Thesis (Ph. D.)--West Virginia University, 2007. / Title from document title page. Document formatted into pages; contains v, 59 p. Includes abstract. Includes bibliographical references (p. 38-51).

Thesis (Ph. D.)--Lehigh University, 2003. / Includes vita. Includes bibliographical references (leaves 121-138).

Asthma is a common chronic disease for children and is a leading cause for their hospitalization. Despite its negative health impact, a local survey has shown that children with asthma as well as their parents have a lack of understanding for asthma management (Wong, Wong, Chung & Lau, 2001). However, to help asthmatic children to better cope with their condition, it is important for health care professional such as nurses to enhance their knowledge in asthma management. Recent empirical research has shown that education promoting knowledge of asthma management can improve health outcomes in asthmatic children. Therefore, it is important to develop an evidence-based asthma education guideline for them. This dissertation aims to evaluate the empirical evidence of the education program for asthmatic children, with the age ranging from 5 to 18, and their parents. The goal of the proposed program is to reduce their re-hospitalization rate by enhancing their knowledge of asthma care. A translational nursing research was conducted and 10 studies focusing on asthma education program for children and their parents were identified from electronic databases. Critical appraisal was performed using the recognized assessment tool, named the Scottish Intercollegiate Guidelines Network (SIGN) (2008). Recommendations were developed based on the data extracted from the review. Based on the literatures reviewed, it was found that a 45-to-60 minute one-to-one educational intervention conducted by nurses using self-management plan is the most effective method for improving the health outcomes for asthmatic children. A plan of translating the empirical information extracted from the review into practice was developed and the potential of implementation was assessed. Based on the assessment, it was found that there is high transferability of the findings from the review and the proposed innovation is feasible in the selected clinical setting. In addition, the benefits generated from the proposed innovation also outweigh its cost. An evidence-based guideline was then developed based on the high and medium level of evidence. The grades of the recommendation were stated as well. A comprehensive communication plan targeting on various stakeholders was prepared. A pilot study was designed to examine the feasibility of the proposed innovation before the full-scale implementation. The outcomes of the proposed innovation include the re-hospitalization rate of asthmatic children, the patients’ and nurses’ level of knowledge in asthma care, the satisfactory level of patients and nurses towards the innovation, the competency of nurses in conducting the innovation, and the utilization rate and the cost of the innovation. They would be evaluated using appropriate methodologies. The proposed innovation would be considered as effective if the primary outcome, the re-hospitalization rate of asthmatic children is reduced. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Thesis (MSocSc)--University of South Australia, 1995

Thesis (Ph. D.)--University of Sydney, 1988. / Includes tables and questionnaires. Title from title screen (viewed May 1, 2007). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Department of Pharmacology. Includes bibliographical references. Also issued in print.

Thesis (Ed.D.)--Liberty University School of Education, 2009. / Includes bibliographical references.

Thesis (Ph. D.)--University of Washington, 1999. / Vita. Includes bibliographical references (leaves 71-79).

No description available.

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Although the effect of inhaled corticosteroids (ICS) on the hypothalamic- pituitary-adrenal axis (HPA) has been regarded as a “benign physiological response”, a survey published in 2002 suggested that adrenal crisis is more common in asthmatic children on ICS than previously thought. Relying on clinical features to detect chronic adrenal insufficiency secondary to corticosteroids may not be wise, as these are non-specific and can therefore easily be missed. Accurate biochemical assessment of the whole axis to detect subclinical HPA suppression (HPAS) is thus desirable. A review of the literature indicates that basal adrenal function tests, including plasma cortisol profiles, do not identify which children can appropriately respond to stress. There is no evidence to suggest that the degree of the physiological adjustment of the HPA to ICS and/or nasal steroids (by reducing basal cortisol production), predicts HPAS. Cortisol profiles should therefore only be used to demonstrate differences in systemic activity of various ICS and delivery devices. Only two tests, considered as gold standard adrenal function tests [the insulin tolerance test (ITT) and the metyrapone test] can assess the integrity of the whole axis. / AFRIKAANSE OPSOMMING: Die outeurs van ´n opname wat in 2002 gepubliseer is stel voor dat ´n bynierkrisis meer algemeen by asmatiese kinders, wat inhalasie kortikosteroïede ontvang, voorkom as wat voorheen gedink is. Dit is strydig met die gevestigde opvatting dat die effek van IKS op die hipotalamiese-hipofise-bynier-as (HHB) ’n “goedaardige fisiologiese reaksie” is. Die kliniese kenmerke van kroniese bynierontoereikendheid sekondêr tot die gebruik van kortikosteroïede (KS) is nie-spesifiek en gevolglik onbetroubaar. ´n Akkurate biochemiese toets van subkliniese HBB onderdrukking (HHBO) sou gevolglik waardevol wees. ´n Literatuur oorsig toon dat toetse van basale bynierfunksie, insluitend plasma kortisol (K) profiele, nie kinders uitken wat toepaslik op stres sal reageer nie. Daar is geen bewyse dat die graad van fisiologiese aanpassing van die HHB, soos aangedui deur laer K-vlakke, na die gebruik van IKS en/of nasale steroïede (NS), HHBO voorspel nie. Serum K profiele is dus slegs van waarde om die sistemiese aktiwiteit van verskillende IKS en toedieningsstelsels te ondersoek. Slegs twee toetse, naamlik die insulien toleransie toets (ITT) en die metyrapone -(MTP)-toets (wat beide as die goue standaard van bynier funksie beskou word), kan die integriteit van die hele as meet.

Background: Exposure to indoor air pollutants has been associated with poorer respiratory health in children. This study investigates the respiratory health of Malaysian schoolchildren in relation to indoor air pollution. Methods: This cross-sectional study was conducted among 2,164 schoolchildren aged 10-11 years in urban and semi-rural schools. Parents completed a questionnaire and concentrations of air pollutants were measured in schools. SHS exposure was assessed using salivary cotinine. Results: The WHO Air Quality Guideline for PM2.5 was exceeded for most of the semi-rural schools while almost all of the urban schools exceeded the annual exposure limit for NO2. The Geometric Mean salivary cotinine concentrations for non-smoking schoolchildren were 0.47 ng/ml. The 3 main predictors of nocturnal cough were the presence of a current smoker at home (OR 1.97; 95% CI: 1.31-2.96), the absence of exhaust system in the kitchen (OR 1.67; 95% CI: 1.03-2.68) and the use of air conditioning (OR 3.10; 95% CI: 1.37-5.71). Exposure to SHS of ≥4 hours per day (OR 2.53; 95% CI: 1.55-4.14) explained approximately 6.0% of the likelihood of reporting doctor-diagnosed asthma. For the measure of asthma severity, NO2 and log average family size were the 2 predictors of limited speech during wheeze; NO2 concentrations of >50 μg/m3 contributes an OR of 5.98 (95% CI: 1.02-34.9) and log average family size with an OR of 14.6 (95% CI: 1.70-126). Conclusion: This study has identified that many Malaysian schoolchildren experience exposure to air pollution indoors that exceeds WHO guidance limits for several pollutants. There was no clear relationship between traffic-generated air pollutants and children’s respiratory health but there was a strong relationship between the number of hours children were exposed to SHS and asthma. There is a need for increased enforcement of existing smoke-free legislation and policies to reduce children’s exposure to SHS.