Assessment of Asthma Control Questionnaire as a Metric for Children s Traffic Air Pollution Exposures at Two Roadside El Paso Elementary Schools
|
|
- Abigayle Cory Newton
- 5 years ago
- Views:
Transcription
1 Assessment of Asthma Control Questionnaire as a Metric for Children s Traffic Air Pollution Exposures at Two Roadside El Paso Elementary Schools Amit U. Raysoni, Ph.D., M.P.H., UTRGV Soyoung Jeon, Ph.D., UTEP Juan Aguilera, M.D., M.P.H., UTEP Wen-Whai Li, Ph.D., P.E., UTEP Session 2: Schools, Childhood Asthma, and Interventions Transportation, Air Quality, and Health Symposium, Austin, TX February 19, 2019
2 Introduction Traffic air pollution and its associated pulmonary health effects have garnered a lot of attention in the scientific community especially in sensitive populations such as young elementary school children. The border city of El Paso, TX is impacted by high traffic emissions due to busy U.S.-Mexico port of entries, and high vehicular traffic on interstate highways crisscrossing the length and breadth of this arid high elevation city. As part of a traffic air pollution and health effects study, continuous monitoring of PM 2.5, NO 2, and O 3 were conducted at two elementary schools adjoining a major interstate highway and asthmatic students were selected for a panel based longitudinal study in fall Various health measurements assessing pulmonary health of the study subjects were administered during the course of the study.
3 Study Design & Methods 23 children (ages 6-12 years) days over 9 weeks in late Fall Assessments included exhaled nitric oxide (eno, marker of airway inflammation), lung function [forced vital capacity (FVC) and forced expiratory volume in one second (FEV1)], and asthma symptoms and control questionnaires (ACQ) Continuous measurements of O3, NO2, and PM2.5 were conducted concurrently outside the two schools (Schools B & CW) and a residential site (Site H) in close proximity to the schools.
4 Asthma Control Questionnaire (ACQ) This study assesses the validity of asthma control questionnaires (ACQ) for understanding children s exposure to air pollution. The Asthma Control Questionnaire (ACQ) is a 7-item questionnaire. It is used to measure the adequacy of asthma control both in clinical research studies and in clinical practice.
5 ACQ The ACQ includes items on specific symptoms, timing of symptoms, (4 questions) activity limitation, (1 question) use of rescue medications (1 question), and lung function (1 question) FEV1% Predicted.
6 Significance of ACQ As per the international guidelines, in order to achieve good asthma control it is necessary that the treatment should minimize day and night time symptoms, activity limitation, airway narrowing, and rescue bronchodilator use and thus reduce the risk of life-threatening exacerbations and long-term morbidity ( Juniper, 2005). It was initially developed for adults (Juniper et al., 1999) but has been subsequently validated for use among children 6-16 years of age (Juniper et al., 2010).
7 Usage of ACQ in the Context of Air Quality Study Very few studies have used these ACQ scores to assess children s exposure to traffic air pollutants. The research work analyzes the questionnaires to understand the role of traffic air pollutants and medicinal usage and its success thereof in controlling asthma in a majority Mexican-American student cohort. Usage of ACQ in the context of air pollution studies could help reflect clinically measurable and biologically relevant changes in lung function and asthma symptoms that result from poor air quality and could increase our understanding of how air pollution influences asthma exacerbation.
8 Asthma Control Questionnaire - Criteria Individual question scores on the ACQ are scaled from 0 to 6 based on severity of symptoms. Overall score is the mean of the 7 questions. Therefore, the minimum overall ACQ score is 0.0 for well-controlled asthma and the maximum score is 6.0 for poorly-controlled asthma. The lowest clinically relevant score for the ACQ among asthmatic children has been shown to be 0.53 ± 0.45 (Juniper et al., 2010). A score of 1.5 on the ACQ has been identified as the best discriminator between asthma patients that are well-controlled and not wellcontrolled.
9 Asthma Control Questionnaire 1. On average, during the past week, how often were you woken by your asthma during the night? 0 Never 1 Hardly ever 2 A few minutes 3 Several times 4 Many times 5 A great many times 6 Unable to sleep because of asthma 2. On average, during the past week, how bad were your asthma symptoms when you woke up in the morning? 0 No symptoms 1 Very mild symptoms 2 Mild symptoms 3 Moderate symptoms 4 Quite severe symptoms 5 Severe symptoms 6 Very severe symptoms
10 Asthma Control Questionnaire. 3. In general, during the past week, how limited were you in your activities because of your asthma? 0 Not limited at all 1 Very slightly limited 2 Slightly limited 3 Moderately limited 4 Very limited 5 Extremely limited 6 Totally limited 4. In general, during the past week, how much shortness of breath did you experience because of you asthma? 0 None 1 A very little 2 A little 3 A moderate amount 4 Quite a lot 5 A great deal 6 A very great deal
11 Asthma Control Questionnaires 5. In general, during the past week, how much of the time did you wheeze? 0 Not at all 1 Hardly any of the time 2 A little of the time 3 A moderate amount of the time 4 A lot of the time 5 Most of the time 6 All the time 6. On average, during the past week, how many puffs of short-acting bronchodilator (eg. Ventolin) have you used each day? 0 None 1 1±2 puffs most days 2 3±4 puffs most days 3 5±8 puffs most days 4 9±12 puffs most days 5 13±16 puffs most days 6 More than 16 puffs most days 7. FEV1 % 0 >95% predicted 1 95±90% 2 89±80% 3 79±70% 4 69±60% 5 59±50% 6 <50% predicted
12 Study Subject Characteristics
13 Results from the 2017 CAR TEEH Study School CW 199 ACQ completed repeated measures per subject Mean ACQ score for the study: 0.52 ± 0.51 Minimum: 0.0 Maximum: 2.71 School FB 165 ACQ completed repeated measures per subject Mean ACQ score for the study: 1.00 ± 0.64 Minimum: 0.0 Maximum: 3.0
14 Average ACQ Score Box plots
15 Mean ACQ Scores Data from School CW 12 subjects in the study cohort 5 Females, 7 Males Females 7 ppb, 63% 46 ppb, 77% 30 ppb, 69% 20 ppb, 70.7% Males ppb, 103.9% ppb, 86.14% 22 ppb, 90.4% 41 ppb, 88.7% ppb, 99.7% 8 ppb, 106.9% 37 ppb, 96.4% 43 ppb, 100% CW-01 CW-02 CW-03 CW-08 CW-11 CW-04 CW-05 CW-06 CW-07 CW-09 CW-10 CW-12 Subject ID
16 Mean ACQ Scores Data from School FB 11 subjects in the study cohort 6 Females, 5 Males 2 78 ppb, 89.4% Females Bliss Elementary School ppb 45 ppb, 76.6% Males ppb, 80.1% 33 ppb, 79.9% 64 ppb, 96.9% 13 ppb, 76.1% 7 ppb, 100.4% 75 ppb, 87.6% ppb 30 ppb, 82.8% 0 FB-1 FB-3 FB-5 FB-8 FB-9 FB-10 FB-2 FB-4 FB-6 FB-7 FB-11 Subject ID
17 Overall Associations between ACQ and (24-/48-/72-/96-hr) Pollutant Metrics
18 Linear mixed effect models (nested model) with school- and subject-specific random intercept and AR(1) correlation including covariates Pollutant Sampling Period Site IQR Change in ACQ/IQR p value PM hr CW PM10 24 hr Overall PM10 24 hr FB PM10 96 hr CW O3 48 hr Overall O3 48 hr FB AQR 96 hr CW
19 Overall and Subject-specific Associations between ACQ and 24hr Averaged PM2.5* *Linear mixed effect models (nested model) with school- and subject-specific random intercept and AR(1) correlation. Including covariates Pollutant (IQR) Subject-specific Factor Chg in ACQ per IQR increase in pollutant 95%CI.lwr 95%CI.upr p.value PM2.5.24hr (6.69) Gender Female Male Father with Asthma Yes No Father with Hay Fever Yes No Siblings with Hay Fever Yes No
20 Overall and Subject-specific Associations between ACQ and 24hr Averaged PM10* *Linear mixed effect models (nested model) with school- and subject-specific random intercept and AR(1) correlation. Including covariates Pollutant (IQR) Subject-specific Factor Chg in ACQ per IQR increase in pollutant 95%CI.lwr 95%CI.upr p.value PM10.24hr (30.82) Gender Female Male Father with Asthma Yes No Father with Hay Fever Yes No Siblings with Hay Fever Yes No
21 Overall and Subject-specific Associations between ACQ and 24hr Averaged NO2* *Linear mixed effect models (nested model) with school- and subject-specific random intercept and AR(1) correlation. Including covariates Pollutant (IQR) Subject-specific Factor Chg in ACQ per IQR increase in pollutant 95%CI.lwr 95%CI.upr p.value NO2.24hr (8.14) Gender Female Male Father with Asthma Yes No Father with Hay Fever Yes No Siblings with Hay Fever Yes No
22 Overall and Subject-specific Associations between ACQ and 24hr Averaged O3* Pollutant (IQR) Subject-specific Factor Chg in ACQ per IQR increase in pollutant 95%CI.lwr 95%CI.upr p.value O3.24hr (13.46) Gender Female Male Father with Asthma Yes No Father with Hay Fever Yes No Siblings with Hay Fever Yes No
23 Overall and Subject-specific Associations between ACQ and 24hr Averaged AQG* *Linear mixed effect models (nested model) with school- and subject-specific random intercept and AR(1) correlation. Including covariates Pollutant (IQR) Subject-specific Factor Chg in ACQ per IQR increase in pollutant 95%CI.lwr 95%CI.upr p.value AQG.24hr (28.36) Gender Female Male Father with Asthma Yes No Father with Hay Fever Yes No Siblings with Hay Fever Yes No
24 Conclusions Air pollution panel studies mirror a brief snapshot in space and time of a potential exposure response relationship. 24 hr exposure levels more robust to elicit a statistically detectable response in ACQ. ACQ scores are also dependent on the person answering the questions in terms of their understanding of the questions and personal perception of asthma symptom severity. Our current findings strongly warrant additional studies with larger sample sizes that might be able to detect significant changes in ACQ scores based on the various pollutants and their levels.
25 Thank You
The Asthma Guidelines: Diagnosis and Assessment of Asthma
The Asthma Guidelines: Diagnosis and Assessment of Asthma Christopher H. Fanta, M.D. Partners Asthma Center Brigham and Women s Hospital Harvard Medical School Objectives Know how the diagnosis of asthma
More informationRelationship between physical activity, fruits & vegetables, and air quality in children with asthma
Relationship between physical activity, fruits & vegetables, and air quality in children with asthma Juan Aguilera 1 MD, MPH; David Perez 1, BS; Alisha Redelfs 1, Dr. PH, MPH, CHES; Soyoung Jeon 1, Ph.D.;
More informationAsthma: Chronic Management. Yung-Yang Liu, MD Attending physician, Chest Department Taipei Veterans General Hospital April 26, 2015
Asthma: Chronic Management Yung-Yang Liu, MD Attending physician, Chest Department Taipei Veterans General Hospital April 26, 2015 Global Strategy for Asthma Management and Prevention Evidence-based Implementation
More informationSGRQ Questionnaire assessing respiratory disease-specific quality of life. Questionnaire assessing general quality of life
SUPPLEMENTARY MATERIAL e-table 1: Outcomes studied in present analysis. Outcome Abbreviation Definition Nature of data, direction indicating adverse effect (continuous only) Clinical outcomes- subjective
More informationOutline FEF Reduced FEF25-75 in asthma. What does it mean and what are the clinical implications?
Reduced FEF25-75 in asthma. What does it mean and what are the clinical implications? Fernando Holguin MD MPH Director, Asthma Clinical & Research Program Center for lungs and Breathing University of Colorado
More informationAsthma COPD Overlap (ACO)
Asthma COPD Overlap (ACO) Dr Thomas Brown Consultant Respiratory Physician Thomas.Brown@porthosp.nhs.uk Dr Hitasha Rupani Consultant Respiratory Physician Hitasha.rupani@porthosp.nhs.uk What is Asthma
More informationAsthma Management for the Athlete
Asthma Management for the Athlete Khanh Lai, MD Assistant Professor Division of Pediatric Pulmonary and Sleep Medicine University of Utah School of Medicine 2 nd Annual Sports Medicine Symposium: The Pediatric
More informationDiscrimination, Psycho-Social Stress and the Relationship to Non-Atopic Neutrophilic Asthma and Other Asthma Phenotypes
Discrimination, Psycho-Social Stress and the Relationship to Non-Atopic Neutrophilic Asthma and Other Asthma Phenotypes November 3, 2017 Neeta Thakur, MD MPH Neeta.Thakur@ucsf.edu OVERVIEW Asthma as a
More informationSUMMARY THIS IS A PRINTED COPY OF AN ELECTRONIC DOCUMENT. PLEASE CHECK ITS VALIDITY BEFORE USE.
i SUMMARY ZENECA PHARMACEUTICALS FINISHED PRODUCT: ACTIVE INGREDIENT: ACCOLATE zafirlukast (ZD9188) Trial title (number): A Dose-ranging, Safety and Efficacy Trial with Zafirlukast (ACCOLATE ) in the Treatment
More informationASTHMA-COPD OVERLAP SYNDROME 2018: What s All the Fuss?
ASTHMA-COPD OVERLAP SYNDROME 2018: What s All the Fuss? Randall W. Brown, MD MPH AE-C Association of Asthma Educators Annual Conference July 20, 2018 Phoenix, Arizona FACULTY/DISCLOSURES Randall Brown,
More informationWhere each child is special and every child matters. Asthma Policy
Where each child is special and every child matters Asthma Policy Introduction Asthma is one of the commonest chronic diseases of childhood, affecting approximately 1.1 million children in the UK. Children
More informationExhaled Nitric Oxide: An Adjunctive Tool in the Diagnosis and Management of Asthma
Exhaled Nitric Oxide: An Adjunctive Tool in the Diagnosis and Management of Asthma Jason Debley, MD, MPH Assistant Professor, Pediatrics Division of Pulmonary Medicine University of Washington School of
More informationDemographic Form ARC ID. Name: Date: Id Copy (Office use only) Current Address: Street
Demographic Form Name: Date: Current Address: Street ARC ID Id Copy (Office use only) Apt # City State Zip Code Contact Information: Phone # - Home Phone # - Cellular May we have your permission to text
More informationThis is a cross-sectional analysis of the National Health and Nutrition Examination
SUPPLEMENTAL METHODS Study Design and Setting This is a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) data 2007-2008, 2009-2010, and 2011-2012. The NHANES is
More informationOn completion of this chapter you should be able to: discuss the stepwise approach to the pharmacological management of asthma in children
7 Asthma Asthma is a common disease in children and its incidence has been increasing in recent years. Between 10-15% of children have been diagnosed with asthma. It is therefore a condition that pharmacists
More information7/7/2015. Somboon Chansakulporn, MD. History of variable respiratory symptoms. 1. Documented excessive variability in PFT ( 1 test)
Definition of Asthma GINA 2010: Chronic inflammatory disorder of the airways Airway hyper-responsiveness Recurrent wheezing, breathlessness, chest tightness, coughing Variable, reversible airflow obstruction
More informationBecause the more you know, the better you ll feel.
ABOUT ASTHMA Because the more you know, the better you ll feel. This booklet is designed to help you understand asthma and the things you can do every day to help control symptoms. As always, talk to your
More information#POMAD8 #ChoosePOMA #POMAD8 #ChoosePOMA #POMAD8 #ChoosePOMA
Where There s Smoke There s Obstruction Stephen G. Basheda, D.O., F.C.C.P. 1 Disclosures Dr. Basheda is an independent contractor for AstraZeneca Pharmaceuticals, LP and GlaxoSmithKline and on the speaker
More informationLife-long asthma and its relationship to COPD. Stephen T Holgate School of Medicine University of Southampton
Life-long asthma and its relationship to COPD Stephen T Holgate School of Medicine University of Southampton Definitions COPD is a preventable and treatable disease with some significant extrapulmonary
More informationSponsor. Generic drug name. Trial indication(s) Protocol number. Protocol title. Clinical trial phase. Study Start/End Dates.
Sponsor Novartis Generic drug name Fluticasone propionate Trial indication(s) Moderate-severe bronchial asthma Protocol number CQAE397A2202 Protocol title A randomized open label study to assess the utility
More informationBecause the more you know, the better you ll feel.
ABOUT ASTHMA Because the more you know, the better you ll feel. What You ll Find Attitudes and Beliefs Asthma What Is It? Where You ll Find It Page 4-5 This booklet is designed to help you understand asthma
More informationDiagnosis. you have asthma? Get the answers. Your Asthma Basics series: Asthma Basics #1. Diagnosis Triggers Medications Kids
Diagnosis Asthma Basics #1 Your Asthma Basics series: 1 2 3 Diagnosis Triggers Medications Kids Supported by unrestricted educational grants from: For more information from the Asthma Society of Canada:
More informationOptimal Assessment of Asthma Control in Clinical Practice: Is there a role for biomarkers?
Disclosures: Optimal Assessment of Asthma Control in Clinical Practice: Is there a role for biomarkers? Stanley Fineman, MD Past-President, American College of Allergy, Asthma & Immunology Adjunct Associate
More informationGet Healthy Stay Healthy
Asthma Management WHAT IS ASTHMA? Asthma causes swelling and inflammation in the breathing passages that lead to your lungs. When asthma flares up, the airways tighten and become narrower. This keeps the
More informationDual-Controller Asthma Therapy: Rationale and Clinical Benefits
B/1 Dual-Controller Asthma Therapy: Rationale and Clinical Benefits MODULE B The 1997 National Heart, Lung, and Blood Institute (NHLBI) Expert Panel guidelines on asthma management recommend a 4-step approach
More informationQuestion 1: What is your diagnosis?
Case study title: Target group: Linked to modules: Outdoor air pollution (Clinical case) Paediatricians, General practitioners, Public health professionals Indoor air pollution, Outdoor air pollution,
More information(Asthma) Diagnosis, monitoring and chronic asthma management
Dubai Standards of Care 2018 (Asthma) Diagnosis, monitoring and chronic asthma management Preface Asthma is one of the most common problem dealt with in daily practice. In Dubai, the management of chronic
More informationAnyone who smokes and/or has shortness of breath and sputum production could have COPD
COPD DIAGNOSIS AND MANAGEMENT CHECKLIST Anyone who smokes and/or has shortness of breath and sputum production could have COPD Confirm Diagnosis Presence and history of symptoms: Shortness of breath Cough
More informationAsthma Care in tribal Communities:
Asthma Care in tribal Communities: Addressing Challenges; Improving Care Sofia Ali, MD, MPH Goal Provide good asthma care Reduce burden of asthma in the Indian community Overview Scope of asthma Components
More informationPresented by the California Academy of Family Physicians 2013/California Academy of Family Physicians
Family Medicine and Patient-Centered Asthma Care Presented by the California Academy of Family Physicians Faculty: Hobart Lee, MD Disclosures: Jeffrey Luther, MD, Program Director, Memorial Family Medicine
More informationDiagnosis, Assessment, Monitoring and Pharmacological Treatment of Asthma
Diagnosis, Assessment, Monitoring and Pharmacological Treatment of Asthma Magnitude of Asthma - India Delhi Childhood asthma: 10.9% Adults: 8% Other Cities 3 to 18% Chhabra SK et al Ann Allergy Asthma
More informationInternational co-ordinating investigator Dr Dencho Osmanliev, St Sofia, Pulmonary Dept, 19 D Nestorov Str, Sofia, 1431, Bulgaria.
Drug product: SYNOPSIS Drug substance(s): Budesonide/formoterol Document No.: SD-039-CR-0681 Referring to part Edition No.: 1 of the dossier Study code: SD-039-0681 Date: 24 Oktober, 2003 (For national
More informationNEW PATIENT INTAKE FORM
NEW PATIENT INTAKE FORM NAME: DOB: SEX: MALE FEMALE ADDRESS: ZIP CODE: PHONE #: - - WORK#: - - PHARMACY: PHARMACY #: - - WOULD YOU BE INTERESTED IN HAVING ACCESS TO YOUR MEDICAL RECORDS ONLINE? YES / NO
More informationSupplementary Online Content
Supplementary Online Content Berhane K, Chang C-C, McConnell R, et al. Association of changes in air quality with bronchitic symptoms in children in California, 1993-2012. JAMA. doi:10.1001/jama.2016.3444
More informationAsthma. UVM. University of Vermont. Alicia Jacobs MD Fletcher Allen Health Care and the University of Vermont
University of Vermont ScholarWorks @ UVM Family Medicine Scholarly Works 6-14-2013 Asthma Alicia Jacobs MD Fletcher Allen Health Care and the University of Vermont Follow this and additional works at:
More informationcompare patients preferences and costs for asthma treatment regimens targeting three
APPENDIX I ADDITIONAL METHODS Trial design The Accurate trial lasted from September 2009 until January 2012 and was designed to compare patients preferences and costs for asthma treatment regimens targeting
More informationHow one School-Based Health Center Network Transformed a Community by Addressing Asthma. September 10, 2015
How one School-Based Health Center Network Transformed a Community by Addressing Asthma September 10, 2015 Help Us Count If you are viewing as a group, please go to the chat window and type in the name
More informationStudy No.: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives: Primary Outcome/Efficacy Variable:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationDiagnosis and Management of Asthma in Children based on the British Thoracic Society and Scottish Intercollegiate Guidelines Network September 2016
Diagnosis and Management of Asthma in Children based on the British Thoracic Society and Scottish Intercollegiate Guidelines Network September 2016 Diagnosis: There is no lower limit to the age at which
More informationWeb appendix: Supplementary data
Web appendix: Supplementary data Azad MA, Coneys JG, Kozyrskyj AL, Field CJ, Ramsey CD, Becker AB, Friesen C, Abou-Setta AM, Zarychanski R. Probiotic supplementation during pregnancy or infancy for the
More informationAsthma and Air Pollution
Asthma and Air Pollution Health Effects Workshop Nov. 6, 2008 Joann Held with thanks to: Dave Brown Asthma and Airways Asthma Physiology A chronic disease that affects airways. The inside walls of airways
More informationDo patients with sickle cell disease have asthma?
Do patients with sickle cell disease have asthma? Anne Greenough Faculty of Life Sciences and Medicine King s College, London MRC & Asthma UK Centre in Allergic Mechanisms of Asthma Sickle Cell Disease
More informationLowering the Ozone Standard: Questionable Costs & Benefits. Michael Honeycutt, Ph.D. Toxicology Division Texas Commission on Environmental Quality
Lowering the Ozone Standard: Questionable Costs & Benefits Michael Honeycutt, Ph.D. Toxicology Division Texas Commission on Environmental Quality 1 Ozone (O 3 ) O 3 is formed when nitrogen oxides (NOx)
More informationFrequency of nocturnal symptoms in asthmatic children attending a hospital out-patient clinic
Eur Respir J, 1995, 8, 2076 2080 DOI: 10.1183/09031936.95.08122076 Printed in UK - all rights reserved Copyright ERS Journals Ltd 1995 European Respiratory Journal ISSN 0903-1936 Frequency of nocturnal
More informationHow to treat COPD? What is the mechanism of dyspnea? Smoking cessation
: The Increasing Role of the FP Alan Kaplan, MD, CCFP(EM) Presented at the Primary Care Today: Education Conference and Medical Exposition, Toronto, Ontario, May 2006. Chronic obstructive pulmonary disease
More informationCOPD. Helen Suen & Lexi Smith
COPD Helen Suen & Lexi Smith What is COPD? Chronic obstructive pulmonary disease: a non reversible, long term lung disease Characterized by progressively limited airflow and an inability to perform full
More informationIvax Pharmaceuticals UK Sponsor Submission to the National Institute for Health and Clinical Excellence
Ivax Pharmaceuticals UK Sponsor Submission to the National Institute for Health and Clinical Excellence Clinical and cost-effectiveness of QVAR for the treatment of chronic asthma in adults and children
More informationChronic Obstructive Pulmonary Disease. Information about medication and an Action Plan to use if your condition gets worse due to an infection
Chronic Obstructive Pulmonary Disease Information about medication and an Action Plan to use if your condition gets worse due to an infection Information about your medication Your usual treatment Inhalers
More informationAsthma in Children with Sickle Cell Disease
December 18, 2018 Asthma in Children with Sickle Cell Disease Robyn Cohen, MD, MPH Director, Division of Pediatric Pulmonology and Allergy Associate Professor of Pediatrics Boston University/Boston Medical
More informationPulmo-Park Pom-Pom Shooter: Measuring the Effect of Restricted Breathing on Peak Expiratory Flow (PEF) Student Information Page Activity 5D
Pom-Pom Shooter: Measuring the Effect of Restricted Breathing on Peak Expiratory Flow (PEF) Student Information Page Activity 5D Students with asthma or other respiratory problems should not perform the
More informationRELATIONSHIP BETWEEN RESPIRATORY DISEASES OF SCHOOLCHILDREN AND TOBACCO SMOKE IN HONG KONG AND SRI LANKA
RELATIONSHIP BETWEEN RESPIRATORY DISEASES OF SCHOOLCHILDREN AND TOBACCO SMOKE IN HONG KONG AND SRI LANKA 1 S.H. LEE and W.T. HUNG Department of Civil and Environmental Engineering, The Hong Kong Polytechnic
More informationCase-Compare Impact Report
Case-Compare Impact Report October 8, 20 For CME Activity: Developed through an independent educational grant from Genentech: Moderate to Severe Persistent Asthma: A Case-Based Panel Discussion (March
More informationMedical Emergencies at Moderate and High Altitude
Medical Emergencies at Moderate and High Altitude Annalisa Cogo Clinica Pneumologica e Centro Studi Biomedici Applicati allo Sport Università di Ferrara Payer Hutte, Ortler Mountain Environment Barometric
More informationThe Primary Prevention of Asthma
The Primary Prevention of Asthma Risk Factors Associated with Asthma Onset Ted Schettler Science and Environmental Health Network Collaborative on Health and Environment June, 2013 Asthma: a complex disease(s)
More informationAsthma 2015: Establishing and Maintaining Control
Asthma 2015: Establishing and Maintaining Control Webinar for Michigan Center for Clinical Systems Improvement (Mi-CCSI) Karen Meyerson, MSN, APRN, NP-C, AE-C June 16, 2015 Asthma Prevalence Approx. 26
More informationAsthma By Mayo Clinic staff
MayoClinic.com reprints This single copy is for your personal, noncommercial use only. For permission to reprint multiple copies or to order presentation-ready copies for distribution, use the reprints
More informationQ. What is a Peak-Flow Meter? A. It is an instrument that measures Peak Expiratory Flow Rate (PEFR). PEFR is the amount of air a person can blow out
1 2 Q. What is a Peak-Flow Meter? A. It is an instrument that measures Peak Expiratory Flow Rate (PEFR). PEFR is the amount of air a person can blow out during a forced expiration after taking in as full
More informationAn Overview of Asthma - Diagnosis and Treatment
An Overview of Asthma - Diagnosis and Treatment Definition of Asthma: Asthma is a common chronic disease of children and adults. Nationally, more than 1 in 14 Americans report having asthma and as many
More informationChronic persistent asthma presenting to an accident and emergency department compliance with B.T.S. guidelines
Archives of Emergency Medicine, 1993, 10, 347-353 Chronic persistent asthma presenting to an accident and emergency department compliance with B.T.S. guidelines J. R. THOMPSON & M. A. LAMBERT Accident
More information2. Has the child had a physician s diagnosis of atopic dermatitis or atopic eczema ever?
Online Supplement 2: Letter questionnaire RISK FACTORS FOR THE DEVELOPMENT OF ASTHMA 1. Have the child s parents had a history of asthma ever? 2. Has the child had a physician s diagnosis of atopic dermatitis
More informationTARGET POPULATION Eligibility Inclusion Criterion Exclusion Criterion RECOMMENDATIONS
TARGET POPULATION Eligibility Inclusion Criterion Exclusion Criterion RECOMMENDATIONS Recommendation PULMONARY FUNCTION TESTING (SPIROMETRY) Conditional: The Expert Panel that spirometry measurements FEV1,
More informationThe following questions are about your sleep. Please consider both what others have told you about your sleep and what you know yourself.
Sleep History Form FORM CODE: SLE VERSION A 1/29/2009 PARTICIPANT ID NUMBER: CONTACT YEAR: 0 9 LAST NAME: INITIALS: INSTRUCTIONS: This form should be completed during the participant's clinic visit. ID
More informationPKU: Yahong Chen, MD, PhD UM: Steven K. Huang, MD
DNA Methylation Changes Induced by Particulate Matter in Air Pollution Contributes to Chronic Airway Inflammation in Moderate-to-Severe Uncontrolled Asthma PKU: Yahong Chen, MD, PhD UM: Steven K. Huang,
More informationRESPIRATORY CARE IN GENERAL PRACTICE
RESPIRATORY CARE IN GENERAL PRACTICE Definitions of Asthma and COPD Asthma is due to inflammation of the air passages in the lungs and affects the sensitivity of the nerve endings in the airways so they
More informationRespiratory Health L O O K, F E E L A N D L I V E B E T T E R
LOOK, FEEL AND LIVE BET TER Respiratory health: hay-fever and asthma Airway obstruction and symptoms in asthma and hay-fever alike are the result of inappropriate responses of the body s immune system
More informationAsthma: diagnosis and monitoring
Asthma: diagnosis and monitoring NICE guideline: short version Draft for second consultation, July 01 This guideline covers assessing, diagnosing and monitoring suspected or confirmed asthma in adults,
More information7. Study instruments for 13/14 year olds
7. Study instruments for 13/14 year olds 7.1 Instructions for completing questionnaire and demographic questions Examples of instructions for completing questionnaires and demographic questions are given
More information#1 cause of school absenteeism in children 13 million missed days annually
Asthma Update 2013 Jennifer W. McCallister, MD, FACP, FCCP Associate Professor Pulmonary & Critical Care Medicine The Ohio State University Wexner Medical Center Disclosures None 2 Objectives Review burden
More informationAsthma and obesity, implications for airway inflammation and Bronchial Hyperresponsiveness
Asthma and obesity, implications for airway inflammation and Bronchial Hyperresponsiveness Fernando Holguin MD MPH Asthma Institute University of Pittsburgh Obesity Trends* Among U.S. Adults BRFSS, 1990,
More informationConsiderations About Exposure and Health Effects of Traffic Pollution
Considerations About Exposure and Health Effects of Traffic Pollution Northern Transportation and Air Quality Summit 2010 August 24, 2010 Maria Costantini Health Effects Institute What Is HEI HEI is a
More informationRESPIRATORY DISORDERS
RESPIRATORY DISORDERS INTRODUCTION Respiratory disorders refers to the medical term that include different pathological conditions affecting the organs and tissues of respiratory system which make gas
More informationCombustion-related ambient air pollution is a well-documented
ORIGINAL ARTICLE Respiratory Symptoms Following Wildfire Smoke Exposure Airway Size as a Susceptibility Factor Maria C. Mirabelli, a,b,c Nino Künzli, a,b,d Edward Avol, e Frank D. Gilliland, e W. James
More informationOzone and Health: Clinical Studies. Mark W. Frampton MD University of Rochester Medical Center Rochester, NY
Ozone and Health: Clinical Studies Mark W. Frampton MD University of Rochester Medical Center Rochester, NY QUESTIONS What do we know about respiratory effects of ozone? Are there acute cardiovascular
More informationChronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease CareOregon Pharmacy Abridged sample of presentation content Home Equipment Pathophysiology Exacerbations Guidelines Lifestyle Modification Medication Management Sample
More informationAsthma in the Athlete
Asthma in the Athlete Jorge E. Gomez, MD Associate Professor Texas Children s Hospital Baylor College of Medicine Assist Team Physician UH Understand how we diagnose asthma Objectives Be familiar with
More informationTALKING POINTS. Ten Reasons Why the Ozone Air Quality Standard Must Be Strengthened
October 22, 2014 TALKING POINTS Ten Reasons Why the Ozone Air Quality Standard Must Be Strengthened 1. The current standard is not protective of public health. The Clean Air Act requires EPA to set National
More informationBudesonide treatment of moderate and severe asthma in children: A doseresponse
Budesonide treatment of moderate and severe asthma in children: A doseresponse study Soren Pedersen, MD, PhD, and Ove Ramsgaard Hansen, MD Kolding, Denmark Objective: The purpose of the study was to evaluate
More informationDiagnosis, Treatment and Management of Asthma
Diagnosis, Treatment and Management of Asthma Asthma is a complex disorder characterized by variable and recurring symptoms, airflow obstruction, bronchial hyperresponsiveness, and an underlying inflammation.
More informationRobert Kruklitis, MD, PhD Chief, Pulmonary Medicine Lehigh Valley Health Network
Robert Kruklitis, MD, PhD Chief, Pulmonary Medicine Lehigh Valley Health Network Robert.kruklitis@lvh.com Correlation of a Asthma pathophyisology with basic science Asthma (Physiology) Bronchodilators
More informationEnvironmental exposures in asthma: opportunities for prevention. Tim K. Takaro, MD, MPH. Faculty of Health Sciences Simon Fraser University
Environmental exposures in asthma: opportunities for prevention Tim K. Takaro, MD, MPH. Faculty of Health Sciences Simon Fraser University Conflict of Interest Nothing to declare Thank you funders! Private
More informationParamedic Rounds. Pre-Hospital Continuous Positive Airway Pressure (CPAP)
Paramedic Rounds Pre-Hospital Continuous Positive Airway Pressure (CPAP) Morgan Hillier MD Class of 2011 Dr. Mike Peddle Assistant Medical Director SWORBHP Objectives Outline evidence for pre-hospital
More informationAllwin Mercer Dr Andrew Zurek
Allwin Mercer Dr Andrew Zurek 1 in 11 people are currently receiving treatment for asthma (5.4 million people in the UK) Every 10 seconds, someone is having a potentially life-threatening asthma attack
More informationStudy No.: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives: Primary Outcome/Efficacy Variable:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationCheck out these helpful videos about use of mask and spacer in children
Asthma Asthma What is wheezing? Wheezing is a high-pitched whistling sound made while you breathe. Wheezing is caused by inflamma!on of the small airways and can have a variety of different underlying
More informationAsthma in Pregnancy. Asthma. Chronic Airway Inflammation. Objective Measures of Airflow. Peak exp. flow rate (PEFR)
Chronic Airway Inflammation Asthma in Pregnancy Robin Field, MD Maternal Fetal Medicine Kaiser Permanente San Francisco Asthma Chronic airway inflammation increased airway responsiveness to a variety of
More informationRespiratory Disease. Dr Amal Damrah consultant Neonatologist and Paediatrician
Respiratory Disease Dr Amal Damrah consultant Neonatologist and Paediatrician Signs and Symptoms of Respiratory Diseases Cardinal Symptoms Cough Sputum Hemoptysis Dyspnea Wheezes Chest pain Signs and Symptoms
More informationEffects of Physical Activity and Sleep Quality in Prevention of Asthma
Journal of Physiology and Pharmacology Advances Effects of Physical Activity and Sleep Quality in Prevention of Asthma Tartibian B., Yaghoobnezhad F. and Abdollahzadeh N. J Phys Pharm Adv 2014, 4(5): 356-359
More informationAsthma Basic Facts. Staying safe and well with asthma. For people with asthma and their carers.
Asthma Basic Facts Staying safe and well with asthma. For people with asthma and their carers. Asthma App Contact your local Asthma Foundation asthmaaustralia.org.au Breathing Breathing is how we get air
More informationAir Flow Limitation. In most serious respiratory disease, a key feature causing morbidity and functional disruption is air flow imitation.
Asthma Air Flow Limitation In most serious respiratory disease, a key feature causing morbidity and functional disruption is air flow imitation. True whether reversible, asthma and exercise-induced bronchospasm,
More informationAirway eosinophils in older teenagers with outgrown preschool wheeze: a pilot study
LETTERS Airway eosinophils in older teenagers with outgrown preschool wheeze: a pilot study To the Editor, Preschool wheezing affects one-third of all children growing up in the UK []. It varies in clinical
More informationDouglas W. Mapel MD, MPH, Melissa Roberts PhD
Original Article Spirometry, the St. George s Respiratory Questionnaire, and other clinical measures as predictors of medical costs and COPD exacerbation events in a prospective cohort Douglas W. Mapel
More informationImproving the Management of Asthma to Improve Patient Adherence and Outcomes
Improving the Management of Asthma to Improve Patient Adherence and Outcomes Robert Sussman, MD Atlantic Health System Overlook Medical Center Asthma Remains a Serious Health Risk in the US Every day in
More informationNew asthma diagnostic guidelines. Dr Kathryn Bannell Dr Paddy Dennison
New asthma diagnostic guidelines Dr Kathryn Bannell Dr Paddy Dennison Diagnosis no shortage of guidelines BTS Asthma guidelines updated Sept 2016 NICE Asthma guidelines draft form 2015, expected Oct 2017
More informationAllergy and Immunology Review Corner: Chapter 75 of Middleton s Allergy Principles and Practice, 7 th Edition, edited by N. Franklin Adkinson, et al.
Allergy and Immunology Review Corner: Chapter 75 of Middleton s Allergy Principles and Practice, 7 th Edition, edited by N. Franklin Adkinson, et al. Chapter 75: Approach to Infants and Children with Asthma
More informationTHE STATE OF ASTHMA IN INDIANA
THE STATE OF ASTHMA IN INDIANA ASTHMA PROGRAM OCTOBER 2015 Jack Kinsey, MPH Asthma Epidemiologist Indiana State Department of Health A healthier and safer Indiana Today s Session Will Cover: Data from
More informationOU Children s Physicians Pediatric Arthritis Center
Please complete the following questionnaire for your child: Patient Name: Birth Date: Parent/Caretaker Name: Primary Care Physician (Full Name, City, & State) Mother s Occupation: Fathers Occupation: Name
More informationSYNOPSIS. Date 15 June 2004
Drug product Drug substance(s) Document No. Edition No. Study code SYMBICORT pmdi 160/4.5 mg per actuation Budesonide/formoterol SD-039-0719 Date 15 June 2004 SYNOPSIS A Six-Month, Randomized, Open-Label
More informationJames P. Kemp, MD; Margaret C. Minkwitz, PhD; Catherine M. Bonuccelli, MD; and Marshelle S. Warren, MD
Therapeutic Effect of Zafirlukast as Monotherapy in Steroid-Naive Patients With Severe Persistent Asthma* James P. Kemp, MD; Margaret C. Minkwitz, PhD; Catherine M. Bonuccelli, MD; and Marshelle S. Warren,
More informationDevelopment and validation of a questionnaire to measure asthma control
Eur Respir J 1999; 14: 902±907 Printed in UK ± all rights reserved Copyright #ERS Journals Ltd 1999 European Respiratory Journal ISSN 0903-1936 Development and validation of a questionnaire to measure
More informationMedicine Dr. Kawa Lecture 1 Asthma Obstructive & Restrictive Pulmonary Diseases Obstructive Pulmonary Disease Indicate obstruction to flow of air
Medicine Dr. Kawa Lecture 1 Asthma Obstructive & Restrictive Pulmonary Diseases Obstructive Pulmonary Disease Indicate obstruction to flow of air through the airways. As asthma, COPD ( chronic bronchitis
More information