%0 Journal Article %~ PubMed %A Lau, Edmund M T %A Morgan, Philip E %A Belousova, Elena G %A Toelle, Brett G %A Ayer, Julian G %A Celermajer, David S %A Marks, Guy B %T Asymmetric dimethylarginine and asthma: results from the Childhood Asthma Prevention Study. %B The European Respiratory Journal %D 2013 %C Switzerland %I European Respiratory Society %V 41 %N 5 %P 1234-1237 %@ 1399-3003 %X %Z FOR Codes: 110101 110701 %0 Journal Article %~ PubMed %A Fox, Gregory J %A Barry, Simone E %A Britton, Warwick J %A Marks, Guy B %T Contact investigation for tuberculosis: a systematic review and meta-analysis. %B The European Respiratory Journal %D 2013 %C Switzerland %I European Respiratory Society %V 41 %N 1 %P 140-156 %@ 1399-3003 %X Investigation of contacts for patients with tuberculosis is a priority for tuberculosis control in high-income countries, and is increasingly being considered in resource-limited settings. This review was commissioned for a World Health Organization Expert Panel to develop global contact investigation guidelines.We performed a systematic review and meta-analysis of all studies reporting the prevalence of tuberculosis and latent tuberculosis infection, and the annual incidence of tuberculosis among contacts of patients with tuberculosis.After screening 9555 titles, we included 203 published studies. In 95 studies from low and middle-income settings, the prevalence of active tuberculosis in all contacts was 3.1% (95% CI 2.2%-4.4%, I(2)=99.4%), microbiologically proven tuberculosis 1.2% (95% CI 0.9-1.8%, I(2)=95.9%), and latent tuberculosis infection 51.5% (95% CI 47.1-55.8%, I(2)=98.9%). The prevalence of tuberculosis among household contacts was 3.1% (95% CI 2.1-4.5%, I(2)=98.8%) and among contacts of patients with multi-drug resistant or extensively drug resistant tuberculosis was 3.4% (95% CI 0.8-12.6%, I(2)=95.7%). Incidence was greatest in the first year after exposure. In 108 studies from high-income settings, the prevalence of TB among contacts was 1.4% (95% CI 1.1-1.8%, I(2)=98.7%), and the prevalence of latent infection was 28.1% (95% CI 24.2-32.4%, I(2)=99.5%). There was substantial heterogeneity among published studies.Contacts of tuberculosis patients are a high-risk group for developing tuberculosis, particularly within the first year. Children under 5 years and people living with HIV are particularly at risk. Policy recommendations must consider evidence of the cost-effectiveness of various contact tracing strategies, and also incorporate complementary strategies to enhance case finding. %Z FOR Codes: 111799 110203 110309 %0 Journal Article %~ PubMed %A Phillips, Craig L %A Grunstein, Ronald R %A Darendeliler, M Ali %A Mihailidou, Anastasia S %A Srinivasan, Vasantha K %A Yee, Brendon J %A Marks, Guy B %A Cistulli, Peter A %T Health Outcomes of CPAP versus Oral Appliance Treatment for Obstructive Sleep Apnea: A Randomised Controlled Trial. %B American Journal of Respiratory and Critical Care Medicine %D 2013 %C United States %I American Thoracic Society %V 187 %N 8 %P 879-887 %@ 1073-449X %X %Z FOR Codes: 110399 %0 Journal Article %~ PubMed %A Dobler, Claudia C %A Marks, Guy B %T Risk of tuberculosis among contacts in a low-incidence setting. %B The European Respiratory Journal %D 2013 %C Switzerland %I European Respiratory Society %V 41 %N 6 %P 1459-1461 %@ 1399-3003 %X %Z FOR Codes: 110203 111716 110309 %0 Journal Article %~ PubMed %A Kidd, Timothy J %A Ramsay, Kay A %A Hu, Honghua %A Marks, Guy B %A Wainwright, Claire E %A Bye, Peter T %A Elkins, Mark R %A Robinson, Philip J %A Rose, Barbara R %A Wilson, John W %A Grimwood, Keith %A Bell, Scott C %A , the ACPinCF Investigator Group %T Shared pseudomonas aeruginosa genotypes are common in australian cystic fibrosis centres. %B The European Respiratory Journal %D 2013 %C Switzerland %I European Respiratory Society %V 41 %N 5 %P 1091-1100 %@ 1399-3003 %X %Z FOR Codes: 60501 %0 Journal Article %A Marks, Guy %T The role of the Journal in fulfilling The Union's mission and pursuing its vision %B International Journal of Tuberculosis Lung Disease %D 2013 %C France %I International Union against Tuberculosis and Lung %V 16 %N 1 %P 1 %@ 1815-7920 %X %Z FOR Codes: 110203 %0 Journal Article %~ PubMed %A Bunker, Jeremy M %A Reddel, Helen K %A Dennis, Sarah M %A Middleton, Sandy %A Van Schayck, Cp %A Crockett, Alan J %A Hasan, Iqbal %A Hermiz, Oshana %A Vagholkar, Sanjyot %A Marks, Guy B %A Zwar, Nicholas A %T A pragmatic cluster randomized controlled trial of early intervention for chronic obstructive pulmonary disease by practice nurse-general practitioner teams: Study Protocol. %B Implementation Science %D 2012 %C United Kingdom %I BioMed Central Ltd. %V 7 %N %P 83 %@ 1748-5908 %X %Z FOR Codes: 110399 111099 %0 Journal Article %~ PubMed %A Cowie, Christine T %A Ezz, Wafaa %A Xuan, Wei %A Lilley, William %A Rose, Nectarios %A Rae, Michael %A Marks, Guy B %T A randomised cross-over cohort study of exposure to emissions from a road tunnel ventilation stack. %B BMJ Open %D 2012 %C United Kingdom %I BMJ Group %V 2 %N 4 %P e001201 %@ 2044-6055 %X BACKGROUND AND OBJECTIVE: Road tunnels are increasingly important components of urban infrastructure. However, knowledge of their health impact on surrounding communities is limited. Our objective was to estimate the short-term respiratory health effects of exposure to emissions from a road tunnel ventilation stack. METHODS: We conducted a randomised cross-over cohort study in 36 volunteers who underwent three exposure scenarios in 2006 before the road tunnel opened, and in 2007 (n=27) and 2008 (n=20) after the tunnel opened. Exposure downwind of the stack was compared to upwind of the stack and to a distant heavily trafficked location adjacent to a main road. Spirometry, exhaled nitric oxide (eNO) and symptom scores were measured repeatedly during each 2 h exposure session. RESULTS: Downwind locations were associated with increased reports of ''dry nose'' (score difference 0.36; 95% CI 0.09 to 0.63) compared with the control location (2006 vs 2007/2008), but not with impaired lung function, increased airway inflammation or other symptoms. The heavily trafficked location was associated with significantly increased eNO (ratio=1.09; 95% CI 1.04 to 1.14), eye (score difference 0.05; 95% CI 0.01 to 0.10) and chest (score difference 0.21; 95% CI 0.09 to 0.33) symptoms compared to the stack locations. CONCLUSIONS: There was no consistent evidence of adverse respiratory effects from short-term exposures downwind of the tunnel ventilation stack, except for dry nose symptoms. However, the findings of increased airway inflammation and symptoms in subjects after only 2 h exposure at the heavily trafficked location, are suggestive of detrimental effects of short-term exposures to traffic-related air pollution. %Z FOR Codes: 111705 111706 110203 %0 Journal Article %~ PubMed %A Marks, Guy B %T Are reference equations for spirometry an appropriate criterion for diagnosing disease and predicting prognosis? %B Thorax %D 2012 %C United Kingdom %I BMJ Group %V 67 %N 1 %P 85-87 %@ 0040-6376 %X In the last few years, there has been considerable debate on the use of threshold criteria for the diagnosis of obstructive lung disease based on FEV(1) and FEV(1)/FVC ratio. It has been argued that a fixed ratio and fixed percentage criterion result in misclassification. The author argues that this critique is based on a false presumption about the validity of reference equations as a criterion for normality. The flaw lies in the methods used to derive reference equations, which involve arbitrary and circular criteria for exclusion of some members of the population, use potentially non-representative reference populations and include predictive variables that are really risk factors for disease or for adverse outcomes of disease. The author argues for a new interpretative approach for the use of lung function data in clinical practice based on prognostic equations analogous to the Framingham cardiovascular risk factor equations. These interpretative equations should be based on data from cohort studies and randomised controlled trials, rather than cross-sectional studies, and if properly formulated, will prove to be valuable aids to clinical decision making. %Z FOR Codes: 110203 %0 Journal Article %~ PubMed %A Garden, Frances L %A Marks, Guy B %A Simpson, Judy M %A Webb, Karen L %T Body Mass Index (BMI) Trajectories from Birth to 11.5 Years: Relation to Early Life Food Intake. %B Nutrients %D 2012 %C Switzerland %I M D P I AG %V 4 %N 10 %P 1382-1398 %@ 2072-6643 %X %Z FOR Codes: 111706 111799 %0 Journal Article %~ PubMed %A Brew, Bronwyn K %A Kull, Inger %A Garden, Frances %A Almqvist, Catarina %A Bergström, Anna %A Lind, Tomas %A Webb, Karen %A Wickman, Magnus %A Marks, Guy B %T Breastfeeding, asthma, and allergy: a tale of two cities. %B Pediatric Allergy and Immunology %D 2012 %C United Kingdom %I Wiley-Blackwell Publishing Ltd. %V 23 %N 1 %P 75-82 %@ 1399-3038 %X To cite this article: Brew BK, Kull I, Garden F, Almqvist C, Bergstr??m A, Lind T, Webb K, Wickman M, Marks GB. Breastfeeding, asthma, and allergy: a tale of two cities. Pediatric Allergy Immunology 2012: 23: 75-82. ABSTRACT: Background:??? The effect of breastfeeding duration on subsequent asthma and allergy remains the subject of much controversy. Objective:??? To investigate whether differences in study design or disease-related exposure modification were the cause of the differences in study findings. Method:??? The data from two cohorts, the Childhood Asthma Prevention Study (CAPS) from Australia and the Barn Allergi Miljo Stockholm cohort from Sweden, which had reported different findings on the association between breastfeeding and asthma, were combined. For this analysis, the definitions for breastfeeding, asthma, and allergy were harmonized. Subjects were included if they had at least one parent with wheeze or asthma and had a gestational age of more than 36???wks (combined n???=???882). The risk of disease-related exposure modification was assessed using survival analysis. Results:??? Breastfeeding reduced the risk of asthma at 4/5 and 8???yrs of age in children with a family history of asthma. The effect was stronger in the Swedish cohort. Breastfeeding had no effect on the prevalence of sensitization to inhaled allergens in this cohort with a family history of asthma but was a risk factor for sensitization to cow''s milk, peanuts, and eggs in the CAPS cohort at 4/5???yrs and in the combined cohort at 8???yrs. There was no evidence to support the existence of disease-related exposure modification in either cohort. Conclusion:??? These findings point to the importance of harmonization of features of study design, including subject selection criteria and variable definitions, in resolving epidemiological controversies such as those surrounding the impact of breastfeeding on asthma and allergic sensitization. %Z FOR Codes: 110203 111104 111403 %0 Journal Article %~ PubMed %A Zwar, Nicholas A %A Hermiz, Oshana %A Comino, Elizabeth %A Middleton, Sandy %A Vagholkar, Sanjyot %A Xuan, Wei %A Wilson, Stephen F %A Marks, Guy B %T Care of patients with a diagnosis of chronic obstructive pulmonary disease: a cluster randomised controlled trial. %B The Medical Journal of Australia %D 2012 %C Australia %I Australasian Medical Publishing Company Pty. Ltd. %V 197 %N 7 %P 394-398 %@ 1326-5377 %X %Z FOR Codes: 110203 111717 %0 Journal Article %~ PubMed %A Skilton, Michael R %A Sullivan, Tim R %A Ayer, Julian G %A Harmer, Jason A %A Toelle, Brett G %A Webb, Karen %A Marks, Guy B %A Celermajer, David S %T Carotid extra-medial thickness in childhood: Early life effects on the arterial adventitia. %B Atherosclerosis %D 2012 %C Ireland %I Elsevier Ireland Ltd. %V 222 %N 2 %P 478-482 %@ 0021-9150 %X Structural modification of the arterial adventitia may be an early event in atherosclerosis. Carotid extra-medial thickness is a new measure of arterial adventitial thickness. We examined the association of cardiovascular risk factors with extra-medial thickness, in childhood. %Z FOR Codes: 110201 %0 Journal Article %~ PubMed %A Dobler, Claudia C %A Marks, Guy B %T Completion of Treatment for Latent Tuberculosis Infection with Monthly Drug Dispensation Directly through the Tuberculosis Clinic. %B PLoS One %D 2012 %C United States %I Public Library of Science %V 7 %N 11 %P e48900 %@ 1932-6203 %X %Z FOR Codes: 111716 110309 110203 %0 Journal Article %~ PubMed %A Fox, Gregory James %A Nhung, Nguyen Viet %A Sy, Dinh Ngoc %A Lien, Luu Thi %A Cuong, Nguyen Kim %A Britton, Warwick John %A Marks, Guy Barrington %T Contact investigation in households of patients with tuberculosis in hanoi, Vietnam: a prospective cohort study. %B PLoS One %D 2012 %C United States %I Public Library of Science %V 7 %N 11 %P e49880 %@ 1932-6203 %X %Z FOR Codes: 110203 111799 110309 %0 Journal Article %~ PubMed %A Rangan, Anna M %A Flood, Victoria M %A Denyer, Gareth %A Webb, Karen %A Marks, Guy B %A Gill, Timothy P %T Dairy consumption and diet quality in a sample of Australian children. %B Journal of the American College of Nutrition %D 2012 %C United States %I American College of Nutrition %V 31 %N 3 %P 185-193 %@ 1541-1087 %X %Z FOR Codes: 111104 %0 Journal Article %~ PubMed %A Ramasamy, Adaikalavan %A Kuokkanen, Mikko %A Vedantam, Sailaja %A Gajdos, Zofia K %A Couto Alves, Alexessander %A Lyon, Helen N %A Ferreira, Manuel A R %A Strachan, David P %A Zhao, Jing Hua %A Abramson, Michael J %A Brown, Matthew A %A Coin, Lachlan %A Dharmage, Shyamali C %A Duffy, David L %A Haahtela, Tari %A Heath, Andrew C %A Janson, Christer %A Kähönen, Mika %A Khaw, Kay-Tee %A Laitinen, Jaana %A Le Souef, Peter %A Lehtimäki, Terho %A , Australian Asthma Genetics Consortium Collaborators %A Madden, Pamela A F %A Marks, Guy B %A Martin, Nicholas G %A Matheson, Melanie C %A Palmer, Cameron D %A Palotie, Aarno %A Pouta, Anneli %A Robertson, Colin F %A Viikari, Jorma %A Widen, Elisabeth %A Wjst, Matthias %A Jarvis, Deborah L %A Montgomery, Grant W %A Thompson, Philip J %A Wareham, Nick %A Eriksson, Johan %A Jousilahti, Pekka %A Laitinen, Tarja %A Pekkanen, Juha %A Raitakari, Olli T %A O'Connor, George T %A Salomaa, Veikko %A Jarvelin, Marjo-Riitta %A Hirschhorn, Joel N %T Genome-wide association studies of asthma in population-based cohorts confirm known and suggested loci and identify an additional association near HLA. %B PLoS One %D 2012 %C United States %I Public Library of Science %V 7 %N 9 %P e44008 %@ 1932-6203 %X %Z FOR Codes: 110203 60408 %0 Journal Article %~ PubMed %A Lozano, Rafael %A Naghavi, Mohsen %A Foreman, Kyle %A Lim, Stephen %A Shibuya, Kenji %A Aboyans, Victor %A Abraham, Jerry %A Adair, Timothy %A Aggarwal, Rakesh %A Ahn, Stephanie Y %A Alvarado, Miriam %A Anderson, H Ross %A Anderson, Laurie M %A Andrews, Kathryn G %A Atkinson, Charles %A Baddour, Larry M %A Barker-Collo, Suzanne %A Bartels, David H %A Bell, Michelle L %A Benjamin, Emelia J %A Bennett, Derrick %A Bhalla, Kavi %A Bikbov, Boris %A Bin Abdulhak, Aref %A Birbeck, Gretchen %A Blyth, Fiona %A Bolliger, Ian %A Boufous, Soufiane %A Bucello, Chiara %A Burch, Michael %A Burney, Peter %A Carapetis, Jonathan %A Chen, Honglei %A Chou, David %A Chugh, Sumeet S %A Coffeng, Luc E %A Colan, Steven D %A Colquhoun, Samantha %A Colson, K Ellicott %A Condon, John %A Connor, Myles D %A Cooper, Leslie T %A Corriere, Matthew %A Cortinovis, Monica %A de Vaccaro, Karen Courville %A Couser, William %A Cowie, Benjamin C %A Criqui, Michael H %A Cross, Marita %A Dabhadkar, Kaustubh C %A Dahodwala, Nabila %A De Leo, Diego %A Degenhardt, Louisa %A Delossantos, Allyne %A Denenberg, Julie %A Des Jarlais, Don C %A Dharmaratne, Samath D %A Dorsey, E Ray %A Driscoll, Tim %A Duber, Herbert %A Ebel, Beth %A Erwin, Patricia J %A Espindola, Patricia %A Ezzati, Majid %A Feigin, Valery %A Flaxman, Abraham D %A Forouzanfar, Mohammad H %A Fowkes, Francis Gerry R %A Franklin, Richard %A Fransen, Marlene %A Freeman, Michael K %A Gabriel, Sherine E %A Gakidou, Emmanuela %A Gaspari, Flavio %A Gillum, Richard F %A Gonzalez-Medina, Diego %A Halasa, Yara A %A Haring, Diana %A Harrison, James E %A Havmoeller, Rasmus %A Hay, Roderick J %A Hoen, Bruno %A Hotez, Peter J %A Hoy, Damian %A Jacobsen, Kathryn H %A James, Spencer L %A Jasrasaria, Rashmi %A Jayaraman, Sudha %A Johns, Nicole %A Karthikeyan, Ganesan %A Kassebaum, Nicholas %A Keren, Andre %A Khoo, Jon-Paul %A Knowlton, Lisa Marie %A Kobusingye, Olive %A Koranteng, Adofo %A Krishnamurthi, Rita %A Lipnick, Michael %A Lipshultz, Steven E %A Ohno, Summer Lockett %A Mabweijano, Jacqueline %A MacIntyre, Michael F %A Mallinger, Leslie %A March, Lyn %A Marks, Guy B %A Marks, Robin %A Matsumori, Akira %A Matzopoulos, Richard %A Mayosi, Bongani M %A McAnulty, John H %A McDermott, Mary M %A McGrath, John %A Mensah, George A %A Merriman, Tony R %A Michaud, Catherine %A Miller, Matthew %A Miller, Ted R %A Mock, Charles %A Mocumbi, Ana Olga %A Mokdad, Ali A %A Moran, Andrew %A Mulholland, Kim %A Nair, M Nathan %A Naldi, Luigi %A Narayan, K M Venkat %A Nasseri, Kiumarss %A Norman, Paul %A O'Donnell, Martin %A Omer, Saad B %A Ortblad, Katrina %A Osborne, Richard %A Ozgediz, Doruk %A Pahari, Bishnu %A Pandian, Jeyaraj Durai %A Rivero, Andrea Panozo %A Padilla, Rogelio Perez %A Perez-Ruiz, Fernando %A Perico, Norberto %A Phillips, David %A Pierce, Kelsey %A Pope, C Arden %A Porrini, Esteban %A Pourmalek, Farshad %A Raju, Murugesan %A Ranganathan, Dharani %A Rehm, Jürgen T %A Rein, David B %A Remuzzi, Guiseppe %A Rivara, Frederick P %A Roberts, Thomas %A De León, Felipe Rodriguez %A Rosenfeld, Lisa C %A Rushton, Lesley %A Sacco, Ralph L %A Salomon, Joshua A %A Sampson, Uchechukwu %A Sanman, Ella %A Schwebel, David C %A Segui-Gomez, Maria %A Shepard, Donald S %A Singh, David %A Singleton, Jessica %A Sliwa, Karen %A Smith, Emma %A Steer, Andrew %A Taylor, Jennifer A %A Thomas, Bernadette %A Tleyjeh, Imad M %A Towbin, Jeffrey A %A Truelsen, Thomas %A Undurraga, Eduardo A %A Venketasubramanian, N %A Vijayakumar, Lakshmi %A Vos, Theo %A Wagner, Gregory R %A Wang, Mengru %A Wang, Wenzhi %A Watt, Kerrianne %A Weinstock, Martin A %A Weintraub, Robert %A Wilkinson, James D %A Woolf, Anthony D %A Wulf, Sarah %A Yeh, Pon-Hsiu %A Yip, Paul %A Zabetian, Azadeh %A Zheng, Zhi-Jie %A Lopez, Alan D %A Murray, Christopher J L %T Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. %B Lancet %D 2012 %C United Kingdom %I The Lancet Publishing Group %V 380 %N 9859 %P 2095-2128 %@ 0140-6736 %X %Z FOR Codes: 111706 %0 Journal Article %~ PubMed %A Skilton, Michael R %A Ayer, Julian G %A Harmer, Jason A %A Webb, Karen %A Leeder, Stephen R %A Marks, Guy B %A Celermajer, David S %T Impaired fetal growth and arterial wall thickening: a randomized trial of omega-3 supplementation. %B Pediatrics %D 2012 %C United States %I American Academy of Pediatrics %V 129 %N 3 %P e698-e703 %@ 0031-4005 %X Impaired fetal growth is an independent cardiovascular risk factor and is associated with arterial wall thickening in children. No preventive strategy has been identified. We sought to determine whether dietary omega-3 fatty acid supplementation during early childhood prevents the association between impaired fetal growth and carotid arterial wall thickening. %Z FOR Codes: 111401 %0 Journal Article %~ PubMed %A Marshall, Nathaniel S %A Ayer, Julian G %A Toelle, Brett G %A Phillips, Craig L %A Grunstein, Ronald R %A Celermajer, David S %A Marks, Guy B %T Parentally Reported Snoring Is Not Enough Information To Justify Treatment. %B Journal of Paediatrics and Child Health %D 2012 %C United Kingdom, Australia %I Wiley-Blackwell Publishing Ltd. %V 48 %N 1 %P 78 %@ 1034-4810 %X %Z FOR Codes: 110203 110201 111706 %0 Journal Article %~ PubMed %A Brew, B K %A Marks, G B %A , the CAPS (Childhood Asthma Prevention Study) Investigators %T Perinatal factors and respiratory health in children. %B Clinical and Experimental Allergy %D 2012 %C United Kingdom %I Wiley-Blackwell Publishing Ltd. %V 42 %N 11 %P 1621-1629 %@ 1365-2222 %X %Z FOR Codes: 110203 111403 %0 Journal Article %~ PubMed %A Cowie, Christine T %A Rose, Nectarios %A Gillett, Robert %A Walter, Scott %A Marks, Guy B %T Redistribution of traffic related air pollution associated with a new road tunnel. %B Environmental Science & Technology %D 2012 %C United States %I American Chemical Society %V 46 %N 5 %P 2918-2927 %@ 1520-5851 %X The aim of this study was to assess the effect of a new road tunnel on the concentration and distribution of traffic-related air pollution (TRAP), specifically nitrogen dioxide (NO(2)) and particulate matter (PM), and to determine its relationship to change in traffic flow. We used continuously recorded data from four monitoring stations at nonroadside locations within the study area and three regional monitors outside the area. The four monitors in the study area were in background locations where smaller pollutant changes were expected compared with changes near the bypassed main road. We also deployed passive samplers to assess finer spatial variability in NO(2) including application of a land use regression model (LUR). The study was conducted from 2006 to 2008. Analysis of the continuously recorded data showed that the tunnel intervention did not lead to consistent reductions in NO(2) or PM over the wider study area. However, there were significant decreases in NO(2), NO(x), and PM(10) in the eastern section of the study area. Analysis of passive sampler data indicated that the greatest reductions in NO(2) concentrations occurred within 100 m of the bypassed main road. The LUR model also demonstrated that changes in NO(2) were most marked adjacent to the bypassed main road. These findings support the use of methods that highlight fine spatial variability in TRAP and demonstrate the utility of traffic interventions in reducing air pollution exposures for populations living close to main roads. %Z FOR Codes: 111705 %0 Journal Article %~ PubMed %A Cowie, Christine T %A Rose, Nectarios %A Ezz, Wafaa %A Xuan, Wei %A Cortes-Waterman, Adriana %A Belousova, Elena %A Toelle, Brett G %A Sheppeard, Vicky %A Marks, Guy B %T Respiratory Health before and after the Opening of a Road Traffic Tunnel: A Planned Evaluation. %B PLoS One %D 2012 %C United States %I Public Library of Science %V 7 %N 11 %P e48921 %@ 1932-6203 %X %Z FOR Codes: 110203 111705 %0 Journal Article %~ PubMed %A Dobler, Claudia Caroline %A Flack, Jeffrey Ronald %A Marks, Guy Barrington %T Risk of tuberculosis among people with diabetes mellitus: an Australian nationwide cohort study. %B BMJ Open %D 2012 %C United Kingdom %I BMJ Group %V 2 %N 1 %P e000666 %@ 2044-6055 %X Previous studies that have found an increased risk for tuberculosis (TB) in people with diabetes mellitus (DM) have been conducted in segments of the population and have not adjusted for important potential confounders. We sought to determine the RR for TB in the presence of DM in a national population with data on confounding factors in order to inform the decision-making process about latent tuberculosis infection (LTBI) screening in people with diabetes. %Z FOR Codes: 110203 111799 %0 Journal Article %A Marks, Guy %T The challenge of delivering effective care for asthma %B Public Health Action %D 2012 %C Canada %I The Union %V 2 %N 3 %P 44 %@ 2220-8372 %X %Z FOR Codes: 111717 110203 %0 Journal Article %~ PubMed %A Rangan, A M %A Flood, V L %A Denyer, G %A Ayer, J G %A Webb, K L %A Marks, G B %A Celermajer, D S %A Gill, T P %T The effect of dairy consumption on blood pressure in mid-childhood: CAPS cohort study. %B European Journal of Clinical Nutrition %D 2012 %C United Kingdom %I Nature Publishing Group %V 66 %N 6 %P 652-657 %@ 0954-3007 %X BACKGROUND/OBJECTIVES:It has been postulated that a higher dairy consumption may affect blood pressure regulation. The aim of this study was to examine the association between dairy consumption and blood pressure in mid-childhood.SUBJECTS/METHODS:Subjects (n=335) were participants of a birth cohort at high risk of asthma with information on diet at 18 months and blood pressure at 8 years. Multivariate analyses were used to assess the association of dairy consumption (serves) and micronutrient intakes (mg). In a subgroup of children (n=201), dietary intake was also measured at approximately 9 years.RESULTS:Children in the highest quintile of dairy consumption at 18 months had lower systolic blood pressure (SBP) and diastolic blood pressure (DBP) at 8 years (2.5?mm?Hg, P=0.046 and 1.9?mm?Hg, P=0.047, respectively) than those in the lowest quintiles. SBP was lowest among children in the highest quintiles of calcium, magnesium and potassium intakes. Significant negative linear trends were observed between SBP and intakes of dairy serves, calcium, magnesium and potassium. Furthermore, SBP and DBP were lowest in the group of children that consumed at least two dairy serves at both 18 months and the follow-up dietary data collection at 9 years, compared with all other children (SBP 98.7 vs 101.0?mm?Hg, P=0.07; and DBP 56.5 vs 59.3?mm?Hg, P=0.006, respectively).CONCLUSION:These results are consistent with a protective effect of dairy consumption in childhood on blood pressure at age 8 years.European Journal of Clinical Nutrition advance online publication, 11 January 2012; doi:10.1038/ejcn.2011.218. %Z FOR Codes: 111706 %0 Journal Article %~ PubMed %A Fox, Gregory J %A Dobler, Claudia C %A Marks, Guy B %T Active case finding in contacts of people with tuberculosis. %B Cochrane Database of Systematic Reviews %D 2011 %C United States %I John Wiley & Sons Ltd. %V 9 %N %P CD008477 %@ 1469-493X %X Tuberculosis is a major global health challenge that is caused by a bacteria which is spread by airborne droplets. Mostly patients are identified in high-burden countries when they visit health care facilities (''passive case finding''). Contacts of tuberculosis patients are a high-risk group for developing the disease. Actively screening contacts of people with confirmed tuberculosis may improve case detection rates and control of the disease. %Z FOR Codes: 111716 110203 110309 %0 Journal Article %~ PubMed %A Ferreira, Manuel A R %A Matheson, Melanie C %A Duffy, David L %A Marks, Guy B %A Hui, Jennie %A Le Souëf, Peter %A Danoy, Patrick %A Baltic, Svetlana %A Nyholt, Dale R %A Jenkins, Mark %A Hayden, Catherine %A Willemsen, Gonneke %A Ang, Wei %A Kuokkanen, Mikko %A Beilby, John %A Cheah, Faang %A de Geus, Eco J C %A Ramasamy, Adaikalavan %A Vedantam, Sailaja %A Salomaa, Veikko %A Madden, Pamela A %A Heath, Andrew C %A Hopper, John L %A Visscher, Peter M %A Musk, Bill %A Leeder, Stephen R %A Jarvelin, Marjo-Riitta %A Pennell, Craig %A Boomsma, Dorret I %A Hirschhorn, Joel N %A Walters, Haydn %A Martin, Nicholas G %A James, Alan %A Jones, Graham %A Abramson, Michael J %A Robertson, Colin F %A Dharmage, Shyamali C %A Brown, Matthew A %A Montgomery, Grant W %A Thompson, Philip J %A , Australian Asthma Genetics Consortium %T Identification of IL6R and chromosome 11q13.5 as risk loci for asthma. %B Lancet %D 2011 %C United Kingdom %I The Lancet Publishing Group %V 378 %N 9795 %P 1006-1014 %@ 0140-6736 %X We aimed to identify novel genetic variants affecting asthma risk, since these might provide novel insights into molecular mechanisms underlying the disease. %Z FOR Codes: 110203 %0 Journal Article %~ PubMed %A Salome, Cheryl M %A Brown, Nathan J %A Reddel, Helen K %A Xuan, Wei %A Marks, Guy B %T Indices of bronchial reactivity and sensitivity. %B Thorax %D 2011 %C United Kingdom %I BMJ Group %V 66 %N 3 %P 265-266 %@ 0040-6376 %X %Z FOR Codes: 110203 %0 Journal Article %~ PubMed %A Garden, F L %A Marks, G B %A Almqvist, C %A Simpson, J M %A Webb, K L %T Infant and early childhood dietary predictors of overweight at age 8 years in the CAPS population. %B European Journal of Clinical Nutrition %D 2011 %C United Kingdom, Switzerland %I Nature Publishing Group %V 65 %N 4 %P 454-462 %@ 0954-3007 %X Background/Objectives:Programs to address obesity are a high priority for public policy especially for young children. Research into dietary determinants of obesity is challenging but important for rational planning of interventions to prevent obesity, given that both diet and energy expenditure influence weight status. We investigated whether early life dietary factors were predictive of weight status at 8 years in a cohort of Australian children.Subjects/Methods:We used data from the Childhood Asthma Prevention Study-a birth cohort at high risk of asthma. Dietary data (3-day weighed food records) were collected at 18 months and height, weight and waist circumference were collected at 8 years. We assessed the relationship between dietary predictor variables and measures of adiposity using linear regression.Results:Intakes of protein, meat and fruit at age 18 months were positively associated with measures of adiposity at age 8 years, namely, body mass index and/or waist circumference. We also showed a significant negative relationship between these measures of adiposity at 8 years and intake at 18 months of dairy foods as a percent of total energy, and intake of energy dense cereal-based foods such as cookies and crackers.Conclusions:This birth cohort study with rigorous design, measures and analyses, has shown a number of associations between early dietary intake and subsequent adiposity that contribute to the growing evidence base in this important field. %Z FOR Codes: 111104 %0 Journal Article %~ PubMed %A Tovey, Euan R %A Marks, Guy B %T It's time to rethink mite allergen avoidance. %B Journal of Allergy and Clinical Immunology %D 2011 %C United States %I Mosby, Inc. %V 128 %N 4 %P 723-727.e6 %@ 1097-6825 %X The role of allergen exposure in the etiology of allergic sensitization and asthma is complex. Advice on strategies to avoid domestic allergens remains contentious because trials of interventions aimed to prevent asthma or reduce symptoms have often failed to demonstrate benefits. Asthma management guidelines differ widely in their recommendations, while Web-based information often claims benefits associated with products. In this rostrum we argue that although many factors have a role in both the etiology and the exacerbation of asthma, allergen exposure probably remains an important contributor to the manifestations of the disease. Currently, there is no evidence-based framework for effective domestic allergen avoidance interventions to reduce chronic aeroallergen exposure. The development of an effective approach to allergen avoidance requires a better understanding of (a) the physical nature of chronic aeroallergen exposure and methods for measuring and reducing this, (b) the interaction between allergen exposure and innate immune modulators at different disease stages, and (c) markers enabling the identification of individuals who would benefit from this. The strategic risk of overemphasizing other novel mechanisms and approaches to asthma management is that we will prematurely abandon and fail to improve an existing approach that could have a significant impact on the development, progression, and symptoms of the disease. %Z FOR Codes: 110203 %0 Journal Article %~ PubMed %A Ayer, Julian G %A Belousova, Elena G %A Harmer, Jason A %A Toelle, Brett %A Celermajer, David S %A Marks, Guy B %T Lung Function Is Associated with Arterial Stiffness in Children. %B PLoS One %D 2011 %C United States %I Public Library of Science %V 6 %N 10 %P e26303 %@ 1932-6203 %X BACKGROUND: In older adults, an independent association exists between impaired lung function and cardiovascular disease. This interaction might be related to the effects of aging and/or smoking. In order to explore possible childhood antecedents to this association, we hypothesized that decreased lung function and vascular stiffness might be related, in early life. OBJECTIVE: To determine the relationship between lung function and carotid augmentation index (AIx), a measure of vascular stiffness, in 8-year old children. METHODS: Data on brachial blood pressure, lung function (FEV(1), FVC, FEV(1)/FVC, obtained by spirometry) and carotid AIx75 (AIx standardised to an arbitrary heart rate of 75 beats per minute, obtained by applanation tonometry) was available in 249 community-based 8-year old children. These healthy children had been subjects in a randomised controlled trial of two interventions (omega-3 fatty acid supplementation and house-dust mite avoidance) to prevent asthma. Smoking in pregnancy and childhood environmental tobacco smoke (ETS) exposure was prospectively collected by questionnaire. The association between lung function and carotid AIx75 was assessed in multivariate models that included sex, height, smoking status during pregnancy, ETS exposure and randomisation groups (house dust mite avoidance and dietary intervention) as covariates. RESULTS: In the fully adjusted models, Carotid AIx75 was independently associated with FEV1 (standardised ?????=???-0.17,b???=???-6.72, partial R(2)???=???.02, p???=???0.03), FVC (standardised ?????=???-0.29, b???=???-9.31, partial R(2)???=???0.04, p<0.001) and FEV1/FVC (standardised ?????=???.13, b???=???18.4, partial R(2)???=???0.02, p???=???0.04). CONCLUSION: Lower lung volumes are associated with increased vascular stiffness at an early age. The interaction between lung function and vascular stiffness may thus represent more than just age-related alterations in both the pulmonary and vascular systems. %Z FOR Codes: 110201 110203 %0 Journal Article %~ PubMed %A Ayer, Julian G %A Belousova, Elena %A Harmer, Jason A %A David, Clementine %A Marks, Guy B %A Celermajer, David S %T Maternal cigarette smoking is associated with reduced high-density lipoprotein cholesterol in healthy 8-year-old children. %B European Heart Journal %D 2011 %C United Kingdom %I Oxford University Press %V 32 %N 19 %P 2446-2453 %@ 0195-668X %X Smoking in pregnancy is common. Its effects on lipoprotein levels and arterial structure in childhood are not well characterized. We aimed to determine the effects of maternal smoking in pregnancy on lipoprotein levels and arterial wall thickness in healthy pre-pubertal children. %Z FOR Codes: 1102 %0 Journal Article %~ PubMed %A Zwar, Nicholas A %A Marks, Guy B %A Hermiz, Oshana %A Middleton, Sandy %A Comino, Elizabeth J %A Hasan, Iqbal %A Vagholkar, Sanjyot %A Wilson, Stephen F %T Predictors of accuracy of diagnosis of chronic obstructive pulmonary disease in general practice. %B Medical Journal of Australia %D 2011 %C Australia %I Australasian Medical Publishing Company Pty. Ltd. %V 195 %N 4 %P 168-171 %@ 1326-5377 %X To compare the clinical diagnosis of chronic obstructive pulmonary disease (COPD) with results of post-bronchodilator spirometry in general practice, and examine practitioner, practice and patient characteristics associated with agreement between clinical and spirometric diagnoses. %Z FOR Codes: 110203 111717 %0 Journal Article %~ PubMed %A Robinson, Paul D %A Turner, Martin %A Brown, Nathan J %A Salome, Cheryl %A Berend, Norbert %A Marks, Guy B %A King, Greg G %T Procedures to improve the repeatability of forced oscillation measurements in school-aged children. %B Respiratory Physiology & Neurobiology %D 2011 %C Netherlands %I Elsevier BV %V 177 %N 2 %P 199-206 %@ 1569-9048 %X Forced oscillation technique (FOT) parameters are less repeatable than spirometry, and the impact of technical factors, such as data acquisition and data filtering, are unknown. FOT was performed, in triplicate, on 48 children (8-11 years) and repeated two weeks later. We examined the separate effects of monitoring tidal volume (V(T)) prior to measurement and length of data acquisition on measurement repeatability. We compared the effects on repeatability of a filtering technique in which complete breaths containing respiratory artefact were rejected and statistical filters in which outlying data points were rejected. Within- and between-session repeatability of respiratory system resistance (Rrs) and reactance (Xrs) were assessed using coefficient of variation (CV) and intra-class correlation coefficient (ICC). Longer data acquisition reduced CV of Rrs and Xrs (60s vs. shorter durations, p ??? 0.001). Monitoring V(T) reduced CV of Rrs (p = 0.05). Complete breath filtering improved CV and ICC for both Rrs and Xrs. The repeatability of FOT measurements can be improved by optimising data acquisition and filtering. %Z FOR Codes: 110203 111603 111403 %0 Journal Article %~ PubMed %A Dobler, Claudia C %A McDonald, Stephen P %A Marks, Guy B %T Risk of tuberculosis in dialysis patients: a nationwide cohort study. %B PLoS One %D 2011 %C United States %I Public Library of Science %V 6 %N 12 %P e29563 %@ 1932-6203 %X The ability to identify individuals at increased risk of developing tuberculosis (TB) has important implications for public health policy and patient care. We conducted a general population historical cohort study in all Australian States and Territories to establish the risk of TB arising in people on chronic hemo- or peritoneal dialysis. %Z FOR Codes: 110309 110202 110312 %0 Journal Article %~ PubMed %A Salome, C M %A Marks, G B %T Sex, asthma and obesity: an intimate relationship? %B Clinical and Experimental Allergy %D 2011 %C United Kingdom %I Wiley-Blackwell Publishing Ltd. %V 41 %N 1 %P 6-8 %@ 1365-2222 %X %Z FOR Codes: 111603 %0 Journal Article %~ PubMed %A Marshall, Nathaniel S %A Ayer, Julian G %A Toelle, Brett G %A Harmer, Jason A %A Phillips, Craig L %A Grunstein, Ronald R %A Celermajer, David S %A Marks, Guy B %T Snoring is not associated with adverse effects on blood pressure, arterial structure or function in 8-year-old children: The Childhood Asthma Prevention Study (CAPS). %B Journal of Paediatrics and Child Health %D 2011 %C United Kingdom %I Wiley-Blackwell Publishing Ltd. %V 47 %N 8 %P 518-523 %@ 1034-4810 %X To study the association between childhood snoring and cardiovascular risk factors. %Z FOR Codes: 110399 %0 Journal Article %~ PubMed %A Brew, Bronwyn K %A Allen, C Wendy %A Toelle, Brett G %A Marks, Guy B %T Systematic review and meta-analysis investigating breast feeding and childhood wheezing illness. %B Paediatric and Perinatal Epidemiology %D 2011 %C United Kingdom %I Wiley-Blackwell Publishing Ltd. %V 25 %N 6 %P 507-518 %@ 1365-3016 %X Brew BK, Allen CW, Toelle BG, Marks GB. Systematic review and meta-analysis investigating breast feeding and childhood wheezing illness. Paediatric and Perinatal Epidemiology 2011; 25: 507-518. There is conflicting evidence concerning the relationship between breast feeding and wheezing illness. The objective of this study was to investigate whether there is any association between breast feeding and wheezing in children aged over 5 years and to discover possible sources of heterogeneity. An electronic search of MEDLINE and EMBASE databases was conducted from January 2000 to June 2010. In addition, reference lists from relevant publications were searched. Birth cohort, cross-sectional and case-control studies were included if they measured any breast feeding or exclusive breast feeding for 3 or 4 months. Wheezing illness, including asthma, was identified based on symptoms, reported diagnosis or objective criteria. Thirty-one publications were identified for meta-analysis. There was no association found between any or exclusive breast feeding and wheezing illness, although there was a high level of heterogeneity between the studies. Subgroup analysis revealed that any breast feeding slightly lowers the odds of wheeze (pooled odds ratio 0.92 [0.86, 0.98]) but slightly increases the odds of asthma defined by specific criteria (pooled odds ratio 1.10 [1.00, 1.22]). This meta-analysis does not provide evidence that breast feeding is protective against wheezing illness in children aged 5 years and over. The difference in the effects of breast feeding according to the nature of the wheezing illness highlights the importance of the heterogeneity of illness phenotypes. %Z FOR Codes: 110203 111104 111403 %0 Journal Article %~ PubMed %A Marks, Guy B %T The allergic paradox: A key to progress in primary prevention of asthma. %B Journal of Allergy and Clinical Immunology %D 2011 %C United States %I Mosby, Inc. %V 128 %N 4 %P 789-790 %@ 1097-6825 %X %Z FOR Codes: 110203 110701 %0 Journal Article %~ PubMed %A Rose, Nectarios %A Cowie, Christine %A Gillett, Robert %A Marks, Guy B %T Validation of a Spatiotemporal Land Use Regression Model Incorporating Fixed Site Monitors. %B Environmental Science & Technology %D 2011 %C United States %I American Chemical Society %V 45 %N 1 %P 294-299 %@ 1520-5851 %X Land use regression (LUR) has been widely adopted as a method of describing spatial variation in air pollutants; however, traditional LUR methods are not suitable for characterizing short-term or time-variable exposures. Our aim was to develop and validate a spatiotemporal LUR model for use in epidemiological studies examining health effects attributable to time-variable air pollution exposures. A network of 42 NO(2) passive samplers was deployed for 12 two week periods over three years. A mixed effects model was tested using a combination of spatial predictors, and readings from fixed site continuous monitors, in order to predict NO(2) values for any two week period over three years in the defined study area. The final model, including terms based on traffic density at 50 and 150 m, population density within 500 m, commercial land use area within 750 m, and NO(2) concentrations at a central fixed site monitor, explained over 80% of the overall variation in NO(2) concentrations. We suggest that such a model can be used to study the association between variable air pollutant exposures and health effects in epidemiological studies. %Z FOR Codes: 111705 111706 %0 Journal Article %~ PubMed %A Gibson, Peter G %A McDonald, Vanessa M %A Marks, Guy B %T Asthma in older adults. %B Lancet %D 2010 %C United Kingdom %I The Lancet Publishing Group %V 376 %N 9743 %P 803-813 %@ 0140-6736 %X Asthma in older people is common and is characterised by underdiagnosis and undertreatment. Ageing is associated with unique issues that modify expression, recognition, and treatment of the disease. In particular, asthma and chronic obstructive pulmonary disease (COPD) both overlap and converge in older people. This concurrence, together with absence of precise diagnostic methods, makes diagnosis complex. A multidimensional assessment that addresses airway problems, comorbidities, risk factors, and management skills will draw attention to key needs for intervention. Increased attention to the complications of asthma and obstructive airway disease in older people is needed, specifically to develop effective systems of care, appropriate clinical practice guidelines, and a research agenda that delivers improved health outcomes. %Z FOR Codes: 110203 %0 Journal Article %~ Isi %A Ayer, J. G. %A Harmer, J. A. %A Marks, G. B. %A Avolio, A. %A Celermajer, D. S. %T Central arterial pulse wave augmentation is greater in girls than boys, independent of height %B Journal of Hypertension %D 2010 %C United Kingdom, United States %I Lippincott Williams & Wilkins, Ltd. %V 28 %N 2 %P 306-313 %@ 0263-6352 %X %Z FOR Codes: 110201 %0 Journal Article %~ PubMed %A Rofail, Lydia Makarie %A Wong, Keith K H %A Unger, Gunnar %A Marks, Guy B %A Grunstein, Ronald R %T Comparison between a single-channel nasal airflow device and oximetry for the diagnosis of obstructive sleep apnea. %B Sleep %D 2010 %C United States %I The American Academy of Sleep Medicine %V 33 %N 8 %P 1106-1114 %@ 0161-8105 %X RATIONALE: The most common single channel devices used for obstructive sleep apnea (OSA) screening are nasal airflow and oximetry. No studies have directly compared their role in diagnosing OSA at home. STUDY OBJECTIVES: To prospectively compare the diagnostic utility of home-based nasal airflow and oximetry to attended polysomnography (PSG) and to assess the diagnostic value of adding oximetry to nasal airflow for OSA. DESIGN: Cross-sectional study. SETTING: Laboratory and home. PARTICIPANTS: Sleep clinic patients with suspected OSA. INTERVENTIONS: All patients had laboratory PSG and 2 sets of 3 consecutive nights on each device; nasal airflow (Flow Wizard, DiagnoselT, Australia) and oximetry (Radical Set, Masimo, USA) at home in random order. RESULTS: Ninety-eight of the 105 patients enrolled completed home monitoring. The accuracy of nasal airflow respiratory disturbance index (NF RDI) was not different from oximetry (ODI 3%) for diagnosing OSA (area under the ROC curve (AUC) difference, 0.04; 95% CI of difference -0.05 to 0.12; P = 0.43) over 3 nights of at-home recording. The accuracy of NF RDI was higher after 3 nights compared to one night (AUC difference, 0.05; 95% CI of difference, 0.01 to 0.08; P = 0.04). Addition of oximetry to nasal airflow did not increase the accuracy for predicting OSA compared to nasal airflow alone (P > 0.1). CONCLUSIONS: Nasal flow and oximetry have equivalent accuracy for diagnosing OSA in the home setting. Choice of device for home screening of sleep apnea may depend on logistical and service delivery issues. %Z FOR Codes: 110203 %0 Journal Article %~ PubMed %A Dennis, Sarah %A Zwar, Nicholas %A Marks, Guy %T Diagnosing asthma in adults in primary care: a qualitative study of Australian GPs' experiences. %B Primary care respiratory journal : journal of the General Practice Airways Group %D 2010 %C United Kingdom %I General Practice Airways Group (G PIA G) %V 19 %N 1 %P 52-6 %@ 1475-1534 %X To explore what difficulties are faced by general practitioners (GPs) when trying to make a diagnosis of asthma in adults, and whether there are patient characteristics that influence this process. %Z FOR Codes: 110203 111717 %0 Journal Article %~ PubMed %A Parappil, Ali %A Depczynski, Barbara %A Collett, Peter %A Marks, Guy B %T Effect of comorbid diabetes on length of stay and risk of death in patients admitted with acute exacerbations of COPD. %B Respirology (Carlton, Vic.) %D 2010 %C Australia, Japan %I Wiley-Blackwell Publishing Asia %V 15 %N 6 %P 918-22 %@ 1440-1843 %X Hyperglycaemia during hospital admission is associated with poor outcomes in patients admitted with acute myocardial infarction, stroke and pneumonia. Less evidence exists for effect of diabetes mellitus (DM) on those admitted with an acute exacerbation of COPD (AECOPD). We proposed that comorbidity with DM is associated with an increased length of stay in patients admitted with AECOPD. %Z FOR Codes: 602 %0 Journal Article %~ PubMed %A Almqvist, Catarina %A Garden, Frances %A Kemp, Andrew S %A Li, Qiang %A Crisafulli, Daniel %A Tovey, Euan R %A Xuan, Wei %A Marks, Guy B %A , CAPS Investigators %T Effects of early cat or dog ownership on sensitisation and asthma in a high-risk cohort without disease-related modification of exposure. %B Paediatric and Perinatal Epidemiology %D 2010 %C United Kingdom, Unit %I Wiley-Blackwell Publishing Ltd. %V 24 %N 2 %P 171-178 %@ 0269-5022 %X Variation in the observed association between pet ownership and allergic disease may be attributable to selection bias and confounding. The aim of this study was to suggest a method to assess disease-related modification of exposure and second to examine how cat acquisition or dog ownership in early life affects atopy and asthma at 5 years. Information on sociodemographic factors and cat and dog ownership was collected longitudinally in an initially cat-free Australian birth cohort based on children with a family history of asthma. At age 5 years, 516 children were assessed for wheezing, and 488 for sensitisation. Data showed that by age 5 years, 82 children had acquired a cat. Early manifestations of allergic disease did not foreshadow a reduced rate of subsequent acquisition of a cat. Independent risk factors for acquiring a cat were exposure to tobacco smoke at home odds ratio (OR) 1.92 [95% confidence interval (CI) 1.13, 3.26], maternal education < or =12 years OR 1.95 [1.08, 3.51] and dog ownership OR 2.23 [1.23, 4.05]. Cat or dog exposure in the first 5 years was associated with a decreased risk of any allergen sensitisation, OR 0.50 [0.28, 0.88] but no association with wheeze OR 0.96 [0.57, 1.61]. This risk was not affected by age at which the cat was acquired or whether the pet was kept in- or outdoors. In conclusion, cat or dog ownership reduced the risk of subsequent atopy in this high-risk birth cohort. This cannot be explained by disease-related modification of exposure. Public health recommendations on the effect of cat and dog ownership should be based on birth cohort studies where possible selection bias has been taken into account. %Z FOR Codes: 111403 110701 %0 Journal Article %~ PubMed %A Toelle, Brett G %A Ng, Kitty K W %A Crisafulli, Daniele %A Belousova, Elena G %A Almqvist, Catarina %A Webb, Karen %A Tovey, Euan R %A Kemp, Andrew S %A Mellis, Craig M %A Leeder, Stephen R %A Marks, Guy B %A , Childhood Asthma Prevention Team %T Eight-year outcomes of the Childhood Asthma Prevention Study. %B The Journal of allergy and clinical immunology %D 2010 %C United States %I Mosby, Inc. %V 126 %N 2 %P 388-9, 389.e1-3 %@ 1097-6825 %X %Z FOR Codes: 1103 %0 Journal Article %~ PubMed %A Dobler, Claudia Caroline %A Marks, Guy Barrington %T Medical decision making at the individual patient level. %B Archives of Internal Medicine %D 2010 %C United States %I American Medical Association %V 170 %N 14 %P 1275 %@ 0003-9926 %X %Z FOR Codes: 110399 111706 %0 Journal Article %~ PubMed %A Marks, G B %A Kwok, P C L %A Chan, H-K %A Fiakos, E %T Particle sizes of talc for pleurodesis available in Australia. %B Internal medicine journal %D 2010 %C Australia, United Kingdom, Netherlands, United States %I Wiley-Blackwell Publishing Asia %V 40 %N 4 %P 316-8 %@ 1445-5994 %X %Z FOR Codes: 111501 %0 Journal Article %~ PubMed %A Marks, Guy B %A Ezz, Wafaa %A Aust, Nathan %A Toelle, Brett G %A Xuan, Wei %A Belousova, Elena %A Cosgrove, Carmen %A Jalaludin, Bin %A Smith, Wayne T %T Respiratory Health Effects of Exposure to "Low NOx" Unflued Gas Heaters in the Classroom: a Double-blind, Cluster Randomized Cross-over Study. %B Environmental health perspectives %D 2010 %C United States %I US Department of Health and Human Services %V 118 %N 10 %P 1476-82 %@ 1552-9924 %X There are long-standing concerns about adverse effects of gas appliances on respiratory health. However, the potential adverse effect of low-NOx (nitrogen oxide) unflued gas heaters on children''s health has not been assessed. %Z FOR Codes: 111705 %0 Journal Article %~ PubMed %A Rofail, Lydia Makarie %A Wong, Keith K H %A Unger, Gunnar %A Marks, Guy B %A Grunstein, Ronald R %T The role of single-channel nasal airflow pressure transducer in the diagnosis of OSA in the sleep laboratory. %B Journal of Clinical Sleep Medicine %D 2010 %C United States %I The American Academy of Sleep Medicine %V 6 %N 4 %P 349-56 %@ 1550-9389 %X RATIONALE: Obstructive sleep apnea (OSA) is a common but underdiagnosed disorder. There is a need for validated simpler modalities such as single-channel monitors to assist diagnosis of OSA. STUDY OBJECTIVES: To assess data sufficiency, agreement, and diagnostic accuracy of nasal airflow measured by a single-channel pressure transducer device (Flow Wizard, DiagnoseIT, Sydney, Australia) compared to attended full polysomnography (PSG) on the same night for OSA diagnosis. DESIGN: Cross-sectional study. SETTING: Laboratory. PARTICIPANTS: Subjects with possible OSA referred to the sleep laboratory for PSG were eligible. METHODS: Nasal airflow was measured by a pressure transducer in the laboratory concurrently with PSG. RESULTS: Of 226 eligible subjects who consented, 221 (97.8%; 151 males, 70 females) completed the protocol. With nasal airflow measurement, 5.3% of subjects had insufficient data, compared with 2.2% on PSG. The mean difference between PSG AHI and NF RDI was -6.2 events/h with limits of agreement (+/- 2 standard deviation [SD]) of 17.0 events/hr. The accuracy of the Flow Wizard for diagnosing severe OSA (PSG AHI > 30) was very good (area under the ROC curve [AUC] 0.96; 95% confidence interval [CI] 0.92 to 0.99) and for diagnosing OSA (PSG AHI > 5) was good (AUC, 0.84; 95% CI, 0.77 to 0.90). There was no difference in the rate of data insufficiency and accuracy between males and females. CONCLUSION: Nasal flow measured by a nasal pressure transducer has a low rate of data insufficiency, good agreement, and high accuracy compared to PSG for diagnosing OSA in the monitored sleep laboratory setting. %Z FOR Codes: 110203 %0 Journal Article %~ PubMed %A Rofail, Lydia Makarie %A Wong, Keith K H %A Unger, Gunnar %A Marks, Guy B %A Grunstein, Ronald R %T The utility of single-channel nasal airflow pressure transducer in the diagnosis of OSA at home. %B Sleep %D 2010 %C United States %I The American Academy of Sleep Medicine %V 33 %N 8 %P 1097-1105 %@ 0161-8105 %X RATIONALE: Given the high prevalence of obstructive sleep apnea (OSA) and the demand on polysomnography (PSG), there is a need for low cost accurate simple diagnostic modalities that can be easily deployed in primary care to improve access to diagnosis. STUDY OBJECTIVES: The aim was to examine the utility of single-channel nasal airflow monitoring using a pressure transducer at home in patients with suspected OSA. DESIGN: Cross-sectional study SETTING: Laboratory and home PARTICIPANTS: The study was conducted in two populations. Consecutive patients with suspected OSA were recruited from the sleep disorders clinic at a tertiary referral center and from 6 local metropolitan primary care centers. INTERVENTIONS: All patients answered questionnaires and had laboratory PSG. Nasal airflow was monitored for 3 consecutive nights at home in random order either before or after PSG. RESULTS: Atotal of 193 patients participated (105 sleep clinic patients and 88 from primary care). The mean bias PSG apnea hypopnea index (AHI) minus nasal flow respiratory disturbance index (NF RDI) was -4.9 events per hour with limits of agreement (2 SD) of 27.8. NF RDI monitored over 3 nights had high accuracy for diagnosing both severe OSA (defined as PSG AHI > 30 events per hour) with area under the receiver operating characteristic curve (AUC) 0.92 (95% confidence interval (CI) 0.88-0.96) and any OSA (PSG AHI > 5), AUC 0.87 (95% CI 0.80-0.94). CONCLUSIONS: Single-channel nasal airflow can be implemented as an accurate diagnostic tool for OSA at home in both primary care and sleep clinic populations. %Z FOR Codes: 110203 %0 Journal Article %~ PubMed %A Dobler, Claudia C %A Wong, Keith K %A Marks, Guy B %T Associations between statins and COPD: a systematic review. %B BMC Pulmonary Medicine %D 2009 %C United Kingdom %I BioMed Central Ltd. %V 9 %N %P 32 %@ 1471-2466 %X ABSTRACT: BACKGROUND: Statins have anti-inflammatory and immunomodulating properties which could possibly influence inflammatory airways disease. We assessed evidence for disease modifying effects of statin treatment in patients with chronic obstructive pulmonary disease (COPD). METHODS: A systematic review was conducted of studies which reported effects of statin treatment in COPD. Data sources searched included MEDLINE, EMBASE and reference lists. RESULTS: Eight papers reporting nine original studies met the selection criteria. One was a randomized controlled trial (RCT), one a retrospective nested case-control study, five were retrospective cohort studies of which one was linked with a case-control study, and one was a retrospective population-based analysis. Outcomes associated with treatment with statins included decreased all-cause mortality in three out of four studies (OR/HR 0.48-0.67 in three studies, OR 0.99 in one study), decreased COPD-related mortality (OR 0.19-0.29), reduction in incidence of respiratory-related urgent care (OR 0.74), fewer COPD exacerbations (OR 0.43), fewer intubations for COPD exacerbations (OR 0.1) and attenuated decline in pulmonary function. The RCT reported improvement in exercise capacity and dyspnea after exercise associated with decreased levels of C-reactive protein and Interleukin-6 in statin users, but no improvement of lung function. CONCLUSION: There is evidence from observational studies and one RCT that statins may reduce morbidity and/or mortality in COPD patients. Further interventional studies are required to confirm these findings. %Z FOR Codes: 110203 %0 Journal Article %~ PubMed %A Jenkins, Christine R %A Chang, Anne B %A Poulos, Leanne M %A Marks, Guy B %T Asthma in Indigenous Australians: so much yet to do for Indigenous lung health. %B The Medical Journal of Australia %D 2009 %C Australia %I Australasian Medical Publishing Company Pty. Ltd. %V 190 %N 10 %P 530-531 %@ 0025-729X %X %Z FOR Codes: 110203 111701 %0 Journal Article %~ PubMed %A Marks, Guy B %A Poulos, Leanne M %A Jenkins, Christine R %A Gibson, Peter G %T Asthma in older adults: a holistic, person-centred and problem-oriented approach. %B The Medical Journal of Australia %D 2009 %C Australia %I Australasian Medical Publishing Company Pty. Ltd. %V 191 %N 4 %P 197-199 %@ 0025-729X %X Regardless of how obstructive lung disease is labelled, targeting treatment to components of the problem is the best solution. %Z FOR Codes: 110203 111702 %0 Journal Article %~ PubMed %A Ampon, Rosario D %A Reddel, Helen K %A Correll, Patricia K %A Poulos, Leanne M %A Marks, Guy B %T Cost is a major barrier to the use of inhaled corticosteroids for obstructive lung disease. %B The Medical Journal of Australia %D 2009 %C Australia %I Australasian Medical Publishing Company Pty. Ltd. %V 191 %N 6 %P 319-323 %@ 0025-729X %X OBJECTIVE: To examine the effect of the level of patient copayment on the rate of purchase of inhaled corticosteroids (ICS) by patients with obstructive lung disease. DESIGN AND SETTING: Cross-sectional study of records of all prescriptions for ICS dispensed to general and concessional beneficiaries aged 15 years or over in the period January 2003 to December 2006. Data were obtained from the Pharmaceutical Benefits Scheme, which subsidises medication costs for all Australians. MAIN OUTCOME MEASURES: The number of prescriptions for ICS dispensed to government concession card holders compared with the number dispensed to general beneficiaries, expressed as a rate ratio. RESULTS: ICS prescriptions were dispensed to over 1.6 million people during the study period. Concession card holders were dispensed ICS prescriptions at a higher rate than general beneficiaries, both overall (43.7 v 9.1 ICS prescriptions per 100 person-years) and in all population subgroups. After adjusting for age, sex, remoteness category and socioeconomic status, people holding a concession card were dispensed over 2.5 times the number of ICS prescriptions (alone or in combination with a long-acting beta(2)-agonist) compared with general beneficiaries. Similar patterns were seen after adjusting for differences between the two groups in the prevalence of obstructive lung disease. CONCLUSIONS: As the patient copayment for general beneficiaries is over six times higher than for concession card holders, our findings imply that cost is a barrier to the purchase of ICS prescriptions for obstructive lung disease, independent of socioeconomic status. %Z FOR Codes: 110203 %0 Journal Article %~ PubMed %A Ayer, Julian G %A Harmer, Jason A %A Xuan, Wei %A Toelle, Brett %A Webb, Karen %A Almqvist, Catarina %A Marks, Guy B %A Celermajer, David S %T Dietary supplementation with n-3 polyunsaturated fatty acids in early childhood: effects on blood pressure and arterial structure and function at age 8 y. %B American Journal of Clinical Nutrition %D 2009 %C United Kingdom %I American Society for Nutrition %V 90 %N 2 %P 438-446 %@ 0002-9165 %X BACKGROUND: n-3 Fatty acid supplementation in adults results in cardiovascular benefits. However, the cardiovascular effects of n-3 supplementation in early childhood are unknown. OBJECTIVE: The objective was to evaluate blood pressure (BP) and arterial structure and function in 8-y-old children who had participated in a randomized controlled trial of dietary n-3 and n-6 modification over the first 5 y of life. DESIGN: The children (n = 616; 49% girls) were randomly assigned antenatally to active (n = 312; increase in n-3 intake and decrease in n-6 intake) or control (n = 304) diet interventions implemented from the time of weaning or introduction of solids until 5 y of age. At age 8.0 +/- 0.1 y, BP, carotid intima-media thickness, carotid artery distensibility, augmentation index, and brachial pulse wave velocity were measured in 405 of these children. Venous blood was collected for measurement of plasma fatty acids, lipoproteins, high-sensitivity C-reactive protein, and asymmetric dimethylarginine. Plasma fatty acid concentrations were also assessed during the intervention. RESULTS: Plasma concentrations of n-3 fatty acids were higher and of n-6 were lower in the active than in the control diet group at 18 mo and 3 and 5 y (P < 0.0001). Concentrations of n-3 and n-6 fatty acids were similar at 8 y. At 8 y of age, no significant differences were found in BP, carotid intima-media thickness, carotid artery distensibility, augmentation index, asymmetric dimethylarginine, high-sensitivity C-reactive protein, or lipoproteins between diet groups. CONCLUSION: A dietary supplement intervention to increase n-3 and decrease n-6 intakes from infancy until 5 y does not result in significant improvements in arterial structure and function at age 8 y. This trial was registered at the Australian Clinical Trials Registry as ACTRN012605000042640. %Z FOR Codes: 110299 %0 Journal Article %~ PubMed %A Ayer, Julian G %A Harmer, Jason A %A Nakhla, Shirley %A Xuan, Wei %A Ng, Martin K C %A Raitakari, Olli T %A Marks, Guy B %A Celermajer, David S %T HDL-cholesterol, blood pressure, and asymmetric dimethylarginine are significantly associated with arterial wall thickness in children. %B Arteriosclerosis, Thrombosis, and Vascular Biology %D 2009 %C United States %I Lippincott Williams and Wilkins %V 29 %N 6 %P 943-999 %@ 1079-5642 %X OBJECTIVE: Atherosclerosis is found at autopsy in the arteries of adolescents and young adults. Arterial wall thickening may be assessed in vivo by ultrasound measurement of the carotid intima media thickness (CIMT), a marker of subclinical atherosclerosis. As the determinants of arterial wall thickness in childhood are unknown, we assessed the influence of cardiovascular risk factors on CIMT in 8-year-old children. METHODS AND RESULTS: A community-based sample of 405 children (age 8.0+/-0.1 years, 49% girls) had anthropometry, family history, blood pressure (BP), and CIMT measured. A blood sample was collected for HDL and non-HDL cholesterol, apolipoproteins A1 and B, high-sensitivity C-reactive protein, bilirubin, and asymmetric dimethylarginine (ADMA, an endogenous nitric oxide inhibitor). CIMT was significantly associated with systolic BP (r=0.17, P<0.001), diastolic BP (r=0.10, P=0.04), HDL (r=-0.13, P=0.02), and ADMA (r=0.18, P=0.001). CIMT was significantly higher in children with premature parental CHD (0.63+/-0.07 versus 0.59+/-0.06 mm, P=0.03). On multivariate analysis, HDL (beta coefficient=-0.02, P=0.04), ADMA (beta coefficient=0.05, P<0.001), and systolic BP (beta coefficient=0.001, P=0.003) were significantly and independently associated with CIMT. CONCLUSIONS: Lower HDL-cholesterol, higher levels of ADMA, and systolic BP are significantly associated with greater arterial wall thickness in early childhood. %Z FOR Codes: 110201 111403 %0 Journal Article %~ PubMed %A Kidd, Timothy J %A Ramsay, Kay A %A Hu, Honghua %A Bye, Peter T P %A Elkins, Mark R %A Grimwood, Keith %A Harbour, Colin %A Marks, Guy B %A Nissen, Michael D %A Robinson, Philip J %A Rose, Barbara R %A Sloots, Theo P %A Wainwright, Claire E %A Bell, Scott C %A , ACPinCF Investigators %T Low rates of Pseudomonas aeruginosa misidentification in isolates from cystic fibrosis patients. %B Journal of Clinical Microbiology %D 2009 %C United States %I American Society for Microbiology %V 47 %N 5 %P 1503-1509 %@ 0095-1137 %X Pseudomonas aeruginosa is an important cause of pulmonary infection in cystic fibrosis (CF). Its correct identification ensures effective patient management and infection control strategies. However, little is known about how often CF sputum isolates are falsely identified as P. aeruginosa. We used P. aeruginosa-specific duplex real-time PCR assays to determine if 2,267 P. aeruginosa sputum isolates from 561 CF patients were correctly identified by 17 Australian clinical microbiology laboratories. Misidentified isolates underwent further phenotypic tests, amplified rRNA gene restriction analysis, and partial 16S rRNA gene sequence analysis. Participating laboratories were surveyed on how they identified P. aeruginosa from CF sputum. Overall, 2,214 (97.7%) isolates from 531 (94.7%) CF patients were correctly identified as P. aeruginosa. Further testing with the API 20NE kit correctly identified only 34 (59%) of the misidentified isolates. Twelve (40%) patients had previously grown the misidentified species in their sputum. Achromobacter xylosoxidans (n = 21), Stenotrophomonas maltophilia (n = 15), and Inquilinus limosus (n = 4) were the species most commonly misidentified as P. aeruginosa. Overall, there were very low rates of P. aeruginosa misidentification among isolates from a broad cross section of Australian CF patients. Additional improvements are possible by undertaking a culture history review, noting colonial morphology, and performing stringent oxidase, DNase, and colistin susceptibility testing for all presumptive P. aeruginosa isolates. Isolates exhibiting atypical phenotypic features should be evaluated further by additional phenotypic or genotypic identification techniques. %Z FOR Codes: 60503 %0 Journal Article %~ PubMed %A King, Madeleine T %A Kenny, Patricia M %A Marks, Guy B %T Measures of asthma control and quality of life: longitudinal data provide practical insights into their relative usefulness in different research contexts. %B Quality of Life Research %D 2009 %C Netherlands %I Springer Netherlands %V 18 %N 3 %P 301-312 %@ 0962-9343 %X PURPOSE: To further our understanding of the relationships between asthma control and health-related quality of life (HRQOL) and provide insights into the relative usefulness of various measures in different research contexts. We present a conceptual model and test it with longitudinal survey data. METHODS: Participants recruited via population sampling and hospital Emergency Departments completed questionnaires every 6 months for up to 3 years. Measures included: sleep disturbance, use of short-acting beta agonists (SABA), activity limitation, urgent medical visits, hospital use, Marks'' Asthma Quality of Life Questionnaire (AQLQ-M) and the SF-36 Health Survey. Correlation analysis and multi-level models tested predictions from the conceptual model. RESULTS: A total of 213 people with asthma aged 16-75 years provided 967 observations. Correlations between asthma control and asthma-specific HRQOL were stronger than those between asthma control and generic HRQOL. The asthma control variables explained 54-58% of the variance in asthma-specific HRQOL and 8-25% of the variance in generic HRQOL. Activity limitation was the main contributor to between-person variation, while sleep disturbance and SABA use were the main contributors to within-person variation. CONCLUSIONS: Sleep disturbance and SABA use may be most useful in evaluating treatment effectiveness, while activity limitation may be better when monitoring the impact of asthma in populations. %Z FOR Codes: 110203 111706 140208 %0 Journal Article %~ PubMed %A Kidd, Timothy J %A Marks, Guy B %A Bye, Peter T P %A Wainwright, Claire E %A Robinson, Philip J %A Rose, Barbara R %A Harbour, Colin %A Bell, Scott C %A , ACPinCF INVESTIGATORS %T Multi-centre research in Australia: analysis of a recent National Health and Medical Research Council-funded project. %B Respirology %D 2009 %C Australia, Japan %I Wiley-Blackwell Publishing Asia %V 14 %N 7 %P 1051-1055 %@ 1440-1843 %X BACKGROUND AND OBJECTIVE: Human research ethics committees provide essential review of research projects to ensure the ethical conduct of human research. Several recent reports have highlighted a complex process for successful application for human research ethics committee approval, particularly for multi-centre studies. Limited resources are available for the execution of human clinical research in Australia and around the world. METHODS: This report overviews the process of ethics approval for a National Health and Medical Research Council-funded multi-centre study in Australia, focussing on the time and resource implications of such applications in 2007 and 2008. RESULTS: Applications were submitted to 16 hospital and two university human research ethics committees. The total time to gain final approval from each committee ranged between 13 and 77 days (median = 46 days); the entire process took 16 months to complete and the research officer''s time was estimated to cost $A34 143. CONCLUSIONS: Obstacles to timely human research ethics committee approval are reviewed, including recent, planned and potential initiatives that could improve the ethics approval of multi-centre research. %Z FOR Codes: 220106 %0 Journal Article %~ PubMed %A Dobler, C C %A Crawford, A B H %A Jelfs, P J %A Gilbert, G L %A Marks, G B %T Recurrence of tuberculosis in a low incidence setting. %B The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology %D 2009 %C Switzerland %I European Respiratory Society %V 33 %N 1 %P 160-7 %@ 0903-1936 %X Recurrence of active tuberculosis following treatment of an initial disease episode can occur due to endogenous re-activation or exogenous re-infection. Cases of recurrent tuberculosis in the Australian state of New South Wales between 1994 and 2006 were identified by data linkage analysis with confirmatory review of case notes. Patients with more than one culture-positive disease episode during that time period who had completed treatment for the initial disease episode were included. Genotyping of Mycobacterium tuberculosis was used to determine whether recurrence was likely to be due to re-activation or re-infection. There were 5,723 tuberculosis notifications between 1994 and 2006, 3,731 of which were culture-positive. Fifteen (0.4%) patients had recurrent culture-positive disease over a mean 5.7 yrs of follow-up (crude annual incidence 71 per 100,000 population). Recurrent tuberculosis was attributable to re-activation (indistinguishable strains) in 11 (73%) cases and to re-infection (different strains) in four (27%). In a low-incidence setting of tuberculosis, a control programme incorporating directly observed therapy for active disease resulted in a very low rate of recurrent tuberculosis over a long period of follow-up. Re-infection is less likely than re-activation, but still contributes significantly to the number of cases with recurrent disease. %Z FOR Codes: 111706 %0 Journal Article %A Rose, N %A Cowie, C %A Gillett, R %A Marks, Guy %T Weighted road density: a simple way of assigning traffic-related air pollution exposure %B Atmospheric Environment %D 2009 %C United Kingdom %I Pergamon %V 43 %N 32 %P 5009-5014 %@ 1352-2310 %X %Z FOR Codes: 111799 %0 Journal Article %~ PubMed %A Zwar, Nicholas %A Hermiz, Oshana %A Hasan, Iqbal %A Comino, Elizabeth %A Middleton, Sandy %A Vagholkar, Sanjyot %A Marks, Guy %T A cluster randomised controlled trial of nurse and GP partnership for care of chronic obstructive pulmonary disease. %B BMC pulmonary medicine %D 2008 %C United Kingdom %I BioMed Central %V 8 %N 0 %P 0 %@ 1471-2466 %X BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a significant health problem worldwide. This randomised controlled trial aims at testing a new approach that involves a registered nurse working in partnership with patients, general practitioners (GPs) and other health professionals to provide care to patients according to the evidence-based clinical practice guidelines. The aim is to determine the impact of this partnership on the quality of care and patient outcomes. METHODS: A cluster randomised control trial design was chosen for this study. Randomisation occurred at practice level. GPs practising in South Western Sydney, Australia and their COPD patients were recruited for the study.The intervention was implemented by nurses specifically recruited and trained for this study. Nurses, working in partnership with GPs, developed care plans for patients based on the Australian COPDX guidelines. The aim was to optimise patient management, improve function, prevent deterioration and enhance patient knowledge and skills. Control group patients received ''usual'' care from their GPs.Data collection includes patient demographic profiles and their co-morbidities. Spirometry is being performed to assess patients'' COPD status and CO analyser to validate their smoking status. Patients'' quality of life and overall health status are being measured by St George''s Respiratory Questionnaire and SF-12 respectively. Other patient measures being recorded include health service use, immunisation status, and knowledge of COPD. Qualitative methods will be used to explore participants'' satisfaction with the intervention and their opinion about the value of the partnership. ANALYSIS: Analysis will be by intention to treat. Intra-cluster (practice) correlation coefficients will be determined and published for all primary outcome variables to assist future research. The effect of the intervention on outcomes measured on a continuous scale will be estimated and tested using mixed model analysis of variance in which time and treatment group will be fixed effects and GP practice and subject nested within practice will be random effects. The effect of the intervention on the dichotomous variables (such as smoking status, patient knowledge) will be analysed using generalised estimating equations with a logistic link and a model structure that is analogous to that described above. TRIAL REGISTRATION: ACTRN012606000304538. %Z FOR Codes: 110203 111717 %0 Journal Article %~ PubMed %A Aaron, S D %A Fergusson, D %A Marks, G B %A Suissa, S %A Vandemheen, K L %A Doucette, S %A Maltais, F %A Bourbeau, J F %A Goldstein, R S %A Balter, M %A O'Donnell, D %A Fitzgerald, M %A , Canadian Thoracic Society/Canadian Respiratory Clinical Research Consortium %T Counting, analysing and reporting exacerbations of COPD in randomised controlled trials. %B Thorax %D 2008 %C United Kingdom %I BMJ Group %V 63 %N 2 %P 122-128 %@ 1468-3296 %X BACKGROUND: Clinical trials measure exacerbations of chronic obstructive pulmonary disease (COPD) inconsistently. A study was undertaken to determine if different methods for ascertaining and analysing COPD exacerbations lead to biased estimates of treatment effects. METHODS: Information on the methods used to count, analyse and report COPD exacerbation rates was abstracted from clinical trials of long-acting bronchodilators or long-acting bronchodilator/inhaled steroid combination products published between 2000 and 2006. Data from the Canadian Optimal Therapy of COPD Trial was used to illustrate how different analytical approaches can affect the estimate of exacerbation rates and their confidence intervals. RESULTS: 22 trials (17,156 patients) met the inclusion criteria and were reviewed. None of the trials adjudicated exacerbations or determined independence of events. 14/22 studies (64%) introduced selection bias by not analysing outcome data for subjects who prematurely stopped study medications. Only 31% of trials used time-weighted analyses to calculate the mean number of exacerbations/patient-year and only 15% accounted for between-subject variation. In the Canadian Optimal Therapy of COPD Trial the rate ratio for exacerbations/patient-year was 0.85 when all data were included in a time-weighted analysis, but was overestimated as 0.79 when data for those who prematurely stopped study medications were excluded and was further overestimated as 0.46 when a time-weighted analysis was not conducted; p values ranged from 0.03 to 0.24 depending on how exacerbations were determined and analysed. CONCLUSIONS: Clinical trials have used widely different methods to define and analyse COPD exacerbations and this can lead to biased estimates of treatment effects. Future trials should strive to include blinded adjudication and assessment of the independence of exacerbation events, and trials should report time-weighted intention-to-treat analyses with adjustments for between-subject variation in COPD exacerbations. %Z FOR Codes: 110399 %0 Journal Article %~ PubMed %A Reddel, Helen K %A Belousova, Elena G %A Marks, Guy B %A Jenkins, Christine R %T Does continuous use of inhaled corticosteroids improve outcomes in mild asthma? A double-blind randomised controlled trial. %B Primary care respiratory journal %D 2008 %C United Kingdom %I Strategic Medical Publishing %V 17 %N 1 %P 39-45 %@ 1471-4418 %X AIM: To compare the effects of fluticasone and placebo on asthma control in patients with mild asthma. METHOD: Adults with FEV1 >80% predicted and reliever use