***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective Home dampness and the presence of mold and allergens have been associated with  asthma morbidity . We examined changes in  asthma morbidity in children as a result of home remediation aim ed at moisture sources . Design In this prospect i ve , r and omized controlled trial , symptomatic , asthmatic children ( n = 62 ) , 2–17 years of age , living in a home with indoor mold , received an asthma intervention including an action plan , education , and individualized problem solving . The remediation group also received household repairs , including reduction of water infiltration , removal of water-damaged building material s , and heating/ventilation/air-conditioning alterations . The control group received only home cleaning information . We measured children ’s total and allergen-specific serum immuno-globulin E , peripheral blood eosinophil counts , and urinary cotinine . Environmental dust sample s were analyzed for dust mite , cockroach , rodent urinary protein , endotoxin , and fungi . The follow-up period was 1 year . Results Children in both groups showed improvement in asthma symptomatic days during the preremediation portion of the study . The remediation group had a significant decrease in symptom days ( p = 0.003 , as r and omized ; p = 0.004 , intent to treat ) after remodeling , whereas these parameters in the control group did not significantly change . In the postremediation period , the remediation group had a lower rate of exacerbations compared with control asthmatics ( as treated : 1 of 29 vs. 11 of 33 , respectively , p = 0 . 003 ; intent to treat : 28.1 % and 10.0 % , respectively , p = 0.11 ) . Conclusion Construction remediation aim ed at the root cause of moisture sources and combined with a medical/behavioral intervention significantly reduces symptom days and health care use for asthmatic children who live in homes with a documented mold problem BACKGROUND Exposure to cat and dog allergens is very common in the Western World and is a serious cause of asthma in sensitized subjects . OBJECTIVE We sought to study the clinical effects of air cleaners in living rooms and bedrooms of asthmatic children sensitized to cat or dog allergens . METHODS Twenty asthmatic children sensitized to pet allergens ( cat/dog ) and with an animal at home participated in a double-blind , placebo-controlled , cross-over study in which the effects of air cleaners placed in the living room and bedroom for 3 months were compared with the effects of sham air cleaners . Before and after each study period , lung function , airway hyperresponsiveness ( adenosine monophosphate ) , and peak flow variation were recorded . Cat and dog allergen levels were assessed in the filters of the air cleaners . RESULTS After a 3-month intervention with active air cleaners , airway hyperresponsiveness decreased significantly , showing a 1.2 doubling dose increase of PC(20 ) adenosine ( P = .003 ) . Peak flow amplitude also decreased ( P = . 045 ) . Substantial amounts of airborne cat and dog allergen were captured by the air cleaners in living rooms and bedrooms as well . Allergen levels in floor dust were not changed . CONCLUSION In young asthmatic patients sensitized and exposed to pets in the home , application of air cleaners in living rooms and bedrooms was accompanied by a significant improvement in airway hyperresponsiveness and a decrease in peak flow amplitude BACKGROUND Environmental exposures to indoor allergens are major contributors to asthma symptoms , particularly in inner cities . The effectiveness of household allergen reduction as an adjunct to National Asthma Education Prevention Program guideline -based pharmacologic therapy in asthma has not been prospect ively studied . OBJECTIVE To study the effect of individualized allergen reduction on ability to reduce asthma pharmacologic therapy over 40 weeks . METHODS We performed a r and omized controlled trial to determine the effect of multifaceted indoor allergen avoidance measures on the ability to reduce  asthma controller therapy in adults and children residing in New York City who were both sensitized and exposed to at least 1 indoor allergen . Asthma treatment and control were optimized in all subjects before r and omization . RESULTS A total of 125 subjects were r and omized to receive individualized household allergen reduction and 122 received a sham intervention .  Subjects in the intervention group significantly reduced all measured allergen levels ( cat , dog , dust mite allergens in the bedroom , cockroach and mouse allergens in the kitchen and bedroom ) ; those in the control group reduced only dust mite and mouse allergens in the bedroom and cockroach allergen in the kitchen . Participants in the intervention arm reduced  National Asthma Education Prevention Program-based therapy  from step 4.4 at r and omization to 3.50 postintervention ( range , 0 - 6 ) ; participants in the control arm reduced medication from step 4.4 to 3.4 ( P = .76 ) . There were no differences in other measured asthma outcomes . CONCLUSIONS Targeted allergen avoidance measures do not allow for reduction in asthma pharmacologic therapy compared with usual care in patients already receiving optimal controller therapy Background Exposure to cockroaches is an important asthma trigger , particularly for children with asthma living in inner cities . Integrated pest management is the recommended approach to cockroach abatement ; however , it is costly and difficult to implement . The impact of reducing cockroach exposure on asthma outcomes is not known . Objective We sought to test the use of a single intervention , insecticidal bait , to reduce cockroach exposure in the home of children with asthma in New Orleans and to examine the impact of cockroach reduction on asthma outcomes . Methods One hundred two children aged 5 to 17 years with moderate to severe asthma were enrolled in a 12‐month r and omized controlled trial testing the use of insecticidal bait on cockroach counts and asthma morbidity . Homes were visited 6 times and asthma symptoms were assessed every 2 months . Results After adjustment , intervention homes had significantly fewer cockroaches than did control homes ( mean change in cockroaches trapped , 13.14 ; 95 % CI , 6.88‐19.39 ; P < .01 ) . Children in control homes had more asthma symptoms and unscheduled health care utilization in the previous 2 weeks ( 1.82 , 95 % CI , 0.14‐3.50 , P = .03 ; 1.17 , 95 % CI , 0.11‐2.24 , P = .03 , respectively ) and a higher proportion of children with FEV1 of less than 80 % predicted ( odds ratio , 5.74 ; 95 % CI , 1.60‐20.57 ; P = .01 ) compared with children living in intervention homes . Conclusions Previous research has demonstrated improvement in asthma health outcomes using multifaceted interventions . The strategic placement of insecticidal bait , which is inexpensive , has low toxicity , and is widely available , result ed in sustained cockroach elimination over 12 months and was associated with improved asthma outcomes . This single intervention may be an alternative to multifaceted interventions currently recommended to improve asthma morbidity Background Despite medical advice , many pet‐allergic asthma sufferers refuse to remove the pet to which they are sensitized from their home Objective To determine whether insulating existing houses increases indoor temperatures and improves occupants ' health and wellbeing . Design Community based , cluster , single blinded r and omised study . Setting Seven low income communities in New Zeal and . Participants 1350 households containing 4407 participants . Intervention Installation of a st and ard retrofit insulation package . Main outcome measures Indoor temperature and relative humidity , energy consumption , self reported health , wheezing , days off school and work , visits to general practitioners , and admissions to hospital . Results Insulation was associated with a small increase in bedroom temperatures during the winter ( 0.5 � C ) and decreased relative humidity ( −2.3 % ) , despite energy consumption in insulated houses being 81 % of that in uninsulated houses . Bedroom temperatures were below 10 � C for 1.7 fewer hours each day in insulated homes than in uninsulated ones . These changes were associated with reduced odds in the insulated homes of fair or poor self rated health ( adjusted odds ratio 0.50 , 95 % confidence interval 0.38 to 0.68 ) , self reports of wheezing in the past three months ( 0.57 , 0.47 to 0.70 ) , self reports of children taking a day off school ( 0.49 , 0.31 to 0.80 ) , and self reports of adults taking a day off work ( 0.62 , 0.46 to 0.83 ) . Visits to general practitioners were less often reported by occupants of insulated homes ( 0.73 , 0.62 to 0.87 ) . Hospital admissions for respiratory conditions were also reduced ( 0.53 , 0.22 to 1.29 ) , but this reduction was not statistically significant ( P=0.16 ) . Conclusion Insulating existing houses led to a significantly warmer , drier indoor environment and result ed in improved self rated health , self reported wheezing , days off school and work , and visits to general practitioners as well as a trend for fewer hospital admissions for respiratory conditions To evaluate the effect of a room high-efficiency particulate air ( HEPA ) cleaner on cat-induced asthma and rhinitis , 35 cat-allergic subjects who were living with one or more cats were studied in a double-blind , placebo controlled trial . After a 1 mo baseline period , subjects ' bedrooms were equipped with an active or placebo air cleaner for the following 3 mo . Evaluations included monthly measurement of cat-allergen levels , daily morning , afternoon , and nighttime nasal- and chest-symptom scores , twice-daily measurement of peak-flow rates , daily medication scores , monthly spirometry , and methacholine ( MCh ) challenge testing before and after the study . Airborne allergen levels were reduced in the active-filter group as compared with the placebo group ( p = 0.045 ) . However , no differences were detected in settled-dust allergen levels ( p = 0.485 ) , morning , afternoon , or nighttime nasal-symptom scores ( p = 0.769 , 0.534 , and 0.138 ) , chest-symptom scores ( p = 0.388 , 0.179 , and 0.215 ) , sleep disturbance ( p = 0.101 ) , morning or afternoon peak-flow rates ( p = 0 . 424 and 0.679 ) , or rescue medication use ( nasal , p = 0.164 , chest , p = 0.650 ) , respectively . Although the combination of a HEPA room air cleaner , mattress and pillow covers , and cat exclusion from the bedroom did reduce airborne cat-allergen levels , no effect on disease activity was detected for any parameter studied Background : In temperate climates , exposure to house dust mite ( HDM ) allergens is the strongest environmental risk factor for childhood asthma . Environmental modifications to limit exposure have the potential to reduce the prevalence of asthma . The aim of this study was to reduce allergen exposure for children at high risk of developing asthma Abstract Background : Dust mite allergens can induce allergic sensitization and exacerbate asthma symptoms . Although dust mite reduction and control strategies exist , few asthmatics employ them . Objectives : We examined whether an in-home test kit , which quantifies dust mite allergen levels , result ed in behavioral changes in implementation and maintenance of mite reduction strategies and helped reduce allergen levels in homes of dust mite-sensitive children . Methods : We enrolled 60 households of children aged 5–15 with parent-reported dust mite allergy into a r and omized controlled trial . Intervention homes ( N = 30 ) received educational material about reducing dust mites and test kits at 1 , 2 , 5 and 8 months . Control homes ( N = 30 ) received only educational material . At baseline , 6 and 12 months , study staff visited all homes , collected dust sample s from three locations and obtained information about parents ’ mite reduction behaviors by question naire . Allergen concentrations ( Der f 2/Der p2 ) in dust were assessed by immunoassays . After adjusting for visit and location , allergen concentrations in intervention and control homes were compared using mixed effects model analysis . Results : In the intervention homes , allergen concentrations in the child ’s bedroom and living room floors were significantly reduced over time compared to control homes . Although not all location-specific differences in allergen concentrations were statistically significant , combining data across locations , there was a differential reduction in allergen concentrations in the intervention group versus the control group ( p = 0.02 ) . Conclusion : The use of in-home test kits along with education may beneficially influence behaviors and attitudes toward dust mite reduction strategies and help reduce residential dust mite allergen levels BACKGROUND Clinical ly relevant reductions in exposure to cockroach allergen , an important risk factor for asthma in inner-city households , have proven difficult to achieve in intervention trials . OBJECTIVE This study investigated a method for the abatement of cockroach allergen in low-income , urban homes . The goal was to reduce mean Bla g 1 concentrations below the previously proposed thresholds for allergic sensitization and asthma morbidity . METHODS A prer and omized , nonmasked trial with 16 intervention and 15 control homes was conducted . Study inclusion was based on 50 to 500 cockroaches trapped in a 3-day period . The interventions consisted of occupant education , placement of insecticide bait , and professional cleaning . V 
    Output:
    
Summary Given evidence for effective interventions , control of environmental exposures should lead to improved asthma outcomes .