Thesis (M.P.H.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 90-95).

Thesis (Ph.D.) - University of Queensland, 2006. / Includes bibliography.

Thesis (M.S.)--University of Wyoming, 2009. / Title from PDF title page (viewed on Apr. 15, 2010). Includes bibliographical references (p. 42-45).

published_or_final_version / Medicine / Master / Master of Public Health

Nasal AEC cultures were established from children (0.6-14.9 years) undergoing elective surgical procedures under general anaesthetic, categorised as atopic asthmatics (n=12), virus-induced wheezers (n=8) or healthy controls (n=32) using questionnaire and serum IgE levels. All subjects were free of current respiratory symptoms. Successful AEC cultures were maintained to passage 2 or 41 (79%) subjects. AEC from children with a history of wheeze produced significantly less IL-8, IL-6, MCP-1 and G-CSF than AEC from healthy controls. When the wheezing phenotypes were considered separately, AEC from atopic asthmatic children released significantly less IL-8, IL-6, MCP-1 and G-CSF than AEC from controls but there were no significant differences between AEC mediator release from children with virus-induced wheeze and either atopic asthmatics or controls. Similar results were found for cytokine-stimulated AEC. In non-wheezy subjects, there were no differences in AEC mediator release between atopic and non-atopic individuals. There were no differences between the study groups in the percentage increments in mediator release in response to stimulation. In multivariate analysis, taking into account age, gender, passive smoke exposure, use of inhaled corticosteroids, total serum IgE and specific responses to inhaled aeroallergens as possible confounders, wheeze was the only significant predictor of AEC mediator release. It was concluded that there are intrinsic differences in AEC from children with a history of wheeze compared to healthy controls and these are independent of atopic status. This study provides further evidence that the airway epithelium is implicated in the pathogenesis of childhood wheezing. It is hypothesised that different systemic factors, such as atopy and viral responsiveness, interact with common epithelial abnormalities to give rise to different wheezing phenotypes. Further work is required to establish whether these abnormalities are primary or secondary and to confirm these findings in well-differentiated AEC cultured with an air-liquid interface.

Objective: Acute lower respiratory infection (ALRI) is the leading cause of mortality in pediatric group all around the world. Vitamin D has been demonstrated to play a possible role in the prevention of ALRI in children because of its physiological importance in the immune system. This systematic review aims to explore the protective role of vitamin D on ALRIs among children and its preventive effectiveness by synthesizing RCTs. And the other objective is to determine dosage of vitamin D with the best effect by investigating the association of different level of vitamin D supplementation with risk of ALRIs. Methods: Studies were searched through three databases PubMed, ISI Web of Knowledge and Cochran Central Register of Controlled Trials and Cochran Library databases among publication from April2003 to April 2013 with a combination of key terms. Inclusion and exclusion criteria were used to select studies. And then CONSORT guideline and JADAD scale were used to assess quality of these studies. Data on outcome measurements including health outcomes (e.g. incidence of pneumonia and influenza A, duration of recovery of pneumonia and bronchiolitis, the risk of relapse of pneumonia, the number of parent-reported ARIs); and surrogate outcomes (e.g. measuring scores of ATAQ test) were extracted and tabulated. The association with vitamin D level of risk of ALRIs were explored as well. Results: Eight RCTs were found to be relevant and adopted in this systematic review of the 796 identified articles in English or Chinese. The findings were mixed, but most studies suggested vitamin D supplementation reduced risk or illness duration of ALRIs significantly among children with different levels of vitamin D deficiency. Four studies suggested statistically significant risk reduction on incidence of repeat pneumonia (by29%, 95%CI 6% to 46%), parent-reported ARIs (by 48%, 95%CI 11% to 69), influenza A (by 42%, 95%CI 1% to 66%), and asthma exacerbation triggered by ALRIs (P= 0.029), while one study showed an insignificant outcome. For recovery events and hospitalization of ALRIs, three studies suggested statistically significant reduction on recovery time from pneumonia (P= 0.008), severe asthma (P= 0.004) and bronchiolitis (P< 0.05), and two studies suggested significant decrease on duration of hospitalization for bronchiolitis (P< 0.05) and pneumonia (P= 0.005). The increasing changes in serum 25(OH)D were consistent with the significant difference of ALRIs events between intervention and control groups. Conclusion: Overall, the evidence is insufficient to conclude that vitamin D supplementation is beneficial to all kinds of children in preventing or assistant treating ALRIs. More number of high quality, large scale and unbiased RCTs should be conducted to confirm the effectiveness of vitamin D among children in Hong Kong and different areas in mainland China. / published_or_final_version / Public Health / Master / Master of Public Health

Thesis (Ph.D.)--Aberdeen University, 2008. / Title from web page (viewed on June 11, 2009). Includes bibliographical references.

Thesis (D.P.H.)--University of Michigan.

Dissertation (D.P.H.)--University of Michigan.

Thesis (Ph.D.)--University of Alberta, 2010. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Medical Sciences - Pediatrics. Title from pdf file main screen (viewed on January 24, 2010). Includes bibliographical references.