The Journal of asthma : official journal of the Association for the Care of Asthma
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Randomized Controlled Trial
Does parental involvement in pediatric emergency department asthma treatment affect home management?
To determine whether parents who deliver albuterol treatments in a pediatric emergency department with a metered dose inhaler with a spacer device (MDIS) report better adherence to MDIS use at home compared to parents whose children undergo standard nebulizer therapy. Children aged 1-5 years were randomized by day to usual treatment with nebulized albuterol (40 children) or to treatment by the parent with albuterol with an MDIS (46 children). ⋯ At follow-up, children in the MDIS group were 7.5 times more likely to be using the MDIS for their albuterol treatments (95%CI 1.6-35.6). Involving parents in treatment of asthma exacerbations in the emergency department using an MDIS may improve adherence to MDIS use at home.
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Childhood asthma is a major public health problem, with mainland and island Puerto Rican children having the highest asthma rates of any ethnic group in the United States. ⋯ Previous research suggests children of Puerto Rican descent are especially vulnerable to asthma. Our results suggest that maternal mental health problems and prenatal smoking are both associated with increased odds of asthma among Puerto Rican youth and that prenatal smoking may partly explain the observed relationship between maternal psychopathology and childhood asthma. Future longitudinal and geographically diverse epidemiological studies may help to identify the role of both maternal mental health problems and prenatal smoking in the health disparities in childhood asthma.
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Research on air quality in and around schools, and the associated vulnerability of school-age children, is limited in less developed countries (LDCs), particularly Africa. The main objective of this study was to conduct an initial assessment of sources of air pollution in and around schools as a surrogate for air quality and report adverse health effects among students at selected secondary schools in urban Ibadan, Nigeria. ⋯ Proximity of study schools to certain sources and activities such as refuse burning and major roadways seemed to present substantial risk factors for reported respiratory morbidity among secondary students in urban Ibadan, Nigeria. Future research should quantify source emissions and exposure and further characterize frequency and severity of respiratory symptoms, among other parameters, at schools in Nigeria and other sprawling urban areas of Africa.
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Bronchial asthma (A) is frequently diagnosed in patients with chronic cough. The study was conducted to determine whether an evaluation of fractional exhaled nitric oxide (FeNO) concentration can be used as a screening test for asthma in young adults with chronic cough (CCP). ⋯ In clinical practice, assessment of FeNO concentration can be used as a screening test for asthma in young adults who have chronic cough.
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Various factors have been reported to be useful for predicting future exacerbations. ⋯ These results demonstrated that combining the ACT score and percentage of predicted FEV(1), but not FE(NO,) can sufficiently stratify the risk for future exacerbations within one year.