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New Peak Flow Chart |
November 2007
For peak flow monitoring the eyes have it
Asthma Management for Indigenous Australians
New discovery to help
people with asthma
Post–Traumatic Stress
Disorder Symptoms and Asthma
Links found between asthma and
depressive disorders
Infant bedding and
asthma
Economic Status Tied
To Lung Function
Fracture Risk Involving Inhaled Beta-agonists
2nd Australian Lung Cancer
Conference 2008
Research Funding Opportunities
Conference Diary
For peak flow monitoring the eyes have it
When it comes to asthma monitoring,
the eye is the key; according to Associate Professor
Helen Reddel, who has spent years researching and
refining a new peak expiratory flow chart.
The new chart, which is available
from the National Asthma Council Australia and
Woolcock Institute of Medical Research websites, has
been designed to enable easy identification of
changes in lung function and to overcome the
confusion caused by the disparity of charts in
circulation.
“Being able to interpret the results
at a glance is critical,” explained Assoc Prof
Reddel, Research Leader at the Woolcock and
Respiratory Physician at the Asthma Centre at Royal
Prince Alfred Hospital.
“But, unfortunately there are so
many different charts available in Australia for
recording peak flow, that this has not previously
been possible.
“The design of some existing charts
actually makes changes in lung function extremely
hard to detect and can hide important variations in
asthma control,” she cautioned.
Research has shown that the shape of
the chart itself has an effect on our perception of
the results.
“On a stretched-out chart, even a
severe exacerbation may appear mild and the
beginning of the exacerbation may be hard to
recognise,” Assoc Prof Reddel said. “On a chart that
is compressed horizontally, however, it is easy for
the patient or doctor to see when the peak flow
falls below the patient’s usual range and to see
gradual rises or falls in peak flow.”
Based on her research and feedback
from patients and health professionals who have
piloted the new chart, Assoc Prof Reddel is a strong
advocate for the standardisation of PEF charts in
Australia. “There should be no room for confusion,”
she said. “In the same way that ECG traces are
displayed consistently in every ICU around the
country, peak flow readings should be displayed
consistently too.
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Immediate, consistent, visual impact
is the key to ensuring peak flow monitoring is an
effective asthma management tool when it is used.
Associate
Professor Helen Reddel
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The National Asthma Council’s
Asthma Management Handbook 2006 recommends peak
flow monitoring for certain adults with moderate to
severe asthma, in addition to monitoring of asthma
symptoms and reliever use.
The new peak flow chart developed by
Assoc Prof Reddel and colleagues at the Woolcock
Institute of Medical Research and the Asthma Centre
at Royal Prince Hospital is available at:
www.nationalasthma.org.au and
www.woolcock.org.au
Resources
NAC Asthma Programs with the Rural Health Education
Foundation
Peak flow chart
Lung
function tests: information for consumers
Lung function tests: information for health professionals
Asthma
Management Handbook 2006. Melbourne: National Asthma Council Australia,
2006. See:
Role of PEF monitoring
Asthma Management for Indigenous Australians
 The
National Asthma Council's program Taking a Breather:
Asthma Management for Indigenous Australians will be
broadcast on the Rural Health Education Foundation
satellite network on the evening of Tuesday 11
December.
Contrary to popular belief, Indigenous
Australians are more likely to have asthma than
non-Indigenous Australians. This difference exists
across all age groups but it is most pronounced in
older adults, especially women aged over 35 in whom
the prevalence for Indigenous Australians is double
that for non-Indigenous Australians.
Asthma is a manageable condition, however many of
the current mainstream asthma management programs
are less appropriate in Indigenous communities due
to factors such as resource availability, language
use and cultural context.
The program will focus on the cultural and
medical issues surrounding effective asthma
management in Indigenous Australians, including
prevalence, diagnosis and risk factors. With an
emphasis on culturally appropriate information,
topics include the role of asthma action plans in
patient self-management, appropriate medications,
and use of and access to devices.
Speakers
- Chair: Dr Norman Swan, Presenter of the
Health Report on ABC Radio National.
- Professor Anne Chang, Paediatric
Respiratory Medicine Consultant, Royal
Children’s Hospital, Brisbane and Menzies School
of Health, Darwin
- A/Prof Graeme Maguire, Respiratory
and Outreach Physician, James Cook University
and Cairns Base Hospital, Cairns
- Ms Anne Bastian, Asthma Educator,
Asthma Foundation Northern Territory, Darwin
- Dr Penny Abbott, General
Practitioner, Western Sydney Aboriginal Medical
Service, Mt Druitt
- Mr Chris O’Brien, Aboriginal Health
Worker, Illawarra Aboriginal Medical Service,
Dapto
Learning outcomes
After viewing this program, participants will be
able to:
- Recognise specific issues relating to asthma
in Indigenous communities
- Increase their understanding of the
importance and effectiveness of:
- early detection of asthma
- trigger and risk factor management,
particularly smoking
- self-management, particularly the use of
asthma action plans and adherence to
pharmacotherapy
- Identify community-based initiatives that
improve access to medications and devices
- Understand the importance of culturally
appropriate patient information
Resources
NAC Asthma Programs with the Rural Health Education
Foundation
http://www.rhef.com.au/programs/720/720.html
New discovery to help people with asthma
Hunter researchers have discovered a new protein that plays
a crucial role in the development of one of Australia's
biggest health problems - asthma.
Dr Joerg Mattes and colleagues from the University
of Newcastle, the Hunter Medical
Research Institute (HMRI), and the University
of Freiburg in Germany,
discovered high concentrations of a protein called TRAIL in the airways of
asthmatics.
The research shows the inhibition of TRAIL provides protection from the
development of airway inflammation and airflow obstruction, which are the
hallmark features of asthma.
Dr Mattes, winner of the 2006 TSANZ and NAC Asthma Prize for his earlier work on
TRAIL, said the team would now conduct further research
to investigate new therapies for asthma, which involve inhibiting the protein.
The research is one of many projects being undertaken by
researchers in the University of Newcastle's
Priority Research Centre (PRC) for Asthma and Respiratory Diseases.
The University
of Newcastle recently secured
almost $3.5m in National Health and Medical Research Council (NHMRC) funding
for research into understanding and developing new ways to treat the chronic
condition.
Centre Director Professor Paul Foster received more than
$1.7m for three projects exploring new therapies in the treatment of asthma,
advanced ways to inhibit the development of the disease, and preclinical
testing of new asthma treatments.
"Asthma is one of the most significant health and
economic burdens on society, and its prevalence has steadily increased over the
last 25 years," Professor Foster said. "One in five Australian
children suffer from asthma, making it the most common chronic disease in
childhood."
Professor Foster said new ways of treating asthma were
urgently required as current therapies treated the symptoms and not the causes
of the disease.
A further $1.7 million was awarded to four other researchers
in the PRC investigating asthma and other respiratory diseases.
Established in 2006, the PRC works in collaboration with
HMRI's Vaccines, Immunity, Viruses and Asthma program. The University
of Newcastle is also part of a
Cooperative Research Centre (CRC) for Asthma
and Airways, a collaborative team that brings together many of the best asthma
researchers in Australia.
Resources
TSANZ and NAC Asthma Prize
Post–Traumatic Stress Disorder Symptoms and Asthma
For the first time, a study has linked asthma with
post-traumatic stress disorder (PTSD) among adults in the community. The study
of male twins who were veterans of the Vietnam
era suggests that the association between asthma and PTSD is not primarily
explained by common genetic influences.
The study included 3,065 male twin pairs, who had lived
together in childhood, and who had both served on active military duty during
the Vietnam War. The study found that among all twins, those who suffered from
the most PTSD symptoms were 2.3 times as likely to have asthma compared with
those who suffered from the least PTSD symptoms.
The research was published in the first issue for November
2007 of the American Journal of Respiratory and Critical Care Medicine,
published by the American Thoracic Society.
The study included both monozygotic (identical) twins, who
share all the same genetic material, and
dizygotic (fraternal) twins, who share only half of the same genetic
material. "If there had been a strong genetic
component to the link between asthma and PTSD, the results between these two
types of twins would have been different, but we didn't find substantial
differences between the two," said lead researcher Renee D. Goodwin, PhD,
MPH., Assistant Professor of Epidemiology at the Mailman School of Public
Health at Columbia University in New York City.
Several other studies have found a relationship between
asthma and other anxiety disorders, Dr Goodwin noted. This new research also
confirmed previous findings that linked asthma with a higher risk of
depression. "No one knows the reason for the association between asthma and
mental disorders," she said. "Asthma could increase the risk of anxiety
disorders, or anxiety disorders might cause asthma, or there could be common
risk factors for both asthma and anxiety disorders. Our study found the
association between asthma and PTSD does not appear to be primarily due to a
common genetic predisposition."
The researchers found the association between asthma and
PTSD existed even after they took into account factors such as cigarette
smoking, obesity and socioeconomic status, all of which are associated with
both anxiety disorders and asthma.
"It is conceivable that traumatic stress, which has been
associated with compromised immune functioning, leads to increased
vulnerability to immune-system-related diseases, including asthma," Dr Goodwin
and colleagues wrote. "Alternatively, it may be that having asthma places
adults at increased risk for PTSD as it increases the likelihood that they will
be exposed to a traumatic situation because they have a life-threatening chronic
medical condition."
The findings suggest that a person with asthma who
experiences a traumatic event may benefit from seeking professional help,
because they could be more vulnerable to developing post-traumatic stress
disorder, Dr Goodwin said.
Reference
Goodwin RD, Fischer FE, Goldberg J. A Twin Study of Post–Traumatic Stress
Disorder Symptoms and Asthma. Am J Respir Crit Care Med. 2007 Nov
15;176(10):983-7. Epub 2007 Aug 16.
http://ajrccm.atsjournals.org/cgi/content/abstract/176/10/983
Links found between asthma and
depressive disorders
Young people with asthma are about twice as likely to suffer
from depressive and anxiety disorders than are children without asthma,
according to a study by a research team in Seattle.
Previous research had suggested a possible link in young people between asthma
and some mental health problems, such as panic disorder, but this study is the
first showing such a strong connection between the respiratory condition and
depressive and anxiety disorders. The findings appear in the November issue of
the Journal of Adolescent Health.
The study was conducted by researchers at the University of
Washington School of Medicine, Group Health Cooperative, and Seattle Children's
Hospital Research Institute. The researchers interviewed more than 1,300
youths, ages 11 to 17, who were enrolled in the Group Health Cooperative health
maintenance organization. Of the participants, 781 had been diagnosed with or
treated for asthma, and the rest were randomly selected youths with no history
of asthma.
About 16 percent of the young people with asthma had
depressive or anxiety disorders, the researchers found, compared to about 9
percent of youth without asthma. When controlling for other possible variables,
youth with asthma were about 1.9 times as likely to have such depressive or
anxiety disorders.
Researchers tested for several depressive and anxiety
disorders, including depression, a mood disorder called dysthymia, panic
disorder, generalized anxiety disorder, separation anxiety, social phobia, and
agoraphobia. These disorders are somewhat common in youth, and are associated
with high risk for school problems, early pregnancy, adverse health behaviors
like smoking or lack of exercise, and suicide.
Young people with depressive and anxiety disorders often
find it harder to manage their asthma and describe more impaired physical
functioning because of the combination of asthma and a depressive or anxiety
disorder, the researchers said. Youth with asthma and one of the disorders are
also more likely to smoke, making their asthma more difficult to treat.
"Physicians treating young people with asthma should
realize that those children are at a greater risk of depressive and anxiety
disorders, and should try to educate patients and their families about this
increased risk," said Dr Wayne Katon, professor and vice-chair of
psychiatry at the UW School of Medicine, and corresponding author of the study.
"The primary care system is correctly identifying only about 40 percent of
the cases in which children with asthma also have a psychiatric disorder. We
should improve our screening for these disorders, and develop effective treatment
programs for affected patients that address both asthma and the depressive or
anxiety disorder."
In addition to exploring the link between asthma and
depressive and anxiety disorders, researchers found other variables that
further increase the risk of such disorders. Female respondents were at a
greater risk of depressive and anxiety disorders, as were youth living in a
single-parent household, those who had been diagnosed with asthma more
recently, and those with more impairment in asthma-related physical health.
Reference
Katon W, Lozano P, Russo J, McCauley E, Richardson L, Bush T. The
prevalence of DSM-IV anxiety and depressive disorders in youth with asthma
compared with controls. J Adolesc Health. 2007 Nov;41(5):455-63. Epub 2007 Sep
4.
http://www.jahonline.org/article/PIIS1054139X07002443/abstract
Infant bedding and asthma
Research suggests children who sleep on old
mattresses during the first year of life are more at
risk of developing breathing disorders such as
asthma.
A study by The University of Auckland showed that
wheezing at ages 3.5 and 7 years was more common in
children who slept on a used mattress in the first
year of life. Children who were treated with
antibiotics or spent time at daycare in the first
year of life also showed signs of breathing problems
at 7 years old.
The study assessed 871 New Zealand children of
European descent at birth and ages 12 months, 3.5
years and 7 years. Any incidents of wheezing or
whistling in the chest over the year prior to the
assessments were noted, and parents were asked to
provide details of lifestyle, including pet
ownership, breastfeeding, smoking by members of the
household, use of bedding, such as mattresses,
quilts and pillows, day care attendance and health
and development.
The study found that 24% of children suffered
from wheezing at 3.5 years and 18% at 7 years. The
main factors associated with children with breathing
problems were maternal smoking during pregnancy,
being in day care, antibiotic use, the presence of a
dog and sleeping on a used cot mattress in the first
year of life.
"Environmental factors are known to have an
effect on allergic diseases, such as asthma,
particularly in children," says Professor Ed
Mitchell of the Faculty of Medical and Health
Sciences. "This study has shown that some factors
thought to affect children’s breathing, such as use
of pillows, do not have a great effect but others,
such as maternal smoking, antibiotics, day care
attendance and used mattresses, do. The observation
that used cot mattresses are associated with asthma
at 7 is particularly intriguing, and may be related
to higher levels of house dust mite, endotoxin or
other germs in the mattress."
Resource
Asthma and Infant Bedding
Asthma and
Infant Bedding - A guide for health professionals
Reference
Mitchell EA, Robinson E, Black PN, Becroft DMO, Clark PM,
Pryor JE, Thompson JMD, Waldie KE, Wild CJ. Risk factors for
asthma at 3.5 and 7 years of age Clinical & Experimental Allergy. 2007: 37 (12),
1747–1755. doi:10.1111/j.1365-2222.2007.02847.x (http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2222.2007.02847.x)
In Brief
Economic Status Tied To Lung Function
New research reveals that a person's socioeconomic status (SES)
may be an important determinant of lung function. After reviewing 20 years of
medical literature regarding the relationship between SES
and lung function in children and adults, researchers from LDS
Hospital and the University
of Utah in Salt
Lake City found a significant negative correlation
between the two, even after adjusting for smoking status, occupational
exposures, and race. In some instances, researchers reported reductions of FEV1
of greater the 300 mL in men and 200 mL in women of low SES.
Reference
Hegewald MJ, Crapo RO. Socioeconomic status and lung function. Chest. 2007
Nov;132(5):1608-14.
http://www.chestjournal.org/cgi/content/abstract/132/5/1608
Fracture Risk Involving Inhaled Beta-agonists
Increased fracture risk associated with inhaled short-acting
beta-agonists may be linked to the severity of the underlying disease, rather
than the medication, according to a new study. Researchers from Denmark
matched patients experiencing a fracture with three age- and gender-matched
control subjects. They found that those patients with more severe chronic lung
diseases, such as
COPD and emphysema, had a higher relative risk of fracture vs patients with
asthma. They also found that while some bronchodilators and inhaled
corticosteroids were not associated with fracture risk, oral beta-agonists at low
doses were associated with fracture, and inhaled short-acting beta-agonists were
associated with an increased risk that was not dose-dependent.
Reference
Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk in patients with chronic
lung diseases treated with bronchodilator drugs and inhaled and oral
corticosteroids. Chest. 2007 Nov;132(5):1599-607. Epub 2007 Sep 21.
http://www.chestjournal.org/cgi/content/abstract/132/5/1599
2nd Australian Lung Cancer Conference 2008
 The Australian Lung Foundation invites you to attend the 2nd Australian Lung Cancer Conference 2008
which will be held at the Holiday Inn at Surfers Paradise, Gold Coast
from 21 August to 24 August 2008.
This conference will bring together international experts including Jim
Jett (USA) and Drew Turrisi (USA). It also includes Australia's key
opinion leaders in an interactive workshop environment addressing the
latest update and scientific research on lung cancer.
Who should attend?
Professionals with a vested interest in the continued development and research of lung cancer should not miss this conference.
It is anticipated the conference will attract clinicians and scientists involved in lung cancer, including:
- Physicians
- Surgeons
- Oncologists
- Medical Oncologists
- Radiotherapists & Radiologists
- Pathologists
- Nursing Professionals
- Allied Health Professionals
- Clinical Scientists and Medical Researchers
- Palliative Care Clinicians
- General Practitioners
- Researchers
For up to date information please visit the conference website www.alcc.net.au
Research Funding Opportunities
| 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
Submit brief conference/meeting details to
the National Asthma Council Australia for possible posting in our
Conference Diary by email to
editor@nationalasthma.com.au.
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Asian Intensive Care: problems and solutions
28-30 November 2007
Hong Kong SAR, China
Department of Anaesthesia and Intensive Care, the Chinese University of Hong Kong
Contact: Ms. Rebecca Luk, Dept. of Anaesthesia and Intensive Care, Prince of Wales Hospital, Hong Kong
Fax: (852) 2637 2422
http://www.aic.cuhk.edu.hk/web8/Conference.htm
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Australian Asthma and
Respiratory Educators Association 2007 Conference
“Come and breathe new life into your practice”
29-30 November 2007
Legends Hotel
Surfers Paradise
Australian Asthma and Respiratory Educators Association
(http://www.aareducation.org.au) |
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12th APSR Congress
30 November - 4 December 2007
Gold Coast Convention & Exhibition Centre
Broadbeach, Surfers Paradise,
Queensland, Australia
APSR
2007
(http://www.apsr2007.org) |
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World Allergy Organization
2-6 December 2007
Thailand, Bangkok
http://www.worldallergy.org/
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Annual Meeting of Taiwan Society of Pulmonary and Critical Care Medicine
8-9 December 2007
Taipei, Taiwan
spccm@mars.seed.net.tw
http://www.tspccm.org.tw/
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2008
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Pulmocon
2008
Working together to promote lung health
20-22 February 2008
Dhaka, Bangladesh
http://www.lungbd.org |
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3rd Global Patients Congress
20-22 February 2008,
Budapest, Hungary
http://www.patientsorganizations.org/congress2008 |
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11th Asian Congress of Agricultural Medicine and Rural Health
22-24 February 2008
Aurangabad, Maharashtra, India
11asiancongress@pmtpims.org
http://www.pravara.com/
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64th Annual Meeting of American Academy of Allergy, Asthma & Immunology
7-11 March 2008
Philadelphia, United States
http://www.aaaai.org/
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16th Annual Meeting of The Asian Society For Cardiovascular Surgery
13-16 March 2008
Singapore
http://www.ascvs2008.com/
mice@themeetinglab.com
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2008 Annual
Scientific Meeting
30 March - 2 April 2008
Melbourne Convention Centre
Melbourne, Victoria
2008 ASM TSANZ
(http://www.thoracic.org.au/asm2008.html) |
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ATS, Annual meeting of the American Lung Association & American Thoracic Society
16-21 May 2008
Toronto, Canada
http://www.thoracic.org/
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2nd
Australian Lung Cancer Conference
21–24 August 2008
Holiday Inn – Surfers Paradise
Queensland
http://www.alcc.net.au/ |
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