An Integrated Theatre Production for School Nutrition Promotion Program.

In the context of stubbornly high childhood obesity rates, health promotion activities in schools provide a potential avenue to improve children's nutritional behaviours. Theatre production has a rich history as a health behaviour promotion strategy but lacks sound, outcome-based evaluation. This study evaluated the effect of an integrated, two-part, place-based theatre performance program with 212 students in five schools in a regional urban and semi-rural area. The program included a theatre performance and a healthy eating competition. A brief survey assessed student healthy eating knowledge and attitudes at three time points. Nutrition behaviour was measured by scoring the contents of children's lunch boxes before, during and up to six weeks after the intervention. Statistical analysis tested change over time on five variables (Knowledge, Attitude, Sometimes foods, Everyday foods, Overall lunch box score). Results showed that both components of the integrated program improved nutrition knowledge and that the theatre performance improved children's healthy eating attitudes. All three lunch box scores peaked after the integrated program and remained significantly higher than baseline at 4-6 weeks follow-up. Interaction effects were identified for school catchment area on four of the five dependent variables. Evaluation of this integrated theatre production program indicates the potential benefit of taking a "super-setting" approach. It demonstrates an effect from students taking home information they had learned and incorporating it into lunch box preparation. It also showed consistent effects for school geographical catchment. This study suggests that, with careful, theory-based design, theatre productions in schools can improve student nutritional activities.

Advances in environmental and occupational respiratory diseases in 2009.

The year 2009 led to a number of significant advances in environmental and occupational allergic diseases. The role of exposure to environmental pollutants, respiratory viruses, and allergen exposure showed significant advances. New allergens were identified. Occupational asthma and the relationship of complementary and alternative medicine to allergic diseases were extensively reviewed. New approaches to immunotherapy, novel vaccine techniques, and methods to reduce risks for severe allergic disease were addressed.

Sublingual immunotherapy in patients with allergic rhinoconjunctivitis caused by ragweed pollen.

BACKGROUND: Specific allergen immunotherapy is most often delivered subcutaneously, but sublingual immunotherapy may confer greater benefit in terms of tolerability and safety, accessibility, and improved antigen delivery. OBJECTIVE: This randomized, double-blind, placebo-controlled trial was conducted to identify a safe and effective maintenance dose range of sublingual standardized glycerinated short ragweed pollen extract in adults with ragweed-induced rhinoconjunctivitis. METHODS: In May 2006, a total of 115 patients with ragweed-induced rhinoconjunctivitis were randomly allocated to placebo (n = 40), medium-dose extract (4.8 microg Amb a 1/d; n = 39), or high-dose extract (48 microg Amb a 1/d; n = 36). In a 1-day (rush) dose-escalation regimen, ragweed pollen extract was administered sublingually in incremental doses until maximum tolerable or scheduled dose was reached and then maintained during the ragweed pollen season. Patient diaries were used to monitor nasal and ocular symptoms and medication. The primary endpoint was symptom score. RESULTS: Both active treatment groups achieved a 15% reduction in total rhinoconjunctivitis symptom scores compared with placebo during the entire ragweed pollen season, but the difference was not statistically significant (P > .10) However, in an analysis of covariance correcting for preseasonal symptoms, both mean daily symptom scores (0.19 +/- 1.16 vs 1.00 +/- 2.30) and medication scores (0.0003 +/- 1.64 vs 0.63 +/- 1.06) for the entire pollen season were significantly reduced in the high-dose versus placebo groups, respectively (P

Effects of a DNA vaccine in an animal model of Alternaria alternata sensitivity

La sensibilidad al hongo Alternaria se asocia con la persistencia y gravedad del asma. Las opciones terapéuticasactuales para el tratamiento de la inflamación de las vías aéreas inducida por Alternaria son limitadas.En este estudio se han utilizado ratas Brown Norway para estudiar la eficacia de una vacuna de ADN administradapor vía aérea para atenuar la respuesta al alérgeno mayor de Alternaria rAlt a 2. Comparados conlos animales sensibilizados sin tratar, o con los animales que recibieron una vacuna de ADN con un marcode lectura incorrecto, los animales tratados con una vacuna ADN con un marco de lectura correcto mostraronuna atenuación en los títulos de anticuerpos específicos IgE frente a rAlt a 2, un aumento en IgG2b (unarespuesta Th1), una reducción en la liberación espontánea de IL-13 por suspensiones celulares de nóduloslinfáticos peribronquiales y una atenuación en la diminución en la capacidad pulmonar total 72 h despuésde la administración del alérgeno. El examen histopatológico de los tejidos pulmonares reveló una inflamaciónpulmonar reducida tras la administración del alérgeno en los animales tratados con ADN comparadoscon los animales sensibilizados sin tratamiento. Se concluye que una vacuna de ADN administrada por víaaérea ejerce una influencia significativa sobre las alteraciones inmunológicas, fisiológicas pulmonares ehistológicas inducidas por el alérgeno mayor de Alternaria rAlt a 2 en animales sensibilizados(AU)

Sensitivity to the fungus Alternaria is associated with asthma persistence and severity. Current therapeuticoptions for treating Alternaria-induced airway inflammation are limited. In this study, Brown Norway ratsare used to study the effectiveness of a DNA-based vaccine delivered to the airway in attenuating theresponse to a major Alternaria allergen, rAlt a 2. Compared to untreated sensitized animals, or animalsreceiving an “out-of-frame” DNA-based vaccine, animals treated with “in-frame” DNA vaccine showed anattenuation in specific IgE antibody titers to rAlt a 2, an increase in IgG2b (a Th1 response), a reduction inspontaneous IL-13 release by peribronchial lymph node cell suspensions, and an attenuation in thedecrease in total lung capacity 72 h post-allergen challenge. Further, histopathologic examination of thelung tissues revealed reduced pulmonary inflammation post-allergen challenge in the DNA-vaccine-treatedcompared to sensitized, untreated animals. We conclude that a DNA-based vaccine delivered to the airwaysignificantly influences the immunologic, pulmonary physiologic, and histological alterations induced bychallenge with a major Alternaria allergen, rAlt a 2, in sensitized animals(AU)

Sublingual-oral administration of standardized allergenic extracts: phase 1 safety and dosing results.

BACKGROUND: European studies provide a preponderance of evidence for sublingual allergen immunotherapy (SLIT) safety and efficacy, but they use allergen products that differ from those expected to be approved in the United States. OBJECTIVE: To determine the safety and tolerability of 4 US-licensed standardized SLIT allergenic extracts. METHODS: Adults 18 to 50 years old with allergic rhinitis with or without asthma due to timothy grass pollen, short ragweed pollen, house dust mite, or cat hair allergy completed a single-session dose escalation followed by an 8-week, open-label daily course of SLIT. Participants documented the presence and severity of adverse effects and adherence using a daily electronic diary. RESULTS: Ninety-one participants initiated treatment, and 77 completed the phase 1 testing. Maximum tolerable doses ranged from 50 to 2,090 BAU for cat hair and dust mite extract, 31 to 91 Amb a 1 Units for short ragweed pollen extract, and 50 to 21,090 BAU for timothy grass pollen extract. During the 8-week treatment course, 98.9% of participants reported at least 1 mild, 70.4% at least 1 moderate, and 13.6% at least 1 severe adverse effect. Most adverse effects (94.6%) were rated as mild, 5.2% as moderate, and 0.1% as severe; nasal and oral-mucosal adverse effects were most commonly reported. No life-threatening adverse reactions occurred in more than 4,500 administered doses. CONCLUSIONS: Daily sublingual-oral dosing of standardized allergenic extracts at maximum tolerable doses was generally well tolerated. These results are a first step toward establishing the safety of US-licensed SLIT extracts when appropriately self-administered and monitored.

Pollen immunotherapy: selection,prevention, and future directions.

Pollens are an important cause of allergic rhinitis and asthma. Pollen immunotherapy is effective and potentially curative. It has been shown to prevent new sensitizations, to prevent the development of asthma in children, and to induce long-term benefit. Standardization of allergen extracts is necessary to improve immunotherapy safety and efficacy. Knowledge of the local plant taxonomy and allergen cross-reactivity is important in selecting clinically relevant vaccines. In general, allergenic cross-reactivities correspond to taxonomic relations. Tree and weed species demonstrate variable degrees of cross-reactivity. Most grasses have extensive allergenic cross-reactivity. Mechanism of action continues to be an area of investigation, including the induction of immunoglobulin G blocking antibodies. Sublingual immunotherapy, concurrent anti-immunoglobulin E use, hypoallergic peptides, and DNA vaccines are other promising technologies.