as in previous studies,7'8 we compared peak expiratory flow rates over seven day periods during respiratory episodes and control periods. By doing this we may have failed to recognise brief asthma exacerbations with modest decreases in peak expiratory flow rate, but we were less likely to include as exacerbations variability in airflow related to poorly controlled asthma.None of the previous studies in adults tested for coronaviruses, and Huhti et al did not culture for rhinoviruses.5 In our study, identifications of rhinoviruses by seminested reverse transcriptase polymerase chain reaction and coronaviruses by ELISA improved the diagnosis of both viruses and enabled us to show that they are important causes of respiratory disease leading to exacerbations of asthma in adults as well as in children.2A2425 Given the far better performance of polymerase chain reaction than conventional diagnostic techniques, the newer molecular methods should greatly facilitate research in this important area.This work was in part supported by the British Lung Foundation and the Cystic Fibrosis Trust. We thank Mrs L Jacklin for excellent technical assistance; Drs J Wales,

During menopause and midlife, female workers, particularly those in low-paid jobs, experience more occupational health problems than other groups of workers. Workplace interventions are often lacking, however. In the Netherlands, a workplace health promotion intervention—the work–life program (WLP)—has been developed to support female workers. Here, we tailored the WLP to the needs of female workers in low-paid jobs working at Amsterdam University Medical Center. In an exploratory mixed-methods study with a convergent design, among 56 participants, we used questionnaires before and after the intervention and semi-structured, in-depth interviews to address the following research question: What is the impact of the WLP on the women’s health and work functioning? Our quantitative data showed that menopausal symptoms improved significantly after the WLP. Our qualitative data, derived from 12 participants, showed that the WLP initiated a process of mental empowerment that initiated positive changes in four domains: behavior, physical health, mental wellbeing, and in the workplace. Taken with caution, our findings suggest that the WLP mentally empowers female workers to make choices that enhance their health and wellbeing, both at work and in their private lives, as summarized in the quote of one participant: “I get that spirit in me!”.

Workplace health promotion (WHP) may be an appropriate way to support women with a low socioeconomic position (SEP) during midlife. Little is known about reaching and engaging women in WHP, particularly not at the intersection of midlife, low SEP, and ethnicity. We initiated the ProudWoman project, in which we implemented a WHP intervention aimed at supporting midlife women as a pilot in an academic hospital. We qualitatively evaluated the implementation using the RE-AIM framework. The pilot comprised multiple steps: tailoring the intervention to the needs of ethnically diverse group of midlife women with a low SEP, developing an implementation protocol, implementing the tailored intervention, and evaluating the implementation process. The main findings of our study are: (1) due to a wide range of recruitment activities that were actively deployed, we were able to reach an ethnically diverse group of midlife women with a low SEP; (2) regarding adoption, awareness of the relevance of this topic as an occupational health challenge was not self-evident at the organizational level; (3) according to our participants, various facilitators and barriers should be taken into account in the implementation of the work–life program; and (4) our focus group discussion revealed as maintenance is relevant to these levels in different ways, awareness of midlife and menopause as an occupational health challenge should be raised at four professional levels. We conclude that elements, such as an active and personal recruitment approach, are important in the implementation of WHP for ethnically diverse midlife women with an SEP.

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