Source: Dissertation Abstracts International, Volume: 70-07, Section: B, page: 4118. Adviser: Charles L. Begley. Includes bibliographical references.

Thesis (Ph.D.) - University of Queensland, 2003. / Includes bibliography.

Esta dissertação de mestrado teve como objetivo avaliar a morbidade de crianças asmáticas, atendidas em um programa de saúde, na Unidade de Saúde Criança Saudável (USCS), da rede municipal de saúde de Criciúma – SC, com avaliação de variáveis clínicas e terapêuticas pré e pós-inclusão no programa. A implantação de um programa de saúde para atendimento de crianças asmáticas, na rede pública de saúde, visa ao conhecimento, adequado manejo e tratamento da asma. Esperava-se que pacientes asmáticos atendidos regularmente tivessem menor morbidade. Quanto à metodologia, foi realizado um estudo de coorte, com análise de variáveis pré e pós-acesso ao programa de saúde para crianças com asma, através da aplicação de escore de acompanhamento da gravidade da asma (EAGA). Foram incluídas oitenta e sete crianças, divididas em dois grupos de acordo com a adesão ao programa, determinada, através da analise da curva ROC para a melhora. Quanto às considerações finais sobre os resultados obtidos, pode-se afirmar que houve diferença significativa entre os grupos considerando a adesão ao programa. O grupo que não aderiu ao programa levou mais tempo para melhora e teve maior uso de corticóide sistêmico. O grupo que aderiu ao programa teve melhora clinica em menor período de tempo, com uso regular de corticóide inalado e técnica de inalação correta. Foi possível concluir, que os pacientes que aderiram ao programa obtiveram significativa diminuição de morbidade, em menor período de tempo, e foram menos expostos ao uso de corticóide sistêmico. / The objective of this master’s thesis was to evaluate the morbidity of asthmatic children treated at a health program at the “Criança Saudável” health unit, belonging to the Criciúma municipal health system, by evaluating the clinical variables and treatment before and after inclusion in the program. The analysis of the implementation of the health care program for asthmatic children in the public health system is important in order to understand the management and treatment of asthma, with a consequent reduction in morbidity of asthma patients who were assisted regularly. Patients who were assisted regularly were expected to have lower morbidity. Regarding methodology, there was a cohort study, comparing results before and after attendance to an asthma program for children through the implementation of a follow-up severity score (EAGA). Eight - seven children were included divided into two groups according to adherence to the program, determined by the ROC curve for improvement. As for final comments on the results, one can say that there was a significant difference between groups, when considering adherence to the program. There was clinical improvement sooner, with regular use of inhaled corticosteroids and a correct inhalation technique, in the adherence group. In the non-adherence group improvement took longer, and they required more courses of systemic corticosteroids. It was possible to conclude that the patients who participated in the program obtained a decrease in morbidity in less time and therefore less exposed to the use of systemic corticosteroids.

Esta dissertação de mestrado teve como objetivo avaliar a morbidade de crianças asmáticas, atendidas em um programa de saúde, na Unidade de Saúde Criança Saudável (USCS), da rede municipal de saúde de Criciúma – SC, com avaliação de variáveis clínicas e terapêuticas pré e pós-inclusão no programa. A implantação de um programa de saúde para atendimento de crianças asmáticas, na rede pública de saúde, visa ao conhecimento, adequado manejo e tratamento da asma. Esperava-se que pacientes asmáticos atendidos regularmente tivessem menor morbidade. Quanto à metodologia, foi realizado um estudo de coorte, com análise de variáveis pré e pós-acesso ao programa de saúde para crianças com asma, através da aplicação de escore de acompanhamento da gravidade da asma (EAGA). Foram incluídas oitenta e sete crianças, divididas em dois grupos de acordo com a adesão ao programa, determinada, através da analise da curva ROC para a melhora. Quanto às considerações finais sobre os resultados obtidos, pode-se afirmar que houve diferença significativa entre os grupos considerando a adesão ao programa. O grupo que não aderiu ao programa levou mais tempo para melhora e teve maior uso de corticóide sistêmico. O grupo que aderiu ao programa teve melhora clinica em menor período de tempo, com uso regular de corticóide inalado e técnica de inalação correta. Foi possível concluir, que os pacientes que aderiram ao programa obtiveram significativa diminuição de morbidade, em menor período de tempo, e foram menos expostos ao uso de corticóide sistêmico. / The objective of this master’s thesis was to evaluate the morbidity of asthmatic children treated at a health program at the “Criança Saudável” health unit, belonging to the Criciúma municipal health system, by evaluating the clinical variables and treatment before and after inclusion in the program. The analysis of the implementation of the health care program for asthmatic children in the public health system is important in order to understand the management and treatment of asthma, with a consequent reduction in morbidity of asthma patients who were assisted regularly. Patients who were assisted regularly were expected to have lower morbidity. Regarding methodology, there was a cohort study, comparing results before and after attendance to an asthma program for children through the implementation of a follow-up severity score (EAGA). Eight - seven children were included divided into two groups according to adherence to the program, determined by the ROC curve for improvement. As for final comments on the results, one can say that there was a significant difference between groups, when considering adherence to the program. There was clinical improvement sooner, with regular use of inhaled corticosteroids and a correct inhalation technique, in the adherence group. In the non-adherence group improvement took longer, and they required more courses of systemic corticosteroids. It was possible to conclude that the patients who participated in the program obtained a decrease in morbidity in less time and therefore less exposed to the use of systemic corticosteroids.

D.Litt. et Phil. (Psychology) / Asthma, which affects persons from early childhood to adulthood, is an old, potentially fatal, worldwide disease but still of increasing prevalence and still with no evidence that the condition can be cured. For patients whose symptoms are severe and intractable the condition can be particularly disruptive causing major changes in daily living and severely impinging upon not only the quality of the individual's life but that of the entire family as well.

The aim of the study was to determine and document evidence of the comparative effect of a 12- week whole body vibration training programme, exercise training programme and sedentary control group on the anthropometric profile, aerobic capacity, lung volumes and hence, the pulmonary capacity in people with asthma. The study used a descriptive, exploratory, quasi-experimental research approach employing randomised pairing to classify participants into either the whole body vibration therapy or exercise training group. Accidental and snowball sampling was used to identify and obtain a base of volunteers. A three-group pre-test/post-test design was employed to gain insight into statistical differences that might be apparent between the whole body vibration therapy group, the exercise group and the control group, and which could potentially be attributed to participation in the whole body vibration exercise programme. Randomised pairing for participant selection was selected because of the potential effects varying pulmonary variables might have had on the reliability of the study. A Physical Activity Selection Criteria Questionnaire was completed by participants to ascertain baseline physical activity readiness and as a means of determining selection criteria for their allocation to the whole body vibration training group, the experimental exercise group or the true control group. The pre-test/post-test assessment made use of a combination evaluation that incorporated an anthropometric profile assessment of height, weight, biceps, triceps, subscapular and suprailliac skinfolds, waist and hip circumference and posture, an aerobic capacity evaluation that incorporated aspects of both the YMCA and Astrand and Rhyming Physical Work Capacity (PWC) evaluation on a cycle ergometer and, lastly, a pulmonary variable assessment that made use of both the Datospir Peak-10 peak flow meter and the Spirovit SP-100AT spirometry unit integrated into the Cardiovit AT-6 model for all spirometry measurements. Participants were required to complete either the whole-body vibration or the exercise training programme a minimum of twice a week and a maximum of four times over the same period. The duration of the intervention programmes was approximately 30 minutes and consisted of three sections including a warm-up comprising flexibility exercises, whole body strength training exercises, and a cool-down which, in turn, consisted of massage exercises or replicated flexibility exercises. The main difference between the whole body vibration and exercise training group thus lay in the exclusion of the use of vibration for those participants assigned to the exercise training programme. Analysis of data was performed using descriptive and inferential statistics with the help of a qualified statistician. The identified variables were tested at a 95 percent level of probability (p<0.05) as recommended by Thomas and Nelson (1996:117). Descriptive data, in the form of a statistical mean, standard deviation, minimum, median and maximum values, obtained during this study were reported in the form of a t-score for selected anthropometric and pulmonary variables. The 12-week intervention programme, on analysis of the results, produced statistically insignificant improvements in the variables of anthropometric profile, aerobic capacity and lung volumes identified as determinants of, and factors influencing, the cardiorespiratory fitness level of participants with asthma and hence, the subsequent severity of this chronic condition. However, slight mean increases for the whole body vibration training group were evident for certain variables identified in this study. Based on the results, the inference could be made that whole body vibration therapy and exercise were both effective modes of training to improve the cardiorespiratory fitness level of people with asthma, but the results of the study did not show sufficient practical or statistical significance to verify the assumption that whole body vibration training was a method superior to conventional exercise training. Hence, the significance of whole body vibration training on the pulmonary variables of people with asthma could not be determined. The researcher recommends that future studies be undertaken to verify whether whole body vibration training incorporating larger participant groups could produce significant improvements in pulmonary variables in people with asthma.

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