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Guo B, Wang Y, Pei L, Yu Y, Liu F, Zhang D, Wang X, Su Y, Zhang D, Zhang B, Guo H. Determining the effects of socioeconomic and environmental determinants on chronic obstructive pulmonary disease (COPD) mortality using geographically and temporally weighted regression model across Xi'an during 2014-2016. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 756:143869. [PMID: 33280870 DOI: 10.1016/j.scitotenv.2020.143869] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/21/2020] [Accepted: 11/11/2020] [Indexed: 05/19/2023]
Abstract
Numerous methods have been implemented to evaluate the relationship between environmental factors and respiratory mortality. However, the previous epidemiological studies seldom considered the spatial and temporal variation of the independent variables. The present study aims to detect the relations between respiratory mortality and related affecting factors across Xi'an during 2014-2016 based on a novel geographically and temporally weighted regression model (GTWR). Meanwhile, the ordinary least square (OLS) and the geographically weighted regression (GWR) models were developed for cross-comparison. Additionally, the spatial autocorrelation and Hot Spot analysis methods were conducted to detect the spatiotemporal dynamic of respiratory mortality. Some important outcomes were obtained. Socioeconomic and environmental determinants represented significant effects on respiratory diseases. The respiratory mortality exhibited an obvious spatial correlation feature, and the respiratory diseases tend to occur in winter and rural areas of the study area. The GTWR model outperformed OLS and GWR for determining the relations between respiratory mortality and socioeconomic as well as environmental determinants. The influence degree of anthropic factors on COPD mortality was higher than natural factors, and the effects of independent variables on COPD varied timely and locally. The results can supply a scientific basis for respiratory disease controlling and health facilities planning.
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Affiliation(s)
- Bin Guo
- College of Geomatics, Xi'an University of Science and Technology, Xi'an, China.
| | - Yan Wang
- College of Geomatics, Xi'an University of Science and Technology, Xi'an, China
| | - Lin Pei
- School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Yan Yu
- School of Public Health, Xi'an Jiaotong University, Xi'an, China.
| | - Feng Liu
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, China
| | - Donghai Zhang
- College of Geomatics, Xi'an University of Science and Technology, Xi'an, China
| | - Xiaoxia Wang
- College of Geomatics, Xi'an University of Science and Technology, Xi'an, China
| | - Yi Su
- College of Geomatics, Xi'an University of Science and Technology, Xi'an, China
| | - Dingming Zhang
- College of Geomatics, Xi'an University of Science and Technology, Xi'an, China
| | - Bo Zhang
- College of Geomatics, Xi'an University of Science and Technology, Xi'an, China
| | - Hongjun Guo
- Weinan Central Hospital, Weinan, Shaanxi, China
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Abstract
Governments could help prevent chronic obstructive pulmonary disease (COPD) by reducing smoking rates; for example, through tobacco sale restriction, increasing tobacco prices, reducing nicotine content, and banning smoking in public areas and workplaces. Smoking cessation in general, and in particular among patients with COPD, could be achieved through specific programs, including behavior modification and the use of nicotine replacement therapy, bupropion, or varenicline. Prevention and/or slowed COPD progression could be achieved by occupational exposure prevention; improved indoor/outdoor air quality; reduced cooking and heating pollutants; use of better stoves and chimneys, and alternative energy sources; and influenza and pneumococcal vaccination.
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Affiliation(s)
- Alberto Papi
- Section of Respiratory Diseases, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Cona General Hospital, Via Aldo Moro 8, Ferrara 44124, Italy.
| | - Luca Morandi
- Section of Respiratory Diseases, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Cona General Hospital, Via Aldo Moro 8, Ferrara 44124, Italy
| | - Leonardo M Fabbri
- Section of Respiratory Diseases, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Cona General Hospital, Via Aldo Moro 8, Ferrara 44124, Italy
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Ni Y, Shi G, Qu J. Indoor PM 2.5, tobacco smoking and chronic lung diseases: A narrative review. ENVIRONMENTAL RESEARCH 2020; 181:108910. [PMID: 31780052 DOI: 10.1016/j.envres.2019.108910] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/05/2019] [Accepted: 11/07/2019] [Indexed: 06/10/2023]
Abstract
The lung is one of the most important organs exposed to environmental agents. People spend approximately 90% of their time indoors, and risks to health may thus be greater from exposure to poor air quality indoors than outdoors. Multiple indoor pollutants have been linked to chronic respiratory diseases. Environmental tobacco smoke (ETS) is known as an important source of multiple pollutants, especially in indoor environments. Indoor PM2.5 (particulate matter with aerodynamic diameter < 2.5 μm) was reported to be the most reliable marker of the presence of tobacco smoke. Recent studies have demonstrated that PM2.5 is closely correlated with chronic lung diseases. In this paper, we reviewed the relationship of tobacco smoking and indoor PM2.5 and the mechanism that underpin the link of tobacco smoke, indoor PM2.5 and chronic lung diseases.
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Affiliation(s)
- Yingmeng Ni
- Department of Pulmonary and Critical Care Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guochao Shi
- Department of Pulmonary and Critical Care Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieming Qu
- Department of Pulmonary and Critical Care Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Kumarihamy RMK, Tripathi NK. Geostatistical predictive modeling for asthma and chronic obstructive pulmonary disease using socioeconomic and environmental determinants. ENVIRONMENTAL MONITORING AND ASSESSMENT 2019; 191:366. [PMID: 31254075 DOI: 10.1007/s10661-019-7417-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 03/20/2019] [Indexed: 06/09/2023]
Abstract
The spatial distribution of the prevalence of asthma and chronic obstructive pulmonary disease (COPD) remains under the influence of a wide array of environmental, climatic, and socioeconomic determinants. However, a large proportion of these influences remain unexplained. In completion, this study examined the spatial associations between asthma/COPD morbidity and their determinants using ordinary least squares (OLS) and geographically weighted regressions (GWR). Inpatient records collected from the secondary and tertiary care hospitals in Kandy from 2010 to 2014 were considered as the dependent variable. Potential risk factors (explanatory variables) were identified in four distinguished classes: 1) meteorological factors, (2) direct and indirect factors of air pollution, (3) socioeconomic factors, and (4) characteristics of the physical environment. All possible combinations of candidate explanatory variables were evaluated through an exploratory regression. A comparison between the regression models was also explored. The best OLS regression models revealed about 55% of asthma variation and 62% of COPD variation while GWR models yielded 78% and 74% of the variation of asthma and COPD occurrences respectively. Relative humidity, proximity to roads (0-200 m), road density, use of firewood as a source of fuel, and elevation play a vital role in predicting morbidity from asthma and COPD. Both local and global regression models are important in assessing spatial relationships of asthma and COPD. However, the local models exhibit a better prediction capability for assessing non-stationary relationships of asthma and COPD than global models. The geostatistical aspects used in this study may also provide insights for evaluating heterogeneous environmental risk factors in other epidemiological studies across different spatial settings.
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Affiliation(s)
- R M K Kumarihamy
- Remote Sensing and Geographic Information System AoS, School of Engineering and Technology, Asian Institute of Technology, P.O. Box 4, Klong Luang, Pathumthani, 12120, Thailand.
- Department of Geography, University of Peradeniya, Peradeniya, Sri Lanka.
| | - N K Tripathi
- Remote Sensing and Geographic Information System AoS, School of Engineering and Technology, Asian Institute of Technology, P.O. Box 4, Klong Luang, Pathumthani, 12120, Thailand
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Hall KK, Petsky HL, Chang AB, O'Grady KF. Caseworker-assigned discharge plans to prevent hospital readmission for acute exacerbations in children with chronic respiratory illness. Cochrane Database Syst Rev 2018; 11:CD012315. [PMID: 30387126 PMCID: PMC6517201 DOI: 10.1002/14651858.cd012315.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Chronic respiratory conditions are major causes of mortality and morbidity. Children with chronic health conditions have increased morbidity associated with their physical, emotional, and general well-being. Acute respiratory exacerbations (AREs) are common in children with chronic respiratory disease, often requiring admission to hospital. Reducing the frequency of AREs and recurrent hospitalisations is therefore an important goal in the individual and public health management of chronic respiratory illnesses in children. Discharge planning is used to decide what a person needs for transition from one level of care to another and is usually considered in the context of discharge from hospital to the home. Discharge planning from hospital for ongoing management of an illness has historically been referral to a general practitioner or allied health professional or self management by the individual and their family with limited communication between the hospital and patient once discharged. Effective discharge planning can decrease the risk of recurrent AREs requiring medical care. An individual caseworker-assigned discharge plan may further decrease exacerbations. OBJECTIVES To evaluate the efficacy of individual caseworker-assigned discharge plans, as compared to non-caseworker-assigned plans, in preventing hospitalisation for AREs in children with chronic lung diseases such as asthma and bronchiectasis. SEARCH METHODS We searched the Cochrane Airways Group Specialised Register of Trials, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, trials registries, and reference lists of articles. The latest searches were undertaken in November 2017. SELECTION CRITERIA All randomised controlled trials comparing individual caseworker-assigned discharge planning compared to traditional discharge-planning approaches (including self management), and their effectiveness in reducing the subsequent need for emergency care for AREs (hospital admissions, emergency department visits, and/or unscheduled general practitioner visits) in children hospitalised with an acute exacerbation of chronic respiratory disease. We excluded studies that included children with cystic fibrosis. DATA COLLECTION AND ANALYSIS We used standard Cochrane Review methodological approaches. Relevant studies were independently selected in duplicate. Two review authors independently assessed trial quality and extracted data. We contacted the authors of one study for further information. MAIN RESULTS We included four studies involving a total of 773 randomised participants aged between 14 months and 16 years. All four studies involved children with asthma, with the case-planning undertaken by a trained nurse educator. However, the discharge planning/education differed among the studies. We could include data from only two studies (361 children) in the meta-analysis. Two further studies enrolled children in both inpatient and outpatient settings, and one of these studies also included children with acute wheezing illness (no previous asthma diagnosis); the data specific to this review could not be obtained. For the primary outcome of exacerbations requiring hospitalisation, those in the intervention group were significantly less likely to be rehospitalised (odds ratio (OR) 0.29, 95% confidence interval (CI) 0.16 to 0.50) compared to controls. This equates to 189 (95% CI 124 to 236) fewer admissions per 1000 children. No adverse events were reported in any study. In the context of substantial statistical heterogeneity between the two studies, there were no statistically significant effects on emergency department (OR 0.37, 95% CI 0.04 to 3.05) or general practitioner (OR 0.87, 95% CI 0.22 to 3.44) presentations. There were no data on cost-effectiveness, length of stay of subsequent hospitalisations, or adherence to medications. One study reported quality of life, with no significant differences observed between the intervention and control groups.We considered three of the studies to have an unclear risk of bias, primarily due to inadequate description of the blinding of participants and investigators. The fourth study was assessed as at high risk of bias as a single unblinded investigator was used. Using the GRADE system, we assessed the quality of the evidence as moderate for the outcome of hospitalisation and low for the outcomes of emergency department visits and general practitioner consultations. AUTHORS' CONCLUSIONS Current evidence suggests that individual caseworker-assigned discharge plans, as compared to non-caseworker-assigned plans, may be beneficial in preventing hospital readmissions for acute exacerbations in children with asthma. There was no clear indication that the intervention reduces emergency department and general practitioner attendances for asthma, and there is an absence of data for children with other chronic respiratory conditions. Given the potential benefit and cost savings to the healthcare sector and families if hospitalisations and outpatient attendances can be reduced, there is a need for further randomised controlled trials encompassing different chronic respiratory illnesses, ethnicity, socio-economic settings, and cost-effectiveness, as well as defining the essential components of a complex intervention.
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Affiliation(s)
- Kerry K Hall
- Griffith UniversityMenzies Health Institute QueenslandRecreation RoadNathanBrisbaneQueenslandAustralia4101
| | - Helen L Petsky
- Griffith UniversitySchool of Nursing and Midwifery, Griffith University and Menzies Health Institute QueenslandBrisbaneQueenslandAustralia
| | - Anne B Chang
- Menzies School of Health Research, Charles Darwin UniversityChild Health DivisionPO Box 41096DarwinNorthern TerritoriesAustralia0811
- Queensland University of TechnologyInstitute of Health and Biomedical InnovationBrisbaneAustralia
- Lady Cilento Children's HospitalDepartment of Respiratory and Sleep MedicineBrisbaneAustralia
- Centre for Children's Health ResearchCough, Asthma, Airways Research GroupSouth BrisbaneAustralia
| | - KerryAnn F O'Grady
- Queensland University of TechnologyInstitute of Health and Biomedical InnovationBrisbaneAustralia
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van der Molen HF, de Groene GJ, Hulshof CTJ, Frings-Dresen MHW. Association between Work and Chronic Obstructive Pulmonary Disease (COPD). J Clin Med 2018; 7:E335. [PMID: 30304764 PMCID: PMC6210126 DOI: 10.3390/jcm7100335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/04/2018] [Accepted: 10/06/2018] [Indexed: 12/25/2022] Open
Abstract
To support occupational physicians in their assessment and notification of occupational diseases, diagnostic registration guidelines are developed with information about associations between work-related risk factors and diseases. The objective of this review of systematic reviews is to examine whether work-related risk factors are associated with chronic pulmonary obstructive disease (COPD). We searched the electronic database of Medline for systematic reviews published between 1 January 2009 and 20 June 2017. Reviews were included when COPD was assessed by data on lung function and when work-related exposures to vapors, dusts, gases, or fumes (VDGF) were described. One author selected studies and extracted data; two authors assessed study quality using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). In all eight systematic reviews included, various exposures to vapors, dusts, gases, and fumes (VGDF) at work are associated with COPD. Two-thirds of the included studies are cross-sectional and show a high heterogeneity in population, setting, and mostly self-reported-exposures. Two high-quality reviews (AMSTAR score ≥ 9) including meta-analyses show associations and excess risk of COPD for work-related general exposure to VDGF with a summary odds ratio of 1.4 (95% confidence interval (CI) 1.19⁻1.73) and to inorganic dust with a mean difference in predicted forced expiratory volume in one second (FEV₁) of -5.7% (95% CI: -8.62% to -2.71%). Exposure to VGDF at work is associated with a small but increased risk of COPD. More detailed workplace measurements of specific VGDF are warranted to gain an insight into dose⁻response relationships.
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Affiliation(s)
- H F van der Molen
- Amsterdam UMC, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - G J de Groene
- Amsterdam UMC, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - C T J Hulshof
- Amsterdam UMC, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - M H W Frings-Dresen
- Amsterdam UMC, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
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Ambrosino N, Bertella E. Lifestyle interventions in prevention and comprehensive management of COPD. Breathe (Sheff) 2018; 14:186-194. [PMID: 30186516 PMCID: PMC6118879 DOI: 10.1183/20734735.018618] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Chronic respiratory diseases are among the four major human chronic diseases. Tobacco smoke as well as environmental pollutants, infections, physical activity and nutritional status play a role in the prevalence, development and/or progression of chronic obstructive pulmonary disease (COPD). Changes in lifestyle are possible and may be beneficial in prevention and comprehensive management of COPD. Population-level interventions aimed at early diagnosis, promotion of vaccinations and prevention of infections, and reductions in smoking, environmental pollutants, physical inactivity, obesity and malnutrition may increase the number of life-years lived in good health. EDUCATIONAL AIMS To improve awareness of the influence of lifestyle on natural history of COPD.To describe the effects of some interventions to modify lifestyle in prevention and management.To provide information on the main clinical results.To define recommendations and limitations.
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Affiliation(s)
| | - Enrica Bertella
- Istituti Clinici Scientifici Maugeri, IRCCS Lumezzane, Brescia, Italy
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Ahmed R, Robinson R, Mortimer K. The epidemiology of noncommunicable respiratory disease in sub-Saharan Africa, the Middle East, and North Africa. Malawi Med J 2017; 29:203-211. [PMID: 28955434 PMCID: PMC5610297 DOI: 10.4314/mmj.v29i2.24] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Noncommunicable diseases (NCDs) are a major and increasing global health issue. The World Health Organization (WHO) estimates that NCDs represent 63% of all global deaths of which 3.9 million are due to chronic respiratory diseases (CRDs) and Chronic Obstructive Pulmonary Disease (COPD) in particular. COPD is now the third most common cause of death globally; 90% of these deaths occur in Low and Middle Income Countries (LMICs). COPD affects 329 million people, almost 5% of the world's population. In addition, asthma affects 334 million people, again representing almost 5% of the world's population. There is limited literature published on the epidemiology of COPD and Asthma from Sub-Saharan Africa (SSA) and Middle East and North Africa (MENA). Both diseases are under-diagnosed and underestimated in both SSA and MENA regions. The burden of COPD in sub-Saharan Africa is disputed and reports offer variable prevalence estimates, ranging from 4.1% to almost 22.2%. SSA and MENA countries report similar mortality rates from COPD of 18 per 100,000 population (2001 data). Asthma is a less common cause of death than COPD but is a major cause of morbidity; WHO estimates that there are 250,000 deaths per year from asthma, mainly in LMICs and it remains in the top twenty causes of disability in children globally. Risk factors for CRD are genetic and environmental; the latter dominated by air pollution exposures including tobacco smoke, household air pollution, outdoor air pollution and occupational exposures.
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Affiliation(s)
- Rana Ahmed
- The Epidemiological Laboratory, Khartoum, Sudan
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Ryan Robinson
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Kevin Mortimer
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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le Roux DM, Zar HJ. Community-acquired pneumonia in children - a changing spectrum of disease. Pediatr Radiol 2017; 47:1392-1398. [PMID: 29043417 PMCID: PMC5608782 DOI: 10.1007/s00247-017-3827-8] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 03/03/2017] [Indexed: 12/17/2022]
Abstract
Pneumonia remains the leading cause of death in children outside the neonatal period, despite advances in prevention and management. Over the last 20 years, there has been a substantial decrease in the incidence of childhood pneumonia and pneumonia-associated mortality. New conjugate vaccines against Haemophilus influenzae type b and Streptococcus pneumoniae have contributed to decreases in radiologic, clinical and complicated pneumonia cases and have reduced hospitalization and mortality. The importance of co-infections with multiple pathogens and the predominance of viral-associated disease are emerging. Better access to effective preventative and management strategies is needed in low- and middle-income countries, while new strategies are needed to address the residual burden of disease once these have been implemented.
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Affiliation(s)
- David M. le Roux
- 5th Floor ICH Building Red Cross War Memorial Children’s Hospital, Klipfontein Road Cape Town, 7700, South Africa ,Department of Paediatrics, New Somerset Hospital, Cape Town, South Africa
| | - Heather J. Zar
- 5th Floor ICH Building Red Cross War Memorial Children’s Hospital, Klipfontein Road Cape Town, 7700, South Africa
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Hall KK, Chang AB, O'Grady KF. Discharge plans to prevent hospital readmission for acute exacerbations in children with chronic respiratory illness. Hippokratia 2016. [DOI: 10.1002/14651858.cd012315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Kerry K Hall
- Queensland University of Technology; Institute of Health and Biomedical Innovation; 62 Graham Street South Brisbane Brisbane Queensland Australia 4101
| | - Anne B Chang
- Queensland University of Technology; Institute of Health and Biomedical Innovation; 62 Graham Street South Brisbane Brisbane Queensland Australia 4101
- Menzies School of Health Research, Charles Darwin University; Child Health Division; PO Box 41096 Darwin Northern Territories Australia 0811
| | - KerryAnn F O'Grady
- Queensland University of Technology; Institute of Health and Biomedical Innovation; 62 Graham Street South Brisbane Brisbane Queensland Australia 4101
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