Made available in DSpace on 2015-03-05T19:35:30Z (GMT). No. of bitstreams: 0 Previous issue date: 5 / Nenhuma / O estudo das manifestações psicossomáticas decorrentes de uma relação mãe-bebê conturbada vem despertando crescente interesse na comunidade científica. Conjugando a essa idéia à visão psicanalítica winnicottiana do potencial curativo existente na arte, a presente pesquisa objetivou desenvolver a oficina de contos de fadas como intervenção terapêutica com crianças asmáticas, tendo como enfoque as contribuições de Donald Winnicott em seus escritos sobre o desenvolvimento humano. Os dispositivos clínicos utilizados para o entendimento do funcionamento psicodinâmico das cinco crianças participantes foram: a realização de uma hora do jogo diagnóstica, a aplicação dos instrumentos projetivos H-T-P e o Teste das Fábulas, além da realização de entrevistas com os pais e professores. Após esse contato inicial com os protagonistas da pesquisa, foram desenvolvidas nove oficinas de contos de fadas com as crianças e uma oficina com os pais e o pediatra. A análise dos resultados, em sua dimensão qualitativa, focalizou os f / The study of psychosomatic manifestation due to a troublesome baby-mother relation is raising scientific community’s interest. Associating this idea to the Winnicotttian healing potential psychoanalytic view found in art, this survey’s objective is to develop the fairy tales workshops, as a therapeutic intervention for asthmatics children, focusing on Donald Winnicott’s writings about human development. The clinic device used to understand the five children taking part on a psychodynamic work were: carrying out one hour of diagnostic game, applying H-T-P projected instruments and the fable’s test, as well as interviewing parents and teachers. Following this initial contact with the survey’s protagonists were developed nine fairy tales workshops with the kids and one with the parents and pediatrician. The analyses result in a qualitative view, focused the clinic fragments taken out of these kids life’s story and the reports brought/ produced by them on the workshops. Those are added to the information collec

Purpose: The Purpose of this research was to design, implement and evaluate a patient centered asthma intervention pilot program directed by physicians and administered by community pharmacists to a group of Managed Care contracted Oregon Health Plan asthmatics. The evaluation was to determine if the proposed intervention could improve the enrolled asthma patient's related education and quality of life while simultaneously creating economic benefit for the sponsoring health plan. Methods: The study was designed to be a prospective, six month pre and posttest quasi-experimental evaluation combined with a Solomon-like two-control group comparison. All patients in the sponsoring health plan twelve years of age and older who had six months of continuous enrollment were eligible. Enrollment of the target patients was voluntary and the time period of the evaluation (November, 1997 to May, 1998) was purposely conducted to capture the notoriously difficult asthma trigger cold and allergy seasons. Information regarding the cost and frequency of pre and post emergency room visits, hospitalizations, physician's office and medications use and Health Related Quality of Life (HRQL) was collected for the intervention group and control group. Satisfaction information for the major actors was collected and analyzed at posttest. Within group comparisons were conducted using the paired T-test and the unpaired T-test was used for between group comparison. Results: Patients in the intervention group who had their physician and pharmacist fully participate in respectively directing and administering the study protocol showed associated improvements in their quality of life measures. Economic benefit to the health plan is suggested by a cost benefit ratio of 1:5.71 resulting from favorable decreases in health care related resources and improved asthma related medication utilization. Analysis of the satisfaction measures suggests that all the major participants were very satisfied with the intervention. Conclusion: Even though the sample size in this pilot study was relatively small, the resulting information should not be immediately discounted. The evidence suggests that in those cases where the study protocol was followed, favorable economic, HRQL and satisfaction is comparable to larger, previously conducted studies. / Graduation date: 2000

Introduction On the 5th of December 2009, at the 40th Union World Conference on Lung Health in Cancun, Mexico, the American Thoracic Society and the Forum of International Respiratory Societies declared 2010 as the “Year of the Lung”. Asthma features amongst the “big five” of the respiratory diseases worldwide. It is estimated that South Africa has the 25th highest asthma prevalence in the world and the 5th highest case fatality rate in the world. Asthma has been reported as one of the most serious common chronic condition affecting young children. The South African media and government reports states that one in eight children in South Africa has asthma. Children spend a considerable amount of time at school. Teachers are often recognised as in loco parentis at school. Therefore, it is imperative that primary schoolteachers have some knowledge of asthma and its management to ensure that asthmatic school children can be assisted. Aim The aim of this study was to elucidate asthma knowledge and management in primary schools in Umdoni subdistrict. Methods A cross sectional study design was used. Two hundred and twenty six schoolteachers’ from 19 primary schools participated in this paperless survey. An asthma knowledge questionnaire was developed by the researcher in consultation with a paediatric asthma specialist and was fielded using the Mobile Researcher mobile application channel, provided by Clyral. The survey was conducted using cellular telephones that were used to capture teachers’ responses during face-to-face interviews with fieldworkers. The completed surveys were uploaded using general packet radio service (GPRS) to the web-based “Research Centre”. Data were exported to a Microsoft Excel spreadsheet, cleaned and then imported into SPSS 15.10 for analysis. Results This study found that although the majority of primary schoolteachers (61.5%) had above 50% correct answers in the asthma knowledge test, the vast majority (95.1%) felt asthma education was necessary for schoolteachers. The results suggest that although teachers have reasonable knowledge on certain areas regarding asthma, however there is huge gap in their knowledge on the care of a child with an acute exacerbation of asthma. The lack of medical or nursing personnel at these schools means that the initial management of the child during an asthma attack will be in the hands of school personnel. In light of this, it is important to note that 38.5% of participants scored less than 50% on an asthma knowledge test, which denoted poor or limited knowledge of asthma and its management. This study also showed that teachers’ knowledge of asthma and sports was deficient and teachers do have misconceptions about asthmatic children’s abilities. None of the schools had written material to guide the management and care of asthmatic children. Such materials would be necessary, especially in circumstances when prompt action is required in a severe acute asthma attack. Conclusion The results conclude that primary schoolteachers’ knowledge in Umdoni subdistrict is deficient especially in the knowledge of the care of a child with an acute exacerbation of asthma. Teachers in Umdoni subdistrict are in contact with and exposed to asthmatic schoolchildren on a regular basis. Teachers have to cope with asthmatic children who have diverse needs. The importance of enhancing school based asthma health promotion strategies is highlighted by the following recommendations: asthma education training for school personnel, participation and support from Departments of Health and Education and the development and implementation of sound asthma policies in schools. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2011.

Several epidemiological studies have revealed an association between particulate matter (PM) pollution and various health effects. Importantly, there is evidence to suggest that individuals with pre-existing respiratory disease, such as asthma, are more sensitive to elevated ground levels of particulate matter as compared to healthy subjects. Among the various sources of PM pollution, diesel powered vehicles have been identified as important contributors. The aim of this thesis was to investigate the airway effects of experimental chamber exposure to diesel exhaust (DE) in healthy and asthmatic subjects, focusing on airway responsiveness, airway inflammation and lung function. To achieve a comprehensive picture of the airway responses to DE, a number of different methods were used, including lung function measurements, methacholine inhalation tests, induced sputum and bronchoscopy. Each subject acted as his/her own control by being exposed both to filtered air and DE in a crossover design. Short term exposure to DE, at a particle concentration (PMi0) of 300 ug/m3, was associated with a clinically significant increase in bronchial hyperresponsiveness in asthmatic subjects. In accordance with the epidemiological data suggesting a 1-4 day lag effect for most health outcomes to PM pollution, the increase was detected one day after DE exposure, indicating a long lasting response to DE in asthmatic airways. Diesel exhaust induced a range of airway inflammatory changes as reflected in induced sputum, bronchoalveolar lavage and bronchial mucosal biopsies. In healthy subjects, DE exposure was associated with an increase in neutrophils and IL-6 in sputum, elevated levels of IL-8 and IL-6 in bronchial wash (BW), enhanced expression of IL-8 and GRO-a in the bronchial epithelium and with increases in P-selectin and VCAM-1 in the airway mucosa. In contrast, asthmatics responded with an increase in IL-6 in sputum and an enhanced expression of IL-10 in the bronchial epithelium following exposure DE. Thus, clear differences were identified between healthy and asthmatic subjects in the inflammatory response to DE. Airway epithelial cells constitute the first line of cellular defence towards inhaled air pollutants and increasing evidence suggests that these cells contribute markedly to the initiation of airway inflammatory responses. The bronchial epithelium was identified to have an important regulatory role in response to diesel exhaust, including the capacity to produce chemoattractant and immunoregulatory proteins associated with development of airway inflammation and bronchial hyperresponsiveness. Lung function measurements revealed that short-term exposure to DE induces an immediate bronchoconstrictive response in both healthy and asthmatic individuals, with significant increases in airway resistance (Raw) following DE exposure. This thesis also investigated the effects of a lower concentration of DE (PMio 100 ug/m3) than previously studied. It was shown that exposure to DE at a concentration corresponding to a PM level that may be encountered in busy traffic situations, was still associated with potentially adverse airway responses in healthy and asthmatic subjects. In summary, the results presented here indicate that short term exposure to diesel exhaust, at high ambient concentrations, has the potential to induce a range of biological events in the airways of healthy and asthmatic subjects. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 2002, härtill 4 uppsatser.</p> / digitalisering@umu

Thesis (D.P.H.)--University of Hawaii at Manoa, 1996. / Includes bibliographical references (leaves 83-108). / Microfiche. / vii, 108 leaves, bound 29 cm

Includes bibliography (v. 2, leaves 80-93) / 2 v. : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Aims to develop a tool to measure parents' approaches to the management of their children's asthma, and to also identify the influence of psychosocial factors on parents' management of childhood asthma. In order to do this the author developed a questionnaire asking parents to describe their management approaches to typical asthma scenarios. / Thesis (Ph.D.)--University of Adelaide, Dept. of Psychiatry, 1998

Thesis (M.S.)--University of Wyoming, 2007. / Title from PDF title page (viewed on Feb. 19, 2009). Includes bibliographical references (p. 44-47).

An attempt has been made in this study to critically appraise, systematically review and gather together the results obtained in individual trials and examine the strength of evidence supporting the component for Education for a Partnership in Asthma Care of the National Asthma Education and Prevention Program (NAEPP) to test whether health outcomes are influenced by education and self-management programs.