Asthma control and management in 8,000 European patients : the REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey

We thank Dr Peter Haidl (Schmallenberg, Germany) and Professor Chantal Raherison-Semjen (Bordeaux, France) for their advice and input on the survey questions. We are also grateful to Weber Shandwick (London, UK) for assistance in developing and running the survey, Incite Marketing Planning Ltd (London, UK) for support in the development of the questionnaire and analysing the results, and Dr Mark Rolfe and Dr Andreas Leidenroth (Oxford PharmaGenesis, Oxford, UK) for medical writing support.Peer reviewedPublisher PD

Identifying and managing asbestiform minerals in geological collections

Asbestos is widely recognised as a serious hazard, and its industrial use is now banned within the UK, and EU, and strict regulations govern the use of older manufactured materials which may contain asbestos. However, asbestos is also a natural geological material, and may occur in museum collections as minerals or constituents of rock specimens. In the UK the Control of Asbestos Regulations 2012 (CAR 2012) provides the legal framework for the safe identification, use and disposal of asbestos. However, these regulations, and other EU regulations, provide no specific guidance on dealing with potentially asbestos-containing natural materials. CAR 2012 specifies just six asbestos minerals although a number of other minerals in museum collections are known to have asbestiform structures and be hazard-ous, including other amphiboles, and the zeolite erionite. Despite the lack of specific guid-ance, museums must comply with CAR 2012, and this paper outlines the professional ad-vice, training and procedures which may be needed for this. It provides guidance on identifi-cation of potential asbestos-bearing specimens and on procedures to document them and store them for future use, or to prepare them for professional disposal. It also makes sug-gestions how visitors, employees and others in a museum can be protected from asbestos as incoming donations and enquiries, managed in the event of an emergency, and safely included in displays

The Effect of Photochemical Smog on Respiratory Health Patients in Abuja Nigeria: ICAPC 2018 : 20th International Conference on Air Pollution and Control.

This study aims to critically evaluate effect of photochemical smog on respiratory health in Nigeria. A cohort of chronic obstructive pulmonary disease (COPD) patients was recruited from two large hospitals in Abuja Nigeria. Respiratory health questionnaires, daily diaries, dyspnoea scale and lung function measurement were used to obtain health data and investigate the relationship with air quality data (principally ozone, NOx and particulate pollution). Concentrations of air pollutants were higher than WHO and Nigerian air quality standard. The result suggests a correlation between measured air quality and exacerbation of respiratory illness. Introduction: Photochemical smog is a significant health challenge in most cities and its effect on respiratory health is well acknowledged. This type of pollution is most harmful to the elderly, children and those with underlying respiratory disease. This study aims to investigate impact of increasing temperature and photochemically generated secondary air pollutants on respiratory health in Abuja Nigeria. Method and Result: Health data was collected using spirometry to measure lung function on routine attendance at the clinic, daily diaries kept by patients and information obtained using respiratory questionnaire. Questionnaire responses (obtained using an adapted and internally validated version of St George’s Hospital Respiratory Questionnaire), shows that ‘time of wheeze’ showed an association with participants activities: 30% had worse wheeze in the morning: 10% cannot shop, 15% take long-time to get washed, 25% walk slower, 15% if hurry have to stop and 5% cannot take-bath. There was also a decrease in Forced expiratory volume in the first second and Forced Vital Capacity, and daily change in the afternoon–morning may be associated with the concentration level of pollutants. Also, dyspnoea symptoms recorded that 60% of patients were on grade 3, 25% grade 2 and 15% grade 1. Daily frequency of the number of patients in the cohort that cough /brought sputum is 78%. Air pollution in the city is higher than Nigerian and WHO standards with NOx and PM10 concentrations of 693.59ug/m-3 and 748ugm-3 being measured respectively. The results show that air pollution may increase occurrence and exacerbation of respiratory disease. Conclusion: High temperature and local climatic conditions in urban Nigeria encourages formation of Ozone, the major constituent of photochemical smog, resulting also in the formation of secondary air pollutants associated with health challenges. In this study we confirm the likely potency of the pattern of secondary air pollution in exacerbating COPD symptoms in a vulnerable patient group in urban Nigeria. There is need for better regulation and measures to reduce ozone, particularly when local climatic conditions favour development of photochemical smog in such settings. Climate change and likely increasing temperatures add impetus and urgency for better air quality standards and measures (traffic-restrictions and emissions standards) in developing world settings such as Nigeria

Patient reported burden of asthma on resource use and productivity across 11 countries in europe

ACKNOWLEDGMENTS Sponsorship for this study and article processing charges were funded by Mundipharma International Limited (Cambridge, UK). All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published. We thank Emily Taylor, Incite Marketing Planning Limited (London, UK) for assistance in data analysis and Caoimhe McKerr (Adelphi Values, Bollington, UK) for editorial assistance. Support for this assistance was funded by Mundipharma International Limited. Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.Peer reviewedPublisher PD

The Effect of Photochemical Smog on Respiratory Health Patients in Abuja Nigeria: 11th International Conference on Air Quality: Science & Application: Barcelona 12th-16th March 2018

Summary This study aims to critically evaluate the effect of photochemical smog on COPD patients in Nigeria. A cohort of COPD patients was recruited from two large hospitals in Abuja Nigeria. Symptom questionnaires, daily diaries, dyspnoea scale and measurement of lung function were used to obtain health data. Real-time air pollution data was obtained from a monitoring site at Abuja airport. Measured air pollution concentrations, for the precursors of photochemical smog, are far higher than those recorded in the developed world where a link between air pollution and respiratory health has been observed. The lung function values recorded for the cohort would indicate that respiratory health in the cohort is poor with a mean age suggesting that COPD is developing at a far earlier age in Nigeria. The correlation between measured air pollution and an exacerbation of symptoms will be investigated as part of this project

Multisensory Perception and Learning: Linking Pedagogy, Psychophysics, and Human–Computer Interaction

In this review, we discuss how specific sensory channels can mediate the learning of properties of the environment. In recent years, schools have increasingly been using multisensory technology for teaching. However, it still needs to be sufficiently grounded in neuroscientific and pedagogical evidence. Researchers have recently renewed understanding around the role of communication between sensory modalities during development. In the current review, we outline four principles that will aid technological development based on theoretical models of multisensory development and embodiment to foster in-depth, perceptual, and conceptual learning of mathematics. We also discuss how a multidisciplinary approach offers a unique contribution to development of new practical solutions for learning in school. Scientists, engineers, and pedagogical experts offer their interdisciplinary points of view on this topic. At the end of the review, we present our results, showing that one can use multiple sensory inputs and sensorimotor associations in multisensory technology to improve the discrimination of angles, but also possibly for educational purposes. Finally, we present an application, the ‘RobotAngle’ developed for primary (i.e., elementary) school children, which uses sounds and body movements to learn about angles

Training, status and migration of general practitioners / family physicians within Europe

The survey intended to explore and identify the training background and status of general practitioners/ family physicians (GPs) in member countries within EURACT (European Academy of Teachers in General Practice/Family Medicine), and to gain an overview of processes involved when GP-trained doctors migrate to work in another member country. A questionnaire, with closed and open-ended questions, was sent to representatives of all 39 EURACT-member countries in 2009. The main outcome measures were the training background and status of GPs in public/private settings in each country and the requirements of additional training and testing when migrating to another country. Forty-one completed questionnaires were received from 31 (79%) of the EURACT countries. The data indicate that specialist training for General Practice/ Family Medicine (GP/FM) is well established throughout and generally required for appointment to public career posts. The data also indicate that European Uniontrained GPs can move freely to most countries with usually no tests of medical knowledge or language proficiency. Orientation to the healthcare system in the destination country is usually not provided. work in public/private GP/FM posts in many European countries, although new appointments to public posts RESEARCH ARTICLE Training, status and migration of General Practitioners/Family Physicians within Europe in nearly all countries require specialist GP training. It was not possible to identify a uniform or agreed approach applied by employing agencies to confirm the medical competence and language skills of migrant doctors and to provide them with orientation to healthcare systems. In the high-context dependent discipline of GP/FM this is of concern.peer-reviewe

A Patient-Centered Description of Severe Asthma:Patient Understanding Leading to Assessment for a Severe Asthma Referral (PULSAR)

BACKGROUND: Although severe asthma can be life-threatening, many patients are unaware they have this condition. OBJECTIVES: Patient Understanding Leading to Assessment for a Severe Asthma Referral (PULSAR) is a novel, multidisciplinary working group aiming to develop and disseminate a global, patient-centered description of severe asthma to improve patient understanding of severe asthma and effect a change in patient behavior whereby patients are encouraged to visit their healthcare professional, when appropriate. METHODS: Current definitions from patient organization websites, asthma guidelines, and medication information for key asthma drugs were assessed and informed a multidisciplinary working group, convened to identify common concepts and terminology used to define severe asthma. A patient-centered description of severe asthma and patient checklist were drafted based on working-group discussions and reviewed by an external behavioral scientist for patient understanding and relevance. These were tested using an online US/Canadian survey. RESULTS: The patient-centered description of severe asthma and patient checklist were reviewed and re-drafted by the authors. The text was simplified following the behavioral-scientist review. The survey (n = 153) included 105 patients with severe asthma. Of those with severe asthma, 92.2% of patients reported that the description was consistent with their experiences of severe asthma and 92.6% of patients reported that the PULSAR initiative would encourage them to visit their healthcare provider. CONCLUSION: A patient-centered description of severe asthma has been developed and tested using patients with severe asthma; this description will allow patients to assess whether they might have severe asthma and prompt them to visit their healthcare provider, if appropriate