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To examine the association between body mass index (BMI) percentile and asthma in children 2–11 years of age, we performed a cross-sectional analysis of 853 Black and Hispanic children from a community-based sample of 2- to 11-year olds with measured heights and weights screened for asthma by the Harlem Children’s Zone Asthma Initiative. Current asthma was defined as parent/guardian-reported diagnosis of asthma and asthma-related symptoms or emergency care in the previous 12 months. Among girls, asthma prevalence increased approximately linearly with increasing body mass index (BMI) percentile, from a low of 12.0% among underweight girls (BMI ≤5th percentile) to a high of 33.3% among girls at risk for overweight (BMI 85th–94th percentile). Among boys, asthma prevalence was associated in a U-shaped curve with the extremes of BMI percentile, that is, 36.4% among underweight boys, 19.1% among normal weight boys (BMI 6th–84th percentile), and 34.8% among overweight boys (>95th percentile). After adjusting for age, race/ethnicity, and household smoking, among girls, having asthma was associated with being at risk for overweight (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.4–5.0) and being overweight (OR, 2.1; 95% CI, 1.2–3.8) compared to normal weight; among boys, having asthma was associated both with overweight (OR, 2.4; 95% CI, 1.4–4.3) and with underweight (OR, 2.9; 95% CI, 1.1–7.7). Large, prospective studies that include very young children are needed to further explore the observed association between underweight and asthma among boys. Early interventions that concomitantly address asthma and weight gain are needed among pre-school and school-aged children.

Health disparities that affect whole communities may involve factors like housing quality that lie at least partly within planners' realm of policy influence. This article demonstrates a link between housing and childhood asthma. The magnitude of the childhood asthma epidemic in Harlem in New York City and the commitment of engaged community partners led to an interdisciplinary, participatory, and multifaceted approach to the planning, implementation, and evaluation of the Harlem Children's Zone Asthma Initiative. Here we present the first year's data on environmental triggers in the homes of program participants, showing that intensive, community-based programs can reduce both home environmental triggers and adverse childhood asthma outcomes. This provides an example of a community-wide public health intervention that informs public policy and planning, and may provide a sustainable model for reducing childhood asthma in impoverished communities.

Objectives. We determined the prevalence of asthma and estimated baseline asthma symptoms and asthma management strategies among children aged 0–12 years in Central Harlem. Methods. The Harlem Children’s Zone Asthma Initiative is a longitudinal, community-based intervention designed for poor children with asthma. Children aged 0–12 years who live or go to school in the Harlem Children’s Zone Project or who participate in any Harlem Children’s Zone, Inc, program were screened for asthma. Children with asthma or asthma-like symptoms were invited to participate in an intensive intervention. Results. Of the 1982 children currently screened, 28.5% have been told by a doctor or nurse that they have asthma, and 30.3% have asthma or asthma-like symptoms. To date, 229 children are enrolled in the Harlem Children’s Zone Asthma Initiative; at baseline, 24.0% had missed school in the last 14 days because of asthma. Conclusion. The high prevalence of asthma among children in the Harlem Children’s Zone Project is consistent with reports from other poor urban communities. Intensive efforts are under way to reduce children’s asthma symptoms and improve their asthma management strategies.

Recent research has quantified the national health care resource use (HCRU) and health care expenditure (HCE) burden associated with adult asthma; however, estimates specific to school-aged children are more than 2 decades old.To estimate the national HCRU and HCEs attributable to asthma among school-aged children in the United States.This was a cross-sectional retrospective analysis of school-aged children (aged 6-17 years) in the nationally representative 2007-2013 Medical Expenditure Panel Survey. All-cause HCRU and HCEs of school-aged children with asthma were compared with school-aged children without asthma, controlling for sociodemographics and comorbidities. HCRU encounters included emergency department (ED) and outpatient visits, hospitalizations, and prescriptions. Expenditures included total, medical, ED, inpatient, outpatient, and pharmacy. Negative binomial regression analyses were used for HCRU and Heckman selection with logarithmic transformation, and smearing retransformation was used for HCEs.There were 44,320 school-aged children of whom 5,890 had asthma. Children with asthma incurred a higher rate of all-cause annual ED visits (incidence rate ratio [IRR], 1.5; P.001), hospitalizations (IRR, 1.4; P.05), outpatient visits (IRR, 1.4; P.001), and prescription drugs (IRR, 3.3; P.001) compared with school-aged children without asthma. They incurred US$847 (2015 dollars) more annually in all-cause expenditures (P.001). Private insurance and Medicaid paid the largest share of expenditures. Pharmacy and outpatient costs represented the largest proportion of total expenditures. On the basis of the nationally representative Medical Expenditure Panel Survey sample weights from 2013, the total annual HCEs attributable to asthma for school-aged children in the United States was US$5.92 billion (2015 dollars).Childhood asthma continues to represent a prevalent and significant clinical and economic burden in the United States. More aggressive treatment and asthma management programs are needed to address this national financial and resource burden.

Dado el gran numero de controladores PI instalados en la industria y con el requerimiento de mejoras, en los metodos de sintonizacion de estos controladores; en este trabajo se ofrece una propuesta de sintonizacion de un controlador PI, aplicado a un proceso de control de temperatura real, similar a los usados en la industria, mediante el planteamiento de un problema de optimizacion multiobjetivo, aplicando un algoritmo genetico. El modelo propuesto, corresponde a un sistema lineal de primer orden mas retardo. Los parametros del modelo, se obtuvieron a traves de la aplicacion de un escalon a la Planta, en lazo abierto, y un metodo de identificacion de multiples puntos de la respuesta en frecuencia. El diseno de los controladores incluye la existencia de incertidumbre no estructurada en la Planta. El espacio factible del problema de optimizacion esta dado por el calculo de la Region de estabilidad de los controladores PI.

The teleoperation of a servomechanism by means of a local area network is presented. A master-slave configuration is developed, where the DC Motor with inertial load functions as the slave and a control terminal connected through a local network is the master. Signal transmission between the master and the remote (slave) terminals was made over an UDP internet protocol. The UDP/IP-communication introduces time delays in the control loop. Vertex type stability results are applied to analyze the closed loop stability of the system under proportional control, and the stabilization of the plant is tested from the simulation. The k p gain calculated for the stabilization of the plant was tested in a simulated Matlab/Simulink environment. Experimental results were obtained and compared to the analytical ones.

The modification of the aromatic part of fluorinated O -aryl lactic acids allows the improvement of the fluorine NMR δΔ values in diastereomeric esters, but also the observation of other nuclei such as Hg ( δΔ > 6 ppm). The enantiomeric purity of chiral acids has been determined through the dl- and meso compounds formed from achiral diols.

Although almost one in ten (8.6%) preschool children has been diagnosed with asthma, few asthma management programs are designed for parents of preschool children. The Asthma Basics for Children program addressed this need in 2003–2008 by implementing a multi-layered approach that offered educational activities to center staff, parents, and children and PACE training to physicians in 31 Northern Manhattan daycare centers. Following program participation, 85% of parents reported reducing their child's triggers, 89% said it was easier to talk to their child's physician, and 80% were confident in their ability to manage their child's asthma. Children's any daytime symptoms dropped from 78% to 42%, any nighttime symptoms from 81% to 49%, any daycare absences from 56% to 38%, any asthma-related emergency department (ED) visits from 74% to 47%, and any asthma-related hospitalizations from 24% to 11% (p

Treatment options for palatal fractures range from orthodontic braces, acrylic bars, and arch bars for maxillomandibular fixation to internal fixation, with plates and screws placed under the palate mucosa and periosteum, together with pyriform aperture or alveolar plating plus buttress reconstruction. Forty-five patients, ages 4 to 56, were treated using medium- or high-profile locking plates placed over the palatal mucosa as an external fixator for palatal fractures, together with treatment for other associated facial fractures. In open fractures, plates were placed after approximating the edges of the mucosal wounds. Plates and screws for palate fixation were removed at 12 weeks, when computed tomography scans provided evidence of fracture healing. All palatal fractures healed by 12 weeks, with no cases of mucosal necrosis, bone exposure, fistulae, or infections. This approach achieves adequate stability, reduces the risk of bone and mucosal necrosis, and promotes healing of mucosal wounds in case of open fractures.

The modification of the aromatic part of fluorinated O -aryl lactic acids allows the improvement of the fluorine NMR δΔ values in diastereomeric esters, but also the observation of other nuclei such as Hg ( δΔ > 6 ppm). The enantiomeric purity of chiral acids has been determined through the dl- and meso compounds formed from achiral diols.

Developed road infrastructure is one of the main ingredients to economic growth. At the same time, economic growth enables further expansion of infrastructure. The co-evolutionary aspects of the growth of economic output and road infrastructure are thus apparent and represent the main motivation for the study presented in this chapter. We develop a model analyzing the interdependence between a country’s economic growth and the development of transportation infrastructure in this country, explicitly taking into account the mutual influence of the rate of economic growth and the transportation capacity. Formulating an optimal control problem, the optimal investment rate can be determined. This model forms a comprehensive framework for understanding the underlying dynamics and the patterns of economic growth in relation to transport infrastructure. An analytical solution for the infinite horizon problem is derived and the steady state is shown to depend crucially on the rate of physical decay of roads. Testing the model for the data of two countries illustrates the usefulness of such an approach to real world problems and possibly policy recommendations, even though the model would have to be adapted to the specific characteristics of each country or region to make precise statements.

In 1991 Dr. Kenneth Olden became the first AfricanAmerican director of an institute in the National Institutes of Health (NIH) when he assumed the leadership of the National Institute of Environmental Health Sciences (NIEHS) (Brown 2004). That same year, the NIEHS—with Dr. Olden in prominent attendance—hosted the Interagency Symposium on Health Research Needs to Ensure Environmental Justice, which was held 11 February 1994 in Arlington, Virginia (Shepard et al. 2002). Throughout his tenure at the helm of NIEHS, Dr. Olden has listened to the needs, both small and large, of communities that have experienced severe disparities in both environmental exposures and health outcomes. This E s s a y o n Community-Based Participatory Research

“La presente tesis describe y analiza las transformaciones que un espacio étnico ha experimentado a lo largo del tiempo. Para ello se recurrió a un análisis por aproximaciones sucesivas tanto en lo especial como en lo temporal. De esta manera se pudo detectar las discontinuidades históricas más importantes en el uso de los recursos naturales, de este territorio indígena, desde la época del “contacto” hasta nuestros días, para arribar así a la identificación de 27 diferentes paisajes agropecuarios y forestales y cuatro grandes paisajes agrarios a nivel regional, los cuales se expresaron en un juego cartográfico a escala 1:300 000. En el nivel local se caracterizaron las estrategias y el espacio productivo del ejido de Plan de Hidalgo, Veracruz, así como la transformación de sus paisajes a lo largo de los últimos 100 años lo anterior dio por resultado una cartografía a escala 1:50 000 y 1:25 000 de la historia de la tenencia de la tierra del relieve del uso del suelo y vegetación y de una versión de agrohabitats basada en criterios propuestos por los propios ejidatarios. Además se realizó un análisis del usufructo de la tierra, d las tendencias más recientes de la evolución del uso del suelo y una primera aproximación crítica a la racionalidad económica en el uso de los recursos naturales. El tercer nivel de acercamiento, que involucró activamente a los ejidatarios, reveló una particular versión de la historia del ejido, una reconstrucción del uso del suelo en lo últimos 25 años a nivel parcela y una identificación de microunidades ambientales a lo largo de un perfil topográfico”.

La prensa cumple actualmente función de enseñanza, pero condicionada a los factores estructurales de las sociedades en las que opera. Es incuestionable que sus comentarios, críticas e informaciones permiten en cierta forma la educación permanente de los públicos que leen esos contenidos, obligándoles al análisis y reflexión sobre los temas de actualidad. El problema se plantea en relación a la utilización de la prensa como medio de educación de los sectores de bajos niveles educativos y económicos, o sea precisamente de quienes están más necesitados de aprovechar los sistemas de difusión colectiva, para desarrollar un conocimiento de sí mismos y del ambiente circundante, lo cual podría entenderse como elevación del nivel cultural. Por lo tanto, la prensa en función de su papel propio, es medio de educación permanente. Si ahora no alcanza el ámbito que podría lograr se debe a las distorsiones de contenido y lenguaje.