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Asthma by Numbers (Australian Institute of Health and Welfare, 2016)

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Asthma by Numbers (Australian Institute of Health and Welfare, 2016)

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Image retrieved from: http://www.aihw.gov.au/asthma/

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Image retrieved from: http://www.tasteofthemed.com/the-mediterranean-diet-pyramid.php

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Image retrieved from: http://www.physio-pedia.com/Asthma

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Diet and asthma

As we know a modified diet has some benefits for reducing the risk of asthma. The results from most of these research studies indicate that there is a relative correlation between the consumption of certain type of diets composition with the management of the symptoms of asthma; however, there is still no sufficient evidence to support this argument. Asthma is a condition that can have a detrimental impact on an individual. Due to an evidence based practice approach in health care it is not recommended to use diet as treatment for asthma, however changing a diet whilst using the recommended medications could increase assistance in controlling and preventing the condition. More assistance in preventing and controlling this disease, could not only prevent asthma related deaths but could improve daily life for many people living with this condition.

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Blitz, M., Hughes, R., Diner, B., Beasely, R., Knopp, J., & Rowe, B. (2002). Aerosolized magnesium sulfate for acute asthma. Protocols.http://dx.doi.org/10.1002/14651858.cd003898

Ciliska, D., DiCenso, A., & Guyatt, G. (2014). Evidence-Based Nursing: A Guide to Clinical Practice. Elsevier Health Sciences.

Doeing, D. & Solway, J. (2013). Airway smooth muscle in the pathophysiology and treatment of asthma. Journal Of Applied Physiology, 114(7). Retrieved from http://jap.physiology.org/content/114/7/834#T1

Dhawan, V., & Kalluri, M. (2013). A 24-year-old woman with episodes of shortness of breath, cough and wheezing. Canadian Medical Association Journal, 185(15). Retrieved from http://www.cmaj.ca/content/185/15/1337

Harold, K. & Mazza, J. (2011). Allergy, Asthma & Clinical Immunology. AACI Journal, 7(1). Retrieved from http://aacijournal.biomedcentral.com/articles/10.1186/1710-1492-7-S1-S2

Hasudungan, A. (2014, December 01). Asthma Pathophysiology. Retrieved from https://www.youtube.com/watch?v=NNfx27io8-k

Hooper, R., Heinrich, J., Omenaas, E., Sausenthaler, S., Garcia-Larsen, V., Bakolis, I., & Burney, P. (2009). Dietary patterns and risk of asthma: results from three countries in European community respiratory health survey-II. British Journal of Nutrition, 103(09), 1354-1365. http://dx.doi.org/10.1017/s0007114509993266

Julia, V., Macia, L., & Dombrowicz, D. (2015). The impact of diet on asthma and allergic disease . Nature Review Immunology , 15(5), 308-322.

Kent, B. & McCormack, B. (2011). Clinical context for evidence-based nursing practice. Chichester, West Sussex, U.K.: Sigma Theta Tau International Honor Society of Nursing.

Martin, E, & McFerran, T (2014). A Dictionary of Nursing (6 ed.) (6th ed.). Oxford University Press. Retrieved from http://www.oxfordreference.com.ezproxy1.acu.edu.au/view/10.1093/acref/9780199666379.001.0001/acref-9780199666379-e-1207?rskey=skfo6W&result=1 Nurmatov, U., Devereux,

G., Sheikh, A. (2011). Nutrients and foods for the primary prevention of asthma and allergy: Systematic review and meta-analysis. Journal Of Allergy And Clinical Immunology, 127(3), 724-733.e30. http://dx.doi.org/10.1016/j.jaci.2010.11.001

Peters, S. (2014). Asthma Phenotypes: Nonallergic (Intrinsic) Asthma. The Journal Of Allergy And Clinical Immunology: In Practice, 2(6), 650-652. http://dx.doi.org/10.1016/j.jaip.2014.09.006

Pogson, Z. & McKeever, T. (2011). Dietary sodium manipulation and asthma. Cochrane Database Of Systematic Reviews.http://dx.doi.org/10.1002/14651858.cd000436.pub3

Reveals , A., & Katasos, T. (2011). The effects of maternal diet and breastfeeding on children with asthma and allergy . S Afr Fam Pract 2012, 54(6), 492-494.

Richardson-Tench, M., Taylor, B., Kermode, S., Roberts, K. (2016). Inquiry in Health Car (5th Ed). South Melbourne: Cengage Learning Australia.

Rosenkranz, R., Rosenkranz, S., Neessen, K. (2012). Dietary factors associated with lifetime asthma or hayfever diagnosis in Australian middle-aged and older adults: a cross-sectional study. Nutrition Journal, 11(1). http://dx.doi.org/10.1186/1475-2891-11-84

Seyedrezazadeh, E., Pour Moghaddam, M., Ansarin, K., Reza Vafa, M., Sharma, S., Kolahdooz, F. (2014). Fruit and vegetable intake and risk of wheezing and asthma: a systematic review and meta-analysis. Nutrition Review, 72(7), 411-428.http://dx.doi.org/10.1111/nure.12121

Sexton, P., Black, P., Metcalf, P., Wall, C., Ley, S., Wu, L., . . . Kolbe , J. (2013). Influence of Mediterranean Diet on Asthma Symptoms, Lung Function, and Systemic Inflammation: A Randomized Controlled Trial . Journal of Asthma , 50(1), 75-81.

Tanaka, T., & Takahashi, R. (2013). Flavonoids and Asthma . Nutrients , 5(6), 2128-2143.

Thiara, G., & Goldman, R. D. (2012). Milk consumption and mucus production in children with asthma. Canadian Family Physician Médecin De Famille Canadien, 58(2), 165-166

Thien, F., De Luca, S., Woods, R., Abramson, M. (2002). Dietary marine fatty acids (fish oil) for asthma in adults and children. Cochrane Database Of Systematic Reviews.http://dx.doi.org/10.1002/14651858.cd001283

Welsh, E., Bara, A., Barley, E., & Cates, C. (2010). Caffeine for asthma. Cochrane Database Of Systematic Reviews. http://dx.doi.org/10.1002/14651858.cd001112.pub2

World Health Organisation . (2013, November ). Asthma . Retrieved from World Health Organisation : http://www.who.int/mediacentre/factsheets/fs307/en/

Wilkinson, M., Hart, A., Milan, S., Sugumar, K. (2014). Vitamins C and E for asthma and exercise-induced bronchoconstriction. Cochrane Database Of Systematic Reviews. http://dx.doi.org/10.1002/14651858.cd010749.pub2

Yang, H., Xun, P., & He, K. (2013). Fish and fish oil intake in relation to risk of asthma: A systematic review and meta-analysis.Plos one, 8(11), e80048. http://dx.doi.org/10.1371/journal.pone.0080048

Zhou, Y., Yang, M., Dong, B. (2012). Monosodium glutamate avoidance for chronic asthma in adults and children. Cochrane database of systematic reviews. http://dx.doi.org/10.1002/14651858.cd004357.pub

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Topic 3: Diet is a key factor in asthma management, and needs to be modified to reduce the risk of asthma exacerbations. 

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Topic 3: Diet is a key factor in asthma management, and needs to be modified to reduce the risk of asthma exacerbations. 

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Agree/Disagree. Discuss the nursing implications for your position utilising evidence based research.

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Kelsea Hogan S00152117
Sarah Barnes S00195888
Renee Kirkup S00171311
Paul Vincent Perez S00191959

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Why is it important
to follow evidence-based practice? 

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Why is it important
to follow evidence-based practice? 

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Evidence based practice is the use of the most relevant, current, best evidence in making decisions in regards to the care of patients (Kent & McCormack, 2011). When a nurse performs care using evidence based practices they are committing themselves to deliver care that is constructed from resources that have been critically appraised, based on evidence, the information is combined with clinical experience and meets patient expectations. Nurses who practice at this level operate with more detailed knowledge and skill due to their sources being gold standard, they have the ability to critically answer needs and use the provided evidence when planning their care delivery (Ciliska, DiCenso, & Guyatt, 2014).

Through the material that has been gathered from both sides of the topic, ‘Diet is a key factor in asthma management, and needs to be modified to reduce the risk of asthma exacerbations’,it can be believed that nurses who perform using evidence-based practices will disagree with the statement. Even though there is supportive evidence towards the connection involving consumption of various foods and amendments of asthma symptoms there is limited data to support this statement, hence why the nurse would be unable to agree with this statement.

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A wide range of dietary interventions have been researched to determine whether the addition or removal of certain foods can have an effect on asthma control. Although the results of these studies indicate that there is a correlation between consumption of particular foods and improvements in asthma symptoms, there has been no definitive link or strong enough evidence to support implementing a particular diet to patients with asthma.

Stronger evidence with higher quality research methodology which can draw conclusions based on causation and not correlation would provide greater reliability and support for the link between diet and asthma management. Below is a summary of evidence of particular dietary interventions and their effects on asthma.

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Asthma can be defined as a chronic disease which is characterised by the reoccuring incidents of obstruction to the airway, this obstruction is often due to inflamation or hyper-reponsiveness of the bronchial. There are two types of asthma, intrinsic and extrinsic. Intrinsic is asthma that is non-allergenic or non seasonal, the triggers of this are cold, damp or dry weather, dust, strong odors, infections of the respiratory system, anxiety /stress, exercise, coughing and smoke (Peters, 2014).  Extrinsic asthma or otherwise known as allergic asthma is far more common, it occurs when airborne antigens are inhaled, for example, pollen, animal dander, dust, mold and insects (Keller, 2014). The presentation that can be seen when experiencing an asthma attack is breathlessness/dyspnea, wheezing, coughing, chest tightness and labored breathing (Harold & Mazza, 2011).

Extrinsic asthma occurs when an allergen provokes an immunoglobulin (Ig) immune response. The allergen passes through the epithelial barrier and comes into connection with the dendritic cell. It is here where the dendritic cell presents the antigen to the T lymphocytes (T cell), which then becomes an allergen-specific helper T cell. Helper T cells produce cytokines that are essential for the stimulation of B cells, B cells construct antibodies (Doeing & Solway, 2013). Antibodies attach themselves to basophils and mast cells, which can be located in the smooth muscle of the respiratory system. Here they continue to circulate throughout the body until the same type of antigen causes another immune response. These circulating cell-binded mast cells release mediators, for example, prostaglandin, leukotriene and histamine, subsequently enabling over secretion of mucus, contraction of the smooth muscle, inflammation and bronchi constriction. Shortness of breath, wheezing and gasping can be seen here (Dhawan & Kalluri, 2013).

The pathophysiology characteristic of intrinsic asthma is very similar to extrinsic asthma, it includes alike manifestation of T lymphocytes, in particular Th2 cytokines, and a comparable immune reaction, although people with intrinsic asthma have higher findings of RANTS (Cytokine) in the mucosa and increased bronchoalveolar fluid (Peters, 2014).

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Asthma is an obstructive lung disease characterised by acute symptomatic episodes of bronchial constriction that occur as a result of a homeostatic response due to a trigger or viral infection (Reveals & Katasos, 2011). According to the World Health Organisation asthma is one of the most common chronic diseases in the world affecting approximately 235 million people (2013). Asthma is believed to be an interaction between environmental and genetic factors causing one to become sensitized to environmental allergens (Tanaka & Takahashi, 2013). A randomized clinical trial that was undertaken in 2013 has made links with a Mediterranean Diet (which includes low intake of meaty and poultry moderate intake of oily fish and dairy products and high intake of fruits, whole grains vegetables, olive oil and legumes) and a reduced asthma risk (Sexton, et al., 2013). The below diagram demonstrates the immune response modulated by lipids either having a promotion on allergic reaction or protection against allergic reaction. One of the main elements leading to promotion of allergic reaction is medium-chain fatty acids (MCFA) that are saturated fatty acids found in oils like coconut oil (Julia, Macia, & Dombrowicz, 2015). Another link to controlling the body’s immune response to inflammation is in omega-6 and omega-3 polyunsaturated fattys acids (PUFAs). As seen in the diagram, Omega-6 PUFAs (found in foods such as meat, eggs, poultry etc.)  promote mast cell production (responsible for inflammatory response) where as omega-3 PUFAs (found in fish, vegetable oils, leafy vegetables etc.) decrease T cell responses (immune response to antigens) (Julia, Macia, & Dombrowicz, 2015).

More evidence from 2013 demonstrate a link between flavonoids (which are found in fruits, vegetables and beverages) and a decrease in the release of chemical mediators due to the antioxidant and anti-allergic traits (Tanaka & Takahashi, 2013). Although some of these human clinical trials are limited, there is some strong evidence to suggest dietary intervention could propose prevention and alleviation of allergic disease including asthma (Julia, Macia, & Dombrowicz, 2015). Changing a diet for an individual not only poses less adverse side effects in comparison to other asthma treatments it has proven health benefits beyond asthma (Sexton, et al., 2013).

Image retrieved from: (Julia, Macia, & Dombrowicz, 2015).