Upper-Air Observation Indicators Predict Outbreaks of Asthma Exacerbations among Elementary School Children: Integration of Daily Environmental and School Health Surveillance Systems in Pennsylvania

YoussefAgha, Ahmed; Lohrmann, David K.; Jayawardene, Wasantha; Afandi, Gamal Salah El

doi:10.3109/02770903.2012.677896

Cited by 6 publications

(6 citation statements)

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“…, YoussefAgha et al . ). Although specific roles have been identified, little is known about the care‐coordination process and strategies that school nurses use to provide quality asthma care in the school system.…”

Section: Introductionmentioning

confidence: 97%

“…• The International School Nurse Asthma Care Coordination Model provides a useful framework for practicing school nurses and nursing students, which delineates core elements of school-based care coordination for youth with asthma. (Splett et al 2006, Bruzzese et al 2009, Borowsky et al 2013, provision of direct asthma care (Splett et al 2006, Bruzzese et al 2009, Noyes et al 2013, education of children with asthma, their parents and teachers (Taras et al 2004, Levy et al 2006, Splett et al 2006, Bruzzese et al 2009, Kintner et al 2012, Nabors et al 2012, communication with parents, school personnel and healthcare providers (Taras et al 2004, Levy et al 2006, Splett et al 2006, Bruzzese et al 2009, Milnes et al 2013, Sigurdardottir et al 2013) and prevention activities related to the school environment (Levy et al 2006, Jones et al 2009, YoussefAgha et al 2012. Although specific roles have been identified, little is known about the carecoordination process and strategies that school nurses use to provide quality asthma care in the school system.…”

Section: Introductionmentioning

confidence: 99%

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Development of an International School Nurse Asthma Care Coordination Model

Garwick

Svavarsdóttir

Seppelt

et al. 2014

Journal of Advanced Nursing

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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 – 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 health care 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 health care 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.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Development of an International School Nurse Asthma Care Coordination Model

Garwick

Svavarsdóttir

Seppelt

et al. 2014

Journal of Advanced Nursing

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“…Third, only one previous study (also by these authors) has tested the association and usefulness of upper atmosphere observations in asthma research; however, it has not integrated air pollution data. 9 Fourth, the vertical temperature structure of upper atmosphere influences plume rise and thus the vertical exchange of pollutants. 27 The interaction effects of upper atmosphere temperature, dew point, and mixing ratio with air pollutants (Tables 3 and 4) predicted the occurrence of asthma exacerbations among Pennsylvania school children.…”

Section: Discussionmentioning

confidence: 99%

“…8 A previous study by these authors has tested the relationship between upper atmosphere observations and asthma occurrence; however, it has not integrated air pollution. 9 School health records have been used for asthma tracking because they are readily accessible through the existing school data collection and storage infrastructure. 10 In many Pennsylvania schools student health records are compiled through a web-based software application portal called "Health eTools for Schools" (hereafter referred to as "eTools").…”

mentioning

confidence: 99%

Prediction of asthma exacerbations among children through integrating air pollution, upper atmosphere, and school health surveillances

Jayawardene

YoussefAgha²,

Lohrmann³

et al. 2013

allergy asthma proc

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Climatic factors and air pollution are important in predicting asthma exacerbations among children. This study was designed to determine if a relationship exists between asthma exacerbations among elementary school children and the combined effect of daily upper atmosphere observations (temperature, relative humidity, dew point, and mixing ratio) and daily air pollution (particulate matter, sulfur dioxide, nitrogen dioxide, carbon monoxide, and ozone) and, if so, to predict asthma exacerbations among children using a mathematical model. Using an ecological study design, school health records of 168,825 students in elementary schools enrolled in "Health eTools for Schools" within 49 Pennsylvania counties were analyzed. Data representing asthma exacerbations were originally recorded by school nurses as the type of treatment given to a student during a clinic visit on a particular day. Daily upper atmosphere measurements from ground level to the 850-mb pressure level and air pollution measurements were obtained. A generalized estimating equation model was used to predict the occurrence of >48 asthma exacerbations, the daily mean for 2008-2010. The greatest occurrence of asthma among school children was in the fall, followed by summer, spring, and winter. Upper atmosphere temperature, dew point, mixing ratio, and six air pollutants as well as their interactions predicted the probability of asthma exacerbations occurring among children. Monitoring of upper atmosphere observation data and air pollutants over time can be a reliable means for predicting increases of asthma exacerbations among elementary school children. Such predictions could help parents and school officials implement effective precautionary measures.

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“…A study conducted among school children in Spain indicates that humidity significantly influences the occurrence of atopic eczema [82] . Youssefagha and colleagues indicate that upper-air relative humidity ≥50% and higher dew point (>−1.9) are significantly associated with exacerbation of asthma among children [83] . Another study performed in Japan also suggests that asthmatic children frequently visit the emergency department during early mornings with high absolute humidity [84] .…”

Section: Discussionmentioning

confidence: 99%

Impact of Ambient Humidity on Child Health: A Systematic Review

Gao

Sun

et al. 2014

PLoS ONE

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Background and ObjectivesChanges in relative humidity, along with other meteorological factors, accompany ongoing climate change and play a significant role in weather-related health outcomes, particularly among children. The purpose of this review is to improve our understanding of the relationship between ambient humidity and child health, and to propose directions for future research.MethodsA comprehensive search of electronic databases (PubMed, Medline, Web of Science, ScienceDirect, OvidSP and EBSCO host) and review of reference lists, to supplement relevant studies, were conducted in March 2013. All identified records were selected based on explicit inclusion criteria. We extracted data from the included studies using a pre-designed data extraction form, and then performed a quality assessment. Various heterogeneities precluded a formal quantitative meta-analysis, therefore, evidence was compiled using descriptive summaries.ResultsOut of a total of 3797 identified records, 37 papers were selected for inclusion in this review. Among the 37 studies, 35% were focused on allergic diseases and 32% on respiratory system diseases. Quality assessment revealed 78% of the studies had reporting quality scores above 70%, and all findings demonstrated that ambient humidity generally plays an important role in the incidence and prevalence of climate-sensitive diseases among children.ConclusionsWith climate change, there is a significant impact of ambient humidity on child health, especially for climate-sensitive infectious diseases, diarrhoeal diseases, respiratory system diseases, and pediatric allergic diseases. However, some inconsistencies in the direction and magnitude of the effects are observed.

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Upper-Air Observation Indicators Predict Outbreaks of Asthma Exacerbations among Elementary School Children: Integration of Daily Environmental and School Health Surveillance Systems in Pennsylvania

Abstract: Monitoring of upper-air observation data over time can be a reliable means for predicting increases of asthma exacerbations among elementary school children. Such predictions could help parents and school nurses implement effective precautionary measures.

Cited by 6 publications

References 24 publications

Development of an International School Nurse Asthma Care Coordination Model

Development of an International School Nurse Asthma Care Coordination Model

Prediction of asthma exacerbations among children through integrating air pollution, upper atmosphere, and school health surveillances

Impact of Ambient Humidity on Child Health: A Systematic Review

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