Sheniz Moonie

The Relationship Between School Absence, Academic Performance, and Asthma Status

BACKGROUND Children with asthma experience more absenteeism from school compared with their nonasthma peers. Excessive absenteeism is related to lower student grades, psychological, social, and educational adjustment. Less is known about the relationship between the presence of asthma and the academic achievement in school-aged children. Since students with asthma miss more days from school, this may negatively impact their academic achievement. The goal of this study was to investigate the relationships between absenteeism, presence of asthma, and asthma severity level with standardized test level performance in a predominantly African American urban school district. METHODS A cross-sectional analysis was conducted of 3812 students (aged 8-17 years) who took the Missouri Assessment Program (MAP) standardized test during the 2002-2003 academic year. RESULTS After adjustment for covariates, a significant inverse relationship was found between absenteeism and test level performance on the MAP standardized test in all children (F = 203.9, p < .001). There was no overall difference in test level achievement between those with and without asthma (p = .12). Though not statistically different, those with persistent asthma showed a modestly increased likelihood of scoring below Nearing Proficient compared with those with mild intermittent asthma (adjusted odds ratio = 1.93, 95% confidence intervals = 0.93-4.01, p = .08). CONCLUSIONS A negative impact of absenteeism on standardized test level achievement was demonstrated in children from an urban African American school district. Children with asthma perform the same academically as their nonasthma peers. However, those with persistent asthma show a trend of performing worse on MAP standardized test scores and have more absence days compared with other students. More research is warranted on the effects of persistent asthma on academic achievement.

Prevalence and Correlates of Walking and Biking to School Among Adolescents

Increasing the rates that our adolescents walk and bicycle to school, also called active transport to school (ATS), could increase the physical activity (PA) levels of that age group. This type of activity has been identified as a missed opportunity for PA. It is currently estimated that 15% of American youth walk or bicycle to school. These rates of ATS are lower than those of European and Asian youth. Efforts to enhance levels of non-motorized transport to school could aid in reducing obesity rates among American youth, decrease traffic congestion and attenuate emission of greenhouse gasses. The objective was to identify demographic, environmental and psychosocial predictors of ATS. A 30-questionnaire was completed by 2,692 students. Logistic regression was used to identify psychosocial, demographic and environmental predictors of ATS. Only 4.6% of students used ATS. Predictors of ATS were street connectedness (density of street intersections) and gender, (boys had higher ATS rates). Public health officials should be alert for opportunities to select sites for new schools that are in neighborhoods with well connected street systems. Interventions promoting ATS will need to target male and female students and there appears to be an opportunity to increase rates that students bicycle to school.

The Impact of Unemployment on Mental and Physical Health, Access to Health Care and Health Risk Behaviors

The purpose of this study was to examine the impact of employment status and unemployment duration on perceived health, access to health care, and health risk behaviors. Data from Nevadas 2009 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. We compared participants who were unemployed (greater than and less than one year) to those who were employed and those who were voluntarily out of the labor force (OLF). Unemployed participants had significantly worse perceived mental health profiles, were more likely to delay health care services due to cost, and were less likely to have access to health care than employed participants and OLF participants. OLF participants were not significantly different from employed participants. Contrary to previous findings, unemployed participants in this study were not more likely to binge drink, smoke, or be physically inactive. Findings from this study suggest that the impetus for unemployment, be it voluntary or involuntary, may significantly impact a persons mental health.

Physical Activity Participation among Adult Nevadans with Self-Reported Asthma

Objective. This study looked at physical activity patterns among adults (≥ 18 years old) with self-reported asthma living in Nevada and investigated how physical inactivity is associated with asthma prevalence. Methods. We examined data from the 2009 Nevada Behavioral Risk Factor Surveillance System. Different physical activity measures among individuals were compared by asthma status. Results. Among 3840 respondents, 13.9% and 9.0% of them self-reported lifetime and current asthma, respectively. Significantly higher proportions of people with lifetime (12.9%) and current (17.7%) asthma did not engage in regular physical activity or exercise than those without lifetime (7.0%) and current (6.8%) asthma (p < .01). Over 30% of the respondents with asthma had no leisure-time physical activity compared with about 23% of those without asthma (p < .05). Moreover, these findings were statistically significant after adjusting for body mass index as well as other common sociodemographic variables. It was also found that asthmatic people spent significantly less time on moderate and vigorous physical activity than their nonasthmatic counterparts (223 minutes/week vs. 283 minutes/week for moderate physical activity; 214 minutes/week vs. 281 minutes/week for vigorous physical activity; p < .001). More than half of the respondents with asthma and close to half of those without asthma did not meet the current physical activity recommendation. Conclusion. A majority of adults with self-reported asthma living in Nevada are physically inactive. It appears that physical inactivity is associated with an increased prevalence of asthma.

Examining the Consulting Physician Model to Enhance the School Nurse Role for Children With Asthma

BACKGROUND The Centers for Disease Control and Preventions Strategies for Addressing Asthma Within a Coordinated School Health Program recommends a consulting physician for schools to help manage asthma. The literature examines the effects when a school nurse is present, but the addition of a consulting physician is not well understood. The purpose of this study is to assess the effect of having a consulting physician on school absenteeism and children sent home due to health reasons for children with asthma and all children pooled together. METHODS A 2-year preimplementation group cohort and 1-year implementation group cohort of grades K-6 in an urban school district were used to determine the impact of a consulting physician on school absenteeism for children with asthma and all children pooled together. RESULTS A consulting physician was significantly associated with reduced missed school days for children with asthma and all children as a group. All children pooled together were 44% more likely (OR = 1.44, 95% CI = 1.31-1.58) to be sent home without the consulting physician. There was a reduction from 13.8% to 12.6% of sent home events in children with asthma. CONCLUSIONS Having consulting physicians in school districts appears to be associated with fewer days of school absence. The results provide additional evidence and suggest that more research is required to determine if this association is valid and to better understand the cause of such an association.

Sample size calculation based on efficient unconditional tests for clinical trials with historical controls

ABSTRACT In historical clinical trials, the sample size and the number of success in the control group are often considered as given. The traditional method for sample size calculation is based on an asymptotic approach developed by Makuch and Simon (1980). Exact unconditional approaches may be considered as alternative to control for the type I error rate where the asymptotic approach may fail to do so. We provide the sample size calculation using an efficient exact unconditional testing procedure based on estimation and maximization. The sample size using the exact unconditional approach based on estimation and maximization is generally smaller than those based on the other approaches.

Asthma severity in children and the quality of life of their parents

This study examines the effect of asthma severity of children aged 7-17 years and sociodemographic characteristics on the caregivers quality of life. For parents of asthmatic children, there was a negative correlation between overall asthma severity and quality-of-life score. Measuring parental quality of life enables the development of effective asthma programs.

Macrophage Colony Stimulating Factor-Induced Macrophage Differentiation Influences Myotube Elongation

Background: Unaccustomed exercise, high-intensity dynamic sports activities, or the resumption of normal weight-bearing after a period of disuse can induce skeletal muscle injury, which activates an inflammatory response followed by muscle regeneration. Specific subsets of macrophages are involved in muscle regeneration. But the exact role of macrophage differentiation during muscle regeneration remains to be elucidated. Objective: The objective of the study was to examine the effect of macrophage colony stimulating factor (M-CSF)-differentiated, lipopolysaccharides (LPS)-stimulated-macrophage-conditioned medium on muscle-cell proliferation, fusion, and elongation, which are key events during muscle regeneration and myogenesis. Method: Murine C2C12 myoblasts were cultured in conditioned medium obtained from PU5-1R macrophages that were (a) undifferentiated, unstimulated; (b) M-CSF-differentiated, unstimulated; (c) undifferentiated, LPS-stimulated; or (d) M-CSF-differentiated, LPS-stimulated. Myoblast proliferation ratio, nuclei number, and length were measured. Results: C2C12 cells cultured in conditioned medium from M-CSF-differentiated, LPS-stimulated macrophages had significantly more nuclei and greater length than cells cultured in conditioned medium from undifferentiated, LPS-stimulated macrophages. Dilution and denaturization of the M-CSF-differentiated, LPS-stimulated-macrophage medium prevented a marked increase in C2C12 nuclei number and length. However, the C2C12 myoblast proliferation ratio was significantly greater in conditioned medium from undifferentiated, LPS-stimulated macrophages than in conditioned medium from M-CSF-differentiated, LPS-stimulated macrophages. Conclusions: M-CSF-differentiated, LPS-stimulated macrophages may influence myogenesis and the early and terminal stages of muscle regeneration. This knowledge may aid in developing therapies that will directly expedite muscle repair and lead to faster rehabilitation and reduced rehabilitation costs.

Grade retention risk among children with asthma and other chronic health conditions in a large urban school district.

Abstract Asthma accounts for 12.8 million missed school days for children nationwide. Whether this excess absenteeism contributes to poor outcomes such as grade retention is of interest. The Clark County School District in Las Vegas, NV has incorporated the Federal “No Child Left Behind Act,” which states that absences per individual in excess of 10 per school year are considered unapproved and may put a child at risk for repeating a grade. The purpose of this study was to determine if children with asthma are at increased risk for absenteeism associated with grade retention. Secondary data were obtained for students in attendance for the 2006-2007 school year. Days absent were weighted for enrollment time. Frequencies were obtained using descriptive statistics, and multivariate logistic regression was used to model the odds of absenteeism > 10 days per year. Of 300 881 students, 27 299 (9.1%) reported having asthma, as determined by school health records. The population was 52% male, 37% white, and 39% Hispanic. Significant predictors of missing > 10 days per school year included ethnicity, gender, grade, and health status (P < 0.0001). Students with asthma (adjusted odds ratio [aOR], 1.5) or asthma plus another health condition (aOR, 1.6) were at significantly increased odds of missing > 10 school days per year compared with healthy students or those with a medical condition other than asthma (P < 0.0001). Lastly, some disparities were found in current grade point average by race, gender, and asthma status. Children with asthma have a greater risk of absenteeism associated with grade retention. Therefore, improved asthma management and tailored education is necessary to identify and eliminate asthma triggers in the home and school setting for school-aged children.

Association of Leisure-Time Physical Activity to Cardiovascular Disease Prevalence in Relation to Smoking among Adult Nevadans.

It is well known that cigarette smoking and physical activity have significant impacts on cardiovascular disease (CVD) mortality and morbidity. Meanwhile, it is of interest to understand whether physical activity protects against CVD for smokers in a similar manner as it does for non-smokers. The present study examined how leisure-time physical activity (LTPA) is associated with the prevalence of CVD in relation to smoking status among adult Nevadans, using data from the 2010 Nevada Behavioral Risk Factor Surveillance System. Of the 3,913 survey respondents, 8.5% self-reported that they had ever been diagnosed with CVD. People with a history of CVD were significantly less likely to engage in LTPA than those with no history of CVD (p < 0.05). After adjusting for common sociodemographic variables, it was revealed that people with CVD were twice more likely to not engage in LTPA than their counterparts independent of smoking status. Without taking LTPA into account, the odds of having CVD for current and former smokers was 1.87–2.25 times higher than the odds for non-smokers. Interestingly, however, if LTPA was accounted for, there was no significant difference in the odds of having CVD between current and non-smokers. These results indicate that LTPA is inversely associated with the prevalence of CVD independent of smoking status, and that regular physical activity may protect against CVD for smokers as well as for non-smokers. Physical activity, along with smoking cessation, should be promoted to better prevent and control CVD among smokers.