Related Articles

Development of an International School Nurse Asthma Care Coordination Model.

J Adv Nurs. 2014 Sep 16;

Authors: Garwick AW, Svavarsdóttir EK, Seppelt AM, Looman WS, Anderson LS, Orlygsdóttir B

Abstract
AIM: To identify and compare how school nurses in Reykjavik, Iceland and St. Paul, Minnesota coordinated care for youth with asthma (ages 10-18) and to develop an asthma school nurse care coordination model.
BACKGROUND: Little is known about how school nurses coordinate care for youth with asthma in different countries.
DESIGN: A qualitative descriptive study design using focus group data.
METHODS: Six focus groups with 32 school nurses were conducted in Reykjavik (n = 17) and St. Paul (n = 15) using the same protocol between September 2008 and January 2009. Descriptive content analytic and constant comparison strategies were used to categorize and compare how school nurses coordinated care, which resulted in the development of an International School Nurse Asthma Care Coordination Model.
FINDINGS: Participants in both countries spontaneously described a similar asthma care coordination process that involved information gathering, assessing risk for asthma episodes, prioritizing healthcare needs and anticipating and planning for student needs at the individual and school levels. This process informed how they individualized symptom management, case management and/or asthma education. School nurses played a pivotal part in collaborating with families, school and healthcare professionals to ensure quality care for youth with asthma.
CONCLUSIONS: Results indicate a high level of complexity in school nurses' approaches to asthma care coordination that were responsive to the diverse and changing needs of students in school settings. The conceptual model derived provides a framework for investigators to use in examining the asthma care coordination process of school nurses in other geographic locations.

PMID: 25223389 [PubMed - as supplied by publisher]

High-dose sublingual immunotherapy in patients with uncontrolled allergic rhinitis sensitized to pollen: a real-life clinical study.

Int Forum Allergy Rhinol. 2014 Sep 15;

Authors: Irani C, Saleh RA, Jammal M, Haddad F

Abstract
BACKGROUND: High-dose pollen sublingual immunotherapy (SLIT) is indicated in patients with moderate to severe allergic rhinitis (AR), especially those who are unable to control their disease with pharmacotherapy. We explore the use of high-dose SLIT in patients with severe AR and sensitized to pollen, in real-life clinical practice. We also analyzed the effect on asthma.
METHODS: This was a prospective observational study conducted at the Allergy outpatient clinic at Hotel Dieu de France Hospital (HDF), Beirut, Lebanon. The cohort, composed of 118 patients between 7 and 55 years old, was regularly evaluated at inclusion, at 12 months, and at 36 months. Fifty-five percent of AR patients had associated controlled asthma. Patients received a standardized pollen extract (Staloral 300IR). The pollen combination was 1 to 3 pollens, the most commonly used were Parietaria judaica, Cupressaceae, 5 grasses, and Oleaceae. In a previous study, those were the main allergenic pollens correlated to AR in the same population. Global assessment of the effect of SLIT was measured using a rhinitis total symptom score (RTSS), a rhinitis medication consumption score (RMCS), a global asthma score (ASS), and an asthma medication consumption score (AMCS).
RESULTS: Using a t test we found that the average scores at inclusion, 12 months, and 36 months, respectively, were as follows: RTSS: 31.32, 16.39 (p < 0.041), and 13.35 (p < 0.041); RMCS: 6.96, 1.96 (p < 0.0162), and 1.61 (p < 0.0162); ASS: 4.62, 1.96 (p < 0.0005), and 1.33 (p < 0.0005); and AMCS: 2.35, 0.78 (p < 0.0005), and 0.7 (p < 0.0005).
CONCLUSION: Our study showed favorable results of SLIT to aeroallergens in patients with uncontrolled AR. The effect is also applicable to the subgroup of patients suffering from concomitant, controlled asthma.

PMID: 25224283 [PubMed - as supplied by publisher]

Related Articles

Disagreement Between Skin Prick Test and Specific IgE in Young Children.

Allergy. 2014 Sep 16;

Authors: Schoos AM, Chawes BL, Følsgaard N, Samandari N, Bønnelykke K, Bisgaard H

Abstract
RATIONALE: Skin prick test (SPT) and measurement of serum specific IgE (sIgE) are important tools for the clinician to diagnose allergic sensitization. However, little is known about the agreement between the two methods in young children.
METHODS: SPT and sIgE levels were assessed simultaneously for 16 common inhalant and food allergens at age ½, 1½, 4 and 6 years in 389 children from the Copenhagen Prospective Study on Asthma in Childhood2000 (COPSAC2000 ) at-risk birth cohort. Agreement between the two methods for diagnosing inhalant and food allergic sensitization at the four age-points was analyzed using kappa statistics.
RESULTS: The prevalence of inhalant allergen sensitization increased during childhood diagnosed by both sIgE levels (0.6% to 4.2% to 18.1% to 24.8%, p<0.0001) and SPT results (1.5% to 3.8% to 8.4% to 15.4%, p<0.0001). In contrast, the prevalence of food sensitization increased during childhood when diagnosed from sIgE (7.8% to 12.1% to 15.0% to 18.9%, p<0.0001), but decreased when diagnosed from SPT (5.3% to 5.1% to 3.7% to 3.0%, p=0.05). Overall, the agreement between SPT and sIgE results was poor to moderate (all κ-coefficients≤0.60) and decreased from moderate to slight for food allergens by increasing age (κ-coefficients: 0.46 to 0.31 to 0.16 to 0.14).
CONCLUSION: There is substantial disagreement between SPT and sIgE for diagnosing allergic sensitization in young children, which increase with age for food sensitization. Choice of assessment method therefore has major impact on results with wide implications for both clinical practice and research. This article is protected by copyright. All rights reserved.

PMID: 25224528 [PubMed - as supplied by publisher]