An exploration of the positive and negative relationships associated with the development of asthma and atopic disorders in primary school children in Cork

Childhood asthma, allergic rhinitis and eczema are complex heterogenic chronic inflammatory allergic disorders which constitute a major burden to children, their families. The prevalence of childhood allergic disorders is increasing worldwide and merely rudimentary understanding exists regarding causality, or the influence of the environment on disease expression. Phase Three of the International Study of Asthma and Allergy in Childhood (ISAAC) reported that Irish adolescents had the 4th highest eczema and rhinoconjunctivitis prevalence and 3rd highest asthma prevalence in the world. There are no ISAAC data pertaining to young Irish children. In 2002, Sturley reported a high prevalence of current asthma in Cork primary school children aged 6-9 years. This thesis comprises of three cross-sectional studies which examined the prevalence of and associations with childhood allergy and a quasi-retrospective cohort study which observed the natural history of allergy from 6-9 until 11-13 years. Although not part of ISAAC, data was attained by parentally completed ISAAC-based questionnaires, using the ISAAC protocol. The prevalence, natural history and risk factors of childhood allergy in Ireland, as described in this thesis, echo those in worldwide allergy research. The variations of prevalence in different populations worldwide and the recurring themes of associations between childhood allergy and microbial exposures, from farming environments and/or gastrointestinal infections, as shown in this thesis, strengthen the mounting evidence that microbial exposure on GALT may hold the key to the mechanisms of allergy development. In this regard, probiotics may be an area of particular interest in allergy modification. Although their effects in relation to allergy, have been investigated now for several years, our knowledge of their diversity, complex functions and interactions with gut microflora, remain rudimentary. Birth cohort studies which include genomic and microbiomic research are recommended in order to examine the underlying mechanisms and the natural course of allergic diseases.

Spinoza on method and freedom

The thesis as a whole argues that Spinoza’s Ethics in both method and content is aimed at the normal, partly rational person. Chapter 1 is on Spinoza’s writing style, finding that rather than being arid and technical, it aims to convince the reader by means of various rhetorical techniques, so does not assume an already rational reader. The following chapters of Part 1 examine whether the Ethics’ use of the synthetic geometric method exposes it to Descartes’ critique of that method in the “Second Replies” to his Meditations, that it is not suitable for pedagogy. This involves a consideration of the role of the TIE, finding in that early text not the analytic wing of a two-part analytic-synthetic method, but rather a defence and necessitation of a stand-alone synthetic method. Part 2 of the thesis develops this study of Spinoza’s writing for the common man to consider whether he is writing about the common man. This is done by examining one of the seemingly most abstract propositions in the Ethics, 4P72, which claims that a free man will not deceive even to save his own life. The study examines who exactly is this “free man” and what is his role in the Ethics. The study looks at the examples of free men in the TTP and at the concept of the model in the Ethics, and finds that rather than the free man being an impossible ideal which we can aim at but never achieve, everyone is free to some extent, and that even normal people are at times “the free man”.