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Background: School settings are one of the most crucial context for asthma management second only to a child’s home. Today school administrators are faced with many challenges, not only are they responsible for students' learning needs but they also manage complex behavioural and health issues including asthma. Most do not have standardized plans regarding asthma management. Objectives: 1) Systematically review the research literature related to asthma management within the school setting. 2) Determine current asthma management practices as reported by school administrators. 3) Explore experiences and barriers to asthma management practices with school administrators. Method: Guided by the Knowledge to Action framework, the study was divided in three phases using a planned action approach and included an integrative synthesis of the evidence, an administrators’ survey, and an administrator’s meeting. Findings: Phase One: Following a search using three databases, 67 articles were critiqued. The literature illustrates that many countries have established “asthma friendly schools” legislation that includes process for identifying children with asthma, right to self-carry and administer medications, enhancing communication and cooperation between school staff, parents, and children with asthma, reducing triggers in school environment, and effective policies that make legislation a functioning reality within schools. Phase Two: Ninety-seven surveys were distributed within two district school boards with 61 completed surveys returned (63% response rate). Key findings included underestimation of the prevalence of asthma, no standardized process for identifying children with asthma, staff training deficiency for recognizing and responding to asthma exacerbations, lack of individual asthma action plans for children, absence of programs to support current legislation and best practice guidelines. Communication was the most common barrier identified by school administrators. Phase Three: Two principals in an administrator’s meeting validated the survey results. Participants were not familiar with the concept of asthma friendly school, asthma prevalence rates, or free school asthma resources. Asthma Action Plans were not universally understood as individualized written plans but rather a generalized first aide response plan. Conclusion: There are knowledge and practices gaps placing children with asthma at risk for exacerbation and death within school setting. Administrators want to partner to facilitate optimal asthma management within the school setting. / Thesis (Master, Nursing) -- Queen's University, 2013-11-25 11:38:01.902

There is evidence to suggest that inspiratory muscle training (IMT) may influence the functional properties of the muscles of the upper (UA) and lower (LA) airway. However, the nature and functional relevance of this influence is currently unclear. This thesis examined the effect of acute and chronic IMT in the context of UA and LA function. The ability of IMT to activate the UA dilator muscles, genioglossus (GG) and geniohyoid (GH), was examined using magnetic resonance imaging (MRI), as was the effect of chronic training on these muscles. In addition, the effect of acute and chronic IMT upon LA resistance (Rrs) and function was investigated in people with asthma using the Forced Oscillation Technique and conventional spirometry. For the UA, an acute bout of IMT at 60% maximal inspiratory mouth pressure (MIP) resulted in significant GG and GH activation (P < 0.001) as demonstrated by increases in the transverse relaxation time of muscle water (T2). Despite this, MRI was unable to detect any effect of chronic IMT upon UA function. For the LA, the usual increase in Rrs, following deep inhalation (DI) in people with asthma was attenuated with both single and multiple breaths against a pressure-threshold load equal to 50% MIP. However, six weeks IMT had no effect on baseline airway function or response to DI. In conclusion, an acute effect of pressure-threshold IMT upon UA and LA function was demonstrated. A strong rationale for a beneficial influence of chronic pressure-threshold IMT was therefore demonstrated. However, the data were insufficient to either reject, or accept the hypothesis that IMT exerts more than a transient influence upon UA and LA function, but insights are presented that support the need for further investigations.

Childhood asthma is a chronic condition affecting up to one in every seven children. Self-management programs have been developed to help improve children's abilities to both manage and cope with their asthma. If these programs are to be fully effective, an understanding of the psychological factors that influence children's sense of competence to manage their condition is required. This study aimed to identify psychological variables that may influence children's asthma self-efficacy including children's health locus of control, child's attitudes toward illness and children's level of anxiety. The relationship between children's level of asthma knowledge and their sense of competence to manage the illness was explored. The importance of parent's level of asthma knowledge and parent asthma self-efficacy was also examined in relation to children's level of asthma self-efficacy. The study adopted a within group cross-sectional approach. Children aged 7-15 years of age with asthma were invited to participate in the research. Data were collected on 71 children and their parents based on self-report measures rating child and parent asthma self-efficacy and asthma knowledge, child health locus of control, child attitudes toward illness and anxiety. A correlational design was employed to test for associations and relationships between children's asthma self-efficacy and the factors noted above. Results will be given and discussed with reference to previous research findings with conclusions reached.

Class of 2017 Abstract / Objectives: A chart will be used to assess the need for the asthma education program. The chart review aims to: analyze the refill history of asthma medications along with verifying adherence via electronic health record and assess if patients are getting appropriate asthma therapy per 2007 NHLBI asthma guidelines. Methods: The patient’s MHC Healthcare electronic record profile and pharmacy refill record will be accessed. The information that will be obtained from the electronic health record will be: ethnicity, age, sex, allergic rhinitis diagnosis, flu vaccine status, pneumonia vaccine status, GERD diagnosis, spirometry measure if available, use of prednisone for exacerbation, prescribed asthma therapy, and provider’s (MD, NP, PA, etc)’s notes that might indicate nonadherence. The information that will be obtained from the pharmacy record are controller and rescue medication refill history. The information will be recorded in paper data collection forms and electronic versions will be saved to the secure college of pharmacy workgroup. The raw physical information described above will be stored in a locked cabinet at MHC healthcare pharmacy inside the pharmacy director’s office and the de-identified information will be stored in the secure workgroup. Results: Conclusions: