***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: STUDY OBJECTIVE We determined whether a simple emergency department intervention improves the likelihood of primary care provider ( PCP ) follow-up after ED discharge for an acute asthma exacerbation . METHODS This r and omized , controlled clinical trial was conducted in an urban university-based ED . Participants were patients with asthma between the ages of 16 and 45 years who were treated and discharged from the ED . The study intervention was usual care or an intervention that consisted of a free 5-day course of prednisone , vouchers for transportation to and from their PCP , and a 48-hour telephone reminder to make an appointment with their PCP . The main outcome was whether the patient received follow-up care as determined by PCP contact at 4 weeks . RESULTS One hundred ninety-two patients with asthma were enrolled over 8 months ; 178 ( 93 % ) had complete follow-up . The intervention and control groups were similar with regard to age , sex , ethnicity , or years of education . The 2 groups were also comparable with respect to multiple measures of baseline access/barriers to care and severity of ED exacerbation . Patients receiving the intervention were significantly more likely to follow up with their PCP than control patients ( relative risk 1.6 ; 95 % confidence interval [ CI ] 1.1 , 2.4 ) . When adjusted for other factors influencing PCP follow-up care ( ethnicity , prior PCP relationship , insurance status , regular car access ) , intervention patients were more likely to follow up with their PCP ( odds ratio 3.1 ; 95 % CI 1.5 , 6.3 ) . CONCLUSION Providing medication , transportation vouchers , and a telephone reminder to make an appointment increased the likelihood that discharged patients with asthma obtained PCP follow-up BACKGROUND Whether asthma morbidity in minority groups can be reduced by preventative health care measures delivered in the relevant ethnic dialects requires further evaluation . This study reports clinical outcomes and quality of life from a community based project investigating white European ( W/E ) and Indian subcontinent ( ISC ) ethnic groups with asthma living in deprived inner city areas of Birmingham , UK . METHODS Six hundred and eighty nine asthmatic subjects ( 345 W/E , 344 ISC ) of mean ( SD ) age 34.5 ( 15 ) years ( range 11–59 ) and mean forced expiratory volume in one second ( FEV1 ) of 80 % predicted were interviewed in English , Punjabi , Hindi , or Urdu . Subjects r and omised to the active limb of a prospect i ve , open , r and omised , controlled , parallel group , 12 month follow up study underwent individually based asthma education and optimisation of drug therapy with four monthly follow up ( active intervention ) . Control groups were seen only at the beginning and end of the study . Urgent or emergency interactions with primary and secondary health care ( clinical outcomes ) and both cross sectional and longitudinal data from an Asthma Quality of Life Question naire ( AQLQ ) were analysed . RESULTS Clinical outcomes were available for 593 subjects . Fewer of the active intervention group consulted their GP ( 41.8 % versus 57.8 % , odds ratio ( OR ) 0.52 ( 95 % CI 0.37 to 0.74 ) ) or were prescribed antibiotics ( 34.9 % versus 51.2 % , OR 0.51 ( 95 % CI 0.36 to 0.72 ) ) , but by ethnicity statistically significant changes occurred only in the W/E group with fewer also attending A&E departments and requiring urgent home visits . Active intervention reduced the number of hospital admissions ( 10 versus 30 ) , GP consultations ( 341 versus 476 ) , prescriptions of rescue oral steroids ( 92 versus 177 ) , and antibiotics ( 220 versus 340 ) , but again significant improvements by ethnicity only occurred in the active W/E group . AQLQ scores were negatively skewed to the higher values ; regression analysis showed that lower values were associated with ISC ethnicity . Longitudinal changes ( for 522 subjects ) in the mean AQLQ scores were small but statistically significant for both ethnic groups , with scores improving in the active and worsening in the control groups . CONCLUSIONS Active intervention only improved clinical outcomes in the W/E group . AQLQ scores , although lower in the ISC group , were improved by active intervention in both ethnic groups BACKGROUND Isl and and mainl and Puerto Rican children have the highest rates of asthma and asthma morbidity of any ethnic group in the United States . OBJECTIVE We evaluated the effectiveness of a culturally adapted family asthma management intervention called CALMA ( an acronym of the Spanish for " Take Control , Empower Yourself and Achieve Management of Asthma " ) in reducing asthma morbidity in poor Puerto Rican children with asthma . METHODS Low-income children with persistent asthma were selected from a national health plan insurance cl aims data base by using a computerized algorithm . After baseline , families were r and omly assigned to either the intervention or a control group . RESULTS No significant differences between control and intervention group were found for the primary outcome of symptom-free days . However , children in the CALMA intervention group had 6.5 % more symptom-free nights , were 3 times more likely to have their asthma under control , and were less likely to visit the emergency department and be hospitalized as compared to the control group . Caregivers receiving CALMA were significantly less likely to feel helpless , frustrated , or upset because of their child 's asthma and more likely to feel confident to manage their child 's asthma . CONCLUSION A home-based asthma intervention program tailored to the cultural needs of low income Puerto Rican families is a promising intervention for reducing asthma morbidity BACKGROUND AND OBJECTIVE There are significant health disparities between Māori and non-Māori with asthma , a pattern seen between other ethnic population s. This study investigates outcomes for Māori in a r and omized controlled trial ( RCT ) of combination budesonide/formoterol inhaler therapy in asthma . METHODS This 24-week multicentre RCT recruited 303 adult asthma patients , 44 of whom were Māori . Participants were r and omized to the single combination budesonide/formoterol inhaler as maintenance and reliever therapy ( ' SMART ' ) regimen or ' st and ard ' regimen ( combination budesonide/formoterol inhaler for maintenance and salbutamol as reliever ) . Outcomes included patterns of beta-agonist inhaler use including ' high use ' of reliever therapy ( > 8 actuations of budesonide/formoterol in excess of four maintenance doses per day for SMART and > 16 actuations per day of salbutamol for st and ard ) . Differences in outcomes for Māori versus non-Māori were assessed using an interaction term between ethnicity and treatment . RESULTS With adjustment for ethnicity , the SMART group had fewer days of high use ( relative rate ( RR ) 0.57 ( 95 % confidence interval ( CI ) : 0.38 - 0.85 ) ) , days of high use without medical review within 48 h ( RR 0.49 ( 95 % CI : 0.32 - 0.75 ) ) and severe exacerbations ( RR 0.54 ( 95 % CI : 0.36 - 0.81 ) ) compared with st and ard . The magnitude of the benefit from the SMART regimen was similar in Māori and non-Māori . Regardless of treatment regimen , Māori demonstrated more days of high use , high use without medical review and underuse of maintenance therapy . CONCLUSIONS The SMART regimen has a favourable risk/benefit profile in Māori . Days of high use , days of high use without medical review and underuse of maintenance treatment were greater in Māori , regardless of treatment regimen BACKGROUND Few interventions have focused on the difficulties that African American women face when managing asthma . OBJECTIVE To evaluate a telephone-based self-regulation intervention that emphasized African American women 's management of asthma in a series of 6 sessions . METHODS A total of 422 African American women with persistent asthma were r and omly assigned to either an intervention or control group receiving usual care .  Behavioral factors , symptoms and asthma control , asthma-related quality of life , and health care use at baseline and 2 years after baseline were assessed . Generalized estimating equations were used to assess the long-term effect of the intervention on outcomes . RESULTS Compared with the control group , those who completed the full intervention ( 6 sessions ) had significant gains in self-regulation of their asthma ( B estimate , 0.73 ; 95 % CI , 0.17 - 1.30 ; P < .01 ) , noticing changes to their asthma during their menstrual cycle ( B estimate , 1.42 ; 95 % CI , 0.69 - 2.15 ; P < .001 ) , and when having premenstrual syndrome ( B estimate , 1.70 ; 95 % CI , 0.67 - 2.72 ; P < .001 ) . They also had significant reductions in daytime symptoms ( B estimate , -0.15 ; 95 % CI , -0.27 to -0.03 ; P < .01 ) , asthma-related hospitalization ( B estimate , 0.51 ; 95 % CI , 0.00 - 1.02 ; P < .05 ) , and improved asthma control ( B estimate , 1.34 ; 95 % CI , 0.57 - 2.12 ; P < .001 ) . However , neither grouped changed over time in outcomes . CONCLUSION Despite high comorbidity , African American women who completed a culturally responsive self-management program had improvements in asthma outcomes compared with the control group . Future work should address significant comorbidities and psychosocial issues alongside asthma management to improve asthma outcomes in the long term . TRIAL REGISTRATION clinical trials.gov Identifier NCT01117805 OBJECTIVE To assess the outcomes of an education intervention for childhood asthma conducted by Australian Indigenous health care workers ( IHCWs ) . DESIGN AND SETTING R and omised controlled trial in a primary health care setting on Thursday Isl and and Horn Isl and , and in Bamaga , Torres Strait region of northern Australia , April 2005 to March 2007 . PARTICIPANTS 88 children , aged 1 - 17 years , with asthma diagnosed by a respiratory physician ( intervention group , 35 ; control group , 53 ; 98 % Indigenous children ) . INTERVENTIONS Children were r and omly allocated to : ( i ) three additional asthma education sessions with a trained IHCW , or ( ii ) no additional asthma education . Both groups were re-assessed at 12 months . MAIN OUTCOME MEASURES Primary endpoint : number of unscheduled visits to hospital or a doctor caused by asthma exacerbation . SECONDARY OUTCOMES measures of quality of life ( QoL ) and functional severity index ; asthma knowledge and underst and ing of asthma action plans ( AAPs ) ; and school days missed because of wheezing . RESULTS The groups were comparable at baseline ( except for asthma severity , which was adjusted for in the analysis ) . There were no significant differences in the primary outcome ( number of unscheduled medical visits for asthma ) . School children in the intervention group missed fewer school days because of wheezing ( 100 % < 7 days v 21 % of those in the control group missed 7 - 14 days ) . Significantly more carers in the intervention group could answer questions about asthma medication , knew where their AAP was kept ( 84 % v 56 % ) , and were able to describe the plan ( 67 % v 40 % ) . In both the intervention and control groups ( before- and -after comparison ) , there was a significantly reduced frequency of asthma exacerbations , as well as an improved QoL score and functional severity index , with no significant differences between the groups . CONCLUSIONS A community-based asthma education program conducted by trained IHCWs improves some important asthma outcomes in Indigenous children with asthma . TRIAL REGISTRATION Australian Clinical Trials Registry ACTRN012605000718640 OBJECTIVE To determine the effectiveness of a home-based asthma education intervention in increasing appropriate nebulizer use and reducing symptom frequency , emergency department ( ED ) visits , and hospitalizations over 12 months . DESIGN A r and omized clinical trial . Setting s Pediatric primary care , pulmonary/allergy , and ED practice s associated with the University of Maryl and Medical System and The Johns Hopkins Hospital , Baltimore . PARTICIPANTS Children with persistent asthma , aged 2 to 9 years , with regular nebulizer use and an ED visit or hospitalization within the past 12 months . Children were r and omized into the intervention ( n = 110 ) or control ( n = 111 ) group . Follow-up data were available for 95 intervention and 86 control children . INTERVENTION Home-based asthma education , including symptom recognition , home treatment of acute symptoms , appropriate asthma medication , and nebulizer practice . MAIN OUTCOME MEASURES Estimates of mean differences in asthma symptom frequency , number of ED visits and hospitalizations and appropriate quick relief , controller medication , and nebulizer practice over 12 months . RESULTS Of the 221 children , 181 ( 81.9 % ) completed the study . There were no 
    Output:
    
The available evidence showed that culture-specific education programmes for adults and children from minority groups are likely effective in improving asthma-related outcomes .
Not all asthma-related outcomes improved with culture-specific programs for both adults and children .
Nevertheless , while modified culture-specific education programs are usually more time intensive , the findings of this review suggest using culture-specific asthma education programmes for children and adults from minority groups .