Asthma is a chronic respiratory illness where the airway occasionally constricts, becomes inflamed, and is lined with excessive amounts of mucus. There are many lipid mediators involved in this inflammatory response. Hepoxilins are biologically active hydroxyepoxy eicosatrienoic acid metabolites of arachidonic acid, formed through the 12-lipoxygenase pathway. Our goal in this study was to identify if hepoxilins had a direct effect on smooth muscle contractions, to identify the source of hepoxilins in asthmatic-like mouse model, and to determine if blocking this pathway reduced inflammation associated with ovalbumin sensitization. We found that hepoxilins had no direct effect on smooth muscle contraction. We identified the bronchiolar epithelium as a major source of hepoxilins in OVA-challenged mice. We demonstrated that baicalein inhibits total lung resistance in the OVA-treated mice, but also found that the drug in-vivo is not specific for 12-lipoxygenase.

TLRs play a key role in initiating innate immunity and in regulating the nature of the adaptive immune response. We hypothesized that functional responsiveness to TLR stimulation differs in clinically; environmentally; ethnically distinct pediatric populations. PBMC obtained from 272 children were stimulated with a panel of TLR ligands. Levels of pro- and anti-inflammatory, Th1-, Th2-associated cytokines were quantified by ELISA. We demonstrate that use of threshold concentrations of TLR4 and TLR2 ligands reveal striking differences in cytokine responses between asthmatic and non-atopic children. Specifically, non-atopic controls produce higher levels of pro-inflammatory cytokines, whereas asthmatics exhibit increased anti-inflammatory IL-10 responses. Asthmatic children exposed to environmental tobacco smoke (ETS) demonstrated elevated levels of chemokines relative to non-ETS exposed asthmatics and controls. First Nation children favor anti-inflammatory IL-10 responses, whereas Caucasian population respond to TLR activation by production of more robust pro-inflammatory and Th1 biased cytokine and chemokine responses. / October 2007

The purposes of this study are to examine the relationship of self-efficacy regarding self-management of asthma and student self-management knowledge and also examine the extent to which self-efficacy and self-management knowledge predicts student outcomes such as reading grades, the number of times a student was absent and the number of visits a student made to the school nurse. Students were sampled from one public school district within a suburban city in the southwest portion of the United States. The sample was comprised of 33 males and 12 females ranging in age from six to eleven years of age. Three data collection instruments were developed for this study. Parents of the participants were asked to fill out a demographic survey to provide descriptive data. Participants of the study were administered two face-to-face interview surveys: The Asthma Student Self-Management Knowledge in a School Setting Survey (SMS) and the Asthma Self-Efficacy of Self-Management of Asthma Survey (AMES). Both surveys were developed based on the six lesson topics of Open Airways. Two separate data analyses were conducted based on the data collected from each participant. To better understand the relationship between the AMES and the SMS, a Pearson Product Moment Correlation Coefficient was used in the regression analysis. The findings showed that there was a statistically significant positive relationship between the SMS and the AMES. To determine if the AMES and the SMS could predict reading grades, the number of times a student was absent and the number of visits a student made to the school nurse, a multiple linear regression was used. The findings showed that there is minimal evidence showing that only reading scores maybe predicted by asthma self-efficacy and asthma self-management knowledge. Taking into account identified limitations such as not taking into account the severity of the participant??s asthma, one would be cautious to generalize these findings to other children with asthma. Based on these results and limitations, recommendations for future practice and for future research are provided.

Background Children with asthma usually use more medical resources than those without asthma. However, studies on the relationship between ratios of asthma-related complications and consumption of medical resources are rare. Methods We sampled data from ¡§Registry for beneficiaries¡¨ of ¡§National Health Insurance Research Database¡¨, National Health Insurance Institute, 2004. The target group was patients, aged between 1 and 18 years old, whose main diagnosis number from outpatient department (ICD-9-CM) is 493. Ratios of asthma-related complications and consumption of medical costs and resources were submitted to statistical analysis. Results Data of 394197 outpatients, of whom 62.5% are males, were included. Among the entire sample, 7627 children have asthma. Children with asthma are 8.2 times likely to get allergic rhinitis than those without asthma. Children with asthma are 2.1 times likely to get atopic dermatitis, 1.3 times likely to get otitis media, 1.5 times likely to get sinusitis than those without asthma. With regard to average expenditure on medical treatment, that of children with asthma is higher than that of children without asthma. Expenditures on medical treatment are compared among four divided groups. Children without asthma or complications ( NT$ 3714 ¡Ó 24538 ) , Children without asthma having complications ( NT$ 6448 ¡Ó 8880 ) , children with asthma not having complications ( NT$ 7396 ¡Ó 6434 ) , children with asthma having complications ( NT$ 12708 ¡Ó 10585 ) . Results of expenditures on medical treatment among these four divided groups show statistically significant. Seventy % of medical resources utilized are pediatrics, 40% are clinics, 50% are in the northern area. Conclusion Ratio of comorbidities of children with asthma is obviously higher than that of children without asthma. With regard to medical costs, that of children with asthma having comorbidities is higher than that of children with asthma not having comorbidities. Therefore, local pediatricians have an important role in the care of children with asthma.

Thesis (Ph. D.)--University of Missouri--Columbia, 2001. / Typescript. Vita. Includes bibliographical references (leaves 163-171). Also available on the Internet.

Thesis (M.A.)--West Virginia University, 2003. / Title from document title page. Document formatted into pages; contains vii, 57 p. Includes abstract. Includes bibliographical references (p. 39-45).

published_or_final_version / Community Medicine / Master / Master of Public Health

Asthma is a chronic inflammatory disease causing bronchospasm, which leads to the sensation of shortness of breath. Children with asthma are often afraid of exercise because the exercise induced exacerbation which gives children a sense of breathlessness. As a result, they usually have a sedentary lifestyle that decreases their physical fitness. However, there is evidence supporting the claim that exercises do not induce exacerbation, and exercise should be encouraged to asthmatic children to improve their physical fitness. In Hong Kong, protocol for exercise training with asthmatic children is limited. This is unfortunate because recent studies have shown that exercise training has improved the physical fitness of asthmatic children. This present studies used databases included PubMed (from 1950 to 2012), Ovid MEDLINE® (from 1950 to 2012), CINAHL (from 1982 to 2012), and ProQuest (from 1999 to 2012), to identify significant research on the topic. Eight studies, including seven RCTs and one cohort study, were chosen for in depth review. They were all good quality studies with satisfactory results that identified improvement in physical fitness for mild to moderate asthmatic children after exercise training. This present studies proposed an exercise training program for a pediatric ward in a public hospital in Hong Kong. The target population is children, aged 7 to 17, who suffer from mild to moderate asthma. They will enroll in an exercise training program to perform cycling in a clinical setting three times per week. The program will be sustained for nine weeks. The participants will undergo the innovation under the supervision of trained nurses. Evidence-based protocol is developed for the innovation to guide nurses on how to carry out the exercise training effectively and smoothly. The Scottish Intercollegiate Guidelines Network (SIGN) grading system is adopted to measure the levels of evidence and grading of the recommendations in the protocol. A communication plan will be developed to gain support from the identified stakeholders. A pilot study plan will be established in order to determine the feasibility of the proposed innovation. The exercise stress test, which is the primary outcome of the innovation, will be measured in the pilot study. Knowledge, job satisfaction, and confidence level of staff will be evaluated. The effectiveness of the innovation will be evaluated based improvements as measured by lung function, exercise stress and quality of life of the asthmatic children after exercise training. It will also consider nurse competency in carrying out the exercise training program. In the pediatric ward of a public hospital, mild to moderate asthmatic children are going to perform cycling under close monitoring and supervision. The proposed clinical setting for exercise program is intentional. Its relax atmosphere may encourage asthmatic children to do more exercises even after the training program. The researcher identifies transferable elements in the innovation, including characteristics of the patients, staff, setting and philosophy of care. The feasibility of the program is evaluated according to the culture and resource environment. The cost effectiveness is considered and it factors in the benefits of the innovation physically and psychologically. In order to implement this program successfully, a well-designed and planned protocol is proposed. The innovation is designed to be effective in improving the physical and psychological fitness of asthmatic children. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Introduction Due to its widespread use, toxicity and volatility, exposure to the chemical formaldehyde has important implications for human health. Asthma is a common chronic inflammatory disease with both genetic and environmental factors. The common symptoms of asthma include wheezing, coughing, and shortness of breath. The objective of the present study is to evaluate the association between exposure to formaldehyde and adult asthma through systematic review. Methods A literature search was conducted using PubMed with keywords of formaldehyde, adult asthma, and other relevant terms. The basic exclusion and inclusion criteria in this study are as follows: Original randomized controlled trials (RCTs) and observational studies were eligible, but not editorials, reviews, case-reports and case‐series. Studies that focused on behavioral change or other outcomes unrelated to asthma were excluded. Lastly, articles in which full text was unavailable were excluded. Finally, after 3 selection rounds, 7 studies were included in the present systematic review. Results: These 7 studies included 3 RCTs, 2 case‐control studies and 2 cross‐sectional studies, published from 1986 to 2013. The 3 RCTs examined participants with and without asthma and investigated the acute effects of formaldehyde on respiratory phenotypes; in contrast, the 4 observational studies examined the long‐term effects of low dose formaldehyde exposure on asthma. Only 1 RCT reported a strong association between formaldehyde and adult asthma, with the intervention group developed an immediate bronchial response at a significantly lower dose of mite allergen than that of the control group with air exposure. The other 2 RCTs found no significant deleterious effect on airway allergen responses after exposure to 500 μg/m3 formaldehyde; and the concentration of formaldehyde found in the indoor environment was of minor importance for developing pulmonary symptoms. Two case-control studies reported a positive association between formaldehyde exposure and asthma symptoms, while the results in the cross‐sectional studies suggested no significant association between formaldehyde exposure and adult asthma. Conclusions Among the 3 reviewed RCTs, only 1 reported a significant association between formaldehyde and asthma. In the 4 reviewed case‐control and cross‐sectional studies, 2 suggested that exposure to formaldehyde had significant effects on bronchial responses. However, these studies represented different characteristics, hence, after integration of them, this review suggests that exposure to formaldehyde in relative low concentration may not have strong association with adult asthma. However, further studies are required to A: Try to identify more potential confounders and choose most suitable model in various conditions; B: investigate multiple patterns of formaldehyde exposure and provide different outcome measurements in RCTs. In addition, this report indicates that it is important to increase the population awareness of choosing environmental friendly decoration materials for reducing formaldehyde exposure. / published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences