Objectives : To investigate the impacts of traffic related air pollution (TRAP) on children’s respiratory health, and to investigate the policies and regulations implemented in other countries and the suggestions from the World Health Organization (WHO) to tackle this problem. Methods and Results: Using relevant keywords, 122 articles were acquired from PubMed and 15 were from MEDLINE via EBSCO host respectively. The articles were published between 1980 to 2013; all of which had examined the impacts of TRAP on children’s respiratory health. After assessing inclusion and exclusion criteria, 9 articles were finally included in this systematic review. Differences in demographic characteristics were studied and compared to determine the association between TRAP exposure and respiratory health impacts on children aged between 1 and 18. Four cross-section surveys and five cohort studies were selected in this review. The association between TRAP exposure and differences in children’s respiratory impacts were demonstrated in all studies. Multiple outcome measures were used to examine changes of children’s respiratory health such as the decline in lung function, incidences of asthma and inflammatory responses. There were 4 out of 9 articles suggesting the decline in lung function was related to TRAP exposure; 5 out of 9 articles showed the relationships between incidences of asthma and inflammatory responses and TRAP exposure and 2 articles mentioned other respiratory symptoms; notably, wheezing and sneezing, runny and stuffed nose. This review finally summarized the results of selected articles stressing that children who lived close to roadway within a 500 meter radius from home, with an early exposure to air pollution in the first year of age and a frequent exposure to heavy road traffic and outdoor air pollutants would experience greater impacts on respiratory health. Conclusion: The positive association between the impacts on children’s respiratory health and TRAP exposure has been determined through this systematic review. Stricter emission control strategies and updated guidelines are required to regulate traffic emission and improve air quality in order to reduce harm and provide a better living environment for our next generations. / published_or_final_version / Public Health / Master / Master of Public Health

No description available.

The purpose of this study was to identify the complete scope, cognitive, affective and psychomotor, of clinical competencies required for the successful practice by entry-level associate degree respiratory care graduates entering the workforce. The study was conducted using a Delphi technique. American Association for Respiratory Care House of Delegates nominated a panel of experts to participate in the study. A total of 55 individuals were nominated and 21 agree to participate in the study. The individuals represented both college-based educators and hospital managers and educators. The initial questionnaire requested that each panel member list those cognitive, affective and psychomotor clinical competencies that they believed to be required for successful entrylevel practice. The responses from the first round were grouped into like categories and returned to the panel members to be rated on a four-point scale during the second and third rounds of the study. Consensus was achieved with the third round resulting in a final list of 26 cognitive, 20 affective and 28 psychomotor clinical competencies. The final list of competencies includes the most basic cognitive and psychomotor skills of the profession and did not include many of the areas listed by the National Board for Respiratory Care exam matrix. The study also lists 20 affective attributes as essential for successful practice. There are no current standardized methods in use to evaluate affective skills. Research will need to continue to clarify the skills needed for competent and successful entry-level practice. / Department of Educational Studies

Respiratory infection remains a leading cause of morbidity and death in severely immunocompromised febrile neutropenic haematology patients, despite the introduction of numerous prophylactic strategies and advances in diagnosis and treatment. Prognosis is improved if an organism can be isolated and specific therapy commenced as soon as possible. Current practice in this population group is to commence empirical antibiotics and perform flexible bronchoscopy (FB) if temperature does not settle or after patients develop clinical or radiological features suggesting a respiratory source. This delay may result in a lower procedural diagnostic yield due to prior or prolonged anti-microbial treatment, and increased risk of respiratory compromise and procedural complications due to advanced respiratory infections. We hypothesised that proceeding to FB as early as possible after developing febrile neutropenia would improve treatment outcomes. With this randomised, prospective trial, we aim to further define the role of FB with reference to optimal timing of the procedure and its impact on diagnostic yield, future management and complication rate. We also aim to analyse the impact of proven infection on the cytokine profile of immunocompromised patients. Methods: Patients with acute leukaemia, allogeneic bone marrow transplantation or chronic lymphocytic leukaemia (CLL) being treated with Fludarabine/ Mabthera without an obvious non-respiratory source of infection were prospectively randomised into early bronchoscopy or conventional management groups at onset of febrile neutropenia. Bronchoalveolar lavage (BAL) fluid chemokine levels (IP-10, RANTES, MIG, IL-8, MCP-1) were measured using a human Chemokine cytometric bead array (CBA) kit. Results: Thirty-one episodes of febrile neutropenia in 29 patients were analysed; 17 conventional and 14 early. There was an increased yield in fungal growth in the early bronchoscopy group, which was not predicted by prior clinical or radiological changes. However, this had no impact on clinical management in the short-term due to the delayed growth. Overall diagnostic yield was not significantly different between the two groups. Procedural complication rate was negligible overall and there was no difference associated with either group. IP-10 and MIG were significantly lower in those patients who had a fungal pathogen isolated, compared with those study patients who did not (175.17 vs 1157.8, p=0.03, 30.33 vs 247.8, p=0.03 respectively). IP-10 levels were higher in the conventional than early group (1253.0 vs 261.14, p = 0.035) and the study population had higher MCP-1 (734 vs 2.83, p=0.006) and IL-8 levels (606.9 vs 14.25, p=0.00655) than normal controls. Those cases with fungal infection had higher mean MCP-1, RANTES and IL-8 levels than in normal controls (844.0 vs 2.83, p=0.007; 17.5 vs 2.1, p=0.03; 156.0 vs 14.25, p=0.004). Conclusions: Early bronchoscopy as a component of the septic screen in febrile neutropenic patients was feasible and safe. A significant difference in fungal yield was seen in the early bronchoscopy group compared to conventional methods, with a negligible complication rate, but this did not result in a change in immediate clinical management or outcomes. / Thesis (M.Clin.Sc.) - University of Adelaide, School of Medicine, 2009

published_or_final_version / Geography / Master / Master of Philosophy

Bibliography: leaves 107-119.

Bibliography: leaves 107-119 / viii, 149 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D.)--University of Adelaide, Dept. of Community Medicine, 1987

Thesis (MSc) -- Stellenbosch University, 1995. / ENGLISH ABSTRACT: The aim of this study was to investigate the influence of the allergic reaction on the respiratory system. The influence of parasite infestation (with specific reference to the roundworm, Ascaris lumbricoides) on the normal functioning of the respiratory system was also investigated. Firstly a pilot study was done to determine the normal immunoglobulin E (IgE) levels of coloured newborns in the Western Cape. The cord blood IgE values of a group of coloured newborns were determined by using the RIA technique. Although a mean value was reached, it is important for more controlled studies, that would take into account a variety of factors, to be done before determining separate reference values for this population. The levels of one of the most important effector cells in the allergic reaction, namely eosinphils, were determined in a group of asthma patients by using the counting chamber method. In all the cases the eosinophil levels were elevated The influence of Ascaris lumbricoides on the respiratory system was investigated from two different points of view, namely the possible allergic reactions it could induce in the host and secondly by determing the influence of this parasite on one of the parametres of the respiratory system, namely the peak expiratory flow (PEF) values. In the first case the presence of specific Ascaris allergens in a group of asthma patients was determined by using the RAST technique. The incidence of these specific allergens was however not high. Secondly the PEF values of two groups (the one group was infested with the roundworm and the other not) were compared. Wet stool mounts were investigated under a light microscope to identy parasite ova. There was however no significant difference in PEF values between these two groups. This study underlines the complex interaction between parasites and the respiratory system. Further studies in this regard are needed in order to fully understand the nature of this interaction. / AFRIKAANSE OPSOMMING: Die doel van hierdie studie was om ondersoek in te stel na die invloed wat die allergiese reaksie uitoefen op die respiratoriese sisteem. Daar is verder ook aandag gegee aan die uitwerking van parasiet infestasies (met spesifieke verwysing na die rondewurm, Ascaris lumbricoides) op die normale funksionering van die respiratoriese sisteem. 'n Loodsstudie is eerstens uitgevoer ten einde normale immunoglobulien E (IgE) vlakke vir Kleurling pasgeborenes te bepaal. lgE bepalings is gedoen op die nawelstring bloed van 'n groep Kleurling babas in die Wes-Kaap. Die RIA tegniek is vir hierdie doel gebruik. Hoewel 'n gemiddelde waarde verkry is, is dit egter noodsaaklik dat meer gekontrolleerde studies wat 'n wye verskeidenheid van faktore in ag neem, uitgevoer sal moet word alvorens aparte verwysingswaardes vir hierdie bevolkingsgroep saamgestel kan word. Die voorkoms van een van die belangrikste effektor selle in die allergiese reaksie, naamlik eosinofiele, is bepaal in die bloed van 'n groep asma pasiente. Die eosinofiele is getel deur gebruik te maak van die telkamer metode. In al die gevalle was die eosinofiel vlakke verhoog. Die invloed van Ascaris lumbricoides op die respiratoriese sisteem is vanuit twee oogpunte ondersoek, naamlik die uitlokking van 'n allergiese respons in ~ie gasheer en die invloed van hierdie parasiet op een van die parameters van longfunksie, naamlik "peak expiratory flow" (PEF) vlakke. In die eerste geval is die mate van teenwoordigheid van Ascaris allergene in 'n groep asma pasiente bepaal deur gebruik te maak van die RAST tegniek. Die insidensie van allergie teen hierdie allergene was egter nie hoog nie. Tweedens is die PEF waardes van twee groepe proefpersone (die een groep gei:nfesteer met Ascaris lumbricoides en die ander groep nie) met mekaar vergelyk. Daar was egter nie 'n beduidende verskil tussen die waardes van die twee groepe nie. Parasiet ova is gei:dentifiseer deur die maak van eenvoudige nat stoelgang smere en die ondersoek daarvan onder 'n ligmiroskoop. In hierdie studie word die komplekse aard van die interaksie tussen parasiete en die respiratoriese sisteem duidelik na vore gebring. Verdere studies is nodig ten einde die verband tussen hierdie twee faktore te bepaal. / SNO and Stellenbosch 2000 scholarship

published_or_final_version / Microbiology / Doctoral / Doctor of Philosophy

Ren-Wang Jiang. / "July 2002." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references. / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.