Grass pollen as a trigger of emergency department presentations and hospital admissions for respiratory conditions in the subtropics: A systematic review

Introduction: It is unknown if high concentration of airborne grass pollen, where subtropical grasses (Chloridoideae and Panicoideae) dominate, is a risk factor for respiratory health. Here we systematically reviewed the association between airborne grass pollen exposure and asthma emergency department (ED) presentations and hospital admissions in subtropical climates.Objectives: A systematic review was performed to identify and summarise studies that reported on respiratory health (asthma ED presentations and hospital admissions) and airborne grass pollen exposure in subtropical climates.MethodsSearches were conducted in: MEDLINE, Web of Science, Scopus, CINAHL (EBSCO), Embase and Google Scholar databases (1966–2019). Risk of bias was assessed using a validated quality assessment tool. A meta-analysis was planned, however due to the heterogeneity in study design it was determined inappropriate and instead a narrative synthesis was undertaken.Results: Nineteen studies were identified for inclusion, with a total of 598,931 asthma ED presentation participants and 36,504 asthma hospital admission participants in six countries (Australia, India, Israel, Italy, Spain, USA). The narrative synthesis found airborne grass pollen appears to have a small and inconsistent increase on asthma ED presentations (judged as: probably little effect n = 5, may have little effect n = 4, no effect n = 2 and uncertain if there is an effect n = 4) and hospital admissions (judged as: probably increase slightly n = 2 probably little effect n = 1, may have a little effect n = 1, no effect n = 3 and we are uncertain if there is an effect n = 4) in the subtropics. Furthermore, the reported effect sizes were small and its clinical relevance may be difficult to discern.Conclusion: Exposure to airborne grass pollen appears to have a small and inconsistent increase on asthma ED presentations and hospital admissions in the subtropics. These findings are comparable to reported observations from studies undertaken in temperate regions

Efektifitas Modul Berbasis Literasi Lingkungan melalui Pendekatan Saintifik

This research is based on the decreasing awareness of love for the environment of the nation's future generations. It is necessary to internalize methods or approaches in building awareness in fostering a sense of responsibility to nature and the environment. The environment is a place for living things to live in. Meeting the needs of life has a negative impact on the natural environment. Attention to environmental sustainability must be increased from various aspects, one of which is in the field of education to guide students in fostering a generation of environmental literacy using a scientific approach. Students are invited to observe, ask questions, collect information, reason, and then communicate the results that have been compiled from reading, seeing facts, and various information obtained from various ways and sources. This can be trained through student teacher candidates for primary school education to be applied in carrying out their professional duties as a teacher. This study aims to determine the effectiveness of the use of environmental literacy-based modules through a scientific approach in the low-grade science basic concepts course. The subjects of this study were students of Esa Unggul University Elementary School Teacher Education Jakarta. The research method uses development research using the Dick and Carey model. Effectiveness is measured based on the learning outcomes obtained from the pretest and posttest. The results showed that the effectiveness of using environmental literacy-based modules through a scientific approach, with an average increase of 28%. A scientific approach based on environmental literacy can be used in learning low-grade Science Concepts Keyword: modules, environmental literacy, scientific approac

Effects of Introducing Xpert MTB/RIF on Diagnosis and Treatment of Drug-Resistant Tuberculosis Patients in Indonesia: A Pre-Post Intervention Study

<div><p>Background</p><p>In March 2012, the Xpert MTB/RIF assay (Xpert) was introduced in three provincial public hospitals in Indonesia as a novel diagnostic to detect tuberculosis and rifampicin resistance among high risk individuals.</p><p>Objective</p><p>This study assessed the effects of using Xpert in place of conventional solid and liquid culture and drug-susceptibility testing on case detection rates, treatment initiation rates, and health system delays among drug-resistant tuberculosis (TB) patients.</p><p>Methods</p><p>Cohort data on registration, test results and treatment initiation were collected from routine presumptive patient registers one year before and one year after Xpert was introduced. Proportions of case detection and treatment initiation were compared using the Pearson Chi square test and median time delays using the Mood’s Median test.</p><p>Results</p><p>A total of 975 individuals at risk of drug-resistant TB were registered in the pre-intervention year and 1,442 in the post-intervention year. After Xpert introduction, TB positivity rate increased by 15%, while rifampicin resistance rate reduced by 23% among TB positive cases and by 9% among all tested. Second-line TB treatment initiation rate among rifampicin resistant patients increased by 19%. Time from client registration to diagnosis was reduced by 74 days to a median of a single day (IQR 0–4) and time from diagnosis to treatment start was reduced by 27 days to a median of 15 days (IQR 7–51). All findings were significant with p<0.001.</p><p>Conclusion</p><p>Compared to solid and liquid culture and drug-susceptibility testing, Xpert detected more TB and less rifampicin resistance, increased second-line treatment initiation rates and shortened time to diagnosis and treatment. This test holds promise to improve rapid case finding and management of drug-resistant TB patients in Indonesia.</p></div