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April 2007
Influenza - had your vaccination yet?
The Asthma Management Handbook 2006
Allergic rhinitis and asthma symptom protection in children
Weight seems to matter in asthma
Selected abstracts from the 2007 TSANZ Annual Scientific Meeting
Australian Asthma & Respiratory Educators Association - Professional Development Day
Research Funding Opportunities
World Asthma Day May 1, 2007
World Asthma Day (WAD) takes place each year on the first Tuesday in May. Initiated by the Global Initiative for Asthma in 1998, the National Asthma Council Australia (NAC) embraces WAD and marks the occasion to highlight the need for ongoing care and vigilance in managing asthma.
The NAC will publish a special newsletter on May 1.
The Asthma Foundations around Australia also take the opportunity on World Asthma Day to announce asthma initiatives or highlight areas of endeavour in asthma in their otherwise busy calendar of activities. Please take time to view activities and your local Foundation website.
Australian Capital Territory
The Chief Minister of the ACT, Jon Stanhope, will be acknowledging World Asthma Day by participating in activities at Fraser Primary School and then presenting the school with their Asthma Friendly School Certificate of Recognition.
The Asthma Foundation of ACT - www.asthmaact.org.au
New South Wales
Asthma Foundation NSW will be taking the message that “You Can Control Your Asthma” to the public on May 1 through a range of media channels.
Free spirometry testing will be conducted in Pitt Street Mall between 11am and 2pm. Health professionals and Asthma Educators will be available to conduct and interpret the tests.
People with asthma should make an appointment with their GP to get an Asthma Action Plan if they don’t already have one.
The Asthma Foundation of New South Wales - www.asthmansw.org.au
Queensland
The Asthma Foundation of Queensland is conducting the World Asthma Day Forum for health professionals working in asthma management. The purpose of the forum is to present health professionals with the most current research, enabling them to improve health outcomes for people with asthma.
The O2 Initiative being launched by the Asthma Foundation of Queensland is the biggest ever search for people with asthma in Queensland. The Foundation is looking to eventually register all of the estimated 500,000 people with asthma in Queensland. Local television celebrity and Asthma Foundation board member Mr Pat Welsh is leading the campaign. To find out more about the O2 Initiative, visit www.asthmaqld.org.au and click on 'Register your asthma'.
The Asthma Foundation of Queensland's “The Search for the Ruby” begins on World Asthma Day to promote awareness of research into asthma in Queensland and to publicise the Ruby Research Ball 2007 being held later in the year. To find out more about “The Search for the Ruby” and the Ruby Research Ball 2007, go to www.rubyresearch.org.au or phone Tracey McLeod on (07) 3252 7677.
The Asthma Foundation of Queensland - www.asthmaqld.org.au
Northern Territory
On 1 May at 1pm Ludmilla Primary School will promote asthma awareness by involving Asthma Foundation NT in a display about asthma, promoting physical activity and asthma and blowing out five out of six candles on a cake to signify that one in six children has asthma in Australia.
Schools can become asthma friendly by:
- Registering an interest in the program and receiving resources
- Achieving recognition as an Asthma Friendly School by fulfilling the eight essential criteria.For more information please contact Jill McGee at Asthma Foundation NT on 8922 8817.
South Australia
The Asthma Foundation of South Australia - www.asthmasa.org.au
Tasmania
The Asthma Foundation of Tasmania - www.asthmatas.org.au
Victoria
The Asthma Foundation of Victoria - www.asthma.org.au
Western Australia
The Asthma Foundation of Western Australia - www.asthmawa.org.au
Influenza - had your vaccination yet?
For most parts of Australia now is the best time to have your influenza vaccination, before serious outbreaks
of influenza can begin to occur. In the far north of Australia
outbreaks can occur early in the year and vaccination
should be undertaken as early as possible.
It usually takes about two weeks for full immunity to develop.
While some respiratory infections – such as the common cold – are generally easy to recover from, others like influenza can result in serious illness and even death. This is particularly the case for people who have underlying medical conditions which put them at greater risk of complications from respiratory infection. Many people who should be vaccinated are not, because they believe being fit and healthy will protect them against influenza. This is not the case.
Influenza vaccination is currently recommended for all people who want it and particularly recommended for
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children 6 months and older with severe asthma (frequent asthma attacks or regular hospital admissions)
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teenagers with severe asthma
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adults with severe asthma
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anybody aged 65 and over regardless of their health status
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pregnant women with severe asthma or women with asthma who anticipate being pregnant through the winter.
(It is wise to be vaccinated before the pregnancy.)
Other underlying medical conditions which put people at greater risk of complications from respiratory infections such as influenza are:
- chronic respiratory diseases – such as Chronic Obstructive Pulmonary Disease (COPD)
- chronic heart disease – such as ischemic heart disease, angina or those who have suffered a heart attack
- diabetes and
- renal disease.
Beware of the cough or sneeze
Influenza is spread when infected people cough or sneeze into the air, transmitting droplets which are breathed in by other people. One cough or sneeze can transmit the virus up to two metres.
It is estimated that a person who has influenza could pass it on to up to a dozen other people. The infection can also be acquired by contact by hand to face (mouth, eye) contact with contaminated surfaces.
Influenza is highly contagious. After someone coughs or sneezes the virus can survive for:
- up to an hour in the air in enclosed environments.
- more than eight hours on hard surfaces such as stainless steel and plastic.
- up to five minutes on hands after transfer from other surfaces.
Reduce your risks
There are a number of things people can do to protect themselves against influenza:
- vaccination is the best way of helping protect yourself against influenza;
- hand washing and personal hygiene, such as trying not to touch your mouth or nose are also important preventative measures; and
- where possible, avoid crowds when influenza is prevalent.
For more information see
Vaccine Update for people with asthma, COPD, or diabetes
A new face at the NAC
Siobhan
Brophy joined the National Asthma Council Australia in April as
Communications Manager, taking over from Kathy Hope.
Siobhan has a medical publishing background, having worked as an editor and project manager for Blackwell Publishing Asia for some years. While focused primarily on academic journal production, she was also concerned with e-publishing initiatives and business communications.
In addition, Siobhan is a qualified optometrist. She practised full time for three years before moving into the communications field and has continued to consult occasionally since then. As a primary eye-care practitioner, Siobhan has first-hand experience of the challenges and rewards of managing chronic conditions.
Siobhan will soon complete a Graduate Certificate in Arts (Editing & Communications) at the University of Melbourne, where she attained her Bachelor of Optometry.
The combination of her two disparate careers means that Siobhan has a particular interest in dissemination of information in a healthcare context, plus an enthusiasm for project management.
The NAC is delighted to welcome her on board.
As Communications Manager, Siobhan will be co-ordinating the NAC’s publications (hard copy and online) and managing a variety of projects. She will look after the GP Asthma Group and the Pharmacists’ Asthma Group and other expert committees. She has already joined in the deliberations for the next Asthma Management Handbook and begun to implement systems improvements.
The Asthma Management Handbook 2006
A small number of typographical errors have been identified since the Asthma Management Handbook 2006 was published last November.
These errors have been corrected in the online version. If you have a printed version, please amend your copy accordingly.
| Page | Location | Correction | Date |
| iv | Column 2, line 9 |
Specialist reviewer omitted. List
should include: |
7 March 2007 |
| 7 | Column 1, line 7 |
Incorrect unit given. Text should
read: |
17 April 2007 |
| 10 | Table 2 | Table shading incorrect. Shading should be swapped so that dark (red) boxes are pale and pale (green) boxes are dark | 7 March 2007 |
Any further corrections to the handbook will be posted online. See Errata
Allergic rhinitis and asthma symptom protection in children
A "Mediterranean" diet rich in fruits, vegetables and nuts
protects against allergic rhinitis and asthma symptoms, according to
a research group from the UK and Greece.1
The researchers assessed the dietary habits, respiratory symptoms, and allergic reactions of almost 700 children living in four rural areas on the Greek island of Crete.
The children were all aged between 7 and 18 years of age.
Skin allergies are relatively common in Crete, but respiratory allergies, such as asthma and allergic rhinitis are relatively rare.
Parents completed detailed questionnaires on their children's allergic and respiratory symptoms and dietary habits.
Whether the children ate a "Mediterranean" diet was measured against a set of 12 foodstuffs, including fruits, vegetables, whole-grains, legumes, nuts, and olive oil.
Eight out of 10 children ate fresh fruit, and over two thirds of them ate fresh vegetables, at least twice a day.
The effect of diet was strongest on allergic rhinitis, but it also afforded protection against asthma symptoms and skin allergy.
Children who ate nuts at least three times a week were less likely to wheeze.
Nuts are a rich source of vitamin E, the body's primary defence against cellular damage caused by free radicals. And they contain high levels of magnesium, which other research suggests, may protect against asthma and boost lung power.
And a daily diet of oranges, apples, and tomatoes also protected against wheezing and allergic rhinitis.
Grapes in particular seemed to protect against current and previous wheezing and allergic rhinitis, even after adjusting for other potentially influential factors.
Red grape skin contains high levels of antioxidants as well as resveratrol, a potent polyphenol, known to curb inflammatory activity, say the authors.
But high consumption of margarine doubled the chances of asthma and allergic rhinitis, the findings showed.
Reference
1. Leda Chatzi, Gianna Apostolaki, Ioannis Bibakis, Isobel Skypala, Vasiliki Bibaki-Liakou, Tzanakis Tzanakis, Manolis Kogevinas, and Paul Cullinan. Protective effect of fruits, vegetables and the Mediterranean diet on asthma and allergies among children in Crete. Thorax Published Online First: 5 April 2007. doi:10.1136/thx.2006.069419
Weight seems to matter in asthma
For overweight and obese individuals, the incidence of asthma increases by 50 percent, as compared to those of normal weight, according to a meta-analysis of seven studies on severe asthma involving 333,102 patients.2
E. Rand Sutherland, M.D., M.P.H., of the National Jewish Medical and Research Center in Denver, and one associate found a dose-dependent increase in the odds for asthma in overweight and obese men and women. Based on their results, the researchers suggest that asthma incidence could by reduced by targeted interventions against being overweight or obese.
Dr. Sutherland noted that the odds of asthma incidence in overweight men and women were similar.
The researchers noted that obesity in the absence of asthma causes physiologic impairments in lung function, including reduction in lung volume, chest wall restriction and an increase in the oxygen cost of breathing. It also contributes to various other conditions including gastroesophageal reflux and sleep apnea. These difficulties can result in breathlessness (dyspnea) and wheezing, which might be mistaken for asthma by patients and clinicians.
Weight loss studies have shown improvements in lung function and asthma symptoms, but not necessarily in airflow obstruction or airway hyperresponsiveness. Dr Sutherland also noted that it is also reasonable to believe that some of the patients with ‘asthma’ may have respiratory symptoms due to obesity but may not meet rigorous objective physiologic criteria for asthma.
The authors concluded that obesity is a well-established risk factor for diabetes, sleep apnea, stroke, cardiovascular disease, arthritis and other illnesses. They said their findings support the addition of asthma to that list.
Reference
2. David A. Beuther and E. Rand Sutherland Overweight, Obesity, and Incident Asthma: A Meta-analysis of Prospective Epidemiologic Studies Am. J. Respir. Crit. Care Med. 2007; 175: 661-666
Selected abstracts from the 2007 TSANZ Annual Scientific Meeting
The
Thoracic Society of Australia and New Zealand held its 2007 Annual
Scientific Meeting in New Zealand in late March. Some abstracts of
interest are shown here.
All the 2007 TSANZ abstract may be seen at www.thoracic.org.au/asm2007abstracts.html
Increasing the uptake of Written Action Plans in General Practice - a model that works
Judi Wicking, Leigh Barnetby, Melissa Glogolia, Marianne Shearer, Adam McLeod
Whitehorse Division of General Practice (WDGP), Nunawading 3131 Victoria, Australia
Written action plans for asthma have been shown to improve health outcomes although the uptake in General Practice has been poor. The Asthma & Respiratory Clinics in General Practice program developed by the WDGP has been operational since 2001. This program places qualified Asthma & Respiratory Educators in general practices to work collaboratively with GPs in the management of their patients with respiratory health needs.
Objectives:
To assess the ownership of written action plans through this model of care, inhaled medication device use, self management levels of confidence and patient satisfaction with their visits to the clinic.
Methods:
The WDGP nurse educators over a period of ten months collected data from attendees at the clinics n=49. Surveys included ownership of a current written action plan, medication device use and level of confidence in managing their asthma. Patients also completed a satisfaction survey after their final clinic visit.
Results:
Ownership of written action plans increased from 8% at the first visit to 77% which is statistically significant with a p value of <0.05. Patients level of confidence increased by 5%. Device use improved from baseline (poor 72%, adequate 56% and optimal 16%) to the final visit (no patients device use was poor, 52% patients was adequate and 47% patients was optimal). Satisfaction surveys indicated 74% patients rated the clinics very helpful, 23 % rated them helpful and 2% rated them quite helpful.
Conclusions:
The Asthma & Respiratory Clinics in general practice model of care increases the uptake of written action plans, improves patients’ correct use of inhaled medication devices, increases patients self management level of confidence and was shown to be quite helpful to very helpful for patients. Partially supported by the Hospital Admission Reduction Risk Program
Conflict of interest: NO
Can we move beyond the barriers to optimal use of spirometry in general practice?
R Aroni1, R Schattner2, F Thien3, N Sulaiman4, E Side5, MJ Abramson2
1 Monash Institute for Health Services Research, Clayton 3168; 2 Epidemiology & Preventive Medicine, Monash University, Melbourne 3004; 3 Allergy, Immunology & Respiratory Medicine, The Alfred; 4 General Practice, The University of Melbourne; 5 Pulmetrics Ltd
Guidelines for asthma and COPD stress the importance of spirometry. We aimed to identify the perceived barriers and enablers to its more widespread use in general practice.
Methods:
5 focus groups were conducted: 2 of General Practice staff (GPs and nurses) and 3 of consumers and carers, with a total of 33 participants. Each focus group discussion was audio-recorded and transcribed. The facilitator used an agreed list of initiating questions and facilitated more extensive discussion of key topics raised by participants in the course of discussion. Content and thematic analyses were conducted.
Results:
Barriers to the use of spirometry identified by GP staff included: lack of time, insufficient remuneration, the expertise required for calibration / maintenance of equipment and cost of practice nurses. Possession of a spirometer did not guarantee its use; not all used spirometry in their own practices even if they had the equipment. Perceived enablers were support from government and Divisions of General Practice and access to practice nurses with expertise in spirometry. Consumers’ perceived barriers included patients’ lack of knowledge about spirometry, lack of adequate communication by clinicians, concern about potential costs and issues of access. Participants of lower socioeconomic status were concerned about the cost and longer consultations if bulk billing was not available.
Conclusions:
A number of potentially reversible factors that limit the use of spirometry to diagnose and manage asthma and COPD in general practice have been identified. Our results suggest that government and Divisions need to provide more financial and other support (such as access to the optimal equipment, staff training, guidance on test interpretation, calibration and quality assurance).
Supported by an NHMRC General Practice Clinical Research Grant
Barriers and facilitators to influenza vaccination among high risk groups aged less than 65 years
Nicholas Zwar1,2, Iqbal Hasan1, Mark Harris1, Vanessa Traynor1
1 School of Public Health and Community Medicine, University of New South Wales; 2 General Practice Unit, Sydney South West Area Health Service.
In Australia, 42% of the adults aged less than 65 years with high risk factors for influenza complications are currently being vaccinated against influenza compared to 79% of adults aged 65 and over. This indicates a considerable scope for improvement in the vaccination rates among the under 65 high-risk groups. This qualitative study explored the barriers to influenza vaccination among under 65 high-risk groups. Strategies to overcome those barriers were also explored.
Method:
Six focus groups were conducted – five with GPs and one with practice nurses. The groups were conducted across rural and urban Divisions of General Practice in NSW and South Australia.
Results:
The barriers to influenza vaccination revealed included: lack of knowledge and awareness and misconceptions among patients about influenza and influenza vaccination; GP workload; lack of GP motivation; insufficient numbers of practice nurses; lack of patient recall systems; cost of the vaccine; and lack of media campaign targeting under 65 high-risk groups. Strategies proposed to overcome those barriers included: education campaigns targeting patients and health professionals; dissemination of evidence to health professionals as to the benefits of influenza vaccination; incentives to the practices to implement patient recall system; greater involvement of practice nurses in vaccination; and free supply of vaccine.
Conclusions:
An improvement in vaccination rates in the under 65 high-risk groups has significant implications for health benefit, reduced need for health services and reduced health. This study suggests a number of options for improving the vaccination rate in this group of patients. Supported by National Institute of Clinical Studies
Conflict of Interest: No
Australian Asthma & Respiratory Educators Association - Professional Development Day
Monday
7th May 2007, Victoria
Newcomb Community Health Centre Barwon Health 104 – 108 Bellarine Highway Newcomb
Hosted by Chelsea Gielen COPD Community Clinician - HARP
The program for the day includes:
- Congestive Heart Failure – Signs, Symptoms & Management
- Update on the Asthma Annual Cycle of Care
- Effects of Smoking
- Colac Area Health Smoking Cessation Clinic
- Member Update – Smoking Cessation (Poster Presentation)
- Exacerbations in COPD
- Sleep Apnoea, Sleep Studies and CPAP
Venue: Newcomb Community Health Centre Barwon Health
104 – 108 Bellarine Highway Newcomb
Registration Fees: Member $ 55.00 (GST not applicable) Non-member $ 99.00 (includes GST)
To assist with catering and the organisation of the day please complete registration form and forward to AAREA by May 1.
AAREA Regional PD Day Registration (PDF)
AAREA Regional PD Day Programme (PDF)
Research Funding Opportunities
Effective Asthma Research Holds the Key to Improved Lifestyles for Many People Diagnosed With Asthma
Asthma Foundation of Queensland
Research Grants 2008
Up to $250,000
Applications are invited for grants in research relating to asthma. The research, which must be undertaken in Queensland, may be in either basic medical sciences or clinical fields.
Grants will be awarded only to individuals and to institutions with access to appropriate research facilities under the supervision of a responsible investigator. Grants may cover salaries for research, technical, or other assistance as well as the cost of minor equipment, materials and other necessary items.
Further information and application forms are available from:-
Chief Executive Officer
The Asthma Foundation of Queensland
PO Box 394 FORTITUDE VALLEY QLD 4006
Email: info@asthmaqld.org.au
Phone: (07) 3252 7677 or 1800 645 130
Fax: 07 3257 1080
Website: www.asthmaqld.org.au
Applications close on 1 May 2007
| The National Asthma Council Australia would be pleased to list funding opportunities that may be available for asthma research. Submit brief details for consideration by email to editor@nationalasthma.com.au. |
Conference Diary 2007
Submit brief conference/meeting details to the National Asthma Council for possible posting in our Conference Diary by email to editor@nationalasthma.com.au.
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ATS 2007 International
Conference May 18-23, 2007 San Francisco, California (http://www.thoracic.org/sections/meetings-and-courses/international-conference/2007/index.html) |
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XXVI Congress of the
European Academy of Allergology and Clinical Immunology,
EAACI 2007 (http://www.congrex.com/eaaci2007/) |
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17th Annual
Congress of the ERS (http://dev.ersnet.org/51-welcome-address.htm)
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50th Annual
Scientific Convention 2007 New South Wales
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18th ASCIA Annual
Scientific Meeting 14-16 November 2007 Esplanade Hotel, Fremantle, Western Australia (http://www.allergy.org.au/) in conjunction with: |
