scholarly journals 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

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
L. F. Grimsley ◽  
J. Wildfire ◽  
M. Lichtveld ◽  
S. Kennedy ◽  
J. M. El-Dahr ◽  
...  
Keyword(s):  
Hurricane Katrina ◽  
Skin Test ◽  
Skin Sensitivity ◽  
Asthma Morbidity ◽  
Asthma Symptoms ◽  
Children With Asthma ◽  
Allergen Concentration ◽  
Mold Spore ◽  
The City

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, andAlternariaby 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.

scholarly journals Randomized Trial of a Portable HEPA Air Cleaner Intervention to Reduce Asthma Morbidity among Latino Children in an Agricultural Community

2021 ◽  
Author(s):  
Rebecca Drieling ◽  
Paul D. Sampson ◽  
Jennifer E. Krenz ◽  
Maria I. Tchong French ◽  
Karen L. Jansen ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Intervention Group ◽  
Living Room ◽  
Asthma Education ◽  
Asthma Morbidity ◽  
Asthma Symptoms ◽  
Clinical Utilization ◽  
Air Cleaners ◽  
Act Score

Abstract BackgroundData on pediatric asthma morbidity and effective environmental interventions in agricultural settings are few.ObjectivesTo evaluate the effectiveness of HEPA air cleaners on asthma morbidity among a cohort of rural Latino children.MethodsSeventy-five children with poorly controlled asthma and residing in non-smoking homes were randomly assigned to asthma education alone or along with HEPA air cleaners placed in their sleeping area and home living room. Asthma Control Test (ACT) score, asthma symptoms in prior two weeks, unplanned clinical utilization for asthma, creatinine-adjusted urinary leukotriene E4 (uLTE4 [ng/mg]), and other secondary asthma outcomes were assessed at baseline, six and 12 months later. Multivariable-adjusted generalized estimating equations examined differences between groups based on repeated measures. Incident rate ratios of ever experiencing the metrics of poorer asthma health during follow-up (suboptimal asthma management) were estimated using Poisson regression models.ResultsMean intervention group child age was 9.2 years, control mean age was 8.6, and two-thirds of participants were male. In repeated measures analysis, intervention participants were less likely to have an ACT score representing poorly controlled asthma (IRR: 0.45 [95% CI: 0.21–0.97]). In Poisson models, intervention participants had reduced risk of ever experiencing an ACT score representing poorly controlled asthma (IRR: 0.43 [95% CI: 0.21–0.89]), ever having any asthma symptoms in the past two weeks (IRR: 0.71 [95% CI: 0.52–0.98]), and lower risk of any unplanned clinical utilization over the year of follow-up (IRR: 0.35 [95% CI: 0.13–0.94]) compared to control participants. There was a suggestion of greater decrease in uLTE4 (ng/mg creatinine) levels among intervention participants (-10% [95% CI: -20% -1%]).DiscussionHEPA air cleaners may provide additional benefit for child asthma health even in settings with strong asthma education programs and in areas where traditional asthmagens (traffic, tobacco smoke) are not prominent factors.Trial RegistrationClinicalTrials.gov Identifier: NCT04919915. Date of retrospective registration: May 19, 2021.

Impact of Hurricanes on Children With Asthma: A Systematic Literature Review

2021 ◽  
pp. 1-6
Author(s):  
Kristen N. Cowan ◽  
Audrey F. Pennington ◽  
Tchernavia Gregory ◽  
Joy Hsu
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Hurricane Katrina ◽  
Systematic Literature Review ◽  
The United States ◽  
Future Research ◽  
Preparedness Planning ◽  
Asthma Symptoms ◽  
Children With Asthma ◽  
The Impact

Abstract Following hurricanes, there can be increases in exacerbations of chronic diseases, such as asthma. Asthma is common among children, and many asthma exacerbations can be prevented. This systematic literature review assessed literature describing the impact of hurricanes on children with asthma in the United States. Medline, Embase, Global Health, PubMed, and Scopus databases were searched for peer-reviewed, English-language articles published January 1990 to June 2019 that described the effect of a hurricane on children with asthma. This search identified 212 articles; 8 met inclusion criteria. All 8 were related to Hurricane Katrina, but research questions and study design varied. Articles included information on asthma after hurricanes from cross-sectional surveys, retrospective chart review, and objective clinical testing. Four articles described discontinuity in health insurance, asthma-related health care, or asthma medication use; and 3 articles examined the relationship between mold exposure and asthma symptoms and reported varying results. The eighth study quantified the burden of asthma among people visiting mobile medical units but did not describe factors associated with asthma symptoms. These results highlight opportunities for future research (eg, on more recent hurricanes) and disaster preparedness planning (eg, strategies to prevent health-care discontinuity among children with asthma).

scholarly journals Does seeing a psychologist reduce sickness absence due to mental disorders? A quasi-experiment

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Lahti ◽  
J Harkko ◽  
H Sumanen ◽  
K Piha ◽  
O Pietiläinen ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Sickness Absence ◽  
Work Ability ◽  
Early Stage ◽  
Matched Sample ◽  
Full Sample ◽  
Common Support ◽  
The City ◽  
Quasi Experiment

Abstract Background Mental ill-health in young adults is a major public health and work-life problem. We examined in a quasi-experimental design whether occupational psychologist appointment can reduce subsequent sickness absence due to mental disorders among young Finnish employees. Methods The present study was conducted among 18-39-year-old employees of the City of Helsinki using register data from the City of Helsinki and the Social lnsurance Institution of Finland. We used Wald test to compare the differences in sickness absence days due to mental disorders (ICD-10, F-diagnosed) between those treated (occupational psychologist appointment for work ability support) and the non-treated (no psychologist appointment) during a one year follow-up. The full sample (n = 2156, 84% women) consisted of employees with mental disorder diagnosed sickness absence during 2009-2014. To account for the systematic differences between the treated and non-treated, the participants were matched according to their characteristics (age, sex, occupational class, education, previous sickness absence and psychotropic medication). The matched sample included 886 participants. We excluded those with treatment before the treatment screening time (± 3 months to the end of sickness absence period), non-treated with treatment during the follow-up and those that could not be matched (lack of common support). Results In the full sample, the mean of sickness absence days due to mental disorders was 17.7 (95% CI, 11.4, 24.1) days for those treated (n = 240) and 23.2 (95% CI, 20.5, 25.9) days for non-treated (n = 1916), difference being non-significant. The corresponding figures in the matched sample were (16.8, 95% CI, 9.5-24.1) for those treated (n = 195) and (27.8, 95% CI, 22.6-32.9) for non-treated (n = 691), difference being statistically significant (p = 0.02). Conclusions This quasi-experiment suggests that seeing an occupational psychologist to support work ability may be reduce mental health related sickness absence. Key messages We showed that supporting work ability at an early stage may prevent sickness absence due to mental disorders. More efforts to provide early stage support for maintaining work ability may prove useful in reducing sickness absence rates in younger employees.

scholarly journals The hypertriglyceridemic waist phenotype in young adults from the Southern Region of Brazil

2013 ◽  
Vol 29 (5) ◽  
pp. 999-1007 ◽  
Author(s):  
Ricardo Lanzetta Haack ◽  
Bernardo Lessa Horta ◽  
Denise Petrucci Gigante ◽  
Fernando C. Barros ◽  
Isabel Oliveira ◽  
...  
Keyword(s):  
Waist Circumference ◽  
Skin Color ◽  
Family Income ◽  
Southern Region ◽  
Fat Intake ◽  
Hypertriglyceridemic Waist ◽  
Maternity Hospitals ◽  
Hypertriglyceridemic Waist Phenotype ◽  
The City

The present study aimed to assess the prevalence of the hypertriglyceridemic waist phenotype and its associated factors among subjects that have been followed up from birth. In 1982, all maternity hospitals in the city of Pelotas, in the Southern Region of Brazil, were visited and all births were recorded. Babies whose parents lived in the urban area of Pelotas were subsequently followed up on several occasions. A 22 to 23-year follow-up of this birth cohort was carried out in 2004 and 2005. The presence of the hypertriglyceridemic waist phenotype was defined as waist circumference ≥ 90cm and triglyceride levels ≥ 177mg/dL for males, and waist circumference ≥ 85cm and triglyceride levels ≥ 133mg/dL for females. The prevalence of the hypertriglyceridemic waist phenotype was 5.9% and 4.5% among men and women, respectively. Among males, a sedentary lifestyle during leisure time, smoking and obesity were associated with the presence of the hypertriglyceridemic waist phenotype, whereas among females the condition was positively associated with skin color, family income, obesity and dietary fat intake.

scholarly journals USE OF THE TERMINOLOGICAL SUBSET "COMMUNITY NURSING" FOR HYPERTENSIVE AND/OR DIABETIC USERS

2020 ◽  
Vol 29 ◽  
Author(s):  
Paula Cristina Pereira da Costa ◽  
Elaine Ribeiro ◽  
Juliana Prado Biani Manzoli ◽  
Raisa Camilo Ferreira ◽  
Micnéias Tatiana de Souza Lacerda Botelho ◽  
...  
Keyword(s):  
Community Nursing ◽  
Clinical Indicators ◽  
Accuracy Study ◽  
Study Population ◽  
Diabetic Population ◽  
Accuracy Measures ◽  
The City ◽  
Nursing Diagnoses

ABSTRACT Objective: to determine the accuracy measures of clinical indicators of nursing diagnoses contained in the Terminological Subset "Community Nursing" for hypertensive and/or diabetic users. Method: methodological diagnostic accuracy study. The study population consisted of 363 hypertensive and/or diabetic users under follow-up care in three Health Centers in the city of Campinas, from August 2017 to February 2018. Data were collected through anamnesis. Data analysis consisted of the characterization of the population through descriptive statistics, and the analysis of clinical indicators and their respective Nursing Diagnoses was performed through accuracy measures. Results: 25 Nursing diagnoses were listed, related to 37 clinical indicators, which could be used in the hypertensive and/or diabetic population. It is emphasized that three were not contained in the Terminological Subset "Community Nursing", and it is recommended that they be introduced in the International Council of Nurses. Conclusion: through the evaluation of accuracy measures, the Terminological Subset "Community Nursing" can and should be used in Brazil in the hypertensive and/or diabetic population.

scholarly journals Evaluation of effectiveness of mass screening for tuberculosis infection in children from 1 to 7 years old in Moscow

2022 ◽  
Vol 99 (12) ◽  
pp. 14-21
Author(s):  
L. V. Slogotskaya ◽  
E. M. Bogorodskaya ◽  
L. F. Shamuratova ◽  
T. A. Sevostyanova
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Skin Test ◽  
Positive Reaction ◽  
Mass Screening ◽  
Preventive Therapy ◽  
Tuberculosis Infection ◽  
Mantoux Test ◽  
Primary Health

The objective: to evaluate effectiveness of mass screening for tuberculosis infection in children aged 1 to 7 years in different periods – before and after the use of tuberculosis recombinant allergen skin test (TRA) in primary health care as an additional diagnostic method.Subjects and Methods. The study was designed as continuous observational prospective-retrospective study. Two different periods were assessed: the first one was 2014-2016 when screening for tuberculosis infection was performed in all children from 1 to 17 years (inclusive) using Mantoux test with 2 TU PPD-L in pediatric primary health care, and then children suspected to have a positive reaction were referred to TB dispensary where they were examined with a skin test with TRA if necessary. The second period was from 2018 to 2020 when children of 1-7 years old were given Mantoux test and if tuberculosis infection was suspected, a skin test with TRA was done both in primary health care network and TB units. In the first 3 years, 1,864,137 children were examined and in the second 3 years, 2,078,800 children from 1 to 7 years old were examined.Results. Among children of 1-7 years old who were screened by two stages (initial Mantoux test, and then in those who had a positive reaction, the TRA test was used), only 10-12% of those referred to a phthisiologist were subject to dispensary follow-up. Thus, with the implementation of the new edict on screening for tuberculosis infection in children with two tests, this proportion has not changed compared to previous years, when screening was carried out only with one Mantoux test. The reason why almost 90% of the children who were referred to TB Dispensary were not subject to dispensary follow-up is the following: children who have had previous conversion of tuberculin tests, along with everyone else are again screened with Mantoux test despite being previously followed up by TB dispensary due to the primary infection.Recommendations:Currently, there is no division of Group VI into Subgroups A, B, C in the dispensary follow up grouping. Why should conversion of Mantoux test reaction from negative into positive not be considered an infection, and the increase in the reaction must be at least 6 mm.Since Order No. 124n of the Russian Ministry of Health allows testing with TRA in the primary health care in case of suspected infection, it is advisable to refer those who have already had this test to a phthisiologist.A child with conversion of Mantoux test should not be re-screened with Mantoux test but the TRA test should be used. If a positive reaction to the TRA test occurs for the first time, it should be considered as conversion of this test, and in this case the child should be examined by computed tomography (CT), and preventive therapy should be prescribed. If in subsequent years the TRA reaction increases by at least 6 mm after previous preventive therapy, the child should be re-referred for CT to rule out the development of active tuberculosis.

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