RESUMO
OBJECTIVE: This study examined the within-person relations between transitory changes in mood, asthma symptoms, and peak expiratory flow rate (PEFR). METHODS: Thrice-daily for 21 consecutive days, 48 adults with moderate to severe asthma entered information in palm-top computers about their mood and asthma symptoms. A multidimensional model of mood, ie, the mood circumplex, informed the assessment of mood arousal and mood pleasantness. At each observation, participants also recorded their PEFR with peak flow meters that stored blinded data. Albuterol doses were also monitored electronically. Before and after the 21-day study, spirometric measures of airways obstruction were taken under controlled conditions. RESULTS: Random effects regression models revealed a significant, but weak, within-person relation between symptoms and PEFR. Changes in mood vectors with an arousal component were significantly related to PEFR changes, whereas changes in mood vectors with a pleasantness component tracked changes in asthma symptom reports, even after adjustment for contemporaneous PEFR and after controlling for time of day and albuterol dosing. Comparison of spirometric assessments with unsupervised PEFR suggested that part of the relation between mood arousal and PEFR may be attributable to the "effort-dependence" of peak flow self-monitoring. CONCLUSIONS: Different dimensions of mood were associated with transitory changes in asthma symptoms and PEFR. This may be one reason why individuals with asthma misperceive the severity of their symptoms in relation to underlying airways obstruction.
Assuntos
Afeto/fisiologia , Asma/diagnóstico , Asma/psicologia , Adulto , Albuterol/uso terapêutico , Nível de Alerta/fisiologia , Asma/tratamento farmacológico , Broncodilatadores/uso terapêutico , Processamento Eletrônico de Dados/métodos , Feminino , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Pico do Fluxo Expiratório/fisiologia , Índice de Gravidade de DoençaRESUMO
With Malaise traps, we monitored the flight of adult Plecoptera and Trichoptera following emergence from headwater streams in the Fernow Experimental Forest, WV, during the second year after application of diflubenzuron. We placed five traps at various distances from each stream during May through September of 1991, 1992, and 1993. We collected pretreatment samples during the first year. In May 1992, diflubenzuron was applied to two watersheds, and the other two watersheds were used as untreated references. The 1992 study tested the effects of diflubenzuron that fell directly into the streams or were washed into the stream during the first year. For 1993, we tested the hypothesis that diflubenzuron affected adult flight following emergence during the year following abscission and possible ingestion of the treated leaves. The analysis compared the regressions of the number of adults caught in each trap versus distance of the trap from the stream among years and between treatments for each species. The flight of the stonefly Leuctra ferruginea (Walker) was reduced in the treatment watersheds compared with the reference watersheds during the year following abscission of the treated leaves. Adult flight of other species did not decrease in the treatment watersheds during 1993. These results show a relatively small effect of diflubenzuron on these aquatic insects; however, our study involved only a single application of diflubenzuron. Additional research may be needed to predict the possible effects of multiple applications of diflubenzuron over several years as often occurs during actual efforts to suppress gypsy moth, Lymantria dispar (L.).
Assuntos
Diflubenzuron/farmacologia , Voo Animal , Insetos/efeitos dos fármacos , Inseticidas/farmacologia , Água , Animais , Diflubenzuron/administração & dosagem , Insetos/crescimento & desenvolvimento , Insetos/fisiologia , Fatores de TempoRESUMO
BACKGROUND: Although health-related quality of life (HRQL) in asthma is strongly influenced by disease severity, demographic and socioeconomic variables may also be important factors. OBJECTIVE: We related demographics, asthma severity, and socioeconomic factors to HRQL. METHODS: We interviewed 50 patients with moderate or severe asthma recruited from outpatient health center-based clinics to determine demographics, socioeconomic status, asthma severity, medication use, and HRQL. For HRQL, the mean total score of the Asthma Quality of Life Questionnaire (AQLQ) and the Medical Outcomes Study Short-Form 36 questionnaires physical and mental component summary scores (PCS and MCS, respectively) were used. RESULTS: The mean patient age was 46 +/- 14 years, and the FEV1 was 75% +/- 21% of predicted value. Twenty-nine subjects had been hospitalized for asthma, 29 belonged to a minority racial/ethnic group, and 16 had less than 12 years of education. The mean total AQLQ score was 4.12 +/- 1.42, the PCS was 37 +/- 10, and the MCS was 45 +/- 13. In univariate analyses, severity (nighttime awakenings, prednisone use, and a history of emergency department visits), racial/ethnic group (African American, white, or Hispanic), and socioeconomic status (low educational level, unemployed, family income under $20,000, public assistance, or no health insurance) were related to HRQL. These factors explained 67% of the variance of AQLQ and 48% of the variance of the PCS. Much of the quality of life variance was shared among these variables. Explanatory variables were not related to MCS in multivariate analysis. CONCLUSION: Socioeconomic status is an additional important independent factor influencing HRQL in asthma. In this study it was difficult to separate out the unique effects of socioeconomic status and race/ethnicity.
Assuntos
Asma/psicologia , Qualidade de Vida , Adulto , Análise de Variância , Asma/economia , Asma/epidemiologia , Humanos , Pessoa de Meia-Idade , Análise Multivariada , Índice de Gravidade de Doença , Fatores SocioeconômicosRESUMO
Poor adherence to medication regimens may be contributing to the recent increase in asthma morbidity and mortality. We examined patient characteristics that may influence adherence to twice-daily inhaled steroid regimens. Fifty adults with moderate to severe asthma completed questionnaires examining sociodemographics, asthma severity, and health locus of control. Adherence was electronically monitored for 42 d. Following monitoring, patients' understanding of asthma pathophysiology and the function of inhaled corticosteroids were assessed. Patient beliefs about the effectiveness and convenience of these medications, and their perception of communications with their clinician were measured. Mean adherence was 63% +/- 38%; 54% of subjects recorded at least 70% of the prescribed number of inhaled-steroid actuations. Factors associated with poor adherence were less than 12 yr of formal education (p < 0. 001), poor patient-clinician communication (p < 0.001), household income less than $20,000 (p = 0.002), Spanish as primary language (p = 0.005), and minority status (p = 0.007). In a multiple logistic regression analysis, less than 12 yr of formal education (OR: 6.72; CI: 1.10 to 41.0) and poor patient-clinician communication (OR: 1.2; CI: 1.01 to 1.55) were independently associated with poor adherence. These results emphasize the importance of socioeconomic status and adequate patient-clinician communication for adherence to inhaled-steroid schedules.
Assuntos
Asma/tratamento farmacológico , Atitude Frente a Saúde , Glucocorticoides/administração & dosagem , Cooperação do Paciente , Administração por Inalação , Adulto , Comunicação , Esquema de Medicação , Etnicidade , Feminino , Humanos , Controle Interno-Externo , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Relações Médico-Paciente , Fatores SocioeconômicosRESUMO
BACKGROUND AND OBJECTIVE: Studies have demonstrated a weak correlation between the degree of airways obstruction and the severity of asthma symptoms. Although the causes for this disparity are probably multiple, mood has been hypothesized to modulate symptoms. This investigation was designed to evaluate the effect of mood and other patient characteristics on the perception of airways obstruction. METHODS: We compared mood variables, symptom severity, albuterol use, and peak expiratory flow rate (PEFR) measured three times daily over a 21-day period in 21 adults with moderate to severe asthma. Electronic equipment was used for data collection. Analyses included both individual patient assessments and a within-subjects, time series, pooled regression of concurrent and time-lag data. RESULTS: After pooling 1323 observations, there was a weak concurrent relationship between symptoms and PEFR (beta = -0.17, p < 0.001). Only five patients (24%) were accurate perceivers, defined by a statistically significant relationship between symptoms and PEFR across time. Higher forced expiratory flow at 25% to 75% of capacity predicted perception accuracy (p = 0.004); active mood was marginally associated with accuracy (p = 0.06). These two variables together explained 41% of the variation in perception accuracy (p = 0.004). Mood did not independently predict symptoms, but conversely, increased symptoms predicted less pleasant mood (beta = 0.08, p < 0.001), less active mood (beta = -0.11, p < 0.001), and less active-pleasant mood (beta = 0.06, p < 0.001). PEFR did not predict mood, and only pleasant mood independently predicted higher PEFR (beta = 0.04, p < 0.05). Symptoms, but not PEFR, were concurrently associated with albuterol use (beta = 0.24, p < 0.001). CONCLUSION: The relationship between changes in PEFR and symptoms over time was generally poor. Those patients with lower FEF25-75 values tended to be less accurate perceivers. Mood states were influenced by asthma symptoms, but the converse was not true.
Assuntos
Afeto , Obstrução das Vias Respiratórias/psicologia , Asma/psicologia , Percepção , Adolescente , Adulto , Obstrução das Vias Respiratórias/diagnóstico , Obstrução das Vias Respiratórias/terapia , Albuterol/uso terapêutico , Asma/diagnóstico , Asma/terapia , Broncodilatadores/uso terapêutico , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Pico do Fluxo Expiratório , Autoexame , Estatística como AssuntoRESUMO
The evolution of individual or subgroup differences in odors of halictine bees is suggested from possible widespread intraspecific variation in pheromones. An important result of such variation may be maintenance of genetic polymorphisms; in nesting Hymenoptera odor differences may also facilitate individual nest recognition. In Lasioglosum zephyrum males habituate to odors of different females and perhaps thus save time by not trying to copulate with nonreceptive individuals. Guards (females) at nest entrances distinguish their few nestmates (other females) from other conspecific individuals by odors, seemingly pheromones. Duration of the habituation in L. zephyrum is at least an hour (perhaps much more) for males in relation to females and 6 or 7 days for guards in relation to nestmates. Studies of pheromones should take into consideration the possibility of pheromonal polymorphism in any species and the likelihood that it may be significant from biological and practical viewpoints.