christina Cliffordson,2 Bo Lundbäck,1 Jan Lötvall11Krefting Research Centre, Institute of Medicine, Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 2Department of Nursing, Health and Culture, University West, Trollhättan, SwedenBackground: There is evidence that both personality traits and personal beliefs about medications affect adherence behavior. However, limited research exists on how personality and beliefs about asthma medication interact in influencing adherence behavior in people with asthma. To extend our knowledge in this area of adherence research, we aimed to determine the mediating effects of beliefs about asthma medication between personality traits and adherence behavior.Methods: Asthmatics (n=516 selected from a population-based study called West Sweden Asthma Study completed the Neuroticism, Extraversion and Openness to Experience Five-Factor Inventory, the Medication Adherence Report Scale, and the Beliefs about Medicines Questionnaire. Data were analyzed using confirmatory factor analysis and structural equation modeling.Results: Three of the five investigated personality traits – agreeableness, conscientiousness, and neuroticism – were associated with both concerns about asthma medication and adherence behavior. Concerns functioned as a partial mediator for the influencing effects of agreeableness, conscientiousness, and neuroticism on adherence behavior.Conclusion: The findings suggest that personality traits could be used to identify individuals with asthma who need support with their adherence behavior. Additionally, targeting concerns about asthma medication in asthmatics with low levels of agreeableness or conscientiousness or high levels of neuroticism could have a favorable effect on their adherence behavior.Keywords: adherence, individual differences, medication concerns, health behavior

  1. Severe Asthma in Children.

    Science.gov (United States)

    Chipps, Bradley E; Parikh, Neil G; Maharaj, Sheena K

    2017-04-01

    The aim of this study is to characterize, diagnose, evaluate, and treat severe childhood asthma. Understanding the occurrence of the physiologic and clinical presentations of childhood severe asthma, the treatment and response may be predicted by biomarkers, but the patient's response is highly variable. The onset of severe asthma occurs early and is primarily predicted by severity of viral infection and coexistence of the atopic state.

  2. Illicit Drug Use Among Gym-Goers: a Cross-sectional Study of Gym-Goers in Sweden

    OpenAIRE

    Molero, Yasmina; Bakshi, Ann-Sofie; Gripenberg, Johanna

    2017-01-01

    Background The use of anabolic-androgenic steroids has increased among gym-goers, and it has been proposed that this may be part of a polysubstance use pattern that includes the use of illicit drugs. Still, epidemiological data on illicit drug use among gym-goers of both genders are meager. The aim of the present study was thus to examine the use of illicit drugs and its correlates in a large sample of men and women who engaged in weight training at gyms across Sweden. Methods In this cross-s...

  3. Individual traffic-related air pollution and new onset adult asthma:A GIS-based pilot study

    DEFF Research Database (Denmark)

    Lysbeck Hansen, Carl; Jensen, Steen Solvang; Baelum, Jesper

    successfully identified for all study participants (N=33). Using AirGIS traffic-related air pollutant levels from both urban background and street level were estimated for the 10 year study period on an hourly basis. Individual levels of air pollutants in the years preceding debut of asthma or wheeze were...... analyzed using survival analysis. The project showed that accumulated individual median NO2 exposure (mg/m3 x hour) for the 10 year study period was 1,145 (asthma cases), 1,268 (wheeze cases) and 1,005 (controls). No significant correlations between exposure levels and onset of disease or symptom were......The background for the project is that traffic-related air pollution may provoke the onset of asthma. The objective of this pilot study is to investigate the relation between asthma and wheeze debut and individually estimated exposure to traffic-related air pollutants with a validated exposure...

  4. Pharmacists' views on the development of asthma pharmaceutical care model in Indonesia: A needs analysis study.

    Science.gov (United States)

    Widayati, Aris; Virginia, Dita Maria; Setiawan, Christianus Heru; Fenty, Fenty; Donowati, Maria Wisnu; Christasani, Putu Dyana; Hartayu, Titien Siwi; Suhadi, Rita; Saini, Bandana; Armour, Carol

    2018-01-30

    Over recent years the pharmacy profession in Indonesia has adopted a stance of pharmaceutical care to expand their scope of practice. Asthma management presents a key opportunity for pharmacists to test expanded roles in health service provision. There is however no exploratory work on the willingness, experience or future practice needs of Indonesian pharmacists in the realm of specialised asthma service provision. The objectives of this study were to explore Indonesian pharmacists' experiences, perspectives, and needs regarding the provision of pharmaceutical care for asthma patients in Indonesia. The study utilised conventional qualitative content analyses with two stages, i.e.: deductive analyses and inductive concept development. Data were collected using Focus Group Discussion (FGD) Method. FGDs were conducted using a topic guide and by facilitators trained in FGD conduct. FGDs were audio-recorded and transcribed verbatim prior to analysis. A maximum variation sampling methods targeted pharmacist across various settings of practice within Yogyakarta Indonesia. Nine focus groups with 103 pharmacist participants were conducted, with an average of 11 participants in each group. Inductively derived concepts that emerged included: willingness to adopt asthma service provision roles, pragmatism in recognising essential barriers/facilitators in adopting such roles, reflections regarding practice gaps and barriers to interprofessional collaboration mainly in relation to doctors. Inductive data analysis indicated clear differences in responses between hospital and non-hospital pharmacists. Key barriers to service provision included lack of training, lack of supportive professional frameworks, time and lack of reimbursement channels for services. Participants urged for a visionary leadership to facilitate pharmacists' role expansion into health services provision in Indonesia. Indonesian pharmacists were willing to adopt change and reported universally recognised

  5. Implementation of information systems at pharmacies - a case study from the re-regulated pharmacy market in Sweden.

    Science.gov (United States)

    Hammar, Tora; Ohlson, Mats; Hanson, Elizabeth; Petersson, Göran

    2015-01-01

    When the Swedish pharmacy market was re-regulated in 2009, Sweden moved from one state-owned pharmacy chain to several private pharmacy companies, and four new dispensing systems emerged to replace the one system that had previously been used at all Swedish pharmacies for more than 20 years. The aim of this case study was to explore the implementation of the new information systems for dispensing at pharmacies. The vendors of the four dispensing systems in Sweden were interviewed, and a questionnaire was sent to the managers of the pharmacy companies. In addition, a questionnaire was sent to 350 pharmacists who used the systems for dispensing prescriptions. The implementation of four new dispensing systems followed a strict time frame set by political decisions, involved actors completely new to the market, lacked clear regulation and standards for functionality and quality assurance, was complex and resulted in variations in quality. More than half of the pharmacists (58%) perceived their current dispensing system as supporting safe dispensing of medications, 26% were neutral and 15% did not perceive it to support a safe dispensing. Most pharmacists (80%) had experienced problems with their dispensing system during the previous month. The pharmacists experienced problems included reliability issues, usability issues, and missing functionality. In this case study exploring the implementation of new information systems for dispensing prescriptions at pharmacies in Sweden, weaknesses related to reliability, functionality and usability were identified and could affect patient safety. The weaknesses of the systems seem to result from the limited time for the development and implementation, the lack of comprehensive and evidence-based requirements for dispensing systems, and the unclear distribution of quality assurance responsibilities among involved stakeholders. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. The Canadian Healthy Infant Longitudinal Development (CHILD) Study: examining developmental origins of allergy and asthma.

    Science.gov (United States)

    Subbarao, Padmaja; Anand, Sonia S; Becker, Allan B; Befus, A Dean; Brauer, Michael; Brook, Jeffrey R; Denburg, Judah A; HayGlass, Kent T; Kobor, Michael S; Kollmann, Tobias R; Kozyrskyj, Anita L; Lou, W Y Wendy; Mandhane, Piushkumar J; Miller, Gregory E; Moraes, Theo J; Pare, Peter D; Scott, James A; Takaro, Tim K; Turvey, Stuart E; Duncan, Joanne M; Lefebvre, Diana L; Sears, Malcolm R

    2015-10-01

    The Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort study recruited 3624 pregnant women, most partners and 3542 eligible offspring. We hypothesise that early life physical and psychosocial environments, immunological, physiological, nutritional, hormonal and metabolic influences interact with genetics influencing allergic diseases, including asthma. Environmental and biological sampling, innate and adaptive immune responses, gene expression, DNA methylation, gut microbiome and nutrition studies complement repeated environmental and clinical assessments to age 5. This rich data set, linking prenatal and postnatal environments, diverse biological samples and rigorous phenotyping, will inform early developmental pathways to allergy, asthma and other chronic inflammatory diseases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. Disclosing victimisation to healthcare professionals in Sweden: a constructivist grounded theory study of experiences among men exposed to interpersonal violence.

    Science.gov (United States)

    Simmons, Johanna; Brüggemann, Adrianus Jelmer; Swahnberg, Katarina

    2016-06-20

    To develop a theoretical model concerning male victims' processes of disclosing experiences of victimisation to healthcare professionals in Sweden. Qualitative interview study. Informants were recruited from the general population and a primary healthcare centre in Sweden. Informants were recruited by means of theoretical sampling among respondents in a previous quantitative study. Eligible for this study were men reporting sexual, physical and/or emotional violence victimisation by any perpetrator and reporting that they either had talked to a healthcare provider about their victimisation or had wanted to do so. Constructivist grounded theory. 12 interviews were performed and saturation was reached after 9. Several factors influencing the process of disclosing victimisation can be recognised from previous studies concerning female victims, including shame, fear of negative consequences of disclosing, specifics of the patient-provider relationship and time constraints within the healthcare system. However, this study extends previous knowledge by identifying strong negative effects of adherence to masculinity norms for victimised men and healthcare professionals on the process of disclosing. It is also emphasised that the process of disclosing cannot be separated from other, even seemingly unrelated, circumstances in the men's lives. The process of disclosing victimisation to healthcare professionals was a complex process involving the men's experiences of victimisation, adherence to gender norms, their life circumstances and the dynamics of the actual healthcare encounter. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Stable carbon and oxygen isotope studies of Late Weichselian lake sediments in southern Sweden and northern Poland, with palaeoclimatic implications

    International Nuclear Information System (INIS)

    Hammarlund, D.

    1994-04-01

    Late Weichselian lacustrine sediment sequences from southern Sweden and northern Poland were studied by means of stable isotope analysis in order to reconstruct the climatic development and climatically induced environmental changes in the respective regions. The methods used include analyses of the stable carbon isotope composition (δ 13 C) of bulk organic material, and the stable carbon and oxygen isotope compositions (δ 13 C, δ 18 O) of bulk carbonates and carbonate shells of aquatic organisms. These results were complemented and supported by lithological, chemical and biostratigraphic data (plant macrofossils, insects, molluscs). Chronological data were obtained by AMS radiocarbon dates and correlations based on pollen analysis. At c. 12.400 BP a climatic change from arctic, dry, and continental, to subarctic and more humid and maritime conditions occurred in southern Sweden. The Older Dryas stadial (c.12.200-12.000 BP) is characterized by a temporary return to generally colder , drier, and more continental conditions, followed by generally favourable (subarctic), although unstable, climatic conditions. At c. 11.300 BP a gradual transition towards a colder and more continental climate was initiated, followed by total absence of limnic carbonates during the Younger Dryas stadial (c. 11.000-10.200 BP), indicating arctic and continental conditions. The transition to the Holocene is characterized by a rapid and strong climatic warming. The results from northern Poland point to some important differences compared to this development. A climatic warming around 13.000 BP was followed by generally favourable climatic conditions enabling continuous sedimentation of limnic carbonates during the Late Weichselian. Distinct depletions of 13 C in lacustrine organic material at the transition to the Holocene were recorded in southern Sweden, also demonstrated by decreasing mean values obtained from an extensive compilation of δ 13 C data. A number of processes that may

  9. Does asthma affect school performance in adolescents? Results from the Swedish population-based birth cohort BAMSE.

    Science.gov (United States)

    Nilsson, Sara; Ödling, Maria; Andersson, Niklas; Bergström, Anna; Kull, Inger

    2018-03-01

    Asthma is common among schoolchildren and may influence quality of life and school attendance. However, it is unclear if asthma affects school performance. The aim of this study was to examine whether different phenotypes of asthma affect school performance during adolescence. The study population consisted of 1715 adolescents from a population-based birth cohort, followed up to age 16 with questionnaires and clinical examinations. Asthma was defined as at least 4 wheeze episodes or at least 1 wheeze episode in combination with inhaled steroids in the last 12 months. School grades were obtained from Statistics Sweden, and logistic regression analysis was performed to investigate the association between the final overall grade from secondary school and asthma phenotypes. Among the adolescents, 20.8% have had ever asthma; 24.2% early transient, 47.2% school-age onset, and 24.2% persistent asthma. At 16 years, 7.8% had asthma; 71.7% multimorbidity and 73.9% allergic asthma. A statistically significant association for performing less well was seen for ever asthma (OR adj  = 1.43, 95% CI = 1.09-1.88). In analyses of asthma onset, an association was seen for school-age onset (OR adj  = 1.49, CI = 1.02-2.16) and a tendency for persistent asthma (OR adj  = 1.61, CI = 0.98-2.66), although with overlapping confidence intervals. Further, adolescents with uncontrolled asthma tended to perform less well (OR adj  = 2.60, CI = 0.87-7.80) compared to adolescents with partly controlled (OR adj  = 1.12, CI = 0.68-1.83) and fully controlled (OR adj  = 1.29, CI = 0.55-3.01) asthma. Our results indicate that asthma impairs school performance in adolescence. Moreover, some evidence suggests the adolescents with asthma during school age and with poorer asthma control to be more likely to perform less well. © 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

  10. Omalizumab in the management of patients with allergic (IgE-mediated asthma

    Directory of Open Access Journals (Sweden)

    Thomas Sandström

    2009-05-01

    Full Text Available Thomas SandströmDepartment of Respiratory Medicine and Allergy, University Hospital, Umeå, SwedenAbstract: Immunoglobulin E (IgE is central to the pathophysiology of allergic asthma. Omalizumab, an anti-IgE monoclonal antibody, binds to the FcεRI binding site on free IgE. As a result, circulating free IgE is reduced, IgE is prevented from attaching to mast cells and basophils, and FcεRI receptor expression is down-regulated. The inflammatory response to allergens and the acute and chronic effector phases of allergic inflammation are thereby attenuated. In clinical trials in adults and adolescents, omalizumab reduced asthma exacerbations, severe asthma exacerbations, inhaled corticosteroid requirements, and emergency visits, as well as significantly improving asthma-related quality of life, morning peak expiratory flow and asthma symptom scores in patients with severe allergic (IgE-mediated asthma. Results from clinical trials in children (< 12 years are consistent with those in the adult population. It is difficult to predict which patients will respond to omalizumab. Responders to omalizumab should be identified after a 16-week trial of therapy using the physician’s overall assessment. When treatment is targeted to these responders, omalizumab provides a cost-effective therapy for inadequately controlled severe allergic (IgE-mediated asthma. Long-term therapy with omalizumab shows the potential for disease-modification in asthma. Ongoing studies are also evaluating the use of omalizumab in other non-asthma IgE-mediated conditions.Keywords: omalizumab, IgE, allergic asthma

  11. Effect of cat and dog ownership on sensitization and development of asthma among preteenage children.

    Science.gov (United States)

    Perzanowski, Matthew S; Rönmark, Eva; Platts-Mills, Thomas A E; Lundbäck, Bo

    2002-09-01

    An inverse relationship has been proposed between exposure to high quantities of cat allergen at home and both asthma and cat allergy. First- and second-grade children from Luleå, Kiruna, and Piteå, Sweden participated in an asthma questionnaire study (n = 3,431) and incidence was evaluated over the next 3 years. Skin testing was performed on the children in Luleå and Kiruna (n = 2,149). The strongest risk factor for incident cases of asthma was Type 1 allergy (relative risk [RR], 4.9 [2.9-8.4]), followed by a family history of asthma (RR, 2.83 [1.8-4.5]). Living with a cat was inversely related both to having a positive skin test to cat (RR, 0.62 [0.47-0.83]) and incidence of physician-diagnosed asthma (RR, 0.49 [0.28-0.83]). This effect on incident asthma was most pronounced among the children with a family history of asthma (RR, 0.25 [0.08-0.80]). The evidence also suggests that many of the children exposed to cats at home can develop an immune response that does not include immunoglobulin E. Weaker protective trends were seen with dog ownership. The traditional thinking that not owning cats can provide protection against developing allergy and asthma among those with a family history of allergy needs to be re-evaluated. In a community where cat sensitization was strongly associated with asthma, owning a cat was protective against both prevalent and incident asthma.

  12. Integrating Smart Health in the US Health Care System: Infodemiology Study of Asthma Monitoring in the Google Era.

    Science.gov (United States)

    Mavragani, Amaryllis; Sampri, Alexia; Sypsa, Karla; Tsagarakis, Konstantinos P

    2018-03-12

    With the internet's penetration and use constantly expanding, this vast amount of information can be employed in order to better assess issues in the US health care system. Google Trends, a popular tool in big data analytics, has been widely used in the past to examine interest in various medical and health-related topics and has shown great potential in forecastings, predictions, and nowcastings. As empirical relationships between online queries and human behavior have been shown to exist, a new opportunity to explore the behavior toward asthma-a common respiratory disease-is present. This study aimed at forecasting the online behavior toward asthma and examined the correlations between queries and reported cases in order to explore the possibility of nowcasting asthma prevalence in the United States using online search traffic data. Applying Holt-Winters exponential smoothing to Google Trends time series from 2004 to 2015 for the term "asthma," forecasts for online queries at state and national levels are estimated from 2016 to 2020 and validated against available Google query data from January 2016 to June 2017. Correlations among yearly Google queries and between Google queries and reported asthma cases are examined. Our analysis shows that search queries exhibit seasonality within each year and the relationships between each 2 years' queries are statistically significant (PGoogle queries are robust and validated against available data from January 2016 to June 2017. Significant correlations were found between (1) online queries and National Health Interview Survey lifetime asthma (r=-.82, P=.001) and current asthma (r=-.77, P=.004) rates from 2004 to 2015 and (2) between online queries and Behavioral Risk Factor Surveillance System lifetime (r=-.78, P=.003) and current asthma (r=-.79, P=.002) rates from 2004 to 2014. The correlations are negative, but lag analysis to identify the period of response cannot be employed until short-interval data on asthma

  13. Residential traffic exposure and children's emergency department presentation for asthma: a spatial study

    Directory of Open Access Journals (Sweden)

    Pereira Gavin

    2009-11-01

    Full Text Available Abstract Background There is increasing evidence that residential proximity to roadways is associated with an elevated risk of asthma exacerbation. However, there is no consensus on the distance at which these health effects diminishes to background levels. Therefore the optimal, clinically relevant measure of exposure remains uncertain. Using four spatially defined exposure metrics, we evaluated the association between residential proximity to roadways and emergency department (ED presentation for asthma in Perth, Western Australia. Method The study population consisted of 1809 children aged between 0 and 19 years who had presented at an ED between 2002 and 2006 and were resident in a south-west metropolitan area of Perth traversed by major motorways. We used a 1:2 matched case-control study with gastroenteritis and upper limb injury as the control conditions. To estimate exposure to traffic emissions, we used 4 contrasting methods and 2 independently derived sources of traffic data (video-monitored traffic counts and those obtained from the state government road authority. The following estimates of traffic exposure were compared: (1 a point pattern method, (2 a distance-weighted traffic exposure method, (3 a simple distance method and (4 a road length method. Results Risk estimates were sensitive to socio-economic gradients and the type of exposure method that was applied. Unexpectedly, a range of apparent protective effects were observed for some exposure metrics. The kernel density measure demonstrated more than a 2-fold (OR 2.51, 95% CI 2.00 - 3.15 increased risk of asthma ED presentation for the high exposure group compared to the low exposure group. Conclusion We assessed exposure using traffic data from 2 independent sources and compared the results of 4 different exposure metric types. The results indicate that traffic congestion may be one of the most important aspects of traffic-related exposures, despite being overlooked in many

  14. The New Zealand Asthma and Allergy Cohort Study (NZA2CS: Assembly, Demographics and Investigations

    Directory of Open Access Journals (Sweden)

    Epton Michael J

    2007-02-01

    Full Text Available Abstract Background Asthma and allergy are highly prevalent in industrialised countries. Longitudinal and cross-sectional studies have identified a number of potential risk factors for these conditions, including genetic and environmental factors, with significant gene-environment relationships. Birth cohort studies have been proposed as an important tool to explore these risk factors, particularly exposures in early life that are associated with later disease or protection from disease. This paper describes the establishment of a birth cohort in New Zealand. Methods A birth cohort was established in 1996 in Christchurch and Wellington and infants recruited between 1997–2001. Expectant mothers were recruited by midwives. Children and mothers have undergone assessment by serial questionnaires, environmental assessment including mould and allergen exposure, skin-prick testing, and at age six years are undergoing full assessment for the presence of asthma, atopy and allergic disease, including genetic assessment. Results A total of 1105 children have been recruited, and the retention rate at fifteen months was 91.4%. 15.2% of the children at recruitment have been identified as Maori. A positive family history of asthma, eczema or hay fever has been reported in 84% of children. All children have now been assessed at fifteen months and 685 children from the cohort have reached age six years and have completed the six year assessment. Conclusion The cohort is fully assembled, and assessment of children is well advanced, with good retention rates. The study is well placed to address many current hypotheses about the risk factors for allergic disease and asthma.

  15. Association between asthma and chronic periodontitis -A Case–Control Study in Shimla-Himachal Pradesh

    Directory of Open Access Journals (Sweden)

    Vinay Kumar Bhardwaj

    2017-01-01

    Full Text Available Introduction: The colonization of respiratory pathogens appears to be a risk factor for lung infection in high-risk individuals. Evidences dictate a bidirectional relationship between periodontitis and asthma. Aim: The aim of this study is to explore this potential association between asthma and periodontal disease. Materials and Methods: In a case–control study the individuals were selected from patients attending asthma clinic in a hospital. Individuals consist of fifty asthmatics and fifty nonasthmatic healthy controls evaluated for plaque index (PI, gingival index (GI, papillary bleeding index (PBI, calculus index (CI, and clinical attachment level (CAL. The data were analyzed by SPSS version 16. Results: Mean PI scores was 0.649 ± 0.316 for control group in comparison to 1.168 ± 0.46 for asthmatic group. Statistically significant difference among two groups was obtained on a comparison of GI score (P = 0.0231 CI scores (0.0461 for control group. CAL was 3.817 ± 0.722 mm and 4.964 ± 0.871 mm in control group and case group, respectively. The difference of CAL for two groups was statistically highly significant (P = 0.004. Comparison of PBI of test group and control group showed significant difference Comparison of all the parameters for two subgroups (mild asthmatics and moderate-to-severe asthmatics, i.e. PI, CI, GI, and PBI was statistically significant with P value for respective scores as 0.0281, 0.04, 0.027, and 0.0162. CAL measurement for both groups was highly significant (P = 0.001. Conclusion: The present study reveals an association between the occurrence of chronic periodontitis and asthma. Both periodontal and respiratory diseases have an inflammatory nature. Parameters measured using different indices have revealed higher scores for the asthmatics than nonasthmatics.

  16. Does adherence to the Mediterranean dietary pattern reduce asthma symptoms in children? A systematic review of observational studies.

    Science.gov (United States)

    Papamichael, Maria M; Itsiopoulos, Catherine; Susanto, Nugroho H; Erbas, Bircan

    2017-10-01

    The purpose of the present systematic review was to synthesize evidence from the literature to assess efficacy of the Mediterranean dietary pattern in childhood asthma. Design/Setting A systematic search of six databases, three clinical trial registries and hand-search of peer-reviewed articles was conducted up to 29 October 2016. Inclusion criteria included exposure to a Mediterranean dietary pattern, measurement of asthma symptoms and study population of children aged Mediterranean and non-Mediterranean countries were relevant. No randomized controlled trials were retrieved. Twelve studies reported an inverse association between adherence to a Mediterranean dietary pattern and asthma in children, two studies showed no association and one study showed an increase in asthma symptoms. In fourteen out of fifteen studies, quality assessment checks revealed good reliability and validity among study methodologies. The current systematic review revealed a consistent inverse relationship (protective) between a Mediterranean dietary pattern and asthma in children. Future well-designed randomized controlled trials are needed to provide solid evidence. Nevertheless, the existing level of evidence adds to the public health message relating to the beneficial effects of a Mediterranean-type diet in children suffering with asthma.

  17. A telehealth integrated asthma-COPD service for primary care: a proposal for a pilot feasibility study in Crete, Greece

    Directory of Open Access Journals (Sweden)

    Tzanakis Nikolaos E

    2010-07-01

    Full Text Available Abstract Background Chronic obstructive pulmonary disease (COPD and asthma are considered underdiagnosed and misdiagnosed chronic diseases. In The Netherlands, a COPD-asthma telemedicine service has been developed to increase GPs' ability to diagnose and manage COPD and asthma. A telemedicine COPD-asthma service may benefit Greece as it is a country, partly due to its geography, that does not have easy access to pulmonologists. Findings Therefore, a pilot feasibility study has been designed in Greece in order to establish this telemedicine service. Ten rural practices, in the island of Crete, with an average population of 2000 patients per practice will pilot the project supported by three pulmonologists. This paper presents the translated interfaces, the flowcharts and the steps that are considered as necessary for this feasibility study in Crete, Greece.

  18. Dietary intake, leisure time activities and obesity among adolescents in Western Sweden: a cross-sectional study.

    Science.gov (United States)

    Winkvist, Anna; Hultén, Bodil; Kim, Jeong-Lim; Johansson, Ingegerd; Torén, Kjell; Brisman, Jonas; Bertéus Forslund, Heléne

    2016-04-21

    Overweight and obesity among adolescents are increasing worldwide. Risk factors include dietary intake characteristics and high levels of physical inactivity. In Sweden, few large comprehensive population-based surveys of dietary intake and lifestyle among adolescents have been carried out. Thus, the purpose of the current study was to describe dietary intake and food choices as well as leisure time activities in relation to overweight and obesity in a total sample of all schoolchildren aged 15 years in Western Sweden. In 2008, a questionnaire was sent to all 21,651 adolescents born in 1992 in Västra Götaland Region, Sweden. Participation rate was 54.3 % (50.7 % girls/49.3 % boys). The questionnaire included a 73-item semi-quantitative food frequency questionnaire and questions on lifestyle. Results were evaluated against the Nordic Nutrition Recommendations and Swedish indicators of healthy diet and exercise habits. Associations with concurrent overweight and obesity were evaluated in multiple linear regression analysis. Among girls, 49.5 % reached the goal of consuming fruit and vegetables at least daily, whereas for boys the figure was 34.4 %. Among both sexes, 15 % reached the goal of consuming fish at least twice weekly. Two-thirds of both sexes reached the goal of regular moderate or vigorous physical activity weekly. In total, 12.4 % were overweight and 2.4 % were obese. More girls than boys were underweight, whereas more boys than girls were overweight or obese (p bread and potatoes and fast food (p < 0.001). Frequent intake of candies and chocolate was reported by both sexes. Among girls and boys, living in rural areas, living in apartments and reporting no frequent leisure time physical activity were significant risk factors for being overweight or obese, also when adjusted for other risk factors. Dietary habits of adolescents in Western Sweden warrant improvements. Public health actions should be taken to increase consumption of fruit, vegetables and

  19. Role of sulfite additives in wine induced asthma: single dose and cumulative dose studies.

    Science.gov (United States)

    Vally, H; Thompson, P J

    2001-10-01

    Wine appears to be a significant trigger for asthma. Although sulfite additives have been implicated as a major cause of wine induced asthma, direct evidence is limited. Two studies were undertaken to assess sulfite reactivity in wine sensitive asthmatics. The first study assessed sensitivity to sulfites in wine using a single dose sulfited wine challenge protocol followed by a double blind, placebo controlled challenge. In the second study a cumulative dose sulfited wine challenge protocol was employed to establish if wine sensitive asthmatics as a group have an increased sensitivity to sulfites. In study 1, 24 asthmatic patients with a strong history of wine induced asthma were screened. Subjects showing positive responses to single blind high sulfite (300 ppm) wine challenge were rechallenged on separate days in a double blind, placebo controlled fashion with wines of varying sulfite levels to characterise their responses to these drinks. In study 2, wine sensitive asthmatic patients (n=12) and control asthmatics (n=6) were challenged cumulatively with wine containing increasing concentrations of sulfite in order to characterise further their sensitivity to sulfites in wine. Four of the 24 self-reporting wine sensitive asthmatic patients were found to respond to sulfite additives in wine when challenged in a single dose fashion (study 1). In the double blind dose-response study all four had a significant fall in forced expiratory volume in one second (FEV(1)) (>15% from baseline) following exposure to wine containing 300 ppm sulfite, but did not respond to wines containing 20, 75 or 150 ppm sulfite. Responses were maximal at 5 minutes (mean (SD) maximal decline in FEV(1) 28.7 (13)%) and took 15-60 minutes to return to baseline levels. In the cumulative dose-response study (study 2) no significant difference was observed in any of the lung function parameters measured (FEV(1), peak expiratory flow (PEF), mid phase forced expiratory flow (FEF(25-75))) between wine

  20. Study of the Fingertip Pattern as a Tool for the Identification of the Dermatoglyphic Trait in Bronchial Asthma

    Science.gov (United States)

    Pakhale, Sandeep V.; Borole, Bharat S.; Doshi, Megha A.; More, Vijay P.

    2012-01-01

    Introduction Bronchial Asthma is one of the most extensively studied respiratory diseases and its genetic basis is well established. Dermatoglyphic traits are formed under genetic control early in development but may be affected by environmental factors during first trimester of pregnancy. These patterns may represent the genetic makeup of an individual and therefore his/her predisposition to certain diseases. Patterns of dermatoglyphics have been studied in various congenital disorders like Down’s syndrome, Klinefelter’s syndrome and also in chronic diseases like Hypertension, Diabetes Mellitus etc. Epidermal ridge patterns of finger tips in bronchial asthma patients were studied to find out fingertip pattern as Dermatoglyphic features in patients of Bronchial Asthma; it’s comparison and association if exists between normal and bronchial asthma patients and also to find use of fingertip pattern in early childhood as non-invasive anatomical marker for bronchial asthma in adulthood. Methods The study was conducted on clinically diagnosed all bronchial asthma patients attending OPD of Dr Ulhas Patil Medical College, Jalgaon. Matched controls were selected without any respiratory problem or any symptoms related to asthma from medical students, staff members and paramedical staff of hospital after taking the informed consent and permission from the institutional ethical committee. Data collection and fingertip prints were taken by ink and rolling finger method. Prints taken were analysed and tabulated; data was analysed by using statistical tests. Results Study shows that decrease in number of arches, increase in AFRC in patients as compared with controls. Also there were increased ulnar loops in male patients and increased Whorls and radial loops in female patients. Conclusion The fingerprints can represent a non-invasive anatomical marker of bronchial asthma risk and facilitate early detection and effective management which is vital for selecting appropriate

  1. Exhaled nitric oxide, nitrite/nitrate levels, allergy, rhinitis and asthma in the EGEA study.

    Science.gov (United States)

    Nadif, Rachel; Rava, Marta; Decoster, Brigitte; Huyvaert, Hélène; Le Moual, Nicole; Bousquet, Jean; Siroux, Valérie; Varraso, Raphaëlle; Pin, Isabelle; Zerimech, Farid; Matran, Régis

    2014-08-01

    Although interest in biomarkers in the nitrate-nitrite-NO pathway has recently increased, associations between nitrite (NO2(-)) and nitrate (NO3(-)), and asthma, allergic sensitisation and rhinitis remain unclear. The study aimed to evaluate the associations between NO2(-)/NO3(-) and exhaled fraction of nitric oxide (FeNO) levels with asthma, allergic sensitisation and rhinitis. Plasma and exhaled breath condensate (EBC) NO2(-)/NO3(-) and FeNO levels were measured in 523 adults of the French Epidemiological study on Genetics and Environment of Asthma. Allergic sensitisation was defined by a positive skin prick test for at least one aeroallergen. Subjects were classified as non-sensitised, sensitised and as having allergic rhinitis. Plasma NO2 (-)/NO3(-) level was unrelated to any disease phenotypes. EBC NO2(-)/NO3(-) level was unrelated to any asthma phenotypes. EBC NO2(-)/NO3(-) and FeNO levels were correlated in sensitised subjects only (r = 0.21 ± 0.10, p=0.01). EBC NO2(-)/NO3(-) and FeNO levels were higher in sensitised than in non-sensitised subjects (adjusted geometric mean (95% CI): 2.36 (1.96-2.84) versus 1.72 (1.38-2.14) μmol per mg proteins, p=0.008; and 18.3 (16.7-20.0) versus 14.8 (13.3-16.5) ppb, p=0.0006, respectively), with gradual relationships from sensitised subjects to those with allergic rhinitis (p<0.0001). Results suggest that EBC NO2(-)/NO3(-) and FeNO levels may be considered as biological markers of intensity of allergic sensitisation and rhinitis. ©ERS 2014.

  2. Early eczema and the risk of childhood asthma: a prospective, population-based study

    Directory of Open Access Journals (Sweden)

    Saunes Marit

    2012-10-01

    Full Text Available Abstract Background Severe eczema in young children is associated with an increased risk of developing asthma and rhino-conjunctivitis. In the general population, however, most cases of eczema are mild to moderate. In an unselected cohort, we studied the risk of current asthma and the co-existence of allergy-related diseases at 6 years of age among children with and without eczema at 2 years of age. Methods Questionnaires assessing various environmental exposures and health variables were administered at 2 years of age. An identical health questionnaire was completed at 6 years of age. The clinical investigation of a random subsample ascertained eczema diagnoses, and missing data were handled by multiple imputation analyses. Results The estimate for the association between eczema at 2 years and current asthma at 6 years was OR=1.80 (95% CI 1.10-2.96. Four of ten children with eczema at 6 years had the onset of eczema after the age of 2 years, but the co-existence of different allergy-related diseases at 6 years was higher among those with the onset of eczema before 2 years of age. Conclusions Although most cases of eczema in the general population were mild to moderate, early eczema was associated with an increased risk of developing childhood asthma. These findings support the hypothesis of an atopic march in the general population. Trial registration The Prevention of Allergy among Children in Trondheim study has been identified as ISRCTN28090297 in the international Current Controlled Trials database

  3. Costs of illness of multiple sclerosis in Sweden: a population-based register study of people of working age.

    Science.gov (United States)

    Gyllensten, Hanna; Wiberg, Michael; Alexanderson, Kristina; Norlund, Anders; Friberg, Emilie; Hillert, Jan; Ernstsson, Olivia; Tinghög, Petter

    2018-04-01

    Multiple sclerosis (MS) causes work disability and healthcare resource use, but little is known about the distribution of the associated costs to society. We estimated the cost of illness (COI) of working-aged individuals with MS, from the societal perspective, overall and in different groups. A population-based study was conducted, using data linked from several nationwide registers, on 14,077 individuals with MS, aged 20-64 years and living in Sweden. Prevalence-based direct and indirect costs in 2010 were calculated, including costs for prescription drug use, specialized healthcare, sick leave, and disability pension. The estimated COI of all the MS patients were SEK 3950 million, of which 75% were indirect costs. MS was the main diagnosis for resource use, causing 38% of healthcare costs and 67% of indirect costs. The distribution of costs was skewed, in which less than 25% of the patients accounted for half the total COI. Indirect costs contributed to approximately 75% of the estimated overall COI of MS patients of working age in Sweden. MS was the main diagnosis for more than half of the estimated COI in this patient group. Further studies are needed to gain knowledge on development of costs over time during the MS disease course.

  4. Wet Grasslands as a Green Infrastructure for Ecological Sustainability: Wader Conservation in Southern Sweden as a Case Study

    Directory of Open Access Journals (Sweden)

    Michael Manton

    2016-04-01

    Full Text Available Biosphere Reserves aim at being role models for biodiversity conservation. This study focuses on the unsuccessful conservation of waders (Charadrii on wet grasslands in the Kristianstad Vattenrike Biosphere Reserve (KVBR in southern Sweden. Predation on nests and young has been proposed as one reason contributing to the decline of waders. We explored this hypothesis by comparing two landscapes, one with declining (KVBR and one with stable (Östergötland wader populations on managed wet grasslands in southern Sweden. Specifically, we tested three predictions linked to predation on wader nests and young, namely that (1 the relative abundance of avian predators and waders; (2 the avian predator abundance; and (3 the predation rate on artificial wader nests, should all be higher in declining versus stable populations. All predictions were clearly supported. Nevertheless, predation may not be the ultimate factor causing wader population declines. We discuss the cumulative effects of landscape change linked to increased food resources for predators, reduced wet grassland patch size and quality. Holistic analyses of multiple wet grassland landscapes as social-ecological systems as case studies, including processes such as predation and other factors affecting waders, is a promising avenue towards collaborative learning for wet grasslands as a functional green infrastructure. However, if governance and management approaches can be improved is questionable without considerable investment in both ecological and social systems.

  5. Outdoor particulate matter and childhood asthma admissions in Athens, Greece: a time-series study

    Directory of Open Access Journals (Sweden)

    Roma Eleftheria S

    2010-07-01

    Full Text Available Abstract Background Particulate matter with diameter less than 10 micrometers (PM10 that originates from anthropogenic activities and natural sources may settle in the bronchi and cause adverse effects possibly via oxidative stress in susceptible individuals, such as asthmatic children. This study aimed to investigate the effect of outdoor PM10 concentrations on childhood asthma admissions (CAA in Athens, Greece. Methods Daily counts of CAA from the three Children's Hospitals within the greater Athens' area were obtained from the hospital records during a four-year period (2001-2004, n = 3602 children. Mean daily PM10 concentrations recorded by the air pollution-monitoring network of the greater Athens area were also collected. The relationship between CAA and PM10 concentrations was investigated using the Generalized Linear Models with Poisson distribution and logistic analysis. Results There was a statistically significant (95% CL relationship between CAA and mean daily PM10 concentrations on the day of exposure (+3.8% for 10 μg/m3 increase in PM10 concentrations, while a 1-day lag (+3.4% for 10 μg/m3 increase in PM10 concentrations and a 4-day lag (+4.3% for 10 μg/m3 increase in PM10 concentrations were observed for older asthmatic children (5-14 year-old. High mean daily PM10 concentration (the highest 10%; >65.69 μg/m3 doubled the risk of asthma exacerbations even in younger asthmatic children (0-4 year-old. Conclusions Our results provide evidence of the adverse effect of PM10 on the rates of paediatric asthma exacerbations and hospital admissions. A four-day lag effect between PM10 peak exposure and asthma admissions was also observed in the older age group.

  6. Acceptability and feasibility of the 'DASH for Asthma' intervention in a randomized controlled trial pilot study.

    Science.gov (United States)

    Blonstein, Andrea C; Lv, Nan; Camargo, Carlos A; Wilson, Sandra R; Buist, A Sonia; Rosas, Lisa G; Strub, Peg; Ma, Jun

    2016-08-01

    'DASH for Asthma' (n 90) was a 6-month randomized controlled trial that demonstrated potential benefits of a DASH (Dietary Approaches to Stop Hypertension) behavioural intervention for improving diet quality and asthma control by comparing intervention to usual care in adults with uncontrolled asthma. The present study examined acceptability and feasibility of the intervention from the perspective of intervention participants and lifestyle coaches. Grounded in Social Cognitive Theory, the 3-month intensive stage, including three individual and eight group sessions, focused on diet modifications and behavioural self-regulation. The 3-month maintenance stage contained telephone consultations. Participants and lifestyle coaches completed surveys including 5-point Likert scales and open-ended questions. We analysed data using descriptive and inductive content analyses. Forty-six intervention participants (survey response rate was 65-72 %) and two lifestyle coaches. Participants and lifestyle coaches were highly satisfied (all mean ratings >4) with individual and group sessions. Participants identified mastery of knowledge and skills (awareness, goal setting, self-monitoring, problem solving), social learning (class members sharing experiences and ideas) and good coaching skills (reflective listening, empathy, motivational counselling) as important contributors to self-efficacy and programme satisfaction. Participants also valued personalized feedback received in individual sessions. Lifestyle coaches viewed participant engagement as a facilitator to effective sessions. Finally, participants and lifestyle coaches identified food tasting as beneficial for observational learning and facilitation of participant engagement. High class attendance and self-monitoring rate also reflected the high engagement among participants. The DASH behavioural intervention was feasible and highly acceptable to participants with uncontrolled asthma and lifestyle coaches.

  7. Metabolomic study for monitoring of biomarkers in mouse plasma with asthma by gas chromatography-mass spectrometry.

    Science.gov (United States)

    Seo, Chan; Hwang, Yun-Ho; Lee, Hyeon-Seong; Kim, Youngbae; Shin, Tae Hwan; Lee, Gwang; Son, Young-Jin; Kim, Hangun; Yee, Sung-Tae; Park, Ae Kyung; Paik, Man-Jeong

    2017-09-15

    Asthma is a multifaceted chronic disease caused by an alteration of various genetic and environmental factors that is increasing in incidence worldwide. However, the biochemical mechanisms regarding asthma are not completely understood. Thus, we performed of metabolomic study for understanding of the biochemical events by monitoring of altered metabolism and biomarkers in asthma. In mice plasma, 27 amino acids(AAs), 24 fatty acids(FAs) and 17 organic acids(OAs) were determined by ethoxycarbonyl(EOC)/methoxime(MO)/tert-butyldimethylsilyl(TBDMS) derivatives with GC-MS. Their percentage composition normalized to the corresponding mean levels of control group. They then plotted as star symbol patterns for visual monitoring of altered metabolism, which were characteristic and readily distinguishable in control and asthma groups. The Mann-Whitney test revealed 25 metabolites, including eight AAs, nine FAs and eight OAs, which were significantly different (pcycle. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Exploration of asthma risk by occupation--extended analysis of an incidence study of the Finnish population.

    Science.gov (United States)

    Karjalainen, Antti; Kurppa, Kari; Martikainen, Rami; Karjalainen, Jussi; Klaukka, Timo

    2002-02-01

    The objective of the study was to determine asthma risks at the most-detailed level of occupational classification in a previously described nationwide follow-up study that included the entire employed workforce of Finland. In Finland, persons with clinically verified persistent asthma are registered for medication reimbursement within the national health insurance scheme. Data were combined from three national registers, and all 25- to 59-year-old employed Finns were followed for asthma incidence in 1986-1998. Altogether 49,575 cases were detected. A log-linear model was used to estimate the relative risks of asthma for 275 nonadministrative occupations in comparison with administrative work (33 occupations). A significantly increased risk was found for either men or women in 125 occupations. For the men, the risk was highest among bakers, laundry workers, shoemakers and repairers, tanners, fell mongers and pelt dressers, and metal plating and coating workers. For the women, the risk was highest among shoemakers and repairers, railway and station personnel, jewelry engravers, engineroom crew, molders, round-timber workers. and bakers. The results suggest that the work-related excess of asthma incidence is much more widely spread across the labor force than has been previously thought. A great number of occupations deserves to be targeted for in-depth studies focusing on the determinants of asthma excess and on possibilities for better asthma control among asthmatics working in these occupations. The large work-relatedness of asthma incidence should also raise public health interest because of the economic losses incurred and the potential for prevention.

  9. Changes over time in the relationship between symptoms of asthma, rhinoconjunctivitis and eczema: a global perspective from the International Study of Asthma and Allergies in Childhood (ISAAC).

    Science.gov (United States)

    Asher, M I; Stewart, A W; Wong, G; Strachan, D P; García-Marcos, L; Anderson, H R

    2012-01-01

    The International Study of Asthma and Allergies in Childhood (ISAAC) identified trends in the prevalence of symptoms of asthma, rhinoconjunctivitis and eczema over a seven-year period. We hypothesised that environmental influences on the three diseases are different and therefore investigated the correlation over time between trends in the prevalence of these diseases and their combinations at centre and individual level. Centre level analyses were correlations between time trends in the prevalence of symptoms. At an individual level, odds ratios were calculated for associations between symptoms between Phases One and Three. We also investigated potential effect modification in the younger versus older age group; male versus female; and by average Gross National Income per capita (GNI). Both phases were completed in 66 centres in 37 countries for the 6-7 year age group and in 106 centres in 56 countries for the 13-14 year age group. We found that the correlations in time trends were stronger for the older age group than the younger one. Between symptoms of diseases, correlations of time trends were the strongest for rhinoconjunctivitis with eczema and weakest for eczema with asthma. The relationship between the three diseases was generally consistent over the seven-year period, and there was little association found with average GNI. Despite some increase in the proportion of children with symptoms of asthma, rhinoconjunctivitis and eczema, the pattern between the three diseases has not changed much, suggesting that similar factors may be affecting them at a global level. Copyright © 2011 SEICAP. Published by Elsevier Espana. All rights reserved.

  10. A radioanalytical study of radionuclides in a dysoligotrophic lake in Southern Sweden

    International Nuclear Information System (INIS)

    Eriksson, M.; Roos, P.; Holm, E.; Peck, G.

    1998-01-01

    Unusually high activity concentration of various artificial radionuclides (from nuclear test fallout and the Chernobyl accident) and some natural radionuclides, have been discovered in lakes with high amounts of humic substances. These lakes tend to have low pH, at times down to pH 5. The lake, Svartsjoen, in the southern part of Sweden is one of these lakes. The food chain and resulting concentration factors in Svartsjoen were investigated and compared to results for other 'normal' lakes. Fish and water samples were collected and analysed for 137 Cs 239+240 Pu, 241 Am and 210 Po during a 4-month visit to Lund. The level of 239/240 Pu in the water of Svartsjoen was found to be elevated. The work on fish from the lake indicates that these elevated levels are not transferred into the food chain. It appears that the humic substances could be blocking plutonium from entering the food chain

  11. Inverse Relationship Between Helicobacter Pylori Infection and Asthma Among Adults Younger than 40 Years: A Cross-Sectional Study.

    Science.gov (United States)

    Lim, Joo Hyun; Kim, Nayoung; Lim, Seon Hee; Kwon, Jin-Won; Shin, Cheol Min; Chang, Yoon-Seok; Kim, Joo Sung; Jung, Hyun Chae; Cho, Sang-Heon

    2016-02-01

    Recent studies have suggested that Helicobacter pylori could prevent allergic disease, particularly in children. However, whether this is true in adults is controversial. The aim of this study was to investigate whether there is negative association between H. pylori infection and asthma among adults in an area with a high prevalence of H. pylori.This was a cross-sectional study using 2011 health surveillance data. Blood samples were taken from all participants to measure serum H. pylori IgG status. Information on demographics, socioeconomic status, and medical history, including asthma and other allergic conditions were collected by a questionnaire.Of the 15,032 patients, 9492 (63.1%) had a history of H. pylori infection, 359 (2.4%) had asthma, and 3277 (21.8%) had other allergic conditions. H. pylori infection was positively correlated with age (OR, 1.050; 95% CI, 1.047-1.053, P history was positively correlated with age (OR, 1.022; 95% CI, 1.013-1.032, P pylori and age were shown to have interaction on asthma in the total participants (OR, 1.041; 95% CI, 1.021-1.062, P pylori infection among those pylori infection among the total and those pylori infection and asthma among young adults suggests that the underlying immune mechanism induced by H. pylori infection may affect allergic reactions associated with asthma in young adults.

  12. ATTITUDES OF PATIENTS WITH ASTHMA ON INHALER USE- A CROSS-SECTIONAL STUDY FROM SOUTH KERALA

    Directory of Open Access Journals (Sweden)

    Shajahan Purathel Sulaiman

    2017-03-01

    Full Text Available BACKGROUND Asthma is an important health problem worldwide. High prevalence and poor control of asthma make its management a major public health problem with more than 5,00,000 hospital admissions and 2,50,000 deaths annually all over the world. India contribute maximum to the death toll accounting for 22.3% of all global asthma deaths. Medications in the inhaled forms are the best therapeutic options currently available for asthma. Despite this, the percentage of patients opting inhalers as the preferred modality of treatment seems to be low. The patient’s ability to use the device correctly and the adherence to the treatment regimen are likely to be influenced by their beliefs, attitudes and concerns about the use of inhalers as the preferred mode of treatment. The aim of the study is to- 1. To find out the proportion of asthmatics using inhalers as the preferred modality of treatment. 2. To bring out the various beliefs and misconceptions on inhalers among the above study group. MATERIALS AND METHODS Study subjects were asthmatics in the age group of 15 to 45 years who attended the medical camps conducted in Alappuzha and Kottayam districts of Kerala during the period 2006-2009 (n=912. A semi-structured interview schedule regarding the use of inhalers were administered to collect the data. RESULTS 52% of the study subjects accept inhaled preparations as the preferred modality of treatment (male-68%, female-35%. 48% are reluctant to take inhalers in the first step (male- 32%, female- 65%. 47% believe the term inhaler is the name of a particular drug rather than a device (male- 45%, female- 48%. 76% of inhaler users do not know how to use it properly. 7% think the powder in the dry powder inhalers can block the airways. CONCLUSION Knowledge about asthma and the importance of its proper management are poor in our population. A joint effort in the form of health awareness programmes are needed to alleviate fears and misconceptions of patients

  13. Effects of traffic-related air pollution on susceptibility to infantile bronchiolitis and childhood asthma: A cohort study in Korea.

    Science.gov (United States)

    Lee, Ji-Young; Leem, Jong-Han; Kim, Hwan-Cheol; Lamichhane, Dirga Kumar; Hwang, Seung-Sik; Kim, Jeong-Hee; Park, Myung-Sook; Jung, Dal-Young; Ko, Jung-Keun; Kwon, Ho-Jang; Hong, Soo-Jong

    2018-03-01

    This study examined the role of exposure to traffic-related air pollution (TRAP) on susceptibility to asthma in children with past episodes of bronchiolitis. The baseline data included 2,627 school children aged 6-14 years who had participated in the longitudinal follow-up survey of the Children's Health and Environmental Research of Korea. Lifetime wheezing, past episodes of bronchiolitis, and doctor-diagnosed asthma were evaluated using an International Study of Asthma and Allergies in Childhood questionnaire. We used generalized linear regression with binomial distribution to calculate the relative risk (RR) between TRAP, assessed by proximity to a main road and the total length of roads, and asthma. Compared with the subjects who had less than 100 m of road length within 200-m radius from their home, those with more than 500 m of road length had significantly increased odds for infantile bronchiolitis (adjusted OR [aOR]: 1.57, 95% confidence interval [CI]: 1.01-2.42). Positive exposure-response relationships were found between residential proximity to the main road and asthma (aOR: 1.79, 95% CI: 1.05-3.06; 700 m from a main road, P for the trend = 0.02). Closer residential proximity to the main road (<75 m) and bronchiolitis combined increased the risks of newly diagnosed asthma (adjusted RR: 3.62, 95% CI: 1.07-12.26) compared with those without bronchiolitis and living ≥ 75 m away from the main road. TRAP appeared to be associated with an increased asthma among children with bronchiolitis, indicating the importance of modifying effects of bronchiolitis in asthma pathogenesis.

  14. Recruitment into a long-term pediatric asthma study during emergency department visits.

    Science.gov (United States)

    Smith, Sharon R; Jaffe, David M; Petty, Marvin; Worthy, Vanetta; Banks, Phillip; Strunk, Robert C

    2004-06-01

    Asthma is the most common chronic illness in childhood. Recruiting children and their parents into a research study in a busy urban emergency department (ED) is challenging. The purpose of this manuscript is to describe the recruitment process and the results of our recruitment in soliciting children and their parents to participate in an ED-based asthma research study. The data for this manuscript came from a National Heart, Lung, and Blood Institute-funded study: Study of Asthma Follow-up from the Emergency Department (SAFE). SAFE evaluated an ED-based intervention to link low-income urban children with asthma to their primary care providers. Two persons were assigned specifically to enrolling, which was done from 0700 to 2300 hours Monday through Friday. Data for the analysis come from the web-based database, the master log, and the hospital's patient database. A computerized randomization scheme chose 512 patients from all patients in the master log for more detailed demographic analyses. Five hundred twenty-seven subjects were enrolled between February 1999 and May 2001. There were 9188 children who presented for treatment of an acute asthma exacerbation during this interval. The number of eligible parents was similar to the predicted number. Chart reviews were conducted on a subset of patients presenting to the ED to ensure that the recruitment strategy did not bias the patients enrolled. Demographic characteristics of asthma patients were similar during enrollment and non-enrollment times. Comparison of patients who were enrolled with those who were not enrolled indicated no differences by gender, race, insurance status, age, or socioeconomic status of neighborhood residence. The high rate of enrollment was primarily due to the two dedicated enrollers. The enrollers quickly learned how to function within the ED and how to interact with both families and ED staff. Strategies identified by the enrollers as helpful in randomizing subjects included visits with

  15. Diagnosing Asthma

    Science.gov (United States)

    ... give your pediatrician will help determine if your child has asthma. Your pediatrician will need information about Your child’s ... function testing may be normal even if your child has asthma. Also keep in mind that not all children ...

  16. Occupational asthma

    Science.gov (United States)

    ... in the airways of the lungs. When an asthma attack occurs, the lining of the air passages swells ... small amount of the substance can trigger an asthma attack. Using a respiratory device to protect or reduce ...

  17. Asthma Research

    Science.gov (United States)

    EPA is working to explore the role of common air pollutants in the development and exacerbation of asthma at different life stages as well as other environmental and genetic factors that might make a person more sensitive to developing asthma.

  18. Study of serum vitamin D level in adult patients with bronchial asthma

    Directory of Open Access Journals (Sweden)

    Mohamed Yousry A. Shahin

    2017-01-01

    Conclusion: There is an important association between adult bronchial asthma and vitamin D deficiency or even insufficiency. A strong correlation between the serum vitamin D level and asthma severity and control was found.

  19. 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...

  20. Mechanical surface analysis of bone: a case study of cut marks and enamel hypoplasia on a Neolithic cranium from Sweden.

    Science.gov (United States)

    During, E M; Nilsson, L

    1991-02-01

    A method for measuring, recording, and studying fine surface irregularities in three dimensions is presented. The method, which involves recording the movements of a diamond-tipped stylus as it scans the surface being studied, is demonstrated on a Neolithic cranium from Sweden. The cranium emanates from a pile dwelling dated to about 3000 B.C. Its frontal bone exhibits distinct cut marks indicative of scalping, and the teeth show signs of enamel hypoplasia. The surface topography of the putative cut marks and hypoplastic enamel were investigated using the stylus method. Measurements of enamel hypoplasia were also carried out for comparison on a front tooth from the lower jaw, and the cut mark study was compared with scanning electron micrographs. The results of this case study demonstrate that the stylus method can obtain high-resolution measurements of fine surface details directly on the original bone without preparation of or damage to the specimen.

  1. Establishing a culturally specific nursing home for Finnish-speaking older persons in Sweden: A case study.

    Science.gov (United States)

    Hadziabdic, Emina; Hjelm, Katarina

    2018-04-01

    The study aims to describe the establishment of a culturally specific nursing home for Finnish-speaking older persons in Sweden. A descriptive qualitative study. A descriptive case study based on a review of 14 public documents and individual interviews with two experts in the area, analysed with qualitative content analysis. This study found that shared language, preservation of customs and habits and collaboration between the representatives of the municipality, Finnish-speaking migrant associations and staff at the nursing home influenced the development of the culturally specific nursing home for older Finnish-speaking people intended to avoid loneliness, isolation and misunderstandings among older Finnish-speaking. Collaboration between healthcare service for older persons and minority people resulted in an optimal culturally specific nursing home, simultaneously encountering the majority culture. Nursing and healthcare services need to be aware of positive effects of collaboration with stakeholders to achieve optimal culturally specific nursing homes.

  2. Low exercise among children with asthma: a culture of over protection? A qualitative study of experiences and beliefs.

    Science.gov (United States)

    Williams, Brian; Hoskins, Gaylor; Pow, Jannette; Neville, Ron; Mukhopadhyay, Somnath; Coyle, Joanne

    2010-08-01

    Research shows that children are insufficiently active in most affluent societies. Although children with asthma may particularly benefit from physical activity, they are less active than their peers. To explore the reasons for low physical activity levels among children with asthma and to identify strategies to improve activity. A qualitative study using in-depth interviews and focus groups. Six GP practices, a Paediatric Respiratory Unit, and four schools in Tayside, Scotland. Purposive sampling identified 30 children with asthma, their parents (n = 38) and school staff (n = 28), who were interviewed or took part in focus groups. Data were examined using constant comparative analysis. The lower level of activity among children with asthma was supported by a climate of fear among parents and teachers about what was safe and possible for the child. Restrictions were imposed because of perceived dangers of exercising in the presence of 'triggers'. Physical activity was regarded as a threat to be managed rather than something beneficial. Teachers found it difficult to distinguish between children who were physically incapable of exercise due to asthma and those who were unmotivated. GPs were unknowingly drawn into the controversy by children and parents who cite medical advice to sanction exemption from exercise. GPs and asthma nurses need to provide clear management plans explaining what is appropriate and safe in terms of exercise on a child-by-child basis, to counter the considerable misunderstanding and disagreement among children, parents, and teachers.

  3. Long-term exposure to air pollution and asthma hospitalisations in older adults: a cohort study

    DEFF Research Database (Denmark)

    Andersen, Zorana Jovanovic; Bønnelykke, Klaus; Hvidberg, Martin

    2012-01-01

    Exposure to air pollution in early life contributes to the burden of childhood asthma, but it is not clear whether long-term exposure to air pollution can lead to asthma onset or progression in adulthood.......Exposure to air pollution in early life contributes to the burden of childhood asthma, but it is not clear whether long-term exposure to air pollution can lead to asthma onset or progression in adulthood....

  4. Economic analysis of the phase III MENSA study evaluating mepolizumab for severe asthma with eosinophilic phenotype.

    Science.gov (United States)

    Basu, Anirban; Dalal, Anand; Canonica, Giorgio Walter; Forshag, Mark; Yancey, Steven W; Nagar, Saurabh; Bell, Christopher F

    2017-04-01

    Severe eosinophilic asthma patients are at risk of exacerbations, which are associated with substantial costs. Mepolizumab lowers eosinophil levels and reduces exacerbation risk in severe eosinophilic asthma. We evaluated asthma-related exacerbation costs in mepolizumab-treated patients (versus placebo). A within-trial economic analysis of the Mepolizumab as Adjunctive Therapy in Patients with Severe Asthma (MENSA) trial. Objectives were to quantify the incremental: (1) medical costs of asthma-related exacerbation; (2) asthma-related exacerbation emergency department visit/hospitalization costs; and (3) asthma-related total healthcare resource utilization. Mean medical costs of asthma-related exacerbations at 8 months were $969, $852, and $1692 in the mepolizumab 75 mg intravenous (IV), mepolizumab 100 mg subcutaneous (SC), and placebo groups, respectively (p = 0.16). Mean medical costs from emergency department visits or hospitalizations due to asthma-related exacerbations were $901, $795, and $1557 in the mepolizumab 75 mg IV, mepolizumab 100 mg SC, and placebo groups (p = 0.020). Asthma-related healthcare resource utilization (all services) was lower for the mepolizumab groups versus placebo. Adding mepolizumab to standard-of-care treatment for severe eosinophilic asthma lowered asthma exacerbation-related medical costs/healthcare resource utilization; although the cost savings ranged from $723-$840 per patient, differences were not statistically significant.

  5. 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

    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......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....... 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...

  6. Asthma in elite athletes: how do we manage asthma-like symptoms and asthma in elite athletes?

    DEFF Research Database (Denmark)

    Lund, Thomas Kromann

    2009-01-01

    . Elite athletes with physician-diagnosed asthma seem to have less airway reactivity and fewer sputum eosinophils than non-athletes with physician-diagnosed asthma, but more studies are needed to further investigate if and how the asthma phenotype of elite athletes differs from that of classical asthma....

  7. Critical factors for bioenergy technology implementation. Five case studies of bioenergy markets in the United States, Sweden and Austria

    Energy Technology Data Exchange (ETDEWEB)

    Roos, Anders [Swedish Univ. of Agricultural Sciences, Uppsala (Sweden). Dept. of Forest-Industry-Market Studies

    1998-07-01

    This report analyses the driving forces of, and barriers to, biomass energy technology implementation with the objective of defining the most important factors behind the growth of bioenergy markets and suggesting strategies for policy makers and investors. The approach is to describe the important factors for the development of real bioenergy markets at two levels: (1) Institutional, primarily policy, and (2) market structure. Concepts from economic theory, primarily transaction cost theory and industrial organisation, are used in a qualitative way. The report is based on literature studies and field studies of bioenergy markets in three countries: the United States of America, Austria, and Sweden. It is divided into five sections. After the introduction in section one, literature with relevance for this study is reviewed in section two. In section three the energy policy and energy sectors of each country are described. The descriptions include an overview of the biomass energy sectors. Five cases of developed bioenergy markets in the three countries are presented in section four. The cases are residential heating with wood pellets in New Hampshire, United States, biomass power production in Maine, residential heating with pellets in Sweden, biomass district heating in Sweden, and biomass district heating in Austria. All markets are described in terms of the historical development, technical issues, economics, market structure and local policy influences. In the discussion in section five a number of key factors behind the success or failure of bioenergy are presented. Six factors are most important: (1) Complementaries between the bioenergy operations and another activity (for instance when the bioenergy production uses biomass waste products from another industry); (2) economics of scale within the bioenergy business through larger production series, standards, specialization etc.; (3) a competitive bioenergy market (Many sellers and buyers operate in the

  8. Critical factors for bioenergy technology implementation. Five case studies of bioenergy markets in the United States, Sweden and Austria

    International Nuclear Information System (INIS)

    Roos, Anders

    1998-01-01

    This report analyses the driving forces of, and barriers to, biomass energy technology implementation with the objective of defining the most important factors behind the growth of bioenergy markets and suggesting strategies for policy makers and investors. The approach is to describe the important factors for the development of real bioenergy markets at two levels: (1) Institutional, primarily policy, and (2) market structure. Concepts from economic theory, primarily transaction cost theory and industrial organisation, are used in a qualitative way. The report is based on literature studies and field studies of bioenergy markets in three countries: the United States of America, Austria, and Sweden. It is divided into five sections. After the introduction in section one, literature with relevance for this study is reviewed in section two. In section three the energy policy and energy sectors of each country are described. The descriptions include an overview of the biomass energy sectors. Five cases of developed bioenergy markets in the three countries are presented in section four. The cases are residential heating with wood pellets in New Hampshire, United States, biomass power production in Maine, residential heating with pellets in Sweden, biomass district heating in Sweden, and biomass district heating in Austria. All markets are described in terms of the historical development, technical issues, economics, market structure and local policy influences. In the discussion in section five a number of key factors behind the success or failure of bioenergy are presented. Six factors are most important: (1) Complementaries between the bioenergy operations and another activity (for instance when the bioenergy production uses biomass waste products from another industry); (2) economics of scale within the bioenergy business through larger production series, standards, specialization etc.; (3) a competitive bioenergy market (Many sellers and buyers operate in the

  9. Characteristics of spousal homicide perpetrators: a study of all cases of spousal homicide in Sweden 1990-1999.

    Science.gov (United States)

    Belfrage, Henrik; Rying, Mikael

    2004-01-01

    In Sweden 20 000 cases of assault against women are reported to the police every year. All data on the perpetrators of spousal homicide in Sweden between 1990 and 1999 were investigated (n = 164). A control group of all other perpetrators of homicide in Sweden during the same period, i.e. cases of homicide not committed in the context of spouse violence (n = 690) was used. All verdicts, as well as all material in the police investigations, including interviews with all of the police investigators, were analysed. Copies of police examinations of the suspects, and forensic reports from the autopsies, were also examined. Data on all registered criminality were collected from the National Police Register, and in cases where the perpetrators had been subject to forensic psychiatric examinations, those reports were obtained from the Swedish National Board of Forensic Medicine. In addition, the Psychopathy Checklist: Screening Version scores were rated from the forensic psychiatric examinations. There was a four times higher suicide rate among the spousal homicide perpetrators (24%, n = 40) compared with the perpetrators in the control-group (6%, n = 39, chi-squared = 55,42 df = 1, p suicidal ideation must be considered as an important risk factor for spousal homicide. In 79% of the cases the spousal homicide perpetrators were subject to forensic psychiatric examinations. All except 5% were diagnosed with at least one psychiatric diagnosis, and 34% were sentenced to forensic psychiatric treatment. If it is assumed that the psychiatric morbidity was high in the 24% of the perpetrators who committed suicide, then 80% of all perpetrators of spouse homicide during the study period can be characterized as mentally disordered. 'Psychopathic' perpetrators, who generally are over-represented in most violent criminality, were comparatively uncommon. Only seven (4%) in the study group met the diagnostic criteria for psychopathy as measured with the PCL:SV. The group of spouse

  10. Intra- and extra-familial child homicide in Sweden 1992-2012: A population-based study.

    Science.gov (United States)

    Hedlund, Jonatan; Masterman, Thomas; Sturup, Joakim

    2016-04-01

    Previous studies have shown decreasing child homicide rates in many countries - in Sweden mainly due to a drop in filicide-suicides. This study examines the rate of child homicides during 21 years, with the hypothesis that a decline might be attributable to a decrease in the number of depressive filicide offenders (as defined by a proxy measure). In addition, numerous characteristics of child homicide are presented. All homicide incidents involving 0-14-year-old victims in Sweden during 1992-2012 (n = 90) were identified in an autopsy database. Data from multiple registries, forensic psychiatric evaluations, police reports, verdicts and other sources were collected. Utilizing Poisson regression, we found a 4% annual decrease in child homicides, in accordance with prior studies, but no marked decrease regarding the depressive-offender proxy. Diagnoses from forensic psychiatric evaluations (n = 50) included substance misuse (8%), affective disorders (10%), autism-spectrum disorders (18%), psychotic disorders (28%) and personality disorders (30%). Prior violent offences were more common among offenders in filicides than filicide-suicides (17.8% vs. 6.9%); and about 20% of offenders in each group had previously received psychiatric inpatient care. Aggressive methods of filicide predominated among fathers. Highly lethal methods of filicide (firearms, fire) were more commonly followed by same-method suicide than less lethal methods. Interestingly, a third of the extra-familial offenders had an autism-spectrum disorder. Based on several findings, e.g., the low rate of substance misuse, the study concludes that non-traditional risk factors for violence must be highlighted by healthcare providers. Also, the occurrence of autism-spectrum disorders in the present study is a novel finding that warrants further investigation. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  11. Risk factors and potential preventive measures for nephropatia epidemica in Sweden 2011–2012: a case–control study

    Directory of Open Access Journals (Sweden)

    Alin Gherasim

    2015-06-01

    Full Text Available Introduction: Nephropatia epidemica (NE, a relatively mild form of hemorrhagic fever with renal syndrome caused by the Puumala virus (PUUV, is endemic in northern Sweden. We aim to study the risk factors associated with NE in this region. Methods: We conducted a matched case–control study between June 2011 and July 2012. We compared confirmed NE cases with randomly selected controls, matched by age, sex, and place of infection or residence. We analyzed the association between NE and several occupational, environmental, and behavioral exposures using conditional logistic regression. Results: We included in the final analysis 114 cases and 300 controls, forming 246 case–control pairs. Living in a house with an open space beneath, making house repairs, living less than 50 m from the forest, seeing rodents, and smoking were significantly associated with NE. Conclusion: Our results could orient public health policies targeting these risk factors and subsequently reduce the NE burden in the region.

  12. Characteristics of nursing studies in diabetes research published over three decades in Sweden, Norway, Denmark and Iceland

    DEFF Research Database (Denmark)

    Iversen, Marjolein M; Graue, Marit; Leksell, Janeth

    2015-01-01

    Similarities and differences across borders of Nordic countries constitute a suitable context for investigating and discussing factors related to the development of diabetes nursing research over the last three decades. The present study reviewed the entire body of contemporary diabetes nursing...... research literature originating in four Nordic countries: Norway, Sweden, Denmark and Iceland. Our aims were (i) to catalogue and characterise trends in research designs and research areas of these studies published over time and (ii) to describe how research involving nurses in Nordic countries has...... nurse researchers have contributed to the development of new knowledge in self-management of diabetes in childhood, adolescence and adulthood, and to some extent also in the treatment and care of diabetes foot ulcers. Future research may benefit from (i) larger nurse-led research programmes organised...

  13. Ecohydrological Responses to Diversion of Groundwater: Case Study of a Deep-Rock Repository for Spent Nuclear Fuel in Sweden

    International Nuclear Information System (INIS)

    Werner, Kent; Collinder, Per; Berglund, Sten; Maartensson, Erik

    2013-01-01

    Planning and license applications concerning groundwater diversion in areas containing water-dependent or water-favored habitats must take into account both hydrological effects and associated ecological consequences. There is at present no established methodology to assess such ecohydrological responses. Thus, this paper describes a new stepwise methodology to assess ecohydrological responses to groundwater diversion from, e.g., water-drained pits, shafts, tunnels, and caverns in rock below the groundwater table. The methodology is illustrated using the planned deep-rock repository for spent nuclear fuel at Forsmark in central Sweden as a case study, offering access to a unique hydrological and ecological dataset. The case study demonstrates that results of ecohydrological assessments can provide useful inputs to planning of monitoring programs and mitigation measures in infrastructure projects. As a result of the assessment, artificial water supply to wetlands is planned in order to preserve biological diversity, nature values, and vulnerable species

  14. Incidence rates of atopic dermatitis, asthma, and allergic rhinoconjunctivitis in Danish and Swedish children

    DEFF Research Database (Denmark)

    Henriksen, Lonny; Simonsen, Jacob; Haerskjold, Ann

    2015-01-01

    BACKGROUND: Several studies have shown that the prevalence of the frequent chronic conditions of atopic dermatitis, asthma, and allergy has increased substantially for reasons not fully understood. Atopic diseases affect quality of life in both children and their family members. OBJECTIVE: Using...... national registers, we sought to establish up-to-date incidence rates of atopic dermatitis, asthma, and allergic rhinoconjunctivitis in the Danish and Swedish child populations. METHODS: Children born in Denmark from 1997 to 2011 or born in Sweden from 2006 to 2010 participated in this cross......-national, population-based cohort study. Incidence rates of atopic dermatitis, asthma, and allergic rhinoconjunctivitis in the Danish and Swedish child cohorts were ascertained through disease-specific dispensed prescribed medication, specific hospital contacts, or both. RESULTS: In both countries the incidence rate...

  15. Familial confounding of the association between maternal smoking during pregnancy and offspring criminality: a population-based study in Sweden.

    Science.gov (United States)

    D'Onofrio, Brian M; Singh, Amber L; Iliadou, Anastasia; Lambe, Mats; Hultman, Christina M; Grann, Martin; Neiderhiser, Jenae M; Långström, Niklas; Lichtenstein, Paul

    2010-05-01

    The association between maternal smoking during pregnancy (SDP) and offspring disruptive behaviors has been well documented, but it is unclear whether exposure to SDP or the effects of factors correlated with SDP account for the increased risk. To test whether the association between SDP and offspring criminal convictions was consistent with a causal connection or due to familial background factors by controlling for measured covariates and using a quasi-experimental approach. We used a population-based study of children born in Sweden from 1983 to 1989 (N = 609,372) to examine the association between SDP and offspring criminal convictions while controlling for measured traits of both parents. We also compared siblings differentially exposed to SDP (n = 50,339) to account for unmeasured familial factors that could account for the association. Population-based study of all children born in Sweden from 1983 to 1989 with information on maternal SDP and offspring criminal convictions based on national registries collected by the Swedish government. Children born in Sweden from 1983 to 1989 (N = 609,372) and siblings differentially exposed to SDP (n = 50,339). Violent and nonviolent convictions, based on the Swedish National Crime Register, a register with detailed information on all convictions in the country. Moderate (hazard rate [HR], 2.47; 95% confidence interval [CI], 2.34-2.60) and high (HR, 3.43; 95% CI, 3.25-3.63) levels of maternal SDP were associated with an increased risk for offspring violent convictions, even when controlling for maternal and paternal traits. There was no association between SDP and violent convictions, however, when comparing differentially exposed siblings (HR(moderate), 1.02; 95% CI, 0.79-1.30; HR(high), 1.03; 95% CI, 0.78-1.37). Smoking during pregnancy also was associated with nonviolent convictions in the entire population (HR(moderate), 1.62; 95% CI, 1.58-1.66; HR(high), 1.87; 95% CI, 1.82-1.92) and when controlling for covariates

  16. Long-term studies of the natural history of asthma in childhood

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Bønnelykke, Klaus

    2010-01-01

    secondary prevention through the use of inhaled corticosteroids can effectively halt the long-term disease progression in childhood. In conclusion, the natural history of asthma and the associated airway changes is still poorly understood, and we have not managed to translate findings from long-term studies...... into a deeper understanding of the underlying endophenotypes or improved disease management. We propose the need for a translational research approach based on long-term clinical studies of birth cohorts with comprehensive and objective assessments of intermediate phenotypes and environmental exposures combined...

  17. Adequate vitamin D levels in a Swedish population living above latitude 63°N: The 2009 Northern Sweden MONICA study

    Science.gov (United States)

    Ramnemark, Anna; Norberg, Margareta; Pettersson-Kymmer, Ulrika; Eliasson, Mats

    2015-01-01

    Background Even though vitamin D is mainly produced by exposure to sunlight, little is known regarding vitamin D levels in populations living in sub-Arctic areas with little or no daylight during winter. Objective We describe distributions of vitamin D3 and the prevalence of adequate levels in a population living above 63°N. Design We sampled 1,622 randomly selected subjects, aged 25–74 years, between January and May, 2009, as part of the Northern Sweden MONICA study (69.2% participation rate). By using HPLC, 25(OH) vitamin D3 was analysed. Levels used for definitions were deficient, D3Sweden or Finland had lower levels. Conclusion The large majority living close to the Arctic Circle in Sweden have adequate D3 levels even during the second half of the dark winter. Subjects with D3 deficiency were uncommon but insufficient levels were often found among young men. PMID:25976742

  18. Asthma - quick-relief drugs

    Science.gov (United States)

    ... Asthma - children Wheezing Patient Instructions Asthma and school Asthma - child - discharge Asthma - control drugs Asthma - what to ask the doctor - adult Asthma - what to ask your doctor - child Bronchiolitis - discharge Exercise-induced asthma Exercising and asthma ...

  19. Fertility outcomes in asthma

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...... pregnancies during fertility treatment, 39.6 versus 60.4% (p=0.002). Increasing age was of negative importance for expected time to pregnancy, especially among asthmatic women (interaction between age and asthma on time to pregnancy, p=0.001). Female asthmatics had a longer time to pregnancy and less often...

  20. Earthquake activity in Sweden. Study in connection with a proposed nuclear waste repository in Forsmark or Oskarshamn

    International Nuclear Information System (INIS)

    Boedvarsson, Reynir; Lund, Bjoern; Roberts, Roland; Slunga, Ragnar

    2006-02-01

    The aim of this report is to evaluate the risks for future earthquakes in the vicinity of the proposed nuclear waste repository sites at Forsmark and Oskarshamn. Time periods of 100 and 1,000 years will be considered, which implies that the focus of this study is on an evaluation of the current, general situation in the region. Major events on a longer time scale, such as an ice-age, will only be briefly considered. Earthquakes are products of ongoing deformations within the Earth and this report will, therefore, concentrate on the current state of knowledge about deformations in the region. As earthquakes are our most important source of information about deformations at depth in the crust, we will focus on the available seismic data using the Nordic earthquake catalog maintained at the Institute of Seismology, Helsinki University, and the recent data from the new Swedish National Seismic Network. Direct measurements of surface deformation using the Global Positioning System will also be utilized in the analysis. Sweden is a low seismicity area, with most earthquakes being observed in the south-west, around Lake Vaenern, along the north-east coast and in Norrbotten. South-eastern Sweden is on the contrary relatively inactive. Seismicity is also, generally, episodic in time which together with the short period of instrumental observation, approximately 100 years, makes our knowledge about the activity far from complete. Although very large earthquakes (magnitude about 8) have occurred in Sweden, it is generally agreed that these were connected to the late stages of deglaciation at the end of the previous ice-age. At the time scales considered in this report, inferences from current seismicity is of more relevance. This data suggests that we should expect at least one magnitude 5 earthquake in our region every century and one magnitude 6 earthquake every one thousand years. In order to illustrate the effects of static and dynamic deformation from a magnitude 5

  1. Earthquake activity in Sweden. Study in connection with a proposed nuclear waste repository in Forsmark or Oskarshamn

    Energy Technology Data Exchange (ETDEWEB)

    Boedvarsson, Reynir; Lund, Bjoern; Roberts, Roland; Slunga, Ragnar [Uppsala Univ. (Sweden). Dept. of Earth Sciences

    2006-02-15

    The aim of this report is to evaluate the risks for future earthquakes in the vicinity of the proposed nuclear waste repository sites at Forsmark and Oskarshamn. Time periods of 100 and 1,000 years will be considered, which implies that the focus of this study is on an evaluation of the current, general situation in the region. Major events on a longer time scale, such as an ice-age, will only be briefly considered. Earthquakes are products of ongoing deformations within the Earth and this report will, therefore, concentrate on the current state of knowledge about deformations in the region. As earthquakes are our most important source of information about deformations at depth in the crust, we will focus on the available seismic data using the Nordic earthquake catalog maintained at the Institute of Seismology, Helsinki University, and the recent data from the new Swedish National Seismic Network. Direct measurements of surface deformation using the Global Positioning System will also be utilized in the analysis. Sweden is a low seismicity area, with most earthquakes being observed in the south-west, around Lake Vaenern, along the north-east coast and in Norrbotten. South-eastern Sweden is on the contrary relatively inactive. Seismicity is also, generally, episodic in time which together with the short period of instrumental observation, approximately 100 years, makes our knowledge about the activity far from complete. Although very large earthquakes (magnitude about 8) have occurred in Sweden, it is generally agreed that these were connected to the late stages of deglaciation at the end of the previous ice-age. At the time scales considered in this report, inferences from current seismicity is of more relevance. This data suggests that we should expect at least one magnitude 5 earthquake in our region every century and one magnitude 6 earthquake every one thousand years. In order to illustrate the effects of static and dynamic deformation from a magnitude 5

  2. Costs of shoulder pain and resource use in primary health care: a cost-of-illness study in Sweden

    Directory of Open Access Journals (Sweden)

    Virta Lena

    2012-02-01

    Full Text Available Abstract Background Painful shoulders pose a substantial socioeconomic burden. A prospective cost-of-illness study was performed to assess the costs associated with healthcare use and loss of productivity in patients with shoulder pain in primary health care in Sweden. Methods The study was performed in western Sweden, in a region with 24 000 inhabitants. Data were collected during six months from electronic patient records at three primary healthcare centres in two municipalities. All patients between 20 and 64 years of age who presented with shoulder pain to a general practitioner or a physiotherapist were included. Diagnostic codes were used for selection, and the cases were manually controlled. The cost for sick leave was calculated according to the human capital approach. Sensitivity analysis was used to explore uncertainty in various factors used in the model. Results 204 (103 women patients, mean age 48 (SD 11 years, were registered. Half of the cases were closed within six weeks, whereas 32 patients (16% remained in the system for more than six months. A fifth of the patients were responsible for 91% of the total costs, and for 44% of the healthcare costs. The mean healthcare cost per patient was €326 (SD 389 during six months. Physiotherapy treatments accounted for 60%. The costs for sick leave contributed to 84% of the total costs. The mean annual total cost was €4139 per patient. Estimated costs for secondary care increased the total costs by one third. Conclusions The model applied in this study provides valuable information that can be used in cost evaluations. Costs for secondary care and particularly for sick leave have a major influence on total costs and interventions that can reduce long periods of sick leave are warranted.

  3. Disease burden of herpes zoster in Sweden - predominance in the elderly and in women - a register based study

    Science.gov (United States)

    2013-01-01

    Background The herpes zoster burden of disease in Sweden is not well investigated. There is no Swedish immunization program to prevent varicella zoster virus infections. A vaccine against herpes zoster and its complications is now available. The aim of this study was to estimate the herpes zoster burden of disease and to establish a pre-vaccination baseline of the minimum incidence of herpes zoster. Methods Data were collected from the Swedish National Health Data Registers including the Patient Register, the Pharmacy Register, and the Cause of Death Register. The herpes zoster burden of disease in Sweden was estimated by analyzing the overall, and age and gender differences in the antiviral prescriptions, hospitalizations and complications during 2006-2010 and mortality during 2006-2009. Results Annually, 270 per 100,000 persons received antiviral treatment for herpes zoster, and the prescription rate increased with age. It was approximately 50% higher in females than in males in the age 50+ population (rate ratio 1.39; 95% CI, 1.22 to 1.58). The overall hospitalization rate for herpes zoster was 6.9/100,000 with an approximately three-fold increase for patients over 80 years of age compared to the age 70-79 group. A gender difference in hospitalization rates was observed: 8.1/100,000 in females and 5.6/100,000 in males. Herpes zoster, with a registered complication, was found in about one third of the hospitalized patients and the most common complications involved the peripheral and central nervous systems. Death due to herpes zoster was a rare event. Conclusions The results of this study demonstrate the significant burden of herpes zoster disease in the pre-zoster vaccination era. A strong correlation with age in the herpes zoster- related incidence, hospitalization, complications, and mortality rates was found. In addition, the study provides further evidence of the female predominance in herpes zoster disease. PMID:24330510

  4. Exercise-induced bronchospasm related to different phenotypes of rhinitis without asthma in primary schoolchildren: the French Six Cities Study.

    Science.gov (United States)

    Caillaud, D; Horo, K; Baiz, N; Banerjee, S; Charpin, D; Lavaud, F; de Blay, F; Raherison, C; Annesi-Maesano, I

    2014-06-01

    Exercise-induced bronchospasm (EIB) is frequent among asthmatic children. However, opinions differ on the relation between EIB and rhinitis in the absence of asthma. We assessed the relationship between EIB and various phenotypes of rhinitis according to asthmatic status at the general population level in the Six Cities Study. Of 7781 schoolchildren with a mean age of 10 years underwent an EIB test and skin prick test to assess allergic sensitization. Their parents completed a standardized questionnaire recording asthma-like symptoms and past-year rhinoconjunctivitis, ever hay fever (EHF), and a score for allergic rhinitis (SFAR) ≥7 as a marker of 'past-year allergic rhinitis'. Exercise-induced bronchospasm was defined as a fall in peak expiratory flow rate ≥15% after exercise. Of the 6813 schoolchildren retained for analysis, 227 (3.33%) experienced EIB after exercise. Odds ratios [95% confidence intervals] between EIB and allergic rhinitis phenotypes in the absence of asthma were 1.56 [0.92-2.63] for EHF, 1.97 [1.16-3.35] for past-year rhinoconjunctivitis, and 1.84 [1.16-2.91] for a SFAR ≥7. Results were unchanged after adjustment for confounders. Multiple correspondence analysis showed that EIB, although related to asthma, constitutes a separate entity. Exercise-induced bronchospasm was not significantly related to familial history of asthma. In our large population-based sample of children, different phenotypes of atopic rhinitis were associated with EIB, independently of asthma. Exercise-induced bronchospasm, although related to asthma, seems to constitute a separate entity. In this large (6813) sample of 10-year children drawn from the general population, EIB is associated with rhinitis phenotypes in the absence of asthma. Furthermore, it constitutes an entity independent from asthma and is not related to a familial history of asthma. Thus, investigating these symptoms could be important in this disease, as a specific nasal treatment might improve EIB

  5. Duration of residence and psychotropic drug use in recently settled refugees in Sweden - a register-based study

    DEFF Research Database (Denmark)

    Brendler-Lindqvist, Maria; Nørredam, Marie Louise; Hjern, Anders

    2014-01-01

    INTRODUCTION: Recently settled refugee populations have consistently been reported to have high rates of mental health problems, particularly Post-traumatic stress disorder, depression, and anxiety disorders. The aim of this study was to investigate psychotropic drug use among young adult refugees......-born residents. Logistic regression was used to assess the association between duration of residence in Sweden and the dispensing of at least one psychotropic medication during 2009 in four categories (any drug, neuroleptics, antidepressants and anxiolytics/hypnotics), adjusting for age, gender and domicile....... RESULTS: Rates of dispensed psychotropic drugs among recently settled refugees were low, compared to the Swedish-born, with an increase with duration of residence. For refugee men and women from Iraq/Iran who had resided for 0-3 years the adjusted ORs compared to Swedish natives, were 0.83 (95% CI 0...

  6. Comparing Global Initiative for Asthma (GINA) criteria with the Childhood Asthma Control Test (C-ACT) and Asthma Control Test (ACT)

    NARCIS (Netherlands)

    Koolen, B.B.; Pijnenburg, M.W.; Brackel, H.J.; Landstra, A.M.; Berg, N.J. van den; Merkus, P.J.F.M.; Hop, W.C.J.; Vaessen-Verberne, A.A.

    2011-01-01

    Several tools are useful in detecting uncontrolled asthma in children. The aim of this study was to compare Global Initiative for Asthma (GINA) guidelines with the Childhood Asthma Control Test (C-ACT) and the Asthma Control Test (ACT) in detecting uncontrolled asthma in children. 145 children with

  7. 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.

  8. Are Sudanese community pharmacists capable to prescribe and demonstrate asthma inhaler devices to patrons? A mystery patient study.

    Science.gov (United States)

    Osman, Abuzar; Ahmed Hassan, Imad S; Ibrahim, Mohamed Izham M

    2012-04-01

    Although community pharmacists have become more involved in the care of asthma patients, several studies have assessed pharmacists''ability to illustrate appropriately inhalation technique of different asthma devices. Many studies addressed inappropriate use of asthma devices by patients and pharmacists, in addition to its clinical, humanistic and economic burden. To evaluate community pharmacists' practical knowledge and skills of demonstrating proper inhalation technique of asthma inhaler devices available in Sudan. THREE HUNDRED COMMUNITY PHARMACIES LOCATED AROUND THE THREE MAJOR HOSPITALS IN THE CAPITAL CITY (KHARTOUM) AND FOUR OTHER PROVINCES WERE APPROACHED, AND FOUR ASTHMA DEVICES WERE ASSESSED: Metered-dose inhaler (MDI) (n=105), MDI with Spacer (n=83), Turbuhaler (n=61), and Diskus (n=51). Investigator (a pharmacist) acted as a mystery patient. He selected one device and asked the serving pharmacist to demonstrate how to use the device. Investigator completed a checklist of 9 steps of inhaler device use immediately after leaving the pharmacy. Essential steps derived from published literature were pre-specified for each device. Five evaluation categories were accordingly formulated as follows: optimal technique, adequate technique, poor technique, totally unfamiliar with the device, and does not know. More than half of the pharmacists approached with metered dose inhaler did not know how to use optimal technique (ie all steps correct) all through. A third poorly demonstrated the technique, and only one pharmacist was categorized as being able to demonstrate an "optimal technique". The majority of pharmacists approached with spacing chamber and dry powder inhalers (Turbuhaler and Diskus) either did not know proper technique or were totally unfamiliar with the devices. The majority of community pharmacists, who were expected to educate asthma patients on their dispensed inhalers, lack the basic knowledge of proper use of commonly dispensed asthma inhaler

  9. Are Sudanese community pharmacists capable to prescribe and demonstrate asthma inhaler devices to patrons? A mystery patient study

    Directory of Open Access Journals (Sweden)

    Osman A

    2012-06-01

    Full Text Available Although community pharmacists have become more involved in the care of asthma patients, several studies have assessed pharmacists’ ability to illustrate appropriately inhalation technique of different asthma devices. Many studies addressed inappropriate use of asthma devices by patients and pharmacists, in addition to its clinical, humanistic and economic burden.Objective: To evaluate community pharmacists’ practical knowledge and skills of demonstrating proper inhalation technique of asthma inhaler devices available in Sudan.Method: Three hundred community pharmacies located around the three major hospitals in the capital city (Khartoum and four other provinces were approached, and four asthma devices were assessed: Metered-dose inhaler (MDI (n=105, MDI with Spacer (n=83, Turbuhaler (n=61, and Diskus (n=51. Investigator (a pharmacist acted as a mystery patient. He selected one device and asked the serving pharmacist to demonstrate how to use the device. Investigator completed a checklist of 9 steps of inhaler device use immediately after leaving the pharmacy. Essential steps derived from published literature were pre-specified for each device. Five evaluation categories were accordingly formulated as follows: optimal technique, adequate technique, poor technique, totally unfamiliar with the device, and does not know.Results: More than half of the pharmacists approached with metered dose inhaler did not know how to use optimal technique (ie all steps correct all through. A third poorly demonstrated the technique, and only one pharmacist was categorized as being able to demonstrate an “optimal technique”. The majority of pharmacists approached with spacing chamber and dry powder inhalers (Turbuhaler and Diskus either did not know proper technique or were totally unfamiliar with the devices.Conclusion: The majority of community pharmacists, who were expected to educate asthma patients on their dispensed inhalers, lack the basic knowledge

  10. Comorbidity, disease burden and mortality across age groups in a Swedish primary care asthma population: An epidemiological register study (PACEHR).

    Science.gov (United States)

    Lisspers, Karin; Janson, Christer; Larsson, Kjell; Johansson, Gunnar; Telg, Gunilla; Thuresson, Marcus; Ställberg, Björn

    2018-03-01

    Asthma is often associated with other diseases. To identify and manage comorbidities is important, as these conditions may increase the disease burden. To describe the prevalence of comorbidities, disease burden and mortality across age groups in a large Swedish primary care real-life asthma population. Observational cohort study of asthma patients, all ages, identified from electronic medical records by ICD-10-CM code, data from 36 primary care centers. Data were linked to national mandatory Swedish health registers. Comorbidities were identified by ICD-10-CM codes and collected from electronic medical records and the National Patient Registers, mortality data from the Cause of Death Register. Exacerbations were defined as hospitalizations due to asthma, and/or emergency visits at hospital and/or prescription claims of oral steroids. In total 33,468 patients (58% women) were included. The most prevalent comorbidities were acute upper respiratory tract infection (53%), rhinitis (25%), acute lower respiratory tract infection (25%), hypertension (21%), anxiety and depression (20%). The comorbidities associated with highest risk for an exacerbation were COPD OR 1.98 (95%CI: 1.80-2.19), nasal polyps OR 1.75 (95%CI: 1.49-2.05) and rhinitis OR 1.52 (95%CI: 1.41-1.63). All-cause mortality was similar to the Swedish population, 1011 deaths per 100,000 person/year compared with 1058 deaths (standardized risk = 0.99 [95%CI:0.95-1.04]). The pulmonary related death rate was greater in the study population versus the Swedish population (122 versus 72 per 100,000person/year). Comorbid disease was frequent in this large real-life asthma population with an impact on exacerbations. To identify and treat comorbidities with impact on asthma outcomes are essential to improve asthma care. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Greater severity of new onset asthma in allergic subjects who smoke: a 10-year longitudinal study

    Directory of Open Access Journals (Sweden)

    Antic Tjana

    2011-01-01

    Full Text Available Abstract Background Little is known about the association between cigarette smoking and asthma severity. We assessed smoking as a determinant of disease severity and control in a cohort of clinic-referred allergic subjects who developed new onset asthma. Methods Allergic rhinitis subjects with no asthma (n = 371 were followed-up for 10 years and routinely examined for asthma diagnosis. In those who developed asthma (n = 152, clinical severity and levels of asthma control were determined. Among these subjects, 74 (48.7% were current smokers, 17 (11.2% former smokers, and 61 (40.1% never smokers. Results When comparing current or past smokers to never smokers they had a higher risk of severe asthma in the univariate analysis, which became non-significant in the multivariate analysis. On the other hand, the categories of pack-years were significantly related to severe asthma in a dose response relationship in both the univariate and multivariate analysis: compared to 0 pack years, those who smoked 1-10 pack-years had an OR(95% CI of 1.47(0.46-4.68, those who smoked 11-20 pack-years had an OR of 2.85(1.09-7.46 and those who smoked more than 20 pack-years had an OR of 5.59(1.44-21.67 to develop more severe asthma. Smokers with asthma were also more likely to have uncontrolled disease. A significant dose-response relationship was observed for pack-years and uncontrolled asthma. Compared to 0 pack years, those who smoked 1-10 pack-years had an OR of 5.51(1.73-17.54 and those who smoked more than 10 pack-years had an OR of 13.38(4.57-39.19 to have uncontrolled asthma. Conclusions The current findings support the hypothesis that cigarette smoking is an important predictor of asthma severity and poor asthma control.

  12. 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...... sensitive towards. Reducing this exposure may improve the asthma control in these children. Previous studies give conflicting information on the effect of mechanical ventilation on asthma control in children. Objectives We aim at investigating whether mechanical ventilation is capable of improving indoor...... 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...

  13. Assessment of population radiation exposure after a nuclear reactor accident. Field studies in Russia and Sweden after Chernobyl

    International Nuclear Information System (INIS)

    Wallstroem, E.

    1998-10-01

    Since May 1986 a number of studies connecting to the Chernobyl accident have been performed in Western Sweden and in the Brjansk region in Russia. The total deposition of 137 Cs in the investigated area in Sweden was 0.001 - 0.002 MBq/m 2 , mainly deposited as wet deposition on May 8, and in the Brjansk region 0.9 - 2.7 MBq/m 2 . In Sweden, studies of the transfer of 134 Cs, 137 Cs and 131 I in soil, grass, cow's milk, cow and man are presented for 1986-1987. Whole-body measurements of 134 Cs and 137 Cs in 1986-1989 as well as measurements of 131 I in thyroids have been made with stationary whole-body counters. External exposure of persons in villages in the Brjansk region are given for the years 1990 - 1994. The method of estimating the body burden of 137 Cs from individual urine samples taken in the Brjansk region 1991-1997 has been investigated from samples and whole-body measurements performed by 'lap-geometry'. In the investigated farms in Western Sweden the transfer values of 131 l and 134 Cs, 137 Cs from grass to cow's milk in 1986 were similar to values found in the period of deposition from atmospheric nuclear weapons tests in the 1960s. In 1987 the values of transfer of 134 Cs and 137 Cs were more similar to studies with artificially added cesium in the form of e.g. CsCI. Whole-body measurements in Goeteborg and Malmoe showed an increase of the whole-body content of 134 Cs and 137 Cs up to one year after the accident followed by a slow decrease. Maximum mean value of 137 Cs was 400 - 450 Bq or around 6 Bq/kg in adults. The content of 131 I in the thyroids showed already before the wet main deposition measurable values which decreased fast. The internal contamination of 131 I was due to inhalation, but also to ingestion. The total effective dose was estimated, based on calculations and measurements, to be 37 μSv to 13 μSv year one to four after the accident. The external exposure in villages in the Brjansk region was estimated by measurements of

  14. Febrile Seizures and Epilepsy: Association With Autism and Other Neurodevelopmental Disorders in the Child and Adolescent Twin Study in Sweden.

    Science.gov (United States)

    Gillberg, Christopher; Lundström, Sebastian; Fernell, Elisabeth; Nilsson, Gill; Neville, Brian

    2017-09-01

    There is a recently well-documented association between childhood epilepsy and earlysymptomaticsyndromeselicitingneurodevelopmentalclinicalexaminations (ESSENCE) including autism spectrum disorder, but the relationship between febrile seizures and ESSENCE is less clear. The Child and Adolescent Twin Study in Sweden (CATSS) is an ongoing population-based study targeting twins born in Sweden since July 1, 1992. Parents of 27,092 twins were interviewed using a validated DSM-IV-based interview for ESSENCE, in connection with the twins' ninth or twelfth birthday. Diagnoses of febrile seizures (n = 492) and epilepsy (n = 282) were based on data from the Swedish National Patient Register. Prevalence of ESSENCE in individuals with febrile seizures and epilepsy was compared with prevalence in the twin population without seizures. The association between febrile seizures and ESSENCE was considered before and after adjustment for epilepsy. Age of diagnosis of febrile seizures and epilepsy was considered as a possible correlate of ESSENCE in febrile seizures and epilepsy. The rate of ESSENCE in febrile seizures and epilepsy was significantly higher than in the total population without seizures (all P < 0.001). After adjusting for epilepsy, a significant association between febrile seizures and autism spectrum disorder, developmental coordination disorder, and intellectual disability remained. Earlier age of onset was associated with all ESSENCE except attention-deficit/hyperactivity disorder in epilepsy but not with ESSENCE in febrile seizures. In a nationally representative sample of twins, there was an increased rate of ESSENCE in childhood epilepsy and in febrile seizures. Febrile seizures alone could occur as a marker for a broader ESSENCE phenotype. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Combining scientific and societal challenges: a water supply case study from the Koster Islands, Sweden

    Science.gov (United States)

    Barthel, Roland; Ekström, Linda Louise; Ljungkvist, Andreas; Granberg, Maria; Merisalu, Johanna; Pokorny, Sebastian; Banzhaf, Stefan

    2017-04-01

    Until now, groundwater in coastal areas has not received much attention in Sweden, neither from water authorities nor the research community. Extractable volumes from bedrock aquifers are too small for the public water supply of larger permanent settlements. However, of the 450,000 private wells in Sweden, many are located in attractive coastal areas or on islands, creating pressure on groundwater resources during the summer months as periods with low or no natural groundwater recharge. This situation is exacerbated as municipalities receive increasing applications to build summerhouses, or to convert existing ones into permanent residencies. In view of such rising demands, as well as the growing awareness of potential environmental impacts and climate change, Swedish municipalities recognize groundwater usage in coastal areas is a major concern. However, the responsibility for private wells is left almost exclusively to their owners, and obligations in the water sector are distributed over a wide range of authorities which operate on local, regional, and national scales (1). Therefore, it remains unclear how to deal with and administer the related challenging questions which are of varying legal, social, economic, environmental, and hydrological natures. Here, we present intermediate results of an ongoing investigation on the "Koster" archipelago which forms an "in-a-nutshell" example of a coastal zone with such groundwater use. With around 300 annual permanent residents, but up to 6000 summer overnight guests in peak season, water supply, largely based on 800 private wells, is at its limit. Water availability forms an obstacle to future development and even the current operation is considered unsustainable, leaving the municipality to decide how to secure future supply. The municipality favors a "large scale technical solution" (either a pipeline from the mainland or a large desalination plant) while many locals prefer to keep the existing private wells. While

  16. Vitamin D levels and susceptibility to asthma, elevated immunoglobulin E levels, and atopic dermatitis: A Mendelian randomization study.

    Science.gov (United States)

    Manousaki, Despoina; Paternoster, Lavinia; Standl, Marie; Moffatt, Miriam F; Farrall, Martin; Bouzigon, Emmanuelle; Strachan, David P; Demenais, Florence; Lathrop, Mark; Cookson, William O C M; Richards, J Brent

    2017-05-01

    Low circulating vitamin D levels have been associated with risk of asthma, atopic dermatitis, and elevated total immunoglobulin E (IgE). These epidemiological associations, if true, would have public health importance, since vitamin D insufficiency is common and correctable. We aimed to test whether genetically lowered vitamin D levels were associated with risk of asthma, atopic dermatitis, or elevated serum IgE levels, using Mendelian randomization (MR) methodology to control bias owing to confounding and reverse causation. The study employed data from the UK Biobank resource and from the SUNLIGHT, GABRIEL and EAGLE eczema consortia. Using four single-nucleotide polymorphisms (SNPs) strongly associated with 25-hydroxyvitamin D (25OHD) levels in 33,996 individuals, we conducted MR studies to estimate the effect of lowered 25OHD on the risk of asthma (n = 146,761), childhood onset asthma (n = 15,008), atopic dermatitis (n = 40,835), and elevated IgE level (n = 12,853) and tested MR assumptions in sensitivity analyses. None of the four 25OHD-lowering alleles were associated with asthma, atopic dermatitis, or elevated IgE levels (p ≥ 0.2). The MR odds ratio per standard deviation decrease in log-transformed 25OHD was 1.03 (95% confidence interval [CI] 0.90-1.19, p = 0.63) for asthma, 0.95 (95% CI 0.69-1.31, p = 0.76) for childhood-onset asthma, and 1.12 (95% CI 0.92-1.37, p = 0.27) for atopic dermatitis, and the effect size on log-transformed IgE levels was -0.40 (95% CI -1.65 to 0.85, p = 0.54). These results persisted in sensitivity analyses assessing population stratification and pleiotropy and vitamin D synthesis and metabolism pathways. The main limitations of this study are that the findings do not exclude an association between the studied outcomes and 1,25-dihydoxyvitamin D, the active form of vitamin D, the study was underpowered to detect effects smaller than an OR of 1.33 for childhood asthma, and the analyses were restricted to white populations of

  17. An association study of 13 SNPs from seven candidate genes with pediatric asthma and a preliminary study for genetic testing by multiple variants in Taiwanese population.

    Science.gov (United States)

    Wang, Jiu-Yao; Liou, Ya-Huei; Wu, Ying-Jye; Hsiao, Ya-Hsin; Wu, Lawrence Shih-Hsin

    2009-03-01

    Asthma is one of the most common chronic diseases in children. It is caused by complex interactions between various genetic factors and exposures to environmental allergens and irritants. Because of the heterogeneity of the disease and the genetic and cultural differences among different populations, a proper association study and genetic testing for asthma and susceptibility genes is difficult to perform. We assessed 13 single-nucleotide polymorphisms (SNPs) in seven well-known asthma susceptibility genes and looked for association with pediatric asthma using 449 asthmatic subjects and 512 non-asthma subjects in Taiwanese population. CD14-159 C/T and MS4A2 Glu237Gly were identified to have difference in genotype/allele frequencies between the control group and asthma patients. Moreover, the genotype synergistic analysis showed that the co-contribution of two functional SNPs was riskier or more protective from asthma attack. Our study provided a genotype synergistic method for studying gene-gene interaction on polymorphism basis and genetic testing using multiple polymorphisms.

  18. Occupational rhinitis affects occupational asthma severity.

    Science.gov (United States)

    Moscato, Gianna; Pala, Gianni; Folletti, Ilenia; Siracusa, Andrea; Quirce, Santiago

    2016-06-16

    The strong interactions between asthma and rhinitis, and the influence of rhinitis in the severity and/or control of asthma, have clearly been demonstrated. Nevertheless, no specific study has been conducted in the occupational setting. The aim of the study was to assess the severity of occupational asthma and rhinitis and evaluate whether rhinitis is a predictor for increased asthma severity. We retrospectively reviewed the clinical charts of 72 patients who received a diagnosis of allergic occupational asthma, with or without associated occupational rhinitis. Our findings suggested that persistent asthma tended to be more common in subjects with associated occupational asthma and rhinitis, and occupational asthma severity was associated with occupational rhinitis severity. Moderate-severe persistent occupational rhinitis is a risk factor for persistent occupational asthma. We demonstrated, for the first time in the occupational setting, a significant association between occupational rhinitis and asthma severity.

  19. 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...

  20. Caesarean Birth is Associated with Both Maternal and Paternal Origin in Immigrants in Sweden: a Population-Based Study.

    Science.gov (United States)

    Juárez, Sol P; Small, Rhonda; Hjern, Anders; Schytt, Erica

    2017-11-01

    To investigate the association between maternal country of birth and father's origin and unplanned and planned caesarean birth in Sweden. Population-based register study including all singleton births in Sweden between 1999 and 2012 (n = 1 311 885). Multinomial regression was conducted to estimate odds ratios (OR) for unplanned and planned caesarean with 95% confidence intervals for migrant compared with Swedish-born women. Analyses were stratified by parity. Women from Ethiopia, India, South Korea, Chile, Thailand, Iran, and Finland had statistically significantly higher odds of experiencing unplanned (primiparous OR 1.10-2.19; multiparous OR 1.13-2.02) and planned caesarean (primiparous OR 1.18-2.25; multiparous OR 1.13-2.46). Only women from Syria, the former Yugoslavia and Germany had consistently lower risk than Swedish-born mothers (unplanned: primiparous OR 0.76-0.86; multiparous OR 0.74-0.86. Planned; primiparous OR 0.75-0.82; multiparous OR 0.60-0.94). Women from Iraq and Turkey had higher odds of an unplanned caesarean but lower odds of a planned one (among multiparous). In most cases, these results remained after adjustment for available social characteristics, maternal health factors, and pregnancy complications. Both parents being foreign-born increased the odds of unplanned and planned caesarean in primiparous and multiparous women. Unplanned and planned caesarean birth varied by women's country of birth, with both higher and lower rates compared with Swedish-born women, and the father's origin was also of importance. These variations were not explained by a wide range of social, health, or pregnancy factors. © 2017 John Wiley & Sons Ltd.

  1. Exercise-induced asthma

    Science.gov (United States)

    ... Asthma - children Wheezing Patient Instructions Asthma and school Asthma - child - discharge Asthma - control drugs Asthma - quick-relief drugs Asthma - what to ask the doctor - adult Asthma - what to ask your doctor - child Exercising and asthma at school How to use ...

  2. Path analytic, sib-pair linkage and co-twin control studies of asthma and atopy

    Energy Technology Data Exchange (ETDEWEB)

    Duffy, D.L.; Healey, S.C.; Martin, N.G. [Queensland Institute of Medical Research, Brisband (Austria)

    1994-09-01

    Asthma and atopy are complex traits with multifactorial determinants, and require appropriate choice of phenotypes and analyses, including a linkage analysis of the putative 11q atopy locus. Participants in a large registry-based twin study of asthma were invited to take part in clinical testing. A total of 863 individuals including 419 complete twin pairs (where one or both members reported a history of wheeze) underwent histamine inhalation challenge, allergen skin prick testing, and venesection. Total serum immunoglobulin E (IgE) and bronchial responsiveness (BR) to histamine were highest in those who had wheezed most recently, and whose skin tests demonstrated allergy to house dust mite, cockroach, and rye grass. In ascertainment-corrected path analyses (FISHER), the heritability of IgE and BR were both 60%. Monozygotic (MZ) co-twin control analyses suggested house dust mite sensitization was the single strongest environmentally controlled risk factor for wheeze, while path analyses suggested genetic determination. In dizygotic (DZ) co-twin control analyses, sensitization to grasses was also an important predictor, suggesting pollinosis to be genetically correlated with wheezing, rather than causative. Multivariate path analyses suggested separate (correlated) genetic factors for BR, IgE, and allergy to house dust mite. A sib-pair (Haseman-Elston) linkage analysis of 220 DZ twin pairs did not support linkage to the high-affinity IgE receptor beta-subunit gene on 11q13 of atopy or BR. More recent linkage analyses that include parental genotyping will also be discussed. We conclude that the atopic phenotype consists of a number of traits with specific genetic allergens. Exposure to particular allergens can then cause specific outcomes, such as asthma.

  3. Healthcare utilisation by pregnant patients with asthma in South Korea: a cohort study using nationwide claims data.

    Science.gov (United States)

    Lee, Chang-Hoon; Kim, Jimin; Jang, Eun Jin; Kim, Yun Jung; Choi, Seongmi; Lee, Joon-Ho; Kim, Deog Kyeom; Yim, Jae-Joon; Yoon, Ho Il

    2015-11-06

    Few nationwide population-based studies have examined the burden of asthma during pregnancy. Here, we investigated the burden and medical treatment of asthma during pregnancy requiring healthcare utilisation in South Korea. Cohort study. Nationwide insurance claims database. A total of 1,306,281 pregnant women who delivered in South Korea in 2009-2011. The prevalence and exacerbation rates of asthma requiring healthcare utilisation, and the prescription of antiasthmatic drugs during pregnancy. The prevalence of asthma requiring healthcare utilisation was 0.43% among pregnant women. Among those with asthma requiring healthcare utilisation, 6.9% were hospitalised and treated with systemic steroids and short-acting β2-agonists during pregnancy. Oral drugs were prescribed less during the third trimester than during the first trimester (all p values for trends were women were likely to stop taking antiasthmatic drugs, and those who did tended to experience exacerbations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Hormonal contraception increases risk of asthma among obese but decreases it among nonobese subjects: a prospective, population-based cohort study

    Directory of Open Access Journals (Sweden)

    Melanie C. Matheson

    2015-11-01

    Full Text Available Epidemiological data on asthma suggest a sex difference that varies with age. Hormonal effects have been suggested as a possible explanation for these differences but there is a scarcity of evidence on these relationships. Our objective was to examine the relationship between reproductive factors and asthma risk among females and to examine whether body mass index (BMI modifies this relationship. Female participants in the 2004 fifth decade follow-up postal survey of the Tasmanian Longitudinal Health Study formed the study population. Reproductive history and data on hormonal contraceptive (HC use were collected on 2764 females. Multiple logistic regression was used to assess the association between the reproductive factors and current asthma. The mean age of participants was 43 years and the prevalence of middle-aged current asthma was 12.8%. Females with very early menarche (≤10 years had higher odds of middle-aged current asthma (OR 1.91, 95% CI 1.14–3.2. Pregnancy history (number of births and age at first pregnancy were not associated with current asthma risk at 44 years. Ever having used HCs, years of use and age started using HCs were not individually associated with current asthma risk. However, body mass index significantly modified the relationship between HC use and asthma. We found increasing years of pill use was associated with a significantly increased risk of current asthma in overweight/obese women but a reduced risk in normal weight women (interaction p=0.015. Hormonal effects from use of HCs and early menarche may contribute to the sex differential in asthma risk. Our findings suggest that in obese women with a history of long-term HC use may be at an increased risk of chronic respiratory disease, and regular monitoring for asthma and asthma symptoms may be recommended.

  5. Sick Leave and Work Participation among Parents of Children with Autism Spectrum Disorder in the Stockholm Youth Cohort: A Register Linkage Study in Stockholm, Sweden

    Science.gov (United States)

    McEvilly, Miranda; Wicks, Susanne; Dalman, Christina

    2015-01-01

    This population-based register study explored the association between having a child with/without autism spectrum disorder (ASD) and parental sick leave and work participation. Parents of children with ASD living in Stockholm, Sweden in 2006 were more likely to be on sick leave, not in the labor force, or earning low income when compared to…

  6. Effects of earthquakes on the deep repository for spent fuel in Sweden based on case studies and preliminary model results

    International Nuclear Information System (INIS)

    Baeckblom, Goeran; Munier, Raymond

    2002-06-01

    The Baltic Shield is one of the most stable areas in the world. Earthquakes have only on a few occasions exceeded magnitude 4 in Sweden in modern times. The safety case for a deep repository for spent fuel however includes an earthquake scenario due to the following reason: Earthquakes with much greater magnitudes occurred in northern Sweden during the most recent deglaciation period some 9,000 - 10,000 years ago when re-activated faults ruptured the surface. One of the most prominent evidences is the Paervie fault in Lapland, Sweden. The displacements exceeded 10 m in places and occurred over distances of around 150 km. The deep repository is designed to keep radiation well below the natural, ambient radiation for any time in the future. The safety function is achieved by a combination of engineered and natural barriers. One important safety issue is that future displacements in the rock should be less than 0.1 m at the precise location where the engineered canisters containing the waste are emplaced in the rock. Larger displacements could damage the canister that is designed to be tight for several 100,000 of years. SKB now re-visits the issues of seismic effects on underground facilities to supplement and update previous work. The project Effects of Earthquakes on Underground Facilities aims to re-compile field evidences of seismic damage on underground facilities, to shed additional light on the matter of friction loss in bedrock due to water-level changes and finally to find suitable ways to inform concerned citizens on the matter. The fact-finding was carried out in the form of interviews, literature surveys, Internet searches and by sending letters to some 60 organisations and researchers asking for co-operation. The most important conclusions are: Earthquake impact during the pre-closure phase: Damage due to shaking in an underground facility may occur if the peak ground acceleration exceeds 2 m/s 2 . Sweden is located in the Baltic Shield that is

  7. Asthma Triggers: Gain Control

    Science.gov (United States)

    ... in your house and may trigger asthma. Your asthma or your child's asthma may be worse around products such as ... You Can Take If you find that your asthma or your child's asthma gets worse when you use a certain ...

  8. Common Asthma Triggers

    Science.gov (United States)

    ... Grass Other Triggers If you have asthma, an asthma attack can happen when you are exposed to “asthma ... a second person. Secondhand smoke can trigger an asthma attack. If you have asthma, people should never smoke ...

  9. Asthma: Basic Information

    Science.gov (United States)

    ... after you use asthma medicine. What Is an Asthma Attack? An asthma attack may include coughing, chest tightness, ... to go to the hospital. What Causes an Asthma Attack? An asthma attack can happen when you are ...

  10. Nasal epithelial cells can act as a physiological surrogate for paediatric asthma studies.

    Directory of Open Access Journals (Sweden)

    Surendran Thavagnanam

    Full Text Available INTRODUCTION: Differentiated paediatric epithelial cells can be used to study the role of epithelial cells in asthma. Nasal epithelial cells are easier to obtain and may act as a surrogate for bronchial epithelium in asthma studies. We assessed the suitability of nasal epithelium from asthmatic children to be a surrogate for bronchial epithelium using air-liquid interface cultures. METHODS: Paired nasal and bronchial epithelial cells from asthmatic children (n = 9 were differentiated for 28 days under unstimulated and IL-13-stimulated conditions. Morphological and physiological markers were analysed using immunocytochemistry, transepithelial-electrical-resistance, Quantitative Real-time-PCR, ELISA and multiplex cytokine/chemokine analysis. RESULTS: Physiologically, nasal epithelial cells from asthmatic children exhibit similar cytokine responses to stimulation with IL-13 compared with paired bronchial epithelial cells. Morphologically however, nasal epithelial cells differed significantly from bronchial epithelial cells from asthmatic patients under unstimulated and IL-13-stimulated conditions. Nasal epithelial cells exhibited lower proliferation/differentiation rates and lower percentages of goblet and ciliated cells when unstimulated, while exhibiting a diminished and varied response to IL-13. CONCLUSIONS: We conclude that morphologically, nasal epithelial cells would not be a suitable surrogate due to a significantly lower rate of proliferation and differentiation of goblet and ciliated cells. Physiologically, nasal epithelial cells respond similarly to exogenous stimulation with IL-13 in cytokine production and could be used as a physiological surrogate in the event that bronchial epithelial cells are not available.

  11. Total antioxidant intake and prostate cancer in the Cancer of the Prostate in Sweden (CAPS) study. A case control study

    International Nuclear Information System (INIS)

    Russnes, Kjell M.; Möller, Elisabeth; Wilson, Kathryn M.; Carlsen, Monica; Blomhoff, Rune; Smeland, Sigbjørn; Adami, Hans-Olov; Grönberg, Henrik; Mucci, Lorelei A.; Bälter, Katarina

    2016-01-01

    The total intake of dietary antioxidants may reduce prostate cancer risk but available data are sparse and the possible role of supplements unclear. We investigated the potential association between total and dietary antioxidant intake and prostate cancer in a Swedish population. We used FFQ data from 1499 cases and 1112 controls in the population based case–control study Cancer of the Prostate in Sweden (CAPS). The ferric reducing antioxidant potential (FRAP) assay was used to assess the total antioxidant capacity (TAC) of diet and supplements. We calculated odds ratios (ORs) for the risk of prostate cancer across quintiles of antioxidant intake from all foods, from fruit and vegetables only, and from dietary supplements using unconditional logistic regression. Coffee comprised 62 % of the dietary antioxidant intake, tea 4 %, berries 4 %, chocolate 2 %, and boiled potatoes 2 %. In total 19 % and 13 % of the population took multivitamins and supplemental Vitamin C respectively, on a regular basis. Antioxidant intake from all foods and from fruits and vegetables separately measured by the FRAP assay was not associated with prostate cancer risk. For antioxidant intake from supplements we found a positive association with total, advanced, localized, high grade and low grade prostate cancer in those above median supplemental TAC intake of users compared to non-users (Adjusted ORs for total prostate cancer: 1.37, 95 % CI 1.08–1.73, advanced: 1.51, 95 % CI 1.11–2.06, localized: 1.36. 95 % CI 1.06–1.76, high grade 1.60, 95 % CI 1.06–2.40, low grade 1.36, 95 % CI 1.03–1.81). A high intake of coffee (≥6 cups/day) was associated with a possible risk reduction of fatal and significantly with reduced risk for high grade prostate cancer, adjusted OR: 0.45 (95 % CI: 0.22–0.90), whereas a high intake of chocolate was positively associated with risk of total, advanced, localized and low grade disease (adjusted OR for total: 1.43, 95 % CI 1.12–1.82, advanced: 1

  12. Complementary therapy use by patients and parents of children with asthma and the implications for NHS care: a qualitative study

    Directory of Open Access Journals (Sweden)

    Sharp Debbie

    2006-06-01

    Full Text Available Abstract Background Patients are increasingly using complementary therapies, often for chronic conditions. Asthma is the most common chronic condition in the UK. Previous research indicates that some asthma patients experience gaps in their NHS care. However, little attention has been given to how and why patients and parents of children with asthma use complementary therapies and the implications for NHS care. Methods Qualitative study, comprising 50 semi-structured interviews with a purposeful sample of 22 adults and 28 children with asthma (plus a parent, recruited from a range of NHS and non-NHS settings in Bristol, England. Data analysis was thematic, drawing on the principles of constant comparison. Results A range of complementary therapies were being used for asthma, most commonly Buteyko breathing and homeopathy. Most use took place outside of the NHS, comprising either self-treatment or consultation with private complementary therapists. Complementary therapies were usually used alongside not instead of conventional asthma treatment. A spectrum of complementary therapy users emerged, including "committed", "pragmatic" and "last resort" users. Motivating factors for complementary therapy use included concerns about conventional NHS care ("push factors" and attractive aspects of complementary therapies ("pull factors". While participants were often uncertain whether therapies had directly helped their asthma, breathing techniques such as the Buteyko Method were most notably reported to enhance symptom control and enable reduction in medication. Across the range of therapies, the process of seeking and using complementary therapies seemed to help patients in two broad ways: it empowered them to take greater personal control over their condition rather than feel dependant on medication, and enabled exploration of a broader range of possible causes of their asthma than commonly discussed within NHS settings. Conclusion Complementary therapy

  13. Association between Concentrations of Metals in Urine and Adult Asthma: A Case-Control Study in Wuhan, China.

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    Xiji Huang

    Full Text Available Several metals have been reported to be associated with childhood asthma. However, the results on relationships between metals and risk of childhood asthma are inconclusive, and the research on adult asthma in the Chinese general population is rare.To investigate potential associations between levels of urinary metals and adult asthma.A case-control study of 551 adult asthma cases and 551 gender- and age-matched controls was conducted in Wuhan, China. Demographic information was obtained, and lung function was assessed. The urinary concentrations of 22 metals were measured by inductively coupled plasma mass spectrometry.After adjusting for other metalsand other covariates, urinary cadmium, molybdenum, chromium, copper, uranium and selenium were positively associated with asthma, with odds ratios (95% CI of 1.69 (1.00, 2.85, 3.76 (2.30, 6.16, 4.89 (3.04, 7.89, 6.06 (3.27, 11.21, 6.99 (4.37, 11.19 and 9.17 (4.16, 20.21, respectively. By contrast, urinary lead, barium, iron, zinc, nickel, manganese and rubidium were negatively associated with asthma, with odds ratios (95% CI of 0.48 (0.29, 0.80, 0.44 (0.27, 0.71, 0.41 (0.26, 0.64, 0.40 (0.24, 0.66, 0.30 (0.22, 0.41, 0.23 (0.14, 0.39 and 0.07 (0.03, 0.15, respectively. When comparing urinary metals in different subgroups of cases with those in matched controls, the associations of above 13 metals with asthma prevalence were nearly the same.Our results suggested that asthma prevalence in the Chinese adults was positively associated with urinary chromium, chromium, selenium, molybdenum, cadmium, and uranium, and negatively associated with urinary manganese, iron, nickel, zinc, rubidium, barium and lead. Additional research with larger populations in different regions is required to support our findings.

  14. Asthma and Adolescents: Review of Strategies to Improve Control

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    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…

  15. Genetic polymorphisms and asthma: findings from a case-control study in the Madeira island population.

    Science.gov (United States)

    Berenguer, Anabela Gonçalves; Fernandes, Ana Teresa; Oliveira, Susana; Rodrigues, Mariana; Ornelas, Pedro; Romeira, Diogo; Serrão, Tânia; Rosa, Alexandra; Câmara, Rita

    2014-09-04

    Asthma is a complex disease influenced by multiple genetic and environmental factors. While Madeira has the highest prevalence of asthma in Portugal (14.6%), the effect of both genetic and environmental factors in this population has never been assessed. We categorized 98 asthma patients according to the Global Initiative for Asthma (GINA) guidelines, established their sensitization profile, and measured their forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) indexes. Selected single nucleotide polymorphisms (SNPs) were analysed as potential markers for asthma susceptibility and severity in the interleukin 4 (IL4), interleukin 13 (IL13), beta-2-adrenergic receptor (ADRB2), a disintegrin and metalloprotease 33 (ADAM33), gasdermin-like (GSDML) and the signal transducer and activator of transcription 6 (STAT6) genes comparatively to a population reference set. Although mites are the major source of allergic sensitization, no significant difference was found amongst asthma severity categories. IL4-590*CT/TT and IL4-RP2*253183/183183 were found to predict the risk (2-fold) and severity (3 to 4-fold) of asthma and were associated with a lower FEV1 index. ADRB2-c.16*AG is a risk factor (3.5-fold), while genotype GSDML-236*TT was protective (4-fold) for moderate-severe asthma. ADAM33-V4*C was associated to asthma and mild asthma by the transmission disequilibrium test (TDT). Finally, ADAM33-V4*CC and STAT6-21*TT were associated with higher sensitization (mean wheal size ≥10 mm) to house dust (1.4-fold) and storage mite (7.8-fold). In Madeira, IL4-590C/T, IL4-RP2 253/183, GSDML-236C/T and ADAM33-V4C/G SNPs are important risk factors for asthma susceptibility and severity, with implications for asthma healthcare management.

  16. Genetic polymorphisms and asthma: findings from a case - control study in the Madeira island population

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    Anabela Gonçalves Berenguer

    2014-01-01

    Full Text Available BACKGROUND: Asthma is a complex disease influenced by multiple genetic and environmental factors. While Madeira has the highest prevalence of asthma in Portugal (14.6%, the effect of both genetic and environmental factors in this population has never been assessed. We categorized 98 asthma patients according to the Global Initiative for Asthma (GINA guidelines, established their sensitization profile, and measured their forced expiratory volume in 1second (FEV1 and forced vital capacity (FVC indexes. Selected single nucleotide polymorphisms (SNPs were analysed as potential markers for asthma susceptibility and severity in the interleukin 4 (IL4, interleukin 13 (IL13, beta-2-adrenergic receptor (ADRB2, a disintegrin and metalloprotease 33 (ADAM33, gasdermin-like (GSDML and the signal transducer and activator of transcription 6 (STAT6 genes comparatively to a population reference set. RESULTS: Although mites are the major source of allergic sensitization, no significant difference was found amongst asthma severity categories. IL4-590*CT/TT and IL4-RP2*253183/183183 were found to predict the risk (2-fold and severity (3 to 4-fold of asthma and were associated with a lower FEV1 index. ADRB2-c.16*AG is a risk factor (3.5-fold, while genotype GSDML-236*TT was protective (4-fold for moderate-severe asthma. ADAM33-V4*C was associated to asthma and mild asthma by the transmission disequilibrium test (TDT. Finally, ADAM33-V4*CC and STAT6-21*TT were associated with higher sensitization (mean wheal size ≥10mm to house dust (1.4-fold and storage mite (7.8-fold. CONCLUSION: In Madeira, IL4-590C/T, IL4-RP2 253/183, GSDML-236C/T and ADAM33-V4C/G SNPs are important risk factors for asthma susceptibility and severity, with implications for asthma healthcare management.

  17. Asthma medication use before and after the onset of type 1 diabetes in children and adolescents: A population-based cohort study

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    Ahmadizar, Fariba; Maitland-Van Der Zee, Anke-Hilse; De Boer, Anthonius; Souverein, Patrick; Arets, Hubertus

    2015-01-01

    Background: It has been reported that patients with type 1 diabetes (T1DM) have a decreased lung function. Studies on the association of T1DM and asthma in children show controversial results. Objectives: The aim of this study was to quantify asthma medication use in children and adolescents with

  18. Exhaled breath condensate cysteinyl leukotrienes and airway remodeling in childhood asthma: a pilot study

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    Kharitonov Sergei A

    2006-04-01

    Full Text Available Abstract Background It has been suggested that cysteinyl leukotrienes (cysLTs play an important role in airway remodeling. Previous reports have indicated that cysLTs augment human airway smooth muscle cell proliferation. Recently, cysLTs have been measured in exhaled breath condensate (EBC. The aim of this study was to evaluate the relationship between cysLTs in EBC and another marker of airway remodeling, reticular basement membrane (RBM thickening, in endobronchial biopsies in children. Methods 29 children, aged 4–15 years, with moderate to severe persistent asthma, who underwent bronchoscopy as part of their clinical assessment, were included. Subjects underwent spirometry and EBC collection for cysLTs analysis, followed by bronchoscopy and endobronchial biopsy within 24 hours. Results EBC cysLTs were significantly lower in asthmatic children who were treated with montelukast than in those who were not (median (interquartile range 36.62 (22.60–101.05 versus 249.1 (74.21–526.36 pg/ml, p = 0.004. There was a significant relationship between EBC cysLTs and RBM thickness in the subgroup of children who were not treated with montelukast (n = 13, r = 0.75, p = 0.003. Conclusion EBC cysLTs appear to be associated with RBM thickening in asthma.

  19. Both environmental tobacco smoke and personal smoking is related to asthma and wheeze in teenagers.

    Science.gov (United States)

    Hedman, Linnéa; Bjerg, Anders; Sundberg, Sigrid; Forsberg, Bertil; Rönmark, Eva

    2011-01-01

    Environmental tobacco smoke (ETS) has been reported as a significant risk factor for childhood asthma. Among adults, personal smoking is a major cause of respiratory symptoms and diseases. The effects of these exposures on the prevalence of asthma and wheeze among teenagers are less well known. The aim was to study the independent and combined effects of ETS and personal smoking on the prevalence of asthma and wheeze in teenagers. A longitudinal study of asthma and allergic diseases in schoolchildren has been in progress in Northern Sweden since 1996. All children aged 7-8 years in three municipalities were invited and 3430 (97%) participants have been followed by annual questionnaires. At the age 16-17 years, 82% of the initial participants took part in the 2005 survey. Prevalence of physician-diagnosed asthma, ever wheeze and current wheeze was significantly higher among those exposed to maternal ETS and among daily smokers. In multivariate analyses, maternal ETS was a significant risk factor for physician-diagnosed asthma and ever wheeze (OR 1.3-1.5) and personal daily smoking for current wheeze (OR 2.0). ORs for asthma and ever wheeze were highest among daily smokers who were also exposed to maternal ETS with ORs of 1.7 and 2.5, respectively. A significant dose-response association between number of cigarettes/day and the prevalence of wheeze was also found. Both ETS and personal smoking were significantly related to asthma and wheeze in teenagers. Maternal ETS exposure was associated with lifetime symptoms, but daily smoking among the teenagers was more strongly related to current symptoms.

  20. Preliminary studies on the effect of rebamipide against the trypsin and egg-albumin induced experimental model of asthma.

    Science.gov (United States)

    Gohil, Priyanshee; Thakkar, Himani; Gohil, Unnati; Deshpande, Shrikalp

    2011-12-01

    The present investigation was carried out to study the effect of rebamipide in experimentally induced bronchial asthma in mice. Trypsin and egg-albumin induced chronic model of asthma was used and various parameters were measured on the 35th day. The asthmatic control group showed lower level of haemoglobin saturation with oxygen, tidal volume, airflow rate and higher respiratory rate, serum bicarbonate level, eosinophil count in bronchoalveolar lavage fluid and histamine level compared to the normal control group. Dexamethasone and rebamipide treated groups showed the return of all the above parameters towards normal values. Histopathological examination of lungs showed more prominent alveolar and muscular layer destruction in the asthmatic control group than in dexamethasone and rebamipide treated groups. Rebamipide showed a beneficial effect and might be used for the treatment of bronchial asthma.

  1. Few Associations Found between Mold and Other Allergen Concentrations in the Home versus Skin Sensitivity from Children with Asthma after Hurricane Katrina in the Head-Off Environmental Asthma in Louisiana Study

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    L. F. Grimsley

    2012-01-01

    Full Text Available Mold and other allergen exposures exacerbate asthma symptoms in sensitized individuals. We evaluated allergen concentrations, skin test sensitivities, and asthma morbidity for 182 children, aged 4–12 years, with moderate to severe asthma, enrolled 18 months after Katrina, from the city of New Orleans and the surrounding parishes that were impacted by the storm, into the Head-off Environmental Asthma in Louisiana (HEAL observational study. Dust (indoor and air (indoor and outdoor samples were collected at baseline of 6 and 12 months. Dust samples were evaluated for dust mite, cockroach, mouse, and Alternaria by immunoassay. Air samples were evaluated for airborne mold spore concentrations. Overall, 89% of the children tested positive to ≥1 indoor allergen, with allergen-specific sensitivities ranging from 18% to 67%. Allergen concentration was associated with skin sensitivity for 1 of 10 environmental triggers analyzed (cat. Asthma symptom days did not differ with skin test sensitivity, and surprisingly, increased symptoms were observed in children whose baseline indoor airborne mold concentrations were below median levels. This association was not observed in follow-up assessments. The lack of relationship among allergen levels (including mold, sensitivities, and asthma symptoms points to the complexity of attempting to assess these associations during rapidly changing social and environmental conditions.

  2. Asthma knowledge, subjective assessment of severity and symptom perception in parents of children with asthma.

    Science.gov (United States)

    Silva, Cláudia Mendes; Barros, Luísa

    2013-11-01

    This study aimed to confirm the tendency for parents to underestimate the severity of symptoms and the poor consistency between parents' reports of symptoms and the physicians' evaluation of asthma control. Additionally, the relationship between parents' asthma knowledge and their report of symptoms and estimation of asthma severity was explored. Fifty children (M = 10.5 years) and their caregivers were recruited from two Portuguese hospitals. A measure of asthma symptoms report (Severity of Chronic Asthma, SCA) and a subjective evaluation of asthma severity were collected and compared with physicians' ratings of asthma control, as well as parents' knowledge about asthma (Asthma Knowledge Questionnaire, AKQ) and emotional disturbance (Brief Symptom Inventory, BSI). Although parents' evaluation of perceived asthma severity was moderately correlated to symptoms reported, results confirm an inconsistency between parents' reports of symptoms, their subjective rating of asthma severity and the physician's rating of clinical control, revealing a tendency for parents to underestimate disease severity and to underreport asthma symptoms. Asthma knowledge was not significantly correlated to SCA or to parents' subjective evaluation of asthma severity. Parents with poorer knowledge reported fewer symptoms. Portuguese parents revealed a tendency to overestimate their child's level of asthma control and a low level of asthma knowledge. Parents' education, psychological disturbance and time since diagnosis were associated with asthma knowledge. Parents' knowledge was not related to the child's asthma outcomes or to their subjective evaluation of asthma severity or symptoms reports. Parents' asthma knowledge deficits, underreporting of symptoms and underestimation of asthma severity, may affect parent-provider communication and impede asthma control.

  3. Asthma in British Columbia: Are we finally breathing easier? A population-based study of the burden of disease over 14 years.

    Science.gov (United States)

    Bardal, Stan; Smith, Anne; Luo, Hao Allan; Zhang, Tingting; Groeneweg, Gabriella; Jimenez Mendez, Ricardo; Goldman, Ran; Carleton, Bruce C

    2017-04-01

    Asthma presents a significant global burden, but whether the incidence and prevalence of asthma is rising is still debated. The objective of this study was to determine the prevalence and incidence of asthma in British Columbia (BC), Canada, and characterize associated health services utilization. We extracted data from provincial administrative hospitalization, medical services, and prescription drug databases for patients aged 5 to 55 years, during 1996 to 2009 having ≥270 MSP registration days and meeting asthma definition of: ≥1 hospital admissions with asthma as the principal diagnosis, or ≥2 physician visits for asthma as the principal diagnosis, or ≥3 asthma drug dispensings. Regression models were used to test change in asthma incidence and prevalence, and use of various health care services, such as physician and emergency department (ED) visits, and hospitalizations. 379,950 patients met the study criteria. The prevalence (2.6%) and incidence (0.7%) of asthma was relatively stable over the study period. There was a decline in proportion of patients visiting family practitioners (FP) (OR 0.92; 95% CI 0.90-0.94), specialists (OR 0.60; 95% CI 0.58-0.62), using ED services (OR 0.31; 95% CI 0.30-0.32) and hospitalizations (OR 0.34; 95% CI 0.31-0.37). Regional differences were noted, with lower rates of FP and specialist visits and higher rates of ED visits for asthma in rural versus urban areas. In BC, the incidence and prevalence of asthma has remained stable over 14 years. Although health service utilization declined, there is variation between rural and urban regions.

  4. The role of trait mindfulness in quality of life and asthma control among adolescents with asthma

    NARCIS (Netherlands)

    Cillessen, L.J.G.; Ven, M.O.M. van de; Karremans, J.C.T.M.

    2017-01-01

    Objective: The current study focused on the role of trait mindfulness in asthma-related quality of life (QoL) and asthma control in adolescent asthma patients. Furthermore, potential underlying mechanisms (general and asthma-specific stress) of this relationship were investigated. Methods: In this

  5. Improved results in paediatric diabetes care using a quality registry in an improvement collaborative: a case study in Sweden.

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    Anette Peterson

    Full Text Available Several studies show that good metabolic control is important for children and adolescents with type 1 diabetes. In Sweden, there are large differences in mean haemoglobin A1c (HbA1c in different hospitals and difficulties implementing national guidelines in everyday practice. This study shows how the participation in an improvement collaborative could facilitate improvements in the quality of care by paediatric diabetes teams. The Swedish paediatric diabetes quality registry, SWEDIABKIDS was used as a tool and resource for feedback and outcome measures.Twelve teams at paediatric diabetes centres, caring for 30% (2302/7660 of patients in Sweden, participated in an 18-month quality improvement program. Each team defined treatment targets, areas needing improvement, and action plans. The main outcome was the centre patients' mean HbA1c levels, but other clinical variables and change concepts were also studied. Data from the previous six months were compared with the first six months after starting the program, and the long-term follow up after another eleven months.All centres reduced mean HbA1c during the second and third periods compared with the first. The mean reduction for all was 3·7 mmol/mol (p<0.001, compared with non-participating centres who improved their mean HbA1c with 1·7 mmol/mol during the same period. Many of the participating centres reduced the frequency of severe hypoglycaemia and/or ketoacidosis, and five centres reached their goal of ensuring that all patients had some sort of physical activity at least once weekly. Change concepts were, for example, improved guidelines, appointment planning, informing the patients, improving teamwork and active use of the registry, and health promotion activities.By involving paediatric diabetes teams in a quality improvement collaborative together with access to a quality register, the quality of paediatric diabetes care can improve, thereby contributing to a reduced risk of late

  6. Employment status and psychological distress in a population-based cross-sectional study in Sweden: the impact of migration.

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    Sidorchuk, Anna; Engström, Karin; Johnson, Charisse M; Kayser Leeoza, Naima; Möller, Jette

    2017-04-07

    Unemployment and temporary employment are known to impact psychological health. However, the extent to which the effect is altered by migration-related and sociodemographic determinants is less clear. The purpose of this study was to investigate whether the association between employment status and psychological distress differs between immigrants and Swedish-born and to what extent, the association is modified by gender and reason for immigration. Cross-sectional survey study. Data from public health surveys undertaken in 2002, 2006 and 2010 from random samples of Stockholm County residents, Sweden, were used to analyse a weighted sample of 51 118 individuals aged 18-64 (43 444 Swedish-born, 4055 non-refugees, 3619 refugees). According to their activity in the labour market, the participants were categorised into permanently/self-employed, temporarily employed and unemployed. Associations between self-reported employment and psychological distress measured by a 12-item version of the General Health Questionnaire were explored across individuals with different migration status and reasons for immigration using logistic regression and pairwise comparisons. The analyses were stratified by gender and adjusted for age, socioeconomic characteristics and survey year. Unemployment was associated with elevated likelihood of psychological distress across the study population, regardless of migration status and gender. Fully adjusted models revealed nearly a 3-fold higher odds of distress in unemployed Swedish-born (OR 3.05, 95% CI 2.66 to 3.51), non-refugees (OR 3.51, 95% CI 2.44 to 5.05) and refugees (OR 2.91, 95% CI 2.20 to 3.85) when compared with permanently/self-employed. Temporary employment also increased the likelihood of distress, particularly among refugees and Swedish-born. The effect of unemployment on increased likelihood of poor psychological well-being overcomes gender-specific and migration-specific differences and is equally pronounced for Swedish

  7. Asthma and Therapeutics: Recombinant Therapies in Asthma

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    Cockcroft Donald W

    2005-03-01

    Full Text Available Abstract Numerous recombinant therapies are being investigated for the treatment of asthma. This report reviews the current status of several of these novel agents. Anti-immunoglobulin (IgE (omalizumab, Xolair markedly inhibits all aspects of the allergen challenge in subjects who have reduction of free serum IgE to undetectable levels. Several clinical studies in atopic asthma have demonstrated benefit by improved symptoms and lung function and a reduction in corticosteroid requirements. Early use in atopic asthmatics may be even more effective. Several approaches target interleukin (IL-4. Soluble IL-4 receptor has been shown to effectively replace inhaled corticosteroid; further studies are under way. Recombinant anti-IL-5 and recombinant IL-12 inhibit blood and sputum eosinophils and allergen-induced eosinophilia without any effect on airway responsiveness, allergen-induced airway responses, or allergen-induced airway hyperresponsiveness. Efalizumab, a recombinant antibody that inhibits lymphocyte trafficking, is effective in psoriasis. A bronchoprovocation study showed a reduction in allergen-induced late asthmatic response and allergen-induced eosinophilia, which suggests that it should be effective in clinical asthma. These exciting novel therapies provide not only promise of new therapies for asthma but also valuable tools for investigation of asthma mechanisms.

  8. Exercising and asthma at school

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    ... resources Asthma - children Patient Instructions Asthma and school Asthma - child - discharge Asthma - control drugs Asthma - quick-relief drugs Asthma - what to ask your doctor - child Exercise-induced asthma How to use a nebulizer ...

  9. Inequalities in asthma treatment among children by country of birth and ancestry: a nationwide study in Denmark.

    Science.gov (United States)

    Cantarero-Arévalo, Lourdes; Holstein, Bjørn Evald; Andersen, Anette; Kaae, Susanne; Nørredam, Marie; Hansen, Ebba Holme

    2013-11-01

    Investigations in several Western countries have reported ethnic differences in asthma prevalence and treatment among children and in some countries these differences are increasing. The aim of this study was to analyse whether there are inequalities in asthma treatment by country of birth and ancestry among children residing in Denmark, and whether this potential association may vary between different household income groups. Data were obtained by linking the Danish Civil Registration System, the Central Taxpayers' Register and the Danish National Prescription Register. the entire population of children in Denmark from 0 to 17 years of age in 2008 (n=1 209 091). Information on asthma treatment was obtained from the National Prescription Register. The analyses included multiple logistic regression models stratified by household income. Compared with ethnic Danes, immigrant children had the lowest OR for redeeming a prescription for asthma medication, both relief (OR 0.37; 95% CIs, 0.20 to 0.68) and preventive (OR 0.37; (0.22 to 0.59)). Similar associations were found among descendant children (OR for relief treatment 0.82 (0.79 to 0.89) and for preventive treatment 0.68 (0.61 to 0.75)). The pattern of the association remained after stratifying for household income. We found that, inequalities that cannot be explained by household income alone exist in treatments to prevent asthma as well as to relieve symptoms in children residing in Denmark, by country of birth and ancestry. The difference between immigrants and descendants may indicate that unfamiliarity with the Danish healthcare system is a contributory cause of the inadequate treatment of asthma.

  10. A retrospective cohort study in severe asthma describing commonly measured biomarkers: Eosinophil count and IgE levels.

    Science.gov (United States)

    Haughney, John; Morice, Alyn; Blyth, Kevin G; Lee, Amanda J; Coutts, Alasdair; McKnight, Eddie; Pavord, Ian

    2018-01-01

    Identifying asthma patients suitable for biologic therapy includes the assessment of blood biomarkers (IgE and eosinophils (EOS)). How they relate to each other is unclear. This retrospective, database study used routinely collected clinical data to identify and evaluate an asthma cohort (classification code for asthma; ≥ 18 years; ≥1 prescription for asthma; ≥1 estimation of serum IgE, in 2 years prior to index date). Distribution into high and low IgE and EOS groups (IgE cut-point: > or ≤75 kU/L; EOS cut point: >or ≤400 μ/L), and characteristics by group are described. In patients with severe asthma (British Thoracic Society Step (BTS) ≥4; N = 884), using maximum recorded IgE/EOS, 33% had high IgE/high EOS, 28% low IgE/low EOS and approximately a fifth each had high IgE/low EOS or low IgE/high EOS. Proportions were similar when EOS values measured 2 or 4 weeks before an exacerbation were excluded. Using EOS/IgE 'same day' measurements (N = 578) only identified half of the high EOS group. Patients in high IgE groups were more likely to be younger males without comorbid COPD; those in high EOS groups were more likely to be on BTS treatment Step 5 vs 4. The low IgE/low EOS group had the lowest incidence of asthma-related hospital attendances, the highest incidence was observed in the high EOS groups. Maximum available EOS measurement irrespective of exacerbations may be relevant when considering therapy. These data showed low IgE/Low EOS to be more benign and high EOS groups at increased risk of frequent, severe exacerbations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Experiences of Racism and the Incidence of Adult-Onset Asthma in the Black Women’s Health Study

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    Yu, Jeffrey; O’Connor, George T.; Brown, Timothy A.; Cozier, Yvette C.; Palmer, Julie R.; Rosenberg, Lynn

    2014-01-01

    Background: Chronic stress resulting from experiences of racism may increase the incidence of adult-onset asthma through effects on the immune system and the airways. We conducted prospective analyses of the relation of experiences of racism with asthma incidence in the Black Women’s Health Study, a prospective cohort of black women in the United States followed since 1995 with mailed biennial questionnaires. Methods: Among 38,142 participants followed from 1997 to 2011, 1,068 reported incident asthma. An everyday racism score was created based on five questions asked in 1997 and 2009 about the frequency in daily life of experiences of racism (eg, poor service in stores), and a lifetime racism score was based on questions about racism on the job, in housing, and by police. We used Cox regression models to derive multivariable incidence rate ratios (IRRs) and 95% CIs for categories of each racism score in relation to incident asthma. Results: The IRRs were 1.45 (95% CI, 1.19-1.78) for the highest compared with the lowest quartile of the 1997 everyday racism score (P for trend racism. Among women who reported the same levels of racism in 1997 and 2009, the IRRs for the highest categories of everyday and lifetime racism were 2.12 (95% CI, 1.55-2.91) and 1.66 (95% CI, 1.20-2.30), respectively. Conclusions: Given the high prevalence of experiences of racism and asthma in black women in the United States, a positive association between racism and asthma is of public health importance. PMID:23887828

  12. Experiences of racism and the incidence of adult-onset asthma in the Black Women's Health Study.

    Science.gov (United States)

    Coogan, Patricia F; Yu, Jeffrey; O'Connor, George T; Brown, Timothy A; Cozier, Yvette C; Palmer, Julie R; Rosenberg, Lynn

    2014-03-01

    Chronic stress resulting from experiences of racism may increase the incidence of adult-onset asthma through effects on the immune system and the airways. We conducted prospective analyses of the relation of experiences of racism with asthma incidence in the Black Women's Health Study, a prospective cohort of black women in the United States followed since 1995 with mailed biennial questionnaires. Among 38,142 participants followed from 1997 to 2011, 1,068 reported incident asthma. An everyday racism score was created based on five questions asked in 1997 and 2009 about the frequency in daily life of experiences of racism (eg, poor service in stores), and a lifetime racism score was based on questions about racism on the job, in housing, and by police. We used Cox regression models to derive multivariable incidence rate ratios (IRRs) and 95% CIs for categories of each racism score in relation to incident asthma. The IRRs were 1.45 (95% CI, 1.19-1.78) for the highest compared with the lowest quartile of the 1997 everyday racism score (P for trendracism. Among women who reported the same levels of racism in 1997 and 2009, the IRRs for the highest categories of everyday and lifetime racism were 2.12 (95% CI, 1.55-2.91) and 1.66 (95% CI, 1.20-2.30), respectively. Given the high prevalence of experiences of racism and asthma in black women in the United States, a positive association between racism and asthma is of public health importance.

  13. First attack of acute pancreatitis in Sweden 1988 – 2003: incidence, aetiological classification, procedures and mortality – a register study

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    Stenlund Hans C

    2009-03-01

    Full Text Available Abstract Background Population-based studies suggest that the incidence of first attack of acute pancreatitis (FAAP is increasing and that old age is associated with increased mortality. Beacuse nationwide data are limited and information on standardized mortality ratio (SMR versus age is lacking, we wanted to describe incidence and mortality of first attack acute pancreatitis (FAAP in Sweden. Methods Hospital discharge data concerning diagnoses and surgical procedures and death certificate data were linked for patients with FAAP in Sweden. Mortality was calculated as case fatality rate (CFR, i.e. deaths per 1000 patients and SMR using age-, gender- and calendar year-specific expected survival estimates, and is given as mean with 95% confidence intervals. Data are presented as median values with 25% and 75% percentiles, means and standard deviations, or proportions. Proportions have been compared using the chi square test, Poisson-regression test or Fisher exact test. Location of two groups of ratio scale variables were compared using independent samples t-test or Mann-Whitney U-test. Results From 1988 through 2003, 43415 patients (23801 men and 19614 women were admitted for FAAP. Age adjusted incidence rose from 27.0 to 32.0 per 100000 individuals and year. Incidence increased with age for both men and women. At index stay 19.7% of men and 35.4% of women had biliary diagnoses, and 7.1% of men and 2.1% of women alcohol-related diagnoses. Of 10072 patients who underwent cholecystectomy, 7521 (74.7% did so after index stay within the audit period. With increasing age CFR increased and SMR decreased. For the whole period studied SMR was 11.75 (11.34–12.17 within 90 days of index admission and 2.03 (1.93–2.13 from 91 to 365 days. Alcohol-related diagnoses and young age was associated with increased SMR. Length of stay and SMR decreased significantly during the audit period. Conclusion Incidence of FAAP increased slightly from 1988 to 2003

  14. Illicit Drug Use Among Gym-Goers: a Cross-sectional Study of Gym-Goers in Sweden.

    Science.gov (United States)

    Molero, Yasmina; Bakshi, Ann-Sofie; Gripenberg, Johanna

    2017-08-29

    The use of anabolic-androgenic steroids has increased among gym-goers, and it has been proposed that this may be part of a polysubstance use pattern that includes the use of illicit drugs. Still, epidemiological data on illicit drug use among gym-goers of both genders are meager. The aim of the present study was thus to examine the use of illicit drugs and its correlates in a large sample of men and women who engaged in weight training at gyms across Sweden. In this cross-sectional study, a total of 1969 gym-goers who engaged in weight training in 54 gyms across Sweden were invited to fill in a questionnaire. The questionnaire included 25 items on background variables, weight training frequency, use of illicit drugs and doping substances, and non-medical use of benzodiazepines. Of the gym-goers, 19.6% reported having ever used illicit drugs, 6.5% reported use during the past 12 months, and 2.1% during the past 30 days. The most commonly used drug was cannabis, followed by cocaine, amphetamine, and ecstasy. Almost 40% of those who reported drug use had used more than one drug. Male participants and participants between 20 and 39 years of age made up the majority of users. Furthermore, 5.1% of the reported drug users had ever used a doping substance. There was an almost threefold higher odds (OR = 2.99, 95% CI = 1.16-7.66, p gyms is typically considered a health-promoting behavior. However, our results revealed a slightly higher prevalence of illicit drug use among gym attendees as compared to the general population. Our findings may have captured an underrecognized group of young adult males who engage in weightlifting and use illicit drugs recreationally and/or as training aids. Developing knowledge is imperative in orientating preventive efforts among at-risk gym-goers. ISRCTN11655041.

  15. Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden.

    Directory of Open Access Journals (Sweden)

    Cecilia Dhejne

    Full Text Available CONTEXT: The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person's body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment. OBJECTIVE: To estimate mortality, morbidity, and criminal rate after surgical sex reassignment of transsexual persons. DESIGN: A population-based matched cohort study. SETTING: Sweden, 1973-2003. PARTICIPANTS: All 324 sex-reassigned persons (191 male-to-females, 133 female-to-males in Sweden, 1973-2003. Random population controls (10:1 were matched by birth year and birth sex or reassigned (final sex, respectively. MAIN OUTCOME MEASURES: Hazard ratios (HR with 95% confidence intervals (CI for mortality and psychiatric morbidity were obtained with Cox regression models, which were adjusted for immigrant status and psychiatric morbidity prior to sex reassignment (adjusted HR [aHR]. RESULTS: The overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% CI 1.8-4.3 than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% CI 5.8-62.9. Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% CI 2.9-8.5 and psychiatric inpatient care (aHR 2.8; 95% CI 2.0-3.9. Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls. CONCLUSIONS: Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.

  16. Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden

    Science.gov (United States)

    Dhejne, Cecilia; Lichtenstein, Paul; Boman, Marcus; Johansson, Anna L. V.; Långström, Niklas; Landén, Mikael

    2011-01-01

    Context The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person's body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment. Objective To estimate mortality, morbidity, and criminal rate after surgical sex reassignment of transsexual persons. Design A population-based matched cohort study. Setting Sweden, 1973-2003. Participants All 324 sex-reassigned persons (191 male-to-females, 133 female-to-males) in Sweden, 1973–2003. Random population controls (10∶1) were matched by birth year and birth sex or reassigned (final) sex, respectively. Main Outcome Measures Hazard ratios (HR) with 95% confidence intervals (CI) for mortality and psychiatric morbidity were obtained with Cox regression models, which were adjusted for immigrant status and psychiatric morbidity prior to sex reassignment (adjusted HR [aHR]). Results The overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% CI 1.8–4.3) than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% CI 5.8–62.9). Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% CI 2.9–8.5) and psychiatric inpatient care (aHR 2.8; 95% CI 2.0–3.9). Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls. Conclusions Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group. PMID:21364939

  17. Duration of residence and psychotropic drug use in recently settled refugees in Sweden--a register-based study.

    Science.gov (United States)

    Brendler-Lindqvist, Maria; Norredam, Marie; Hjern, Anders

    2014-12-20

    Recently settled refugee populations have consistently been reported to have high rates of mental health problems, particularly Post-traumatic stress disorder, depression, and anxiety disorders. The aim of this study was to investigate psychotropic drug use among young adult refugees according to duration of residence during the first 10 years in Sweden. Cross-sectional register study of a national cohort of 43 403 refugees and their families (23-35 years old) from Iraq, Iran, Eritrea, Ethiopia, Somalia and Afghanistan and a comparison population of 1.1 million Swedish-born residents. Logistic regression was used to assess the association between duration of residence in Sweden and the dispensing of at least one psychotropic medication during 2009 in four categories (any drug, neuroleptics, antidepressants and anxiolytics/hypnotics), adjusting for age, gender and domicile. Rates of dispensed psychotropic drugs among recently settled refugees were low, compared to the Swedish-born, with an increase with duration of residence. For refugee men and women from Iraq/Iran who had resided for 0-3 years the adjusted ORs compared to Swedish natives, were 0.83 (95% CI 0.77-0.90) and 0.48 (0.44-0.53) respectively; for men and women from the Horn of Africa the ORs were 0.50 (0.42-0.61) and 0.36 (0.30-0.41) respectively. After 7-10 years of residence, the ORs in these refugee groups approached the Swedish comparison population. Refugees from Afghanistan presented ORs similar to the Swedish-born, with no consistent trend by duration of residence. Women from the Horn of Africa and Iraq/Iran consumed less psychotropic drugs compared with men from these regions of origin, relative to the Swedish-born (p residence. This pattern suggests barriers to access mental health care. Interventions that can lower these barriers are needed to enable newly settled refugees to access mental health care on equal terms with the native population.

  18. Exploring workplace related health resources from a salutogenic perspective. Results from a focus group study among healthcare workers in Sweden.

    Science.gov (United States)

    Bringsén, Asa; Andersson, H Ingemar; Ejlertsson, Göran; Troein, Margareta

    2012-01-01

    The aim of this study was to explore healthcare workers' opinions on workplace related health resources relevant to promotion of their health. 16 registered nurses and 19 assistant nurses, from a medical emergency ward at a medium sized hospital in the south of Sweden, participated in the study. Eight focus group interviews were conducted, the material was condensed and conventional qualitative content analysis was used to elicit and identify patterns in the expressed opinions of the participants. The analysis yielded four themes that were labelled the reward, the team, the mission and the context. An explanatory model was constructed consisting of concentric circles, with the reward at the core. The qualitative analysis also revealed two divergent patterns; some of the participants associated positive health with stability while others referred to flexibility. The results from this study have contributed to the body of knowledge regarding salutogenic health indicators in the field of work and health research in particular as well as in health promotion in general. The findings show that individuals can have diverse responses to any given work situation, and this should be taken into account before implementation of salutogenic health promotion programs.

  19. Children with Asthma and Sports

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    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

  20. Causal Direction between RSV Bronchiolitis and Asthma Studied in Monozygotic Twins

    DEFF Research Database (Denmark)

    Poorisrisak, Porntiva; Halkjaer, Liselotte Brydensholt; Thomsen, Simon Francis

    2010-01-01

    , fractional of exhaled nitric oxide, asthma diagnosis, use of asthma medication, and skin prick test to common inhalant allergens. RESULTS: There were no differences within monozygotic twin pairs discordant for respiratory syncytial virus hospitalization in infancy with respect to pulmonary function...

  1. Meta-analysis of genome-wide linkage studies of asthma and related traits

    NARCIS (Netherlands)

    Denham, Samuel; Koppelman, Gerard H.; Blakey, John; Wjst, Matthias; Ferreira, Manuel A.; Hall, Ian P.; Sayers, Ian

    2008-01-01

    Background: Asthma and allergy are complex multifactorial disorders, with both genetic and environmental components determining disease expression. The use of molecular genetics holds great promise for the identification of novel drug targets for the treatment of asthma and allergy. Genome-wide

  2. A large-scale, consortium-based genomewide association study of asthma

    NARCIS (Netherlands)

    Moffatt, Miriam F.; Gut, Ivo G.; Demenais, Florence; Strachan, David P.; Bouzigon, Emmanuelle; Heath, Simon; von Mutius, Erika; Farrall, Martin; Lathrop, Mark; Cookson, William O. C. M.; Kumar, Ashish; Burney, Peter; Jarvis, Debbie; Wjst, Matthias; Kogevinas, Manolis; Jogi, Rain; Janson, Christer; Franklin, Karl A.; Omenaas, Ernst; Leynaert, Benedicte; Pin, Isabelle; Heinrich, Joachim; Probst-Hensch, Nicole M.; Anto, Josep M.; Sunyer, Jordi; Maldonado, Jose-Antonio; Martinez-Moratalla, Jesus; Urrutia, Isabel; Payo, Felix; Kauffmann, Francine; Dizier, Marie-Hélène; Siroux, Valérie; Boznanski, Andrzej; Braun-Fahrländer, Charlotte; Genuneit, Jon; Glas, Juergen; Horak, Elisabeth; Kabesch, Michael; Pillai, Sreekumar G.; Helms, Peter J.; Carlsen, Karin; Carlsen, Kai-Håkon; Gerritsen, Jorrit; Silverman, Michael; Sly, Peter; Tsanakas, John; Von Berg, Andrea; Whyte, Moira; Blumenthal, Malcolm; Imboden, Medea; Rochat, Thierry; Thun, Gian Andri; Gerbase, Margaret W.; Curjuric, Ivan; Gaspoz, Jean-Michel; Liu, Lee-Jane S.; Wouters, Inge M.; Sigsgaard, Torben; Heederik, Dick; Basinas, Ioannis; Schlunssen, Vivi; Omland, Øyvind; Cullinan, Paul; Vermeulen, Roel; Henderson, John; Granell, Raquel; McArdle, Wendy L.; Smith, George Davey; James, Alan L.; Hui, Jennie; Palmer, Lyle J.; Beilby, John; Musk, A. William; Laprise, Catherine; Hudson, Thomas J.; Lemire, Mathieu; Daley, Denise; Becker, Allan; Chan-Yeung, Moira; Sandford, Andrew; Kozyrskyj, Anita L.; Paré, Peter; Ferguson, Alexander; Dimich-Ward, Helen; Watson, Wade T.; Freidin, Maxim B.; Bragina, Elena Iu; Deev, Ivan A.; Deeva, Eugenia V.; Kobyakova, Olga S.; Puzyrev, Valery P.; Ogorodova, Ludmila M.; Khusnutdinova, Elza K.; Karunas, Alexandra S.; Fedorova, Yuliya Y.; Hall, Ian P.; Sayers, Ian; Tobin, Martin D.; Wan, Yize I.; Heaney, Liam G.; Al-Momani, Basima A. H.; Mansur, Adel H.; Manney, Sarah; Thomson, Neil C.; Chaudhuri, Rekha; Brightling, Christopher E.; Bafadhel, Mona; Singapuri, Amisha; Niven, Robert; Simpson, Angela; Holloway, John W.; Howarth, Peter H.; Polonikov, Alexey V.; Ivanov, Vladimir P.; Solodilova, Maria A.; Melén, Erik; Pershagen, Göran; Bergström, Anna; Kull, Inger; Nyberg, Fredrik; Wickman, Magnus; Söderhäll, Cilla; Kere, Juha; Postma, Dirkje S.; Kerkhof, Marjan; Brunekreef, Bert; Smit, Henriette A.; de Jongste, Johan C.; Wijga, Alet; Aalberse, R. C.; Hoekstra, Maarten O.; Koppelman, Gerard H.; Binia, Aristea; Chung, Kian Fan; Bhavsar, Pankaj; Chow, Florence; Macedo, Patricia; Menzies-Gow, Andrew; van Stiphout, Nicole; Bush, Andrew; Lee, Young-Ae; Esparza-Gordillo, Jorge; Nickel, Renate; Wahn, Ulrich; Lau, Susanne; Marenholz, Ingo; Haahtela, Tari; von Hertzen, Leena; Jousilahti, Pekka; Laatikainen, Tiina; Mäkelä, Mika J.; Vartiainen, Erkki; Laitinen, Tarja; Balding, David J.; Peden, John F.; Corda, Eve; Lechner, Doris; Besse, Cèline; Zelenika, Diana; Boland, Anne; Bacq, Delphine; Demonchy, Stephanie; Blanche, Helene; Kamatani, Yoichiro

    2010-01-01

    Susceptibility to asthma is influenced by genes and environment; implicated genes may indicate pathways for therapeutic intervention. Genetic risk factors may be useful in identifying subtypes of asthma and determining whether intermediate phenotypes, such as elevation of the total serum IgE level,

  3. Body mass and fat mass in refractory asthma: an observational 1 year follow-up study.

    Science.gov (United States)

    Bafadhel, Mona; Singapuri, Amisha; Terry, Sarah; Hargadon, Beverley; Monteiro, William; Green, Ruth H; Bradding, Peter H; Wardlaw, Andrew J; Pavord, Ian D; Brightling, Christopher E

    2010-01-01

    Background. Asthma and obesity are common; however the impact of obesity upon asthma remains uncertain. Objectives. To assess relationships between obesity and fat mass with airway inflammation, lung function, and disease control in patients with refractory asthma. Methods. 151 refractory asthma patients were characterised for measures of airway inflammation, lung function, Juniper asthma control questionnaire (JACQ), body mass index (BMI), and fat mass index (FMI) derived from dual energy X-ray absorptiometry. Patients were reassessed over 12 months. Results. 74% of patients had an elevated BMI. BMI and FMI correlated (r = 0.9, P < .001). FMI and JACQ correlated in men (r = 0.3, P = .01). After 12 months 23% lost weight. Weight change over 12 months correlated with FEV(1) change (r = -0.3, P = .03), but not with change in JACQ or exacerbations. Conclusion. Increased fat mass is common in refractory asthma and is associated with asthma symptom control in men. Loss of weight is associated with improvement in lung function in refractory asthma.

  4. Body Mass and Fat Mass in Refractory Asthma: An Observational 1 Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Mona Bafadhel

    2010-01-01

    Full Text Available Background. Asthma and obesity are common; however the impact of obesity upon asthma remains uncertain. Objectives. To assess relationships between obesity and fat mass with airway inflammation, lung function, and disease control in patients with refractory asthma. Methods. 151 refractory asthma patients were characterised for measures of airway inflammation, lung function, Juniper asthma control questionnaire (JACQ, body mass index (BMI, and fat mass index (FMI derived from dual energy X-ray absorptiometry. Patients were reassessed over 12 months. Results. 74% of patients had an elevated BMI. BMI and FMI correlated (r=0.9, P<.001. FMI and JACQ correlated in men (r=0.3, P=.01. After 12 months 23% lost weight. Weight change over 12 months correlated with FEV1 change (r=−0.3, P=.03, but not with change in JACQ or exacerbations. Conclusion. Increased fat mass is common in refractory asthma and is associated with asthma symptom control in men. Loss of weight is associated with improvement in lung function in refractory asthma.

  5. Evaluation of Agreement Between Video and Written Questionnaires for Asthma Symptoms Among Children of Tehran: ISAAC Study

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    MR Masjedi

    2008-07-01

    Full Text Available Introduction: International study on asthma was conducted to study the prevalence of Asthma symptoms among 13-14 year old children using written and video questionnaires during the early 90's. The aim of the present study (ISAAC was to evaluate the agreement between the two questionnaires which were self-completed by the children. Methods: This study, which was a part of the third phase of International Study of Asthma and Allergy in Childhood (ISAAC and performed exactly similar to phase1, was performed by National Research Institute of Tuberculosis and Lung Diseases (NRITLD in two cities of Iran; Rasht and Tehran. All stages of the study were performed in accordance with ISAAC protocol. The present study discusses data related to children of Tehran. A total of 3100 school children aged 13-14 years were questioned about asthma symptoms using written and video questionnaires of ISAAC study. For