Asthma diagnosis and management in adults: Is the risk of underdiagnosis and undertreatment related to patients' education levels?

To determine the relationship between patient education and the risk of underdiagnosis and undertreatment of asthma, a cross-sectional study of 500 (250 males and 250 females) adult attendees between 16 and 44 years of age was undertaken at five primary health care (PHC) centers in Al-Ain, United Arab Emirates. We used an Arabic translation of the European Community Respiratory Health Survey Screening Questionnaire. Asthmatics with higher levels of education had a significantly higher risk of underdiagnosis and undertreatment than asthmatics with less education. Doctors at PHC centers failed to diagnose 34.6% of the asthmatics with low er levels of education and 77.6% of the patients with higher levels of education. Eighty-five percent of the asthmatics with lower levels of education and 46.6% of the asthmatics with higher levels of education recognized that they had asthma. Thirty-eight percent of the asthmatics with lower levels of education and 83% of the asthmatics with higher levels of education were undertreated It was found that 19% of the asthmatics with lower levels of education and 3% of the asthmatics with higher level of education were on prophylactic medication for asthma. We concluded that education level was related to underdiagnosis and undertreatment of asthma among adults between 16 and 44 years of age. People with higher levels of education have a higher risk of underdiagnosis and undertreatment than do those with lower levels of education. The factors that might be associated with these findings need to be explored in further studies

Respiratory symptoms and skin disorders in sewage workers

This paper reports on the prevalence of respiratory symptoms, skin disorders, status of spirometric lung functions, and amino acid profiles among sewage workers. The data showed that sewage workers had a higher prevalence of respiratory symptoms than manual workers, being significantly greater for chronic cough (p<0.02), chronic phlegm (p<0.03), chronic bronchitis (p<0.02), asthma (p<0.02), dyspneoa (p<0.001), and nasal catarrh (p<0.001). Also, a higher prevalence of all acute symptoms of pruritus (p<0.003), tinea (p<0.004), dermatitis (p<0.001), and nose irritation (p<0.005) was recorded among sewage workers than in manual workers (non-sewage workers). Furthermore, all forced spirometric tests in the exposed sewage workers tended to be lower than in manual workers. Finally, the results revealed that the most plasma amino acid concentrations were higher among sewage workers than those among manual workers. Pill essential amino acids except two (valine and arginine) were significantly higher among the savage workers than those among the manual workers. The present study suggests that a high prevalence of respiratory symptoms is associated with an exposure to sewage as a working place

Wear protection of deep drawing tools by systematic optimization of highly stressed surfaces

The automotive sector is one of the largest energy consumers in Germany. Requests from politics and industry to significantly reduce emissions require new developments during utilization as well as during production phase. In line with the framework concept "InnoCaT", where more than 60 companies and research facilities from Germany take part, possibilities for producing companies are developed and analyzed to reduce the resource and energy consumption and by this reducing costs along the entire process chain of car body manufacturing. One approach to design car bodies lighter and more efficiently is to use aluminium and high strength steels. By this means weight and sheet thickness are reduced. However higher strengths of the steels and the adhesion affinity of aluminium significantly increase the requirements regarding the used tool steel. Thus grooves or galling appear more frequent at highly stressed surfaces. To assure high lifetimes and by this increase especially the resource efficiency concerning use of material and setting-up times within the press plant, a local optimization at the highly stressed surfaces is necessary. For this a FEM/BEM-tool for a time efficient and exact calculation of the occurring tool loads for complex die profiles is developed. Based on this development of load calculation a shape-optimization is performed at the corresponding areas. After the geometric optimization of the tool a local laser surface treatment for further wear protection is carried out using laser cladding or laser alloying/ -dispersing. By combining the technologies a highly wear resistant surface is achievable, which increases the tool's lifetime as well as the reproducibility within production