No abstract

Although the relationship between asthma and exposure to fine particulate matter (PM2.5) has been frequently measured, reported conclusions have not been consistent. As emergency department (ED) visits are an effective way to estimate health outcomes for people with asthma and short-term exposure to PM2.5, this review systematically searched five databases without language or geographical restrictions from inception to January 13, 2015 to study the impact of PM2.5 on asthma ED visits. A random-effects model was used to calculate the pooled risk ratio (RR) and 95% confidence intervals (CI). With respect to short-term effects, asthma ED visits increased at higher PM2.5 concentrations (RR 1.5% per 10 μg/m(3); 95% CI 1.2-1.7%), and children were more susceptible (3.6% per 10 μg/m(3); 95% CI 1.8, 5.3%) than adults (1.7, 95% CI 0.7%, 2.8%) to increased PM2.5; the ED visits increased during the warm season by 3.7% (95% CI 0.5, 6.9%) per 10 μg/m(3) increase in PM2.5, which was higher than the corresponding increase during the cold season (2.6, 95% CI 0.7-4.6%). This demonstrates that ambient PM2.5 has an adverse impact on asthma ED visits after short-term exposure and that children are a high-risk population when PM2.5 concentrations are high, particularly in warm seasons, during which measures should be taken to prevent PM2.5.

ObjectivesTo synthesise evidence on longer term unmet needs perceived by stroke survivors, and psychometric properties of the tools used to evaluate unmet care needs after stroke.DesignSystematic review.SettingCommunity or patients’ home.ParticipantsStroke survivors.MethodsWe searched PubMed, PsycINFO, CINAHL, EMBASE from inception to 31 March 2018 to identify survey studies that evaluated unmet needs perceived by stroke survivors after hospital discharge. Reported unmet needs were categorised under three domains: body functioning, activity/participation and environmental factors. Ranges of prevalence rates of unmet needs reported in studies were presented.ResultsWe included 19 eligible studies, with considerable heterogeneity in patients, survey methods and results. Psychometric properties of two stroke-specific tools were formally evaluated, indicating their moderate reliability and content/concurrent validity. The median number of reported unmet needs per stroke survivor was from two to five, and the proportion of stroke survivors with at least one unmet needs was on average 73.8% (range 19.8%– 91.7%). Unmet needs perceived by stroke survivors included 55 records of unmet body functioning needs, 47 records of unmet activities/participatory needs and 101 records of unmet environmental needs. Common unmet service needs were unmet information needs (3.1%– 65.0%), transport (5.4%–53.0%), home help/personal care (4.7%–39.3%) and therapy (2.0%–35.7%).ConclusionsThe prevalence of unmet long-term needs is high among stroke survivors, and there is considerable heterogeneity in type and frequency of specific unmet needs. More research is required to link regular assessment of long-term unmet needs of stroke survivors with the provision of cost-effective patient-centred health and social care services.

The effect of soil drenching with 10 µM abscisic acid (ABA) on the physiological responses of two spring wheat (Triticum aestivum L.) cultivars released in different decades was evaluated when subjected to a water deficit at jointing or at booting. Exogenous ABA application increased the ABA concentration in the leaves, reduced the stomatal conductance (gs), slowed the rate of water use, decreased the lethal leaf water potential (ψ) used to measure desiccation tolerance and lowered the soil water content (SWC) at which leaf relative water content (RWC) began to decrease and wilting was observed. Exogenous ABA application also reduced reactive oxygen species (ROS) formation and increased antioxidant enzyme activity, leading to a reduction in the oxidative damage to lipid membranes in both cultivars exposed to water stress at jointing and booting. The decrease in leaf RWC and wilting occurred at lower values of SWC in the recently-released cultivar than in the earlier-released cultivar. The recently-released cultivar also had higher grain yield than the earlier-released cultivar at moderate water stress, but the grain yield in both cultivars was reduced by water stress and by the exogenous ABA treatment. However, exogenous ABA treatment increased transpiration efficiency for grain (TEG) of both cultivars under moderate water stress. These results indicate that ABA played an important role in slowing water use and enhancing the antioxidant defence during soil drying, but this did not result in increased yields under drought stress.