Dissertations / Theses on the topic 'Asthma Prevention'
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1
Wang, Wei-qing. "Prevention therapy on bone loss in asthmatic patients on high dose inhaled steroids /." Hong Kong : University of Hong Kong, 1997. http://sunzi.lib.hku.hk/hkuto/record.jsp?B18540028.
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Amenyah, Augustine M. "Asthma Prevalence: Focus on Prevention Management in Community Settings." Digital Archive @ GSU, 2011. http://digitalarchive.gsu.edu/iph_theses/203.
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Asthma prevalence continues to increase across the United States of America, affecting more than 43.1 million people and projected to affect over 50 million people by 2025. Asthma prevalence differs by demographic characteristics, such as race, ethnicity, socio-economic status, education, age and gender. Poor quality of life is common among people who suffer from asthma, in addition to school and work absenteeism. In 2008, children 5-17 years old with at least one reported asthma attack missed 10.5 million school days in the past year (CDC, 2010). Healthcare use for asthma is high and disparities remain in asthma healthcare use and reimbursement. In community settings, reimbursement for asthma education and prevention has been problematic due to current reimbursement mechanisms (Bodenheimer et al. (2003); Halterman (2010); CDC (2011) and Laster et al. 2010) that do not go far enough in assisting low-income communities manage their asthma medically nor have uniform standards for billable services associated with asthma management provided by both healthcare professionals and public health workers. A change in reimbursement policy is advocated and the evidence for the effectiveness of community health workers in asthma management is examined.
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Scott, Martha. "The primary prevention of asthma and associated allergic disease." Thesis, University of Southampton, 2013. https://eprints.soton.ac.uk/374749/.
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王衛慶 and Wei-qing Wang. "Prevention therapy on bone loss in asthmatic patients on high dose inhaled steroids." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1997. http://hub.hku.hk/bib/B31214691.
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Conlin, Tim. "Prevention of exercise-induced asthma in an outdoor environment following bronchodialator use in asthmatic children." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1020158.
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The purpose of this study was to determine if exercise-induced asthma (EIA) could be prevented in an outdoor environment in asthmatic children attending a summer camp 3 hours after their usual dose of medication. Most studies that test for ETA are done in a controlled environment which may make results not applicable to asthmatic children who spend a lot of their time outside. The relationship of aerobic fitness and level of activity to the severity of EIA were also examined. A total of 25 subjects (10.9+0.9 yrs, M±SD) were tested. Subjects were instructed to run around a grass field circular course (0.1 mile) for 5 minutes. The subjects could stop at any time. Baseline measurements of heart rate, respiratory rate and peak flow were determined before the test and at 1, 5, and 10 minutes following the end of the run. A fall in peak flow of >10% from baseline was considered positive for EIA. A total of 14 subjects experienced EIA following the run. There were no significant differences between the group who experienced EIA and those who did not in terms of heart rate, respiratory rate, or distance run. There was a significant difference between peak flow recordings as expected. Aerobic fitness and physical activity were not related to the severity of EIA. The results of this study suggests that additional medications may be needed to prevent EIA in these children in order to allow participation in activities which may produce EIA. Moreover, 3 hours may be beyond the protection time limit for some asthmatic children.School of Physical Education
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Malkovych, N. M. "Nebuliser therapy for prevention and treatment of viral-induced bronchial asthma exacerbation." Thesis, БДМУ, 2017. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/17101.
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Bolcas, Paige. "Pathogenesis and Treatment Strategies for Difficult-to-Treat Asthma." University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1561393922642685.
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Kuiper, Sandra. "Family history of asthma prognostic impact in infants and cost-effectiveness of primary prevention /." [Maastricht : Maastricht : Universiteit Maastricht] ; University Library, Universiteit Maastricht [host], 2007. http://arno.unimaas.nl/show.cgi?fid=7930.
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Neffen, Hugo, Carlos Fritscher, Francisco Cuevas Schacht, Gur Levy, Pascual Chiarella, Joan B. Soriano, and Daniel Mechali. "Asthma control in Latin America: the Asthma Insights and Reality in Latin America (AIRLA) survey." Pan American Health Organization, 2005. http://hdl.handle.net/10757/625754.
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Objectives. The aims of this survey were (1) to assess the quality of asthma treatment and control in Latin America, (2) to determine how closely asthma management guidelines are being followed, and (3) to assess perception, knowledge and attitudes related to asthma in Latin America. Methods. We surveyed a household sample of 2 184 adults or parents of children with asthma in 2003 in 11 countries in Latin America. Respondents were asked about healthcare utilization, symptom severity, activity limitations and medication use. Results. Daytime asthma symptoms were reported by 56% of the respondents, and 51 % reported being awakened by their asthma at night. More than half of those surveyed had been hospitalized, attended a hospital emergency service or made unscheduled emergency visits to other healthcare facilities for asthma during the previous year. Patient perception of asthma control did not match symptom severity, even in patients with severe persistent asthma, 44.7% of whom regarded their disease as being well or completely controlled. Only 2.4% (2.3% adults and 2.6% children) met all criteria for asthma control. Although 37% reported treatment with prescription medications, only 6% were using inhaled corticosteroids. Most adults (79%) and children (68%) in this survey reported that asthma symptoms limited their activities. Absence from school and work was reported by 58% of the children and 31% of adults, respectively. Conclusions. Asthma control in Latin America falls short of goals in international guidelines, and in many aspects asthma care and control in Latin America suffer from the same shortcomings as in other areas of the world.Revisión por pares
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Lulham, George W. "The effect of cytokine administration on treatment and prevention of asthma in a sensitized mouse model." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0008/NQ52173.pdf.
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Cooper, Heather L. "Evidence-based practice and asthma guideline adherence and barriers a study of a university family practice clinic /." Laramie, Wyo. : University of Wyoming, 2007. http://proquest.umi.com/pqdweb?did=1400966251&sid=1&Fmt=2&clientId=18949&RQT=309&VName=PQD.
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Lau, Susanne. "Die Entwicklung des kindlichen Asthma bronchiale unter der besonderen Berücksichtigung der Innenraumallergen-Exposition." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2002. http://dx.doi.org/10.18452/13793.
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Die Prävalenz allergischer Erkrankungen und des Asthma bronchiale haben bei Kindern und Jugendlichen in den letzten 20 Jahren deutlich zugenommen. Ursächlich scheinen dafür eher veränderte Umweltfaktoren als genetische Mutationen verantwortlich zu sein. Faktoren des Lebensstils, die sich in den letzten 50 Jahren gewandelt haben, wie z. B. Abnahme von schweren Infektionserkrankungen durch Verbesserung der Hygiene und Entwicklung von Antibiotika, Adipositas und Bewegungsmangel, Abnahme der Familiengröße, veränderte Ernährungsgewohnheiten und eine Zunahme der Innenraumallergen-Konzentration durch bauliche Veränderungen kommen als potentielle Risikofaktoren in Betracht. In einer prospektiven Geburtskohortenstudie (Multizentrische Allergiestudie MAS90) untersuchten wir relevante Expositionsfaktoren wie z. B. Milben- und Katzenallergene im Hausstaub, frühkindliche Infekte und vieles mehr in Hinblick auf die Entstehung des kindlichen Asthma bronchiale. Von den ursprünglich im Jahr 1990 rekrutierten 1314 Neugeborenen lagen uns zum Zeitpunkt 7. Geburtstag von 939 Kindern komplette Informationen vor. Die regelmäßigen Untersuchungen umfassten jährliche Interviews und Blutentnahmen zur Bestimmung von spezifischem Serum-IgE gegen Nahrungsmittel- und Inhalationsallergene und die Quantifizierung von Hausstaubmilben (Dermatophagoides)- und Katzenallergenen im Teppich- und Matratzenstaub an mehreren Zeitpunkten. Im Alter von 7 Jahren wurde bei 645 Kindern eine Lungenfunktionsuntersuchung sowie die Messung der bronchialen Überempfindlichkeit mit Hilfe der Histamin-Provokation gemessen. Bei 10% (94 von 938) der 7-Jährigen trat eine pfeifende Atmung im Beobachtungszeitraum der letzten 12 Monate vor der Untersuchung auf, 6,1% (57 von 939) der Kinder hatten die Arztdiagnose "Asthma bronchiale". Eine Sensibilisierung gegen Innenraumallergene war mit Asthma bronchiale und erhöhter bronchialer Empfindlichkeit assoziiert, es gab jedoch keine Beziehung zwischen der Asthmaprävalenz und der Höhe der Milben- oder Katzenallergenexposition im Hausstaub. Unsere Ergebnisse geben keinen Anhalt für eine kausale Beziehung zwischen Innenraumallergenen und der Entwicklung des kindlichen Asthma bronchiale. Vielmehr scheinen allergische Immunantwort und die Manifestation eines Asthma bronchiale von unterschiedlichen genetischen und Umweltfaktoren beeinflusst zu werden. Die Vermeidung von Innenraumallergenen im Rahmen von Sekundär- und Tertiärprävention scheint weiterhin sinnvoll zu sein, jedoch scheint der Erfolg von Allergenreduktion im häuslichen Milieu hinsichtlich der Senkung der Asthmaprävalenz im Kindesalter zweifelhaft. Beim allergisches Asthma bronchiale als Th2-Erkrankung des Immunsystems scheinen insbesondere immunmodulatorische Faktoren wie frühkindliche Infektionen bzw. hoher Endotoxinexposition oder anderen Faktoren, die Gen-Umweltinteraktion und Suszeptibilität des Individuums beeinflussen, von Bedeutung zu sein.Epidemiological surveys indicate that there has been a notable increase in the prevalence of both asthma and other allergic symptoms in children and young adults. Since it seems unlikely that genetic factors contribute to the rising trend, environmental factors might play a major part in the development of childhood asthma. Several potential determinants have been proposed, such as lack of severe and repeated infections, obesity and lack of physical exercise, decreased family size, changing dietary habits, and increase of indoor allergen exposure. In a prospective birth-cohort study, we assessed the relevance of different exposures like mite and cat allergen exposure and early infectious diseases for the development of childhood asthma up to the age of 7 years. Of 1314 newborn infants enrolled in five German cities in 1990, follow-up data at age 7 years were available for 939 children. Assessments included repeated measurements of specific IgE to food and inhalant allergens, measurement of indoor allergen exposure at 6 months, 18 months, and 3 years of age, and yearly interviews by a paediatrician. At age 7 years, pulmonary function was tested and bronchial hyper-responsiveness was measured in 645 children. At age 7, the prevalence of wheezing in the past 12 months was 10 % (94 of 938), and 6.1 % (57 of 939) parents reported a doctor`s diagnosis of asthma in their children. Sensitization to indoor allergens was associated with asthma, wheeze, and increased bronchial hyper-responsiveness. However, no relation between early indoor allergen exposure and the prevalence of asthma, wheeze, and bronchial-hyperresponsiveness was seen. Our data do not support the hypothesis that exposure to environmental allergen causes asthma in childhood, but rather the induction of specific IgE responses and the development of childhood asthma are determined by independent factors. Indoor allergen avoidance is recommendable as first line of treatment in secondary and tertiary prevention, however, conclusions should be drawn with caution about the possible effect of primary prevention measures. As allergic asthma seems to be a Th2-disease, immunomodulating factors like early childhood infections and LPS-exposure or other factors influencing gene-environment interaction and individual susceptibility seem to be relevant for the development of childhood asthma.
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Maas, Tanja. "Prevention of asthma in genetically susceptible children (PREVASC)? a multi-faceted trial on environmental exposure reduction suitable for implementation in general practice /." Maastricht : Maastricht : Universitaire Pers ; University Library, Universiteit Maastricht [host], 2008. http://arno.unimaas.nl/show.cgi?fid=13441.
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Cardoso, Maria da Conceição Alves. "Active cycle breathing techniques como técnica de higiene brônquica na asma: estudo piloto." Master's thesis, Faculdade de Ciências Médicas. Universidade Nova de Lisboa, 2011. http://hdl.handle.net/10362/6986.
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RESUMO: Relevância e Objectivos: O objectivo deste estudo consistiu em verificar a
eficácia e segurança de uma técnica de higiene brônquica – Active Cycle
breathing technique (ACBT), na remoção de secreções e desinsuflação em crianças asmáticas. É uma técnica recente, que ainda não foi estudada nesta população.
Metodologia: A amostra foi constituída por um total de 14 crianças, com idades
compreendidas entre os 6 e 18 anos, com o diagnóstico de asma. Foi dividida em dois grupos: grupo de controlo, constituído por asmáticos estáveis e grupo experimental constituído por asmáticos pós-crise. Ambos receberam o mesmo tratamento, que consistiu numa única sessão de ACBT. Realizaram um exame da função respiratória (variáveis FEV1, PEF, MEF75%, RV e FRC) antes e após
a aplicação da técnica. Mediu-se a Saturação de O2 antes, a meio e no fim da aplicação da técnica. Por último, pesaram-se as secreções recolhidas durante a sessão de tratamento.
Resultados: Como resultados, quando omparamos o antes e após aplicação do ACBT, obtivemos diferenças significativas no RV (p <0,05) e FRC (p <0,05); muito significativa na Sa02 (p <0,01) e peso de secreções, nos asmáticos pós crise. Ocorreu uma melhoria significativa da saturação (p <0,05) em asmáticos estáveis, não havendo secreções. Não houve efeitos adversos nem broncoespasmo em ambos os grupos.Conclusão: O ACBT é uma técnica que promove a remoção de secreções e
diminuição da insuflação na população de asmáticos.--------------------ABSTRACT:Relevance and Goals: the goal of this study was to verify the efficiency and security of a bronchial hygienic technique - Active Cycle Breathing Technique (ACBT) – in the obstruction and insufflation of asthmatic children. This is a new technique that has not yet been studied in this population.
Procedures: The subjects were 14 children aged between 6 and 18 years old with asthma diagnosis. They were divided in two groups: the control group with stable asthmatics and the experimental group with post-crisis asthmatics. Both received the same treatment that was a single session of ACBT. They made a lung function test before and after the application of the technique (variables
FEV1, PEF, MEF75%, RV and FRC). The level of O2 saturation was measured before, during and after the procedure. In the end, the secretions collected during the treatment were weighted.
Results: We observed a significant difference on RV (p ˂0,05), FRC (p ˂0,05),
Sa02 (p ˂0,01) and in the weight of the secretions in the post-crisis asthmatics
after ACBT. There was a significant improvement of saturation (p ˂0,05) only in
the stable asthmatics. There were no adverse effects or bronchospasm in both groups.
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Navaratnam, Prakash. "Predictors of the prescribing of asthma pharmacotherapy in the ambulatory patient population of the United States." Columbus, Ohio : Ohio State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1171582748.
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Veeranki, Sreenivas P., Shimin Zheng, Yan Cao, and Arsham Alamian. "Association of Serum Vitamin D Levels with Respiratory and Atopic Diseases." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/91.
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Background: Vitamin D is known to be associated with inflammatory diseases, but its relationship with allergic diseases is unclear. The study objective is to determine the association of serum vitamin D levels and markers of wheeze, asthma and atopy.
Methods: Data (n = 9,463) on serum vitamin D levels and atopy were obtained from 2005-2006 National Health and Nutrition Examination Survey. Serum vitamin D level was categorized into four groups: Normal (≥30ng/ml), Insufficient (21-29ng/ml), Deficient (11-20ng/ml) and Severely Deficient (≤10ng/ml). Atopy was defined as at least 1 positive allergen-specific IgE level measured for a panel of 5 common aeroallergens- cat, dog, house dust mite, cock roach and Alternaria species. Doctor-diagnosed asthma and wheeze in the previous 12 months were assessed by means of questionnaire. Multivariable logistic regression analyses were conducted to investigate the association of serum vitamin D with wheeze, asthma and atopy adjusting for age, sex, race, smoking, outdoor physical activity, body mass index and poverty income ratio.
Results: Overall, 15%, 14% and 28% of subjects had wheeze, asthma and atopy, respectively. Approximately 21% had normal serum vitamin D levels, while 35%, 28% and 5% had insufficient, deficient and severely deficient levels. Compared to subjects with normal vitamin D levels, those with insufficient, deficient and severely deficient levels had increased relative odds of wheeze and atopy with highest adjusted estimates in subjects with severe vitamin D deficiency (adjusted odds ratio [OR] 2.31, 95% Confidence Interval [CI] 1.73-3.10 for wheeze; OR 1.49, 95% CI 1.17-1.89 for atopy).
Conclusion: Low serum vitamin D levels were found to be associated with wheeze and atopy. Findings contribute to ongoing efforts to understanding the role of vitamin D in atopic diseases.
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Maître, Anne. "Les peintures polyuréthanes en réparation automobile : développement de méthodes d'évaluation des niveaux d'exposition et approche de la toxicité humaine." Université Joseph Fourier (Grenoble), 1996. http://www.theses.fr/1996GRE10147.
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L'asthme aux isocyanates represente la premiere cause d'asthme chimique professionnel, et les peintres en reparation automobile constituent la population la plus exposee. Si la grande reactivite chimique des isocyanates explique leurs nombreuses applications industrielles, elle est egalement la cause de la diversite des mecanismes d'action toxique et de la meconnaissance des transformations metaboliques chez l'homme. La methode retenue pour evaluer les niveaux d'exposition atmospherique aux polyisocyanates est le barbotage de l'air dans une solution de methoxyphenylpiperazine, suivi d'une analyse par chromatographie liquide avec une detection ultraviolette. Alors que le dosage urinaire de l'hexane diamine a pu etre valide en tant qu'indicateur biologique d'exposition a l'hexamethylene diisocyanate, aucune surveillance biologique aux polyisocyanates n'est actuellement possible. Pendant l'application au pistolet des peintures polyurethanes, l'exposition des peintres aux isocyanates est tres elevee. La performance technique de la ventilation de la cabine, mais egalement le volume et la position des subjectiles par rapport aux grilles d'extraction jouent un role primordial. Le port d'une protection respiratoire individuelle nous semble indispensable pour diminuer l'incidence de l'asthme aux isocyanates.
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Gay, Stéphan. "Malades asthmatiques : connaissances et comportements thérapeutiques, incidences pour la prévention." Bordeaux 2, 1997. http://www.theses.fr/1997BOR2P051.
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Walters, Gareth Iestyn. "Barriers to the identification of occupational asthma." Thesis, University of Birmingham, 2015. http://etheses.bham.ac.uk//id/eprint/5703/.
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Occupational asthma (OA) is associated with an estimated annual societal cost in the UK of £100 million, which is avoidable if workers are identified quickly and removed from exposure to a sensitizing agent. The aim of this work was to identify barriers to diagnosing OA on the part of workers and healthcare professionals. The first study evaluated current practice in assessing working-age asthmatics for OA in a West Midlands primary care population. There was poor enquiry regarding occupation (14% of cases) and the effect of work on asthma symptoms (2%). The second study used qualitative methodology to explore beliefs and behaviours in symptomatic workers. Major influences on workers’ health seeking behavior were (1) understanding of their symptoms, (2) working relationships, (3) course of action with symptoms and (4) negotiation with healthcare professionals. The third study defined the important barriers from the point of view of healthcare professionals. Low awareness and adherence to OA guidelines was evident in all non-specialist groups. The fourth study evaluated the feasibility of introducing an electronic OA screening-tool for primary care. Healthcare professionals who used the tool found it to be quick and easy to implement and user-friendly, without impacting on the length of a consultation.
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Fernandes, Luan Flávia Barufi. "Programa de prevenção seletiva de orientação a pais de crianças com crises de sibilância." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/47/47133/tde-07012016-153153/.
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A asma e a doenca respiratoria cronica de maior ocorrencia no Brasil. Em criancas menores de cinco anos ainda nao e possivel diagnostica-la, mas alguns sintomas, tais como crises de sibilancia, sao indicativos de que estas criancas podem desenvolver asma. A presenca de problemas cronicos de saude na infancia pode representar um importante fator de mediacao da qualidade da interacao cuidador-crianca, pois a rotina da familia e marcada por permanentes cuidados. A Psicologia, neste contexto, pode contribuir por meio do desenvolvimento e implementacao de intervencoes preventivas que ajudem estas familias a enfrentar os eventos estressores influenciados por essa condicao. O objetivo do presente estudo foi avaliar os efeitos de um programa de orientacao parental, com enfoque preventivo para problemas de comportamento infantis, sobre as praticas educativas empregadas por cuidadores cujas criancas apresentavam crises de sibilancia. Foram participantes 19 pais, divididos em dois grupos: Grupo Tratamento (GT), composto de oito pais, e Grupo Comparacao (GC), constituido de onze pais. Os participantes foram recrutados em quatro locais de assistencia a saude infantil no municipio de Sao Paulo/SP e foram abordados para participar da pesquisa pessoalmente, por contato telefonico ou por cartas enviadas pelo correio. Os instrumentos de avaliacao utilizados foram: Adult Self-Report (ASR); Inventario de Comportamentos para Criancas entre 1 . a 5 anos (CBCL/1.-5) e Roteiro de Entrevista de Habilidades Sociais Educativas Parentais (RE-HSE-P). O GT participou do Programa de Orientacao Parental (POP); ambos os grupos foram avaliados em dois momentos: pre e pos-intervencao; os participantes do GC receberam orientacoes pontuais apos o termino da intervencao com o GT. O POP foi estruturado em 10 sessoes, semanais, de 90 minutos cada. Os resultados indicaram que os participantes apresentaram escores elevados para problemas de comportamento (ASR), especificamente do tipo internalizante, sendo que os pais do GT apresentaram mais escores considerados clinicos do que os do GC; os pais de ambos os grupos reportaram escores elevados de problemas de comportamento em seus filhos (CBCL), principalmente do tipo internalizante, observando-se uma reducao destes escores na avalicao pos-intervencao na comparacao dos grupos com eles mesmos e nao entre os grupos. Os cuidadores participantes do POP apresentaram melhora das habilidades educativas nos aspectos positivos da interacao, condicao que nao foi notada no GC, pois dentre estes participantes os escores permaneceram estaveis, sendo que tal melhora foi estatisticamente significativa nas habilidades sociais educativas (p = 0,043). Nos aspectos negativos da interacao, o GT apresentou diminuicao estatisticamente significativa no uso de praticas negativas, principalmente em termos de frequencia (p = 0,019); o GC tambem apresentou reducao da aplicacao de praticas negativas, porem esta reducao nao foi tao expressiva quanto a do GT. Os pais do GT foram avaliados novamente seis meses apos o termino da intervencao, participaram de uma sessao de fortalecimento e os resultados obtidos permaneceram estaveis. Os resultados do estudo indicam que o POP e uma intervencao que pode auxiliar as familias, cujos filhos apresentem problemas cronicos de saude na infancia, no manejo das dificuldades decorrentes desta condicao adversaAsthma is the most frequent chronic respiratory disease in Brazil. In children under five years of age, it cannot be diagnosed, but some symptoms, such as wheezing attacks, are indications that these children may develop asthma. The presence of chronic health problems during childhood may be an important mediating factor of the caregiver-child interaction quality, because it marks the family routine with permanent care. Psychology, in this context, can contribute by developing and implementing preventive interventions to help these families facing the stressful events influenced by this condition. The aim of this study was to evaluate the effects of a parental guidance program, using a preventive approach to child behavior problems, on educational practices employed by caregivers of children that presented wheezing attacks. The sample was composed by 19 parents, divided into two groups: Treatment Group (TG), with eight parents, and Comparison Group (CG), with eleven parents. Participants were recruited by telephone or mail in four childrens health care facilities located in Sao Paulo/SP. Assessment tools used were: Adult Self-Report (ASR); Child Behavior Checklist for Ages 1.-5 (CBCL/1.-5) and Parental Educative Social Skills Interview Script (RE-HSE-P). TG participated of the Parental Guidance Programme (PGP); both groups were assessed pre and post-intervention; CG received specific orientations after the post-intervention assessment. The PGP had 10 weekly sessions, lasting 90 minutes each. Results indicated that participants reached high scores for behavioral problems (ASR), specifically on the internalizing scale, and that TG parents had more scores in the clinical range than CG parents. Parents of both groups reported that their children presents high level of behavioral problems (CBCL), mainly of the internalizing type. Problems levels were reduced on the post-intervention assessment when comparing the group within itself, but not on the between groups comparison. On the interaction positive aspect (RE-HSE-P), TG caregivers showed improvement of educational skills, while CG caregivers presented stable educational skills scores. This difference was statistically significant (p = .043). Considering the interaction negative aspects, TG showed a statistically significant decrease in the use of negative practices, especially in terms of frequency (p = .019); CG also declined the use of negative practices, but this reduction was not significant. TG parents participated in a recapitulation session six months after the end of the intervention and were assessed again, presenting stable results. These findings indicate that PGP is an intervention that can help families whose children present chronic health problems on handling difficulties that arise from these adverse conditions
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Palumbo, Cristin M. "Lack of Routine Preventive Care as a Determinant for Pediatric Asthma ER Visits." VCU Scholars Compass, 2005. http://scholarscompass.vcu.edu/etd_retro/55.
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Objectives. The prevalence and incidence of asthma has been continually increasing with in the United States. High rates of hospitalization, emergency room visits (ER) and infrequent prescribing of controller medications indicates the lack or inadequacies of asthma management in the home as well as primary care programs. This study examines the impact of adequate asthma management and preventive care on asthma ER visits. Methods. Data from the 2003 National Health Interview Survey (NHIS) was utilized. Children (N=653) under the age of 18 years and who have had asthma episode in the past year were included for this analysis. A composite variable was created to determine adequacy of care at home and in the primary care setting using standards from the Global Initiative for Asthma (GINA) supported by the National Heart, Lung and Blood Institute.Results. The prevalence of ER visit among children who had asthma in the past 12 months was 22.7%. Approximately a quarter (24%) of the children had inadequate asthma management and preventive care. The multiple logistic regressions analysis showed that asthma management and preventive care were important determinants for asthma ER visits. Compared to children who had adequate care, children with inadequate asthma management and preventive care were two times more likely to visit the ER for asthma related problems [OR=2.06 (95%CI=1.257, 3.361)]. Child's age, maternal education, and family income were also statistically significant determinants for asthma related ER visits.Conclusions. Practices that support early interventions for asthma management and preventive care were associated with reduced risk of ER visits. Initiatives to support mandatory asthma management education and programming at primary care practices and as well as the home setting are essential in the management of pediatric asthma.
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Houri, Agnès. "Mise au point sur le traitement de la maladie asthmatique." Paris 5, 1993. http://www.theses.fr/1993PA05P110.
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Gijsbers, Barbara. "Promotion of exclusive breastfeeding for six months in asthmatic families." Maastricht : Maastricht : Universiteit Maastricht ; University Library, Universiteit Maastricht [host], 2007. http://arno.unimaas.nl/show.cgi?fid=9382.
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Moore, Vicky Clare. "Development and validation of a diagnostic tool for occupational asthma based on serial lung function measurements." Thesis, University of Birmingham, 2010. http://etheses.bham.ac.uk//id/eprint/1094/.
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Serial peak expiratory flow measurements (PEF) are recommended as an initial investigation in the confirmation of occupational asthma. Plotting measurements in Oasys gives reproducible results and can be used by non-experts. I report a new analysis, the area between curves (ABC) score, which gives 72% sensitivity and 100% specificity using a cut off of 15 L/min/h. Two-hourly measurements of PEF require 8 work days and 3 rest days for sensitive and specific analysis. Serial PEF records with long periods off work (≥ 4 consecutive days) show improved sensitivity from 73% to 80%, implying that 7 more workers in every 100 would be diagnosed. In a comparison of forced expiratory volume in one second (FEV1) to PEF, PEF was more sensitive to diurnal changes than FEV1, although FEV1 was more reproducible. Exhaled breath nitric oxide (FENO) showed similar ABC scores between those with normal and raised FENO. FENO was significantly correlated to methacholine reactivity. In shift workers, mean ABC scores were increased on morning shifts compared to nights, but the cut off of 15 L/min/h would be applicable across all shift types. The ABC score is a new robust method of confirming occupational asthma requiring shorter records than the Oasys score.
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Iosifyan, Marina. "Analyse interculturelle de la valeur de santé chez les adolescents atteints d'asthme." Thesis, Sorbonne Paris Cité, 2015. http://www.theses.fr/2015USPCB223/document.
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Cette thèse a pour objectif de contribuer à la compréhension de rôle des valeurs, des attitudes et des stratégies de coping dans le comportement lié à la santé et les symptômes de l'anxiété et de la dépression des adolescents russes et français atteints d'asthme. L'analyse de médiation a étudié les associations entre les valeurs (la valeur de santé, la valeur de la vie excitante) et le comportement (le comportement préventif et le comportement à risque) à travers les facteurs médiateurs : les attitudes affectives (explicites et implicites), cognitives (explicites) chez les adolescents atteints d'asthme et en bonne santé (N = 200). L'analyse de médiation a aussi étudié les associations entre les valeurs et les symptômes de l'anxiété et de la dépression à travers les stratégies de coping. L'étude qualitative, basée sur une méthodologie de recherche anthropologique, a exploré la phénoménologie de l'asthme et de la santé chez les adolescents russes et français (N = 20). Les valeurs sont associées avec le comportement lié à la santé à travers les attitudes affectives et cognitives. En valorisant la santé ou la vie excitante, les adolescents utilisent des stratégies de coping spécifique à l'asthme qui influent sur les symptômes de l'anxiété et de la dépression. En incluant les valeurs dans les programmes éducatifs il est possible de favoriser le comportement préventif et améliorer la qualité de vie chez les adolescents atteints d'asthmeThis thesis aims to help better understand the role of values, attitudes and coping strategies in health behaviors alongside with anxiety/depression symptoms among Russian and French adolescents with asthma. Mediation analysis was employed to study the associations between values (health value, value of exciting life) and health behaviors (preventive and risk behaviors) through affective (explicit and implicit) and cognitive (explicit) attitudes among adolescents suffering from asthma and healthy adolescents (N = 200). Mediation analysis has also been used to reveal the associations between values and anxiety/depression symptoms through coping strategies. Qualitative study based on anthropological research methodology were applied to study the phenomenology of asthma and health among Russian and French adolescents (N = 20). The study confirmed that values are associated with health behaviors through affective and cognitive attitudes. In valuing health or exciting life, adolescents use coping strategies specific to asthma which influence the symptoms of anxiety and depression. Inclusion of the above values in educational programs makes it possible to promote healthy behaviors and ameliorate the quality of life among adolescents with asthma
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Pai, Hong Jin. "Efeitos da acupuntura sobre os pacientes com asma leve e moderada persistentes: um estudo randomizado, controlado e cruzado." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/5/5144/tde-05052014-121907/.
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Introdução: Este estudo foi realizado com o intuito de avaliar efeitos da acupuntura sobre os pacientes com asma leve e moderada persistentes com o uso de beta-2 agonista ou corticoide inalatório. Métodos e casuística: Trata-se de um estudo prospectivo, duplo-cego, randomizado e cruzado com dois braços. Os 74 pacientes com diagnóstico de asma leve/moderada, de acordo com a classificação de GINA 2002/2003, foram divididos em dois grupos, sendo 31 do Grupo I, e 43 do Grupo II inicialmente. Foram realizadas consultas médicas e exames que incluíram espirometria, citologia de escarro induzido, NO expirado, preenchimento de escala de sintoma, questionários de qualidade de vida de asma e de SF 36, e realização de peak-flow, dependendo da Fase do protocolo. A Fase I constituiu-se dos exames pré-intervenção. Na Fase II, foram realizadas 10 sessões de Acupuntura Real no Grupo I e 10 sessões de Acupuntura Sham no Grupo II, na Fase III, houve 4 semana de washout, na Fase IV, houve a troca de técnicas de acupuntura, sendo uma sessão por semana e, na Fase V, realização dos exames. Resultados: Não há diferença nos critérios de avaliação no pré-tratamento entre dois grupos, com exceção de maior celularidade inflamatória no Grupo II. No entanto, houve uma redução significativa de eosinófilos (p = 0,035) e neutrófilos (p = 0,047), e aumento de macrófagos (p = 0,001), melhora da medida de volume do peak-flow (p = 0,01) na fase IV do Grupo II. No Grupo I, na avaliação de escala de sintomas diária, havia menor uso de medicação de resgate (p = 0,043) na Fase II, e, depois de receber a Acupuntura Sham na Fase IV, havia menos tosse (p = 0,007), menos chiado (p = 0,037), menos dispneia (p < 0,001) e menor uso de medicação de resgate (p < 0,001). No Grupo II, após receber o tratamento com a Acupuntura Sham na Fase II, houve diminuição de tosse (p = 0,037), de chiado (p = 0,013) e de dispneia (p = 0,014), e, na Fase IV, havia menos tosse (p = 0,040), sibilos (p = 0,012), dispneia (p < 0,001) e menos despertares noturnos (p = 0,009). Nos questionários de qualidade de vida de asma e de SF 36, foram encontrados alguns aspectos de melhora significantes na Acupuntura Sham dos dois grupos em relação à Fase I, mas os resultados da Acupuntura Real tiveram maiores índices de melhora em relação aos resultados da Acupuntura Sham nos dois grupos. Mas não há diferença significativa entre os dois na qualidade de vida de SF 36. Entretanto, não houve alteração de avaliação de espirometria e de óxido nítrico expirado. Conclusão: Este estudo demonstrou que o uso de Acupuntura Real num grupo de pacientes com a celularidade mais inflamatória teve melhor resultados de sintomas diários, tais como dispneia e despertar noturno, de medida de volume de peak-flow matutina, e de avaliação de qualidade de vida em asma e SF36, além da diminuição quantitativa de neutrófilos e de eosinófilos, com aumento de macrófagos, que justificam os efeitos anti-inflamatórios e imunitários. A acupuntura é uma terapia segura, não havendo nenhum efeito colateral observado neste projeto que possa interferir com a vida cotidiana e pode ser de grande auxílio no alívio de sintomas, com melhora de qualidade de vida e, possivelmente, pode ter uma ação na modulação do processo inflamatório de vias aéreasIntroduction: This survey has been conducted in order to evaluate the effects of acupuncture in patients with persistent mild and moderate asthma (according to GINA criteria 2003), using beta agonist and/or inhaled glucocorticoid. Methods and patients: This is a prospective, double blinded, randomized and cross-over study with two branches: 74 patients diagnosed with mild and moderate asthma were divided into two groups: Group I with 31, initiating with real acupuncture and Group II, starting with sham acupuncture. Medical interview and laboratory tests including spirometry, induced sputum citology, exhaled NO measurement, quality of life questionnaire (SF-36 and QQL), besides, daily symptom scores and measurement of peak-flow were performed, in the beginning of the study, and in the end of each phase of treatment. Phase I: laboratory tests and other qualitative measurements. There were 10 real acupuncture weekly sessions to Group I and 10 sham acupuncture sessions to Group II in Phase II. On the other hand, in the Phase IV, there was an exchange between Group I and Group II, which was receiving real acupuncture started to receive sham, and vice-versa, the number of sessions remained the same (10 weekly sessions). Phase III, during the interval between Phase II and Phase IV, there was an interval of 4 weeks of washout. Phase V: laboratory tests and other qualitative measurements. Results: There was no difference beween both the groups in all criteria of evaluation pré treatment, with only na exception: in the Group II there was large inflammatory cell counts. However, there was a significant reduction in eosinophils (p = 0.035) and neutrophils (p = 0.047), and increase of macrophages (p = 0.001), improved peak-flow measurement in the morning (p = 0.01) in Group II (started with sham) in Phase IV. In Daily Symptons Score, there was a significant reduction in use of rescue medication (p = 0.043) in Group I (real acupuncture) in Phase II and after received sham acupuncture (Phase IV), there were less cough (p = 0.007), less wheezing (p = 0.037), less dyspnea (p < 0.001) e less use of rescue medication (p < 0.001). In Group II, after received sham (Phase II), there were less cough (p = 0.037), less wheezing (p = 0.013) and less dyspnea (p = 0.014). In Phase IV, less cough (p = 0.040), wheezing (p = 0.012), dyspnea (p < 0.001) and less nocturnal awakening (p = 0.009). In the questionnaires of quality of life SF-36 and QQL, several domains were found to be improved after received sham acupuncture in both groups, comparing phase II against phase I, but the results found after received real acupuncture were better than sham in both groups. Although there was no statistic difference between both groups. However, there was no difference in exhaled NO and spirometry measurement. Conclusion: This survey demonstrated that the use of real acupuncture in a group of patients with large inflammatory cells counts could have contributed to reduce symptoms, improve quality of life, improved peak-flow measurement in the morning and reduced inflammatory cells count in induced sputum, therefore, acupuncture is a safe healing techniques, presented no adverse effects observed in this study, and could of great help in treatment of patients with mild and moderate asthma
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Lanoue, Jacqueline. "L'éducation du patient asthmatique en France." Paris 5, 1999. http://www.theses.fr/1999PA05P079.
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Goring, Sarah. "Effectiveness of inhaled corticosteroids in preventing morbidity and mortality in individuals with chronic obstructive pulmonary disease and the impact of coexisting asthma." Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/1387.
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Background: Chronic obstructive pulmonary disease (COPD) is a devastating illness that affects 4.3% of the population of British Columbia over the age of 45 years. Asthma is known to coexist in 10-20% of individuals with obstructive lung disease, and adds to the substantial burden of illness posed by COPD alone. Inhaled corticosteroids (ICS) are currently recommended for the management of COPD among individuals with frequent exacerbations; however, the ability of inhaled corticosteroids to reduce death and hospitalizations among individuals with COPD is controversial. Less is known about the effectiveness of ICS among individuals who are afflicted with both COPD and asthma.
Methods: We used a retrospective cohort study design and administrative data to estimate the relative effectiveness of ICS in reducing hospitalizations or death among individuals with concomitant asthma and COPD, compared with individuals with COPD alone. We used an extended Cox model to estimate this association, with a time-varying measure of exposure to ICS.
Results: We did not find any association between ICS and hazard of death or hospitalization among individuals with COPD alone (HR = 0.99; 95% CI: 0.94 – 1.05), however the hazard was 18% lower (HR = 0.82; 95% CI: 0.69-0.99) among individuals with concomitant disease.
Conclusions: Individuals with combined COPD and asthma show significant benefit from the use of ICS and are more responsive to the effects of ICS than individuals with COPD alone.
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Xavier, Roberta Araújo Navarro [UNIFESP]. "Modelos Experimentais de inflamação: Ação preventiva de dietas ricas em óleo de Soja ou Peixe na asma e nova estratégia para identificar drogas com proproedades pró-resolução." Universidade Federal de São Paulo (UNIFESP), 2009. http://repositorio.unifesp.br/handle/11600/9819.
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Made available in DSpace on 2015-07-22T20:50:26Z (GMT). No. of bitstreams: 0
Previous issue date: 2009-09-30A asma é uma doença crônica das vias aéreas caracterizada por obstrução do fluxo aéreo e intenso processo inflamatório, no qual, muitas células estão envolvidas, principalmente os eosinófilos. O processo inflamatório na asma pode induzir o aparecimento de alterações estruturais caracterizadas por fibrose subepitelial, hiperplasia da musculatura lisa das vias aéreas, neoformação vascular e remodelamento das vias aéreas. O aumento na prevalência da asma tem sido associado ao elevado consumo de ácidos graxos poliinsaturados do tipo Omega 6. A melhora dos sintomas apresentados por indivíduos asmáticos, por outro lado, foi observada em pacientes tratados com ácidos graxos poliinsaturados Omega 3. No mesmo segmento, alguns trabalhos da literatura têm relacionado efeitos antiinflamatórios benéficos à utilização de dietas enriquecidas com ácidos graxos poliinsaturados Omega 3, em processos inflamatórios agudos e crônicos. Nosso grupo não encontrou evidências do efeito pró-inflamatório dos ácidos graxos poliinsaturados Omega 6, previamente sugerido por vários autores. Nossos dados demonstram que a dieta rica em ácidos graxos poliinsaturados Omega 3, bem como a dieta rica em ácidos graxos poliinsaturados Omega 6, exercem efeito antiinflamatório sobre a inflamação aguda induzida por carragenina. Esse efeito antiinflamatório foi associado aos elevados níveis de corticosterona encontrados nesses animais. Neste trabalho, avaliamos a resposta inflamatória e a liberação de mediadores inflamatórios envolvidos na asma, em ratos alimentados com dietas enriquecidas com óleo de soja, ácidos graxos poliinsaturados Omega 6, ou óleo de peixe, ácidos graxos poliinsaturados Omega 3. Os resultados obtidos demonstram que, a dieta rica em ácidos graxos poliinsaturados Omega 6 não foi pró-inflamatória. Ao contrário, foi tão antiinflamatória quanto a dieta rica em ácidos graxos poliinsaturados Omega 3. Ambas diminuiram o infiltrado celular no lavado broncoalveolar, citocinas associadas ao perfil Th2, redução dos níveis de bradicina e aumento dos níveis de óxido nítrico. Além disso, a dieta rica em óleo de soja, aumentou os níveis de corticosterona e lipoxina A4 no pulmão dos animais alimentados com essa dieta. Com base nesses resultados, acreditamos que essas dietas possam contribuir para o estudo de terapias alternativas ou complementares, atuando em conjunto com as drogas utilizadas para o tratamento da asma.
TEDE
BV UNIFESP: Teses e dissertações
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Barros, Renata Sofia da Cunha Oliveira. "Dietary intake and obesity in asthma control and prevention." Tese, 2014. http://hdl.handle.net/10216/77779.
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Barros, Renata Sofia da Cunha Oliveira. "Dietary intake and obesity in asthma control and prevention." Doctoral thesis, 2014. https://repositorio-aberto.up.pt/handle/10216/100855.
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Chen, Jui-Cheng, and 陳睿成. "Probiotics for prevention or improvement of allergic asthma in the animal model." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/01626237005634149552.
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碩士弘光科技大學
食品暨應用生物科技所
100
Asthma is a serious and chronic disease. The probiotics is helpful in regulating immune-system and improving intestinal flora without side effects from medicines. Therefore, this study was designed to use probiotics as an alternative therapy on mice with air way hyperreactivity. The specific aim is to evaluate the influence of probiotic combination product on OVA-induced BALB/c for airway hyperreactivity(asthma) and intestinal microflora. The following data were analyzed : (1) expression of BALF, airway draining lymph nodes, mesenteric lymph nodes and spleen leukocyte cell surface markers, (2) amount of anti-OVA antibodies in serum and BALF, secretion of cytokines in spleen cells and BALF, (3) measurement of airway enhanced pause value and lymphocyte percentage in BALF, (4) assessment of phagocytosis and NK cell activities, (5) analysis of fecal and cecal microflora growth. The results showed that feeding probiotic combination product does not alter food intake and body weight in mice and improve the fecal and cecal microflora without the influence from OVA sensitization. For immune regulation, feeding probiotic combination product (1) enhanced CD4+CD25+; CD25+, CD8+ (T regulator cells) expression on immune regulation, (2) decreased amount of anti-OVA IgE, anti-OVA IgG1, (3) down-regulated secretion of Th2 pathway cytokines , such as IL-4, IL-5, IL-10, (4) decreased secretion of inflammatory cytokines, such as IL-6, IL-13, TNF-α, (5) down-regulated CD278+, CD4+ (Th2 cell) expression, (6) regulated the lymphocytes percentage in BALF and reduced enhanced pause value resistance. Furthermore feeding probiotic combination product (1) increased amount of anti-OVA IgG2a and secretion of Th1 pathway cytokines, such as IL-2, IL-12, and IFN-γ.It was concluded that probiotic combination product could enhance proceeding to Th1 pathway, instead of Th2 pathway and help to relieve the lung inflammation on OVA-sensitized mice, without inhibiting immune system by affecting the phagocytosis and NK cell activities.
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Chen, Chia-Yu, and 陳佳妤. "An Integrated Bio-Signal Data Mining Mechanism with Applications on Asthma Monitoring and Prevention." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/94933825211188404809.
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碩士國立成功大學
資訊工程學系碩博士班
95
Chronic diseases are the major causes of deaths and disabilities worldwide. The asthma population in Taiwan is also on the rise, thanks to rapid industrial development and changes in lifestyles and food consumption patterns. A report by Taiwan Children's Allergy, Asthma and Immune Institute shows that 11% of the children in Taiwan have asthma [29]. Furthermore, an analysis on asthmatic children in Taipei age seven to fifteen shows an increase of 16.5%, from 1.3% to 17.8%, between year 1974 and 2004 [24]. In our thesis, we proposed an integrated bio-signal data mining system, which monitors bio-signal for chronic asthma patients, and thus is able to calculate the probability of potential asthma attacks. This mechanism provides a user friendly platform that records a patient's daily bio-signal once the user logs in. Then, based on these bio-signal records, along with local air pollution levels and weather reports, our system predicts the chances of asthma attacks. Our studies show an 87.52% of precision and 85.59% of recall, which proves this mechanism to be effective and reliable in asthma attack prediction.
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Toman, Lukáš. "Výskyt a prevence astmatu v běžeckém lyžování u mládežnických kategorií." Master's thesis, 2016. http://www.nusl.cz/ntk/nusl-349014.
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Title: Occurrence and Prevention of Asthma in Youth Division Cross-country Skiers Objectives: The aim of this thesis is to determine the incidence of asthma in youth division cross-country skiers and its prevention. Methods: This thesis will comprise the method of survey and content analysis of documents. Hypotheses: No.1 Assume that asthma will have lower prevalence in youth division cross- country skiers than in adult cross-country skiers. No.2 Assume that the majority of the surveyed cross-country skiing coaches met with asthmatic symptoms in their athletes. Results: We found that 12% of youth division athletes suffer from asthma and 24% from allergies. Keywords: cross country skiing, respiratory diseases, bronchial asthma, exercise-induced asthma, allergy prevention.
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Santos, Pedro Carvalho dos. "Asma ocupacional: uma revisão atualizada." Master's thesis, 2015. http://hdl.handle.net/10316/30519.
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Trabalho final de mestrado integrado em Medicina, apresentado à Faculdade de Medicina da Universidade de Coimbra.A Asma Ocupacional (AO) é a doença ocupacional crónica mais comum em muitos países desenvolvidos, sendo objeto de estudo de várias Especialidades médicas e epidemiológicas. Existem centenas de agentes causadores de AO relatados na literatura, contudo, no contexto de uma investigação médica de AO, o diagnóstico não deve ser apenas baseado na clínica que o doente apresenta. Existe, portanto, a necessidade de o confirmar por meios objetivos, uma vez que um diagnóstico incorreto poderá acarretar consequências deletérias para o trabalhador, seja em termos sanitários, ou no plano socioeconómico. Atualmente, o médico tem ao seu dispor uma diversidade considerável de exames complementares, dos quais se destaca o TPE como padrão de referência. Após o diagnóstico, o tratamento da AO não difere da asma clássica, no entanto, o doente não poderá continuar em contacto com o agente causador de asma, o que pode traduzir-se em graves obstáculos profissionais para o trabalhador. Esta vertente socioeconómica da AO deverá ser resolvida em cooperação com o trabalhador, médico e empregador, pois está comprovado que os doentes com AO que permanecem (de forma inalterada) em contacto com o agente nocivo têm um pior prognóstico, que se traduz num agravamento dos sintomas e num aumento alarmante do risco de vida. Em oposição, os trabalhadores que são tratados de acordo com as recomendações vigentes podem vir a recuperar totalmente do seu quadro sintomatológico, com remissão completa da doença.
Occupational Asthma (OA) is the most common chronic occupational disease in many developed countries, being studied by various medical and epidemiological specialties. There are hundreds of agents causing OA reported in the literature, however, when investigating a patient for OA, the diagnosis should not be based only on the clinic that the patient has. There is therefore the need to confirm it by objetive means, since an incorrect diagnosis can lead to deleterious consequences for the worker, whether in health terms, or in the socioeconomic level. Currently, the physician has at his disposal a considerable range of additional tests, of which stands out the EPT as the reference standard. After the establishment of the diagnosis, treatment of OA does not differ greatly from classic asthma. However, the patient cannot remain in contact with the causative agent of asthma, which may result in serious obstacles for the professional worker. The socioeconomic aspect of the AO should be resolved in cooperation with the worker, doctor and employer, as it is proven that patients with AO that remain (in a unaltered manner) in contact with the noxious agent have a worse prognosis, which translates into an increase of symptoms and increased risk of death. In contrast, workers who are treated according to current recommendations are likely to fully recover its symptomatology, with complete remission of the disease.
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Pralong, Jacques-André. "Prévention de l’asthme professionnel : nouvelles perspectives." Thèse, 2012. http://hdl.handle.net/1866/8732.
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L’asthme professionnel est une maladie fréquente, qui coûte cher, qui touche des travailleurs jeunes, dont le diagnostic est difficile et avec d’importantes conséquences socio-économiques. La prévention occupe une place centrale dans la gestion de l’asthme professionnel, d’un point de vue de santé publique.
Ce mémoire de maîtrise présente trois articles rapportant des développements récents en matière de prévention de l’asthme professionnel. Tout d’abord, une revue de la littérature sur les agents sensibilisants de bas poids moléculaire dans l’asthme professionnel entre 2000 et 2010 recense 41 nouveaux agents et insiste sur l’importance de mettre à jour régulièrement les bases de données afin d’améliorer la prévention primaire. Ensuite, basé sur un cas clinique, la deuxième publication présente l’utilité potentielle du modèle d’analyse de risque QSAR (Quantitative Structure-Activity Relationship) dans le processus diagnostique de l’asthme professionnel, notamment lors d’une exposition multiple à des agents sensibilisants. Enfin, le troisième article présente la performance en milieu clinique du premier questionnaire de dépistage spécifique à l’asthme professionnel. Un modèle simple associant 8 items du questionnaire, l’âge des travailleurs et leur durée d’exposition professionnelle permet de discriminer 80% des 169 sujets adressés pour suspicion d’asthme professionnel. Un tel modèle pourrait être intégré dans les programmes de surveillance médicale qui constituent la base de la prévention secondaire.
Ces trois publications insistent sur les possibilités d’explorer de nouveaux outils préventifs dans le domaine de l’asthme professionnel, outils qui ouvrent des perspectives de développements futurs dont les implications cliniques et socio-économiques peuvent être importantes.Occupational asthma is a common disease, which affects young workers and is difficult to diagnose. It is a major financial burden and has important socioeconomic consequences. Prevention is central in the management of occupational asthma, in terms of public health. This thesis presents three articles reporting on recent developments in the prevention of occupational asthma. First, a review of the literature on sensitizing low-molecular- weight agents in occupational asthma between 2000 and 2010 reports 41 new agents and emphasizes the importance of regularly updating databases to improve primary prevention. Then, based on a clinical case, the second publication presents the potential utility of the model of risk analysis QSAR (Quantitative Structure-Activity Relationship) in the diagnostic workup for occupational asthma, especially in the case of multiple exposure to sensitizing agents. The third article presents the clinical performance of the first screening questionnaire specific to occupational asthma. A simple model consisting of 8 items of the questionnaire, age and exposure duration could discriminate 80% of the 169 subjects with and without OA in a clinical setting. Such a model could be integrated into medical surveillance programs, which are the basis of secondary prevention. These three publications emphasize the possibilities to explore new prevention tools in the field of occupational asthma, tools that provide opportunities for future developments, which could have major clinical and socio-economic implications.
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Taghiakbari, Mahsa. "Développement et validation de modèles pour le diagnostic de l'asthme professionnel." Thèse, 2017. http://hdl.handle.net/1866/20562.
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Su, Yung-Chang, and 蘇永昌. "The preventive effects of BCG treatment on extrinsic bronchial asthma in grinea pig model." Thesis, 1997. http://ndltd.ncl.edu.tw/handle/08191304939382095820.
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Laštovková, Andrea. "Diagnostika nových nemocí z povolání - prevence nových poškození z práce." Doctoral thesis, 2018. http://www.nusl.cz/ntk/nusl-386769.
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6 ABSTRACT Background The existence of risks of new work-related disorders and occupational diseases in the society is constantly increasing in relation to the fast and continuous development of working conditions, techniques used, materials and overall acceleration of the working pace. Aim of the study The aim of the study is to analyse new risks in the working environment and to evaluate early diagnostic possibilities of new occupational diseases including their prevention. The study also compares the current situation in this field in the Czech Republic and other European countries. Materials and methods The doctoral dissertation is a multiple manuscript thesis focusing on one common topic - new occupational diseases. The first publication studied the acknowledgement of low-back pain disease caused by overload as an occupational disease. Specialists from European countries were inquired via questionnaire focusing on diagnostic and evaluation criteria of this disease in their countries. Representatives from countries acknowledging low-back pain diseases caused by overload provided further evaluation criteria and number of cases. Correspondingly, the second publication studied the evaluation of burnout syndrome as an occupational disease. Representatives from countries acknowledging the burnout syndrome as...
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Wickrama, Gunaratne Anoja. "Effects of n-3 LCPUFA supplementation for pregnant and lactating women in preventing allergic diseases in early childhood." Thesis, 2015. http://hdl.handle.net/2440/115480.
Full textAbstract:
It is postulated that maternal n-3 (omega 3) long chain polyunsaturated fatty acids (LCPUFA) supplementation may modulate a range of inflammatory and immune pathways involved in the development of allergic diseases in early childhood, potentially leading to a reduction of allergic diseases in children. Thus the focus of this thesis was to determine whether maternal n-3 LCPUFA supplementation during pregnancy or lactation could prevent allergies in children. Two nested follow-up studies from two randomised controlled trials (RCTs) were performed, as well as a Cochrane systematic review to address this question. Of the two nested follow-up studies, one was a prenatal n-3 LCPUFA supplementation and the other a postnatal n-3 LCPUFA supplementation study. Parental reports of allergy outcomes were evaluated in children between birth to three years of age and birth to seven years of age in these studies. The Cochrane systematic review and meta-analysis was used to determine overall effects of maternal n-3 LCPUFA supplementation on allergy outcomes of the children involved. All relevant RCTs to date and the data from my two follow-up studies were included in the systematic review. Eight trials involving 3366 women and their 3175 children were included and in these trials, women were supplemented with n-3 LCPUFA during pregnancy (five trials), lactation (two trials) or both pregnancy and lactation (one trial). All trials randomly allocated women to either a n-3 LCPUFA supplement or a control group. The risk of bias varied across the eight included trials in this review with only two trials with a low risk of selection, performance and attrition bias. Overall, there is limited evidence to support maternal n-3 LCPUFA supplementation during pregnancy and/or lactation for reducing allergic disease in children. Few differences in childhood allergic disease were seen between women who were supplemented with n-3 LCPUFA and those who were not. N-3 LCPUFA supplementation showed a clear reduction in the primary outcome of any allergy (medically diagnosed IgE mediated) in children aged 12 to 36 months (risk ratio (RR) 0.66, 95% confidence interval (CI) 0.44 to 0.98; two RCTs; 823 children), but not beyond 36 months (RR 0.86, 95% CI 0.61 to 1.20; one RCT, 706 children). For any allergy (medically diagnosed IgE mediated and/or parental report), no clear differences were seen in children either at 12 to 36 months (RR 0.89, 95% CI 0.71 to 1.11; two RCTs, 823 children) or beyond 36 months of age (RR 0.96, 95% CI 0.84 to 1.09; three RCTs, 1765 children). For the secondary outcomes of specific allergies there were no clear differences for food allergies at 12 to 36 months and beyond 36 months, but a clear reduction was seen for children in their first 12 months with n-3 LCPUFA (both for medically diagnosed IgE mediated and medically diagnosed IgE mediated and/or parental report). There was a clear reduction in medically diagnosed IgE mediated eczema with n-3 LCPUFA for children 12 to 36 months of age, but not at any other time point for both medically diagnosed IgE mediated and medically diagnosed IgE mediated and/or parental report. No clear differences for allergic rhinitis or asthma/wheeze were seen at any time point for both medically diagnosed IgE mediated, and medically diagnosed IgE mediated and/or parental report. There was a clear reduction in children's sensitisation to egg and sensitisation to at least one allergen between 12 to 36 months of age when mothers were supplemented with n-3 LCPUFA. In terms of safety for the mother and child, n-3 LCPUFA supplementation during pregnancy did not show increased risk of postpartum haemorrhage or early childhood infections. The data obtained in one of the nested follow-up studies in this thesis was used to compare the validity of parental reports of allergy outcome measures against medical diagnosis of allergies. This revealed that parental reports of doctor diagnosed eczema were the most reliable for the diagnosis of eczema in infants, but further studies are needed to validate other allergy outcomes before parent reports of allergy symptoms can be considered as a useful tool to evaluate early childhood allergies in large scale research.Thesis (Ph.D.) -- University of Adelaide, School of Medicine, 2015.