MEASuRing symptoms in Irritable Bowel Syndrome:towards an individualized and daily life approach

Irritable bowel syndrome (IBS) is a common disorder of the brain-gut axis, characterized by abdominal pain and altered bowel habits. IBS diagnosis is symptom-based and therefore, accurate symptom registration is important for scientific research and clinical practice. In this thesis, the use of the most recent diagnostic criteria is evaluated and the (natural) course of symptoms over time is described. Subsequently, a new method for symptom registration in IBS, the experience sampling method (ESM), is developed and validated, and its applications are described. In summary, this thesis describes the challenges of capturing the full picture of IBS symptoms, including heterogeneity between subjects, within-subject changes over time, and co-morbid psychological and environmental factors that may interfere with gastrointestinal symptoms. The research presented serves as a basis for the use of the ESM in IBS scientific research, and further implementation in clinical care will be future steps

Smoke-free legislation and hospitalizations for childhood asthma

<b>BACKGROUND:</b> Previous studies have shown that after the adoption of comprehensive smoke-free legislation, there is a reduction in respiratory symptoms among workers in bars. However, it is not known whether respiratory disease is also reduced among people who do not have occupational exposure to environmental tobacco smoke. The aim of our study was to determine whether the ban on smoking in public places in Scotland, which was initiated in March 2006, influenced the rate of hospital admissions for childhood asthma.<br></br> <b>METHODS:</b> Routine hospital administrative data were used to identify all hospital admissions for asthma in Scotland from January 2000 through October 2009 among children younger than 15 years of age. A negative binomial regression model was fitted, with adjustment for age group, sex, quintile of socioeconomic status, urban or rural residence, month, and year. Tests for interactions were also performed. <br></br> <b>RESULTS:</b> Before the legislation was implemented, admissions for asthma were increasing at a mean rate of 5.2% per year (95% confidence interval [CI], 3.9 to 6.6). After implementation of the legislation, there was a mean reduction in the rate of admissions of 18.2% per year relative to the rate on March 26, 2006 (95% CI, 14.7 to 21.8; P<0.001). The reduction was apparent among both preschool and school-age children. There were no significant interactions between hospital admissions for asthma and age group, sex, urban or rural residence, region, or quintile of socioeconomic status. <b>CONCLUSIONS:</b> In Scotland, passage of smoke-free legislation in 2006 was associated with a subsequent reduction in the rate of respiratory disease in populations other than those with occupational exposure to environmental tobacco smoke. (Funded by NHS Health Scotland.

Living with childhood asthma: parental perceptions of risk in the household environment and strategies for coping

Aim To explore parents’ perceptions of environmental household risks to their child’s asthma and to identify the strategies they adopt in relation to these perceived risks. Background The prevalence of childhood asthma is increasing worldwide and especially in the UK. Asthma is more common in areas of socio-economic disadvantage. Household environmental factors have been implicated in some of this increase. A number of factors in the home environment have been found to act as triggers to asthma symptoms, including high humidity levels, poor ventilation, mould, second-hand tobacco smoke and pet allergens. Little is known about how parents, as the main care-givers and decision makers in the home, perceive and cope with the risks posed by these triggers. Methods Semi-structured interviews were conducted with a purposive sample of parents of 32 children with asthma aged 4 to 16 years and living in a socio-economically disadvantaged urban community in the North East of England. Interviews were audiotaped, transcribed verbatim and analysed using constant comparison techniques. Findings All parents were aware of some of the risks their children faced at home. Some appeared to know more than others and coping styles varied. A typology of three groups of parents was identified: those who actively seek advice and adopt clear preventative strategies (preventers); those who minimize the risks and only react when things go wrong (reactors); and those who engage in compensatory activities in an attempt to trade-off between harms and benefits (compensators). The unifying themes underpinning these different styles are that all parents are motivated to maintain normal family life but that they adopt different strategies to achieve this

Self-Assessment Of Households Economic Welfare As A Manifestation Of Adjustment To Transition And European Integration Processes In The Case Of Estonia

This paper analyzes Estonian households' perception of welfare, including the determinants and dynamics of said perception under transition. Data from the Estonian Household Income and Expenditures Survey 2000 and 2001 are used to construct samples. Ordered probit and linear regression models are employed to investigate the determinants of the self-assessed economic situations and income levels as determined to be necessary by households for conducting normal life. The income level perceived by households as necessary to conduct normal life is found to vary substantially depending on a given households actual income and other extant household characteristics. This indicates that factors other than income per capita alone are relevant for understanding households welfare and their perception of normal life, and, hence, should be among the targets of social policy and factored into the development strategies of Estonias social protection system