Medicine and Health Sciences Commons^™

Disparities In Administrative Pediatric Asthma Prevalence In Clark County, Aaliyah Goodie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Asthma is one of the most common chronic diseases affecting young children nationally and globally. Asthma affects more than 25 million people in the nation, of which 6

million are children. Lifetime asthma prevalence for children in Nevada is 11.5% (CDC, 2016). This is likely an underestimate due to a large undocumented Hispanic population. In Clark County School District (CCSD) during the 2016-2017 school year, 20,235 students (8%) listed asthma in school records as a health concern. Asthma burden varies by sociodemographic group with highest rates documented among Black/African American, Hispanic/Latino, and pediatric populations. The Centers for Disease Control …

Using Syndromic Surveillance To Assess The Impact Of Environmental Factors On Asthma- And Copd- Related Ed Visits In Douglas County, Nebraska, Sandra Gonzalez-Ramirez, Anne Mardis O'Keefe, Tricia D. Levan, Lynette Smith

Capstone Experience

Background: Asthma and chronic obstructive pulmonary disease (COPD) are chronic diseases associated with health disparities in Douglas County, Nebraska and in the United States. Currently there is a lack of information describing the impact of environmental factors in Nebraska on the burden of emergency department (ED) visits or hospitalizations related to these chronic respiratory (CR) diseases. The aim of this study was to determine if there is an association between the numbers of seasonal viral respiratory (SVR)- related ED visits, outdoor air pollutants, aeroallergens, or meteorological factors on the number of CR- related ED visits in Douglas County, Nebraska.

Methods: …

Improving Residential Asthma Assessment Strategies Within A Low Socioeconomic Community, Monica Ramirez

Doctor of Nursing Practice

Background: Nationally, there are currently 6 million children under the age of 18 with asthma. There are a variety of social determinants and in-home environmental triggers that can contribute to the development of or exacerbation of asthma in children. Therefore, it is important to recognize and improve the needs of children with asthma in older homes and in households with a lower socioeconomic status.

Aim: The aim of this project was to decrease the number of in-home environmental asthma triggers within at-risk homes in San Antonio, Texas.

Purpose: The purpose of this evidence-based practice project was to improve asthma outcomes …

Budesonide Enhances Agonist-Induced Bronchodilation In Human Small Airways By Increasing Camp Production In Airway Smooth Muscle, Cynthia J. Koziol-White, Timothy B. Johnstone, Maia L. Corpuz, Gaoyuan Cao, Sarah Orfanos, Vishal Parikh, Brian Deeney, Omar Tliba, Rennolds S. Ostrom, Ian Dainty, Reynold A. Panettieri Jr.

Pharmacy Faculty Articles and Research

The non-genomic mechanisms by which glucocorticoids modulate β₂ agonist-induced-bronchodilation remain elusive. Our studies aimed to elucidate mechanisms mediating the beneficial effects of glucocorticoids on agonist-induced bronchodilation. Utilizing human precision cut lung slices (hPCLS), we measured bronchodilation to formoterol, prostaglandin E₂ (PGE₂), cholera toxin (CTX) or forskolin in the presence and absence of budesonide. Using cultured human airway smooth muscle (HASM), intracellular cAMP was measured in live cells following exposure to formoterol, PGE₂, or forskolin in the presence or absence of budesonide. We showed that simultaneous budesonide administration amplified formoterol-induced bronchodilation and attenuated agonist-induced phosphorylation …

Hospital Readmissions For Childhood Asthma: The Role Of Individual And Neighborhood Factors., Sze Yan Liu, Deborah Pearlman

Sze Yan Liu

Objectives

This study used a Cox proportional hazards model to determine whether neighborhood characteristics are associated with risk of readmission for childhood asthma independently of individual characteristics.

Methods

Rhode Island Hospital Discharge Data from 2001 to 2005 were used to identify children younger than 19 years of age at the time of the index (i.e., first) asthma admission, defined as a primary diagnosis of asthma or a primary diagnosis of respiratory illness with a secondary or tertiary diagnosis of asthma (n=2,919). Hazard ratios of repeat hospitalizations for childhood asthma from 2001 to 2005 were estimated, controlling for individual- …

Keep The Cat, Change The Care Pathway: A Transformational Approach To Managing Fel D 1, The Major Cat Allergen, Ebenezer Satyaraj, Harold James Wedner, Jean Bousquet

2010-2019 OA Pubs

BACKGROUND: Allergies to cats are the most common animal-origin allergy, and affect approximately 1 in 5 adults worldwide. The prevalence of allergy to furry animals has been increasing, and allergy to cats is a major risk factor for the development of asthma and rhinitis. The diagnosis of cat allergy is now well established. The exact significance of component-resolved diagnosis in the diagnosis of cat allergy remains to be fully understood. Allergen avoidance is effective but often has a psychologic impact. Allergen immunotherapy is not well demonstrated. There is a need for innovative approaches to better manage cat allergens. Next-generation care …

Improving Housing Quality To Reduce Asthma Rates And Healthcare Costs In Athens-Clarke County, Ga, Samantha J. Harris, John M. Johnston, Maria Bowie, Grace Bagwell Adams

Journal of the Georgia Public Health Association

Background: Asthma is a chronic respiratory condition that often develops from controllable environmental factors, such as poor air quality. Our study examined the relationship between mold in the home, which compromises indoor air quality, and asthma prevalence in Athens-Clarke County (ACC), Georgia.

Methods: Data from the Athens Wellbeing Project’s 2016 survey of 1,354 households in ACC was employed to examine indoor air quality and asthma prevalence in ACC. We provided descriptive statistics to examine asthma prevalence and asthma predictors, including the proportion of respondents reporting mold and pest problems, smoking prevalence, and the proportion of households reporting clinical obesity. We …

Urban Air Quality, Spring/Summer 2002, Issue 6

Sustain Magazine

No abstract provided.

Study Of Cd14+ And Cd16+ Peripheral Blood Monocytes In Asthmatic Patients, Ahmed A. Sonbol, Laila M. Montaser, Mohammed A. Agha, Mona A. Ibrahim

Menoufia Medical Journal

Objective This study aimed to investigate the enhanced frequencies of CD14⁺⁺ CD16 + peripheral blood monocytes in asthmatic patients. Background CD16 + monocytes are increased in inflammatory conditions. It was reported that CD16 + monocytes can be divided into two subsets with different potential of modulating inflammatory responses: CD14⁺⁺ CD16 + and CD14 + CD16 + monocytes. CD14⁺⁺ CD16 + and CD14 + CD16 + monocyte subsets are quantified in asthmatic patients regarding severity of disease and glucocorticoids treatment options. Patients and methods CD14⁺⁺ CD16 + was examined in 20 cases of completely controlled asthma, 20 …

Gestational Weight Gain, Offspring Asthma And Wheeze Phenotypes In Project Viva, Kathryn Wagner

Masters Theses

In the US, 8.4% of children are diagnosed with asthma by age 18, making asthma one of the most common chronic conditions among children. Additionally, 25% of children experience persistent wheezing by age 6, an indicator of childhood asthma. Both childhood asthma and persistent wheezing may be linked to inflammatory and immune mechanisms, which are associated with inadequate and excessive gestational weight gain. Studies investigating the relationship between gestational weight gain and offspring asthma and wheeze phenotypes are limited by self-reported gestational weight gain, early age at asthma and wheeze assessments, limited adjustment for potential confounders and no trimester-specific evaluations. …

The Role Of Diagnostic Bronchoscopy In Refractory Asthma Management, Christopher Mcgrath, Md, Tuhina Raman, Md, Jessica Most, Md

Division of Pulmonary and Critical Care Medicine Posters

Refractory asthma is an uncommon entity, manifesting in less than five percent of asthmatics and characterized by high medication requirements, persistent symptoms, frequent exacerbations, and significant airflow obstruction despite standard medical therapy.[1] Bronchoscopy may be an effective tool for identifying refractory asthma phenotypes.[3] The objective of this case series is to demonstrate the use of bronchoscopy to personalize treatment among a population of refractory asthmatics.

Seasonal And Diurnal Patterns Of Pollens And Their Relations With Asthma And Allergies, Jeremy Rivera Sánchez, Benjamin Bolaños Rosero, Phd

Journal of Health Disparities Research and Practice

According to the CDC, 22.4% of the population in Puerto Rico suffers from asthma, increasing in children to a 25.3%. Allergic asthma is a respiratory condition caused by allergens such as mite- dust, fungal spores, and pollen. Asthma symptoms can include lack of air and chronic cough. Biological airborne particles may produce proteins with allergenic potential that at high levels may trigger asthma in susceptible individuals.

To determine the role of tree pollen in asthma, we analyzed the daily data collected from 2015 to 2017 with a Burkard volumetric air sampler located 73 meters above sea level at the San …

Hyperpolarized Helium 3 Mri In Mild-To-Moderate Asthma: Prediction Of Postbronchodilator Reversibility, Rachel L Eddy, Sarah Svenningsen, Christopher Licskai, David G Mccormack, Grace Parraga

Medical Biophysics Publications

Background: Longitudinal progression to irreversible airflow limitation occurs in approximately 10% of patients with asthma, but it is difficult to identify patients who are at risk for this transition.

Purpose: To investigate 6-year longitudinal changes in hyperpolarized helium 3 (3He) MRI ventilation defects in study participants with mild-to-moderate asthma and identify predictors of longitudinal changes in postbronchodilator forced expiratory volume in 1 second (FEV1) reversibility

Materials and Methods: Spirometry and hyperpolarized 3He MRI were evaluated in participants with mild-to-moderate asthma in two prospectively planned visits approximately 6 years apart. Participants underwent methacholine challenge at baseline (January 2010 to April 2011) …

Activation Of Toll-Like Receptor 3 Translates To Long-Term Post-Viral Lung Disease, Xinyu Wang

Arts & Sciences Electronic Theses and Dissertations

Chronic obstructive lung disease (COPD) causes substantial human and economic costs both in the US and worldwide. To identify the molecular mechanisms to allow for targeted therapies for COPD, we developed a high-fidelity mouse model of chronic lung inflammation using the natural rodent pathogen Sendai virus (SeV). While nucleic acid-sensing pattern recognition receptors are important for innate immune responses to viral pathogens, there have been few studies investigating their role in the context of chronic disease. Here we show that Toll-like receptor 3 (Tlr3) signaling is required for the development of chronic lung disease in a postviral mouse model. Activation …

Understanding The Comorbidity Of Asthma And Anxiety In Childhood: Characteristics, Vulnerabilities, And Treatment Implications, Nicole Fleischer, Elizabeth Gosch, Phil Kendall

Research Day

Introduction: Given the high incidence of asthma and anxiety comorbidity, clinicians should be informed of the unique presentation of these clients in clinical practice. Although much is known about the development and characteristics of childhood anxiety, less is known about children with anxiety and comorbid asthma.

Methods: This study, using archival data, examined the potential differences in children with comorbid asthma and anxiety compared to children with anxiety from a random controlled trial. These two groups were compared on negative self-talk, number of physical symptoms, parent anxiety, content of their worries, and presence of panic, generalized anxiety, and …

Asthma Care In The Emergency Department And Urgent Care Center, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Clinical Practice Guidelines)

No abstract provided.

The Effects Of Implementing A Smartphone Application To Improve Asthma Self-Management In Adults, Lindsay J. Humpfer

Evidence-Based Practice Project Reports

Asthma is one of the most common chronic diseases, affecting 20.4 million adults in the United States (CDC, 2018). While asthma can generally be controlled, patients having an exacerbation may experience missed days of work and school, limitations in daily activities, decreased enjoyment of life, and decreased productivity at home, work, and school (MarcanoBelisario et al., 2013). Therefore, the purpose of this project was to improve patients’ overall asthma control and asthma-related quality of life by encouraging self-management through patient education and the implementation of a mobile smartphone application. A total of 26 adult primary care patients with asthma participated …

Acquiring Knowledge Prior To Diagnosis: A Grounded Theory Of Patients’ Experiences, Jennifer K. Roddis, Immy Holloway, Carol Bond, Kathleen T. Galvin

Patient Experience Journal

This research aimed to explore and explain how people make sense of long-term health conditions. Using purposive and theoretical sampling within a grounded theory design, experiences of thrombophilia and asthma were explored. The article focuses on information gained by patients before diagnosis and how this contributes to their understanding. The study adopted a constructivist grounded theory approach, generating a theory of how individuals adapt to their long-term condition. Ethical approval was sought from the NHS and the institution at which the research was conducted. Data were collected through semi-structured interviews, with sixteen participants who had provided informed consent. Individuals with …

Is There A Relationship Between Limited English Proficiency (Lep), Medication Adherence Behaviors, And Adverse Asthma Outcomes In Hispanic Adults With Moderate To Severe Persistent Asthma?, Archana Kartik Chandra

Doctoral Projects

The effects of LEP are well documented in the literature. LEP decreases medication adherence, causes ineffective communication between patients and providers, and reduces health outcomes. Asthma is known to be misdiagnosed and under-treated in Hispanic adults. There are discrepancies in the literature about the effects of LEP in Hispanic adults with persistent asthma.

The purpose of this study was to determine if the presence of LEP is associated with medication adherence behaviors and adverse asthma outcomes in Hispanic adults with moderate to severe persistent asthma. Hispanic adults with LEP were assessed for asthma outcomes and medication adherence behaviors.

The results …

Improving Communication Of Asthma Related Care Between Pediatric Primary Care Providers And Schools, Jessica N. Heichel

Doctoral Projects

Introduction: Asthma is a life-altering chronic disease that affects many children throughout the state of Michigan. Evidence-based guidelines recommend a written asthma action plan (AAP) be given to all caregivers of children with asthma. This would include schools, but the plans are not making it there. This project focused on collecting school asthma data and designing a process change at a local clinic to send the plans directly to the schools.

Objectives: The goal of this project was to improve communication between healthcare providers and schools for children with asthma. The objectives were to increase the percentage of children with …

Asthma-Related Health Outcomes In New Jersey After A Natural Disaster Event, My Ngoc Thuy Nguyen

Health Services Research Dissertations

The occurrence of a natural disaster event such as a hurricane may further hinder the asthma management of asthmatic individuals. Unmanaged asthma has led to increased work absenteeism, preventable emergency department visits, costly hospitalizations and possibly death in severe cases. To improve asthma management in asthmatic adults in New Jersey (NJ) following a natural disaster event, this study examined whether predisposing, enabling and need factors are predictors for asthma exacerbation and asthma-related health care utilization in New Jersey. A retrospective secondary analysis of New Jersey Behavioral Risk Factor Surveillance System (NJBRFSS) data and New Jersey Asthma Call Back Survey (NJACBS) …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

Ovalbumin-Sensitized Mice Have Altered Airway Inflammation To Agriculture Organic Dust, Kristi J. Warren, John D. Dickinson, Amy J. Nelson, Todd A. Wyatt, Debra J. Romberger, Jill A. Poole

Journal Articles: Internal Medicine

Agriculture exposures are associated with reducing the risk of allergy and asthma in early life; yet, repeated exposures later in life are associated with chronic bronchitis and obstructive pulmonary diseases. The objective of this study was to investigate the airway inflammatory response to organic dust extract (ODE) in mice with established ovalbumin (OVA)-induced experimental asthma. C57BL/6 mice were either OVA sensitized/aerosol-exposed or saline (Sal) sensitized/aerosol-challenged. Both groups were then subsequently challenged once with intranasal saline or swine confinement ODE to obtain 4 treatment groups of Sal-Sal, Sal-ODE, OVA-Sal, and OVA-ODE. Airway hyper-responsiveness (AHR) to methacholine, bronchiolar lavage fluid, lung tissues, …

Federal Weatherization And Health Education Team Up: Process Evaluation Of A New Strategy To Improve Health Equity For People With Asthma And Chronic Obstructive Pulmonary Disease, Rachael De Souza, Robin Evans-Agnew, Christine Espina

Nursing & Healthcare Leadership Publications

Unhealthy housing is a major cause of respiratory health inequity. In-home health education improves health equity for low-income and minority populations with asthma and chronic obstructive pulmonary disease. Yet, outcomes of educational interventions are limited by poor housing conditions. Federal weatherization programs represent a promising source of funding for home repairs. Innovative legislation in Washington State integrates the 2 interventions as "Weatherization Plus Health," offering environmental health education in partnership with the Weatherization Assistance Program for low-income families with respiratory disease. This practice brief describes process evaluation results of a Weatherization Plus Health program in Pierce County, Washington. Evaluation data …

Association Between Asthma And Dental Caries Amongst 12 - 15 Years Old Children: A School-Based Cross-Sectional Study In Karachi, Pakistan, Wajeeha Zahid, Shafquat Rozi, Farhan Raza Khan, Nida Zahid, Muhammad Masood Kadir

Community Health Sciences

Objective: The study aimed to determine an association between dental caries and asthma among 12 to 15 years old children.
Methods: This is a school-based cross-sectional study conducted from January to February 2016. A random sample of 544 children aged 12 - 15 years were enrolled from five private schools of Karachi. Dental caries was assessed using DMFT Index (Decayed, Missing, Filled teeth). The main exposure variable was asthma and information on it was collected through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire.
Results: The data was analyzed using Cox Proportional Hazard algorithm. Crude and adjusted …

Oscillometry And Pulmonary Magnetic Resonance Imaging In Asthma And Copd, Rachel L Eddy, Andrew Westcott, Geoffrey N Maksym, Grace Parraga, Ronald J Dandurand

Medical Biophysics Publications

Developed over six decades ago, pulmonary oscillometry has re-emerged as a noninvasive and effort-independent method for evaluating respiratory-system impedance in patients with obstructive lung disease. Here, we evaluated the relationships between hyperpolarized

A Community Outreach Project Addressing Mental Health, Obesity, And Asthma In Underserved Saint Paul Youth, Anna Ehnstrom, Ellie Hoopman, Caitlin Olson

All Electronic Theses and Dissertations

Due to a lack of resources, awareness, and reinforcement of information, underserved youth are predisposed to unique health concerns. The health disparities prevalent among children living in poverty are many, but the topics of focus for this community outreach project include mental health, obesity, and asthma. Supplemental health education curriculum has the potential to alleviate the health disparities prevalent among such a vulnerable population (Thomas & Aggleton, 2016). To address the health disparities present specifically among underserved youth in St. Paul, MN, the group partnered with the after-school tutoring program at Central Baptist Church to provide education on the topics …

Association Between Substandard Housing And Asthma In African-American Children, Sharmanita Davis

Walden Dissertations and Doctoral Studies

An improved understanding of the role of housing in asthma prevalence among African-American children is essential to addressing the issues associated with asthma and housing that perpetuate racial and ethnic health disparities. This study was conducted to examine the influence of substandard housing on the odds of asthma among low-income African-American children. The social ecological model was used as the theoretical framework for this study, that allowed consideration of the housing environment where African-American children live as an influential determinant of respiratory health. A cross-sectional research design using data obtained from the 2012 National Health Interview Survey and Comprehensive Housing …

Standardizing Asthma Management In Primary Care, Michael Vernon Chmielewski

Family Medicine Clerkship Student Projects

Asthma is a chronic, relapsing-remitting inflammatory airway disease that continues to increase in prevalence in the United States. When properly managed, patients with asthma experience less morbidity than those whose asthma is poorly controlled. Although the National Heart, Lung and Blood Institute (NHLBI) has published guidelines regarding the evidence-based diagnosis and management of asthma, many primary care practices do not fully utilize these best-practices. The purpose of this project was to develop a system of standardized protocols and a reference guide to promote adherence to evidence-based guidelines in asthma management for the Champlain Valley Physician’s Hospital Family Medicine residents and …

Spirometry In Primary Care, Megan Garrido

Family Medicine Clerkship Student Projects

Prevalence of COPD in the United States is rising, yet many people with Chronic Obstructive Pulmonary Disease (COPD) diagnoses do not have diagnoses. In Vermont 18% of adults are current smokers and 27% are former smokers. The lack of provider and nurse training regarding indications, mechanism, interpretation and benefit of spirometry have limited it's use. Spirometry is recommended for both asthma & COPD diagnoses and management, and may provide better disease management.