Дисертації: "Chronic Children"

1

Poustie, Vanessa Jane. "Dietary interventions for children with chronic disease." Thesis, University of Liverpool, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269705.

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2

Lindholm, Michelle Marie. "Chronic childhood disease and child abuse." CSUSB ScholarWorks, 1998. https://scholarworks.lib.csusb.edu/etd-project/1559.

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The purpose of the present research is to investigate whether or not chronically ill children are victims of child abuse more frequently than healthy children. The gender of the child and of the parent will also be examined for differences in the treatment children receive.

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3

Jean, Raynice Eveline. "The perceptions among African American caregivers of children with chronic illnesses /." Digital version accessible at:, 1999. http://wwwlib.umi.com/cr/utexas/main.

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4

Godovanets, O. I. "Pathogenetic aspects of the formation of chronic catarrhal gingivitis in children under chronic nitrate loading." Thesis, БДМУ, 2020. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/17833.

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5

Beugnot, Sophie. "Children of chronic pain sufferers, assessing their social competence." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1996. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/MQ30888.pdf.

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6

Duquette, Peter J. Hooper Stephen R. "Attention functions in children with pediatric chronic kidney disease." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2008. http://dc.lib.unc.edu/u?/etd,1648.

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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2008.
Title from electronic title page (viewed Sep. 16, 2008). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the School of Education School Psychology." Discipline: Education; Department/School: Education.

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7

Norman, Lisa Jane. "Nutrition and growth in children with chronic renal insufficiency." Thesis, University of Nottingham, 2002. http://eprints.nottingham.ac.uk/14596/.

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Practical joint dietetic/medical guidelines are required for children with differing levels of severity of chronic renal insufficiency (CRI). This thesis describes the current dietetic/medical package of care provided within a specialised paediatric renal unit, and provides an insight into considerations for future clinical guidelines. Children were grouped at baseline following [51Cr]-labelled EDTA glomerular filtration rate (GFR, m1/min/1.73m2) estimations, into 'normal' kidney function [GFR > 75, mean 106 (SD 19.5), n=58], providing baseline data only, mild (GFR 51-75, n=27), moderate (GFR 25-50, n=21) and severe (GFR < 25, n=19) CRI. Those with CRI were followed for two years and 51 children completed the study (19 mild, 19 moderate, 13 severe CRI). Baseline and 6 monthly measurements of anthropometry, blood pressure, laboratory investigations and yearly dietary intakes (3-day semi-quantitative diaries) were obtained. EDTA GFR's were compared to estimations of GFR using serum cystatin C and plasma creatinine/height concentrations. Amongst the findings, mean standard deviation scores (SDS) for all anthropometric markers deteriorated with worsening renal function at baseline, from mean SDS for weight, height, body mass index and mid upper arm circumference in 'normal' children of O.28 (SD 1.0), 0.19 (SD 1.0),0.21 (SD 1.1) and 0.39 (SD 1.0) respectively, to values of -1.32 (SD 1.0), -1.55 (SD 1.1), -0.44 (SD 1.1) and -0.58 (SD 0.9) in severe CRI. Over two years, mean height SDS significantly increased in children with severe CRI (p=0.003) and was maintained in mild and moderate CRI, despite deterioration in renal function. Correlation between changes in energy intake and height SDS was observed in severe CRI (r2=0.5, p=0.001). From individual observations and correlation, higher phosphate and sodium intakes appeared to be associated with greater deterioration in estimated GFR in children with mild CRI. An inverse correlation between calcium intake and plasma parathyroid hormone was observed in severe CRI (r2=0.27, p=0.065). Disturbances in nutritional intakes, bone biochemistry and growth occurred early in the course of CRI and deterioration in renal function, as determined by estimated GPR, was greatest in those with mild CRI. Regular joint dietetic/medical intervention is likely to be beneficial in children with mild and moderate CRI, in addition to those with more severe CRI, to both correct initial disturbances and reduce the chances of progression.

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8

Pit-ten, Cate Ineke Martha. "Family adjustment to disability and chronic illness in children." Thesis, University of Southampton, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.400489.

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9

Weston, Christine Anne. "Psychosocial adjustment in children and adolescents with chronic illness." Thesis, University of Southampton, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.327607.

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10

Bodnar, G. B. "Specifics of elemental status in children with chronic constipation." Thesis, БДМУ, 2022. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/19762.

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11

Mikheeva, Tetyana, Dmytro Yuriiovych Nechytailo, and Yuriy Mykolaiovych Nechytailo. "Assessment of microcirculation in children with chronic gastroduodenal pathology." Thesis, International medical studens congress Saraevo 2016, 2016. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/12084.

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12

Earle, D. T., and Reid B. Blackwelder. "Management of Chronic Medical Conditions in Children and Adolescents." Digital Commons @ East Tennessee State University, 1998. https://dc.etsu.edu/etsu-works/6909.

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13

Kroner, John. "Associated Symptoms of Chronic Migraine in Children and Adolescents." University of Cincinnati / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1427980899.

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14

Avendt-Reeber, Mary M. D. "Chronic Kidney Disease and Heavy Metal Exposure in Children." University of Cincinnati / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1504873108060796.

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15

Thompson, Jacquelyn J. "How chronic illness affects family relationships and the individual." Online version, 2009. http://www.uwstout.edu/lib/thesis/2009/2009thompsonj.pdf.

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16

McIntosh, Kent. "Academic, behavioral, and functional predictors of chronic problem behavior in elementary grades /." view abstract or download file of text, 2005. http://wwwlib.umi.com/cr/uoregon/fullcit?p3181113.

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Thesis (Ph. D.)--University of Oregon, 2005.
Typescript. Includes vita and abstract. Includes bibliographical references (leaves 106-117). Also available for download via the World Wide Web; free to University of Oregon users.

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17

Chi, Donald Leslie Damiano Peter C. "The impact of chronic condition status, chronic condition severity, and other factors on access to dental care for Medicaid-enrolled children in Iowa." [Iowa City, Iowa] : University of Iowa, 2009. http://ir.uiowa.edu/etd/345.

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18

Fertuck, Deborah. "Children with chronic physical disorder : maternal characteristics and child outcomes." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=56618.

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The purpose of this study was to examine child psychosocial adjustment (i.e., behavioural problems and self-esteem) as a function of maternal well-being, parenting competence, and maternal stress in a sample of children (8 to 16 years) with a chronic physical disorder (CPD) (n = 60) as compared to a sample of non-chronically disabled children (n = 60). While the groups did not differ on either maternal variables or child behavioural problems, CPD children had higher self-esteem than comparison group children. For both groups, mothers with high well-being, high competence, and low stress had children with fewer behavioural problems. Furthermore, mothers of older CPD children perceived themselves as more competent parents, which in turn was related to fewer behavioural problems and higher self-esteem in the child. Mothers who assessed their child's condition as less stressful also had a higher sense of well-being and/or perceived themselves as more competent mothers. While this sample consisted of children whose conditions were of mild to moderate severity, children with more severe conditions had higher self-esteem.

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19

Jenkins, Kate S. M. "Parents of children with disabilities : chronic sorrow and parenting stress." Thesis, University of Southampton, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.420251.

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20

Vatamanesku, L. I. "Diagnostics and treatment of chronic constipations of children with dolichosigmoid." Thesis, БДМУ, 2020. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/17680.

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21

Kueny, Angela M. "Amish family care for children with chronic illnesses: an ethnography." Diss., University of Iowa, 2011. https://ir.uiowa.edu/etd/3326.

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The purpose of this study was to understand the cultural context in which Amish families manage the care of a child with a chronic illness and how it frames the interface with the larger health care delivery system outside their communities. The aims of this study were to describe Amish families' understanding of their children's chronic illnesses, and to describe Amish families' health management and health seeking behaviors for their children within the Amish community and with health services outside their community. Ethnographic research methods were used to paint a cultural portrait of individuals and families, using data sources such as formal and informal interviews with participants, participant observations in the Amish community and family homes, Amish newspapers, and direct observations in health care clinic settings. Informants in this study included Amish families, Amish community members, and health care providers to illustrate commonalities and differences in perspectives on the chronic illness management for children. The study made use of ethnographic analysis, guided by thematic and cultural narrative techniques, to describe Amish family management for children with chronic illnesses in a way that pulls forward how their cultural background is involved in their behaviors and experiences. The results of this study highlight several points: a) the Amish community influences how families understand and appraise concern for their children's illnesses, and families prioritize children's function as a measure of health/illness and see children as ultimately in the hands of God; b) minimal entanglement with the health care community allows for children to be as normalized as possible into the everyday life of the Amish community; c) families prefer to use home remedies to lower costs, potentially prevent the need for health services, and alleviate their child's symptoms in their own homes and community; d) when seeking health services, families prefer treatments they can manage in their homes, health care providers who are knowledgeable about the use of Amish home remedies for their children, and the ability to make health decisions in consideration of the impact to the greater Amish community. To provide culturally competent care for Amish children, this study describes provider competencies needed to understand and accommodate the child's family cultural orientation, values, beliefs, and health care practices into cooperative care planning. One of the most significant attributes for providers to understand when working with Amish families is their collectivist perspective. As collectivists, these families may place the ultimate Amish community goals of believing in God, separation from society, and traditional lifestyle choices over their own when caring for children with chronic illnesses. This is a difficult competency for health care providers who function within a larger medical legal system that requires the placement of individuals above other considerations. It is at the intersection of these two cultures that this study is situated.

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22

Koudys, Julie. "Experiences of children with chronic illness: A qualitative evaluation of a children's mental skills program." Thesis, University of Ottawa (Canada), 2001. http://hdl.handle.net/10393/9027.

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Children with chronic illness are confronted with a variety of acute and chronic stressors. As a result, they require coping strategies that can be used successfully during extremely stressful situations. Mental skills training programs teach children stress management and relaxation techniques that may be used during stressful encounters. The primary purpose of this multiple case study was to evaluate the effectiveness of Orlick's Feeling Great Program in teaching children with chronic illness to deal successfully with stress and find highlights. Qualitative research methods were used to explore factors related to the process of learning mental skills, including types of skills used most often, the influence of context, and factors that effect skill development. Four children receiving treatment for cancer between the ages of 7--9 learned techniques such as muscle relaxation, diaphragm breathing and imagery. Data collection included participant observation, field notes, interview data and highlight journals. Program participants perceived the program to be effective in fostering the development of improved coping skills for use within a variety of situations. During acute stressors, such as painful medical procedures, children and parents reported fewer incidents of reactive coping behaviors, such as crying, and described an increased number of proactive coping responses, such as deep breathing. Furthermore, children learned to cope effectively with chronic stressors, such as feelings of anxiety, nausea and treatment side effects.

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23

Fung, Shuk-man Amy. "Psychosocial risk and protective factors in chronic childhood illnesses : the case of thalassaemia major /." Hong Kong : University of Hong Kong, 1996. http://sunzi.lib.hku.hk/hkuto/record.jsp?B17390084.

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24

Nogueira, Rossana Candiota. "Exercising opportunities to prevent chronic disease: The CAPO Kids trial." Thesis, Griffith University, 2015. http://hdl.handle.net/10072/365819.

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Physical activity is considered to be an effective strategy to improve children’s health and reduce the risk of developing chronic diseases; osteoporosis and obesity being two examples with particularly high morbidity and increased mortality. An exercise program to improve both bone and reduce fat would be ideal. Problematically, bone is known to respond primarily to brief bouts of high-impact activity, while the traditional exercise recommendation to reduce fat is longer duration, low to moderate intensity aerobic activity. The overall aim of the current work was to develop a novel exercise program for pre and peripubertal children to improve bone and minimise the accumulation of fat. The thesis describes four studies, presented as two published manuscripts, one in press and another under review. In the first study, we conducted a comprehensive systematic review, to determine the effects of previous bone-targeted exercise interventions on bone, muscle and fat in school-age children. Meta-analyses were conducted to quantify the findings of the sixteen studies included in the review. We concluded that improvements in fat have previously been observed as secondary benefits of bone-targeted in-school exercise programs.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Allied Health
Griffith Health
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25

Ho, Hoe Yan Greenly. "Cognitive functioning and academic achievement in children and adolescents with chronic pain /." Burnaby B.C. : Simon Fraser University, 2005. http://ir.lib.sfu.ca/handle/1892/2354.

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26

Stork, Dena Diane. "The value of the SPI in forecasting chronic stuttering." PDXScholar, 1991. https://pdxscholar.library.pdx.edu/open_access_etds/4285.

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Speech-language pathologists are in need of useful assessment instruments which differentiate early stuttering behaviors and will enable them to identify preschool children who need immediate intervention for stuttering. Furthermore, useful assessment tools are needed especially due to the variability across studies of normal disfluency and lack of reliability information on more formal measures of differential evaluation of normal disfluency and incipient stuttering.

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27

Hoard, Laura Ruth. "Chronic illness and behavior problems in children mediating and moderating influences /." College Park, Md. : University of Maryland, 2004. http://hdl.handle.net/1903/1578.

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Thesis (Ph. D.) -- University of Maryland, College Park, 2004.
Thesis research directed by: Family Studies. Title from t.p. of PDF. Includes bibliographical references. Published by UMI Dissertation Services, Ann Arbor, Mich. Also available in paper.

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28

Ginkel, Rijk van. "Defecation disorders and chronic abdominal pain in children pathophysiology and treatment /." [S.l. : Amsterdam : s.n.] ; Universiteit van Amsterdam [Host], 2002. http://dare.uva.nl/document/62191.

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29

Shroff, R. "Uraemic vascular damage and calcification in children with chronic kidney disease." Thesis, University College London (University of London), 2009. http://discovery.ucl.ac.uk/14730/.

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Summary of thesis: Cardiovascular disease is the most common cause of death in patients with chronic kidney disease. Structural and functional vascular abnormalities and arterial calcification begins early in the course of renal decline and can be found even in children, contributing to their high mortality risk. Through clinical and laboratory studies, this thesis sought to investigate the causes of uraemic vascular damage and calcification in children with chronic kidney disease and on dialysis. Dysregulated mineral metabolism, manifested by hyperparathyroidism and high phosphate, in association with low vitamin D levels, is key to the pathophysiology of ectopic vascular and soft tissue calcification. In addition, a number of treatment- related factors can potentially lead to a high calcium load, contributing to an increased risk of calcification. Importantly, these are modifiable risk factors and have been associated with an increased mortality risk in adult dialysis patients. Using established surrogate measures of vascular damage, carotid artery intima media thickness, pulse wave velocity and multi-slice CT scan, I have studied a cohort of children on chronic dialysis, and shown that those with mean parathyroid hormone levels above twice the upper limit of normal had increased vascular thickness, stiffer vessels and a higher prevalence of coronary artery calcification, whereas those with lower levels had vascular measures that were similar to age-matched controls. Also, a higher vitamin D dosage was associated with thicker vessels and coronary calcification. To explore this association, in a further study I have measured the levels of 25-hydroxy and 1,25-dihydroxy vitamin D and shown that both low and high levels of 1,25-dihydroxy vitamin D are associated with thicker vessels and calcification. Also, 1,25-dihydroxy vitamin D showed a strong inverse association with high sensitivity CRP, and we speculate that vitamin D’s influence on calcium-phosphate homeostasis and inflammation may be lead to this bimodal effect. Levels of the circulating calcification inhibitors, fetuin-A, osteoprotegerin and Matrix Gla-protein, may influence an individual patients’ susceptibility to calcify, and but have not been described in children. I found that these levels influenced vascular stiffness and calcification, and that there may be a protective upregulation of fetuin-A in the early stages of exposure to a pro-calcific and pro-inflammatory uraemic environment. In a subsequent translational study I have sought to find direct evidence of vascular damage and calcification in the vessels. Using intact human arteries removed at the time of routine surgery, I have shown that calcium accumulation begins pre-dialysis, but dialysis induced vascular smooth muscle cell apoptosis coupled with osteo/chondrocytic transformation and a loss of the normal calcification inhibitors leads to overt calcification. Our currently available clinical measures are not sensitive enough to detect the earliest stages of calcification. On in vitro culture in calcifying media, dialysis but not control vessels showed accelerated time-dependent calcification, suggesting that these vessels had lost their smooth muscle cell defence mechanisms and were primed to undergo rapid calcification. Apoptotic cell death was a key event that triggerred calcification, and this was a vesicle mediated process, possibly involving oxidative DNA damage. This thesis investigates the role of modifiable risk factors in uraemic vascular damage and calcification in children with CKD and explores the earliest changes in the pathophysiology of uraemic medial calcification in intact human vessels.

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30

Bennett-Richards, Katy. "Endothelial dysfunction in children with chronic renal failure : causes and therapies." Thesis, University College London (University of London), 2005. http://discovery.ucl.ac.uk/1445397/.

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Premature death from cardiovascular disease is common amongst adult patients with chronic renal failure (CRF). The implication for paediatric patients, the majority of whom now survive into adulthood, is that they maybe similarly affected but at an earlier age. Children with CRF already show signs of arterial disease in the absence of classical risk factors. The aim of this research was to develop ways of improving the outcome for children with CRF by investigating the effect of interventions on vascular function. Vascular endothelial function, which is dependent on nitric oxide (NO) (an antiatherogenic substance) can be measured using a non-invasive technique of high resolution ultrasound. Abnormal responses represent the earliest change in the pathogenesis of vascular disease and may be reversible. Bioavailability of NO may be reduced in CRF due to low levels of precursors, increased levels of inhibitors and increased oxidant stresses. The hypotheses examined were: 1) Dietary supplementation with L-arginine (the substrate for NO synthetase) improves large vessel endothelium-dependent vasodilatation and NO bioavailability. 2) Dietary supplementation with folic acid reduces homocysteine levels and improves large vessel endothelium-dependent dilatation. 3) Haemodialysis improves large vessel endothelium-dependent dilatation by lowering homocysteine levels, removing inhibitors of NO synthesis, reducing oxidative stress and/or removing free radicals. Methodology was double blinded, randomized and placebo controlled in children with stable CRF in the absence of classical risk factors for atherosclerosis. Endothelial function was measured in the brachial artery. Biochemical measures of NO activity and oxidant stress were also measured, along with the acute effect of haemodialysis on endothelial function. We demonstrated that L-arginine was not beneficial as a therapeutic agent. Folic acid improved vascular function and is now used routinely in all children with CRF at Gt Ormond St Hospital. Haemodialysis had an adverse effect on vascular function-an observation that needs further study as the process in itself may contribute to the development of atherosclerosis.

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31

Hunefeld, Alexandra. "Benefits of Camp Programs for Children and Adolescents with Chronic Conditions." Thesis, Mills College, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10790978.

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A chronic condition causes many psychosocial and emotional impacts to children and adolescents who are diagnosed. However, various interventions, including camp programs, have been developed to promote coping. The intention of this study was to examine the benefits of camps for children and adolescents with chronic conditions from camper-first perspectives. Data was collected through semi-structured interviews of seven participants who attended a camp for children and adolescents with chronic conditions. Results of this study indicated campers experienced many benefits. Further, this study brings an awareness to the impact and importance of camp programs long after the week-long session has ended. Further, it displays camp programs should serve as an intervention utilized by Child Life Specialists and other medical staff to promote optimal growth and development.

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32

Bodnar, O. B., and B. M. Bodnar. "Diagnostics and surgical treatment of chronic constipations of children with dolichosigmoid." Thesis, БДМУ, 2017. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/17153.

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33

Burbage, Michelle L. B. A. "Children with Chronic Illnesses and their Siblings: Building Resilience and Optimism." University of Cincinnati / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1406819854.

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34

Francis, Anna. "Long-Term Outcomes of Children and Adolescents with Chronic Kidney Disease." Thesis, The University of Sydney, 2019. http://hdl.handle.net/2123/20404.

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Chronic kidney disease (CKD) or end stage kidney disease (ESKD) in children is devastating. The overall annual mortality rate for children with ESKD is around 30 times higher than the age matched general population. Cancer after kidney transplantation in adults contributes to mortality risk, but the impact on childhood transplant recipients is unclear. Cancer is not the only complication of transplantation, with disease recurrence a possibility for some children, particularly those with focal segmental glomerulosclerosis (FSGS). In addition, the detrimental effect of kidney disease on the quality of life (QoL) of adults is well known, but poorly described in children across all stages of kidney disease. Finally, adolescents with kidney disease need to transition to adult care. This is well known to be a high-risk period for graft loss and other complications, but the optimal method for transitioning care is unknown. The aim of this program of research was to define long-term medical and psychosocial outcomes for children with CKD and the risk factors for these outcomes. The first chapter summarizes research around selected psychosocial (QoL) and medical (cancer and disease recurrence) complications of CKD. Chapter 2 investigates the QoL of children with kidney disease. Chapter 3 describes the incidence and predictors of skin and non-skin cancers after childhood kidney transplantation. Chapter 4 compares the incidence of post-transplant lymphoproliferative disease (PTLD) between adult and paediatric kidney transplant recipients and chapter 5 investigates the patient and graft survival after a diagnosis of PTLD. Chapter 6 examines the incidence and risk factors of FSGS recurrence. Chapter 7 details treatments of recurrent FSGS in children and adolescents. Finally, chapter 8 explores complications surrounding transition to adult care and details different models of care.

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35

Coleman, Eddie Lee. "Differences in Coping Strategies of African American Children With Chronic Pain." Thesis, Walden University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10978038.

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Chronic pain is a significant problem in the U.S. pediatric population, conservatively estimated to affect 15% to 20% of children. Few studies have focused on coping strategies African American children use to manage chronic pain. The purpose of this study was to examine coping strategies used by African American children and adolescents ages 11 to 18 years suffering from chronic pain and to examine gender and age differences in this population. The gate control theory provided the framework for the study. The Pain Coping Questionnaire was used to measure coping strategies in a convenience sample of 44 children and adolescents recruited from pain clinics and online pain support groups. Descriptive statistics indicated that active coping was used most often, and emotion-focused coping was used least often. Analyses of variance indicated that age was positively related with cognitive distraction, that male participants used problem-solving more often than female participants, and that female participants sought out social support and used internalizing/catastrophizing more often that male participants. Findings may be used to improve assessment and management of chronic pain by providing mental health professionals and doctors with a better understanding of African American children and adolescents’ coping strategies.

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36

Shiu, Shiona. "Achieving equity in educational outcomes for students with chronic illness." View thesis, 2008. http://handle.uws.edu.au:8081/1959.7/19222.

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Thesis (Ed.D.)--University of Western Sydney, 2008.
A thesis submitted to the University of Western Sydney, College of Arts, School of Education, in fulfilment of the requirements for the degree of Doctor of Education. Includes bibliography.

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37

Cavanagh, Ellyn Elizabeth. "Maintaining a childhood : a phenomenologic study of family experiences providing home care for chronically ill, technology-dependent children /." Thesis, Connect to this title online; UW restricted, 1999. http://hdl.handle.net/1773/7373.

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38

Al-Nowaiser, Abeer. "The oral health and oral microflora of children with chronic renal failure and children undergoing renal transplantation." Thesis, University College London (University of London), 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.249318.

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39

Shiu, Shiona. "Achieving equity in educational outcomes for students with chronic illness." Thesis, View thesis, 2008. http://handle.uws.edu.au:8081/1959.7/19222.

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This portfolio documents an investigation of both parent and educator perspectives of managing a chronic illness at school with the aim of developing a framework to ensure that students with chronic illness have equitable access to the same educational outcomes as their healthy peers. This study provides an in-depth exploration of a number of facets of the impact of having a chronic illness, including social, emotional, cognitive and physical aspects. The use of both parent and teacher perspectives provides insights into the realities of having a child with chronic illness at school, and offers some understandings of the risks and challenges parents face as they relinquish care of their ill child into the hands of educators. It also examines the role of educators as they assume much of the responsibility for providing educational, social and emotional support for these students, as well as monitoring their medical needs and health status whilst at school. The evidence from research in the field of child chronic illness suggests that students with chronic illness are at risk academically, emotionally and socially. The effectiveness of any strategy that aims to achieve equity in participation and outcomes for this group of students will depend upon understanding the complex factors that impact on students with chronic illness at school such as absenteeism, relationships with peers and individual resilience. This study addresses the research questions: What are the concerns of parents, educators and students with chronic illness in the educational context? What strategies are consistently being identified as effective in supporting students with a chronic illness at school? And what are the barriers to chronically ill students accessing educational services? Two, two part questionnaires were used to elicit responses from parents and educators of students with chronic illness. The parent respondents consisted of 121 parents of students with chronic illness attending Department of Education schools across NSW, Australia. The teacher respondents consisted of 111 teachers of students with chronic illness in Department of Education schools across NSW. The insights that emerged from the research suggest that the needs of this group of students remain unrecognised and under-resourced. Major findings indicate that many students with chronic illness have high levels of absenteeism, are underachieving academically, have difficulties keeping up and catching up with missed school work, are challenged in their relationships with their peers, and their medical needs are not recognised nor resourced adequately. Teachers of students with chronic illness are inadequately trained, and lack the time and resources to meet the individual needs of these students. The results demonstrated that students with chronic illness are not accessing educational services in the same ways as their healthy peers. The findings of this study suggest schools can make a difference to how well a student and a family cope with chronic illness. The provision of appropriate support, resources and the demonstration of positive attitudes by school communities can foster an environment that facilitates the academic and social growth of the student. The study includes recommendations in the areas of: building communication between home, school and medical professionals; maintaining academic achievement; building peer relationships; managing student medical needs; supporting students returning to school; reducing absenteeism; and supporting emotional health of student and family. The findings of this study have raised an awareness of the needs of students with chronic illness at school, and identified strategies for their support and inclusion. The findings also provide a framework for the provision of educational services for students with chronic illness. Hence, this portfolio represents an exploration of the journey much traveled by parents and educators of students with a chronic illness, with the intent of raising awareness of their needs, and providing direction for policy makers in the field of education, to ensure that students with chronic illness have equitable access to the same educational outcomes as their healthy peers.

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Rayner, Meredith, and n/a. "Resilience and vulnerability in siblings of children with chronic illness or disability." Swinburne University of Technology, 2007. http://adt.lib.swin.edu.au./public/adt-VSWT20071009.105131.

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The focus of this research is the stress placed on a child when a sibling in the family has a chronic illness or disability, and analysis of what factors may buffer this stress and be associated with well child resilience in the face of family illness. Several major studies from other countries (Cadman, Boyle, & Offord, 1988; Houtzager, Grootenhuis, Caron & Last, 2005; Laufersweiler-Plass, Rudnik-Schoneborn, Zerres, Backes, Lehmkuhl & von Gontart, 2003; Sharpe & Rossiter, 2002; Williams, Williams, Graff, Hanson et al., 2002) suggest that there may be deleterious outcomes for well children in such families, for example higher rates of anxiety, depression, aggressive behaviour and rule breaking behaviour. However there is a lack of clarity about the processes which lead to these negative outcomes. The current study had two major research aims. The first was to describe social, family and personal characteristics of a group of well children with siblings who have a chronic illness or disability. The second aim was to examine relationships between adjustment problems in these well children and factors relating to the family (income, number of children in family, respite availability and utilisation), parents (stress, parenting style, maternal education, access to support) and children (ill child behaviour, amount of care required, well child age, well and ill child participation in social activities). Adjustment in well-children (n=102) was assessed using child self report, child projective and parent rating measures. Parents rated well children with ill siblings as significantly higher in externalising and internalising behaviour than age and gender matched population norms. Children did not rate their behaviour problems higher than norms but did indicate quite high rates of emotional problems on a projective (drawing) test. Parent-rated behaviours of well children were associated with parental, family and ill child variables, including (high) parental stress (daily hassles), (low) family income and (high) ill child internalising and externalising behaviours. Relationships between the well child's perception of having a sibling with a chronic illness or disability and various parent, child and family variables were also explored. Well children who listed more negative (than positive) attributes about having a sibling with a chronic illness were more aggressive and rule breaking in their behaviour. Well children with emotional problems, as assessed by the child family drawings, did not differ significantly from children without emotional problems in any of the parent, child or family variables however both the emotional problems index and the use of scribble drawings were associated with several measures of well child maladjustment. The results were discussed in terms of family systems and resilience theory. Implications for well children and their families including practical applications for existing interventions which target well children, ill siblings and parents were discussed and ideas for future directions for interventions to improve outcomes for well siblings were presented.

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Chiriboga, Jennifer Ann. "The effects of gender, ethnicity, and social self concept, on behavioral intentions towards children with chronic illness." Virtual Press, 2005. http://liblink.bsu.edu/uhtbin/catkey/1317742.

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Graves, Carolyn Mary. "Comparing parents' and nurses' identification and prioritization of parental needs in the context of caring for children with chronic conditions." Thesis, University of British Columbia, 1991. http://hdl.handle.net/2429/29728.

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Accurate assessment is the foundation on which effective nursing interventions rest. However, it is not known how accurately nurses identify and prioritize the needs of parents whose children have chronic conditions. When nurses proceed with interventions based on inaccurate assessments, the results can be unsuccessful interventions that neither meet parental needs nor provide optimal health care for this population of children. This descriptive comparative study was conducted to 1) examine parental needs identified and prioritized by parents of children with chronic conditions and their respective nurse care-givers, and 2) identify similarities and differences between the two groups. Patterns that evolved from these similarities and differences provide us with information related to where nurses have expertise or difficulty identifying and prioritizing the needs of parents. Kleinman's (1978) health care systems theory, which supports the premise that health care professionals and clients perceive health care episodes differently, provided the conceptual framework for this study. Study participants included 38 parents and 13 nurses who were affiliated with ten ambulatory programs in a Western Canadian pediatric hospital. Both groups completed the modified Family Needs Survey (Bailey & Simeonsson, 1988b) and socio-demographic tool developed by this investigator. Responses to the 35-item scale of the Family Needs Survey were described and ranked, in addition to being analyzed using inferential parametric statistics to determine differences between parents' and nurses' identification of parental needs. Responses to the open-ended question on the Survey were described and ranked. Research findings revealed some similarities and a number of striking differences between the responses of parents and nurses. On the 35-item scale, parents and nurses agreed that five parental needs were 1) information about current research, future services and treatments, 2) help locating competent regular or respite care providers, 3) reading material about other parents with a similar child, 4) opportunity to meet and talk with other parents, with a similar child, and 5) more time for self, spouse and other children. Both groups were consistent in their ranking of the first two needs as the most important needs in the information and community services subscales, respectively. However, nurses had generally higher responses on all subscales and identified eight more parental needs than did parents which were related to information, support, and family functioning. Parents and nurses repeated most of the above needs on the open-ended question, although nurses indicated that parents also had a number of needs related to psychosocial issues and family functioning. Nurses ranked counselling (child's condition, treatment, stress management) as the primary support need. Further, both groups differed in their prioritization of parental needs on the open-ended question. Where parents ranked information, community services, and support needs as the most important, nurses ranked support, information, and community services. The implications of these research findings for nursing practice and education are discussed and recommendations for future research are presented.
Applied Science, Faculty of
Nursing, School of
Graduate

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Williams, Margaret. "A chronic care coordination model for HIV-positive children requiring antiretroviral therapy." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1020346.

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The human immunodeficiency virus / acquired immune deficiency syndrome pandemic (HIV/AIDS) continues to increase in prevalence worldwide, particularly in South Africa. There is a concurrent and distinct increase in the prevalence of HIV/AIDS and HIV-related diseases in the paediatric population in South Africa, particularly those using public sector health services, with a corresponding increase in morbidity and mortality rates (Abdool Karim & Abdool Karim, 2010:363), which impacts greatly on paediatric healthcare services. Adding to this, the provision of paediatric antiretroviral care has numerous stumbling blocks, not least of which is lack of decentralisation of facilities to provide treatment. There is the additional shortage of staff, which includes staff that are comfortable dealing with children, lack of training programmes on the provision of antiretroviral therapy to children, and minimal on-site mentorship of staff regarding HIV/AIDS disease in children. This lack of capacity in the healthcare system means that not all of those who require treatment will be able to access it, and this is particularly pertinent to paediatric patients (Meyers et al., 2007:198). Therefore the purpose of this research was to develop a nursing model that would assist healthcare professionals, in particular professional nurses, to optimise the comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy at PHC clinics. To achieve the purpose of this study, a theory-generating design based on a qualitative, explorative, descriptive and contextual approach was implemented by the researcher to gain an understanding of how the healthcare professionals and parents/caregivers of HIV-positive children experienced the comprehensive treatment, care and support provided at primary healthcare clinics. The information obtained was used to develop a chronic care coordination model for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy. The study design comprised the following four steps: Step One of the research design focused on the identification, classification and definition of the major concepts of the study. This involved describing and selecting the research population and the sampling process prior to conducting the field work which comprised in-depth interviews with two groups of participants, namely healthcare professionals and parents/caregivers who accompany their HIV-positive children to PHC clinics in order to receive antiretroviral therapy. Step Two of the research design focused on the development of relationship statements in order to bring clarity and direction to the understanding of the phenomenon of interest. Step Three of the design concentrated on the development and description of the chronic care coordination model for optimising comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy in order to ensure a well-managed child on ART. A visual representation of the structure of the model for chronic care coordination was given and described as well as a detailed description of the process of the model. Step Four was the last step of the research design and its focus was the development of guidelines for the operationalisation of the model for chronic care coordination for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at PHC clinics. Guidelines and operational implications for each of the five sequential steps of the model were developed. The evaluation criteria of Chinn & Kramer (2008:237‒248) were used to evaluate the model. It is therefore concluded that the researcher succeeded in achieving the purpose for this study because a chronic care coordination model that is understandable, clear, simple, applicable and significant to nursing practice has been developed for use by healthcare professionals, particularly professional nurses, in order to optimise the comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at primary healthcare clinics.

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Joshi, Suchita. "Long term cardiorespiratory outcome in children with chronic lung disease of prematurity." Thesis, Cardiff University, 2010. http://orca.cf.ac.uk/55504/.

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The findings of this thesis suggest that children with CLD continue to have airway abnormalities including reversible airway obstruction, air trapping and impaired gas transfer compare to term and preterm controls at 8-12 years of age. Although they had similar exercise capacity to preterm and term control groups, this was at the expense of using greater proportion of their ventilatory reserve. At school age, they do not have evidence of myocardial dysfunction or subclinical pulmonary arterial hypertension.

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Swallow, Veronica Mary. "Learning to manage chronic renal disease : the experiences of children and families." Thesis, Northumbria University, 2006. http://nrl.northumbria.ac.uk/1121/.

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Advances in health care have led to an increasing emphasis on family involvement in the day-to-day care of children with chronic renal disease, but if families do not become competent in this it can negatively influence the child's management. Research into the psychosocial implications of childhood chronic disease has been prolific in recent years, although relatively few studies have investigated the way that families learn about chronic disease management. However, a body of work is emerging in the human sciences around the premise that social engagement in communities of practice is a fundamental process by which people learn. Building on these lines of research this study, therefore, aimed to explore the way that children with chronic renal disease and their families learned to manage the condition, and to determine the impact of relationships between families and professionals on the learning process. Using grounded theory within a symbolic interactionist approach, data were collected and analysed in two phases (retrospective and prospective). Phase one aimed to uncover the issues that eight children and/or their parents identified as important in learning about the condition since diagnosis in the preceding four years. In phase two, a longitudinal approach (building on phase one analysis) involving six families and key professionals, allowed detailed exploration, over eighteen months, of learning events that arose following referral to a Children's Kidney Unit. A focus on learning by families as social participation in care was identified in the study. A novel, substantive theory, the social theory of learning in childhood chronic renal disease is proposed comprising three categories: the processes of assessing; interacting and synthesising. Assessing is the process by which families and professionals learn through assessing the disease course as well as each others' ability and social positioning. Interacting is the process whereby families and professionals learn through sharing knowledge, earning and maintaining trust and engaging jointly in decision making. Synthesising is the process whereby families' and professionals' learn through a new, shared understanding based on knowledge of each others' communities of practice, cultures and patterns of learning. The theory conceptualises family learning as: a two way process of interaction in developing an ongoing practice between family members and professionals; the influence of interpersonal as well as intrapersonal learning; and not only acquisition of skills but also the formation of identities in the context where the skills are learned. Three patterns of learning also emerged from the data (parallel, integrated and synthesised). These help to explain some of the differences and similarities between families' learning as they move through the chronic disease journey. This study develops and modifies Wenger's (1998) social theory of learning and Gibson's concept of participatory competence (1995) and contributes an innovative perspective to the growing body of knowledge around childhood chronic disease. Testing and further development of the theory and its use in child health is indicated.

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Cook, Arlene Jane. "The role of leukotrienes in diseases causing chronic airway obstruction in children." Thesis, King's College London (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.244248.

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Hale, Elizabeth Dorothy Pamela. "Children of parent's with chronic inflammatory musculoskeletal diseases : experiences, needs and resources." Thesis, University of Leicester, 2017. http://hdl.handle.net/2381/40394.

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Overview: Whilst each section of the thesis is required to stand alone, it is presented in the following order so that the thesis has a logical flow. Literature review: Presents an overview of the rheumatic diseases and their impact upon parenting and families. We note the provision of patient education for parents, but not for their children. The comprehensive but selective narrative review focuses upon how adults and children conceptualise and understand illness, and explores the concept of normalisation as a potential family management strategy. Service Evaluation: We sought to establish whether parents/grandparents would welcome the provision of appropriate patient education about rheumatic disease being made available to their children/grandchildren. Using a cross-sectional study design, a questionnaire was distributed to adult patients attending the local rheumatology service and members of four UK national rheumatology charities. Participants were strongly in favour of developmentally appropriate patient education for their children/grandchildren. Suggestions were made for content, format, timing and method of delivery. Main Report: We sought to understand how the diagnosis and impact of parental rheumatic disease has been understood, talked about, and managed within families who have young children. Again, we asked for views about providing patient education for children. We were particularly keen to give children a voice in determining whether, and how, any resources designed for them should develop. Utilising a qualitative design informed by an interpretivist framework, we employed semi-structured interviews and visual data collection methods. Eleven families with children aged between seven and 11were recruited from the local rheumatology service. Interviews and visual data were analysed using thematic analysis. The results are discussed within the concept of 'normalization'. Implications for clinical practice and further research are highlighted. Critical Appraisal: Contains a critique of both the research process and the methodology used.

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Leclair, Nadine, Gregor Thörmer, Ina Sorge, Lutz Ritter, Volker Schuster, and Franz Wolfgang Hirsch. "Whole-body diffusion-weighted imaging in chronic recurrent multifocal osteomyelitis in children." Universitätsbibliothek Leipzig, 2016. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-204133.

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Objective: Chronic recurrent multifocal osteomyelitis/ chronic non-bacterial osteomyelitis (CRMO/CNO) is a rare auto-inflammatory disease and typically manifests in terms of musculoskeletal pain. Because of a high frequency of musculoskeletal disorders in children/ adolescents, it can be quite challenging to distinguish CRMO/ CNO from nonspecific musculosketetal pain or from malignancies. The purpose of this study was to evaluate the visibility of CRMO lesions in a whole-body diffusion-weighted imaging (WB-DWI) technique and its potential clinical value to better characterize MR-visible lesions. Materials and methods: Whole-body imaging at 3T was performed in 16 patients (average: 13 years) with confirmed CRMO. The protocol included 2D Short Tau Inversion Recovery (STIR) imaging in coronal and axial orientation as well as diffusion-weighted imaging in axial orientation. Visibility of lesions in DWI and STIR was evaluated by two readers in consensus. The apparent diffusion coefficient (ADC) was measured for every lesion and corresponding reference locations. Results: A total of 33 lesions (on average 2 per patient) visible in STIR and DWI images (b = 800 s/mm2 and ADC maps) were included, predominantly located in the long bones. With a mean value of 1283 mm2/s in lesions, the ADC was significantly higher than in corresponding reference regions (782 mm2/s). By calculating the ratio (lesion to reference), 82% of all lesions showed a relative signal increase of 10% or higher and 76% (25 lesions) showed a signal increase of more than 15%. The median relative signal increase was 69%. Conclusion: This study shows that WB-DWI can be reliably performed in children at 3T and predominantly, the ADC values were substantially elevated in CRMO lesions. WB-DWI in conjunction with clinical data is seen as a promising technique to distinguish benign inflammatory processes (in terms of increased ADC values) from particular malignancies.

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Deggelman, Elissa Lampe. "Coping and Quality of Life for Siblings of Children with Chronic Illness." Kent State University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=kent1309541030.

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Nehus, Edward J. "Correlates of Resistin in Children with Chronic Kidney Disease: The CKiD Cohort." University of Cincinnati / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1318862589.

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Дисертації з теми "Chronic Children"

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