Diet and asthma, allergic rhinoconjunctivitis and atopic eczema symptom prevalence: an ecological analysis of the International Study of Asthma and Allergies in Childhood (ISAAC) data. ISAAC Phase One Study Group.

Several studies have suggested that the increasing prevalence of symptoms of asthma, rhinitis and eczema, could be associated with dietary factors. In the present paper, a global analysis of prevalence rates of wheeze, allergic rhinoconjunctivitis and atopic eczema was performed in relation to diet, as defined by national food intake data. Analyses were based on the International Study of Asthma and Allergies in Childhood (ISAAC) data for 6-7 and 13-14 yr old children. Symptoms of wheeze, allergic rhinoconjunctivitis and atopic eczema symptom prevalence were regressed against per capita food intake, and adjusted for gross national product to account for economic development. Dietary data were based on 1995 Food and Agriculture Organisation of the United Nations data for 53 of the 56 countries that took part in ISAAC phase I (1994/1995). The 13-14 year age group showed a consistent pattern of decreases in symptoms of wheeze (current and severe), allergic rhinoconjunctivitis and atopic eczema, associated with increased per capita consumption of calories from cereal and rice, protein from cereals and nuts, starch, as well as vegetables and vegetable nutrients. The video questionnaire data for 13-14 yr olds and the ISAAC data for 6-7 yr olds showed similar patterns for these foods. A consistent inverse relationship was seen between prevalence rates of the three conditions and the intake of starch, cereals, and vegetables. If these findings could be generalised, and if the average daily consumption of these foods increased, it is speculated that an important decrease in symptom prevalence may be achieved

P109 Can A Theory-informed Interactive Animation Increase Intentions To Engage In Physical Activity In Young People With Asthma?

Background Participation in regular physical activity improves aerobic fitness and well-being. For people with asthma the benefits also include reduced hospital admissions, absenteeism, medication use, and improved ability to cope with the disease. However, although people with asthma can exercise safely, children and young people with asthma are less likely to be physically active than their peers. Integrating the principles of user-centred design and the MRC Framework for Complex interventions a theoretically-informed interactive animation was developed to encourage young people aged 12–18 years with asthma to engage in physical activity. Methods A mixed-methods two stage approach was used. In stage 1 a user group (young people with asthma, parents, health professionals) used online consultation and discussion methods to inform the development of the intervention in a highly iterative manner (modelling). The theoretical basis for the intervention was then refined and converted into a 3D animation with accompanying action plan and volitional help sheet. In stage 2 a web-based Interactive Modelling Experiment evaluated effectiveness in three key areas: knowledge about asthma, inhaler use, and intention to increase physical activity. One-to-one interviews and focus groups were used to evaluate the acceptability of the animation and whether the theoretical basis was effective. Results Twenty three people were recruited to the user group. Facilitated by multiple online consultation methods the group was highly engaged throughout. Fifty-three individuals were randomised online to receive the intervention or control; 26 completed follow-up questionnaires (49%). The pilot online experiment supported the evidence base for the intervention but demonstrated that recruitment methods and loss to follow-up need addressed before a future trial. Though not powered to detect an effect on intentions and behaviour, the study revealed an impact on intentions to be active (increase) and on safe inhaler use (decrease). Qualitative feedback was positive across all groups, the intervention being well received and regarded as understandable, meaningful, engaging and potentially very useful within an asthma review. Conclusion We have developed a high quality, two part intervention regarded as meaningful, acceptable and potentially useful. Future work is needed to establish whether acceptability levels and perceived effectiveness translate into behaviour chang

A BRAVE LEAP OR A GRADUAL CLIMB? THE DYNAMICS OF INVESTMENT IN R&D OF INTEGRATIVE TECHNOLOGIES

Our paper explores the optimal investment in integrative technologies (such as command and control systems), which are a major part of defense R&D at the beginning of the 21st century. Employing a dynamic optimization framework, we find that under linear development costs, it may be optimal or nearly optimal to build military forces using a myopic, short-termed, approach. In such cases, it would be optimal to transform an armed force into a network-centric environment within just a few years. When development costs are convex however, early investment in technological infrastructure is required, extending the transformation period over more than a decade.Technology, Defense R&D, Dynamic optimization,