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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

A developmental study of stress and physical health in childhood

Walling, Bobbi R. 15 August 2012 (has links)
Recent shifts in perspectives on health recognize the complex interplay among biological, psychological, and social factors. Psychosocial stress, including the socioeconomic environment, individual differences in self-evaluative cognitions and emotions, and the quality of social relationships have been found to be particularly potent stressors with strong associations to biological systems that mediate health and illness. Accumulating evidence suggests that the impact of stress on health begins in childhood when early environmental conditions program patterns of biological and behavioural processes that mediate health, and that health problems develop out of the cumulative dysregulating effects of exposure to multiple sources of stress over time. Using a bioecological framework, which conceptualizes child health in terms of the dynamic and interactive relationships among the child and his or her social context, the present study examined the combined effects of family socioeconomic stress, high biological reactivity to stress, exposure to negative parenting, and internalizing problems on mother’s report of children’s general health in a community sample of children participating in three phases of a longitudinal study. Results of hierarchical regression indicated initial child health and the interaction between children’s behavioural inhibition and internalizing problems at Time 1 were significant predictors of child health at Time 2. Findings demonstrate the importance of controlling for initial health status in longitudinal research and to further assessment of the role of these proximal, individual child factors in health outcomes.
2

A developmental study of stress and physical health in childhood

Walling, Bobbi R. 15 August 2012 (has links)
Recent shifts in perspectives on health recognize the complex interplay among biological, psychological, and social factors. Psychosocial stress, including the socioeconomic environment, individual differences in self-evaluative cognitions and emotions, and the quality of social relationships have been found to be particularly potent stressors with strong associations to biological systems that mediate health and illness. Accumulating evidence suggests that the impact of stress on health begins in childhood when early environmental conditions program patterns of biological and behavioural processes that mediate health, and that health problems develop out of the cumulative dysregulating effects of exposure to multiple sources of stress over time. Using a bioecological framework, which conceptualizes child health in terms of the dynamic and interactive relationships among the child and his or her social context, the present study examined the combined effects of family socioeconomic stress, high biological reactivity to stress, exposure to negative parenting, and internalizing problems on mother’s report of children’s general health in a community sample of children participating in three phases of a longitudinal study. Results of hierarchical regression indicated initial child health and the interaction between children’s behavioural inhibition and internalizing problems at Time 1 were significant predictors of child health at Time 2. Findings demonstrate the importance of controlling for initial health status in longitudinal research and to further assessment of the role of these proximal, individual child factors in health outcomes.
3

Colonisation with extended spectrum beta-lactamase producing and carbapenem-resistant enterobacterales in children admitted to a paediatric referral hospital in South Africa

Ogunbosi, Babatunde Oluwatosin 18 February 2021 (has links)
Introduction: There are few studies describing colonisation with extended spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) and carbapenem-resistant Enterobacterales (CRE) among children in subSaharan Africa. Colonisation often precedes infection and multi-drug-resistant Enterobacterales are important causes of invasive infection. Methods: In this prospective cross-sectional study, conducted between April and June 2017, 200 children in a tertiary academic hospital were screened by rectal swab for EBSL-PE and CRE. The resistance-conferring genes were identified using polymerase chain reaction technology. Risk factors for colonisation were also evaluated. Results: Overall, 48% (96/200) of the children were colonised with at least one ESBL-PE, 8 of these with 2 ESBLPE, and one with a CRE (0.5%, 1/200). Common colonising ESBL-PE were Klebsiella pneumoniae (62.5%, 65/104) and Escherichia coli (34.6%, 36/104). The most frequent ESBL-conferring gene was blaCTX-M in 95% (76/80) of the isolates. No resistance- conferring gene was identified in the CRE isolate (Enterobacter cloacae). Most of the Klebsiella pneumoniae isolates were susceptible to piperacillin/tazobactam (86.2%) and amikacin (63.9%). Similarly, 94.4% and 97.2% of the Escherichia coli isolates were susceptible to piperacillin/tazobactam and amikacin, respectively. Hospitalisation for more than 7 days before study enrolment was associated with ESBL-PE colonisation. Conclusion: Approximately half of hospitalised children in this study were colonised with ESBL-PE. This highlights the need for improved infection prevention and control practices to limit the dissemination of these microorganisms.
4

Health service utilization patterns by preschool children with autism spectrum disorder compared to those with global developmental delay at a tertiary centre in South Africa

Oringe, Florence Nafula 20 February 2021 (has links)
Background Children with autism spectrum disorder (ASD) and those with global developmental delays (GDD) have complex health care needs that span long periods. Affected families in low resourced countries face substantial barriers in accessing care. Challenging behaviours in children with ASDs further complicates their service encounters and may result in forgone care, resulting in poor outcomes. Aim The aim of the study was to compare health service use (HSU) by preschool children with ASD and GDD attending developmental services at a tertiary hospital, and to explore the major factors impacting patterns of access. Methods A retrospective cohort study was done, where 240 children with ASD and GDD (Non -ASD) were enrolled at a ratio of 1:1. HSU was determined by a retrospective review of their medical records, in the preceding 1 year. A structured questionnaire administered sought information on socio-demographics, child characteristics, perspectives, family distress level, experiences, and level of service satisfaction. Descriptive statistics and logistic regression analysis were used to evaluate primary study questions. Ethical approval was obtained by the University of Cape Town Human Research Ethics Committee (HREC: 397/2019). Families gave informed consent prior to enrolment. Results A total of 240 children were enrolled,116 had ASD and 124 had GDD. Their median age was 5.2 years, and male: female ratio was 2:1. Higher co-occurring syndromic diagnoses were documented in GDD vs ASD at (46/124, 37.1% versus 14/116, 9.5%); (p<0.01) as well as higher comorbid diagnoses in GDD vs ASD at (51/124, 41.0% vs 14/116, 12.1%); (p=0.0001). A higher mean total health care visits was reported in those with GDD vs ASD (13.3 versus 11.5 (p=0.02), primarily due to higher specialist visits at 4.0 (2.0-5.5) vs 2.0 (2.0-3.0) (p<0.0001). Attendance for other services were similar in both groups, including therapy 6.0 (2.0-10.0), auxiliary services xiii 0 (0-1.0), emergency visits 1.0 (1.0-2.0), and primary care visits 0 (0-1.0). Respiratory infections (91/240;37.9%) and unspecified fever (57/240; 23.8%) were the leading reasons for emergency visits in this cohort. Hospitalization was higher among children with GDD (38/124, 31%) than ASD (16/116, 14%), p=0.02. Factors associated with higher HSU included primary diagnosis of GDD (p=0.02), female (vs male, average 1.59 more annual visits, p=0.04), being younger at first diagnosis (<2 vs ≥ 2 years, 1.72 more annual visits, p= 0.02), and having a concurrent syndromic diagnosis (vs none, 2.19 more annual visits, p=0.01). On logistic regression, controlling for these confounders, parental employment emerged as the strongest residual predictive factor for increased HSU (β 1.49, 95% CI -0.02 to 3.00, p=0.05). Conclusion: Children with GDD had greater service use than those with ASD, primarily due to higher specialist visits for their higher syndromic and comorbid diagnoses. Core therapy services were underutilized despite being key interventions in both groups. Parental employment, an enabling factor, predicted greater service use. This calls for systemic reduction in access costs to optimize care.
5

Assessing children's visual acuity with steady state evoked potentials

Mackay, Alison January 2003 (has links)
The majority of children attending ophthalmology clinics require a visual acuity assessment. The optimal technique depends on age as well as the ability to cooperate with testing. Most acuity assessments are performed subjectively by an orthoptist. Objective acuity assessment by Visual Evoked Potential (VEP) provides a complementary assessment in those subjects who cannot complete subjective tests. The aim of this study was to develop and evaluate a rapid, objective visual acuity assessment. The technique was named the step_ VEP and is based on the real-time analysis of steady-state VEPs (ssVEP). It presents high contrast checkerboard stimuli of sizes 0.4 to 3.0 LogMAR with a successive approximation algorithm. Speed of response detection, specificity and sensitivity were optimised by investigation of recording montage and analysis techniques in a group of normal children and adults (N=102). The success, duration and outcome of step_ VEP acuity assessment was compared to transient VEP (t-VEP) acuity assessment and subjective acuity assessment in a group of paediatric patients (N=218). I-D Laplacian analysis of three occipital electrodes was significantly faster than conventional recording and analysis (Oz-Fz) at detecting ssVEP responses near visual acuity threshold (3' checks) from three years upwards, and at detecting responses to 6' and 9' checks in the 7-9 year age group. A lateral electrode site at 15% of the half-head circumference was fastest most often in adults. Step_ VEPs were 16% more successful than t-VEPs and 9% more successful than subjective tests in providing a complete acuity assessment. Subjective acuity scores were systematically higher than VEP acuity scores in subjects who successfully completed both assessments. A closer agreement with subjective acuity scores was found for step_ VEPs than t-VEPs. The disparity between step_ VEP acuity score and subjective acuity score was shown to reduce with age.
6

The impact of child labour on health and psychosocial status of working children aged between 10 and 16 years in Jordan

Hawamdeh, Hasan Mahmoud January 2001 (has links)
Objective: to examine the effects of work on health and pyschosocial status among boys aged 10-16 years in Jordan. Study design: This is a comparative cross-sectional study, comparing working and non-working with respect to health and psycho-social outcomes, taking account of confounding due socio-economical factors. Results. Bivariate analysis showed that child's work was a strong significant predictor for eight z score, height z score, PCV, morbidity, skinfold thickness percentile and PEFR. This significant effect persisted in the full regression models after controlling for socio-economic and smoking status. Working children had significant lower weight z score (B=-0.31), height z score (B=-0.51), PCV (B=-2.96), skinfold thickness percentile (B=-6.85) compared to non-working subjects. Pyschosocial score tended to be reduced by 13 points (better pyschosocial status) when the child was non-working (B=-12.7). The significant negative relationship between work and PEFR in the bivariate model disappeared in the full regression model. In multiple regression modelling work status explained 3% of the 6.5% of variance explained in the weight z-score model, 6.7% of 9.8% for height z-score, 12.5% of 14.9% for PCV, 15% of 21% for skinfold thickness, 115 of 24% for PEFR, 9.4% of 30.9% for morbidity and 46% of 50% for pyschosocial status. Mean height and weight z-scores and packed cell volume among working children were significantly lower than those of their siblings; 5% and 9.6% of working children respectively were wasted and stunted (z score<-2 SD) compared to none of the siblings. No statistically significant correlation was also found between weight z-scores, height z-scores, packed cell volume and skinfold thickness of siblings and the proportion of household income contributed by the working child. Duration of work, child's monthly income, household per capita income and maternal height, were significant predictors of the growth of working children expressed by weight and height z score.
7

'Following the line' : an ethnographic study of the influence of routine baby weighing on breastfeeding women in a town in the Northwest of England

Sachs, Anna Magda January 2005 (has links)
Weight monitoring is an integral part of routine community child health care in the United Kingdom. An intensive focus on fluctuations in charted weight of young babies has been charged by some breastfeeding advocates with undermining continued breastfeeding. Concern has also been expressed by clinicians and women about the applicability of current growth charts to breastfed babies - a concern echoed by the World Health Organisation. This ethnographic study involved two phases. Six months' participant observation in a child health clinic in the Northwest of England was followed by longitudinal interviews with 14 breastfeeding women. Equal numbers of first and second-time mothers were included; they were interviewed two to three times in the first six months. Data were analysed using grounded theory, allowing an in-depth examination of the lived experiences of weighing and how these shaped on-going feeding decisions and the course of breastfeeding. Weighing babies was the major focus of clinic visits for women and for health visitors. Interactions centred on the concern that the baby's weight should 'follow the line' of the centiles on the chart. Mothers and health visitors also collaborated in efforts to achieve prescriptive routines of baby feeding and sleeping. Breastfeeding was treated as a milk production system, and required to measure up. If weight gain caused concern a variety of strategies were used, including formula supplements and 'worrying'. Techniques to improve the physical effectiveness of breastfeeding were not part of the routine approach to any feeding difficulty on the part of either mothers or health visitors. Using anthropological theory, the character of weighing as a ritual occasion is explored. Weighing sessions are shown to provide occasions to mark the rite of passage through the liminal time of early motherhood. Building on the observation of this ritual experience, it is suggested that the experience of breastfeeding is 'even more liminal', as our society treats formula feeding routines and growth as the implied norm for infants. Weight gain which conforms to chart centiles has become the measure and arbiter of breastfeeding adequacy. Minor fluctuations in weight were treated as potentially serious threats to infant health, while the maintenance of breastfeeding was considered secondary. Recommendations are offered for improving the practical conduct of routine weight monitoring to improve its ability to identify growth which should genuinely spark concern. At the same time, the need for rituals to ease women through their early months of motherhood and the experience of breastfeeding is highlighted. Currently breastfeeding as a method of feeding milk to babies is poorly supported with suggestions for improving physical effectiveness, while at the same time, breastfeeding as a social practice is pushed to the margins of normal everyday experience. This lived dilemma for women and the health visitors who support them deserves attention at national policy level and serious consideration in overall planning of services.
8

Effect of therapeutic interventions on skeletal growth & development in paediatric inflammatory bowel disease

Malik, Umm ie Salma January 2013 (has links)
Crohn’s disease (CD) is a chronic inflammatory bowel disease. Once considered rare in the paediatric population, it is recognized with increasing frequency among children of all ages. Approximately 20-30% of all patients with CD present when they are younger than 20 years. With its increasing recognition, CD has become one of the most important chronic diseases that affect children and adolescents. In addition to the common gastrointestinal (GI) symptoms (diarrhoea, rectal bleeding, and abdominal pain) children often experience growth retardation, pubertal delay, and bone demineralization. In these children, maintenance of skeletal health is a complex process that is influenced by a number of different mechanisms including steroid therapy, the disease process, nutritional status, endocrine status and the response of the body to inflammatory mediators. The recent introduction of biologic therapy that targets specific mediators of the proinflammatory process is a promising adjunct in the therapeutic management of the child with chronic inflammation. These drugs may also exert beneficial effects on the adverse effects of inflammation on growth and skeletal development. It is unclear whether these beneficial effects are due to improvement in overall disease or due to a direct ‘anti-cytokine’ effect at the level of the target tissue involved in growth and skeletal development. The hypothesis of this study was that the biologic therapy improves linear growth, puberty, bone health, body composition and muscle function in children with CD and this is associated with changes in the IGF-1 axis and markers of bone formation and bone resorption. Chapter 1 is an extensive literature review about the effects of biologic therapy on growth and skeletal development in paediatric patients with chronic inflammatory conditions particularly inflammatory bowel disease (IBD). The main aim of this review was to summarize and evaluate effects of inflammation and biologic therapy on growth and skeletal development in children with chronic inflammatory conditions and to explore the areas of interest for further research. Chapter 2 is the study about the growth in children receiving contemporary disease specific therapy in children with CD. The aim of this study was to assess the frequency of short stature and poor growth and their relationship to disease course and therapy in children with CD. Clinical records of all children with a confirmed diagnosis of CD, who were between 2yrs and 18yrs at the Royal Hospital for Sick Children, Glasgow were examined retrospectively. Data were collected at diagnosis, 1-yr, 2-yr and 3-yr after diagnosis and at maximum follow-up. The relationship of a number of factors including therapeutic modalities to two commonly used anthropometric markers of growth height velocity standard deviation scores (HVSDS) and change in height standard deviation scores (∆HtSDS) was examined. This study suggested that ∆HtSDS may be a more valid method of assessing and reporting longitudinal growth in children with chronic disease, particularly when there is a high prevalence of children of a peri-pubertal age. This study provides clear evidence that despite advances in therapy, short stature and slow growth continue to be encountered in a sub-group of children with CD. Chapter 3 is about the effect of Infliximab therapy on growth, puberty and disease activity in children with CD. The aim of this study was to assess growth, puberty, markers of disease and concomitant therapy over the six months prior to starting Infliximab and for the 6 and 12 months following treatment. Clinical records of all children with IBD who were started on Infliximab therapy between 2003 and 2008 at the Royal Hospital for Sick Children were examined retrospectively. This study has shown an average improvement of approximately 50% in HV in the 6 months after the initiation of Infliximab therapy which was further sustained for a further 6 months. Improvement in growth was found to be better in those children who were responders as compared to non-responders suggests that growth improved as a result of disease control. Improvement in growth was also observed in children who remained pre-pubertal and those who had never been on glucocorticoids (GC) compared to those who had been on GC. This study suggests that increase in height may not be simply due to progress in pubertal status or reduction in glucocorticoid dose. Chapter 4 is about the effect of Adalimumab therapy on growth in paediatric patients with CD. This is the one and only world wide multicentre study that adequately assess the effect of Adalimumab on linear growth in children with CD. The aim of this study was to assess the effect of Adalimumab therapy on growth, puberty and disease activity over the 6 months prior to and 6 months after starting Adalimumab treatment in children with CD. This study provides evidence that Adalimumab is associated with improvement in short term linear growth in children with CD who enter remission but not in those who do not. It is also more likely to happen in children who are on immunosuppression and those in early puberty but seems to be relatively independent of steroid use. These findings suggest that growth improves as a result of several interrelated factors, including improved disease control. It was also interesting to note that the growth response to Adalimumab varied dependent on the reason for discontinuing Infliximab; those who had an allergic reaction to Infliximab fared best. Chapter 5 is Longitudinal observational prospective study of changes in physical growth, IGF-1 axis, bone health, body composition, muscle function and disease activity at baseline (BL), 2 weeks (2wk), 6 weeks (6wk), 6 and 12 months (6M & 12M) following biologic therapy in paediatric patients with CD. The aim of this longitudinal observational prospective study was to assess changes in physical growth, puberty, IGF-1 axis, bone health; body composition and muscle function following biologic therapy in paediatric patients with CD. Patients either newly diagnosed or patients with long-lasting disease in clinical relapse, who started treatment with biologic therapy as part of their standard clinical management, were recruited. A non significant improvement was observed in both ∆HtSDS and HVcms/yr at 12M as compared to BL. Individually, the majority of the children experienced improvement in clinical activity and improvement of the systemic inflammatory markers. A significant increase in biomarker of bone formation bone specific alkaline phosphatase (BALP) and a non-significant increase in a biomarker of bone resorption cross-linked c-terminal telopeptides (CTX-1) was observed from BL to 12M. This observation suggests the beneficial effect of biologic therapy on bone formation. This study showed a significant change in fat mass (FM (kg) in paediatric patients with CD following biologic therapy an effect that has not been reported extensively in previously published studies. A significant change in both fat free mass (FFM (kg) and fat free mass index (FFMI(kg/m²) shows that the treatment with anti-TNF-α therapy also had a significant impact on fat mass accrual. This is the first study that charts the effect of biologic therapy on changes in lower limb muscle function using jumping mechanography in paediatric patients with CD. A non significant change was observed in jump height (m), V-max (m/s), EFI (%), efficiency % from BL to 12M following biologic therapy and a significant increase in both F-max (kN), and P-max (kW) at 12M. Despite the fact that the increase in efficiency % of the movement was not significant but however, the change was likely to be through improvements in jump height and velocity thereby indicating higher muscular flexibility. These data are suggestive of an effect of biologic therapy on lower limb muscle function through improvements in the mechanical efficiency of the muscle.
9

Randomised controlled trial of a novel dietetic treatment for childhood obesity and a qualitative study of parents’ perceptions of dietetic treatment

Stewart, M. Laura January 2008 (has links)
Introduction Obesity is the most common nutritional disorder in the world and is widely acknowledged as having become a global epidemic.(1) The prevalence of childhood obesity in the United Kingdom (UK) dramatically increased over a short number of years in the 1990s.(2-4) There are well-recognised health consequences of childhood obesity, both during childhood as well as those tracking into adulthood affecting health, psychological and economical welfare.(5;6) However, there is a surprising lack of well conducted published research into effective childhood obesity treatment strategies and few with relevance to the UK National Health Service (NHS).(5;7) This thesis describes (a) the Scottish Childhood Obesity Treatment Trial (SCOTT), a randomised controlled trial (RCT) that compared standard NHS dietetic management of childhood obesity with a novel intensive dietetic approach in Scottish primary school aged (5 – 11 years old) children and (b) reports a complementary qualitative study that explored the parents’ perceptions of the dietetic treatments their child received during the SCOTT project. The SCOTT project was conceived to be an easily reproducible treatment programme within the UK NHS system for primary school aged children. Methodology The SCOTT quantitative study was a single-blind RCT involving 134 obese children of primary school age (5 -11 years), 75 females and 59 males. Inclusion criteria were children with ‘simple’ obesity (body mass index (BMI)  98th centile on the UK 1990 charts) and families that perceived the child’s weight as a problem and were motivated to change. The intervention arm involved an evidence-based novel dietetic treatment over 6-months giving 5 hours of treatment and used client-centred behavioural change techniques to increase motivation for changing diet (using a modified traffic light diet), increasing physical activity and reducing sedentary behaviour. The control arm received 1.5 hours of ‘typical’ dietetic weight management delivered in a traditional (educational) manner. Outcomes recorded at baseline, six and 12 months were BMI standard deviation (SD) score, objectively measured physical activity and sedentary behaviour (using accelerometers) and possible adverse effects of treatment (height growth and quality of life). The primary outcome was change in BMI SD score at six months. The complementary qualitative study used in-depth interviews to explore the thoughts and feeling of parents of the children who had completed the dietetic intervention. All interviews took place after the SCOTT 12 month outcome measurements had been completed. Purposive sampling was used and out of the 79 eligible SCOTT parents 17 were interviewed. The interviews were taped and then transcribed by experienced secretaries. Analysis was carried out using the Framework methodology (8) and aided by Nvivo software. Key Results The novel treatment programme had no significant effect relative to the standard dietetic care on BMI SD score from baseline to six months (-0.10 vs -0.06; 95% CI -0.05 to 0.11) and 12 months (-0.07 vs -0.19; 95% CI -0.17 to 0.07). BMI SD score decreased significantly within both groups from baseline to six and 12 months. There were significant differences between the groups in favour of the novel treatment group for changes in total percentage of time spent in physical activity (95%CI 0.8 to 6.3) and light intensity physical activity (95%CI -4.8 to -0.5). In the qualitative study we found themes and concepts both on our original evaluation and emergent data on the parents’ thoughts and feelings on entering, continuing and leaving treatment. Those parents who had taken part in the behavioural change techniques applauded the process finding it child-friendly and talked of ‘forming a partnership’ with the child and dietitian. Developing a rapport with the dietitian was significant for the parents in their perception of a positive experience. Parents appeared to be characterised as being unaware of their child’s weight problem, in denial, or actively seeking treatment. Parents were consistently motivated to enter treatment due to perceived benefits to their child’s self esteem or quality of life, and weight outcomes were considered less important. During treatment parents expressed a lack of support for lifestyle changes outside the clinic, and noted that members of the extended family often undermined changes. Parents generally felt that treatment should have continued beyond six months, and that it had provided benefits to their child’s well-being, self-esteem, and quality of life, and this is what motivated many of them to remain engaged with treatment. Conclusions The modest magnitude of the benefits observed in the SCOTT study perhap suggest that interventions should be longer term and more intense. The results of the qualitative study suggested that longer term interventions would be acceptable to parents. The qualitative study was an informative addition to the SCOTT quantitative study as it allowed exploration of the subtle differences as perceived by the parents who took part in both arms of the study. It may help inform future treatments for childhood obesity by providing insights into the aspects of treatment and approaches applauded by parents. Future treatments may need to consider providing greater support to lifestyle changes within the extended family, and may need to focus more on psychosocial outcomes. This study highlighted skills and qualities required by dietitians and other health professionals to engage with families of obese children.
10

The effect of Insulin Pump Therapy on children and adolescents' quality of life : a qualitative study

Whittaker, Jennifer A. January 2012 (has links)
Introduction: Insulin Pump Therapy has gained worldwide acceptance for the treatment of Type 1 diabetes mellitus (T1D), offering a new method of insulin delivery, which circumvents the need for Multiple Daily Injections (MDI). It is thought to improve quality of life (QoL) by facilitating an increase in lifestyle flexibility, independence and glycaemic control (Scottish Intercollegiate Guidelines Network, 2010; National Institute for Clinical Excellence, 2008). These benefits have resulted in the National Health Service (NHS) Scotland pledging funding of at least £1million to deliver insulin pumps to under 18s (Scottish Government, 2012). Currently, investigations regarding the impact of Insulin Pump Therapy on QoL have resulted in conflicting findings (Barnard et al., 2007). This study aims to explore the impact of Insulin Pump Therapy on the QoL of children and adolescents, using Interpretative Phenomenological Analysis. Method: Eight participants with T1D, aged between 8 and 13 years and using an insulin pump, were recruited from the Glasgow Royal Hospital for Sick Children Diabetes Clinic. Each participant completed an in-depth interview, which explored their beliefs and attitudes towards Insulin Pump Therapy including its impact on their QoL. Results: Analysis of the transcripts led to the identification of six super-ordinate themes: ‘Physical Impact’, ‘Mood and Behaviour’, ‘Lifestyle Flexibility’, ‘Practicalities’, ‘Peer Reactions’, and ‘Support’. It is suggested that these six factors are not mutually exclusive and together inform the complexity of individuals’ experiences and the impact that the insulin pump has had on many aspects of their lives. These findings suggest a framework to help clinicians understand how young people with T1D perceive and conceptualise their treatment regimes. Conclusions: There was general agreement amongst participants that switching to Insulin Pump Therapy resulted in improvements to their QoL. Additional concerns were outlined but reportedly none of the participants regretted switching to an insulin pump.

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