Monitoring and Management of Childhood Asthma in Asian Countries

BACKGROUND: A recent study by the International Study of Asthma and Allergies in Childhood has shown that asthma symptom prevalence is still increasing in parts of Asia. As such, it is important to know how well asthma is being managed. Practices of physicians in India, China, Sri Lanka, Australia, Singapore, Indonesia, Philippines, and Taiwan in monitoring and treating childhood asthma were examined. METHODS: A 6-page standardized questionnaire was sent to physicians via post. The questionnaire is made up of 3 parts, including (1) methods of monitoring of childhood asthma, (2) practices in managing acute asthma exacerbations, and (3) choice of therapy in maintenance treatment. RESULTS: Our study reflects mostly the practices of physicians who practice in urban regions. Of respondents, 41.4% were general pediatricians, whereas 26.3% were general practitioners. A small fraction of physicians used score cards or diaries to monitor asthma, ranging from 0% (Philippines and Australia) to 15.9% (India). Only 8.1% (Sri Lanka) to 52.0% (Australia) use either a peak flow meter and/or spirometry to monitor asthma. However, for frequency of use, 35% (China) to 94% (Indonesia) never or seldom make use of a peak flow meter, and 33% (China) to 97.6% (Indonesia) never or seldom use spirometry for monitoring. Most physicians treat acute asthma appropriately with short-acting bronchodilators. For maintenance treatment, an inhaled corticosteroid was the most frequently chosen first-choice therapy. However, a significant fraction of physicians chose a long-acting β-agonist monotherapy as a first-choice treatment for asthma maintenance. For infants, the percentage ranged from 1.4% (Australia) to 76.3% (Indonesia); in preschoolers, 1.8% (Australia) to 43.3% (Indonesia); and in older children, 0% (Philippines) to 28.8% (Indonesia). These results may be related to the overall affluence of each nation. CONCLUSIONS: There is much room for improvement in increasing physicians' awareness to guidelines for more effective management of pediatric asthma in Southeast Asia, especially regarding the high use of long-acting β-agonist monotherapy, even in young children

Secondary Household Transmission of SARS, Singapore

Secondary household transmission of severe acute respiratory syndrome (SARS) was studied in 114 households involving 417 contacts. The attack rate was low (6.2%). Occupation of the index case was the factor that most influenced household transmission (adjusted hazard ratio for healthcare workers 0.157; 95% confidence interval 0.042 to 0.588)

The relationship between collaboration in learning, quantity and timing of feedback, and self-efficacy of students in higher education / Chan Yuen Fook … [et al.]

The purpose of this study was to identify the effect of collaboration in learning, and the quantity and timing of feedback towards the enhancement of self-efficacy among students in a public university in Malaysia. Data was collected using a survey questionnaire. The questionnaire was distributed to a total of 500 randomly selected tertiary students. A total of 475 questionnaires were returned and used for analysis. Data was analysed with both descriptive and inferential st atistics. The findings revealed that most of the students collaborate with peers in their learning. Feedback that was identified has a positive and significant relationship with student selfefficacy. A moderate, positive and significant correlation has been identified between collaboration in learning, quantity and timing of feedback and selfefficacy among the students in a public university. However, collaboration in learning and quantity and timing of feedback only induced a low effect size on self-efficacy

Manejo nutricional de las intolerancias digestivas más comunes del lactante

Las intolerancias digestivas más comunes del lactante incluyen estreñimiento, Regurgitación , llanto/irritabilidad, cólico, gas excesivo y diarrea, que en muchos casos, pueden ser normales, sin embargo, es frecuente ante estas intolerancias, cambiar las fórmulas infantiles. En el presente artículo, un grupo de profesionales de la salud relacionados con la gastroenterología y alergología pediátrica, describen los antecedentes, las definiciones, y el manejo nutricional de cada una de estas intolerancias digestivas

Atopic dermatitis in early life: evidence for at least three phenotypes? Results from the GUSTO study

10.1159/000381342International Archives of Allergy and Immunology1664273-279GUSTO (Growing up towards Healthy Outcomes

GESTÃO DO RISCO E POLÍTICAS PÚBLICAS: Política de Habitação em Cabo Verde

Governar democraticamente as cidades, como territórios de grande diversidade económica, social, ambiental, política e cultural e de grandes dualidades, de modo que sejam respeitados os direitos dos habitantes, constitui um dos maiores desafios do séc. XXI. Para que existam cidades justas, democráticas, humanas e saudáveis, é fundamental incorporar os direitos humanos no campo da governação das cidades, de modo a que a gestão e as políticas públicas resultem na eliminação das desigualdades sociais, das práticas de discriminação em todas as formas da segregação de indivíduos, grupos sociais e comunidades, em razão do tipo de habitação e da localização dos assentamentos em que vivam. Ciente da importância do estudo das políticas públicas para a compreensão dos fenómenos sociais, o estudo da Política de Habitação de Interesse Social (HIS) possibilita a previsão dos impactos da acção do Estado sobre a sociedade e abre o caminho à criação de novos modelos que possam auxiliar tanto o Estado quanto a sociedade no processo de formulação, implementação e avaliação dessa mesma política, bem como de todas as que com ela se entrecruzam. Com base numa pesquisa bibliográfica e análise documental, partindo da compreensão do conceito de gestão do risco, políticas públicas, vulnerabilidade social e Habitação de Interesse Social, este ensaio procura identificar a estratégia, os actores, os instrumentos e os meios de implementação da Política de HIS em Cabo Verde; objectiva identificar as medidas preventivas para a mitigação dos riscos associados à habitação e consequente vulnerabilidade social, e reconhecer as dificuldades inerentes à sua implementação.To rule cities democratically, as major economical, social, environmental, political and cultural and with great dualities for territorial diversity, to maintain inhabitants‟ rights respect, it‟s the biggest challenges for XXI century. In order to have rightful, democratic, human and healthy cities it‟s fundamental the human rights incorporation in city governance, which result in the management and public policy to extinguish social inequalities, discrimination practices in all individual segregation forms, social groups and communities, due to the habitation type and settlements location of their living. Aware of the importance of public policy study to understand social phenomena, the Policy of Habitation of Social Interest (HSI) study allows the prediction of the actions impact of the State to the society and opens the way to the creation on new models that may help both the State and society for formulation process, implementation and evaluation of that same policy, as others which may intersects. On the basis of literature search and analysis of documents, from the understanding the concept of risk management, public policy, social vulnerability and Habitation of Social Interest, this essay searches the strategy identification, the actors, instruments and implementation meanings for HSI policies in Cape Verde; objectively identify the preventive measures to the risk mitigation associated to the habitation and consequent social vulnerability, and to recognize the difficulties inertly to its implementation

House dust mite sensitization, eczema, and wheeze increase risk of shellfish sensitization

Non peer reviewe

Allergic sensitization trajectories to age 8 years in the Singapore GUSTO cohort

Background: Allergic sensitization is linked to allergy development, with early sensitization often associated with worse outcomes. We aimed to identify if distinct allergic sensitization trajectories existed within a diverse and multi-ethnic Asian cohort.Methods: We administered modified ISAAC questionnaires in the first 8 years and conducted skin prick testing at ages 18 months, 3, 5 and 8 years in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. We used latent class analysis to derive allergic sensitization trajectories, and adjusted odds ratios (AOR) to evaluate predictive risk factors and associations with allergic comorbidities.Results: Among 997 children, three trajectories were identified: early food and mite sensitization (16.2%), late mite sensitization (24.2%) and no/low sensitization (59.6%). Early food and mite sensitization was associated with early eczema by 6 months [AOR (95%CI) 4.67 (1.78-12.28)], increased risk of wheeze by 3-8 years (ARR 1.72-1.99) and eczema in the first 8 years of life (ARR 1.87-2.41). Late mite sensitization was associated with female sex [AOR 0.58 (0.35-0.96)], cesar-ean section [AOR 0.54 (0.30-0.98)], early eczema by 6 months [AOR 3.40 (1.38-8.42)], and increased risk of eczema by 18 months [ARR 1.47 (1.03-2.08)] and 8 years [ARR 1.35 (1.05-1.73)].Conclusion: Early onset of eczema and early allergic sensitization were strongly associated. Early sensitization, especially to house dust mites, was associated with increased risks of developing wheeze and eczema, pointing to the importance of developing preventive perinatal interventions and effective therapeutics for sensitized toddlers.Peer reviewe