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Teck-King Tan,Miguel Saps,Cheng-Li Lin,Chang-Ching Wei 대한소화기 기능성질환∙운동학회 2019 Journal of Neurogastroenterology and Motility (JNM Vol.25 No.2
ackground/Aims Recent studies suggest that air pollution may play a role in gastrointestinal disorders. However, the effect of long-term exposure to air pollution on childhood irritable bowel syndrome (IBS) is unclear. Hence, we conducted a nationwide cohort study to investigate the association between long-term air pollution exposure and the incidence and risk of IBS in Taiwanese children during 2000–2012. Methods We collected data from the Taiwan National Health Insurance Research Database, linked to the Taiwan Air Quality-Monitoring Database according to the insurant living area and the air quality-monitoring station locations. Children < 18 years old, identified from January 1st, 2000, were followed-up until IBS diagnosis or December 31st, 2012. The daily average air pollutant concentrations were categorized into 4 quartile-based groups (Q1–Q4). We measured the incidence rate, hazard ratios (HRs), and 95% confidence intervals for IBS stratified by the quartiles of air pollutant concentration. Results A total of 3537 children (1.39%) were diagnosed with IBS within the cohort during the follow-up period. The incidence rate for IBS increased from 0.84 to 1.76, from 0.73 to 1.68, from 0.85 to 1.98, and from 0.52 to 3.22 per 1000 person-years, with increase in the carbon monoxide, nitrogen dioxide, non-methane hydrocarbon, and methane quartile (from Q1 to Q4) exposure concentration, respectively. The adjusted HR for IBS increased with elevated carbon monoxide, nitrogen dioxide, non-methane hydrocarbon, and methane exposure in Q4 to 1.98, 2.14, 2.19, and 5.87, respectively, compared with Q1. Conclusion Long-term ambient air pollutant exposure is an environmental risk factor for childhood IBS.
Disorders of Gut-Brain Interaction in a National Cohort of Children With Down Syndrome
Steven L Ciciora,Kandamurugu Manickam,Miguel Saps 대한소화기 기능성질환∙운동학회 2023 Journal of Neurogastroenterology and Motility (JNM Vol.29 No.1
Background/AimsDisorders of brain-gut interaction (DGBIs) are present in adults and children around the world. Down syndrome (DS) is the most common chromosomal condition in humans. While DS has associations with many organic medical conditions, the frequency of DGBIs in children and adolescents with DS has not previously been studied. We assess the rate of DGBIs in children and adolescents 4-18 years of age with DS in the United States using the Rome IV criteria by caregiver report. MethodsThis is a cross-sectional national survey study in which caregivers (n = 114) of children with DS completed an online survey about their child’s gastrointestinal symptoms and quality of life (QoL). ResultsUsing the Rome IV parent-report diagnostic questionnaire, 51.8% of children met symptom-based criteria for at least 1 DGBI. Functional constipation (36.0%) and irritable bowel syndrome (14.9%) were the most common disorders identified. QoL was lower in children with at least 1 disorder as compared to children who did not meet criteria for any disorders (mean QoL = 62.3 vs mean QoL = 72.9, P < 0.001). Almost all children with DS and concomitant autism (87.5%) had at least 1 DGBI. ConclusionsDGBIs are common in children with DS and are associated with diminished QoL.
Urban Harvest + Approach for 0-impact Built Environments, Case Kerkrade West
Rovers, Ronald,Rovers, Vera,Leduc, Wouter,Gommans, Leo,Sap, Herwin,Van Kann, Ferry Sustainable Building Research Center 2011 International journal of sustainable building tech Vol.2 No.2
The need to restructure our society into a sustainable society has been recognised by many, though a clear direction and ambition in this process usually fails. At the Research Institute for the Built Environment of Tomorrow, RiBuilT, the definition of a sustainable society has been summarised as the 'Concept of O': O for a circular approach of resource management, and 0 (zero) for 0-impacts of our activities; 0-energy, 0-materials, 0-water, 0-landuse and 0-air (pollution). In order to apply this approach to existing urban environments, the Urban Harvestplus approach was developed. This paper will analyse the first test results of the actual implementation of this approach on the Dutch district of Kerkrade West. The pilot on Kerkrade West shows that even when the production of resources is maximised and the demand for them will be drastically reduced, it will still be hard to achieve the 0-impact state. We need new and more innovative solutions to actually make it happen. However, the Urban Harvestplus approach proved to be a straight forward approach in getting closer to the zero-impact situation. It also clarified the interaction between resources and made clear that resource cycles should never be considered on their own, but always in relation to each other to avoid sub-optimisation. Many questions and areas are left for further research, but we believe Urban Harvest-plus represents a strong basis to depart from.
Desiree F Baaleman,Mana H Vriesman,,Ilan J N Koppen,Kim M Osborne,Marc A Benninga,Miguel Saps,Desale Yacob,Peter L Lu,Frederick W Woodley,Carlo Di Lorenzo 대한소화기 기능성질환∙운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.2
Background/AimsTo assess the effectiveness and feasibility of a brief session of hypnosis to reduce distress in children with functional constipation undergoing anorectal manometry (ARM). MethodsA partially-blinded randomized controlled pilot trial was conducted in children 4-18 years old scheduled for ARM. Children were randomized to receive a brief session of hypnosis prior to ARM or standard care. Non-blinded and blinded observers rated the child’s level of distress using the Observation Scale of Behavioral Distress and a 4-point-Likert scale, respectively. Differences between groups were analyzed using Fisher’s exact test or Mann-Whitney U test as appropriate. ResultsData from 32 children (15 hypnosis and 17 standard care) were analyzed. Prior to insertion of the catheter, the observed mean levels of distress were lower in the hypnosis group according to both the non-blinded observer (median 0.0 [interquartile range {IQR} 0.0-0.3] vs 1.4 [IQR 0.3-2.4]; P = 0.009) and the blinded observer (median 0.0 [IQR 0.0-0.0] vs 0.5 [IQR 0.0-1.0]; P = 0.044). During ARM, observed and reported levels of distress did not differ significantly. In the hypnosis group, 92.9% of parents and children reported that hypnosis helped the child to relax. There were no significant differences in resting pressure, squeeze pressure, or duration of the procedure between both groups. ConclusionA brief session of hypnosis for children before ARM is an easily incorporable intervention that lowers distress levels prior to the procedure and is positively perceived by children and parents.