David A. Sterling

Variation in ADAM33 has been shown to be important in the development of asthma and altered lung function. This relationship however, has not been investigated in the population susceptible to COPD; long term tobacco smokers. We evaluated the association between polymorphisms in ADAM33 gene with COPD and lung function in long term tobacco smokers.

BACKGROUND:  The Centers for Disease Control and Prevention’s 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.

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.

Excessive school absence disrupts learning and is a strong predictor of premature school dropout. School‐aged children with asthma are absent more often compared to their healthy peers without asthma; yet, the causes are inadequately documented. We sought to determine the difference in mean absence days between children with and without asthma, the relationship between asthma severity and missed days from school, and if incident absences were due to asthma in a predominantly African American urban school district in the Midwestern United States. A cross‐sectional analysis was conducted of 9014 students (grades K‐12) followed for absenteeism over the 2002‐2003 academic year. A subset of 543 students with asthma was assessed for asthma severity and cause of absence. Those with asthma (9.7% of students) were absent (mean = 9.2 days) approximately 1.5 more days compared to those without asthma (mean = 7.9 days) (p = .006). In the analysis comparing asthma severity and absenteeism, after adjusting for demographic variables and enrollment time, mean days absent increased with increasing asthma severity level: mild intermittent (mean = 8.5 days), mild persistent (mean = 11.3 days), moderate persistent (mean = 10.3 days), and severe persistent (mean = 11.6 days) (p = .001). Out of 1537 tracked absences that resulted from illness, 478 (31%) were due specifically to asthma‐related symptoms. Children with asthma are absent from school more often compared to their healthy peers and this appears to be driven by the underlying severity of symptoms. (J Sch Health. 2006;76(1):18‐24)

In this study, the authors evaluated whether a combination of tailored education, lead dust removal by trained cleaning specialists, and family follow-up visits would be more effective than conventional health educational programs in reducing elevated blood lead levels in children living in or near lead mining hazardous waste sites. The authors randomized children between 6 and 72 mo of age with blood lead levels between 10 and 20 μg/dl into 3 groups: standard care, tailored newsletters, or tailored newsletters and specialized cleaning. The authors obtained questionnaires, blood lead levels, and environmental lead samples during initiation and compared them with the same items obtained at 3, 6, and 9 mo follow-up. They used a linear mixed effect model to evaluate the intervention effect. Blood lead levels decreased overall 1.54 μg/dl (12.1%) during the study. The authors found that tailored newsletters and specialized cleaning produced the greatest decline in blood lead levels, but no statistical differen...