Thesis (doctoral)--University of Tartu, 2005.

Thesis (M.A.) -- Central Connecticut State University, 2006. / Thesis advisor: Marc Goldstein. "... in partial fulfillment of the requirements for the degree of Master of Arts in Psychology." Includes bibliographical references (leaves 42-45). Also available via the World Wide Web.

The purpose of the study was to explore the use of Creative Visualization in the context of Family Therapy for treatment of a family of a child with allergies. Based on a single-case research design, the study included pre- and posttest measures; baseline, continuous, and follow-up self-report of symptoms; plus examination of physician's clinical records to determine the efficacy of the intervention. A further purpose of the study was to explore the possible usefulness of a test being developed on the basis of the Psychosomatic Family Model, the Leuven Family Assessment, as an outcome measure. The subject family was an intact family with one adolescent daughter whose most important allergic symptom was poorly controlled asthma, at least partially due to noncompliance with medical advice. The measures included the Leuven Family Assessment, a measure based on the Psychosomatic Family Model, which has been developed for use with families of children with eating disorders; the Family Adaptability and Cohesion Scale (FACES III), a measure based on the Circumplex Family Model, which is a well-accepted measure of family functioning; symptom self-report; and consultation with the child's physician to report hospital admissions and emergency room visits. The baseline period was two weeks, the intervention consisted of two weeks of Relaxation Training and eight weekly meetings for combined Family Therapy and Creative Visualization, and the follow-up consisted of telephone contact with the symptomatic adolescent beginning fourteen weeks after the last family therapy session and continuing for eight weeks. Post-therapy results show a trend toward expected changes in family structure and functioning and marked improvement in the asthmatic symptoms of the adolescent. Creative Visualization is an intervention tool well worth further exploration in the context of family therapy; and the Leuven Family Assessment merits further investigation and development as an outcome measure. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

No description available.

Measuring the Effects of Mouse Allergen and Black Carbon Exposure on Children Living in New York City with Allergic Diseases Medina Samira Jackson-Browne Background: Exposure to allergens and combustion by-products are risk factors for allergic health outcomes in children. The connection between exposure to allergens and allergic diseases such as asthma, in some children, is through the development of a biological condition known as allergic sensitization. In susceptible children, sensitization may occur when early-life exposure to an allergen causes the production of immunoglobulin E (IgE) antibodies. In asthmatic children, repeated exposures to this allergen may lead to clinical manifestations including airway inflammation, airway mucous production, bronchospasms, and bronchial hyper-responsiveness. Sensitization and repeated exposure to allergens may, therefore, be important risk factors for asthma morbidity in children. Findings from a cross-sectional asthma study of children living in NYC published previously by our group found a positive association between cockroach and dust-mite allergens measured in bed dust and sensitization risk to these allergens consistent with other studies. However, contrary to previously published research, no association was observed between mouse allergen measured in bed dust and mouse sensitization risk in our study. In urban areas such as New York City (NYC), exposure to combustion by-products, including black carbon (BC), has been shown to be associated with both asthma development and asthma morbidity. BC has been proposed to exacerbate asthma symptoms directly through airway irritation or by behaving as an adjuvant, enhancing the production of IgE antibodies following exposure to an allergen in sensitized individuals. Our group previously observed an association between indoor measured BC concentrations and airway inflammation, however no association was found between BC and asthma symptoms for children living in NYC. In the present study, we sought to address some of the limitations of the previous work. These limitations included a singular measurement of mouse allergen exposure, a shorter-term BC exposure measurement, and a cross-sectional study design for asthma symptom risks. My overarching hypothesis for this dissertation is that exposures to mouse allergen and BC are significant risk factors for allergic sensitization and asthma morbidity, respectively, for children living in NYC. I tested these hypotheses in three separate manuscripts by assessing multiple mouse exposure measurements with the risk for mouse sensitization (Chapter 2), testing the correlation between 7-day measured indoor BC and particulate matter smaller than 2.5 microns (PM2.5) concentrations with annual modeled outdoor BC and PM2.5 concentrations (Chapter 3), and determining whether annual modeled outdoor BC concentration is associated with persistent asthma symptoms, over a three-year period, for asthmatic children in NYC (Chapter 4). Methods: For all manuscripts, data from an asthma case-control cohort of children (age 7-8 years) previously established by our group, the NYC Neighborhood Asthma and Allergy Study (NAAS), was utilized for analysis (n=350). Kitchen floor and bed settled dust samples were collected from the children’s home during the initial home visit. Mouse allergen concentrations were quantified from both kitchen floor and bed dust samples using an enzyme-linked immunosorbent assay (ELISA). Blood samples were also collected during this visit. IgE antibodies to mouse allergens were measured by ImmunoCAP (Phadia, Uppsala, Sweden) from these blood samples. Information on the frequency of mouse sightings in the previous 12 months was extracted from a questionnaire administered to parents of NAAS children. Neighborhood and school mouse sightings were collected from reports from the NYC Department of Health and Mental Hygiene (DOHMH). Indoor PM2.5 and BC samples were collected from air samplers placed in NAAS children’s home for an average of 7 days. In collaboration with the NYC DOHMH, we were given access to 2-year averaged modeled outdoor PM2.5 and BC concentrations collected from air monitors at 124 street-level locations throughout NYC from 2008-2010. After the initial home visit, asthmatic NAAS children were followed-up annually for asthma symptoms. The questionnaire data collected from the asthmatics followed were used to evaluate the persistence or remittance of asthma symptoms over the 3-years following the initial home visit. Results: In our mouse study we found that increasing mouse allergen measured from kitchen floor dust and children whose parents reported greater than weekly mouse sightings in the previous 12 months has an increased risk of mouse sensitization (prevalence risk (PR) = 1.09 [1.02-1.17], p=0.04 and PR= 3.84 [1.95-6.97], p=0.001 respectively). Neither mouse allergen measured from settled bed dust (PR = 1.06 [0.95-1.19], p=0.46) nor neighborhood rodent reports (PR = 1.25 [0.94-1.68], p=0.16) were significantly associated with an increased risk of sensitization to mouse. Exposure to mouse at school was also not associated with an increased risk of mouse sensitization (PR=0.66 [0.35-1.26], p=0.30). Results from the correlation study indicated both annual modeled outdoor PM2.5 and BC concentrations were weakly correlated with 7-day measured indoor PM2.5 and BC concentrations (r = 0.21 and 0.39, respectively, p < 0.01). However, annual modeled outdoor BC concentrations predicted almost 20% of the variability of 7-day measured indoor BC (R2=0.19, p<0.001) compared to only 4% of the variability of 7-day indoor PM2.5 explained by annual modeled outdoor PM2.5, which predicted measured indoor PM2.5 (R2 = 0.04, p < 0.001). Our regression analysis of the asthma morbidity study found no significant association between longer-term neighborhood modeled BC concentrations at study participant’s home (PR = 0.87 [0.58-1.29, p=0.49] and school addresses (PR =1.09 [0.77-1.56], p=0.60) and persistent asthma symptoms. Conclusions: My findings suggest that mouse allergen measured from kitchen floor dust and parent reported mouse sightings are important risk factors of mouse sensitization for children living in urban areas such as NYC. The results of the BC analysis indicate a moderate correlation between annual modeled outdoor BC concentrations and 7-day measured indoor BC concentrations. The annual modeled outdoor BC also predicted 20% of the variability in 7-day measured indoor BC. Conversely, PM2.5 analysis indicate that annual modeled outdoor PM2.5 is not correlated with 7-day measured indoor PM2.5 concentrations. Finally, regression analysis of BC exposure and asthma morbidity indicate that annual modeled outdoor BC is not predictive of persistent asthma symptoms in our cohort.

Thesis (M.A.)--West Virginia University, 2000. / Title from document title page. Document formatted into pages; contains viii, 123 p. Includes abstract. Includes bibliographical references (p. 63-68).

Failure to comply with prescribed regimens is a major reason for the failure of treatment programs. This study investigated factors which are related to compliance with prescribed diet revision therapy for food allergies in school-aged children. Forty-five children, aged 6 to 12 years, who were under a physician's care for food allergies, formed the sample. The Health Belief Model was used as the basis for a questionnaire devised to measure these factors. The development of the Diet Revision Therapy Parent Questionnaire involved a pilot test and revisions; the resulting instrument consists of 38 items organized into 4 subtests, of which one 7-item subtest is to be considered optional. The 38-item DRTPQ has a full scale internal consistency reliability of .87, and a composite reliability of .61 for the four subscales. The canonical correlation between 3 types of subjective ratings of compliance and the 4 subtests is .80, with 64% shared variance between these sets of variables. A discriminant function of 3 subtests of the DRTPQ proved capable of discriminating diet therapy dropouts from continuing subjects with 88.9% accuracy. These three subtests measured: 1. Parent and family life factors, such as the amount of perceived interference in normal routines, 2. Child's attitudes to the treatment and his/her normal behavior with respect to cooperation with parental demands, and 3. Belief in the benefits to be derived from the treatment. A fourth category of items measured perceived severity of the condition and perceived susceptibility to illness but proved not to predict compliance in this sample, although it may be useful in clinical practice. Suggestions for interventions to aid compliance are outlined. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Thesis (MSc Consumer Sc)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: Food allergies in children are a growing problem and have various effects on these children, their households, the community and the economy. No medication or cure is currently available to consumers suffering from food-allergies. Medical teams are aware of the patients' need for support, but information is lacking and understanding of their basic needs and problems neglected. Two qualitative research methods, namely the focus group technique and case studies were used to investigate the emotional and physical environment of children allergic to wheat, soy, cow's milk and egg respectively. Five focus group meetings were conducted with the caregivers of food-allergic children. Two during the pilot study and three in the main study. A total of twenty three participants attended the three meetings of the main study. A meeting schedule was developed and the meetings carefully moderated. After the data had been obtained from the focus group meetings, there was a need for more in-depth information and understanding. Seven of the participants of the focus groups were identified, through developed criteria, to be further investigated as case studies. Five units of investigation were identified for the case studies. It was the (i) caregiver, (ii) allergic child, (iii) other children, (iv) "non-caregiver parent" and (v) household. Some of the matters that were investigated in both the focus groups and case studies were health consciousness, menu planning, recipe needs and use, reading of food labels, hidden allergens and the social and emotional effects of having and being a food-allergic child. A great need for better support and educational programs to assist these households were identified. Very few of the households were health conscious, while they all experienced problems with menu planning, identifying hidden allergens and suffered from social and or emotional problems. Very few participants made use of recipes or identified a need for allergen-free recipes. After having gained insight in the daily lives of these households, four - virtually identical, two-week menu cycles were developed to suit the life style requirements and restrictions of these children. The same recipes were used, but allergens omitted, replacements made and the recipes adapted as necessary. Product scouting was done for hidden allergens in selected popular convenience foods, especially those from the lowest level of the USDA Food Guide Pyramid. Hidden allergens appeared to be a problem when food is prepared and bought for the food allergic child. It should be taken into account that despite the information stated on the food label undeclared allergens might still be present in food. The two-week menu cycle for the child allergic to cow's milk was then quantitatively evaluated for nutritional adequacy by FoodFinder ™ 2 - a software program, for children aged between seven and ten years. All the macronutrients and micronutrients identified by the National Survey in 1999 as insufficient «67% of the RDA) among South African children aged between one and nine years, were evaluated as well as those mentioned in the WHO Dietary and Health Goals. All the nutrients were sufficient, except for calcium and Vitamin D. Supplementation is advised. The sensory acceptability of the menu-items in the two-week menu cycles were not evaluated. A vast number of issues pertaining to the food-allergic child require further research. A great need exists for the development of educational programs to support the households with food-allergic children. The identification of hidden allergens and the development of reliable sensory testing models for food-allergic children are all areas that should urgently be researched further. / AFRIKAANSE OPSOMMING: Voedsel-allergieë by kinders is 'n groeiende probleem met 'n verskeidenheid effekte op dié kinders, hulle huishoudings, die gemeenskap en die ekonomie. Tans is geen medikasie of kuur teen voedsel-allergieë beskikbaar nie. Mediese spanne is bewus van die behoefte aan sorg en leiding wat deur dié spesifieke groep verbruikers benodig word, maar inligting oor hulle behoeftes en probleme is ontoereikend. Twee kwalitatiewe navorsingsmetodes, naamlik die fokusgroeptegniek en gevallestudies, is gebruik om die emosionele en fisiese omgewing van kinders allergies vir onderskeidelik grane, soja, melk en eiers te ondersoek. Tydens 'n voorloperstudie is twee fokusgroepvergaderings gehou. Vir die hoofstudie is drie fokusgroepvergaderings met versorgers van kinders met 'n voedsel-allergie gehou met 'n totaal van drie en twintig deelnemers. 'n Vergaderingskedule is ontwikkel en die vergaderings is sorgvuldig gemodereer. Nadat die data van die fokusgroepe ingesamel is, was daar behoefte aan meer in diepte inligting en begrip. Aan die hand van ontwikkelde kriteria is sewe van die deelnemers aan die fokus groepe as gevallestudies geselekteer. Vyf eenhede van ondersoek is geïdentifiseer vir die gevallestudies. Dit is: (i) die allergiese kind, (ii) versorger, (iii) ander kinders, (iv) die "nie-versorgende" ouer en (v) die huishouding. Sommige van die aspekte wat in beide die fokusgroepe en gevallestudies ondersoek is, was gesondheidsbewustheid, spyskaartbeplanning, die gebruik en behoefte aan resepte, lees van voedseletikette, verskuilde allergene en die sosiale en emosionele effek van 'n voedsel-allergie op die kind sowel as die ouers. 'n Groot behoefte aan beter ondersteuning en opvoedkundige programme, om hierdie huishoudings te help, is geïdentifiseer. Baie min van die huishoudings was werkilk gesondheidsbewus, terwyl hulle almal probleme met spyskaartbeplanning, identifisering van verborge allergene en sosioemosionele probleme ondervind het. Weinig van die deelnemers het gebruik gemaak van resepte of het 'n behoefte aan allergeen-vrye resepte ondervind. Nadat insig in die daaglikse lewenstyl van hierdie huishouding verkry is, is vier amper-identiese twee-weekse siklusspyskaarte ontwikkel wat die lewenstyl en behoeftes van hierdie huishoudings aanspreek. Dieselfde resepte was gebruik vir al vier twee-weeksiklusspyskaarte, met die verskil dat verskillende allergene vervang is, na gelang van die allergie verskillende behoefte. Marknavorsing is gedoen op alledaagse produkte en is hoofsaaklik gefokus op die produkte wat die basis van die voedselpiramide uitmaak. Daar is bevind dat verskeulde allergene voorkom in produkte waar dit nie verwag word nie, en soms selfs nie op die voedseletikette verklaar word nie. Die twee-weeksiklusspyskaart van die melk-allergiese kind is kwantitatief ge-evalueer vir toereikendheid van die dieet vir kinders tussen die ouderdomme sewe tot tien jaar op die Foodfinder TM 2 - sagteware program. Die makro- en mikronutriente wat volgens 'n nasionale opname in 1999 as problematiese «67% van die RDA) vir kinders in die ouderdomsgroep een tot nege, uitgewys is, is geneem en die voedingstowwe is ook teen die Werêld Gesondheidsorganisasie (WHO) se dieetdoelwitte getoets. AI die nutriënte was voldoende volgens die analise, behalwe kalsium en Vitamen D. Supplementasie word aanbeveel vir dié twee nutriënte. Die sensoriese aanvaarbaarheid van die spyskaartitems in die siklusspyskaart is nie getoets nie. Verskeie aspekte wat vorendag gekom het, benodig verdere navorsing. 'n Groot behoefte aan die ontwikkeling van opvoedkundige programme, wat die huishoudings met voedsel-allergiese kinders ondersteun, bestaan. Die identifikasie van verskuilde allergene en die ontwikkeling van 'n beproefte sensoriese toetsmodel vir voedsel-allergiese kinders is potensiële gebiede wat dringend verder nagevors behoort te word.

Allergic diseases affect a substantial proportion of people living in urban areas in the United States in general and in New York City (NYC) specifically. Many types of pollen are considered to be allergens, and have been linked to several manifestations of allergic disease, including allergic sensitization, exacerbation of allergic rhinitis, and exacerbation of allergic asthma. However, the role of pollen in determining temporal patterns of allergic disease is incompletely understood, and virtually nothing is known about the spatial distribution of pollen within cities and the relevance of this distribution to health. A better understanding of these relationships is especially critical as massive urban tree planting projects progress, and as the length and severity of the annual pollen season changes in response to changing temperature and carbon dioxide concentrations. The overall objective of this dissertation was to measure the spatial and temporal patterns of tree pollen in NYC and examine their associations with several allergic disease outcomes. Chapter 1 evaluates the health effects of the temporal distribution of pollen by examining the relationship between daily concentrations of several types of tree pollen measured in Armonk, NY with emergency department (ED) visits for asthma in NYC. We found that daily concentrations of four allergenic tree pollen genera were associated with a significantly increased rate of ED visits for asthma citywide. We further found that these associations were stronger in zip codes with higher tree canopy cover, suggesting that there may be spatial heterogeneity in tree pollen exposure within NYC not captured by the daily monitoring station. Chapter 2 tests the hypothesis that there is spatial variability in tree pollen within NYC by developing a novel dataset of spatial pollen measurements for the 2013 pollen season from 45 sites across NYC. These sites were co-located with an established network of air pollutant monitoring sites. Results from the 2013 monitoring campaign demonstrated substantial variability in tree pollen levels across the city. Total tree pollen deposition ranged from 2,942 grains per cm² to 17,460 grains per cm², a factor of almost six. Some individual tree pollen taxa exhibited an even greater degree of variation. We also developed a land use regression model for total tree pollen and tested the hypothesis that tree pollen influx at these sites is associated with tree canopy cover. When included alone in the model, percent tree canopy cover within a 0.5 km radial buffer of the monitoring sites explained 39% of the variance in tree pollen, while the inclusion of additional land use variables did not improve model fit. In Chapter 3, we use the land use regression model to develop tree pollen exposure estimates for children enrolled in the NYC Neighborhood Allergy and Asthma Study and evaluated whether modeled tree pollen influx for the first year of life is associated with allergic sensitization to tree pollen by age 7-8. We found that a standard deviation increase in tree pollen exposure in the first year of life was associated with a 50% increase in the prevalence of allergic sensitization to tree pollen. Furthermore, this association was stronger among children in the top 50% of black carbon exposure, suggesting that exposure to traffic-related pollutants may facilitate allergic sensitization.

Lui, Kit Yee. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 150-157). / Abstracts and questionnaire in English and Chinese. / Title --- p.1 / Abstract --- p.2 / Acknowledgement --- p.7 / Table of contents --- p.8 / List of tables --- p.11 / List of figures --- p.12 / Glossary of terms and abbreviations --- p.13 / Chapter Section I: --- Overview --- p.14 / Chapter Chapter 1: --- Introduction --- p.15 / Chapter 1.1 --- Prevalence of food allergy in children --- p.15 / Chapter 1.1.1 --- Methodologies for studying food allergy --- p.18 / Chapter 1.1.2 --- Skin Prick Test and its mechanism --- p.19 / Chapter 1.1.3 --- Measurement of serum specific IgE levels --- p.21 / Chapter 1.1.4 --- Gold standard for diagnosis of food allergy --- p.22 / Chapter 1.2 --- Aim of Study --- p.25 / Chapter Chapter 2: --- Plan of Study --- p.26 / Chapter Section II: --- Literature Review --- p.28 / Chapter Chapter 3: --- Epidemiology of food allergy --- p.30 / Chapter 3.1 --- Prevalence of food allergy in children in western countries --- p.30 / Chapter 3.2 --- Prevalence of atopic allergies in children in rural areas --- p.34 / Chapter 3.3 --- Euro Prevail - A standardized methodology in studying food allergies --- p.38 / Chapter 3.4 --- Epidemiology of adverse food reaction in Hong Kong pre-school children --- p.40 / Chapter Chapter 4: --- Diagnosis of food allergies --- p.44 / Chapter 4.1 --- History --- p.44 / Chapter 4.2 --- Use of Skin Prick Test for diagnosis --- p.45 / Chapter 4.3 --- Use of serum specific IgE level for diagnosis --- p.47 / Chapter 4.4 --- Use of double-blind placebo-controlled food challenge for diagnosis --- p.49 / Chapter 4.5 --- Factors affecting precise diagnosis of food allergies --- p.51 / Chapter 4.5.1 --- Procedure-related Factors --- p.51 / Chapter 4.5.1.1 --- Performance of skin prick test --- p.51 / Chapter 4.5.1.2 --- Cross-reactivity of serum specific IgE --- p.52 / Chapter 4.5.1.3 --- Different diagnostic decision points in different populations --- p.53 / Chapter 4.5.1.4 --- Sensitization and allergy --- p.54 / Chapter 4.5.1.5 --- False negative oral food challenges --- p.55 / Chapter 4.5.2 --- Patient Factors --- p.56 / Chapter 4.5.2.1 --- Age of subjects --- p.56 / Chapter 4.5.2.2 --- Diet before tests --- p.57 / Chapter 4.5.2.3 --- Anti-histamine medications --- p.57 / Chapter 4.5.2.4 --- Skin sensitivity of subjects --- p.58 / Chapter Chapter 5: --- Risk factors for development of food allergies --- p.59 / Chapter 5.1 --- Factors associated with development of food allergies --- p.59 / Chapter 5.2 --- Food allergy and asthma --- p.62 / Chapter 5.3 --- Food allergy and eczema --- p.63 / Chapter Section III: --- Original Study --- p.64 / Chapter Chapter 6: --- Methodology --- p.65 / Chapter 6.1 --- Study Population --- p.65 / Chapter 6.1.1 --- Sample size calculation --- p.66 / Chapter 6.2 --- The EuroPrevall Study --- p.67 / Chapter 6.3 --- EuroPrevall Questionnaires --- p.68 / Chapter 6.4 --- Standardized Approach for Answering Questions in the Field --- p.69 / Chapter 6.5 --- Anthropometric Measurements and Ethics Approval --- p.70 / Chapter 6.6 --- Skin Prick Testing --- p.71 / Chapter 6.7 --- Measurement of serum specific IgE level --- p.72 / Chapter 6.8 --- Classification of Subjects --- p.74 / Chapter 6.9 --- Statistical Analysis --- p.75 / Chapter Chapter 7: --- Results --- p.76 / Chapter 7.1 --- Subjects and Demography --- p.76 / Chapter 7.2 --- Reported Symptoms in Chinese Children --- p.80 / Chapter 7.3 --- Food allergen sensitization in Chinese Children --- p.81 / Chapter 7.4 --- Association between food sensitization and allergic symptoms --- p.89 / Chapter 7.5 --- Prevalence of Food Allergy in Chinese Schoolchildren --- p.93 / Chapter Chapter 8: --- Discussion --- p.96 / Chapter Chapter 9: --- Conclusion and Further Studies --- p.102 / Appendix 1 Screening questionnaire (Chinese Version) --- p.106 / Appendix 2 Screening questionnaire (English Version) --- p.109 / Appendix 3 Case-control questionnaire (Chinese Version) --- p.111 / Appendix 4 Case-control questionnaire (English Version) --- p.132 / References --- p.150