Tesi: "Asthma in children – Treatment"

1

Khan, Md Sanaur Rahman School of Women?s &amp Children?s Health UNSW. "Improving the management of childhood asthma". Awarded by:University of New South Wales. School of Women?s and Children?s Health, 2003. http://handle.unsw.edu.au/1959.4/19256.

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Objectives: To improve the management of childhood asthma. Subjects & Setting: Children admitted with asthma from 1st January 2000 to 31st December 2000; and children discharged with asthma from Emergency Department (ED) of Sydney Children?s Hospital (SCH) between 16th October 2000 and 28th February 2002. Methods: There were two major studies addressing aspects of asthma management, namely the retrospective in-patient study and the prospective ED presentation study. Each of these was subdivided in two different studies to address different research questions. In the first retrospective study, a priori criteria for theoretical "time ready for discharge" (TRD) for asthmatic admissions were defined based on frequency of use of salbutamol. In the second retrospective study, we followed 361 children for 1 year from the date of their discharge, to find out whether those who received asthma education, written asthma action plan, and preventer medications at the time of discharge and whose follow?up was arranged prior to discharge, represented to the ED or were readmitted. The prospective study, which also addressed two different research questions, was a randomised-controlled trial in which parents of 310 children who had been discharged from ED with asthma, received written asthma materials only or received telephone consultation in addition to written materials. Background severity and control of asthma were assessed in baseline study from parent?s reported symptom frequency and medication uses. Outcome measures: readmission and representation to the ED, regular use of preventer medications, possession and use of written asthma action plan, and asthma symptom measures. Results: (1) 116 (27.7%) children were discharged before our theoretical TRD and only 2 child who were discharged after achieving TRD, developed symptoms which required oxygenation and more frequent doses of salbutamol. Both readmission and representation to ED within one week of discharge were uncommon. (2) 121 children represented within 1 year of their discharge, of whom 68 children were readmitted. Both receiving asthma education during admission and arranging follow-up prior to discharge were associated with a decreased likelihood of representation as well as readmission (P > 0.001). (3) In RCT, the baseline study showed that 14% of children were not receiving appropriate preventer therapy despite indications; and a further 34% had frequent symptoms despite receiving preventer therapy. 62% of the parents reported of having written asthma action plan but less than 50% of them reported using it regularly. At follow up we observed both possession and use of written asthma action plan (p = 0.002) as well as regular use of preventer medications (p = 0.001) were improved in the intervention group compared with the control group. Conclusions: Discharge on 3-hourly rather than 4-hourly doses of salbutamol appears safe and shortens length of stay by an average of 5.5 hrs. Both asthma education and follow-up at the time discharge appear to reduce readmission and representation to ED. Telephone consultation can increase the regular use of preventer medications and written asthma action plan.

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2

McCants, Kellie M. "Factors affecting treatment regimen adherence in children and adolescents with asthma". Connect to this title online, 2003. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1041866923.

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Thesis (Ph. D.)--Ohio State University, 2004.
Title from first page of PDF file. Document formatted into pages; contains xv, 134 p.; also includes graphics Includes bibliographical references (p. 101-108). Available online via OhioLINK's ETD Center

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3

Erasmus, Esther W. "Insights into the psychobiology of personality of individuals living with chronic asthma to inform treatment planning". Pretoria : [s.n.], 2007. http://upetd.up.ac.za/thesis/available/etd-06292007-163159.

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4

Smith, Nerida Ann. "The effects of intervention on medication compliance and asthma control in children with asthma". University of Sydney, 1987. http://hdl.handle.net/2123/1613.

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Doctor of Philosophy
Asthma can be a chronic disorder requiring regular medications if the symptoms are persistent. The regimen is often complex, involving a number of drugs and a variety or routes of administration. Although drug therapy may not alter the natural history of asthma it can improve lung function enabling those with asthma to lead as near a normal life as possible. Thus medication compliance is an important factor in the managemnt of asthma. (Note : Special enclosures (Publication reprints) at end of thesis have been removed for digital submission, with permission of author)

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McCants, Kellie Michele. "Factors Affecting Treatment Regimen Adherence in Children and Adolescents with Asthma". The Ohio State University, 2003. http://rave.ohiolink.edu/etdc/view?acc_num=osu1041866923.

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6

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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7

Walton, Marilyn. "The Relationship Between Asthma Education and the Number of Hospital Visits of Asthmatic Children". Youngstown State University / OhioLINK, 2000. http://rave.ohiolink.edu/etdc/view?acc_num=ysu1007754892.

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8

Ilicak, Selin. "Children's adjustment to asthma or diabetes and treatment adherence". Thesis, Oxford Brookes University, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.515232.

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This thesis had two main aims. Firstly, to develop separate questionnaires for children with asthma and children with diabetes and their parents, which assess children's adjustment to the illness and treatment adherence. Secondly, to test the hypothesis of an association between children's adjustment and treatment adherence. The essence of asthma and diabetes treatment is self-care and consequently children with asthma or diabetes have to learn to cope with the long-term demands and responsibilities of complying with a strict and complex treatment regimen. It is currently recognized that a major problem in paediatrics is poor treatment adherence, which can result in serious health consequences. This led to a shift in paediatric medicine, from focusing only on the physical treatment of the illness to exploring the psychological impact of the illness and how it affects children's socio-emotional adjustment. However, there is a shortage of adjustment and treatment adherence measures; existing ones have major limitations. Thus, the new questionnaires aimed at assessing both children's adjustment and treatment adherence. Four interlinked studies utilising qualitative and quantitative methods were carried out. Study 1 and study 3 were parallel but separate studies and involved interviewing a group of 15 children with asthma and 15 children with diabetes, their parents and paediatric nurses about the children's experiences and feelings in a range of contexts. The interviews showed that there were commonalities in stressors across children but differences in adjustment and treatment adherence levels. On the basis of these interviews separate questionnaires for children with asthma (study 2) and children with diabetes (study 4) and their parents were developed and administered to a sample of 60 children and their parents. The new questionnaires proved to be reliable and valid and confirmed the hypothesis of a significant relation between children's adjustment and treatment adherence. The development of a new assessment tool involves several steps: This work represents the first steps in developing a new assessment tool. As with any new assessment instrument, further development will be required to examine its validity and reliability.

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9

Wright-Jegede, Narue Jaynelle. "Parental Perception of Physician Cultural Sensitivity and Adherence to Asthma Treatment". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7905.

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In the United States, asthma remains a major cause of frequent urgent care visits, hospitalizations, and preventable deaths among children. Nationwide, the chronic disease continues to fall disproportionately on minorities, mostly residing in urban localities. When a child is diagnosed with asthma, the parents are typically tasked with managing the child's condition. Establishing a collaborative partnership between parents and their child's primary physician is significant for improving asthma self-management among youth. Using the theory of reasoned action as a theoretical framework, this mixed-methods study examined whether a relationship exists between parental perceptions of physician cultural sensitivity and parental care in asthma treatment adherence. Phenomenology was used to explore the real-world experiences of study five ethnic minority parents and one guardian grandparent of asthmatic children aged 0–17 who shared similar perspectives. Descriptive surveys were used in combination with in-depth interviews to develop an understanding of parental perceptions on physician cultural sensitivity related to asthma treatment adherence. Overall, 108 minority parents were eligible to complete the survey. The study findings revealed that parents who feel recognized, valued, and respected by their child's physician were more likely to be engaged in shared decision-making about treatment. The findings support the potential for positive social change in terms of modifying the health care behaviors of minority parents with asthmatic children, increasing parental self-efficacy in managing their child's asthma, and improving the cultural sensitivity of physicians who serve the needs of diverse minority families.

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Gaddam, Surender. "The impact of asthma self-management education programs on the health outcomes: A meta-analysis (systemic review) of randomized controlled trials". CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2312.

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An attempt has been made in this study to critically appraise, systematically review and gather together the results obtained in individual trials and examine the strength of evidence supporting the component for Education for a Partnership in Asthma Care of the National Asthma Education and Prevention Program (NAEPP) to test whether health outcomes are influenced by education and self-management programs.

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Nieves, Luz E. "Parents' and Health Professionals' Perceptions of Asthma Medication Noncompliance Among Puerto Rican Children". Thesis, Walden University, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13428227.

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Children of Hispanic origin have the highest prevalence of asthma of all ethnic groups in the United States, especially Puerto Rican children, who have a prevalence of 12.9%. Treatment nonadherence has been identified as one contributing factor. The purpose of this qualitative study was to explore the reasons for nonadherence to the asthma treatment regimen among Puerto Rican children. Parents and health care providers of asthmatic children were interviewed regarding their beliefs about asthma as a disease, its effect on the child’s life, and their experience with asthma treatment. Two models served as the theoretical framework: the health belief model and the Institute of Medicine model framework for asthma disparities. Interview data were collected from 8 parents using a questionnaire, and a focus group was conducted with 3 health care professionals. Data were manually coded to identify emerging themes. Even though parents reported fear of asthma medications and medication side effects, none of the parents stopped the asthma treatment. Results also indicated that lack of education about asthma, asthma treatment, and asthma action plan was evident in 75% of the parents. None of the parents who migrated to the United States from Puerto Rico received education about asthma while living in Puerto Rico. Health care professionals reported that although parents are familiar with asthma, they do not understand that it is a chronic disease that requires daily treatment. Findings may be used to create an asthma education plan tailored to the needs of the Hispanic population.

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Amato, Juliana Neide 1989. "Assessment of sleep bruxism, orthodontic treatment need, orofacial dysfunctions and salivary biomarkers in asthmatic children". [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/289834.

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Orientador: Taís de Souza Barbosa
Texto em inglês e português
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
Made available in DSpace on 2018-08-25T06:55:02Z (GMT). No. of bitstreams: 1 Amato_JulianaNeide_M.pdf: 1027609 bytes, checksum: 3cbd740a1aa393a89f3a3c9d7e1a944a (MD5) Previous issue date: 2014
Resumo: Objetivo: Este estudo objetivou avaliar a presença de bruxismo do sono, maloclusões e disfunções orofaciais bem como os níveis salivares de cortisol e alfa-amilase em crianças asmáticas. Material e Métodos: A amostra consistiu de 108 crianças, de ambos os gêneros, com idade entre sete e nove anos, selecionados da Policlínica Santa Teresinha Doutor Antonio Haddad Dib (grupo com asma, n=53) e das escolas públicas (grupo controle, n=55), ambos do município de Piracicaba, SP, Brasil. O diagnóstico de bruxismo do sono foi confirmado pelo relato dos pais sobre ranger os dentes (pelo menos três vezes por semana) e pela presença de facetas de desgaste em incisivos e/ou molares permanentes. O Índice de Necessidade de Tratamento Ortodôntico ¿ Componente Dentário (IOTN-DHC) foi utilizado para avaliar a oclusão. As disfunções orofaciais foram avaliadas pela versão Brasileira do Nordic Orofacial Test-Screening (NOT-S). O cortisol salivar (?g/dl) e a alfa-amilase (U/ml) foram analisador por kit enzimaimunoensaio. Os dados foram expressos em "resposta ao acordar" (RA), calculada pela diferença entre os valores imediatamente ao acordar e 30 minutos após acordar, e "declínio diurno" (DD), calculado pela diferença entre os valores 30 minutos após acordar e antes de dormir. Os dados foram analisados utilizando os testes Shapiro Wilk/Kolmogorov-Smirnov, Qui-quadrado, teste t não pareado/Mann-Whitney e teste t pareado/Wilcoxon. Resultados: O bruxismo foi mais prevalente em crianças com asma do que controles (47,2% vs. 27,3%, p<0.05). Mais de metade das crianças com asma apresentaram gravidade intermitente (50,9%, p<0.001). O grupo com asma apresentou maiores escores do NOT-S total e entrevista do que o grupo controle (p<0.05). Sintomas de disfunções orais relacionados a (I) Função Sensorial e (IV) Mastigação e Deglutição foram mais frequentes em crianças com asma do que controles (p<0.05). A RA de cortisol salivar no final de semana foi significativamente maior no grupo com asma do que controles (p<0.05). No grupo controle, o DD de cortisol salivar foi significativamente maior em dia de semana do que no final de semana (p<0.05). Conclusões: A presença de asma em crianças esteve associada com sinais e sintomas de bruxismo do sono, percepção negativa das funções sensoriais, mastigação e deglutição e maior concentração de cortisol salivar no final de semana
Abstract: Objective: This study aimed to evaluate the presence sleep bruxism, malocclusions and orofacial dysfunctions as well as the salivary levels of cortisol and alpha-amylase in asthmatic children. Material and Methods: The sample consisted of 108 children of both genders in the age-range from seven to nine years, selected from Policlinic Santa Teresinha Doutor Antonio Haddad Dib (asthma group, n=53) and from public schools (control group, n=55), both of Piracicaba, SP, Brazil. Sleep bruxism diagnosis was confirmed by parental report of grinding sounds (at least three times a week) and the presence of shiny and polish facets on incisors and/or first permanent molars. The Index of Orthodontic Treatment Need ¿ Dental Health Component (IOTN-DHC) was used for occlusion evaluation. Orofacial dysfunctions were evaluated using the Brazilian Portuguese version of the Nordic Orofacial Test-Screening (NOT-S). Salivary cortisol (?g/dl) and alpha-amylase (U/ml) were assayed using enzyme immunoassay kit. These data were expressed as ``awakening response¿¿ (AR), calculated as the difference between levels immediately after awakening and 30 min after waking, and "diurnal decline" (DD), calculated as the difference between levels at 30 min after waking and at bedtime. Data were analyzed using Shapiro-Wilk/Kolmogorov-Smirnov, Chi-square, unpaired t test/Mann-Whitney and paired t/Wilcoxon tests. Results: Sleep bruxism was more prevalent in children with asthma than controls (47.2% vs. 27.3%, p<0.05). More than half of the asthmatic children had intermittent severity (50.9%, p<0.001). The asthma group had higher scores of NOT-S total and interview than control group (p<0.05). Symptoms of oral dysfunctions related to (I) Sensory Function and (IV) Chewing and Swallowing were more frequent in children with asthma than controls (p<0.05). Salivary cortisol AR on weekend was significantly higher for asthma group than controls (p<0.05). In control group, salivary cortisol DD was significantly higher on weekday than weekend (p<0.05). There were no significant differences in alpha-amylase values in and between groups. Conclusions: The presence of asthma in children was associated with signs and symptoms of sleep bruxism, negative perception of sensory, chewing and swallowing functions, and higher concentrations of salivary cortisol on weekend
Mestrado
Odontopediatria
Mestra em Odontologia

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Remera, Jeanne Manywa. "Perceptions among caregivers and physiotherapists on the importance of chest physiotherapy in asthmatic children attending hospitals in Kigali, Rwanda". Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&amp.

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Childhood asthma is one of the commonest chronic respiratory conditions in developed communities. Chest physiotherapy has traditionally been one of the interventions used mainly after an attack and for a relatively short-period on an outpatient basis. The purpose of the study was to determine the perceptions of physiotherapists and caregivers about the importance of chest physiotheraphy in asthmatic children in Kigali. To achieve this aim the author attempted to identify the perceived benefits of chest physiotherapy for asthmatic children among caregivers
to determine the perception of physiotherapists about the importance of chest physiotherapy for asthmatic children and
to identify the physiotherapists experiences with doctors referrals and the caregivers compliance in the management of asthmatic children.

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Cesareo, Jacqueline M. "Psychosocial stress and health-related outcomes in chronic childhood asthma : using a biopsychosocial approach to understand transactional relationships across childhood and adolescence". University of Western Australia. School of Psychology, 2007. http://theses.library.uwa.edu.au/adt-WU2007.0077.

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[Truncated abstract] Despite significant scientific advances in tracking the complex physiological mechanisms that drive the asthma disease process, worldwide trends in childhood asthma continue to rise. This research sought to describe the relationships between psychosocial stress, psychosocial resources, asthma severity, and health-related outcomes from the standpoints of biopsychosocial and developmental theory. The research consisted of three studies based on a prospective study involving 2573 children from a community-based birth cohort. The cohort has been under active follow-up from birth and this thesis draws on data obtained at the 1, 2, 6, 10 and 13 year follow-ups . . . The final study undertook to describe the mediating influence of specific supportive behaviours provided by family members and peers to adolescents with asthma. Ninety-nine adolescents participating in the 13 year follow-up of the community cohort study completed a semi-structured interview adapted from the Diabetes Social Support Interview (La Greca et al., 1995) to assess supportive behaviours and the KINDL (Ravens-Sieberer & Bullinger, 1998) to assess QOL. It was predicted that illness-specific support would mediate the relationship between family dysfunction and quality of life. Qualitative analyses identified parents as important sources of tangible support, peers as important sources of companionship and emotional support, and siblings bridging the two, by providing tangible, companionship and emotional support to the adolescent. Mediator analyses found that specific parent behaviours perceived as unsupportive by the adolescent mediated the relationship between family dysfunction and self-oriented quality of life. Clinical implications support the integration of medical and psychological expertise in the treatment of asthma. Future research directions are also discussed.

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Pajarón, Fernández Manuel José. "Efectividad de montelukast para el control del broncoespasmo inducido por ejercicio en la infancia. Diferencias entre toma diurna y nocturna". Doctoral thesis, Universidad de Murcia, 2007. http://hdl.handle.net/10803/84154.

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Estudiamos 24 niños de entre 6 y 14 años que comenzaron a tomar Montelukast para el control del broncoespasmo inducido por ejercicio tras ser diagnosticados con la prueba de ejercicio físico en tapiz rodante, 12 de ellos por la mañana y 12 por la noche. Después de catorce días se invirtió la hora de la toma tras realizar una nueva prueba de ejercicio en tapiz. Tras otros catorce días, 28 en total, se realiza la prueba de ejercicio final. Encontramos una significativa disminución en la caída del FEV1 del 32% para la mañana y la noche sin diferencias entre las horas de toma al estudiar la máxima caída del FEV1 ni el Área bajo la curva para este parámetro. Montelukast tiene la misma efectividad cuando se toma por la mañana o la noche. Supone un índice de protección para el FEV1 del 32%, tras tomarlo entre 14 y 28 días.
Montelukast was recommended to be taken in the evening with no evidence for that recommendation. We studied 24 children between 6 and 14 years of age to test whether the timing of the administration modified the effectiveness of Montelukast to control exercise induced bronchospasm (EIB). Children diagnosed of EIB after performing a challenge test using standardized exercise on a treadmill, received treatment for a total of 28 days in two periods of 14 days in a clinical trial with a cross over design. Dosage administration were randomly assigned to the morning or night for half the children in each study phase. Montelukast was equally effective to prevent exercise-induced bronchospasm irrespective of the timing of its administration.

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Chateaux, Véronique. "Perception de l'asthme par les enfants et leurs parents : impact sur la qualité de vie et d'adhérence d'enfants asthmatiques". Metz, 2005. http://docnum.univ-lorraine.fr/public/UPV-M/Theses/2005/Chateaux.Veronique.LMZ0508.pdf.

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Face à l'asthme pédiatrique, il est important de cerner ce qui influence la qualité de vie et l'adhérence thérapeutique. Afin de répondre à cette question, quatre axes d'analyses ont été développés à travers l'évaluation des caractéristiques de l'enfant (le sentiment d'auto efficacité, les attitudes face à la maladie, les représentations de l'asthme) et de ses parents (le sentiment d'efficacité dans la gestion de la maladie de leur enfant, les représentations de l'asthme et leur implication dans le traitement). Puis, à partir de ces quatre axes, deux propositions de modélisations de l'influence de ces variables sur la qualité de vie et l'adhérence thérapeutiques des enfants ont été réalisées. Cette recherche a été menée auprès de 144 enfants asthmatiques âgés de 8 à 12 ans et de 92 parents. L'analyse des données empiriques a permis de mettre en évidence, pour la première fois, le rôle essentiel des représentations cognitives et émotionnelles de l'asthme chez les enfants, sur leur qualité de vie et leur adhérence. Accéder à ces représentations de la maladie que l'enfant asthmatique et ses parents se construisent, devrait permettre d'adapter les interventions au sein des programmes d'éducation des Ecoles de l'asthme avec comme objectifs une amélioration de la qualité de vie et une meilleure adhérence thérapeutique de l'enfant
The purpose of this study was to investigate what influence quality of life and therapeutic adherence in pediatric asthma. In order to answer to this question, four point of view analysis were developed through the evaluation of children's characteristics (self-efficacy, attitude, asthma representations) and their parents (self efficacy in the management of illness, asthma representations and involvement in treatment). Then, from these four point of view analysis, two explanatory models of the quality of life and the adherence among children suffering asthma were realised. The population of this research was constituted by 144 asthmatic children 8 to 12 years old and 92 parents. The analysis of empirical data showed up for the first time the essential part of asthma cognitive and emotional representations on quality of life and therapeutic adherence among children. Having access to children's and parent's illness representations, should lead to the adaptation of asthma self-management programs in order to improve children's quality of life and therapeutic adherence

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Kamath, S. V. "Inflammation in paediatric asthma". Thesis, Queen's University Belfast, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269034.

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Hodgson, David Brian. "Investigating new treatment options for refractory asthma". Thesis, University of Nottingham, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.664300.

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Patients with difficult to manage asthma and chronic cough are commonly seen by respiratory physicians in the NHS. This thesis describes three randomised trials which explore new treatment options for these difficult groups. Non-invasive markers of airway inflammation and function were measured before each trial to help determine likely responders. In the first study, 30 patients with asthma and eosinophilic inflammation were given two weeks of prednisolone and then randomised to receive either ciclesonide 360mcg or placebo twice daily for 8 weeks. Though the between- group differences were not significant several patients had changed their usual maintenance dose of prednisolone during the trial. When these patients were removed from the analysis there was a significant improvement sputum eosinophils with ciclesonide. There was no significant change in the marker of small airway inflammation, so it is possible that this effect was due to a general reduction in airway inflammation from the higher dose of inhaled steroids, rather than specifically targeting the small airways. In the second study, 28 patients with refractory asthma were given azithromycin 250mg or placebo three times weekly for six weeks in a randomised, cross-over design. Though significant improvements in airway hyper-responsiveness, asthma control and sputum neutrophils were seen with azithromycin, these changes were not significant when compared to placebo.

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Russell, Linda Moreno. "The effects of family functioning, child behaviors, and asthma beliefs on asthma management in children and adolescents /". Digital version accessible at:, 2000. http://wwwlib.umi.com/cr/utexas/main.

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Toop, Leslie John. "Cough sound analysis in children with asthma". Thesis, University of Bristol, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.361104.

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Tan, Chee Chun. "Spirometry Use in Children Hospitalized with Asthma". University of Cincinnati / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1321888428.

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溫煜讚 e Yuk-tsan Wun. "A study of the peak expiratory flow rates in children in a general practice". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1990. http://hub.hku.hk/bib/B31981422.

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Modi, Avani C. "Adherence in children with cystic fibrosis and asthma". [Gainesville, Fla.] : University of Florida, 2004. http://purl.fcla.edu/fcla/etd/UFE0005641.

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Thesis (Ph.D.)--University of Florida, 2004.
Typescript. Title from title page of source document. Document formatted into pages; contains 94 pages. Includes Vita. Includes bibliographical references.

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Mai, Xiao-Mei. "Asthma, bronchial hyperresponsiveness and body weight in children /". Linköping : Univ, 2003. http://www.bibl.liu.se/liupubl/disp/disp2003/med806s.pdf.

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Hijazi, Nariman. "Epidemiology of asthma among children in Saudi Arabia". Thesis, University of Aberdeen, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.322584.

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26

Piotrowska, Zofia. "Rhinovirus-associated wheezing and asthma in young children". [New Haven, Conn. : Yale University], 2008. http://ymtdl.med.yale.edu/theses/available/etd-12092008-151207/.

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Sinha, Ian. "Outcomes in clinical trials in children with asthma". Thesis, University of Liverpool, 2011. http://livrepository.liverpool.ac.uk/3193/.

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The selection of outcomes is a critically important decision when designing randomised controlled trials (RCTs). Informed clinical decisions can only be based on the results of RCTs that have measured outcomes of importance to both clinicians and patients. It can be difficult to know which outcomes should be measured in RCTs. Some groups advocate core outcome sets, which are a minimum set of outcomes that should be measured, and reported, in all clinical trials in a given condition. These increase the likelihood that important outcomes are measured, reduce nonuniformity between studies, and reduce the risk of outcome reporting bias. We systematically reviewed studies that determined which outcomes to measure in clinical trials in children, and found that such work had been conducted in only few conditions, and the quality of existing work was variable. Few studies used structured consensus techniques to reach agreement about which outcomes to measure in trials, and parents were seldom involved. No studies included children. One condition in which there were no robust recommendations about which outcomes to measurein RCTs was childhood asthma, which is a condition of considerable global importance. We subsequently aimed to assess whether the absence of a core outcome set for RCTs of children with asthma meant that certain outcome domains were measured less frequently than others, and whether there was nonuniformity between studies in terms of outcomes selected. We conducted a systematic review of RCTs of children with asthma, published between January 1988 and December 2007, and found that the included studies focussed on short-term disease activity, but quality of life, functional status, and long-term outcomes were infrequently measured. Certain outcomes were measured and reported in various ways. We recommended that a core outcome set should be developed for childhood asthma, using structured consensus techniques, such as the Delphi process. In order to aid the development of such a core set, we first systematically reviewed studies that used the Delphi process to determine which outcomes to measure in clinical trials. We observed variations in the methodology used, identified potential sources of bias, and provided recommendations about how such studies could be conducted and reported. In order to develop a core outcome set for childhood asthma, we used a Delphi process to ascertain the views of 46 clinicians, and around 100 parents and young people, about which outcomes are most important and relevant from their perspective, when making shared decisions about regular therapies which control asthma. The most important outcomes were symptoms, exacerbations, and quality of life. Although consensus still needs to be reached amongst other groups of individuals involved in clinical trials, we conclude that these outcomes should be measured, and reported, in all RCTs that aim to evaluate the effectiveness of regular therapies for children and young people with asthma.

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28

Ferrugio, Carla Ianni. "Caregivers description of illness in children with asthma". FIU Digital Commons, 1998. http://digitalcommons.fiu.edu/etd/3315.

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Recent studies identify infants, toddlers and preschoolers as high risk groups exhibiting vulnerability and increased morbidity rates associated with asthma. The data collected via review of ER medical records, were analyzed using descriptive and inferential statistics, where appropriate. The study was conducted on a convenience sample of 110 asthmatic children brought to a Children's Emergency Room (ER) in West Palm Beach, Florida for urgent care. This retrospective descriptive correlational study examined the relationship between the caregiver's description of the child's presenting illness and degree of the asthma exacerbation upon admission to the emergency department for management. Relationships between/among these variables were also explored for children with or without a primary care provider and health insurance. Research findings lend support to the hypothesis (p = .001) that the lesser the degree of severity of the child's asthma exacerbation, the less likely caregivers will describe respiratory distress as the presenting illness. However, the findings fail to support the hypotheses that caregivers of children with a primary care provider or health insurance coverage are more likely to appropriately describe the presenting illness as respiratory distress. Other findings point to the need for client-tailored management plans to maximize caregivers and/or child learning about asthma and its management, client education and follow up.

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29

Ställberg, Björn. "Asthma in Primary Care : Severity, Treatment and Level of Control". Doctoral thesis, Uppsala universitet, Allmänmedicin och klinisk epidemiologi, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-9332.

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Aims. The overall aim was to examine the severity, treatment and level of control in patients with asthma in primary care in Sweden. The specific aims were to assess what matters to asthma patients, evaluate symptoms, medication and identify factors related to asthma severity, compare the extent of asthma control in 2001 and 2005, and investigate the development of asthma and degree of asthma control in adolescents and young adults who had reported asthma six years earlier. Methods. The first study was a telephone interview of a representative sample of Swedish asthmatics. In the second study a random sample of 1,136 patients answered two questionnaires. A classification of the asthma severity similar to that in the GINA guidelines was made. In the third study two surveys were performed, in 2001 and in 2005, with a random sample of 1,012 and 224 asthma patients, respectively, and a classification of asthma control similar to the recent GINA guidelines was made. In the fourth study 71 individuals who reported physician-diagnosed asthma in a population-based survey in 1997 and were defined as current asthmatics, were reinvestigated in 2003 with a skin prick test, methacholine challenge test, eucapnic voluntary hyperventilation test and measurement of exhaled nitric oxide. Results. Common situations causing symptoms of asthma were physical exertion and contact with pets. Nocturnal symptoms were frequent. In primary care 35% of the women and 24% of the men were classified as having severe asthma. Female sex, increasing age, not filling the asthma prescription owing to cost, daily smoking, and pollen allergy increased the odds of having severe asthma. In 2001, 37% had achieved asthma control, as compared with 40% in 2005. Uncontrolled asthma was more common in women and smokers. In the 2003 study of adolescents and young adults with asthma six years earlier, the definition of current asthma was fulfilled by 50 of the 71 subjects and one third had achieved asthma control. Conclusions. The majority of the asthmatics reported a large number of symptoms and limitations in their daily living. Many asthma patients in primary care have insufficient asthma control. One reason for lack of control might be undertreatment with inhaled corticosteroids.

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Byrne, Karen. "Efficacy of yoga practices in treatment of asthma : a systematic review /". Thesis, View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B38030627.

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31

Hederos, Carl-Axel. "Asthma in young children : epidemiology, burden of asthma and effects of a parental information program /". Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-251-4/.

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32

McGovern, Colleen M. "COPE for Asthma: A Cognitive Behavioral Skills-Building Intervention for Children with Asthma and Anxiety". The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1541269539391523.

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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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34

Lau, Ming-wai, e 劉明偉. "Effectiveness of pharmacist interventions in the self management of asthma in the community setting : a systematic review". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193784.

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Background: Asthma is a global health problem affecting people of all ages. Despite huge progress on the management of asthma in recent decades, suboptimal health outcomes associated with under-management is still commonly encountered. Self management was shown to be a both clinically and cost effective approach to improve asthma outcomes in some studies. The role of pharmacists in promoting self management of asthma was explored in individual studies but limited review was conducted to assess its effectiveness. Objective: To investigate the effectiveness of pharmacist interventions on the self management of asthma patients in the community setting and to examine if the benefits, if any, could be realized by implementing such interventions in Hong Kong. Methods: A systematic search was conducted on Medline, Embase, Pubmed and Cochrane Library without time limit to identify studies assessing the clinical, humanistic and economic outcomes of pharmacist-led self management interventions towards adolescent or adult patients with asthma compared to usual care. Risk of bias of studies was appraised using a tool adapted from the Effective Practice of Organization of Care version of the Cochrane Risk of Bias Tool. Results: The search yielded 504 studies of which eight studies were eligible for inclusion. The included studies involved 1674 patients, were published between 2001 and 2008 and were originated from seven countries. Discrepancies of findings were noted in the majority of outcome measures reviewed. Significant benefits of pharmacist interventions included improvement of inhalation technique and reduction of rescue medication use although no significant effect was observed with regard to forced expiratory volume in one second and days lost from work or school. Conclusions: The evidence of pharmacist interventions on the self management of asthma remains inconsistent, probably attributable to variable quality of studies and heterogeneous assessment methods and outcome measures. Future research should aim to produce randomized, controlled studies incorporating allocation concealment with a follow-up period of over one year. Nevertheless, pharmacist-led asthma self management initiatives could be implemented at the general outpatient clinic setting in Hong Kong to further improve the quality of primary care.
published_or_final_version
Public Health
Master
Master of Public Health

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35

HOWARD, JOANNE KAY HERGENROTHER. "COGNITIVE ADAPTATION AND THE SCHOOLAGER WITH ASTHMA". Diss., The University of Arizona, 1986. http://hdl.handle.net/10150/183895.

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The purpose of this study was to examine the interrelationships among the themes of Taylor's (1983) Cognitive Adaptation Theory for schoolagers with asthma. In addition, the influence of Taylor's (1983) themes on the children's social behavior was also tested. The three themes of Taylor's (1983) theory included A Search for Meaning, Restoration of Self-Esteem, and Gaining a Sense of Self-Mastery. Two components of A Search for Meaning included the Impact of Disease and the Cause of Disease. Relating Behaviors-Cooperating Behaviors was the index of social behavior. Forty-five Caucasian children between the ages of seven and ten years who had a diagnosis of asthma and did not have any mental disability were the convenient sample. Data were collected in the children's homes. Three questionnaires and two interviews were used to measure Taylor's (1983) themes and Relating Behaviors-Cooperating Behaviors. Descriptive statistics were used to answer the research questions and provide additional findings related to the conceptual framework. Two relationships among Taylor's (1983) themes were significant (p ≤ .05). Children who reported greater impact of asthma upon their lives (Impact of Disease) reported lower self-esteem (Restoration of Self-Esteem). Children who reported greater impact of asthma upon their lives (Impact of Disease) also reported a lesser internal locus of control orientation (Gaining a Sense of Self-Mastery). The Cause of Disease was the only concept which correlated significantly with Relating Behaviors-Cooperating Behaviors and thus, influenced this concept. Children who named a cause for their asthma reported more relating and cooperating skills. The Cause of Disease explained 6.5% of the variance for Relating Behaviors-Cooperating Behaviors. Characteristics of the children's asthma condition and their families were significantly related to the themes of Taylor's (1983) theory and Relating Behaviors-Cooperating Behaviors. Developmental differences were found from age group analyses. The classification of the children's responses for the cause of asthma and reliability and validity estimation for the HIIS were also reported. Five potential sources of error which may have affected the findings included design, instrument, subject, investigator, and specification errors. Suggestions for future research with the conceptual framework were discussed.

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Friedman, Abby H. "Parenting factors related to asthma and anxiety in children". Morgantown, W. Va. : [West Virginia University Libraries], 2007. https://eidr.wvu.edu/etd/documentdata.eTD?documentid=4983.

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37

Murdoch-Schon, Allison. "A study of parents and their children with asthma". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq23436.pdf.

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38

Wallace, Andrea Schneider. "Accessing asthma care : a case study of urban children /". Connect to full text via ProQuest. IP filtered, 2006.

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Thesis (Ph.D. in Nursing) -- University of Colorado at Denver and Health Sciences Center, 2006.
Typescript. Includes bibliographical references (leaves 188-199). Free to UCDHSC affiliates. Online version available via ProQuest Digital Dissertations;

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39

Shaw, Michele R. "Perceptions of Exercise Among School Aged Children with Asthma". Diss., The University of Arizona, 2010. http://hdl.handle.net/10150/194722.

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This grounded theory driven study explored the predominant categories and concepts involved with perceptions of exercise among school aged children with asthma. Ten children (five males, five females), ages 8-12, with various asthma disease severity, were interviewed in their homes. In addition, nine parents completed a health history questionnaire. The emergent grounded theory: The process of creating perceptions of exercise was identified from the data. The ongoing creation of perceptions of exercise was influenced by four predominant categories: perceived benefits, striving for normalcy, exercise influences, and asthma's influence. Because process is an ongoing occurrence, the four predominant categories may influence the creation of exercise perceptions simultaneously, or at different times and in various ways dependent upon the characteristics of the child and their unique situations and experiences (context). Perceived benefits, striving for normalcy, exercise influences, and asthma's influence were identified categories involved with the interactions, actions, and consequences interwoven throughout the creation of perceptions of exercise process. These categories help explain how exercise perceptions are developed from the participants' perspective. The process of creating perceptions of exercise is a continuous, circular, happening with the consequences leading to the development of exercise perceptions. The context may change but the overall process retains applicability to creating perceptions of exercise. The subjective insight gained throughout the development of the theory: the creation of perceptions of exercise, gives light to numerous areas for future nursing research and practice in hopes of improving the overall quality of life among this population.

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40

Beynon, Stephanie Jane. "Behaviour Problems in Children with Asthma and their Siblings". Thesis, University of Canterbury. Educational Studies and Human Development, 2008. http://hdl.handle.net/10092/3158.

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The aim of this study was to examine the relationship between asthma and behaviour, between children with asthma (mean age= 6.11), and their siblings without asthma (mean age= 6.03). Maternal reports of children’s behaviour with asthma (N=10) and their siblings without asthma (N=10) were measured using the Strengths and Difficulties Questionnaire. Additional questions on asthma severity and general health were also included. Using a Chi-square method for matched pairs, the findings indicated that children with asthma did not have more behaviour problems than their siblings who did not have asthma. However, children with asthma were more likely to have tantrums and problems with attention than were their siblings without asthma. The total behaviour score indicated that for seven of the sibling pairs their behaviour was similar, in that there were no problems. Additionally, children who had asthma and took preventer medication were less likely to have behaviour problems than children who did not use asthma preventers. This study was limited by the small sample size and the reliance on maternal reported measure of behaviour. Important factors that might affect behaviour in children with asthma and their siblings were identified, and directions for future research and clinical practice have been proposed.

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41

Tang, Ho-ming Raymond. "Empathy and psychological adjustment in Chinese children with asthma". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B29789497.

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42

Crowley, Suzanne. "Growth and endocrine function in prepubertal children with asthma". Thesis, University of Southampton, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.245044.

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Ross, Kristie R. "Sleep Disordered Breathing, Obesity, and Asthma Severity in Children". Case Western Reserve University School of Graduate Studies / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=case1291296902.

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44

Dawson, Caroline W. "The Lived Experience of Caregivers for Children with Asthma". Thesis, State University of New York at Albany, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10284037.

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The purpose of this study is to describe the meaning of the lived experiences of caregivers of rural children with asthma In order to study the meaning of the experiences for caregivers of asthmatic children with moderate to severe asthma, it was essential that a qualitative methodology in order to explore contextual aspects of the participants’ lives, and the in-depth meaning of their experiences.

The research question was: What is the lived experience of caregivers of children with moderate to severe asthma? Sub-questions included: - What was their understanding of asthma? - How did they respond to their child’ symptoms? - How did their symptoms affected their siblings and spouse? - How did their care needs impact family communication and activities? - What was the impact of care needs on the child’s psychosocial development? - How the child and family response to negative stressors? - What was their perception of social support; and the kinds of support that were - available to them? - What was their perception of control over the management of symptoms? - What was their perception of the social and physical environmental factors affecting asthma symptom management.

The researcher’s primary goal was to learn the lived experience of families with children with asthma from the perspective of the participant. This narrowed the choice of qualitative methodologies to a phenomenological study. The overall intent of the phenomenological study was to learn the meanings that participants attributed to their experiences.

Four overall themes emerged from the study. The themes and sub-themes were: Uncertainty and fear (fear and helplessness; child might die; relief when the symptoms were under control; and long-term effects on the child’s life): Vigilance (potential triggers; early symptoms; emotional changes before the attack; medical regimen; consultation with the physician; and emotional control): Family impact (maternal focus of attention; effects of the hospitalization on child, siblings, and spouse; family social impacts; effects on the child and physical activities; caregivers’ employment; caregiver and child psychological impacts): Social support (spousal; sibling; and physician support).

Earlier studies had identified three primary themes: uncertainty and fear, vigilance, and family impacts. A fourth theme was identified in this study; that asthma is perceived as a chronic condition.

The results demonstrated that there is a need to address both the physiological and the developmental needs not only of the child with asthma but also the child’s family. The results also found that the majority of the caregivers might experience less stress if there were additional sources of social support.

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Gupta, Atul. "Vitamin D and severe therapy resistant asthma in children". Thesis, Imperial College London, 2013. http://hdl.handle.net/10044/1/40890.

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Background There is increasing evidence that low vitamin D levels are implicated in paediatric asthma Hypotheses Children with severe, therapy resistant (STRA) have low serum vitamin D levels which are associated with worse asthma control and airway pathology. In vitro, steroid responsiveness of peripheral blood mononuclear cells (PBMCs) from STRA is improved by vitamin D. Methods Serum 25-hydroxyvitamin D (25[OH]D3) was measured in 36 STRA, 26 mild/moderate asthmatics (MA) and 24 non-asthmatic controls, and related to asthma control and exacerbations. 22/36 children with STRA underwent bronchoscopy with assessment of airway inflammation and remodelling. The in vitro steroid responsiveness of PBMC was assessed, in the absence or presence of dexamethasone and vitamin D. Results Median 25[OH]D3 levels were significantly lower in STRA (28nmol/L) than MA (42.5nmol/L) and controls (56.5nmol/L). There were positive relationships between 25[OH]D3 levels and %predicted first second forced expired volume (r=0.4, p<0.001) and forced vital capacity (r=0.3, p=0.002). 25[OH]D3 levels were positively associated with asthma control test (ACT) (r=0.6, p<0.001) and inversely associated with exacerbations (r=-0.6, p<0.001) and inhaled steroid dose (r=-0.39, p=0.001) in asthmatics. Airway smooth muscle (ASM) mass was inversely related to 25[OH]D3 levels (r=-0.6, p<0.01). Asthmatic children had diminished levels of bronchoalveolar lavage IL-10 (p<0.001). Their PBMC also demonstrated significantly impaired capacity to secrete IL-10 in culture (p<0.001) and the inclusion of vitamin D, enhanced dexamethasone-induced IL-10 (p<0.05), production. Furthermore vitamin D status correlated with airway IL-10 (r=0.6, p<0.01) and CD4+ FoxP3 T regulatory cells (r=0.6, p<0.01). Children with STRA had significantly higher vitamin D binding protein (VDBP) levels in BAL compared to MA (p<0.05) and controls (p<0.01) and these were positively associated with symptoms (ACT) (r=0.5, p=0.01) and inhaled corticosteroid usage (r=0.6, p=0<0.01). Summary Lower serum vitamin D levels in STRA children were associated with increased ASM mass, worse asthma control, lung function and reduced BAL IL-10 and T regulatory cells. In vitro vitamin D enhanced dexamethasone-induced IL-10 production. These data suggest vitamin D supplementation may be useful in STRA and support the need for a clinical trial.

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Turczynowicz, Leonid. "Asthma and risk factors in South Australia : an ecologic analysis". Title page, table of contents and abstract only, 2000. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmt933.pdf.

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Includes CD-ROM inside back cover of volume 2. Bibliography: p. 178-222. Aims to identify current risk factors for asthma and to determine which of these factors, at the population level, is associated with asthma prevalence in children in South Australia. In addition, modelling techniques are used to determine which factors are significant predictors of asthma prevalence in 4 to 5 year old children in S.A. Study results show that at the population level, 9 risk factors are significantly associated with lifetime prevalence and 24 factors with period prevalence. Study findings are generally consistent with existing literature.

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Schuckard, Eeuwe. "Functional Asthma Severity and Impulsive Behaviour in 6 and 7 Year-old Children". Thesis, University of Canterbury. College of Education, 2007. http://hdl.handle.net/10092/1705.

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There is evidence that children with asthma exhibit more externalizing behaviour problems than other children. Impulsive behaviours can mark the onset and severity of externalizing behaviour problems. The present paper reports an exploratory examination of relationships between functional asthma severity and impulsivity in 6 and 7 year old children with asthma (N = 16). Participants with varying functional asthma severity were recruited at age 5 from a larger community study (the Children’s Learning Study). Parents completed items from three subscales of the Connors’ Parent Rating Scale-Revised (CPRS-R), the Hyperactive-Impulsive, Conners’ Global Index: Restless-Impulsive and the DSM-IV Hyperactive-Impulsive subscales. Children completed the Two Choice Paradigm (TCP), a computer program measuring delay aversion type impulsive behaviours. Mean (SD) CPRS-R Hyperactive-Impulsive, Conners’ Global Index: Restless-Impulsive and DSM-IV Hyperactive-Impulsive subscale scores were 59 (11), 56 (10) and 59 (10) respectively. There was no correlation between functional asthma severity and delay aversion or CPRS-R subscale scores and there was no evidence of a trend for such a relationship. Preliminary investigations conducted with a small sample of 6-7 year-old children with asthma thus suggest that functional asthma severity is not related to impulsivity.

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Cox, Karen R. (Karen Rose). "Effects of a self-care deficit nursing theory-designed nursing system on symptom control in children with asthma". free to MU campus, to others for purchase, 2001. http://wwwlib.umi.com/cr/mo/fullcit?p3036817.

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Gaytan, Monika. "The association of dust events with asthma exacerbation in the U.S.-Mexico Border children". To access this resource online via ProQuest Dissertations and Theses @ UTEP, 2009. http://0-proquest.umi.com.lib.utep.edu/login?COPT=REJTPTU0YmImSU5UPTAmVkVSPTI=&clientId=2515.

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50

Edmonds, Marcia. "Inhaled corticosteroids in the emergency department treatment of acute asthma". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ60425.pdf.

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Tesi sul tema "Asthma in children – Treatment"

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