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Amberson T, Ndayishimiye O, Cloud QY, Castner J. Cognitive Interview Validation of a Novel Household Hazard Vulnerability Assessment Instrument. West J Nurs Res 2024; 46:90-103. [PMID: 38146257 PMCID: PMC11106849 DOI: 10.1177/01939459231217935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
BACKGROUND Weather and climate disasters are responsible for over 13 000 US deaths, worsened morbidity, and $1.7 trillion in additional costs over the last 40 years with profound racial disparities. OBJECTIVES This project empirically generated items for a novel survey instrument of household hazard vulnerability with initial construct validation while addressing racial bias in the data collection process. METHODS Cognitive interviews facilitated understanding regarding the performance of drafted survey questions with transdisciplinary expert panelists from diverse US regions on unique hazard/disaster/event items. To prevent representation bias in data collection, those with Black and/or African American racial, biracial, or multiracial identities were over-sampled. Interview video recordings were qualitatively analyzed using thematic and pattern coding. RESULTS A cognitive process mapped to themes of disaster characteristics, resources, individual life facets, and felt effects was revealed. We identified 379 unique instances of linked terms as synonyms, co-occurring, compounding, or cascading events. Potential for racial bias in data collection was elucidated. Analysis of radiation exposure, trauma, and criminal acts of intent items revealed participants may not interpret survey items with these terms as intended. CONCLUSION Potential for racial bias exists relative to water dam failure, evacuation, external flood, suspicious packages/substances, and transportation failure. Hazard terms that were not interpreted as intended require further revision in the validation process of individual or household disaster vulnerability assessments. Several commonalities in the cognitive process and mapping of disaster terms may be utilized in disaster and climate change research aimed at the individual and household unit of analysis.
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Affiliation(s)
- Taryn Amberson
- Contractor to Castner Incorporated, Grand Island, NY, USA
- University of Washington, Seattle, WA, USA
- National Disaster Medical System, Washington, DC, USA
| | | | - Quanah Yellow Cloud
- Contractor to Castner Incorporated, Grand Island, NY, USA
- University of New England, Biddeford, ME, USA
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Kim H, Huh JY, Na G, Park S, Ra SW, Kang SY, Kim HC, Kim HC, Lee SW. Lifestyle practices that reduce seasonal PM 2.5 exposure and their impact on COPD. Sci Rep 2023; 13:11822. [PMID: 37479736 PMCID: PMC10361977 DOI: 10.1038/s41598-023-38714-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/13/2023] [Indexed: 07/23/2023] Open
Abstract
Particulate matter (PM) is a major air pollutant that has led to global health concerns and can cause and exacerbate chronic obstructive pulmonary disease (COPD). We asked patients with COPD to complete a detailed questionnaire about their lifestyle practices to reduce PM2.5 exposure and analyzed the relationship between ambient PM2.5 concentrations and lifestyle practices. We prospectively enrolled 104 COPD patients from four hospitals in different areas of Korea. They completed detailed questionnaires twice (at enrollment and the end of the study) and Internet of Things-based sensors were installed in their homes to continuously measure PM2.5 for 1 year. The relationship between PM2.5 concentrations, lifestyle practices, and COPD exacerbations were analyzed in each season. The PM2.5 concentration was higher outdoors than indoors in all seasons except summer, and the difference was largest in winter. The six lifestyle practices that significantly lowered the annual indoor PM2.5 concentration compared with the outdoors. The higher the economic status and educational level of patients, the lower the indoor PM2.5 concentration. Some lifestyle practices were associated with reduced small airway resistance, presented as R5-R20 determined by impulse oscillometry, and scores of the St. George's Respiratory Questionnaire. Some lifestyle practices are associated with reduced indoor PM2.5 concentrations and can even affect clinical outcomes, including small airway resistance and quality of life of COPD patients.
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Affiliation(s)
- Hajeong Kim
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Jin-Young Huh
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Republic of Korea
| | - Geunjoo Na
- Department of Occupational and Environmental Medicine, College of Medicine, Inha University, 27 Inhang-Ro, Jung-gu, Incheon, 22332, Republic of Korea
- Green Environment Industrial Institute, Seoul, Republic of Korea
| | - Shinhee Park
- Department of Pulmonary, Allergy and Critical Care Medicine, Gangneung Asan Hospital, Gangneung, Republic of Korea
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Seung Won Ra
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Sung-Yoon Kang
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Ho Cheol Kim
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, College of Medicine, Inha University, 27 Inhang-Ro, Jung-gu, Incheon, 22332, Republic of Korea.
| | - Sei Won Lee
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
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Ren L, Wang C, Xi L, Gao Y, Zhang Y, Zhang L. Long-term efficacy of HDM-SCIT in pediatric and adult patients with allergic rhinitis. Allergy Asthma Clin Immunol 2023; 19:20. [PMID: 36906588 PMCID: PMC10007655 DOI: 10.1186/s13223-023-00781-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/27/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Subcutaneous immunotherapy (SCIT) is a well-validated and effective disease modification treatment for house dust mites (HDM)-induced allergic rhinitis (AR). Long-term post-treatment comparisons in children and adults treated with SCIT have rarely been published. This study aimed to evaluate the long-term efficacy of HDM-SCIT administered under a cluster schedule in children compared to adults. METHODS This was an open-design, observational, long-term clinical follow-up study on children and adults with perennial AR treated with HDM-SCIT. The follow-up consisted of a three-year treatment duration plus a post-treatment follow-up of over three years. RESULTS Patients in the pediatric (n = 58) and adult (n = 103) groups completed a post-SCIT follow-up of over three years. The total nasal symptom score (TNSS), combined symptom medication score (CSMS), and rhinoconjunctivitis quality-of-life questionnaire (RQLQ) score decreased significantly at T1 (three-year SCIT completed) and T2 (follow-up completed) in the pediatric and adult groups. In both groups, the improvement rate of TNSS (T0-T1) was moderately correlated with the baseline TNSS (r = 0.681, p < 0.001 and r = 0.477, p < 0.001 for children and adults, respectively). Only in the pediatric group, TNSS was significantly lower at T2 compared with that right after SCIT cessation (T1) (p = 0.030). CONCLUSIONS Children and adults with HDM-induced perennial AR could achieve a sustainable post-treatment efficacy for over three years (up to 13 years) following a three-year SCIT. Patients with relatively severe nasal symptoms at baseline may benefit more from SCIT. Children who have completed an adequate course of SCIT may gain further improvement in nasal symptoms after SCIT cessation.
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Affiliation(s)
- Lei Ren
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Chengshuo Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, No. 17, HouGou Hu Tong, Dong Cheng District, Beijing, 100005, People's Republic of China
| | - Lin Xi
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Yunbo Gao
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Yuan Zhang
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China. .,Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, No. 17, HouGou Hu Tong, Dong Cheng District, Beijing, 100005, People's Republic of China.
| | - Luo Zhang
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China. .,Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China. .,Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, No. 17, HouGou Hu Tong, Dong Cheng District, Beijing, 100005, People's Republic of China. .,Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China.
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Polivka BJ, Huntington-Moskos L, Folz R, Barnett R. CE: Environments & Health: Chemicals in the Home That Can Exacerbate Asthma. Am J Nurs 2022; 122:34-39. [PMID: 35394947 PMCID: PMC10875726 DOI: 10.1097/01.naj.0000829776.73698.e0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Although chemical exposures from cleaning and disinfectant products often go unnoticed or unrecognized, such exposures have been associated with asthma-related symptoms and exacerbations. The Environmental Working Group (EWG) website provides consumer information on a wide range of issues and products related to human health and the environment, including the use of cleaning and disinfectant products, 2,500 of which it has rated in terms of their effects on respiratory function and asthma. In discussing how the use of cleaning and disinfectant products and the frequency of their use may affect asthma control, the authors use the EWG ratings as well as data collected for a study they conducted on older adults with asthma.
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Affiliation(s)
- Barbara J Polivka
- Barbara J. Polivka is an associate dean of research and a professor at the University of Kansas, Kansas City. Luz Huntington-Moskos is an assistant professor at the University of Louisville, Louisville, KY, where Russel Barnett is a lecturer. Rodney Folz is chief, pulmonary, critical care, and sleep medicine at Houston Methodist Lung Center, Houston Methodist Hospital. Contact author: Barbara J. Polivka, . This work was supported by the National Institutes of Health, National Institute on Aging (award number R01AG047297). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors acknowledge the work of Diane Endicott, MS, BSN, RN, and Carol Norton, MUP, in collecting study data. The authors and planners have disclosed no potential conflicts of interest, financial or otherwise
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Eguiluz-Gracia I, Palomares F, Salas M, Testera-Montes A, Ariza A, Davila I, Bartra J, Mayorga C, Torres MJ, Rondon C. Precision Medicine in House Dust Mite-Driven Allergic Asthma. J Clin Med 2020; 9:E3827. [PMID: 33255966 DOI: 10.3390/jcm9123827] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/20/2020] [Accepted: 11/21/2020] [Indexed: 11/17/2022] Open
Abstract
House dust mites (HDMs) are the allergenic sources most frequently involved in airway allergy. Nevertheless, not every sensitized patient develops respiratory symptoms upon exposure to HDM, and there is a clinical need to differentiate allergic asthmatics (AAs) from atopic non-allergic asthmatics with HDM sensitization. This differentiation sometimes requires in vivo provocations like the bronchial allergen challenge (BAC). Interestingly, recent data demonstrate that non-atopic patients with asthma can also develop positive BAC results. This novel phenotype has been termed local allergic asthma (LAA). The interest in identifying the allergic triggers of asthma resides in the possibility of administering allergen immunotherapy (AIT). AIT is a disease-modifying intervention, the clinical benefit of which persists after therapy discontinuation. Recently, new modalities of sublingual tablets of HDM immunotherapy registered as pharmaceutical products (HDM-SLIT tablets) have become commercially available. HDM-SLIT tablets have demonstrated a robust effect over critical asthma parameters (dose of inhaled corticosteroids, exacerbations, and safety), thus being recommended by international guidelines for patients with HDM-driven AA. In this review, we will summarize the current knowledge on the phenotype and endotype of HDM-driven AA, and LAA, address the difficulties for BAC implementation in the clinic, and discuss the effects of AIT in AA and LAA.
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