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1. Tham, Rachel. The contribution of outdoor fungal spores to child and adolescent asthma hospitalisations: lung function and airway inflammation.

Degree: 2017, University of Melbourne

Outdoor fungal spores are among the most common aerobiological particles in the air we breathe. Although a limited number of outdoor fungal species are recognised as exacerbating agents of a number of allergic and respiratory conditions, their contribution towards asthma exacerbation is unclear, particularly among children and adolescents. Moreover, we have limited understanding of the impacts that inhaled fungal spores have on lung function or airway inflammation, which may be pre-clinical signs of asthma exacerbation. Therefore the aim of my doctoral research is to examine whether there are associations between common outdoor fungal spores and child and adolescent asthma hospitalisations, and also to explore if short term exposure to ambient fungal spores is associated with lower lung function or airway inflammation. In Chapter 2, a comprehensive literature review highlights that there are significant knowledge gaps in the contribution of outdoor fungal spores to child and adolescent asthma hospitalisations, lung function and airway inflammation. In order to address some of these gaps, my specific research objectives of this doctoral research were to: (a) systematically synthesise the current evidence as to whether outdoor fungal spores were significant triggers of child and adolescent asthma exacerbations resulting in health service attendances; (b) investigate if there were associations between short term exposure to outdoor fungal spores and child and adolescent asthma hospitalisations; (c) explore if any of these associations were modified by air pollutants, grass pollen, age group, sex, presence of human rhinovirus infection, or fungal sensitisation status; (d) investigate if there were associations between outdoor fungal spores and lower lung function or airway inflammation, and (e) explore if any associations were modified by air pollutants or pollen, age group or fungal sensitisation status. In Chapter 3, my systematic review found that only a small number of studies have been conducted, predominantly in countries located in the northern hemisphere. Children with fungal sensitisation appeared to be at greater risk of asthma hospitalisations. Severity of asthma exacerbation may vary between fungal spore taxa. There were inconsistent findings, possibly due to the lack of accounting for other significant triggers of asthma exacerbations. In Chapter 5, my ecological case-crossover study of child and adolescent asthma hospitalisations in south-west Sydney found that there were associations with Coprinus, Periconia, Chaetomium, Ganoderma and Cerebella, with same day and lagged effects. There was evidence of effect modification by sex, with girls demonstrating stronger associations with Cladosporium, Coprinus and Chaetomium than boys. Age also acted as an effect modifier with older adolescents, demonstrating stronger associations with Coprinus and Ustilago/smuts than those aged under 14 years. In Chapter 6, my case-crossover study of child and adolescent asthma hospitalisations in Melbourne found…

Subjects/Keywords: outdoor fungal spores; asthma hospitalisations; lung function; airway inflammation; epidemiology

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APA (6th Edition):

Tham, R. (2017). The contribution of outdoor fungal spores to child and adolescent asthma hospitalisations: lung function and airway inflammation. (Doctoral Dissertation). University of Melbourne. Retrieved from http://hdl.handle.net/11343/191669

Chicago Manual of Style (16th Edition):

Tham, Rachel. “The contribution of outdoor fungal spores to child and adolescent asthma hospitalisations: lung function and airway inflammation.” 2017. Doctoral Dissertation, University of Melbourne. Accessed March 04, 2021. http://hdl.handle.net/11343/191669.

MLA Handbook (7th Edition):

Tham, Rachel. “The contribution of outdoor fungal spores to child and adolescent asthma hospitalisations: lung function and airway inflammation.” 2017. Web. 04 Mar 2021.

Vancouver:

Tham R. The contribution of outdoor fungal spores to child and adolescent asthma hospitalisations: lung function and airway inflammation. [Internet] [Doctoral dissertation]. University of Melbourne; 2017. [cited 2021 Mar 04]. Available from: http://hdl.handle.net/11343/191669.

Council of Science Editors:

Tham R. The contribution of outdoor fungal spores to child and adolescent asthma hospitalisations: lung function and airway inflammation. [Doctoral Dissertation]. University of Melbourne; 2017. Available from: http://hdl.handle.net/11343/191669

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