January 2008

The 4th IPCRG World Conference

Influenza Specialist Group - new web resource

National spirometry training course

Mothers' stress may increase children's asthma

Lung function in adults with stable but severe asthma

Research Funding Opportunities 

  Asthma Foundation of Queensland Research Grants for 2009

Conference Diary

The 4th IPCRG World Conference: Building bridges among diversity

The International Primary Care Respiratory Group (IPCRG) was founded in June 2000 and represents national groups of Primary Care Physicians who have a particular interest in respiratory medicine. The National Asthma Council is the member organisation representing Australia.

The IPCRG acts as an international umbrella organisation for national primary care respiratory interest groups. The organisation's aim is to use its international network to undertake research in community settings; to lead the production and dissemination of evidence-based guidelines appropriate for primary care professionals; and to develop education programmes to support that dissemination and changes in practice.

The 4th IPCRG World Conference to be held May 28 - 31, 2008 in Seville, Spain will build on previous conferences held in Amsterdam, Melbourne and Oslo.

The conference is for all primary care health professionals with an interest in respiratory health where "the fiery Andalucian backdrop is a perfect setting for cool and reasoned scientific exchange, education and debate. The organising committee have put together an impressive academic programme combining state-of-the-art medical education and research, by primary care for primary care, with an atmosphere of friendship, collaboration and support."

For all conference and accommodation information visit the 4th IPCRG World Conference website.

Website: http://ipcrg-seville2008.unicongress.com/

Resource

About the IPCRG

Influenza Specialist Group - new web resource

The Influenza Specialist Group (ISG) consists of medical and scientific specialists from around Australia and New Zealand with an interest in influenza.

The ISG is chaired by Dr Alan Hampson, former Deputy Director of the Australian World Health Organization Collaborating Centre for Reference and Research on Influenza. Dr Hampson who was instrumental in the formation and development of the ISG, now continues to participate actively in the field of influenza as Editor in Chief of the international journal "Influenza and Other Respiratory Viruses" and in a consultancy role with WHO and the Australian Government.

The ISG works in conjunction with key professional and patient groups and also with the Australian, State and Territory departments of Health in their educational activities regarding influenza and its prevention. As part of that process ISG has established a website to provide the latest information and current news on influenza.

Resource

www.influenzaspecialistgroup.org.au

National spirometry training course

The National Asthma Council's spirometry training course for GPs and practice nurses has generated excellent interest since its launch was announced.

The six hour interactive course, which is open to individual Divisions of General Practice, was developed in consultation with the Australian and New Zealand Society of Respiratory Science (ANZSRS) and the National Asthma Council’s GP Asthma Group.

It is designed to provide participants with comprehensive training in the application, measurement and interpretation of expiratory spirometry in general practice and provides hands on components to allow participants to apply their new knowledge in a practical setting.

For more information about the course, including how your Division can be involved, please go to Spirometry training course

Resources

Spirometry training course

Mothers' stress may increase children's asthma

Children whose mothers are chronically stressed during their early years have a higher asthma rate than their peers, regardless of their income, gender or other known asthma risk factors.

“It is increasingly clear that traditional environmental risk factors do not fully explain the origins of asthma,” according to lead investigator, Anita Kozyrskyj, PhD, Associate Professor in the Faculty of Pharmacy at the University of Manitoba, Canada. “Evidence is emerging that exposure to maternal distress in early life plays a causal role in the development of childhood asthma. In a cohort of children born in 1995, we found that maternal distress which persists beyond the postpartum period is associated with an increased risk of asthma at school-age.”

Dr Kozyrskyj and her colleagues analysed the medical records of nearly 14,000 children born in Manitoba in 1995 who were continuously registered with Manitoba Health Services until 2003. They determined whether the children had current asthma at age seven by analysing records of doctor visits, hospitalisations and medications in the year of the child’s seventh birthday, and related it to maternal distress as defined by doctor visits, hospitalisations and medication for depression and anxiety. Maternal distress was categorized according to onset and duration into four categories: no distress, postpartum distress only, short-term distress and long-term distress.

“Unlike existing studies that have measured maternal stress during the first few years only, the longitudinal nature of our health care study enabled us to characterize maternal distress over time to identify whether it continued,” said Dr Kozyrskyj.

Even after controlling for the known risk factors of male gender, maternal asthma, urban location and total health care visits, long-term maternal stress was associated with an increase of nearly a third in the prevalence childhood asthma. This is the first study of a non-high-risk cohort of children to report an association with childhood asthma.

The study also found that the risk of asthma associated with maternal stress was intensified under specific home environments: children of mothers with chronic distress who were living in high-income households or who had more than one sibling were more at risk of developing asthma than others whose mothers showed distress.

The mechanisms for how maternal distress causes asthma are not well understood. Depressed mothers are more likely to smoke and less likely to breastfeed - actions which are associated with the development of asthma. However, research has also suggested that depressed mothers are also less likely to interact with their infants. Animal studies indicate that decreased attentiveness from the mother affects the infant’s stress and immune response, but the same effect in humans has not yet been definitively demonstrated.

“Our maternal distress measure captured women who sought health care for their depression and anxiety, and thus, our findings may be limited to more severe depression and anxiety,” said Dr Kozyrskyj. “We plan to further explore the role of postpartum distress by doing a similar study which will link health care records with public health nurse assessments of depression and anxiety from a provincial postnatal screening program. This will enable us to assess the effects of less severe depression and anxiety during the postpartum period.”

Reference

Kozyrskyj AL, Mai XM, McGrath P, Hayglass KT, Becker AB, Macneil B. Continued exposure to maternal distress in early life is associated with an increased risk of childhood asthma. Am J Respir Crit Care Med. 2008 Jan 15;177(2):142-7. Epub 2007 Oct 11 (http://ajrccm.atsjournals.org/cgi/content/abstract/177/2/142)

Lung function in adults with stable but severe asthma

An American multi-centre research project to investigate severe asthma has found a key physiological difference between severe and non-severe forms of the disease, a finding that could help explain why those with severe asthma do not respond well to treatment.

The study has found that those with severe asthma are much more likely to show signs of “air trapping” in the lungs, a condition that prevents a full exhalation. The study also found that those who have severe asthma are more likely to have airway obstruction even after maximal treatment. The results suggest that those who suffer severe asthma have a different form of the disease.

“SARP was formed to look for an underlying cause of severe asthma, because it is not responding to treatment,” said Ronald Sorkness, a physiologist at the University of Wisconsin in Madison and the lead author of the study, “Lung Function in Adults with Stable but Severe asthma: Air Trapping and Incomplete Reversal of Obstruction with Bronchodilation.” Understanding the pathophysiology of severe asthma and improving its treatment is the goal of SARP.

The study compared lung function measurements from 287 people with severe asthma and 382 people with mild and moderate (non-severe) forms of the disease.

The study found that air trapping was characteristic of those who suffered severe asthma, but not of those with non-severe asthma. Furthermore, as airflow limitation became more pronounced, there was more air trapping in the severe group, but not among those who suffered moderate or mild asthma.

Airflow limitation was common among asthma sufferers, regardless of whether they had mild, moderate or severe forms of the disease. But there was little air trapping among the non-severe group, even when there was air flow limitation. Conversely, in the severe group, even when there was no airflow limitation, they had some degree of air trapping.

“That tells us that something different is going on in people classified as having severe asthma, either physiologically or in the airways that are affected,” Sorkness said. It’s likely that airflow limitation occurs in the larger airways of the lungs, while air trapping is occurring in the small airways that branch to the outer portions of the lung.

The researchers also found that those with severe asthma showed incomplete reversibility with bronchodilator treatment. That is, the severe group was more likely to have airway obstruction even after maximal treatment.

There was not much difference between severe asthmatics and non-severe asthmatics on the measure of hyperresponsiveness. However, the subjects with the most severe asthma were not included in the airway challenge portion of the study for fear of setting off a serious attack.

“Air trapping and non-reversibility were most important factors in defining the severe asthma group,” Sorkness said.

Reference

Sorkness et al. Lung Function in Adults with Stable but Severe Asthma: Air Trapping and Incomplete Reversal of Obstruction with Bronchodilation J Appl Physiol.2007; 0: 00329.2007v1  (http://jap.physiology.org/cgi/content/abstract/00329.2007v1)

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.

 

Asthma Foundation of Queensland Research Grants for 2009

Funds available 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 for downloading at the Foundation’s website at www.asthmaqld.org.au or from: 

The Managing Director
The Asthma Foundation of Queensland
PO Box 394
Fortitude Valley Qld 4006
Email: info@asthmaqld.org.au
(07) 3252 7677 or 1800 645 130

Applications close on 1 May 2008.

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.

	Pulmocon 2008 Working together to promote lung health 20-22 February 2008 Dhaka, Bangladesh http://www.lungbd.org
	3rd Global Patients Congress International Alliance of Patients' Organizations (IAPO) 20-22 February 2008, Budapest, Hungary http://www.patientsorganizations.org/congress2008
	11th Asian Congress of Agricultural Medicine and Rural Health 22-24 February 2008 Aurangabad, Maharashtra, India 11asiancongress@pmtpims.org http://www.pravara.com/
	64th Annual Meeting of American Academy of Allergy, Asthma & Immunology 7-11 March 2008 Philadelphia, United States http://www.aaaai.org/
	16th Annual Meeting of The Asian Society For Cardiovascular Surgery 13-16 March 2008 Singapore http://www.ascvs2008.com/ mice@themeetinglab.com
	ESAP Tuberculosis in the Asia-Pacific Region in the 21st Century 29 March 2008, JW Marriott Hotel Hong Kong http://www.apsresp.org/education/esap/esap-200803-hongkong.php
	2008 Annual Scientific Meeting 30 March - 2 April 2008 Melbourne Convention Centre Melbourne, Victoria 2008 ASM TSANZ (http://www.thoracic.org.au/asm2008.html)
	2008 Annual Scientific Meeting 30 March - 2 April 2008 Melbourne Convention Centre Melbourne, Victoria 2008 ASM ANZSRS http://www.anzsrs.org.au/asm2008.html
	World Asthma & COPD Forum 26-29 April 2008 Dubai, UAE http://www.wipocis.org/
	ATS, Annual meeting of the American Lung Association & American Thoracic Society 16-21 May 2008 Toronto, Canada http://www.thoracic.org/
	The 4th IPCRG World Conference: Building bridges among diversity May 28 - 31, 2008 Seville, Spain http://ipcrg-seville2008.unicongress.com/
	48th Annual Meeting of the Japanese Respiratory Society 15-17 June 2008 Kobe, Japan http://www.jrs.or.jp/english/information/meeting48.html
	2nd Australian Lung Cancer Conference 21–24 August 2008 Holiday Inn – Surfers Paradise Queensland http://www.alcc.net.au/
	ERS Annual Congress 4-8 October 2008 Berlin, Germany http://www.ersnet.org/
	CHEST, Annual International Scientific Assembly of the American College of Chest Physicians 25-30 October 2008 Miami Beach, United States http://www.chestnet.org/CHEST/
	American College of Allergy, Asthma & Immunology 7-12 November 2008 Seattle, United States http://www.acaai.org/
	13th APSR Congress 19-22 November 2008 Bangkok, Thailand http://www.apsr2008.org
	Annual Meeting of Taiwan Society of Pulmonary and Critical Care Medicine 6-7 December 2008 Taipei, Taiwan spccm@mars.seed.net.tw http://www.tspccm.org.tw/