Rigorous Research

Reports, Presentations, and Workshops

Elizabeth Goodman , ... Andrea Moed , in Observing the User Experience (Second Edition), 2012

Know Your Procedure

Even the well-nigh extensive and rigorous research has limitations. When because how to nowadays findings, proceed them in listen. Acknowledging any limitations in your knowledge helps the audience understand the results, believe in them, and deed on the recommendations.

•

What are the data collection problems? Mention any limitations and potential distortions in the information collection methods upfront ("Nosotros were only able to speak to one of the two user audiences"), only justify your choices ("We chose to focus on one user group considering we believe that, given our express resources, they will requite us the best feedback"). If you recognize potential flaws, address them before your audience members bring them up.

•

What are the limitations of the analysis? There are many ways to analyze a given data set. Your analysis will only use a few. Admit the strengths and limitations of the chosen analysis method. For case, although tabulating survey results is fast and easy, it may non reveal every bit much every bit cross-tabulating the results of several of the variables. Merely cross-tabulation is trickier and requires more responses to be valid.

•

Where is the bias? The recruiting process, the participants' perspective, the research conditions, the analyst's experience—each tin subtly skew the information collection procedure. Pretending that these sources of bias do not matter will only undermine your conclusions. Identifying and minimizing sources of bias will only strengthen the credibility of your assay.

Read full chapter

URL:

https://world wide web.sciencedirect.com/science/commodity/pii/B9780123848697000188

Action enquiry

Majola J.H. Oosthuizen , in Research Methods for Students, Academics and Professionals (Second Edition), 2002

The nature of activity enquiry

Action research has a two-fold focus: action in practice and knowledge generation through rigorous inquiry. Information technology is sometimes shown as:

Action research = action + research .

Activity research is oftentimes intended to bring well-nigh change of practice, while creating knowledge at the same time. These combined characteristics make it useful for exploratory research to bring about improvement of practice, or to advise new solutions to practical bug.

Action inquiry is usually carried out in discrete cycles, where afterwards cycles are used to claiming, support and refine insights and results from previous cycles. When the arroyo is used accordingly, this circadian feature of activity enquiry can be used not only to advise theory, but also to examination theory. However, like case studies, action research is unremarkably concerned with single situations, for example, a single group or company. Therefore, although the approach tin generate theoretical propositions that go beyond single situations, action research is seldom seen as an appropriate arroyo to test the general applicability of theories.

Action research is critically reflective. The demand for reflection exists in times when current activity does non produce the desired results, and modify is needed. This is why activeness research is often concerned with change in practise. The need for critical reflection is the reason why action research is cyclic: it calls for a procedure that has reflection equally a key part of each bike. In its most bones form, the action enquiry cycles can be illustrated as shown in Figure 9.1.

Figure 9.1. The nearly basic action enquiry bicycle

Note that reflection is based on experiences of activity, and that the whole constitutes a learning process. Such a process is particularly useful in situations where effective nominal theory for practice is absent. In these situations the action enquiry cycles function similar mini-experiments in practice. Through reflection on previous action a new theory of the grade 'if I exercise X, then Y volition occur' is proposed, which is so applied in practice, and tested, in a cyclic way. In each cycle, the result indicates whether the theory worked, and thus if it can be used as ground for farther refinement, or if it needs to be changed.

This cyclic approach of noesis generation and testing allows the process to remain flexible. There is no reason why a bike should use the same methods as previous cycles; the action of every new wheel is simply based on the all-time possible action that could be proposed after reflecting on the previous cycles. In this sense, activity research as research methodology is different from other research methods, where is it expected that the method is designed in detail, in accelerate, and used throughout the research project. This does non hateful that deliberate and detailed planning are excluded from action enquiry. In fact, the action enquiry cycle is ofttimes proposed to comprise multiple elements, such as shown in Figure 9.2 where planning is part of the cycle.

Effigy 9.2. A typical action research bike

Some writers, such every bit Pedler (1991), point out that steps, such every bit planning, action and observation, are action in themselves, and therefore each of them could also be followed by reflection. Nonetheless information technology is non then easy, and sometimes artificial, to split such steps in practice. It is important that deliberate reflection goes on throughout action research. To ensure this, reflection ought to be scheduled at least in one case after the main action, for every formal action enquiry bike.

The techniques used within activity research also influence the nature of the action research cycles (some of the major techniques are outlined beneath). For example, the Delphi approach, outlined in Chapter 12, typically uses simply a few, but very distinct cycles. In contrast, when the dialectic approach is used, the individual cycles are many and hardly visible, beingness embedded in the communication betwixt people. The dialectic approach, which is introduced subsequently, is based on advice with an emphasis on the identification and resolution of differences.

A last fundamental characteristic of action enquiry is that it is concerned with the improvement of practise. Here the upshot to draw attending to is that the choice and contribution of participants will determine the extent to which practice is captured and improved. Similar other participants, the researcher will piece of work hard to contribute to solutions. Because action research is concerned with existent practice, it is of import that the stakeholders are sufficiently represented. Dick (1997f) lists the informants, interpreters, planners, implementers, facilitators, researchers and recipients as functions that participants could take. This list provides ideas of stakeholders that could be involved. In practice, some participants could take on many roles.

The selection of people to be involved in action enquiry should, and ordinarily does, receive special attending. To meliorate manage activity research projects, professional action researchers develop skills related to human interaction issues, such as in conflict and communications management. The business of the activeness researcher with human interaction issues is a distinguishing feature of action research when compared with many other research methods.

Read full chapter

URL:

https://www.sciencedirect.com/science/article/pii/B9781876938420500174

Science and Cyber Security

Thomas W. Edgar , David O. Manz , in Inquiry Methods for Cyber Security, 2017

Cryptography

Cryptography is a field of research focused on developing secure advice algorithms and protocols. A fundamental part of this is cryptanalysis, which is the effort to study and discover ways to break cryptographic algorithms. Cryptography includes information theoretic and formal proof enquiry as well as enquiry into how to use these techniques without vulnerability. Encryption and data integrity came from this field of research.

Our hope is that this chapter provides a sufficient introduction to cyber security to provide context for the rest of the book. As this book is more than focused on providing information on the methods of rigorous research for researchers and practitioners, it is non a total introduction to the field of cyber security. There are many proficient books on the market that teach the theories of cyber security and central concepts more in depth. 20,21,22 Nosotros also provided a list of seminal papers nosotros retrieve provide a stiff foundation in cyber security in the Dig Deeper suspension-out box at the end of the chapter.

Dig Deeper: Seminal Cyber Security Work

Equally with every scientific field at that place is research that is performed that is an inflection point for hereafter enquiry. Beneath is a list of seminal papers that volition give y'all a solid foundation into cyber security enquiry. This list includes inquiry that had impacts that changed the mode the field thought about topics. This list is not meant to be a list of just adept research or interesting topics. A brief explanation of why the newspaper is seminal is provided per reference.

Title Author(southward) Seminality
Communication Theory of Secrecy Systems Claude Shannon
•

First formal statement of modern cryptography

•

Defined secrecy system, zippo, and how to determine the strength of secrecy organization from information theoretic perspective
The Protection of Information in Figurer Systems Jerome H. Saltzer, and Michael D. Schroeder
•

Introduces seminal secure design principles

•

Descriptor-based protection systems

•

Historical insights into computer security
Moore's Law (Cramming More than Components onto integrated circuits (1965) and Progress in Digital Integrated Electronics (1975)) Gordon Moore
•

Divers a model of processor development and progression

•

Provided a way to project computing capabilities into the futurity

•

A fundamental concept that has enabled the quantification of encryption security force
New Directions in Cryptography Whitfield Diffie and Martin Hellman
•

Kickoff idea for public-key cryptography

•

Defined Diffie–Hellman fundamental agreement protocol
A Method for Obtaining Digital Signatures and Public-Central Cryptosystems Ron Rivest, Adi Shamir, and Leonard Adleman
•

Divers RSA public-key arrangement

•

One of the most used public-key cryptographic systems
On Information Banks and Privacy Homomorphisms (1978) Ronald Rivest, Leonard Adleman, and Michael Dertouzos
•

Commencement paper defined homomorphic encryption
Fully Homomorphic Encryption Using Ideal Lattices (2009) Craig Gentry
•

2d paper defined the first practical fully homomorphic encryption scheme
The Byzantine Generals Problem Leslie Lamport, Robert Shostak, and Marshall Pease
•

Theoretical exploration of understanding nether adversarial threat

•

Defined limitations of trust in redundant systems

•

Does non solve the common vulnerability challenge
Smashing the Stack for Fun and Profit Aleph 1 (Elias Levy)
•

First widespread introduction to buffer overflows

•

Step-by-step discussion of the vulnerability and shell code

•

Exploration of the implications
On the Security of Public-Cardinal Protocols Danny Dolev and Andrew Yao
•

Theoretical exploration of attacks on public key protocols

•

Defined Dolev-Yao threat model that has become the threat model used for cryptographic protocols
A Computer Virus and a Cure for Computer Virus Fred Cohen
•

First definition of a virus

•

Proof of undecidability of detecting a virus (counter proof) by mapping to halting problem
The Foundations of Calculator Security: Nosotros Need Some Donald Good
•

Essay to complain about lack of potent foundations for applied science in figurer security (cyber security non a concept yet)

•

Surveyed how theoretically secure systems are not really secure

•

Proclaimed we need more theories before being able to engineer "secure" systems
Programming Satan's Computer Ross Anderson and Roger Needham
•

Theoretical exploration of timing, ordering, and oracle attacks

•

Ascertain principles for developing security protocols for integrity and authenticity using cryptography
The Base-Rate Fallacy and Its Implications for the Difficulty of Intrusion Detection Stefan Axelsson
•

Theoretical caption of the bug we have with IDS

•

With extreme ratio of noise to signal (attacks=black swan events) even if yous have a 100% detector yous still need extremely low false-positive rate to non be inundated with false-positive detections
Crimson Pill (2004) Joanna Rutkowska
•

Red pill demonstrated a method to notice that you lot were running as a guest virtual car

•

Bluish pill demonstrated malware becoming a hypervisor to running Bone dynamically
Introducing the Bluish Pill (2006)
The Science of Guessing: Analyzing an Anonymized Corpus of 70 Million Passwords Joseph Bonneau
•

Study that shows that regardless of subpopulation everyone choose equivalently weak passwords

•

An attacker is better off using a global password list

Read full affiliate

URL:

https://www.sciencedirect.com/science/article/pii/B9780128053492000029

Introduction to Software Engineering

Richard F. Schmidt , in Software Engineering, 2013

Systems engineering practitioners have adult a set of principles and practices that enable complex products to be designed and developed inside a projection framework. Many of the challenges encountered by the systems engineering community accept been resolved through years of rigorous enquiry, trial-and-error, and lessons learned from past failures. The software evolution challenges that are targeted to exist resolved by adopting these proven systems engineering practices include:

ane.

Establishing the structure of complex products.

ii.

Managing interfaces with external systems or products.

3.

Minimizing and mitigating risks to project success.

4.

Making informed decisions by considering design alternatives and performing trade-off analyses.

v.

Evaluating change requests and proposals in a formal manner, which enables the adoption of changes and maintains the scope of work to be performed within established budgets and timelines.

6.

Balancing the demands of a diverse group of stakeholders.

7.

Considering nonfunctional and product life-bicycle challenges during production pattern effort.

8.

Allocating performance characteristics among contributing components.

Read full chapter

URL:

https://world wide web.sciencedirect.com/scientific discipline/article/pii/B978012407768300001X

Navigation Map

Avi Parush , in Conceptual Pattern for Interactive Systems, 2015

Projection Direction Considerations

At this point, we have a conceptual model with the navigation map. Having conducted an evaluation and, when relevant, done some revisions, we can say we have a validated model. What is the affect of this step and its outcome?

We should consider several points with respect to what we tin can do with this issue. Remember, this is an interim upshot. We are still in the procedure and this is work in progress. By analogy, if nosotros view the process equally building a house, nosotros have just laid the foundation. The significance and impact of this foundational model are the post-obit:

ane.

We have a conceptual model founded on user research, rigorous methodology, and scientific underpinnings.

two.

We accept a conceptual model that has undergone a formative evaluation.

3.

We have a detailed sketch of the conceptual model nosotros can share with stakeholders.

4.

We have a well-divers framework with which we tin go on towards the detailed design.

5.

We have a well-defined framework within which we tin kickoff prototyping some parts of the production.

Equally we indicated in the previous footstep, the upshot here may not be concrete plenty for some team members and stakeholders to relate to. You can run ahead through the next steps for some of the elements in order to provide a more concrete analogy of the model. Just always brand sure that at the end, you do not skip the steps suggested to ensure a coherent conceptual model.

Navigation Map—Cardinal Applied Points

•

Outline the navigation map based on scenarios and workflows.

•

Include in the navigation map entry points, exit points, and routes that tin exist taken through the conceptual model.

•

Overlay the conceptual model diagram with arrows indicating all navigational information.

•

Validate the model and the navigation map past preparing a scenario with the model to evaluate with squad members and other stakeholders.

Read full chapter

URL:

https://www.sciencedirect.com/scientific discipline/commodity/pii/B9780124199699000164

A SURVEY OF 3D AND MULTIMODAL 3D+2d FACE RECOGNITION

In Face Processing, 2006

16.four.4 Summary

Every bit evidenced past the publication dates in Table 16.2 , activity in 3D and multimodal 3D+2D face up recognition has expanded dramatically in recent years. It is an expanse with important potential applications. At the same time, there are many challenging research problems all the same to exist addressed. These include the development of more practical and robust sensors, the evolution of improved recognition algorithms, and the pursuit of more rigorous experimental methodology. The development of improved recognition algorithms will be spurred by more rigorous enquiry methodology, involving larger and more than challenging datasets, and more than advisedly controlled performance evaluations.

In an application where 3D images of the confront are caused, it may be possible to also use 3D ear biometrics. Yan and Bowyer take looked at ear biometrics using 2D and 3D images, and at several different algorithmic approaches to for the 3D images [42]. The combination of 3D ear and 3D face is a form of multibiometric that has non yet, to our knowledge, been explored. Other 3D body features can too exist used. Woodard and Flynn [39] describe the use of 3D finger shaper as a biometric, and demonstrate good functioning with a correlation-based matcher.

At the fourth dimension that this is written, a number of research groups are working on 3D confront recognition using a big mutual dataset that incorporate substantial expression variation. Results from some of this work were presented at the Face Recognition Grand Challenge Workshop held in June of 2005 in association with the Estimator Vision and Pattern Recognition conference. The larger of the two 3D confront data sets used in the FRGC program to date contains over 4,000 images from over 400 subjects, with susbtantial facial expression variation represented in the data [29].

Read full chapter

URL:

https://world wide web.sciencedirect.com/science/article/pii/B9780120884520500170

Agendas: Political

F.R. Baumgartner , in International Encyclopedia of the Social & Behavioral Sciences, 2001

ii The Development of a Literature

Roger Cobb and Charles Elder (1972), in the first volume-length treatment of the political calendar, noted the difference between the systemic agenda, defined as the group of issues that were under give-and-take in gild, and the institutional agenda, or the set of bug being discussed in a particular authorities establishment (come across as well Cobb et al. 1976). Since and so, scholars have variously written most the public agenda, the media calendar, the legislative agenda, and whatever number of other agendas every bit they have focused on different political institutions.

More recent studies of calendar setting have moved abroad from the concepts of nondecisions and power considering of the difficulties inherent in designing rigorous research on the topic. Instead, scholars accept focused on the ascent and fall of problems on the public or institutional agendas and how decision making during high salience periods differs from the more routine conclusion making that takes place when an consequence is low on an agenda. Jack Walker (1977) provided one of the first statistically based studies in the area with his analysis of the US Senate's agenda. He noted that issues frequently rose on the Senate'southward agenda following heightened levels of discussion within professional communities.

John Kingdon'southward (1984) treatment of the public agenda set the phase for much of our current agreement of where problems come from. He emphasized the separate sources of policy problems from the solutions that may be offered to them. Government programs, he noted, come up nearly when a given solution is attached to a particular problem, and his analysis of health care and transportation policies in the USA showed only how unpredictable these couplings can exist. Political actors' search for popular issues, windows of opportunity open up and shut, stochastic events such every bit natural disasters or airplane crashes momentarily focus public attending on an issue. The confluence of many unrelated factors, often serendipitous, helps explain why a given policy is adopted, co-ordinate to his study. Kingdon's (1984) was the kickoff major book-length study on the topic since Cobb and Elder'due south (1972), and it was based on hundreds of interviews with government and other policymakers in the 1970s and 1980s. (Polsby 1984 besides reached many of these decision in a book actualization in the same year as Kingdon's.)

Frank Baumgartner and Bryan Jones (1993) provided the next major handling of political agendas in their assay of nine unlike policy areas over a 40-twelvemonth period. Utilizing publicly available sources such as media indices and records of congressional hearings, they noted how particular issues rose and fell on the agenda over the entire post-World War 2 menstruation. They developed a punctuated equilibrium model of policy change in which episodic periods of high calendar status typically were related to dramatic and long-lasting policy changes. During these high-salience periods, institutional procedures were oft created or contradistinct. The subsequent ebbing of the upshot from the public agenda enabled the newly empowered political institutions and policymakers to settle into stable routines of behavior persisting for decades at a time. Agenda setting was related to dramatic changes, oftentimes upsetting long-continuing routines of behavior and power by replacing them with new ones.

Read total affiliate

URL:

https://www.sciencedirect.com/science/commodity/pii/B0080430767010925

No middle basis? Perceptions and realities of the distinctions between tenured librarians and their professional colleagues

Peter Hepburn , in Workplace Culture in Academic Libraries, 2013

Groundwork

In order to frame subsequently discussion, information technology is helpful to provide insight on the current state of affairs at the University of Illinois at Chicago Library. Librarians at UIC fall into five categories: tenured/tenure-runway faculty, clinical track faculty, academic professionals, continuous appointments (lecturers and instructors), and visiting appointments (various ranks). The latter three do not confer faculty status. The first category of tenured and tenure-rail librarians outnumbers the other categories combined.

At UIC, tenured and tenure-track librarians have historically been those in public services, as well as others, such as bibliographers, who work closely with kinesthesia in other UIC colleges. The tenure track for faculty at UIC is usually a vi-year process with no subsequent reviews unless an associate professor attempts to be promoted to full professorship. Achieving tenure includes a rigorous research and publication requirement. Clinical runway librarians, by comparison, accept traditionally worked in technical services and other non-public positions. They undergo a similar review process to the tenure track, though there is less emphasis on enquiry and publication. Moreover, there is no incentive for clinical banana professors to ultimately be promoted to associate professorship and beyond. Clinical faculty do non enjoy the aforementioned task protection that tenured faculty enjoy and, in fact, may be terminated with minimal find. Equally noted, until 2011, the clinical ranks received less professional person evolution funding.

The non-faculty librarian ranks are scattered across the remaining iii categories and are not a homogeneous grouping. The academic professional ranks, for example, are not entirely made upwards of people belongings the Master of Library and Informatics degree merely practice include librarians. In recent years, the status of numerous academic professional positions across campus has been challenged, and, equally a result, the Library is considering options for these librarians, including moving some to the clinical rail. Academic professionals are invited (and oft expected) to participate in faculty activities but cannot serve on faculty committees and take no vote in faculty governance. At that place is no peer review for them comparable to the tenure or clinical tracks. They besides receive less funding for professional person evolution. 1 benefit accorded this category of librarians is generous termination notification, up to one year depending on length of service at the Library. As for the other ranks, continuous appointments are few in number and include office-fourth dimension positions. Like the academic professionals, these librarians are invited to faculty activities just are not technically considered faculty. Meanwhile, the gear up of librarians with visiting appointments frequently hold grant-driven positions. Their appointments are express to the terms of their contracts ("visiting" implies a unmarried-year condition), and they, too, receive a lower amount of professional development funding than do their faculty colleagues.

In the last decade at UIC, at that place has been an overall shrinkage of the professional person ranks and shifting in the relationships among the various ranks. Over time, some disparities, and resultant resentments, have come up to the surface, where they take been addressed. To see whether this was a mutual occurrence inside academic libraries, the author created a survey to query academic librarians on the varying statuses at their institutions, and what issue (if any) they idea this had on the organizational climate of their workplace. The author hypothesized that there remain deep and hidden divisions among librarians of differing ranks, and that those divisions have a significant touch on on the climate at academic libraries.

Read full chapter

URL:

https://world wide web.sciencedirect.com/science/article/pii/B9781843347026500150

Professing archives: A very human enterprise1

Ann Pederson , in Archives, 2005

Archival administration strand: A double-edged inheritance

We have seen how, in the early nineteenth century, public recordkeeping action was pragmatically separated into two operational domains: the function where records managers served the current needs of management; and the repository where archivists protected the evidence required for long-term organizational and cultural accountability and continuity and serviced the needs of the research community.

Through third qualifications emphasizing culture and history, traditional archivists and, to some extent, manuscript librarians, have caused the perspective, research methodology and values for understanding and exploiting archives as sources for wide-ranging enquiry, Historical study also provides substantial background knowledge needed for mastery of the content of records and/or agreement those from a specific context.

The value of this historical legacy is threefold. Showtime, good history demands rigorous research methodology, accuracy, objectivity and documentation of any opinions and interpretations drawn from a diversity of sources, peculiarly reliable records. These skills are valuable in whatsoever context, non just those concerned with heritage or cultural concerns. 2nd, history enables and imposes the added dimensions of perspective over time and underscores the cultural importance of recordkeeping, i.e. recordkeeping professionals ensure prove to promote responsibleness, responsiveness, continuity and memory in society. The archivists interpreted this role equally defending the cumulative human tape against distortion by potential enemies in any unmarried generation. Third, history commands a unique weapon – the emotional ability inherent in cultural objects. Equally most cultural managers will attest, many a battle to purchase, restore or develop has been won by harnessing and focusing this energy succinctly.

Historical heritage also has its drawbacks. Undertaking historical enquiry is often a solitary and guarded enterprise, seen by some as antonymous to approaches required by team-based direction. Furthermore, the combined bear upon of this with the bogus separation of the intellectual and technical aspects of record-making and the farther division of recordkeeping into separate repository and role domains had of import consequences for archivists. The initial truncation of making from keeping removed the archives and archivists from regular contact with the ongoing managerial processes of creating offices, shifting their orientation from economy and efficiency in the present to caretakers of 'onetime stuff' – material no longer required for the carry of mainstream business concern. The out-of-sight-out-of-mind isolation of repositories macerated managers' use of the archives and, correspondingly, their understanding of the value of them as essential corporate resources. This down screw has been termed the 'Cycle of Impoverishment', a vortex wherein marginalization results in fewer resources, undermines morale and degrades services. Often archival programs are lumped together with cash-strapped museums, historical societies, libraries and galleries equally not-for-profit 'civilization and heritage' bodies competing for decreasing public and philanthropic dollars. In worst-case scenarios, such archival operations may mirror the stereotype of an irrelevant 'boneyard of information' and be closed down.

Often feeling a flake isolated or devalued inside their own organizations, archivists turned to each other for succour, celebrating together their wider cultural role equally keepers of evidence of the by and reaching out to the academic and research communities for appreciation and support. As servants of scholarship, archivists nurtured relationships inside the historical profession who dominated the search rooms of early archives and manuscript collections attached to swell private or public libraries, historical societies and institutions of learning. Indeed, the traditional path to an archival career was completing tertiary report in some specialty of history, topped off with on-the-job or specialist training in a large, normally public, archival institution.

Cultivating academe did not always lead to more resource or to a better understood and satisfying professional status. The overarching archival 'mission' exposes archivists to a maelstrom of competing responsibilities, protecting the interests of records creators and depositors vs. safeguarding the evidence of organizational and cultural accountability vs. promoting the search for historical truths vs. keeping 1's job. Archivists can exist regarded with defoliation and some apprehension by record creators, arrangement managers – peculiarly those responsible for allocating resources to the archives, researchers and colleagues in related professions such as records management. Being too bookish, not team players and not having the welfare of the current organization foremost are mutual complaints made by internal critics. In short, lack of harmony amidst key groups whose cooperation and skilful will is vital for success can compromise archival interests.

Read full chapter

URL:

https://world wide web.sciencedirect.com/science/article/pii/B9781876938840500032

Volume 2

Vanessa E. Tater , ... Peter One thousand. Gibson , in Encyclopedia of Respiratory Medicine(Second Edition), 2022

Pharmacological Treatment of Asthma During Pregnancy

In general, the guidelines recommend the same treatment for pregnant women as for non-significant women (Murphy and Schatz, 2014). This includes prescribing controller medications where indicated (National Asthma Council, 2016). Asthma should exist assessed every iv   weeks during pregnancy and treatment adjusted as necessary using a stepwise approach (National Asthma Didactics and Prevention Program, 2005; National Asthma Council, 2016). Regarding exacerbations, the guidelines recommend intervening early and setting a low threshold for seeking medical help in a written asthma action plan. Due to the potential take a chance to both mother and child, exacerbations during pregnancy should be managed "aggressively" (National Asthma Education and Prevention Program, 2005 ). Yet, there is a dearth of robust and pregnancy-specific evidence supporting these recommendations, and more rigorous enquiry is required in the area of asthma direction in pregnancy to underpin future guideline recommendations.

Every bit meaning women are generally excluded from clinical trials, the pregnancy prophylactic information for most medications stems from observational studies (Namazy and Schatz, 2017). Every bit is common with many medications, information technology tin can be hard to distinguish negative effects of drug apply from negative effects of the indication they are used for (Gregersen and Ulrik, 2013). With all treatments, potential risks of medication use should be weighed against the potentially severe consequences of uncontrolled asthma during pregnancy (Gregersen and Ulrik, 2013).

Maternal asthma should be fairly treated, as the risk to the health of mother and fetus from asthma exacerbations is greater than the adventure posed past medication exposure (National Asthma Education and Prevention Program, 2005). Many of the most important drugs used in the treatment of asthma are generally considered rubber to use during pregnancy (Grzeskowiak et al., 2018; Labor et al., 2018; Therapeutic Goods Administration, 2019). Brusk-acting β-agonists (SABAs) are considered safe in pregnancy, with albuterol (salbutamol) being preferred (National Asthma Teaching and Prevention Program, 2005; Gregersen and Ulrik, 2013). On the other hand, the reproductive condom of long-acting β-agonists (LABAs) has not yet been conspicuously established (Gregersen and Ulrik, 2013). Yet, the studies regarding their reproductive rubber are by and large reassuring (Gregersen and Ulrik, 2013). Inhaled corticosteroids (ICS) are likewise considered prophylactic in medium to depression doses, with budesonide currently being the ICS with the greatest amount of safety evidence (Bonham et al., 2018). A recent systematic review of the literature showed that 41% of pregnant women with asthma use ICS (Robijn et al., 2019b). Some concerns accept been raised regarding the effects of high doses (Gregersen and Ulrik, 2013; Blais et al., 2009): high doses of ICS tin can produce systemic effects that can event in adverse pregnancy outcomes (National Asthma Teaching and Prevention Program, 2007). However, such high doses are used for the handling of severe, poorly controlled asthma, which in itself tin can negatively affect perinatal outcomes (Blais et al., 2009).

Oral corticosteroids (OCS), used for the handling of poorly controlled severe asthma or acute exacerbations of asthma, have been associated with an increased hazard for gestational diabetes, preeclampsia, preterm delivery, major congenital malformations, and dumb fetal growth (Rocklin, 2011; Bracken et al., 2003; Palmsten et al., 2020). However, as with all asthma drugs, the risks of drug treatment are outweighed past the benefits of improved asthma control and reduced risk of exacerbations. A small increased run a risk of congenital malformations has been suggested in children built-in to mothers with asthma, although this could not be explained by exposure to asthma medication, including exposure to OCS (Tata et al., 2008). The most recent publication examining the link between OCS use and the hazard of preterm nascence examined the influence of OCS dose and timing during pregnancy, using data from >   22,000 women with asthma in California (Palmsten et al., 2020). The risk of preterm nascence increased with increasing cumulative dose in the first one-half of pregnancy, and high dose OCS use remained significantly associated with preterm birth after adjustment for confounders. In the second one-half of pregnancy, neither OCS nor controller medication apply for asthma was associated with preterm nascency (Palmsten et al., 2020).

Despite the favorable adventure-benefit profile of asthma drugs, many women and healthcare professionals have concerns nearly the safety of asthma medication during pregnancy (Beckmann, 2002; Enriquez et al., 2006). Several studies accept revealed that non-adherence to asthma medication is widespread amid pregnant women (Sawicki et al., 2011, Murphy and Schatz, 2014; Enriquez et al., 2006; Murphy et al., 2005c; Robijn et al., 2019b; Zetstra-van der Woude et al., 2013) possibly due to concerns about potential adverse effects of medication. This puts women at an elevated risk for exacerbations and poor asthma control (Murphy and Schatz, 2014). A French database written report revealed that during the offset trimester, prescription of asthma medication decreased when compared to pre-pregnancy, and the type of prescribed medication changed: fixed-combinations were prescribed more rarely during pregnancy, whereas ICS were prescribed more frequently, representing a switch to better evaluated medications (Beau et al., 2017). A 2001 study set in the US suggested that some women reduced treatment during pregnancy although their illness severity warranted treatment continuation, and that reduction of treatment results in negative effects on pregnancy outcome (Olesen et al., 2001). Another study revealed that women were reluctant to utilize asthma medication during pregnancy even when their symptoms were worsening (Sawicki et al., 2012). Two Australian studies evaluating the experiences of pregnant women with asthma concluded that meaning women are non well informed or supported regarding management of their asthma during pregnancy (Murphy et al., 2005c; Lim et al., 2012).

The undertreatment of asthma during pregnancy may, at least in part, be a event of a lack of knowledge and/or conviction among doctors and other healthcare professionals regarding management of asthma in meaning women (Gregersen and Ulrik, 2013; Lim et al., 2011). Two studies have establish that significant women presenting at an emergency section (ED) with acute asthma exacerbations were significantly less likely to receive appropriate treatment with OCS than not-pregnant women (Cydulka et al., 1999; McCallister et al., 2011). Furthermore, pregnant women were most iii times more probable than not-meaning women to have persistent symptoms 2   weeks later an ED visit for an acute asthma exacerbation (OR 2.9, 95% CI 1.2–half dozen.eight) (Cydulka et al., 1999).

These findings highlight the need for both women and wellness care professionals to be well informed regarding asthma management during pregnancy. Good education regarding asthma cocky-direction can improve medication adherence, and in turn result in improve asthma control, which may meliorate outcomes for mothers and their babies (Rejnö et al., 2014; Murphy et al., 2005c).

Read full chapter

URL:

https://www.sciencedirect.com/science/article/pii/B9780081027233001074