1
|
Ren S, Su W, Li J, Yang C. Effect of online vs offline training on practical skills for surgical residents. Asian J Surg 2024; 47:2945-2946. [PMID: 38418326 DOI: 10.1016/j.asjsur.2024.02.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/16/2024] [Indexed: 03/01/2024] Open
Affiliation(s)
- Shangqing Ren
- Robotic Minimally Invasive Surgery Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Wenjie Su
- Department of Anesthesiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Jiacen Li
- Department of Anesthesiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Chong Yang
- Department of Hepatobiliary and Pancreatic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China.
| |
Collapse
|
2
|
Green NS, Manwani D, Aygun B, Appiah-Kubi A, Smith-Whitley K, Castillo Y, Soriano L, Jia H, Smaldone AM. Hydroxyurea Adherence for Personal Best in Sickle Cell Treatment (HABIT) efficacy trial: Community health worker support may increase hydroxyurea adherence of youth with sickle cell disease. Pediatr Blood Cancer 2024; 71:e30878. [PMID: 38321562 PMCID: PMC10919354 DOI: 10.1002/pbc.30878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/18/2023] [Accepted: 01/05/2024] [Indexed: 02/08/2024]
Abstract
Despite disease-modifying effects of hydroxyurea on sickle cell disease (SCD), poor adherence among affected youth commonly impedes treatment impact. Following our prior feasibility trial, the "Hydroxyurea Adherence for Personal Best in Sickle Cell Treatment (HABIT)" multi-site randomized controlled efficacy trial aimed to increase hydroxyurea adherence for youth with SCD ages 10-18 years. Impaired adherence was identified primarily through flagging hydroxyurea-induced fetal hemoglobin (HbF) levels compared to prior highest treatment-related HbF. Eligible youth were enrolled as dyads with their primary caregivers for the 1-year trial. This novel semi-structured supportive, multidimensional dyad intervention led by community health workers (CHW), was augmented by daily tailored text message reminders, compared to standard care during a 6-month intervention phase, followed by a 6-month sustainability phase. Primary outcomes from the intervention phase were improved Month 6 HbF levels compared to enrollment and proportion of days covered (PDC) for hydroxyurea versus pre-trial year. The secondary outcome was sustainability of changes up to Month 12. The 2020-2021 peak coronavirus disease 2019 (COVID-19) pandemic disrupted enrollment and clinic-based procedures; CHW in-person visits shifted to virtual scheduled interactions. We enrolled 50 dyads, missing target enrollment. Compared to enrollment levels, both HbF level and PDC significantly - but not sustainably - improved within the intervention group (p = .03 and .01, respectively) with parallel increased mean corpuscular volume (MCV) (p = .05), but not within controls. No significant between-group differences were found at Months 6 or 12. These findings suggest that our community-based, multimodal support for youth-caregiver dyads had temporarily improved hydroxyurea usage. Durability of impact should be tested in a trial with longer duration of CHW-led and mobile health support.
Collapse
Affiliation(s)
- Nancy S. Green
- Department of Pediatrics, Division of Hematology, Oncology and Stem Cell Transplantation, Columbia University Irving Medical Center, NY
| | - Deepa Manwani
- Department of Pediatrics, Division of Hematology, Oncology and Cellular Therapy, Albert Einstein College of Medicine, NY
| | - Banu Aygun
- Department of Pediatrics, Division of Hematology, Oncology and Cellular Therapy, Cohen Children’s Medical Center, NY
| | - Abena Appiah-Kubi
- Department of Pediatrics, Division of Hematology, Oncology and Cellular Therapy, Cohen Children’s Medical Center, NY
| | - Kim Smith-Whitley
- Division of Hematology, Children’s Hospital of Philadelphia, PA
- Pfizer, Inc., NY
| | - Yina Castillo
- Department of Pediatrics, Division of Hematology, Oncology and Stem Cell Transplantation, Columbia University Irving Medical Center, NY
| | - Lucy Soriano
- Department of Pediatrics, Division of Hematology, Oncology and Stem Cell Transplantation, Columbia University Irving Medical Center, NY
| | - Haomiao Jia
- School of Nursing, Columbia University Irving Medical Center, NY
| | | |
Collapse
|
3
|
Shukla PJ, Sandel P, Phull G, Rethy JA. Development and Utilization of a Diagnostic Support Tool for Asthma within the Electronic Medical Record. J Med Syst 2022; 46:65. [PMID: 36040523 DOI: 10.1007/s10916-022-01858-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/26/2022] [Indexed: 12/01/2022]
Abstract
Asthma in childhood is a common and costly chronic disease. Quality asthma care can lead to better control of asthma thus decreasing use of health services. The gold standard for pediatric asthma diagnosis and management is the National Heart, Lung and Blood Institute (NHLBI) guidelines for Diagnosis and Management of Asthma which center on precisely establishing the severity of asthma, as this precise classification delineates appropriate therapy. However, navigating these guidelines is a challenge for primary care providers that creates a barrier to providing quality care. We aim to improve precision in asthma severity classification in the community healthcare setting through the development of an electronic asthma decision support tool (eADST) incorporating NHLBI guidelines embedded within the electronic health record system. We developed an algorithm for the eADST to guide the health care provider to the appropriate classification and subsequent therapy. We engaged our health system's electronic health record informatics team and together developed and revised the tool. We launched the tool in three academic community clinics and measured precision in asthma classification in the twelve months prior to the availability of the tool and the twelve months following the launch. We found a significant improvement in precision of asthma severity classification following the launch, a necessary first step in improvement of asthma care. The next step will be to evaluate the impact of the tool on asthma outcomes.
Collapse
Affiliation(s)
- Prateek J Shukla
- Department of Pediatrics, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Piper Sandel
- Division of Community Pediatrics, MedStar Georgetown University Hospital, 4200 Wisconsin Ave NW 4th Floor, Washington, DC, 20016, USA
| | - Gurpreet Phull
- Division of Pulmonary and Sleep Medicine, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Janine A Rethy
- Division of Community Pediatrics, MedStar Georgetown University Hospital, 4200 Wisconsin Ave NW 4th Floor, Washington, DC, 20016, USA.
| |
Collapse
|
4
|
Drapkina OM, Kontsevaya AV, Kalinina AM, Avdeev SM, Agaltsov MV, Alexandrova LM, Antsiferova AA, Aronov DM, Akhmedzhanov NM, Balanova YA, Balakhonova TV, Berns SA, Bochkarev MV, Bochkareva EV, Bubnova MV, Budnevsky AV, Gambaryan MG, Gorbunov VM, Gorny BE, Gorshkov AY, Gumanova NG, Dadaeva VA, Drozdova LY, Egorov VA, Eliashevich SO, Ershova AI, Ivanova ES, Imaeva AE, Ipatov PV, Kaprin AD, Karamnova NS, Kobalava ZD, Konradi AO, Kopylova OV, Korostovtseva LS, Kotova MB, Kulikova MS, Lavrenova EA, Lischenko OV, Lopatina MV, Lukina YV, Lukyanov MM, Mayev IV, Mamedov MN, Markelova SV, Martsevich SY, Metelskaya VA, Meshkov AN, Milushkina OY, Mukaneeva DK, Myrzamatova AO, Nebieridze DV, Orlov DO, Poddubskaya EA, Popovich MV, Popovkina OE, Potievskaya VI, Prozorova GG, Rakovskaya YS, Rotar OP, Rybakov IA, Sviryaev YV, Skripnikova IA, Skoblina NA, Smirnova MI, Starinsky VV, Tolpygina SN, Usova EV, Khailova ZV, Shalnova SA, Shepel RN, Shishkova VN, Yavelov IS. 2022 Prevention of chronic non-communicable diseases in Of the Russian Federation. National guidelines. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3235] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
|
5
|
Inácio MLC, Pereira FC, Fernandes LB, Oliveira IRCD, Pereira RC, de Angelis-Pereira MC. Food and Nutrition Education Using Intuitive Method and NOVA Food Classification: Implications for Food Practices of Children and Adolescents Intuitive Method in Food and Nutrition Education. Am J Health Promot 2022; 36:1170-1182. [PMID: 35420920 DOI: 10.1177/08901171221092394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the impact of food and nutrition education interventions based on the intuitive method (IM) proposed by Johaan Henrich Pestalozzi (1746-1827) at different time periods on the food practices of children and adolescents. DESIGN This was a prospective comparative intervention program assessed by a pre-post survey at shorter term (3 months) and longer term (6 months). SETTING Two institutions that provide extracurricular social support for children and adolescents with social and economic vulnerabilities in the city of Lavras, Minas Gerais, Brazil. The shorter-term intervention was conducted in Institution A and the longer term one conducted in Institution B. SUBJECTS The sample consisted of 245 students aged between 5 and 14 years who attended the institutions. For each institution, they were divided into two groups (control and IM). INTERVENTION We compared the effectiveness of the interventions performed by the IM or by expository actions (control) in both institutions. Interventions were focused on the guidelines of the Food Guide for the Brazilian Population and dealt with food choices, meal preparation, commensality, and obstacles to healthy eating. MEASURES The assessed outcomes were food consumption according to NOVA food classification, cooking self-efficacy, and knowledge about food and nutrition. ANALYSIS Paired t-tests were used to compare food consumption before and after interventions. Adjusted logistic regression models were used to analyze the outcomes on food and nutrition knowledge and cooking self-efficacy. RESULTS Subjects receiving IM interventions decreased mean intake of ultra-processed food (3.56 to 1.50 portions; P< .001) and had greater odds of increasing self-efficacy with cooking (OR = 2,33-4,17). Both methods were effective regarding teaching about food and nutrition. Intervention period did not homogeneously impact these outcomes. CONCLUSIONS The use of food and nutrition education interventions presented positive outcomes on the food practices of the participants. The IM is an alternative method to educate children and adolescents about healthy eating practices.
Collapse
Affiliation(s)
| | | | | | | | - Rafaela Corrêa Pereira
- Department of Nutrition, 67739Federal University of Lavras, Lavras, MG, Brazil.,Department of Agricultural Sciences, Federal Institute of Minas Gerais, Bambuí, MG, Brazil
| | | |
Collapse
|
6
|
School-based interventions to improve sleep duration: Lessons learned and future directions. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02137-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
7
|
Lyan NA, Khan MA, Turova EA, Ivanova II, Petrova MS, Bokova IA. [Medical rehabilitation of children with bronchial asthma]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOĬ FIZICHESKOĬ KULTURY 2021; 98:70-78. [PMID: 33899455 DOI: 10.17116/kurort20219802170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Medical rehabilitation of children suffering from bronchial asthma is based on the complex use of natural therapeutic factors, drug, non-drug therapy and other methods in order to achieve control over the disease and long-term remission. The use of non-drug technologies is necessary taking into account the pathogenesis of the bronchial asthma development and is aimed at relieving bronchospasm, reducing the activity of allergic inflammation in the bronchi, improving their drainage function, strengthening the respiratory muscles and increasing exercise tolerance. When carrying out rehabilitation measures it is important to observe the basic principles of medical rehabilitation. An individual medical rehabilitation program is drawn up taking into account the assessment of the child's clinical condition at each stage with the diagnosis of the initial rehabilitation status, the establishment of a rehabilitation diagnosis and an assessment of the rehabilitation potential. The article presents the data of the analysis of scientific publications and our own research allowing to draw up an algorithm for the formation of an individual program of medical rehabilitation for children with bronchial asthma.
Collapse
Affiliation(s)
- N A Lyan
- Moscow Scientific Practical Center of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - M A Khan
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,N.F. Filatov Children's Municipal Clinical Hospital, Moscow, Russia
| | - E A Turova
- Moscow Scientific Practical Center of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - I I Ivanova
- The Chief Medical Department of the RF President's Administration, Moscow, Russia
| | - M S Petrova
- The Chief Medical Department of the RF President's Administration, Moscow, Russia
| | - I A Bokova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| |
Collapse
|
8
|
Martí L, Castarlenas E, Solé E, de la Vega R, Miró J. Video-based Pain Education in Schools: A Study With Adolescents. Clin J Pain 2021; 37:199-205. [PMID: 33290347 DOI: 10.1097/ajp.0000000000000906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/11/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE School-based educational programs have shown positive changes in health-related behaviors among adolescents. The aim of this study was to analyze the changes in pain-related knowledge among adolescents and in the use of positive responses to their peers' pain behaviors after watching a brief educational video. METHODS One hundred and thirty-five adolescents (mean age=13.27; SD=1.17) participated and provided demographic and pain-related information. They also responded to a pain-related knowledge questionnaire before (T1), after (T2), and 1 month after (T3) watching a brief pain educational video, and to a modified version of the Inventory of Parent/Caregiver Responses to the Children's Pain Experience at T1 and at T3. RESULTS There was a significant increase in pain knowledge for all participants between T1 and T2 (η2p=0.73) and between T1 and T3 (η2p=0.62). An increase in responses considered to be positive to peers' pain behaviors (ie, the promotion of well-behaviors and coping responses) 1 month after watching the educational video was also found. Interestingly, these results were not associated with the chronic pain status of the participant. DISCUSSION The findings showed that a brief and inexpensive educational video-based intervention in schools helps to increase pain-related knowledge and change responses to students with chronic pain. This has the potential to prevent chronic pain and related disability among students, and decrease bullying-like behaviors toward students with chronic pain.
Collapse
Affiliation(s)
- Lorena Martí
- Unit for the Study and Treatment of Pain-ALGOS, Universitat Rovira i Virgili
- Department of Psychology, Research Center for Behavior Assessment (CRAMC)
- Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia
| | - Elena Castarlenas
- Unit for the Study and Treatment of Pain-ALGOS, Universitat Rovira i Virgili
- Department of Psychology, Research Center for Behavior Assessment (CRAMC)
- Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia
| | - Ester Solé
- Unit for the Study and Treatment of Pain-ALGOS, Universitat Rovira i Virgili
- Department of Psychology, Research Center for Behavior Assessment (CRAMC)
- Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia
| | | | - Jordi Miró
- Unit for the Study and Treatment of Pain-ALGOS, Universitat Rovira i Virgili
- Department of Psychology, Research Center for Behavior Assessment (CRAMC)
- Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia
| |
Collapse
|
9
|
Elnady HG, Sherif LS, ElGindi HD, Shaaban FA, Abdelmohsen AM, Salah DA, Abdel-Latif GA, Fahmy RF. Assessment of Quality of Life of Primary Caregivers of Egyptian Asthmatic Children and Adolescents. Indian J Community Med 2020; 45:410-414. [PMID: 33623191 PMCID: PMC7877440 DOI: 10.4103/ijcm.ijcm_436_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 04/25/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Asthma as a serious public health problem worldwide exerts a serious load on children's health-related quality of life (HRQOL) and their families. Objective: We assess the HRQOL of the primary caregivers of Egyptian asthmatic children and adolescents and its relation to HRQOL of their children and asthma severity. Materials and Methods: A cross-sectional study was conducted on 128 pairs of asthmatic children (7–16 years) and their primary caregivers. Pediatric asthma quality of life (QOL) questionnaire, pediatric asthma caregiver's QOL questionnaire, and asthma control questionnaire were used. Results: Uncontrolled asthmatic patients had statistically significantly lower mean caregiver score compared to controlled asthmatic (P < 0.005). There was a statistically significant positive correlation between caregiver's individual and overall QOL scores and their children (individual and overall QOL scores) (P < 0.05). A statistically significant negative correlation between asthma severity and QOL scores of the caregivers of asthmatic children and adolescents was found (P < 0.05). Conclusion: The QOL of the primary caregivers of asthmatic children is significantly adversely affected by their children's illness severity.
Collapse
Affiliation(s)
- Hala G Elnady
- Child Health Department, Medical Research Division, National Research Centre, Cairo, Egypt
| | - Lobna S Sherif
- Child Health Department, Medical Research Division, National Research Centre, Cairo, Egypt
| | - Hala D ElGindi
- Child Health Department, Medical Research Division, National Research Centre, Cairo, Egypt
| | - Fatma A Shaaban
- Child Health Department, Medical Research Division, National Research Centre, Cairo, Egypt
| | - Aida M Abdelmohsen
- Community Medicine Department, Medical Research Division, National Research Centre, Cairo, Egypt
| | - Dina A Salah
- Child Health Department, Medical Research Division, National Research Centre, Cairo, Egypt
| | - Ghada A Abdel-Latif
- Community Medicine Department, Medical Research Division, National Research Centre, Cairo, Egypt
| | - Reham F Fahmy
- Child Health Department, Medical Research Division, National Research Centre, Cairo, Egypt
| |
Collapse
|
10
|
Impact of a self-monitoring application on pediatric asthma disparities. Int J Med Inform 2020; 144:104294. [PMID: 33080504 DOI: 10.1016/j.ijmedinf.2020.104294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/27/2020] [Accepted: 10/01/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVES We previously reported improved outcomes after implementing the electronic-AsthmaTracker (e-AT), a self-monitoring tool for children with asthma, at 11 ambulatory pediatric clinics. This study assesses e-AT adherence and impact across race/ethnicity subgroups. STUDY DESIGN Secondary data analysis of a prospective cohort study of children ages 2-17 years with persistent asthma, enrolled from January 2014 to December 2015 to use the e-AT for 1 year. Survival analysis was used to compare e-AT use adherence and generalized estimating equation models to compare outcomes pre- and post e-AT initiation, between race/ethnicity subgroups. RESULTS Data from 318 children with baseline measurements were analyzed: 76.4 % white, 11.3 % Hispanic, 7.8 % "other", and 4.4 % unknown race/ethnicity subgroups. Mean e-AT adherence was 82 % (95 %CI: 79-84 %, reference) for whites, 73 % (64-81 %, p = 0.025) for Hispanics, and 78 % (69-86 %, p = 0.373) for other minorities. Compared to whites, Cox proportional hazard ratio for study dropout risk was 2.14 (1.31-3.77, p = 0.001) for Hispanics and 0.95 (0.60-1.50, p = 0.834) for other minorities. Disparities existed at baseline, with lower QOL (74.9 vs 80.6; p = 0.025) and asthma control (18.4 vs 19.7; p = 0.027) among Hispanics, compared to whites. After e-AT initiation, disparities disappeared at 3 months for QOL (87.2 vs 90.5; p = 0.159) and asthma control (23.1 vs 22.4; p = 0.063), persisting until study end. Disparities also existed at baseline, with lower QOL (74.6 vs. 80.6; p = 0.042) and asthma control (18.2 vs. 19.7, p = 0.024) among "other" minorities, compared to whites, and disappeared at 3 months for QOL (92.7 vs. 90.5, p = 0.432) and asthma control (22.7 vs 22.4; p = 0.518), persisting until study end. Subgroup analysis was underpowered to detect a difference in oral steroid use or ED/hospital admissions. CONCLUSIONS Our study shows improved asthma control and QOL among minorities and disparity elimination after e-AT implementation. Future adequately powered studies will explore the impact on oral steroid and ED/hospital use disparities.
Collapse
|
11
|
Ways in which school psychologists can identify suitable apps for supporting the self-management of asthma by students. THE EDUCATIONAL AND DEVELOPMENTAL PSYCHOLOGIST 2020. [DOI: 10.1017/edp.2020.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
12
|
Mizuta K, Sasaki H, Zhang Y, Matoba A, Emala CW. The short-chain free fatty acid receptor FFAR3 is expressed and potentiates contraction in human airway smooth muscle. Am J Physiol Lung Cell Mol Physiol 2020; 318:L1248-L1260. [PMID: 32209026 DOI: 10.1152/ajplung.00357.2019] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Emerging evidence suggests that gut microbiota-derived short-chain fatty acids (SCFAs; acetate, propionate, and butyrate) are important modulators of the inflammatory state in diseases such as asthma. However, the functional expression of the Gi protein-coupled free fatty acid receptors (FFAR2/GPR43 and FFAR3/GPR41) has not been identified on airway smooth muscle (ASM). Classically, acute activation of Gi-coupled receptors inhibits cyclic AMP (cAMP) synthesis, which impairs ASM relaxation and can also induce crosstalk between Gi- and Gq-signaling pathways, potentiating increases in intracellular Ca2+ concentration ([Ca2+]i), favoring ASM contraction. In contrast, chronic activation of Gi-coupled receptors can sensitize adenylyl cyclase resulting in increased cAMP synthesis favoring relaxation. We questioned whether the Gi-coupled FFAR2 or FFAR3 is expressed in human ASM, whether they modulate cAMP and [Ca2+]i, and whether SCFAs modulate human ASM tone. We detected the protein expression of FFAR3 but not FFAR2 in native human ASM and primary cultured human airway smooth muscle (HASM) cells. In HASM cells, acute activation of FFAR3 with SCFAs inhibited forskolin-stimulated cAMP accumulation, but chronic activation did not sensitize cAMP synthesis. SCFAs induced [Ca2+]i increases that were attenuated by pertussis toxin, gallein, U73122, or xestospongin C. Acute treatment with SCFAs potentiated acetylcholine-stimulated [Ca2+]i increases and stress fiber formation in cells and contraction of ex vivo human airway tissues. In contrast, chronic pretreatment of human ASM with propionate did not potentiate airway relaxation. Together, these findings demonstrate that FFAR3 is expressed in human ASM and contributes to ASM contraction via reduced cAMP and increased [Ca2+]i.
Collapse
Affiliation(s)
- Kentaro Mizuta
- Division of Dento-oral Anesthesiology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Haruka Sasaki
- Division of Dento-oral Anesthesiology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yi Zhang
- Department of Anesthesiology, College of Physicians and Surgeons of Columbia University, New York, New York
| | - Atsuko Matoba
- Division of Dento-oral Anesthesiology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Charles W Emala
- Department of Anesthesiology, College of Physicians and Surgeons of Columbia University, New York, New York
| |
Collapse
|
13
|
Azmeh R, Greydanus DE, Agana MG, Dickson CA, Patel DR, Ischander MM, Lloyd RD. Update in Pediatric Asthma: Selected Issues. Dis Mon 2019; 66:100886. [PMID: 31570159 DOI: 10.1016/j.disamonth.2019.100886] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Asthma is a complex condition that affects 14% of the world's children and the approach to management includes both pharmacologic as well as non-pharmacologic strategies including attention to complex socioeconomic status phenomena. After an historical consideration of asthma, allergic and immunologic aspects of asthma in children and adolescents are presented. Concepts of socioeconomic aspects of asthma are considered along with environmental features and complications of asthma disparities. Also reviewed are links of asthma with mental health disorders, sleep disturbances and other comorbidities. A stepwise approach to asthma management is discussed that includes pharmacologic and non-pharmacologic strategies in the pediatric population. The role of immunotherapy and use of various immunomodulators are considered as well.
Collapse
Affiliation(s)
- Roua Azmeh
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States.
| | - Marisha G Agana
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Cheryl A Dickson
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States; Health Equity and Community Affairs, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, United States
| | - Dilip R Patel
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Mariam M Ischander
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Robert D Lloyd
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, Washington, United States
| |
Collapse
|
14
|
Nkoy FL, Fassl BA, Wilkins VL, Johnson J, Unsicker EH, Koopmeiners KJ, Jensen A, Frazier M, Gaddis J, Malmgren L, Williams S, Oldroyd H, Greene T, Sheng X, Uchida DA, Maloney CG, Stone BL. Ambulatory Management of Childhood Asthma Using a Novel Self-management Application. Pediatrics 2019; 143:peds.2018-1711. [PMID: 31097465 DOI: 10.1542/peds.2018-1711] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Pediatric ambulatory asthma control is suboptimal, reducing quality of life (QoL) and causing emergency department (ED) and hospital admissions. We assessed the impact of the electronic-AsthmaTracker (e-AT), a self-monitoring application for children with asthma. METHODS Prospective cohort study with matched controls. Participants were enrolled January 2014 to December 2015 in 11 pediatric clinics for weekly e-AT use for 1 year. Analyses included: (1) longitudinal changes for the child (QoL, asthma control, and interrupted and missed school days) and parents (interrupted and missed work days and satisfaction), (2) comparing ED and hospital admissions and oral corticosteroid (OCS) use pre- and postintervention, and (3) comparing ED and hospital admissions and OCS use between e-AT users and matched controls. RESULTS A total of 327 children and parents enrolled; e-AT adherence at 12 months was 65%. Compared with baseline, participants had significantly (P < .001) increased QoL, asthma control, and reduced interrupted and missed school and work days at all assessment times. Compared with 1 year preintervention, they had reduced ED and hospital admissions (rate ratio [RR]: 0.68; 95% confidence interval [CI]: 0.49-0.95) and OCS use (RR: 0.74; 95% CI: 0.61-0.91). Parent satisfaction remained high. Compared with matched controls, participants had reduced ED and hospital admissions (RR: 0.41; 95% CI: 0.22-0.75) and OCS use (RR: 0.65; 95% CI: 0.46-0.93). CONCLUSIONS e-AT use led to high and sustained participation in self-monitoring and improved asthma outcomes. Dissemination of this care model has potential to broadly improve pediatric ambulatory asthma care.
Collapse
Affiliation(s)
- Flory L Nkoy
- Department of Pediatrics, University of Utah, Salt Lake City, Utah;
| | - Bernhard A Fassl
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | | | | | - Eun Hea Unsicker
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | | | | | | | | | | | | | - Heather Oldroyd
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Tom Greene
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Xiaoming Sheng
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Derek A Uchida
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | | | - Bryan L Stone
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| |
Collapse
|
15
|
Kai Y, Motegi M, Suzuki Y, Takeuchi H, Harada Y, Sato F, Chiba Y, Kamei J, Sakai H. Up-regulation of Rac1 in the bronchial smooth muscle of murine experimental asthma. Basic Clin Pharmacol Toxicol 2019; 125:8-15. [PMID: 30697954 DOI: 10.1111/bcpt.13204] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 01/16/2019] [Indexed: 01/19/2023]
Abstract
There has been considerable research on the involvement of RhoA/Rho kinase signalling in smooth muscle contractions. However, only a few reports have addressed the specific role of Rac1, which is a member of the Rho GTPase superfamily. Therefore, this study investigated the role of Rac1-related pathways in bronchial smooth muscle (BSM) contractions. Bronchial rings isolated from mice were suspended in an organ bath, and the isometric contractions of circular smooth muscles were monitored. The phosphorylation of myosin light chains (MLCs) was analysed by immunoblotting. The Rac1 inhibitor EHT1864 inhibited carbachol (CCh)-induced BSM contractions, although high K+ depolarization-induced BSM contractions were not significantly attenuated by EHT1864. Moreover, high K+ - and phorbol 12,13-dibutyrate (PDBu; PKC activator)-induced contractions were not attenuated by Rac1 inhibition, whereas sodium fluoride (NaF)-induced force development was inhibited by EHT1864. The gene and protein expression of Rac1 was increased in the BSM of a murine model with antigen-induced airway hyper-responsiveness (AHR). In addition, an increased force of the BSM contractions in AHR was suppressed by EHT1864 treatment, suggesting that the up-regulation of Rac1 is involved in AHR. These findings suggest that an increase in Rac1-mediated signalling is involved in the augmented contractions of BSMs in antigen-induced AHR mice.
Collapse
Affiliation(s)
- Yuki Kai
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, Tokyo, Japan
| | - Momoko Motegi
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, Tokyo, Japan
| | - Yuta Suzuki
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, Tokyo, Japan
| | - Hiroto Takeuchi
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, Tokyo, Japan
| | - Yui Harada
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, Tokyo, Japan
| | - Fumiaki Sato
- Department of Analytical Pathophysiology, School of Pharmacy, Hoshi University, Tokyo, Japan
| | - Yoshihiko Chiba
- Department of Physiology and Molecular Sciences, School of Pharmacy, Hoshi University, Tokyo, Japan
| | - Junzo Kamei
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, Tokyo, Japan
| | - Hiroyasu Sakai
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, Tokyo, Japan
| |
Collapse
|
16
|
Isik E, Fredland NM, Freysteinson WM. School and Community-based Nurse-led Asthma Interventions for School-aged Children and Their Parents: A Systematic Literature Review. J Pediatr Nurs 2019; 44:107-114. [PMID: 30683275 DOI: 10.1016/j.pedn.2018.11.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 10/19/2018] [Accepted: 11/13/2018] [Indexed: 10/27/2022]
Abstract
PROBLEM Asthma is one of the most prevalent chronic diseases in the world. Lack of asthma knowledge can lead to asthma exacerbations, more emergency room visits, school absences, and decreased quality of life. This systematic review examines the effectiveness of educational intervention programs on asthma management for school-aged children and their parents beyond inpatient clinic settings. ELIGIBILITY CRITERIA Educational asthma interventions for school-aged children and their parents with comparison with usual asthma care and the outcome related to asthma management. Studies included were peer-reviewed and published in English within the last five years. SAMPLE The eight study articles were identified in ProQuest, Medline, CINAHL, and PubMed databases. RESULTS The review demonstrated that educational asthma interventions for children and their parents significantly improved knowledge and skills related to asthma self-management. CONCLUSIONS School and community-based asthma educational intervention programs are key components for good management of asthma condition. Well-planned asthma education programs are valuable and should go beyond inpatient clinic settings for promoting and maintaining health for children with asthma and their parents. IMPLICATIONS School nurses are well-positioned to assume a more prominent role in asthma care to improve child health and academic outcomes. School nurses have an opportunity to establish a trusting relationship that is foundational for collaborating with parents and students for better asthma management.
Collapse
Affiliation(s)
- Elif Isik
- Nelda C. Stark College of Nursing, Texas Woman's University, Houston, TX, USA; School Nurse in Houston Independent School District, Briarmeadow Charter School, Houston, TX, USA.
| | - Nina M Fredland
- Nelda C. Stark College of Nursing, Texas Woman's University, Houston, TX, USA
| | | |
Collapse
|
17
|
Agusala V, Vij P, Agusala V, Dasari V, Kola B. Can interactive parental education impact health care utilization in pediatric asthma: A study in rural Texas. J Int Med Res 2018; 46:3172-3182. [PMID: 29848134 PMCID: PMC6134652 DOI: 10.1177/0300060518773621] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective It is well known that parent/patient education helps to reduce the burden of asthma in urban areas, but data are scarce for rural areas. This study explored the impact of asthma education in Ector County, a rural part of Health Services Region 9 in Texas, which has one of the highest prevalence rates of asthma in the state. Methods This prospective study investigated an interactive asthma education intervention in pediatric patients aged 2-18 years and their caregivers. Change in parental/caregiver knowledge about their child's asthma along with frequency of missed school days, emergency department (ED) visits and hospital admissions was obtained via telephone surveys before and after the educational intervention was delivered. Results The study enrolled 102 pediatric patients and their parents/caregivers. Asthma education was associated with significantly fewer school absences, ED visits and hospitalizations. Parents/caregivers reported feeling better educated, knowing what triggers an asthma exacerbation, identifying the signs of a severe asthma attack in their child, feeling confident about managing asthma and feeling that the asthma was under control. Conclusion Asthma education of caregivers and children was associated with better symptom management and fewer acute exacerbations, pointing to the relevance and importance of asthma education among pediatric patients in rural areas.
Collapse
Affiliation(s)
| | | | | | | | - Bhargavi Kola
- Bhargavi Kola, Department of Pediatrics, Texas Tech University Health Sciences Center, Permian Basin, 701 W 5 Street, Odessa, TX 79763, USA.
| |
Collapse
|
18
|
Mejias SG, Ramphul K. Prevalence and Associated Risk Factors of Bronchial Asthma in Children in Santo Domingo, Dominican Republic. Cureus 2018; 10:e2211. [PMID: 29686953 PMCID: PMC5910008 DOI: 10.7759/cureus.2211] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background Bronchial asthma is an important health problem worldwide. There is insufficient data on the prevalence of bronchial asthma among school children in Santo Domingo, Dominican Republic. Objective The objective of this study is to assess the prevalence of asthma and its related risk factors among school children in Santo Domingo, Dominican Republic. Materials and methods A cross-sectional study using a modified questionnaire was conducted in Santo Domingo among 600 children aged three to 11 eleven years. The prevalence of asthma and its associated risk factors such as birth order, family history of asthma, family history of allergy, exposure to pets at home, exposure to tobacco smoke, and source of fuel used at home were collected. The relevant data collected was analyzed using the Statistical Package for the Social Sciences (SPSS) 24.0. (IBM Corp., Armonk, NY) software. Results The prevalence of asthma was found to be 22.0%. Age, family history of asthma, family history of allergy, exposure to tobacco smoke, and birth order showed statistical significance. The source of fuel used at home, gender, and exposure to pets were not statistically significant to be considered as risk factors associated with asthma in the population studied. Conclusion With an asthma prevalence of 22.0% in the pediatric population, the Dominican Republic has one of the highest national rates of asthma in the pediatric population in Latin America. Proper education, screening, and prevention can help lower the burden of this disease economically and socially.
Collapse
Affiliation(s)
- Stephanie G Mejias
- Department of Pediatrics, Robert Reid Cabral Children's Hospital Affiliated to the University Iberoamericana Unibe School of Medicine
| | - Kamleshun Ramphul
- Department of Pediatrics, Shanghai Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| |
Collapse
|
19
|
Walter H, Sadeque-Iqbal F, Ulysse R, Castillo D, Fitzpatrick A, Singleton J. Effectiveness of school-based family asthma educational programs in quality of life and asthma exacerbations in asthmatic children aged five to 18: a systematic review. ACTA ACUST UNITED AC 2018; 14:113-138. [PMID: 27941517 DOI: 10.11124/jbisrir-2016-003181] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Asthma is a common, chronic, non-communicable respiratory disease that affects millions of children worldwide. Asthma exacerbations can range from mild to severe and can have an unfavorable impact on the quality of life of children and their caregivers. Asthma exacerbations often result in absenteeism from school or work, activity intolerance and emergency hospital visits. One strategy to address this health issue in an attempt to improve health outcomes is school-based asthma educational programs. A review of the literature revealed that previous systematic reviews have examined similar topics on the effectiveness of school-based asthma educational programs that have included collaborative efforts between parents and schools. No systematic reviews were found that examined the effectiveness of school-based asthma educational programs that exclusively included children and their caregivers. Research has not been systematically reviewed to determine the effectiveness of a school-based asthma educational program within a familial context. OBJECTIVES To identify the best available evidence on the effectiveness of school-based family asthma educational programs that exclusively included both children and caregivers on the quality of life and number of asthma exacerbations of children aged five to 18 years with a clinical diagnosis of asthma. INCLUSION CRITERIA TYPES OF PARTICIPANTS Children aged five to 18 years of any gender, race or ethnicity with a clinical diagnosis of asthma and their caregivers. TYPES OF INTERVENTION(S) School-based family asthma educational programs. TYPES OF STUDIES Randomized controlled trials. OUTCOMES Quality of life and the number of asthma exacerbations measured by either missed days from school or work, and/or physical activity intolerance, and/or emergency hospital visits. SEARCH STRATEGY The search strategy aimed to find both published and unpublished studies from inception of the database to August 21, 2015. METHODOLOGICAL QUALITY Quantitative papers selected for retrieval were assessed by two independent reviewers for methodological validity before inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute. DATA EXTRACTION Data were extracted from articles included in the review using the standardized data extraction tool from the Joanna Briggs Institute. The data extracted included specific details about the populations, interventions, study methods and outcomes of significance to the review question and its specific objectives. DATA SYNTHESIS Due to the heterogeneity among the included studies, statistical pooling and meta-analysis was not possible. Results are presented in narrative form. RESULTS Six studies examining the intervention were included in this review. All six of the included studies were randomized controlled trials (RCTs). All six studies compared the effects of school-based asthma education to no school-based asthma education/usual care on quality of life and number of asthma exacerbations. Three out of four RCTs showed that children who participated in school-based family asthma educational programs demonstrated a statistically significant improvement in overall quality of life (P < 0.05). All six studies showed improvement in the number of asthma exacerbations that resulted in one or all of the measured outcomes of either missed days from school or work, physical activity intolerance and/or decreased emergency hospital visits. CONCLUSION School-based family asthma educational programs for children that include caregivers can have a positive impact on the quality of life and asthma management of children with asthma. Other outcomes that can be positively affected by school-based family asthma educational programs include absenteeism from school or work, physical activity intolerance and emergency hospital visits as result of asthma exacerbations.
Collapse
Affiliation(s)
- Helen Walter
- 1College of Health Professions, Pace University, New York, New York, USA 2The Northeast Institute for Evidence Synthesis and Translation (NEST): a Joanna Briggs Institute Center of Excellence
| | | | | | | | | | | |
Collapse
|
20
|
Núñez JC, Epstein JL, Suárez N, Rosário P, Vallejo G, Valle A. How Do Student Prior Achievement and Homework Behaviors Relate to Perceived Parental Involvement in Homework? Front Psychol 2017; 8:1217. [PMID: 28798702 PMCID: PMC5529388 DOI: 10.3389/fpsyg.2017.01217] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/03/2017] [Indexed: 11/13/2022] Open
Abstract
This study investigated how students' prior achievement is related to their homework behaviors (i.e., time spent on homework, homework time management, and amount of homework), and to their perceptions of parental involvement in homework (i.e., parental control and parental support). A total of 1250 secondary students from 7 to 10th grade participated in the study. Structural equation models were fitted to the data, compared, and a partial mediation model was chosen. The results indicated that students' prior academic performance was significantly associated with both of the students' homework variables, with direct and indirect results linking achievement and homework behaviors with perceived parental control and support behaviors about homework. Low-achieving students, in particular, perceived more parental control of homework in the secondary grades. These results, together with those of previous research, suggest a recursive relationship between secondary school students' achievement and their perceptions of parental involvement in homework, which represents the process of student learning and family engagement over time. Study limitations and educational implications are discussed.
Collapse
Affiliation(s)
- José C Núñez
- Department of Psychology, University of OviedoOviedo, Spain
| | - Joyce L Epstein
- Center on School, Family and Community Partnerships, Johns Hopkins University, BaltimoreMD, United States
| | - Natalia Suárez
- Department of Psychology, University of OviedoOviedo, Spain
| | - Pedro Rosário
- Departamento de Psicologia Aplicada, Universidade do MinhoBraga, Portugal
| | | | - Antonio Valle
- Department of Developmental and Educational Psychology, University of A CoruñaCorunna, Spain
| |
Collapse
|
21
|
Carr TF, Bleecker E. Asthma heterogeneity and severity. World Allergy Organ J 2016; 9:41. [PMID: 27980705 PMCID: PMC5129643 DOI: 10.1186/s40413-016-0131-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 11/22/2016] [Indexed: 02/06/2023] Open
Abstract
Asthma is a common, chronic inflammatory airways disease characterized by a clinical syndrome of bronchial hyperresponsiveness, inflammation, and reversible airflow obstruction. Individuals with asthma can vary widely in clinical presentation, severity, and pathobiology. The incident factors, pathogenesis, prognosis, and treatment of asthma remain incompletely understood. Utilizing measurable characteristics of asthmatic patients, including demographic, physiologic, and biologic markers, can however identify meaningful phenotypic categories in asthma. Identification of these phenotypes may help improve precision therapeutics targeted toward an individual’s’ disease, and may identify strategies for preventing progression of disease severity.
Collapse
Affiliation(s)
- Tara F Carr
- Asthma and Airway Disease Research Center, University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85724-5030 USA
| | - Eugene Bleecker
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC USA
| |
Collapse
|