Pollen Sources

This chapter reviews what is known about abundance and distribution of the 12 most important aeroallergenic pollens in Europe: Ambrosia, Alnus, Artemisia, Betula, Chenopodiaceae, Corylus, Cupressaceae/Taxaceae, Olea, Platanus, Poaceae, Quercus and Urtica/Parietaria. Abundance is based on 10 years of pollen records from 521 stations of the European Aeroallergen Network that were interpolated into 12 distribution maps covering most of Europe. The chapter compares the distribution maps with other types of distribution maps that are available for selected tree species and discuss two methods for making harmonized pollen source inventories: “bottom-up” and “top-down”. Both methods have advantages and disadvantages, and both need to be explored and further developed. Remote sensing has shown to be a valuable method to improve the inventories, especially the use of satellites. The full potential as well as limitations of remote sensing in relation to pollen sources remains to be explored. The review suggests that the most probable way of obtaining inventories of all 12 pollen species is to use top-down methods that use an ecosystem-based approach that for each particular species connects ecological preference, pollen counts and remote sensing.

Exercise Prescription for Patients with Non-specific Chronic Low Back Pain: a Qualitative Study of Patients' Experiences in Decision Making

Background The culture of current clinical practice calls for collaboration between therapists and patients, sharing power and responsibility. This paper reports on the findings of a qualitative study of exercise prescription for patients with NSCLBP, taking into account issues such as decision making and how this accords with patient preferences and experiences. Objective To understand the treatment decision making experiences, information and decision support needs of patients with NSCLBP who have been offered exercise as part of their management plan. Design A qualitative study using a philosophical hermeneutic approach. Methods Semi-structured interviews with eight patients (including use of brief patient vignettes) was undertaken to explore their personal experiences of receiving exercise as part of the management of their NSCLBP, and their involvement in decisions regarding their care. Findings The findings provide a detailed insight into patients’ perceptions and experiences of receiving exercise-based management strategies. Four themes were formed from the texts: (1) patients’ expectations and patients’ needs are not synonymous, (2) information is necessary but often not sufficient, (3) not all decisions need to be shared, and (4) wanting to be treated as an individual. Conclusions Shared decision making did not appear to happen in physiotherapy clinical practice, but equally may not be what every patient wants. The overall feeling of the patients was that the therapist was dominant in structuring the interactions, leaving the patients feeling disempowered to question and contribute to the decision making.