No description available.

published_or_final_version / abstract / toc / Educational Psychology / Master / Master of Social Sciences

No description available.

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

Thesis (M.A.)--West Virginia University, 2003. / Title from document title page. Document formatted into pages; contains vii, 57 p. Includes abstract. Includes bibliographical references (p. 39-45).

Asthma is a chronic inflammatory disease causing bronchospasm, which leads to the sensation of shortness of breath. Children with asthma are often afraid of exercise because the exercise induced exacerbation which gives children a sense of breathlessness. As a result, they usually have a sedentary lifestyle that decreases their physical fitness. However, there is evidence supporting the claim that exercises do not induce exacerbation, and exercise should be encouraged to asthmatic children to improve their physical fitness. In Hong Kong, protocol for exercise training with asthmatic children is limited. This is unfortunate because recent studies have shown that exercise training has improved the physical fitness of asthmatic children. This present studies used databases included PubMed (from 1950 to 2012), Ovid MEDLINE® (from 1950 to 2012), CINAHL (from 1982 to 2012), and ProQuest (from 1999 to 2012), to identify significant research on the topic. Eight studies, including seven RCTs and one cohort study, were chosen for in depth review. They were all good quality studies with satisfactory results that identified improvement in physical fitness for mild to moderate asthmatic children after exercise training. This present studies proposed an exercise training program for a pediatric ward in a public hospital in Hong Kong. The target population is children, aged 7 to 17, who suffer from mild to moderate asthma. They will enroll in an exercise training program to perform cycling in a clinical setting three times per week. The program will be sustained for nine weeks. The participants will undergo the innovation under the supervision of trained nurses. Evidence-based protocol is developed for the innovation to guide nurses on how to carry out the exercise training effectively and smoothly. The Scottish Intercollegiate Guidelines Network (SIGN) grading system is adopted to measure the levels of evidence and grading of the recommendations in the protocol. A communication plan will be developed to gain support from the identified stakeholders. A pilot study plan will be established in order to determine the feasibility of the proposed innovation. The exercise stress test, which is the primary outcome of the innovation, will be measured in the pilot study. Knowledge, job satisfaction, and confidence level of staff will be evaluated. The effectiveness of the innovation will be evaluated based improvements as measured by lung function, exercise stress and quality of life of the asthmatic children after exercise training. It will also consider nurse competency in carrying out the exercise training program. In the pediatric ward of a public hospital, mild to moderate asthmatic children are going to perform cycling under close monitoring and supervision. The proposed clinical setting for exercise program is intentional. Its relax atmosphere may encourage asthmatic children to do more exercises even after the training program. The researcher identifies transferable elements in the innovation, including characteristics of the patients, staff, setting and philosophy of care. The feasibility of the program is evaluated according to the culture and resource environment. The cost effectiveness is considered and it factors in the benefits of the innovation physically and psychologically. In order to implement this program successfully, a well-designed and planned protocol is proposed. The innovation is designed to be effective in improving the physical and psychological fitness of asthmatic children. / published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

No description available.

Thesis (M. Public Health) -- Univ. of Adelaide, Department of Public Health. / Includes CD-ROM inside back cover of volume 2. Bibliography: p. 178-222.