Spirometry 360 Flyer – Spring 2011 – FINAL

The module will be presented by two national experts: Sande Okelo, MD, Assistant Professor, Johns Hopkins Children’s Center and Lee Pachter, DO, Chief, General Pediatrics; Attending Physician, St. Christopher’s Hospital for Children.

There are two options for attending a study seminar session on Friday, October 8^th, one session will take place in Oakland/Berkeley from 11am-2pm and one session will take place in San Francisco from 6-9pm. Meals will be provided.  Space is limited and registration is required, registration materials will be available soon.  For more information, please call 1-866-913-8477 or e-mail: appuc@peds.ucsf.edu.

Regional Asthma Management and Prevention (RAMP) is a collaborative that promotes strategies for reducing asthma through a broad and comprehensive approach, which includes clinical management and environmental protection. RAMP brings together diverse partners such as public health and community-based organizations, schools, medical providers, and environmental health and justice groups to join forces in reducing the burden of asthma with a focus on communities inequitably affected by the disease.

INTERESTED IN PUBLIC POLICY? CLICK HERE TO LEARN ABOUT POLICIES RAMP
IS ACTIVELY SUPPORTING.

19 August 2010

FUNDING & POLICY UPDATES

Ramp Announces the 2010-2011 Legacy Grants Selection

Update on the Demand for Higher Green House Gas Reduction Targets for the Bay Area

EVENTS

Joint Center for Political and Economic Studies Hosts Symposium on Climate Change; September 17th

SAVE THE DATE: Training for Pediatric Asthma Care Providers in San Francisco or Oakland/Berkeley on October 8th

STUDIES & RESOURCES

APHA Fact Sheets on How Transportation Policy Affects Health

Race and Ethnicity Still a Factor in Asthma Prevalence among Insured Children

The Impact of 100% Smoke-Free Environment Legislation on Respiratory Function among Workers in Argentina

Short-Term Effects of Particulate Matter on Respiratory Health of Asthmatic Children

Expanded Asthma Education Programs Not Costly

Why Farm Children Seem to be Protected from Hay Fever

How Asthma Influences the Daily Life of Children

Work Related Asthma Study in Australia

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The Environmental Health Collaborative’s project, “Land Use Planning to Reduce Asthma in National City,” focuses on addressing poor land use planning. The subcontractor will develop a collaborative approach amongst residents and city officials to implement the pollution reduction element of National City’s new Westside Specific Plan and secure the relocation of 3-5 auto body shops from the vicinity of a neighborhood elementary school. They will measure their success by tracking the community’s participation in meetings, attending hearings, and testifying. They will also look at the reduction of air pollution at the neighborhood elementary school due to the relocations, as well as the number of successfully relocated auto body shops.

Chicago Asthma Consortium

The goal of the Chicago Asthma Consortium’s project, “Crossing the Information Divide: What Do Inner City Communities of Color Want to Know About Health and How Do They Prefer to Learn It?” is to formally develop a brief, low-literacy survey in English and Spanish that identifies which asthma-relevant health information is of interest to community members, how they currently access information, how decisions are made with regard to the quality and relevance of health information, and which avenues might be most effective in delivering asthma health information to community members in the future. They will collect data that informs the approach to conducting effective surveys in the targeted neighborhoods and will measure their success with the production of the survey tool and securing funding to conduct a systematic, representative survey.

Children’s Hospital & Research Center Oakland

The goal of Children’s Hospital & Research Center’s project, “C³PLAT: An innovative systems change approach to build capacity among California’s new generation of pediatricians to become environmental health advocates, is “to train the next generation’s pediatricians to be more sympathetic, better informed, and better equipped to understand and address their patients’ environmental risk factors, and be better able to advocate for pro-health policies for their patients and the public.” This curriculum fits into the “library” of new and revised curricula being developed over time by the California Collaborative in Community Pediatrics and Legislative Advocacy Training (C³PLAT), which reaches 760 residents per year in California. They will measure whether the curriculum positively changes the way the residents practice preventative care and manage asthma.

Although asthma is the most common chronic disease in childhood, information on pediatric patients’ views on asthma-specific health-related quality of life (HRQL) has not been described before. HRQL brings together various aspects of an individual’s subjective experience that relate both directly and indirectly to health, disease, disability, and impairment. In a study reported in the journal, Health and Quality of Life Outcomes,  researchers conducted focus groups to establish the components of asthma-specific HRQL, as experienced by primary school-aged asthmatic children. The most important finding was that asthma influences the life of children physically, emotionally, and socially. The most important components of HRQL were the consequences and negative effects of asthma on peer relationships (e.g., being bullied), the dependence on medication, shortness of breath, cough, limitations in activities, and the social limitations as a result of avoiding environmental cigarette smoke. To read the complete study, please click here.

A scientific study reported in the Journal of Allergy and Clinical Immunology isolated the substance in cowshed dust that possibly protects farm children from developing allergies and allergic asthma — namely the plant sugar molecule arabinogalactan. If high concentrations are inhaled during the first year of life, it inhibits the immune system from excessive defense reactions. It has long been know that children who grow up on farms are less prone to allergies and allergic asthma. The scientists now plan to investigate whether arabinogalactan can be used as prophylaxis or whether it is also suitable for the treatment of allergies and allergic asthma. It is conceivable that arabinogalactan could be used as spray or nose drops because it is highly water-soluble. For access to the full study, please click here.

An article published in the journal, Environmental Health Perspectives, reported on a study to quantify the short-term effects of particulate matter and nitrogen dioxide on respiratory health of asthmatic children. The conclusion provides strong evidence for an effect of particulate matter as an aggravating factor of asthma in children. Although there is no firm toxicologic evidence of adverse health effects of nitrogen dioxide at ambient levels to date, the epidemio­logic results suggest an adverse effect of nitrogen dioxide on respiratory health in children with asthma. To read the complete study, please click here.

A study featured in the journal, Tobacco Control, revealed that a significant reduction in secondhand smoke exposure and respiratory symptoms was observed after the enactment and enforcement of smoke-free environment legislation. Data obtained by spirometry showed a significant forced vital capacity increase. Consistent with other studies, smoke-free legislation improved short-term health outcomes in the sample. Undertaking this study has helped to promote 100% smoke-free environment legislation at the workplace as a legitimate right of hospitality workers, and in reducing social acceptance of designated smoking areas in bars and restaurants. To read the full text of the study, click here.

Results of a study reported in the Archives of Pediatric and Adolescent Medicine showed that asthma prevalence, treatment, and outcome differ among black and Hispanic children compared with white children despite universal health coverage. Black children were more likely to be diagnosed with asthma than either Hispanic or white children. Black children with an asthma diagnosis also were more likely than their Hispanic or white counterparts to have a potentially avoidable hospitalization for asthma. Although the study looked only at children whose parents were in the military — and who therefore had access to health insurance and treatment — evidence was found of racial and ethnic differences in asthma prevalence and outcomes after adjusting for differences in demographic characteristics and socioeconomic status. To access the abstract with a link to the full text of the article, click here.

The American Public Health Association (APHA) has published two new fact sheets, which contain statistics that highlight how transportation affects health, as well as specifics on what initiatives and policies APHA supports. “Transportation and Public Health” explores how transportation decisions affect our individual lives, economy and health. “Equity and Health Issues in Transportation” highlights how limited opportunities for physical activity, higher exposure to poor air quality, higher incidences of adult and childhood obesity and greater prevalence of asthma and cardiovascular disease are a few of the inequities enabled by poor transportation policies.

Regional Asthma Management and Prevention (RAMP) is a collaborative that promotes strategies for reducing asthma through a broad and comprehensive approach, which includes clinical management and environmental protection. RAMP brings together diverse partners such as public health and community-based organizations, schools, medical providers, and environmental health and justice groups to join forces in reducing the burden of asthma with a focus on communities inequitably affected by the disease.

INTERESTED IN PUBLIC POLICY? CLICK HERE TO LEARN ABOUT POLICIES RAMP IS ACTIVELY SUPPORTING.

15 July 2010

EVENTS

Demand Higher Green House Gas Reduction Targets for the Bay Area! Attend MTC Meeting on July 28th

Accessing and Using State and Local Health Data Workshop, Oakland, CA; July 23rd

8th Annual Legislative Education Days, Sacramento, CA; August 9th & 10th

FUNDING OPPORTUNITIES

HHS Announces the Partnerships Active in Communities to Achieve Health Equity (PAC) Program; Applications due: August 2nd

STUDIES

Urban Air Pollution and Climate Change as Environmental Risk Factors of Respiratory Allergy

Health Risks for Those Living within 500m of Main Roads

Moldy Homes a Serious Risk for Severe Asthma Attacks

Estimated Effect of Asthma Case Management Using Propensity Score Methods

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To estimate the treatment effect of participation in an asthma intervention that was part of the National Asthma Control Program, data on children who participated in asthma case management and eligible children who did not participate in case management were extracted from a Medicaid claims database. Measures of healthcare utilization, socio-demographics, and neighborhood characteristics were constructed. After creating a comparison group similar to the participants in terms of all characteristics before participation, researchers estimated the effect of the program on asthma outcomes. The program did increase the use of preventive healthcare by participants. Over the time period studied, these behaviors did not decrease healthcare utilization for asthma exacerbations. Researchers were unable to discern whether the lack of effect was because of the nature of the program, heterogeneity of the effects, or barriers outside the program’s control. To read the complete study in The American Journal of Managed Care, please click here.

Exposure to high levels of fungus may increase the risk of severe asthma attacks among people with certain gene variants. Researchers found that the interaction between environmental mold exposure and certain variants of chitinase genes were positively associated with severe asthma exacerbations requiring hospitalization. Chitinases break down chitin, a component in many fungi, and are induced during allergic inflammation. It has been suggested by past research that these could be biomarkers of inflammation. Moreover, certain variants of chitinase genes are known to be expressed more heavily in people with asthma. The researchers used data from the Childhood Asthma Management Program, a multicenter trial that enrolled children between the ages of 5 and 12 with mild to moderate persistent asthma. To read the complete study published in the American Journal of Respiratory and Critical Care Medicine, please click here.

INTERESTED IN PUBLIC POLICY?  CLICK HERE TO LEARN ABOUT POLICIES RAMP IS ACTIVELY SUPPORTING.

17 June 2010

EVENTS

RAMP to Host Motivational Interviewing Training for Behavior Change, July 15th

Save the Date: IAQ Tools for Schools National Symposium, January 13-15, 2011

FUNDING OPPORTUNITIES

RAMP Announces Request for Applications (RFA) for Legacy Grants Year Three; Applications due: July 1st

CDC REACH Program Grants; Applications due: July 21st

STUDIES

Perinatal Stress and Early Life Programming of Lung Structure and Function

Impact of Environmental Chemicals on Lung Development

Effect of Early Life Exposure to Air Pollution on Development of Childhood Asthma

Knowledge of and Technique for Using Inhalation Devices among Asthma Patients and COPD Patients

Working With Schools to Improve Pediatric Asthma Management

New Study Confirms Link between Obesity and Asthma

Increasing Prevalence of Asthma and Allergy Might Be Related to Diet

Asthma Inhaler Equipped With GPS Locates Source of Asthma Outbreaks

Effectiveness of a Theory-Based IVR Intervention to Improve Adherence to Controller Medications among Adults with Asthma

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Fifty participants aged 18 to 65 years who had a physician diagnosis of asthma and a prescription for a daily inhaled corticosteroid, had a baseline visit with researchers and a final visit 10 weeks later. Participants randomized to the intervention group received 2 automated interactive voice response (IVR) telephone calls separated by one month, with one additional call if they reported recent symptoms of poorly controlled disease or failure to fill a prescription. Calls were completed in less than 5 minutes and included content designed to inquire about asthma symptoms, deliver core educational messages, encourage refilling of inhaled corticosteroid prescriptions, and increase communication with providers. Adherence was tracked during 10 weeks, with objective measures that included either electronic monitors or calculation of canister weight. Participants completed the Asthma Quality of Life Questionnaire, the Asthma Control Test, and the Beliefs in Medications Questionnaire (BMQ) during both visits. Results indicated that the IVR intervention caused a significant increase in adherence to inhaled corticosteroid treatment and improved BMQ scores during the study interval. The association of increased adherence with increased BMQ scores suggests that the intervention succeeded in helping participants adopt a more favorable perception of their controller medication, leading in turn to improved adherence. To read the complete study, published in the Journal of the American Board of Family Medicine, please click here.

In the 1980s, public health officials in Barcelona, Spain, began to notice a series of asthma outbreaks that resulted in unusually high numbers of emergency room visits. The cause of the occasional day-long asthma spikes remained a mystery to officials for nearly a decade, until finally they identified defective grain silos at the city’s busy port complex. The silos had an inadequate filtering system, and on days when soy beans were unloaded, allergen-laden dust from the beans escaped and caused widespread asthma attacks. Using an inhaler equipped with a GPS (Global Positioning System) patients took a puff from the inhaler and the GPS mechanism collected their precise location, as well as the time and date, and reported that information to a database. Public health officials were able to construct a real-time picture of where and when patients were suffering from attacks. When the silos were identified and taken out of use, the outbreaks stopped. The findings were recently presented at the Institute of Medicine at the Community Health Data Forum sponsored by the U.S. Department of Health and Human Services. To read an overview, please click here.