| 1. |
- Bousquet, Jean, et al.
(författare)
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Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018) : Change management in allergic rhinitis and asthma multimorbidity using mobile technology
- 2019
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Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier. - 0091-6749 .- 1097-6825. ; 143:3, s. 864-879
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Tidskriftsartikel (refereegranskat)abstract
- Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional.
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| 2. |
- Menditto, Enrica, et al.
(författare)
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Adherence to treatment in allergic rhinitis using mobile technology : The MASK Study
- 2019
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Ingår i: Clinical and Experimental Allergy. - : WILEY. - 0954-7894 .- 1365-2222. ; 49:4, s. 442-460
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mobile technology may help to better understand the adherence to treatment. MASK-rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis) is a patient-centred ICT system. A mobile phone app (the Allergy Diary) central to MASK is available in 22 countries. Objectives: To assess the adherence to treatment in allergic rhinitis patients using the Allergy Diary App. Methods: An observational cross-sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Possession Ratio (MPR) and the Proportion of days covered (PDC) approach. Results: A total of 12143 users were registered. A total of 6949 users reported at least one VAS data recording. Among them, 1887 users reported >= 7 VAS data. About 1195 subjects were included in the analysis of adherence. One hundred and thirty-six (11.28%) users were adherent (MPR >= 70% and PDC <= 1.25), 51 (4.23%) were partly adherent (MPR >= 70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non-adherent to medications (MPR <70%). Of those, the largest group was non-adherent to medications and the time interval was increased in 442 (36.68%) users. Conclusion and clinical relevance: Adherence to treatment is low. The relative efficacy of continuous vs on-demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analysing medication-taking behaviour in a real-world setting.
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| 3. |
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| 4. |
- Bousquet, J. Jean, et al.
(författare)
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Next-generation ARIA care pathways for rhinitis and asthma : a model for multimorbid chronic diseases
- 2019
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Ingår i: Clinical and Translational Allergy. - : BMC. - 2045-7022 .- 2045-7022. ; 9
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Forskningsöversikt (refereegranskat)abstract
- Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.Main body: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Sante as a Good Practice in the field of digitally-enabled, integrated, person-centred care.Conclusion: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
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| 5. |
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| 6. |
- Matricardi, PM, et al.
(författare)
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EAACI Molecular Allergology User's Guide
- 2016
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Ingår i: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - : Wiley. - 1399-3038. ; 2727 Suppl 23, s. 1-250
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Tidskriftsartikel (refereegranskat)
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| 7. |
- Kleine, Barbara I., et al.
(författare)
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Mineralogical controls on metamorphic fluid flow in metabasaltic sills from Islay, Scotland
- 2016
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Ingår i: Lithos. - : Elsevier BV. - 0024-4937 .- 1872-6143. ; 248, s. 22-39
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Tidskriftsartikel (refereegranskat)abstract
- In this study we show that mineralogy was the primary control of metamorphic fluid flow in the well-studied metabasaltic sills in the SW Scottish Highlands. Here, basaltic sills have been partially carbonated by H2O-CO2 fluids at greenschist facies conditions. This has led to mineral zonation with carbonate-poor sill interiors separated from carbonate-rich sill margins by reaction fronts. Although deformation set the stage for metamorphic fluid flow in the SW Scottish Highlands by causing the preferred alignment of mineral grains, metamorphic fluid flow was not coupled with active deformation but occurred later utilizing the pre-existing mineral alignment as a means of accessing the sill interiors. The sills which were studied were partially carbonated with well-preserved reaction fronts. They were selected because (atypically for the SW Scottish Highlands) they are mineralogically heterogeneous making them ideal for a study of mineralogical controls of metamorphic fluid flow. Their mineralogical heterogeneity reflects chemical heterogeneity arising from magmatic flow differentiation and spilitization, which occurred before greenschist facies metamorphism. Magmatic flow differentiation resulted in parts of the sill containing large crystals with no preferred alignment. Large (up to 3 cm) plagioclase phenocrysts were concentrated in the sill interior whereas large (up to 1 cm) amphibole (after pyroxene) grains formed cumulate layers close to the sill margins. These large randomly oriented crystals were replaced by an interface-coupled dissolution-precipitation mechanism. Replacement is constant volume and with hydration and carbonation affecting the cores of these minerals while the rims are remained intact and unaltered. This finding points to intro-granular metamorphic fluid flow. In contrast inter-granular metamorphic fluid flow was facilitated by mineral alignment on different scales. Pre-metamorphic spilitization, produced layers of epidote called segregations, whereas regional deformation caused preferred alignment mainly of amphibole and chlorite. Epidote undergoes a series of volume changes during greenschist facies metamorphism. This created porosity which produced preferred pathways for metamorphic fluids affecting the advancement of fluid-driven reaction fronts. Preferred alignment of amphibole and chlorite also affected the advancement of reaction fronts. In this case, fluid flow was preferentially parallel to the foliation. In both cases, inter-granular metamorphic fluid flow utilized a pre-existing fabric albeit on different scales. These results show intra-granular metamorphic fluid flow in unfoliated rock and inter-granular metamorphic fluid flow in foliated rock. In both cases metamorphic fluid flow occurred after deformation controlled by pre-existing mineralogical heterogeneities, such as grain composition and shape anisotropy as well as preferred alignment of mineral grains.
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| 8. |
- Kleine, B. I., et al.
(författare)
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Silicon and oxygen isotopes unravel quartz formation processes in the Icelandic crust
- 2018
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Ingår i: Geochemical Perspectives Letters. ; 7, s. 5-11
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Tidskriftsartikel (refereegranskat)abstract
- Quartz formation processes in the Icelandic crust were assessed using coupled δ18O and δ30Si systematics of silica deposits formed over a wide temperature range (<150 to >550 °C). Magmatic quartz reveals δ18O (-5.6 to +6.6 ‰) and δ30Si (-0.4 ± 0.2 ‰) values representative of mantle- and crustally-derived melts in Iceland. Hydrothermal quartz and silica polymorphs display a larger range of δ18O (-9.3 to +30.1 ‰) and δ30Si (-4.6 to +0.7 ‰) values. Isotope modelling reveals that such large variations are consistent with variable water sources and equilibrium isotope fractionation between fluids and quartz associated with secondary processes occurring in the crust, including fluid-rock interaction, boiling and cooling. In context of published δ18O and δ30Si data on hydrothermal silica deposits, we demonstrate that large ranges in δ30Si values coupled to insignificant δ18O variations may result from silica precipitation in a hydrothermal fluid conduit associated with near-surface cooling. While equilibrium isotope fractionation between fluids and quartz seems to prevail at high temperatures, kinetic fractionation likely influences isotope systematics at low temperatures.
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| 9. |
- Kleine, Barbara I., et al.
(författare)
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The mechanism of infiltration of metamorphic fluids recorded by hydration and carbonation of epidote-amphibolite facies metabasaltic sills in the SW Scottish Highlands
- 2015
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Ingår i: American Mineralogist. - : Mineralogical Society of America. - 0003-004X .- 1945-3027. ; 100:11-12, s. 2702-2717
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Tidskriftsartikel (refereegranskat)abstract
- In this study we investigate a group of metabasaltic sills from the SW Scottish Highlands metamorphosed at epidote-amphibolite facies conditions that provide useful insight into the mechanisms and characteristics of fluid infiltration during metamorphism. The sills are amphibole and garnet bearing and exhibit a strong foliation in the sill margins that developed pre- to syn- peak metamorphism. Fluid infiltration caused hydration and carbonation in the sills, expressed as 1) replacement of garnet and amphibole by chlorite and calcite and 2) replacement of amphibole and epidote to form chlorite and calcite. Using garnet-amphibole and garnet-chlorite geothermometers we show that these reactions occurred after peak metamorphism at T = 290 to 400°C. Reaction textures show that the fluid infiltration into the sill that caused hydration and carbonation occurred in the absence of deformation. The fluid infiltration was mineralogically controlled with greater fluid access in areas of abundant fine-grained elongate minerals such as amphibole and chlorite. The replacement of garnet by chlorite most likely occurred by an interface-coupled dissolution-precipitation mechanism as evidenced by perfect pseudomorphic textures of garnet, porosity generation behind the reactive interface and fracturing ahead of this interface. Porosity generated in the product chlorite enhanced fluid access to the replacement front. The study shows that deformation was not required for extensive fluid infiltration and alteration during metamorphism. Fluid flow uses a pre-existing foliation to gain access to the rock, taking advantage of the anisotropic shape of the aligned minerals.
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