As cholinergic innervation is a major contributor to increased vagal tone and mucus secretion, inhaled long-acting muscarinic antagonists (LAMA) are a pillar for the treatment of chronic obstructive pulmonary disease and asthma. By blocking the muscarinic receptors expressed in the lung, LAMA improve lung function and reduce exacerbations in asthma patients who remained poorly controlled despite treatment with inhaled corticosteroids and long-acting β2 agonists. Asthma guidelines recommend LAMA as a third controller to be added on before the initiation of biologicals.
View Article and Find Full Text PDFIncreasing youth behavioral health needs in the United States have underscored the essential role school nurses can play in mitigating them. In response, the District of Columbia Department of Health developed the Behavioral Health Referral Process (BHRP) as a standardized guide, integrating school nurses into multidisciplinary teams and improving students' access to behavioral health services. To assess the BHRP's strengths and opportunities while understanding factors that could impact its implementation, key informant interviews were conducted using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework with seven school nurses and school nurse managers working in DC schools.
View Article and Find Full Text PDFImmunol Allergy Clin North Am
February 2025
Exercise-induced bronchoconstriction (EIB) refers to temporary lower airway narrowing that occurs during or after vigorous physical exertion, with a high incidence in athletes and individuals with pre-existing asthma. The pathophysiology of EIB is not completely understood, but it is thought to involve a complex interplay among airway epithelial changes, immune responses, and environmental interactions. Phenotypic differences are apparent among those affected by EIB.
View Article and Find Full Text PDFWith large wildfires becoming more frequent, we must rapidly learn how megafires impact biodiversity to prioritize mitigation and improve policy. A key challenge is to discover how interactions among fire-regime components, drought and land tenure shape wildfire impacts. The globally unprecedented 2019-2020 Australian megafires burnt more than 10 million hectares, prompting major investment in biodiversity monitoring.
View Article and Find Full Text PDFObjectives: Talk, Understand and Listen for InPatient Settings (TULIPS) was a multi-centred randomized control trial of an intervention that aimed to increase patient access to psychological therapies on acute mental health wards. This paper aims to: (i) describe a strategy for designing a psychological intervention that is implementable in inpatient mental health settings; (ii) describe methods for assessing the fidelity of interventions within these settings; (iii) report on the extent to which fidelity was achieved in the TULIPS trial.
Methods: The TULIPS intervention was designed using information from a systematic review, stakeholder interviews, pilot work and a consensus workshop.