scholarly journals Development of a Conceptual Model of Childhood Asthma to Inform Asthma Prevention Policies

2020 ◽  
Author(s):  
Amin Adibi ◽  
Stuart E Turvey ◽  
Tae Yoon Lee ◽  
Malcolm R Sears ◽  
Allen B Becker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Conceptual Model ◽  
Childhood Asthma ◽  
Large Scale ◽  
Concept Map ◽  
Policy Model ◽  
Open Population ◽  
Characteristic Family ◽  
Asthma Prevention ◽  
Analytic Models

AbstractBackgroundThere is no definitive cure for asthma; as such, prevention remains a major goal. Decision-analytic models are routinely used to evaluate the value-for-money proposition of interventions. Following best practice standards in decision-analytic modeling, the objective of this study was to solicit expert opinion to develop a concept map for a policy model for primary prevention of asthma.MethodsWe reviewed currently available decision-analytic models for asthma prevention. A steering committee of economic modelers, allergists, and respirologists was then convened to draft a conceptual model of pediatric asthma. A modified Delphi method was followed to define the context of the problem at hand (evaluation of asthma prevention strategies) and develop the concept map of the model.ResultsConsensus was achieved after three rounds of discussions, followed by concealed voting. In the final conceptual model, asthma diagnosis was based on three domains of lung function, atopy, and their symptoms. The panel recommended several markers for each domain. These domains were in turn affected by several risk factors. The panel clustered all risk factors under three groups of ‘patient characteristic’, ‘family history’, and ‘environmental factors’. To be capable of modeling the interplay among risk factors, the panel recommended the use of microsimulation, with an open-population approach that would enable modeling phased implementation and gradual and incomplete uptake of the intervention.ConclusionsEconomic evaluation of childhood interventions for preventing asthma will require modeling of several co-dependent risk factors and multiple domains that affect the diagnosis. The conceptual model can inform the development and validation of a policy model for childhood asthma prevention.FundingGenome Canada Large-Scale Applied Research Project

scholarly journals Development of a conceptual model of childhood asthma to inform asthma prevention policies

2021 ◽  
Vol 8 (1) ◽  
pp. e000881
Author(s):  
Amin Adibi ◽  
Stuart E Turvey ◽  
Tae Yoon Lee ◽  
Malcolm R Sears ◽  
Allen B Becker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Conceptual Model ◽  
Childhood Asthma ◽  
Best Practice ◽  
Concept Map ◽  
Policy Model ◽  
Open Population ◽  
Characteristic Family ◽  
Asthma Prevention ◽  
Analytic Models

BackgroundThere is no definitive cure for asthma, as prevention remains a major goal. Decision analytic models are routinely used to evaluate the value-for-money proposition of interventions. Following best practice standards in decision-analytic modelling, the objective of this study was to solicit expert opinion to develop a concept map for a policy model for primary prevention of asthma.MethodsWe reviewed currently available decision analytic models for asthma prevention. A steering committee of economic modellers, allergists and respirologists was then convened to draft a conceptual model of paediatric asthma. A modified Delphi method was followed to define the context of the problem at hand (evaluation of asthma prevention strategies) and develop the concept map of the model.ResultsConsensus was achieved after three rounds of discussions, followed by concealed voting. In the final conceptual model, asthma diagnosis was based on three domains of lung function, atopy and their symptoms. The panel recommended several markers for each domain. These domains were in turn affected by several risk factors. The panel clustered all risk factors under three groups of ‘patient characteristic’, ‘family history’ and ‘environmental factors’. To be capable of modelling the interplay among risk factors, the panel recommended the use of microsimulation, with an open-population approach that would enable modelling phased implementation and gradual and incomplete uptake of the intervention.ConclusionsEconomic evaluation of childhood interventions for preventing asthma will require modelling of several codependent risk factors and multiple domains that affect the diagnosis. The conceptual model can inform the development and validation of a policy model for childhood asthma prevention.

2258-PUB: Impact of Cardiovascular (CV) Risk Factors during the Initial 6 Months of the First Large-Scale Longitudinal Nationwide Study on Management and Real-World Outcomes of Diabetes in India (LANDMARC)

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 2258-PUB
Author(s):  
ROMIK GHOSH ◽  
ASHOK K. DAS ◽  
SHASHANK JOSHI ◽  
AMBRISH MITHAL ◽  
K.M. PRASANNA KUMAR ◽  
...  
Keyword(s):  
Risk Factors ◽  
Real World ◽  
Large Scale ◽  
Nationwide Study

Trends in prevalence and risk factors of childhood asthma in Fuzhou, a city in Southeastern China

2014 ◽  
Vol 52 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Su-Ping Tang ◽  
Yan-Lin Liu ◽  
Shi-Biao Wang ◽  
Sheng-Feng Weng ◽  
Shen Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Childhood Asthma ◽  
Southeastern China

Meat consumption among 18-month-old children participating in the Childhood Asthma Prevention Study

2005 ◽  
Vol 62 (1) ◽  
pp. 12-20 ◽  
Author(s):  
Karen Webb ◽  
Ingrid Rutishauser ◽  
Tamarah Katz ◽  
Natalia Knezevic ◽  
Marjaana Lahti-Koski ◽  
...  
Keyword(s):  
Childhood Asthma ◽  
Meat Consumption ◽  
Prevention Study ◽  
Asthma Prevention

scholarly journals Mental health and caregiving experiences of family carers supporting people with psychosis

2021 ◽  
Vol 30 ◽  
Author(s):  
J. Sin ◽  
J. Elkes ◽  
R. Batchelor ◽  
C. Henderson ◽  
S. Gillard ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
General Population ◽  
Large Scale ◽  
Controlled Trial ◽  
Population Sample ◽  
Poor Mental Health ◽  
Mental Wellbeing ◽  
Family Carers ◽  
Negative Experience

Abstract Aims Family carers supporting an individual with psychosis often experience poorer mental health, however, little is known about specific risk factors among these carers. We investigated the associations between demographic, caregiving characteristics and mental health outcomes in family carers supporting an individual with psychosis and compared carers' outcomes with general population norms. Methods We analysed baseline data from the COPe-support randomised controlled trial of online psychoeducation and peer support for adult carers supporting an individual with psychosis between 2018 and 2020. We collected carers' demographic and health outcome data, including wellbeing using Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS as primary outcome), quality of life using EQ-5D-5L and caregiving experience assessed with Experience of Caregiving Inventory. We tested associations between carers' demographic and caregiving characteristics for each outcome in turn and meta-analysed carers' WEMWBS and EQ-5D-5L with Health Survey England (HSE) general population data from 2016 and 2017, respectively. Results The 407 carers of people with psychosis had a mean WEMWBS score of 42.2 (s.d. 9.21) and their overall weighted pooled WEMWBS score was 7.3 (95% confidence interval (CI) −8.6 to −6.0, p < 0.01) lower than the HSE general population sample, indicating carers have poorer mental wellbeing by more than double the minimum clinically important difference of 3 points on WEMWBS. Among all caring relationships, partners had poorer wellbeing compared to parents with lower WEMWBS score (−6.8, −16.9 to 3.3, p = 0.03). Single carers had significantly poorer wellbeing (−3.6, −5.6 to −1.5, p < 0.01) and a more negative caregiving experience than those who were cohabiting. Spending more than 35 h per week caregiving increased carers' negative experience significantly (p = 0.01). Conclusion Carers of people with psychosis have poorer mental health than non-carers. Partners, lone carers and those spending more than 35 h per week on caring were found to be most at risk of poor mental health. Based on the results, we advocate that the details of carers for individuals with psychosis should be added to the existing carers or severe mental illness registers at all general practitioner surgeries and for their wellbeing screened routinely. Future large-scale prospective studies are needed to develop a predictive model to determine risk factors, hence to aid early identification of carers' support needs. Such understandings are also useful to inform tailored intervention development.

scholarly journals Demographic and Risk Factor Differences between Children with “One-Time” and “Repeat” Visits to the Emergency Department for Asthma

2021 ◽  
Vol 18 (2) ◽  
pp. 486
Author(s):  
Pavani Rangachari ◽  
Jie Chen ◽  
Nishtha Ahuja ◽  
Anjeli Patel ◽  
Renuka Mehta
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Risk Factor ◽  
Childhood Asthma ◽  
Medical Center ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
Primary Research ◽  
Ed Visits ◽  
The Individual

This retrospective study examines demographic and risk factor differences between children who visited the emergency department (ED) for asthma once (“one-time”) and more than once (“repeat”) over an 18-month period at an academic medical center. The purpose is to contribute to the literature on ED utilization for asthma and provide a foundation for future primary research on self-management effectiveness (SME) of childhood asthma. For the first round of analysis, an 18-month retrospective chart review was conducted on 252 children (0–17 years) who visited the ED for asthma in 2019–2020, to obtain data on demographics, risk factors, and ED visits for each child. Of these, 160 (63%) were “one-time” and 92 (37%) were “repeat” ED patients. Demographic and risk factor differences between “one-time” and “repeat” ED patients were assessed using contingency table and logistic regression analyses. A second round of analysis was conducted on patients in the age-group 8–17 years to match another retrospective asthma study recently completed in the outpatient clinics at the same (study) institution. The first-round analysis indicated that except age, none of the individual demographic or risk factors were statistically significant in predicting of “repeat” ED visits. More unequivocally, the second-round analysis revealed that none of the individual factors examined (including age, race, gender, insurance, and asthma severity, among others) were statistically significant in predicting “repeat” ED visits for childhood asthma. A key implication of the results therefore is that something other than the factors examined is driving “repeat” ED visits in children with asthma. In addition to contributing to the ED utilization literature, the results serve to corroborate findings from the recent outpatient study and bolster the impetus for future primary research on SME of childhood asthma.

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