Featured in Course

• Abu-Hasan, M., Tannous, B., & Weinberger, M. (2005). Exercise-induced dyspnea in children and adolescents: If not asthma then what? Annals of Allergy, Asthma & Immunology, 94:366-371. 
• Allen, T. W. (2005). Sideline management of asthma. Current Sports Medicine Reports, 4, 301-304. [Abstract].
• American Academy of Pediatrics. (2022). National Resource Center for Patient/Family-Centered Medical Home.
• American Academy of Pediatrics. (2022). Children and COVID-19: State-Level Data Report.
• American Academy of Pediatrics. (2022).  Post-COVID-19 Conditions in Children and Adolescents: Interim Clinical Guidance.
• Basara, L., Jokić Begić, N., Popović Grle, S., Jakopović, M., & SamarŽija, M. (2018). Dyspnea from Neuropsychyatric Perspective: a Narrative Review. Psychiatria Danubina, 30(1), 11–20. 
• Blomberg, B., Mohn, K. G-I., Brokstad, K. A., Zhou, F., Linchausen, D. W., Hansen, B., . . . Langeland, N. (2021). Long COVID in a prospective cohort of home-isolated patients. Nature Medicine, 27, 1607–1613.
• Boehmer, T. K., Kompaniyets, L., Lavery, A. M., Hsu, J., Ko, J. Y., Yusuf, H.,  . . . Harris, A. M. (2021). Association Between COVID-19 and Myocarditis Using Hospital-Based Administrative Data — United States, March 2020–January 2021. Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR), 70(35), 1228–1232.
• Dantas, F. M. N. A., Correia, M. A. V., Silva, A. R., Peixoto, D. M., Sarinho, E. S. C., & Rizzo, J. A. (2014). Mothers impose physical activity restrictions on their asthmatic children and adolescents: an analytical cross-sectional study. Biomed Central Public Health, 14:287. 
• Ersson K., Mallmin, E., Malinovschi, A., Norlander, K., Johansson, H., & Nordang, L. (2020). Prevalence of exercise‐induced bronchoconstriction and laryngeal obstruction in adolescent athletes. Pediatric Pulmonology, 55, 3509–3516. https://onlinelibrary.wiley.com/doi/pdf/10.1002/ppul.25104
• Fitzgerald, D. A. (2017). The weighty issue of obesity in paediatric respiratory medicine. Paediatric Respiratory Review, 24(4), 4-7. [Abstract]
• Fretzayas, A., Moustaki, M., Loukou, I., & Douros, K. (2017). Differentiating vocal cord dysfunction from asthma. Journal of Asthma and Allergy, 10, 277-283. 
• Fukushi, I., Pokorski, M., & Okada, Y. (2021). Mechanisms underlying the sensation of dyspnea. Respiratory Investigation, 59(1), 66-80.
• Fukushi, I., Nakamura, M., & Kuwana, S. I. (2021). Effects of wearing facemasks on the sensation of exertional dyspnea and exercise capacity in healthy subjects. PLOS ONE, 16(9), e0258104.
• Gargano, J. W., Wallace, M., Hadler, S. C., Langley, G., Su, J. R., Oster, M. E., . . . Oliver, S. E. (2021). Use of mRNA COVID-19 Vaccine After Reports of Myocarditis Among Vaccine Recipients: Update from the Advisory Committee on Immunization. Centers for Disease Control and Prevention, Morbidity Mortality Weekly Report (MMWR), 70, 977–982.
• Gerow, M., & Bruner, P.J. (2021). Exercise Induced Asthma. StatPearls. StatPearls Publishing.
• Johansson, H., Emtner, M., Janson, C., Nordang, L., & Malinovschi, A. (2020). https://openres.ersjournals.com/content/6/4/00349-2020. ERJ Open Research, 6(4).
• Kaplan, A., Szefler, S. J. & Halpin, D. M. G. (2020). Impact of comorbid conditions on asthmatic adults and children. npj Primary Care Respiratory Medicine, 30(36).
• Koya, T., Ueno, H., Hasegawa, T., Arakawa, M., & Kikuchi, T. (2020). Management of Exercise-Induced Bronchoconstriction in Athletes. The Journal of Allergy and Clinical Immunology: In Practice,8(7), 2183-2192.
• Lam, G. Y., Befus, A. D., Damant, R. W., Ferrara, G., Fuhr, D. P., Stickland, M. K., . . . Smith, M. P. (2021). Exertional intolerance and dyspnea with preserved lung function: an emerging long COVID phenotype?  Respiratory Research, 22(222).
• Lands, L. C. (2017). Dyspnea in Children: What is driving it and how to approach it. Paediatric Respiratory Reviews, 24, 29-31. [Abstract]
• Lang, J. E., Bunnell, H. T., Hossain, M. J., Wysocki, T., Lima, J. J., Finkel, T. H., . . . Bacharier, L. (2018). Being Overweight or Obese and the Development of Asthma. Pediatrics, 142(6). 
• Law, Y. M., Lal, A. K., Chen, S., Čiháková, D., Cooper Jr., L. T., Deshpande, S., . . . Towbin, J. A. (2021). Diagnosis and Management of Myocarditis in Children: A Scientific Statement from the American Heart Association. Circulation, 144(6).
• Lentferink, Y. E., Boogaart, N. E., Balemans, W., Knibbe, C., & van der Vorst, M. (2019). Asthma medication in children who are overweight/obese: justified treatment? BMC pediatrics, 19(1), 148. 
• Lucas, J. A., Marino, M., Fankhauser, K., Bailey, S. R., Ezekiel-Herrera, D., Kaufmann, J., . . . Heintzman, J. (2020). Oral corticosteroid use, obesity, and ethnicity in children with asthma. The Journal of Asthma, 57(12), 1288–1297.
• Malaty, J., & Wu, V. (2021). Vocal Cord Dysfunction: Rapid Evidence Review. American Family Physician, 104(5), 471-475.
• Marines-Price, R., Bernhardt, V., Bhammar, D. M., & Babb, T. G. (2019). Dyspnea on exertion provokes unpleasantness and negative emotions in women with obesity. Respiratory Physiology & Neurobiology, 260, 131-136.
• Marlow, L. L., Faull, O. K., Finnegan, S. L., & Pattinson, K. (2019). Breathlessness and the brain: the role of expectation. Current opinion in supportive and palliative care, 13(3), 200–210.
• National Heart, Lung, and Blood Institute. (2020). Focused Updates to the Asthma Management Guidelines: Clinician's Guide.
• National Heart, Lung, and Blood Institute. Guidelines for the Diagnosis and Management of Asthma 2007 (Expert Panel Report-3)
• National Heart, Lung, and Blood Institute. (n.d.). National Asthma Education and Prevention Program.
• Olin, T. (2022). Exercise-induced laryngeal obstruction. Uptodate.com.
• Olin, T. (2019). Exercise-Induced Laryngeal Obstruction: When Pediatric Exertional Dyspnea Does not Respond to Bronchodilators. Frontiers in Pediatrics, 7.
• Røksund, O. D., Olin, J. T., & Halvorsen, T. (2018). Working Towards a Common Transatlantic Approach for Evaluation of Exercise-Induced Laryngeal Obstruction. Immunology and Allergy Clinics of North America, 38(2): 281-292.
• Sayad, E., & Das, S. (2022). Exercise Induced Laryngeal Obstruction. StatPearls. StatPearls Publishing.
• Seear, M., Wensley, D., & West, N. (2005). How accurate is the diagnosis of exercise induced asthma among Vancouver schoolchildren? Archives of Disease in Childhood, 90, 898–902. 
• Sharma, S., Hashmi, M. F., & Badireddy, M. (2021).  Dyspnea on Exertion. StatPearls. StatPearls Publishing.
• Slas, E., Nguyen, Y., & McIltrot, K. (2022). Communication Between Schools Nurses and Health Care Providers on Students with Asthma: An Integrative Review. The Journal of School Nursing: The Official Publication of the National Association of School Nurses, 38(1), 48–60. [Abstract]
• Trevisan, C., Vianello, A., Zanforlini, B. M., Curreri, C., Maggi, S., Noale, M., . . . De Rui, M. (2020). The mutual association between dyspnea and depressive symptoms in older adults: a 4-year prospective study. Aging & mental health, 24(6), 993–1000. [Abstract]
• Van de Hei, S. J., Flokstra-de Blok, B. M. J., Baretta, H. J., Doornewaard, N. E., Van der Molen, T., Patberg, K. W., . . . Kocks, J. W. H. (2020). Quality of spirometry and related diagnosis in primary care with a focus on clinical use. npj Primary Care Respiratory Medicine, 30(22).
• Volerman, A., Carpenter, D., & Press, V. (2020). What can be done to impact respiratory inhaler misuse: exploring the problem, reasons, and solutions. Expert Review of Respiratory Medicine, 14(8), 791–805.
• Vollsæter, M., Stensrud, T., Maat, R., Halvorsen, T., Røksund, O. D., Sandnes, A., & Clemm, H. (2022). Exercise Related Respiratory Problems in the Young—Is It Exercise-Induced Bronchoconstriction or Laryngeal Obstruction? Frontiers in Pediatrics; 9:800073.
• Witberg, G., Barda, N., Hoss, S., Richter, I., Wiessman, M., Aviv, Y., . . .  Kornowski, R. (2021). Myocarditis after Covid-19 Vaccination in a Large Health Care Organization. New England Journal of Medicine, 385, 2132-2139.

Medical Definitions

The medical definitions provided in this module were obtained or adapted from American College of Allergy, American Psychological Association, Asthma & Immunology; American Thoracic Society; Britannica, Free Medical Dictionary; Mayo Clinic; Merck Manual, National Institutes of Health, Neurology, Respiratory Physiology & Neurobiology, Science Direct, U.S. Department of Health and Human Services’ Centers for Medicare & Medicaid Services; U.S. National Library of Medicine and WebMD.

Continuing Medical Education

The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians. 

The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 1.00 contact hour(s) of Continuing Nursing Education.

Social Workers

The Texas Department of State Health Services, Continuing Education Service, the continuing education provider, ensures that the education provided is directly related to the practice of social work; and that the individuals presenting the information have the necessary experience and knowledge in the topics presented. The Texas Department of State Health Services, Continuing Education Service has awarded 1.00 hours of credit.

Certificate of Attendance

The Texas Department of State Health Services, Continuing Education Service has designated 1.00 hour(s) for attendance.

General Disclosure

One of the requirements of continuing education is disclosure of the following information to the learner:

1. Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
   • Create a Texas Health Steps account.
   • Complete on-line registration process.
   • Thoroughly read the content of the module.
   • Complete the on-line examination.
   • Complete the evaluation.
2. Commercial Support.
   The THSTEPS Web-based Continuing Education Series has received no commercial support.
3. Disclosure of Relevant Financial Relationships.
   The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose.
4. Non-Endorsement Statement.
   Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center.
5. Off-Label Use.
   Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).

The following are policies and definitions of terms related to continuing education disclosure:

The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.

All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.

Glossary of Terms

Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.

Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.

Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.

Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).

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