| 1. |
- Callesen, Michael Thude, et al.
(författare)
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Phthalate metabolites in urine and asthma, allergic rhinoconjunctivitis and atopic dermatitis in preschool children
- 2014
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Ingår i: International journal of hygiene and environmental health. - : Elsevier BV. - 1438-4639 .- 1618-131X. ; 217:6, s. 645-652
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Tidskriftsartikel (refereegranskat)abstract
- Phthalate esters are among the most ubiquitous of indoor pollutants and have been associated with various adverse health effects. In the present study we assessed the cross-sectional association between eight different phthalate metabolites in urine and allergic disease in young children. As part of the Danish Indoor Environment and Children's Health study, urine samples were collected from 440 children aged 3-5 years, of whom 222 were healthy controls, 68 were clinically diagnosed with asthma, 76 with rhinoconjunctivitis and 81 with atopic dermatitis (disease subgroups are not mutually exclusive; some children had more than one disease). There were no statistically significant differences in the urine concentrations of phthalate metabolites between cases and healthy controls with the exception of MnBP and MECPP, which were higher in healthy controls compared with the asthma case group. In the crude analysis MnBP and MiBP were negatively associated with asthma. In the analysis adjusted for multiple factors, only a weak positive association between MEP in urine and atopic dermatitis was found; there were no positive associations between any phthalate metabolites in urine and either asthma or rhinoconjunctivitis. These findings appear to contradict earlier studies. Differences may be due to higher exposures to certain phthalates (e.g., BBzP) via non-dietary pathways in earlier studies, phthalates serving as surrogates for an agent associated with asthma (e.g., PVC flooring) in previous studies but not the present study or altered cleaning habits and the use of "allergy friendly" products by parents of children with allergic disease in the current study in contrast to studies conducted earlier.
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| 2. |
- Clausen, Geo, et al.
(författare)
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Children's health and its association with indoor environments in Danish homes and daycare centres - methods
- 2012
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Ingår i: Indoor Air. - : Hindawi Limited. - 0905-6947 .- 1600-0668. ; 22:6, s. 467-475
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Tidskriftsartikel (refereegranskat)abstract
- The principle objective of the Danish research program 'Indoor Environment and Children's Health' (IECH) was to explore associations between various exposures that children experience in their indoor environments (specifically their homes and daycare centers) and their well-being and health. The targeted health endpoints were allergy, asthma, and certain respiratory symptoms. The study was designed with two stages. In the first stage, a questionnaire survey was distributed to more than 17000 families with children between the ages of 1 and 5. The questionnaire focused on the children's health and the environments within the homes they inhabited and daycare facilities they attended. More than 11000 questionnaires were returned. In the second stage, a subsample of 500 children was selected for more detailed studies, including an extensive set of measurements in their homes and daycare centers and a clinical examination; all clinical examinations were carried out by the same physician. In this study, the methods used for data collection within the IECH research program are presented and discussed. Furthermore, initial findings are presented regarding descriptors of the study population and selected characteristics of the children's dwellings and daycare centers. Practical Implications: This study outlines methods that might be followed by future investigators conducting large-scale field studies of potential connections between various indoor environmental factors and selected health endpoints. Of particular note are (i) the two-stage design - a broad questionnaire-based survey followed by a more intensive set of measurements among a subset of participants who have been selected based on their responses to the questionnaire; (ii) the case-base approach utilized in the stage 2 in contrast to the more commonly used case-control approach; (iii) the inclusion of the children's daycare environment when conducting intensive sampling to more fully capture the children's total indoor exposure; and (iv) all clinical examinations conducted by the same physician. We recognize that future investigators are unlikely to fully duplicate the methods outlined in this study, but we hope that it provides a useful starting point in terms of factors that might be considered when designing such a study.
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| 3. |
- Phrochaska, JO, et al.
(författare)
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Engage in the Process of Change : Facts and Methods
- 2012
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- This textbook advocates patients’ empowerment for improving health outcomes and health system performance. It emphasizes the important implications of improving communication between patient and health professionals and the adherence to treatment regimens. Based on research including theories of Stages of Change and Decision Balance, and by incorporating examples from daily clinical practice, this document sets out the guiding principles to support health professionals in better understanding and empowering patients to change lifestyle and behaviour. These principles describe a general approach to patients’ empowerment, consisting of three main tools: the LINE, the BOX and the CIRCLE. It specifically addresses the major risk factors such as smoking, diet, alcohol consumption and physical activity by putting the focus of action upstream to the causes of these types of lifestyle and behaviour. It is built on accumulating evidence, which shows that tailoring interventions to the characteristics of the target audience is key for success.
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