739 research outputs found
Adherence with Preventive Medication in Childhood Asthma
Suboptimal adherence with preventive medication is common and often unrecognised as a cause of poor asthma control. A number of risk factors for nonadherence have emerged from well-conducted studies. Unfortunately, patient report a physician's estimation of adherence and knowledge of these risk factors may not assist in determining whether non-adherence is a significant factor. Electronic monitoring devices are likely to be more frequently used to remind patients to take medication, as a strategy to motivate patients to maintain adherence, and a tool to evaluate adherence in subjects with poor disease control. The aim of this paper is to review non-adherence with preventive medication in childhood asthma, its impact on asthma control, methods of evaluating non-adherence, risk factors for suboptimal adherence, and strategies to enhance adherence
Green space in health research : An overview of common indicators of greenness
Human environments influence human health in both positive and negative ways. Green space is considered an environmental exposure that confers benefits to human health and has attracted a high level of interest from researchers, policy makers, and increasingly clinicians. Green space has been associated with a range of health benefits, such as improvements in physical, mental, and social wellbeing. There are different sources, metrics and indicators of green space used in research, all of which measure different aspects of the environment. It is important that readers of green space research understand the terminology used in this field, and what the green space indicators used in the studies represent in the real world. This paper provides an overview of the major definitions of green space and the indicators used to assess exposure for health practitioners, public health researchers, and health policy experts who may be interested in understanding this field more clearly, either in the provision of public health-promoting services or to undertake research
Assessing exposure of young children to common endocrine-disrupting chemicals in the home environment: A review and commentary of the questionnaire-based approach
Background: Although infants and young children are particularly vulnerable to endocrine disrupting chemical (EDC) exposure, there is an absence of comprehensive exposure data for this age group. As young children spend the majority of their time indoors, improved methods of exposure assessment are needed to characterise the health risks from exposures in the home environment. Biologic assessment, which has been considered the gold standard for exposure assessment in recent years, is difficult to conduct in young children. Questionnaires are an alternative and indirect method of predicting exposure, which may overcome some of the limitations of direct exposure assessment. Research problem: The feasibility of using a questionnaire-based approach to predict exposure of young children to EDCs in the home has yet to be comprehensively reviewed. Moreover, there is no one questionnaire that has been validated for predicting the exposure of infants to common EDCs in the home. Aims and objectives: The aim of this review is to discuss the use and validation of the questionnaire-based approach to predict exposure of children to chemicals from three common classes of EDCs in the home, namely, plasticisers, flame retardants, and insecticides. We discuss the strengths and weaknesses of the questionnaire-based approach as well as the important pathways of exposure in the home environment, by which to guide the design and validation of future exposure questionnaires. Results: The findings from our review indicate that the questionnaire-based approach is a valuable tool in the prediction of exposure to persistent organic pollutants, as well as to toxicants that have consistent patterns of exposure. With improvements to the design and validation process, the questionnaire-based approach may also prove to be a reliable instrument in predicting exposure to EDCs with short-half lives, including bisphenol A, phthalates, and pyrethroid and organophosphate insecticides
Marine geological studies in the eastern Irish Sea and adjacent estuaries, with special reference to sedimentation in Liverpool Bay and River Mersey
Stability of interleukin 8 and neutrophil elastase in bronchoalveolar lavage fluid following long-term storage
AbstractBackgroundInterleukin-8 (IL-8) and neutrophil elastase (NE) are commonly measured markers of inflammation in bronchoalveolar lavage (BAL) fluid from patients with cystic fibrosis. Longitudinal analysis assumes uniform stability during storage, however the effect of extended low-temperature storage on these markers remains unclear.MethodsBAL fluid from 104 children with cystic fibrosis was assayed for IL-8 and NE after storage at 4°C for 7days and −80°C for up to 6years and compared with the initial assays performed soon after collection.ResultsIL-8 levels were stable after any measured length of time at −80°C or 4°C. NE levels were stable for 6months at −80°C but decreased beyond that or after 7days at 4°C.ConclusionsOur data support the stability of IL-8 in BAL stored at −80°C for prolonged periods. NE in BAL decreases with storage and should be assayed as soon as practical after collection
Evolution of pulmonary inflammation and nutritional status in infants and young children with cystic fibrosis
Introduction Improved nutrition is the major proven
benefit of newborn screening programmes for cystic
fibrosis (CF) and is associated with better clinical
outcomes. It was hypothesised that early pulmonary
inflammation and infection in infants with CF is
associated with worse nutrition.
Methods Weight, height and pulmonary inflammation
and infection in bronchoalveolar lavage (BAL) were
assessed shortly after diagnosis in infants with CF and
again at 1, 2 and 3 years of age. Body mass index (BMI)
was expressed as z-scores. Inflammatory cells and
cytokines (interleukin 1b (IL-1b), IL-6, IL-8 and tumour
necrosis factor a (TNFa)), free neutrophil elastase
activity and myeloperoxidase were measured in BAL.
Mixed effects modelling was used to assess longitudinal
associations between pulmonary inflammation,
pulmonary infection (Staphylococcus aureus and
Pseudomonas aeruginosa) and BMI z-score after
adjusting for potential confounding factors.
Results Forty-two infants were studied (16 (38%) male;
39 (93%) pancreatic insufficient); 36 were diagnosed by
newborn screening (at median age 4 weeks) and six by
early clinical diagnosis (meconium ileus). Thirty-one
(74%) received antistaphylococcal antibiotics. More than
two-thirds were asymptomatic at each assessment.
Mean BMI z-scores wer
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