The Canadian Asthma Primary Prevention Study: Outcomes at 2 Years of Age
Notice bibliographique
Résumé
Becker A, Watson W, Ferguson A, Dimich-Ward H, Chan-Yeung M. J Allergy Clin Immunol. 2004;113:650–656To determine the effectiveness of a multifaceted intervention program in the primary prevention of asthma in high-risk infants.Subjects were children (n = 549) born between October 1994 and August 1996, classified as high-risk for development of asthma on the basis of family history.A prospective, controlled clinical trial identified mothers in their third trimester of pregnancy and randomized each mother into either the multifaceted-intervention group (n = 278) or control group (n = 267). The intervention program was implemented during the first year of life and included decreasing allergen (dust mite and pet) and environmental tobacco-smoke exposure, encouraging breastfeeding, and delaying introduction of solid foods. The control group did not receive specific intervention education. Home visits conducted during the third trimester, at 2 weeks, and at 4, 8, 12, 18, and 24 months of age assessed health, demographic, and home characteristics, and dust samples were collected to quantify house dust-mite and cat-allergen levels. Infants in each group were evaluated and prick skin-tested for common food and environmental allergens at 12 months and 2 years of age. Study participants were assessed for possible asthma, probable asthma, recurrent wheeze, recurrent cough, rhinitis without colds, and atopy (defined as positive skin test to ≥1 allergen).In terms of intervention efficacy, there were significant differences in cat-allergen exposure (with no change in prevalence of pets) and day care enrollment between the groups. Asthma was characterized as the sum of possible and probable asthma diagnoses. At 2 years, 40 of 246 (16.3%) intervention children and 53 of 230 (23%) control children were classified as asthmatic. There was a significant reduction in persistent asthma (children meeting criteria for asthma at both 12 and 24 months of age), with only 4.9% of the intervention group versus 11.3% of the control group characterized as having persistent asthma. There was no difference between the groups in regard to recurrent cough and no difference in incidence in the first year of life of recurrent wheeze. However, at 2 years, there were significantly fewer children in the intervention group with recurrent wheeze (1%) versus the control group (3.5%). The prevalence of atopy at 2 years was not different between the intervention (15.6%) and control (13.7%) groups.The multifaceted intervention program, which focused on decreasing exposure in the first year of life to aeroallergens, food allergens, and environmental tobacco smoke for children deemed to be at high risk for development of asthma, was successful in significantly reducing the incidence of asthma at 2 years of age.This study demonstrates that, in infants at high risk for developing asthma, reduction in allergen exposure and environmental modifications in the first year of life can significantly affect disease development and progression. Public health programs targeting these interventions may greatly impact the increasing prevalence and morbidity of childhood asthma.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».