Thesis (M.A.) -- Central Connecticut State University, 2006. / Thesis advisor: Marc Goldstein. "... in partial fulfillment of the requirements for the degree of Master of Arts in Psychology." Includes bibliographical references (leaves 42-45). Also available via the World Wide Web.

No description available.

Failure to comply with prescribed regimens is a major reason for the failure of treatment programs. This study investigated factors which are related to compliance with prescribed diet revision therapy for food allergies in school-aged children. Forty-five children, aged 6 to 12 years, who were under a physician's care for food allergies, formed the sample. The Health Belief Model was used as the basis for a questionnaire devised to measure these factors. The development of the Diet Revision Therapy Parent Questionnaire involved a pilot test and revisions; the resulting instrument consists of 38 items organized into 4 subtests, of which one 7-item subtest is to be considered optional. The 38-item DRTPQ has a full scale internal consistency reliability of .87, and a composite reliability of .61 for the four subscales. The canonical correlation between 3 types of subjective ratings of compliance and the 4 subtests is .80, with 64% shared variance between these sets of variables. A discriminant function of 3 subtests of the DRTPQ proved capable of discriminating diet therapy dropouts from continuing subjects with 88.9% accuracy. These three subtests measured: 1. Parent and family life factors, such as the amount of perceived interference in normal routines, 2. Child's attitudes to the treatment and his/her normal behavior with respect to cooperation with parental demands, and 3. Belief in the benefits to be derived from the treatment. A fourth category of items measured perceived severity of the condition and perceived susceptibility to illness but proved not to predict compliance in this sample, although it may be useful in clinical practice. Suggestions for interventions to aid compliance are outlined. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Lui, Kit Yee. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 150-157). / Abstracts and questionnaire in English and Chinese. / Title --- p.1 / Abstract --- p.2 / Acknowledgement --- p.7 / Table of contents --- p.8 / List of tables --- p.11 / List of figures --- p.12 / Glossary of terms and abbreviations --- p.13 / Chapter Section I: --- Overview --- p.14 / Chapter Chapter 1: --- Introduction --- p.15 / Chapter 1.1 --- Prevalence of food allergy in children --- p.15 / Chapter 1.1.1 --- Methodologies for studying food allergy --- p.18 / Chapter 1.1.2 --- Skin Prick Test and its mechanism --- p.19 / Chapter 1.1.3 --- Measurement of serum specific IgE levels --- p.21 / Chapter 1.1.4 --- Gold standard for diagnosis of food allergy --- p.22 / Chapter 1.2 --- Aim of Study --- p.25 / Chapter Chapter 2: --- Plan of Study --- p.26 / Chapter Section II: --- Literature Review --- p.28 / Chapter Chapter 3: --- Epidemiology of food allergy --- p.30 / Chapter 3.1 --- Prevalence of food allergy in children in western countries --- p.30 / Chapter 3.2 --- Prevalence of atopic allergies in children in rural areas --- p.34 / Chapter 3.3 --- Euro Prevail - A standardized methodology in studying food allergies --- p.38 / Chapter 3.4 --- Epidemiology of adverse food reaction in Hong Kong pre-school children --- p.40 / Chapter Chapter 4: --- Diagnosis of food allergies --- p.44 / Chapter 4.1 --- History --- p.44 / Chapter 4.2 --- Use of Skin Prick Test for diagnosis --- p.45 / Chapter 4.3 --- Use of serum specific IgE level for diagnosis --- p.47 / Chapter 4.4 --- Use of double-blind placebo-controlled food challenge for diagnosis --- p.49 / Chapter 4.5 --- Factors affecting precise diagnosis of food allergies --- p.51 / Chapter 4.5.1 --- Procedure-related Factors --- p.51 / Chapter 4.5.1.1 --- Performance of skin prick test --- p.51 / Chapter 4.5.1.2 --- Cross-reactivity of serum specific IgE --- p.52 / Chapter 4.5.1.3 --- Different diagnostic decision points in different populations --- p.53 / Chapter 4.5.1.4 --- Sensitization and allergy --- p.54 / Chapter 4.5.1.5 --- False negative oral food challenges --- p.55 / Chapter 4.5.2 --- Patient Factors --- p.56 / Chapter 4.5.2.1 --- Age of subjects --- p.56 / Chapter 4.5.2.2 --- Diet before tests --- p.57 / Chapter 4.5.2.3 --- Anti-histamine medications --- p.57 / Chapter 4.5.2.4 --- Skin sensitivity of subjects --- p.58 / Chapter Chapter 5: --- Risk factors for development of food allergies --- p.59 / Chapter 5.1 --- Factors associated with development of food allergies --- p.59 / Chapter 5.2 --- Food allergy and asthma --- p.62 / Chapter 5.3 --- Food allergy and eczema --- p.63 / Chapter Section III: --- Original Study --- p.64 / Chapter Chapter 6: --- Methodology --- p.65 / Chapter 6.1 --- Study Population --- p.65 / Chapter 6.1.1 --- Sample size calculation --- p.66 / Chapter 6.2 --- The EuroPrevall Study --- p.67 / Chapter 6.3 --- EuroPrevall Questionnaires --- p.68 / Chapter 6.4 --- Standardized Approach for Answering Questions in the Field --- p.69 / Chapter 6.5 --- Anthropometric Measurements and Ethics Approval --- p.70 / Chapter 6.6 --- Skin Prick Testing --- p.71 / Chapter 6.7 --- Measurement of serum specific IgE level --- p.72 / Chapter 6.8 --- Classification of Subjects --- p.74 / Chapter 6.9 --- Statistical Analysis --- p.75 / Chapter Chapter 7: --- Results --- p.76 / Chapter 7.1 --- Subjects and Demography --- p.76 / Chapter 7.2 --- Reported Symptoms in Chinese Children --- p.80 / Chapter 7.3 --- Food allergen sensitization in Chinese Children --- p.81 / Chapter 7.4 --- Association between food sensitization and allergic symptoms --- p.89 / Chapter 7.5 --- Prevalence of Food Allergy in Chinese Schoolchildren --- p.93 / Chapter Chapter 8: --- Discussion --- p.96 / Chapter Chapter 9: --- Conclusion and Further Studies --- p.102 / Appendix 1 Screening questionnaire (Chinese Version) --- p.106 / Appendix 2 Screening questionnaire (English Version) --- p.109 / Appendix 3 Case-control questionnaire (Chinese Version) --- p.111 / Appendix 4 Case-control questionnaire (English Version) --- p.132 / References --- p.150

Thesis (MSc Consumer Sc)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: Food allergies in children are a growing problem and have various effects on these children, their households, the community and the economy. No medication or cure is currently available to consumers suffering from food-allergies. Medical teams are aware of the patients' need for support, but information is lacking and understanding of their basic needs and problems neglected. Two qualitative research methods, namely the focus group technique and case studies were used to investigate the emotional and physical environment of children allergic to wheat, soy, cow's milk and egg respectively. Five focus group meetings were conducted with the caregivers of food-allergic children. Two during the pilot study and three in the main study. A total of twenty three participants attended the three meetings of the main study. A meeting schedule was developed and the meetings carefully moderated. After the data had been obtained from the focus group meetings, there was a need for more in-depth information and understanding. Seven of the participants of the focus groups were identified, through developed criteria, to be further investigated as case studies. Five units of investigation were identified for the case studies. It was the (i) caregiver, (ii) allergic child, (iii) other children, (iv) "non-caregiver parent" and (v) household. Some of the matters that were investigated in both the focus groups and case studies were health consciousness, menu planning, recipe needs and use, reading of food labels, hidden allergens and the social and emotional effects of having and being a food-allergic child. A great need for better support and educational programs to assist these households were identified. Very few of the households were health conscious, while they all experienced problems with menu planning, identifying hidden allergens and suffered from social and or emotional problems. Very few participants made use of recipes or identified a need for allergen-free recipes. After having gained insight in the daily lives of these households, four - virtually identical, two-week menu cycles were developed to suit the life style requirements and restrictions of these children. The same recipes were used, but allergens omitted, replacements made and the recipes adapted as necessary. Product scouting was done for hidden allergens in selected popular convenience foods, especially those from the lowest level of the USDA Food Guide Pyramid. Hidden allergens appeared to be a problem when food is prepared and bought for the food allergic child. It should be taken into account that despite the information stated on the food label undeclared allergens might still be present in food. The two-week menu cycle for the child allergic to cow's milk was then quantitatively evaluated for nutritional adequacy by FoodFinder ™ 2 - a software program, for children aged between seven and ten years. All the macronutrients and micronutrients identified by the National Survey in 1999 as insufficient «67% of the RDA) among South African children aged between one and nine years, were evaluated as well as those mentioned in the WHO Dietary and Health Goals. All the nutrients were sufficient, except for calcium and Vitamin D. Supplementation is advised. The sensory acceptability of the menu-items in the two-week menu cycles were not evaluated. A vast number of issues pertaining to the food-allergic child require further research. A great need exists for the development of educational programs to support the households with food-allergic children. The identification of hidden allergens and the development of reliable sensory testing models for food-allergic children are all areas that should urgently be researched further. / AFRIKAANSE OPSOMMING: Voedsel-allergieë by kinders is 'n groeiende probleem met 'n verskeidenheid effekte op dié kinders, hulle huishoudings, die gemeenskap en die ekonomie. Tans is geen medikasie of kuur teen voedsel-allergieë beskikbaar nie. Mediese spanne is bewus van die behoefte aan sorg en leiding wat deur dié spesifieke groep verbruikers benodig word, maar inligting oor hulle behoeftes en probleme is ontoereikend. Twee kwalitatiewe navorsingsmetodes, naamlik die fokusgroeptegniek en gevallestudies, is gebruik om die emosionele en fisiese omgewing van kinders allergies vir onderskeidelik grane, soja, melk en eiers te ondersoek. Tydens 'n voorloperstudie is twee fokusgroepvergaderings gehou. Vir die hoofstudie is drie fokusgroepvergaderings met versorgers van kinders met 'n voedsel-allergie gehou met 'n totaal van drie en twintig deelnemers. 'n Vergaderingskedule is ontwikkel en die vergaderings is sorgvuldig gemodereer. Nadat die data van die fokusgroepe ingesamel is, was daar behoefte aan meer in diepte inligting en begrip. Aan die hand van ontwikkelde kriteria is sewe van die deelnemers aan die fokus groepe as gevallestudies geselekteer. Vyf eenhede van ondersoek is geïdentifiseer vir die gevallestudies. Dit is: (i) die allergiese kind, (ii) versorger, (iii) ander kinders, (iv) die "nie-versorgende" ouer en (v) die huishouding. Sommige van die aspekte wat in beide die fokusgroepe en gevallestudies ondersoek is, was gesondheidsbewustheid, spyskaartbeplanning, die gebruik en behoefte aan resepte, lees van voedseletikette, verskuilde allergene en die sosiale en emosionele effek van 'n voedsel-allergie op die kind sowel as die ouers. 'n Groot behoefte aan beter ondersteuning en opvoedkundige programme, om hierdie huishoudings te help, is geïdentifiseer. Baie min van die huishoudings was werkilk gesondheidsbewus, terwyl hulle almal probleme met spyskaartbeplanning, identifisering van verborge allergene en sosioemosionele probleme ondervind het. Weinig van die deelnemers het gebruik gemaak van resepte of het 'n behoefte aan allergeen-vrye resepte ondervind. Nadat insig in die daaglikse lewenstyl van hierdie huishouding verkry is, is vier amper-identiese twee-weekse siklusspyskaarte ontwikkel wat die lewenstyl en behoeftes van hierdie huishoudings aanspreek. Dieselfde resepte was gebruik vir al vier twee-weeksiklusspyskaarte, met die verskil dat verskillende allergene vervang is, na gelang van die allergie verskillende behoefte. Marknavorsing is gedoen op alledaagse produkte en is hoofsaaklik gefokus op die produkte wat die basis van die voedselpiramide uitmaak. Daar is bevind dat verskeulde allergene voorkom in produkte waar dit nie verwag word nie, en soms selfs nie op die voedseletikette verklaar word nie. Die twee-weeksiklusspyskaart van die melk-allergiese kind is kwantitatief ge-evalueer vir toereikendheid van die dieet vir kinders tussen die ouderdomme sewe tot tien jaar op die Foodfinder TM 2 - sagteware program. Die makro- en mikronutriente wat volgens 'n nasionale opname in 1999 as problematiese «67% van die RDA) vir kinders in die ouderdomsgroep een tot nege, uitgewys is, is geneem en die voedingstowwe is ook teen die Werêld Gesondheidsorganisasie (WHO) se dieetdoelwitte getoets. AI die nutriënte was voldoende volgens die analise, behalwe kalsium en Vitamen D. Supplementasie word aanbeveel vir dié twee nutriënte. Die sensoriese aanvaarbaarheid van die spyskaartitems in die siklusspyskaart is nie getoets nie. Verskeie aspekte wat vorendag gekom het, benodig verdere navorsing. 'n Groot behoefte aan die ontwikkeling van opvoedkundige programme, wat die huishoudings met voedsel-allergiese kinders ondersteun, bestaan. Die identifikasie van verskuilde allergene en die ontwikkeling van 'n beproefte sensoriese toetsmodel vir voedsel-allergiese kinders is potensiële gebiede wat dringend verder nagevors behoort te word.

Thesis (M Nutr)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Background Adverse reactions to food are frequently suspected in daily clinical practice yet the knowledge of health care workers regarding correct diagnosis and management remains limited. This is compounded by few allergy consultants and may contribute to patient dissatisfaction and self‐diagnoses. The primary treatment modality for food hypersensitivity remains strict but nutritionally adequate elimination of offending food allergens based on accurate diagnosis. Nutritional misconceptions and incorrect diagnosis may lead to inappropriate dietary restriction resulting in nutritional deficiencies, malnutrition, growth retardation, and feeding difficulties in children. Elimination diets thus require supervision and monitoring similar to drug treatments, being reviewed regularly for possible food re‐challenges. There is limited research to assess knowledge and management approaches of food allergies by medical doctors and no research of this nature exists for Dietitians. There is also limited information as to whether current approaches conform to the most recent evidence‐based recommendations, particularly with regard to dietary intervention and allergy prevention strategies. Aim The aim of this survey was to determine aspects of food allergy related knowledge and practices of Medical Doctors and Dietitians. Methodology This was an analytical cross sectional study with participants randomly selected from the three largest provinces in South Africa, Gauteng, Western Cape and Kwazulu Natal (N=660). A quantitative questionnaire was compiled to explore aspects of food allergy diagnosis and management. Participants were currently working in South Africa and were selected according to three categories, General Practitioners, Dietitians and Medical Specialists. Ethics approval was obtained from the University of Stellenbosch, Faculty of Health Sciences Committee of Human Research. Results Even though valuable insights were obtained, poor response from all three groups (N=82) compromised the strength of significant findings. There was limited knowledge regarding appropriate diagnosis, dietary intervention and allergy prevention strategies. 98% of respondents believed they needed more education and training in management of allergies. Approximately 50% reported use of complementary therapy by patients prior to and while using conventional medicine. Dietitians weren't consulted for nutritional management by 72% General Practitioners and 45% Specialists. For allergy prevention, over 50% of health professionals advised extensive food avoidance for the first year in high risk infants. Dietitians recommended multiple food avoidance for the longest period of time per food in infants, pregnant and lactating women to prevent allergy. Advice for infant feeding and introduction of solid foods was not evidence‐based. Goat's milk, soya formula and breast milk with maternal dietary avoidance were advised for allergy prevention. 54% of medical doctors and 31% of Dietitians provided no guidance for implementing an elimination diet. Only 15% of respondents did growth assessment of allergic patients. 99% of all participants recognised a need for South African specific 'best practice' guidelines. Conclusion The study highlighted a need in South Africa, at undergraduate and post graduate levels, for better education and training of food allergy, in particular diagnosis, dietary management and prevention strategies. This will create a platform for the achievement of minimum levels of competency in allergy care. It should also provide motivation for the establishment of South African specific guidelines, allergy support networks and better public awareness. / AFRIKAANSE OPSOMMING: Agtergrond Afwykende reaksies tot voedsel word dikwels by gesondheidsorg instellings verdag. Nieteenstaande, bestaan daar steeds beperkte kennis oor allergië. Die tekort aan allergie konsultante vererger sake en het dikwels ontevrede pasiënte en self‐diagnose tot gevolg. Die primêre modaliteit van behandeling van voedsel hipersensitiwiteit behels doelmatige verwydering van die oorsaaklike voedsel allergene deur middel van 'n streng dog voedingswaardige dieet. Ontoepaslike bestuur van, en die verkeerde implementering van die uitskakelings dieet mag egter lei tot komplikasies by kinders soos hongersnood, groei vertraging en voedings probleme. Daar is tans beperkte navorsing om die peil van kennis van voedsel allergië en die bestuur van die probleem te meet. Geen sodanige navorsing ten opsigte van dieëtkundiges is al gedoen nie. Slegs beperkte inligting is beskikbaar tot welke mate huidige behandelings praktyk konformeer met die mees onlangse bewys‐gebaseerde aanbevelings, veral met betrekking tot allergie voorkomende strategië. Doelstelling Die doelstelling van hierdie opname was om die kundigheid en bestuur van voedsel verwante allergië deur medici en dieëtkundiges te bepaal. Metodologie Dwarsprofiel analiese was gedoen met respondente wat onwillekeurig gekies was uit profesionele mediese en dieëtkundige praktisyns uit die drie grootste provinsies in Suid Afrika, Gauteng, Wes‐Kaap en Kwazulu Natal (N=660). Deelnemers was versoek om vraelyste met 'n samestelling van aspekte van voedsel allergie diagnose en bestuur te voltooi. Deelnemers is huidiglik werksaam in Suid Afrika en was verteenwoordigend van drie kategorië, naamlik Algemene Praktisyns, Dieetkundiges en Mediese Spesialiste. Etiese goedkeuring was bekom van die Universiteit Stellenbosch se Fakulteit Gesondheidswetenskappe Navorsingsetiek komitee. Bevindinge Desnieteenstaande insiggewende inligting is die bevindinge gekompromitteer deur beperkte respons (N=82). Kennis met betrekking tot diagnose, dieëtkundige intervensie en allergie voorkomings strategië, is beperk. 88% van respondente versoek meer opleiding in die bestuur van allergië. 53% beweer dat pasiënte komplementêre terapie aanwend voor en gelyktydig met die gebruik van konvensionele medikasie. Interdisiplinêre konsultasie is beperk. Dieëtkundiges word nie geraadpleeg deur 72% van algemene praktisyns en 54% mediese spesialiste nie. Meer as 50% gesondheidsorg praktisyns beveel algemene voedsel ontwyking aan by hoë risiko kleuters gedurende die eerste lewensjaar. Dieëtkundiges se allergie voorkomings aanbevelings aan kleuters, swanger en lakterende vrouens was vir die langste periode. Advies vir kleuter voeding was nie bewys‐gebaseerd nie. Bokmelk, soya formule en borsmelk van moeders met dieëtkundige beperkinge word aanbeveel vir die voorkoming van allergië by kleuters. 54% mediese en 31% dieëtkundiges voorsien geen voorkomings dieët riglyne nie. Slegs 15% respondente takseer kleuter groei van allergie pasiënte. 99% van al die respondente ondersteun die vestiging van spesifieke 'beste praktyk' riglyne vir Suid Afrika. Gevolgtrekking Die bevindinge van die studie beklemtoon die behoefte in Suid Afrika vir verbeterde en doelgerigte voedsel allergie onderrig en opleiding, vir voorgraadse en nagraadse onderrig. Meer doeltreffende diagnose, dieëtkundige bestuur en allergie voorkomings strategië word aanbeveel. Daar word 'n doelwit geskep vir die bereiking van minimum vaardigheids vlakke vir allergie versorging. Die inligting motiveer ook die vestiging van doelgerigte Suid‐Afrikaanse riglyne, allergie ondersteunings bronne en beter, openbare bewuswording van allergië.

published_or_final_version / Paediatrics and Adolescent Medicine / Master / Master of Medical Sciences