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Sample records for adolescent asthma self-management

  1. Effects of a Peer-Led Asthma Self-Management Program for Adolescents

    PubMed Central

    Rhee, Hyekyun; Belyea, Michael J.; Hunt, John F.; Brasch, Judith

    2011-01-01

    Objective To evaluate the effectiveness of a peer-led asthma self-management program for adolescents with asthma. Design Randomized controlled trial comparing a peer-led asthma program (intervention group) vs. a conventional adult-led asthma program (control group). Each program was implemented at a full-day camp. Setting An urban city and adjacent suburbs in upstate New York. Participants 112 Adolescents, ages 13–17 years, with persistent asthma. Intervention Peer-led asthma self-management program implemented at a day camp. Outcome Measures The Children's Attitude toward Asthma Scale and the Pediatric Asthma-related Quality of Life Questionnaire were administered at baseline, and immediate, 3, 6 and 9 months post-intervention. Spirometry was conducted twice - prior to the intervention and 9 months post-intervention. Results The intervention group reported more positive attitudes at 6-months post-intervention (mean difference [Diff]= 4.11, 95%CI:0.65–7.56) and higher quality of life at 6- (Diff=11.38, 95%CI:0.96–21.7) and 9-months post-intervention (Diff=12.97, 95%CI:3.46–22.48) than the control group. The intervention was found to be more beneficial to adolescents of male gender or low family income as shown by greater improvement in positive attitudes and quality of life than their counterparts. Conclusion An asthma self-management program led by peer leaders is a developmentally appropriate approach that can be effective in assisting adolescents with asthma in improving their attitudes and quality of life, particularly for males and those of low socioeconomic status. PMID:21646583

  2. Asthma Self-Management is Sub-optimal in Urban Hispanic and African American/Black Early Adolescents with Uncontrolled Persistent Asthma

    PubMed Central

    Bruzzese, Jean-Marie; Stepney, Cesalie; Fiorino, Elizabeth K.; Bornstein, Lea; Wang, Jing; Petkova, Eva; Evans, David

    2014-01-01

    Introduction Youth as young as 11 are given responsibility to manage their asthma. Yet, little is known regarding early adolescents’ asthma self-management behaviors. This study characterizes urban early adolescents’ asthma self-management behaviors and perceived responsibility to manage asthma, exploring demographic differences and examining the relationship between asthma responsibility and disease management. Methods 317 Hispanic and Black early adolescents (mean age=12.7) with persistent, uncontrolled asthma reported prevention and symptom management steps, and responsibility for asthma care. We used Poisson, cumulative logistic, logistic, and linear mixed-effects regression models to assess relationships between demographic predictors, prevention and management behaviors, and responsibility for asthma care. Results 50% took 7–9 prevention steps; few saw physicians when asymptomatic or took daily medication. When symptomatic, 92% used medication to treat symptoms, 56% sought medical attention. Controlling for asthma responsibility, fewer older youth reported observing how they feel when asthma is likely to start, observing symptom changes, or asking for help. More boys reported taking medication daily or upon trigger exposure. Controlling for age, gender, and race/ethnicity, those reporting more asthma responsibility were less likely to report taking management steps, seeking preventive care, asking for help, or going to a doctor/hospital for their asthma. Conclusions Early adolescents’ asthma self-management is suboptimal. With increasing age, they are less observant regarding their asthma and less likely to seek help. Although they perceive themselves to have greater responsibility for managing their asthma, early adolescents do less to care for their asthma, suggesting they are being given responsibility for asthma care prematurely. PMID:22149141

  3. Mobile phone-based asthma self-management aid for adolescents (mASMAA): a feasibility study

    PubMed Central

    Rhee, Hyekyun; Allen, James; Mammen, Jennifer; Swift, Mary

    2014-01-01

    Purpose Adolescents report high asthma-related morbidity that can be prevented by adequate self-management of the disease. Therefore, there is a need for a developmentally appropriate strategy to promote effective asthma self-management. Mobile phone-based technology is portable, commonly accessible, and well received by adolescents. The purpose of this study was to develop and evaluate the feasibility and acceptability of a comprehensive mobile phone-based asthma self-management aid for adolescents (mASMAA) that was designed to facilitate symptom monitoring, treatment adherence, and adolescent–parent partnership. The system used state-of-the-art natural language-understanding technology that allowed teens to use unconstrained English in their texts, and to self-initiate interactions with the system. Materials and methods mASMAA was developed based on an existing natural dialogue system that supports broad coverage of everyday natural conversation in English. Fifteen adolescent–parent dyads participated in a 2-week trial that involved adolescents’ daily scheduled and unscheduled interactions with mASMAA and parents responding to daily reports on adolescents’ asthma condition automatically generated by mASMAA. Subsequently, four focus groups were conducted to systematically obtain user feedback on the system. Frequency data on the daily usage of mASMAA over the 2-week period were tabulated, and content analysis was conducted for focus group interview data. Results Response rates for daily text messages were 81%–97% in adolescents. The average number of self-initiated messages to mASMAA was 19 per adolescent. Symptoms were the most common topic of teen-initiated messages. Participants concurred that use of mASMAA improved awareness of symptoms and triggers, promoted treatment adherence and sense of control, and facilitated adolescent–parent partnerships. Conclusion This study demonstrates the utility and user acceptability of mASMAA as a potential asthma

  4. Adolescent Asthma Self-Management: Patient and Parent-Caregiver Perspectives on Using Social Media to Improve Care

    ERIC Educational Resources Information Center

    Panzera, Anthony D.; Schneider, Tali K.; Martinasek, Mary P.; Lindenberger, James H.; Couluris, Marisa; Bryant, Carol A.; McDermott, Robert J.

    2013-01-01

    Background: Self-management of asthma can now leverage new media technologies. To optimize implementation they must employ a consumer-oriented developmental approach. This study explored benefits of and barriers to improved asthma self-management and identified key elements for the development of a digital media tool to enhance asthma control.…

  5. Supported self-management for asthma

    PubMed Central

    2015-01-01

    Key points Self-management education in asthma is not an optional extra. Healthcare professionals have a responsibility to ensure that everyone with asthma has personalised advice to enable them to optimise how they self-manage their condition. Overviews of the extensive evidence-base conclude that asthma self-management supported by regular professional review, improves asthma control, reduces exacerbations and admissions, and improves quality of life. Self-management education should be reinforced by a written personalised asthma action plan which provides a summary of the regular management strategy, how to recognise deterioration and the action to take. Successful implementation combines education for patients, skills training for professionals in the context of an organisation committed to both the concept and the practice of supported self-management. Educational aims To summarise the evidence base underpinning supported self-management for asthma To provide clinicians with a practical approach to providing supported self-management for asthma To suggest an appropriate strategy for implementing supported self-management Summary The evidence in favour of supported self-management for asthma is overwhelming. Self-management including provision of a written asthma action plan and supported by regular medical review, almost halves the risk of hospitalisation, significantly reduces emergency department attendances and unscheduled consultations, and improves markers of asthma control and quality of life. Demographic and cultural tailoring enables effective programmes to be implemented in deprived and/or ethnic communities or within schools. A crucial component of effective asthma self-management interventions is the provision of an agreed, written personalised action plan which advises on using regular medication, recognising deterioration and appropriate action to take. Monitoring can be based on symptoms or on peak flows and should specify thresholds for action

  6. Effects of a Classroom-Based Asthma Education Curriculum on Asthma Knowledge, Attitudes, Self-Efficacy, Quality of Life, and Self-Management Behaviors among Adolescents

    ERIC Educational Resources Information Center

    Shaw, Sally Fontamillas; Marshak, Helen Hopp; Dyjack, David T.; Neish, Christine M.

    2005-01-01

    Asthma education interventions primarily target young children and adults, and a few target adolescents. Several constructs of the social cognitive theory were used to design a classroom-based high school asthma education curriculum and to determine if the curriculum would improve asthma knowledge and attitudes among 10th grade students, as well…

  7. Integrated Self-Management System for Improved Treatment of Asthma

    PubMed Central

    NGUYEN, Kristen T.; CULJAT, Martin O.; MIERZWA, Andrzej P.; SINGH, Rahul S.; FONG, Benson; VANLANDINGHAM, Rebecca

    2016-01-01

    A mobile, affordable product that provides clinicians and patients with comprehensive asthma assessment is needed to improve asthma control. Our solution is an integrated system consisting of a portable, inexpensive, easy-to-use spirometer and a mobile application that communicates wirelessly with the spirometer. Results demonstrated that the wireless asthma management solution meets recommended American Thoracic Society (ATS) and European Respiratory Society (ERS) standards. The device is expected to empower patients to accurately self-assess their asthma for better self-management at home, work, or leisure. PMID:27046589

  8. Living with Asthma: Part 2, Manual for Teaching Children the Self-Management of Asthma.

    ERIC Educational Resources Information Center

    National Heart, Lung, and Blood Inst. (DHHS/NIH), Bethesda, MD. Div. of Lung Diseases.

    The Living with Asthma Program is designed to teach asthma self-management skills to children (ages 8-12) with asthma and to give their parents the knowledge and behavior modification skills to help their children take over responsibility for managing the condition. Both groups receive training in problem solving and in ways to improve family…

  9. Living with Asthma: Part I, Manual for Teaching Parents the Self-Management of Childhood Asthma.

    ERIC Educational Resources Information Center

    National Heart, Lung, and Blood Inst. (DHHS/NIH), Bethesda, MD. Div. of Lung Diseases.

    The Living with Asthma Program is designed to teach asthma self-management skills to children (ages 8-12) with asthma and to give their parents the knowledge and behavior modification skills to help their children take over responsibility for managing the condition. Both groups receive training in problem solving and in ways to improve family…

  10. Community-based asthma care: trial of a "credit card" asthma self-management plan.

    PubMed

    D'Souza, W; Crane, J; Burgess, C; Te Karu, H; Fox, C; Harper, M; Robson, B; Howden-Chapman, P; Crossland, L; Woodman, K

    1994-07-01

    Although asthma self-management plans are widely recommended as essential in the long-term treatment of adult asthma, there have been few studies examining their use. Our objective was to assess the effect of a "credit card" adult asthma self-management plan in a community experiencing major health problems from asthma, by means of a before and after intervention trial of the efficacy of the "credit card" plan, when introduced through community-based asthma clinics. The participants were 69 Maori people with asthma. The "credit card" plan consisted of written guidelines for the self-management of asthma, based on self-assessment of asthma severity, printed on a plastic card. On one side, management guidelines were based on the interpretation of peak expiratory flow rate (PEFR) recordings, whilst the reverse side was based on symptoms. The outcome measures used were before and after comparison of markers of asthma morbidity and requirement for acute medical treatment; and a structured questionnaire assessing the acceptability and use of the credit card plan. Following the introduction of the plan, the mean PEFR increased from 347 to 389 l.min-1, the percentage of nights woken fell from 30.4 to 16.9%, and the number of days "out of action" fell from 3.8 to 1.7%. The requirements for acute medical treatment also fell during the intervention period. Most participants commented favourably on the content and usefulness of the plan. In the situation of worsening asthma, 28% of subjects found the peak flow side of the card most helpful, 7% the symptoms side, and 48% found both sides equally helpful.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7925904

  11. Digital Asthma Self-Management Interventions: A Systematic Review

    PubMed Central

    Morrison, Deborah; Wyke, Sally; Agur, Karolina; Cameron, Euan J; Docking, Robert I; MacKenzie, Alison M; McConnachie, Alex; Raghuvir, Vandana; Thomson, Neil C

    2014-01-01

    Background Many people with asthma tolerate symptoms and lifestyle limitations unnecessarily by not utilizing proven therapies. Better support for self-management is known to improve asthma control, and increasingly the Internet and other digital media are being used to deliver that support. Objective Our goal was to summarize current knowledge, evidenced through existing systematic reviews, of the effectiveness and implementation of digital self-management support for adults and children with asthma and to examine what features help or hinder the use of these programs. Methods A comprehensive search strategy combined 3 facets of search terms: (1) online technology, (2) asthma, and (3) self-management/behavior change/patient experience. We undertook searches of 14 databases, and reference and citation searching. We included qualitative and quantitative systematic reviews about online or computerized interventions facilitating self-management. Title, abstract, full paper screening, and quality appraisal were performed by two researchers independently. Data extraction was undertaken using standardized forms. Results A total of 3810 unique papers were identified. Twenty-nine systematic reviews met inclusion criteria: the majority were from the United States (n=12), the rest from United Kingdom (n=6), Canada (n=3), Portugal (n=2), and Australia, France, Spain, Norway, Taiwan, and Greece (1 each). Only 10 systematic reviews fulfilled pre-determined quality standards, describing 19 clinical trials. Interventions were heterogeneous: duration of interventions ranging from single use, to 24-hour access for 12 months, and incorporating varying degrees of health professional involvement. Dropout rates ranged from 5-23%. Four RCTs were aimed at adults (overall range 3-65 years). Participants were inadequately described: socioeconomic status 0/19, ethnicity 6/19, and gender 15/19. No qualitative systematic reviews were included. Meta-analysis was not attempted due to

  12. Development, implementation and evaluation of a new adult asthma self-management program.

    PubMed

    Tousman, Stuart; Zeitz, Howard; Taylor, Linda D; Bristol, Cecelia

    2007-01-01

    The purpose of the research was to develop, implement, and evaluate a new adult asthma self-management program with a multidisciplinary perspective. Small groups of adults met for 2 hr for 7 consecutive weekly meetings. Participants were asked to practice asthma specific behaviors (including peak expiratory flow monitoring, avoidance/removal of asthma triggers, and controller medication adherence) and general lifestyle behaviors (including drinking water, practicing relaxation, washing hands, and exercising). Learner-centered teaching techniques such as interactive communication and social support were utilized to help participants practice self-management behaviors including problem-solving and goal-setting. Paired sample t-tests included statistically significant improvements in asthma knowledge, asthma specific quality of life (QOL), asthma specific behaviors such as peak flow monitoring and general life style behaviors such as frequency of daily exercise. These results provide evidence that this new adult asthma self-management program can lead to both knowledge acquisition and behavioral changes. PMID:18092916

  13. A Comparison of an Individually Tailored and a Standardized Asthma Self-Management Education

    ERIC Educational Resources Information Center

    Shackelford, Judy; Bachman, Jean H.

    2009-01-01

    Background: Asthma is one of the most prevalent chronic diseases in the United States and can be life-threatening. There are a rising number of adults with asthma that cannot be prevented or cured but may be controlled. Self-management education is essential for long-term asthma control; however, the most effective type of education is unknown.…

  14. Asthma action plans and self-management: beyond the traffic light.

    PubMed

    Edwards, Anna L

    2013-03-01

    This article discusses current best practices in asthma care and self-management. This information will support practitioners in planning intervention strategies that maximize staff resources and time, and are patient-centered. PMID:23465446

  15. Self-management of acute asthma among low-income urban adults.

    PubMed

    George, Maureen; Campbell, Jacquelyn; Rand, Cynthia

    2009-08-01

    One approach to address asthma disparities has been to create evidence-based guidelines to standardize asthma care and education. However, the adoption of these recommendations has been suboptimal among many providers. As a result, low-income minority patients may not be receiving adequate instruction in asthma self-management. In addition, these patients may fail to follow guideline-based recommendations. We conducted 25 interviews to identify the extent to which urban low-income adults have received training in, and implement, self-management protocols for acute asthma. Twenty-five adults (92% female; 76% African American; mean age 39) were enrolled. Only one subject had received asthma self-management training and only 10 (40%) used short-acting beta-(2) agonist-based (SABA) self-management protocols for the early treatment of acute asthma. No subject used a peak flow meter or an asthma action plan. Most (52%) chose to initially treat acute asthma with complementary and alternative medicine (CAM) despite the availability of SABAs. Importantly, 21 (84%) preferred an integrated approach using both conventional and CAM treatments. Four themes associated with acute asthma self-management emerged from the qualitative analysis. The first theme safety reflected subjects' perception that CAM was safer than SABA. Severity addressed the calculation that subjects made in determining if SABA or CAM was indicated based on the degree of symptoms they were experiencing. The third theme speed and strength of the combination described subjects' belief in the superiority of integrating CAM and SABA for acute asthma self-management. The final themesense of identity spoke to the ability of CAM to provide a customized self-management strategy that subjects desired. It is unclear if subjects' greater use of CAM or delays in using SABA-based self-management protocols were functions of inadequate instruction or personal preference. Regardless, delays in, or under use of, conventional

  16. Improvement of Rural Children's Asthma Self-Management by Lay Health Educators

    ERIC Educational Resources Information Center

    Horner, Sharon D.; Fouladi, Rachel T.

    2008-01-01

    Background: The purpose of the present analysis is to examine changes in rural children's asthma self-management after they received lay health educator (LHE)-delivered classes. Methods: Elementary schools were randomly assigned to the treatment or attention-control condition and their participating students received either asthma education or…

  17. Development of a Novel Tool for Engaging Children and Parents in Asthma Self-Management

    PubMed Central

    Nkoy, Flory L.; Stone, Bryan L.; Fassl, Bernhard A.; Koopmeiners, Karmella; Halbern, Sarah; Kim, Eun H.; Poll, Justin; Hales, Joseph W.; Lee, Dillon; Maloney, Christopher G.

    2012-01-01

    This paper describes the development and evaluation of an innovative application designed to engage children and their parents in weekly asthma self-monitoring and self-management to prompt an early response to deteriorations in chronic asthma control, and to provide their physicians with longitudinal data to assess the effectiveness of asthma therapy and prompt adjustments. The evaluation included 2 iterative usability testing cycles with 6 children with asthma and 2 parents of children with asthma to assess user performance and satisfaction with the application. Several usability problems were identified and changes were made to ensure acceptability of the application and relevance of the content. This novel application is unique compared to existing asthma tools and may shift asthma care from the current reactive, acute care model to a preventive, proactive patient-centered approach where treatment decisions are tailored to patients’ individual patterns of chronic asthma control to prevent acute exacerbations. PMID:23304339

  18. Home-based asthma self-management education for inner city children.

    PubMed

    Butz, Arlene M; Syron, Laura; Johnson, Betty; Spaulding, Joanne; Walker, Melissa; Bollinger, Mary Elizabeth

    2005-01-01

    Optimal home self-management in young children with asthma includes accurate symptom identification followed by timely and appropriate treatment. The objective of this study was to evaluate a home-based asthma educational intervention targeting symptom identification for parents of children with asthma. Two hundred twenty-one children with asthma were enrolled into an ongoing home-based clinical trial and randomized into either a standard asthma education (SAE) or a symptom/nebulizer education intervention (SNEI). Data included home visit records and parent's self-report on questionnaires. Symptom identification and self-management skills significantly improved from preintervention to postintervention for parents in both groups with the exception of checking medications for expiration dates and the frequency of cleaning nebulizer device and equipment. However, significantly more parents of children in the SNEI group reported treating cough symptoms as compared with the SAE group (p = 0.05). Of concern is that only 38% of all parents reported having an asthma action plan in the home. A targeted home-based asthma education intervention can be effective for improving symptom identification and appropriate use of medications in children with asthma. Home asthma educational programs should address accurate symptom identification and a demonstration of asthma medication delivery devices. PMID:15982192

  19. A woman with asthma: a whole systems approach to supporting self-management.

    PubMed

    Pinnock, Hilary; Ehrlich, Elisabeth; Hoskins, Gaylor; Tomlins, Ron

    2014-01-01

    A 35-year-old lady attends for review of her asthma following an acute exacerbation. There is an extensive evidence base for supported self-management for people living with asthma, and international and national guidelines emphasise the importance of providing a written asthma action plan. Effective implementation of this recommendation for the lady in this case study is considered from the perspective of a patient, healthcare professional, and the organisation. The patient emphasises the importance of developing a partnership based on honesty and trust, the need for adherence to monitoring and regular treatment, and involvement of family support. The professional considers the provision of asthma self-management in the context of a structured review, with a focus on a self-management discussion which elicits the patient's goals and preferences. The organisation has a crucial role in promoting, enabling and providing resources to support professionals to provide self-management. The patient's asthma control was assessed and management optimised in two structured reviews. Her goal was to avoid disruption to her work and her personalised action plan focused on achieving that goal. PMID:25321880

  20. A woman with asthma: a whole systems approach to supporting self-management

    PubMed Central

    Pinnock, Hilary; Ehrlich, Elisabeth; Hoskins, Gaylor; Tomlins, Ron

    2014-01-01

    A 35-year-old lady attends for review of her asthma following an acute exacerbation. There is an extensive evidence base for supported self-management for people living with asthma, and international and national guidelines emphasise the importance of providing a written asthma action plan. Effective implementation of this recommendation for the lady in this case study is considered from the perspective of a patient, healthcare professional, and the organisation. The patient emphasises the importance of developing a partnership based on honesty and trust, the need for adherence to monitoring and regular treatment, and involvement of family support. The professional considers the provision of asthma self-management in the context of a structured review, with a focus on a self-management discussion which elicits the patient’s goals and preferences. The organisation has a crucial role in promoting, enabling and providing resources to support professionals to provide self-management. The patient’s asthma control was assessed and management optimised in two structured reviews. Her goal was to avoid disruption to her work and her personalised action plan focused on achieving that goal. PMID:25321880

  1. Developing education for children with asthma through study of self-management behavior.

    PubMed

    Clark, N M; Feldman, C H; Freudenberg, N; Millman, E J; Wasilewski, Y; Valle, I

    1980-01-01

    Bronchial asthma is the major cause of disability in childhood. Among its effects are impaired levels of physical activity and self-esteem, reduced school attendance and performance, and increased utilization of emergency health services. This paper describes the development of a health education program designed to test the hypothesis that better family self-management of asthma can reduce the negative impact of the disease. Three hundred low income Black and Hispanic families were enrolled in the study. Children and primary caretakers were interviewed separately to obtain baseline data on current levels of self-management and to assess needs for educational intervention. Data have been accumulated on a variety of topics concerning asthma self-management, including health practices and beliefs, coping skills, asthma knowledge, and locus of control. An Asthma Self-Management Index was developed to measure positive management behaviors by the family. The needs assessment indicated that six core themes were priorities for these families in terms of relevant skills and behaviors. These topics were incorporated as lesson plans in the intervention. PMID:7275647

  2. Apps for asthma self-management: a systematic assessment of content and tools

    PubMed Central

    2012-01-01

    Background Apps have been enthusiastically adopted by the general public. They are increasingly recognized by policy-makers as a potential medium for supporting self-management of long-term conditions. We assessed the degree to which current smartphone and tablet apps for people with asthma offer content and tools of appropriate quality to support asthma self-management. Methods We adapted systematic review methodology to the assessment of apps. We identified English-language asthma apps for all ages through a systematic search of official app stores. We systematically assessed app content using criteria derived from international guidelines and systematic review of strategies for asthma self-management. We covered three domains: comprehensiveness of asthma information, consistency of advice with evidence and compliance with health information best practice principles. Results We identified 103 apps for asthma in English, of which 56 were sources of information about the condition and 47 provided tools for the management of asthma. No apps offered both types of functionality. Only three information apps approached our definition of comprehensiveness of information about asthma. No apps provided advice on lay management of acute asthma that included details of appropriate reliever medication use. In 32 of 72 instances, apps made unequivocal recommendations about strategies for asthma control or prophylaxis that were unsupported by current evidence. Although 90% of apps stated a clear purpose, compliance with other best practice principles for health information was variable. Contact details were located for 55%, funding source for 18% and confidentiality policy for 17%. Conclusions No apps for people with asthma combined reliable, comprehensive information about the condition with supportive tools for self-management. Healthcare professionals considering recommending apps to patients as part of asthma self-management should exercise caution, recognizing that some

  3. Effectiveness of asthma education with and without a self-management plan in hospitalized children.

    PubMed

    Espinoza-Palma, Tatiana; Zamorano, Alejandra; Arancibia, Francisca; Bustos, María-Francisca; Silva, Maria José; Cardenas, Consuelo; De La Barra, Pedro; Puente, Victoria; Cerda, Jaime; Castro-Rodriguez, José A; Prado, Francisco

    2009-11-01

    Background. Formal education in primary care can reduce asthma exacerbations. However, there are few studies in hospitalized children, with none originating in Latin America. Methods. A prospective randomized study was designed to evaluate whether a full education with self-management plan (ESM) was more effective than an education without self-management plan (E) in reducing asthma hospitalization. Children (5 to 15 years of age) who were hospitalized for an asthma attack were divided in two groups. Children in the E group received general instructions based on a booklet. Those in the ESM group received the same booklet plus a self-management guide and a puzzle game that reinforces the lessons learned in the booklet. Patients were interviewed every 3 months, by telephone, for one year. Interviewers recording the number of hospitalizations, exacerbations, and emergency visits for asthma and oral steroid burst uses. Results. From 88 children who met the inclusion criteria, 77 (86%) completed one year of follow-up (41 from E and 36 from ESM group). Overall, after one year, the hospitalization decreased by 66% and the inhaled corticosteroids therapy increased from 36% to 79%. At the end of the study, there was no difference in exacerbations, emergency visits, oral steroid burst uses, or hospitalizations between the two groups. Conclusions. Asthma education with or without a self-management plan during asthma hospitalization were effective in reducing exacerbations, emergency visits, oral steroid burst uses, and future rehospitalizations. This evidence supports the importance of providing a complete asthma education plan in any patient who is admitted for asthma exacerbation. PMID:19905916

  4. Helping African American Children Self-Manage Asthma: The Importance of Self-Efficacy

    ERIC Educational Resources Information Center

    Kaul, Teri

    2011-01-01

    Background: Asthma is the leading cause of chronic illness among children in the United States, with a disproportionately higher incidence among minority children. In an attempt to increase understanding of the factors that may influence self-management of chronic disease, the study examined the relationship between self-efficacy belief and asthma…

  5. Randomised comparison of guided self management and traditional treatment of asthma over one year.

    PubMed Central

    Lahdensuo, A.; Haahtela, T.; Herrala, J.; Kava, T.; Kiviranta, K.; Kuusisto, P.; Perämäki, E.; Poussa, T.; Saarelainen, S.; Svahn, T.

    1996-01-01

    OBJECTIVE: To compare the efficacy of self management of asthma with traditional treatment. DESIGN: 12 month prospective randomised trial. SETTING: Outpatient clinics in Finland. SUBJECTS: 115 patients with mild to moderately severe asthma. INTERVENTIONS: Patient education and adjustment of anti-inflammatory therapy guided by peak flow measurements. MAIN OUTCOME MEASURES: Unscheduled admissions to hospital and outpatient visits, days off work, courses of antibiotics and prednisolone, lung function, and quality of life. RESULTS: The mean number of unscheduled visits to ambulatory care facilities (0.5 v 1.0), days off work (2.8 v 4.8), and courses of antibiotics (0.4 v 0.9) and prednisolone (0.4 v 1.0) per patient were lower and the quality of life score (16.6 v 8.4 at 12 months) higher in the self management group than in the traditionally treated group. In both groups admissions for asthma were rare. CONCLUSIONS: Self management reduces incidents caused by asthma and improves quality of life. PMID:8605463

  6. Impact of Patients’ Judgment Skills on Asthma Self-Management: A Pilot Study

    PubMed Central

    Londoño, Ana Maria Moreno; Schulz, Peter J.

    2014-01-01

    Background The majority of current health literacy tools assess functional skills including reading, writing, and numeracy. Although these tools have been able to underline the impact of such skills on individuals’ health behaviour, there is a need for comprehensive measures to examine more advanced skills. The individual’s ability to use health-related information considering his/her own health context, and judging positive and negative consequences of their decisions has been conceptualized as judgment skills. The present study used a newly developed judgment skills tool to explore asthma self-management practices. Design and methods Eighty asthma patients were recruited from medical offices during the year 2013. The questionnaire was self-administered and contained health literacy questions, the judgment skill tool, the Asthma Control Test, and several self-management questions. Results Sixty-nine percent of participants had adequate health literacy, while 24% and 5% had marginal and inadequate levels, respectively. The high-judgment group referred more to their doctor when experiencing asthma problems t(76)=–2.18, P<0.032; complied more with the use of their control medicine t(77)=–3.24, P<0.002 and went more regularly to the doctor t(78)=–1.80, P<0.038 (one-tailed) than the low-judgment group. Conclusions The judgment skills tool can help identify asthma patients’ health information use and reveal how this use may affect some self-management practices. Significance for public health Patients’ health literacy has a great impact on their health behaviours and their health outcomes. Therefore, it has become more and more common to measure health literacy within the healthcare setting to determine the most effective approach to target patients. The measurement of asthma judgment skills contribute to a deeper understanding of patients’ asthma self-management in crucial topics for asthma control, and have the advantage of assessing the specific

  7. A systematic review of complementary and alternative medicine for asthma self-management.

    PubMed

    George, Maureen; Topaz, Maxim

    2013-03-01

    This article is a systematic review of complementary and alternative medicine use for pediatric and adult asthma self-management. The aim of the review was to summarize the existing body of research regarding the types and patterns of, adverse events and risky behaviors associated with, and patient-provider communication about complementary therapies in asthma. This evidence serves as the basis for a series of recommendations in support of patient-centered care, which addresses both patient preferences for integrated treatment and patient safety. PMID:23465447

  8. Findings from a pilot Randomised trial of an Asthma Internet Self-management Intervention (RAISIN)

    PubMed Central

    Morrison, D; Wyke, S; Saunderson, K; McConnachie, A; Agur, K; Chaudhuri, R; Thomas, M; Thomson, N C; Yardley, L; Mair, F S

    2016-01-01

    Objective To evaluate the feasibility of a phase 3 randomised controlled trial (RCT) of a website (Living Well with Asthma) to support self-management. Design and setting Phase 2, parallel group, RCT, participants recruited from 20 general practices across Glasgow, UK. Randomisation through automated voice response, after baseline data collection, to website access for minimum 12 weeks or usual care. Participants Adults (age≥16 years) with physician diagnosed, symptomatic asthma (Asthma Control Questionnaire (ACQ) score ≥1). People with unstable asthma or other lung disease were excluded. Intervention ‘Living Well with Asthma’ is a desktop/laptop compatible interactive website designed with input from asthma/ behaviour change specialists, and adults with asthma. It aims to support optimal medication management, promote use of action plans, encourage attendance at asthma reviews and increase physical activity. Outcome measures Primary outcomes were recruitment/retention, website use, ACQ and mini-Asthma Quality of Life Questionnaire (AQLQ). Secondary outcomes included patient activation, prescribing, adherence, spirometry, lung inflammation and health service contacts after 12 weeks. Blinding postrandomisation was not possible. Results Recruitment target met. 51 participants randomised (25 intervention group). Age range 16–78 years; 75% female; 28% from most deprived quintile. 45/51 (88%; 20 intervention group) followed up. 19 (76% of the intervention group) used the website, for a mean of 18 min (range 0–49). 17 went beyond the 2 ‘core’ modules. Median number of logins was 1 (IQR 1–2, range 0–7). No significant difference in the prespecified primary efficacy measures of ACQ scores (−0.36; 95% CI −0.96 to 0.23; p=0.225), and mini-AQLQ scores (0.38; −0.13 to 0.89; p=0.136). No adverse events. Conclusions Recruitment and retention confirmed feasibility; trends to improved outcomes suggest use of Living Well with Asthma may improve

  9. The Effects of Self-Management Education for School-Age Children on Asthma Morbidity: A Systematic Review

    ERIC Educational Resources Information Center

    Ahmad, Emily; Grimes, Deanna E.

    2011-01-01

    The effects of asthma self-management education for school-age children on number of school days missed, emergency department visits and hospital admissions were evaluated through a systematic review of the published research. A total of 9 studies on asthma education programs that were conducted in schools by school nurses and health educators and…

  10. Self-Management Strategies for Adolescents Entering the Work Force.

    ERIC Educational Resources Information Center

    Schloss, Patrick J.

    1987-01-01

    The article proposes a training program in self-management skills for handicapped youths entering the work force. Included are the following sample forms: critical events log, self-referral for training form, self-monitoring report, self-management contract. The forms provide tangible evidence of student progress in self-management. (DB)

  11. Impact of a Computer-assisted Education Program on Factors Related to Asthma Self-management Behavior

    PubMed Central

    Shegog, Ross; Bartholomew, L. Kay; Parcel, Guy S.; Sockrider, Marianna M.; Mâsse, Louise; Abramson, Stuart L.

    2001-01-01

    Objective: To evaluate Watch, Discover, Think and Act (WDTA), a theory-based application of CD-ROM educational technology for pediatric asthma self-management education. Design: A prospective pretest posttest randomized intervention trial was used to assess the motivational appeal of the computer-assisted instructional program and evaluate the impact of the program in eliciting change in knowledge, self-efficacy, and attributions of children with asthma. Subjects were recruited from large urban asthma clinics, community clinics, and schools. Seventy-six children 9 to 13 years old were recruited for the evaluation. Results: Repeated-measures analysis of covariance showed that knowledge scores increased significantly for both groups, but no between-group differences were found (P = 0.55); children using the program scored significantly higher (P < 0.01) on questions about steps of self-regulation, prevention strategies, and treatment strategies. These children also demonstrated greater selfefficacy (P < 0.05) and more efficacy building attribution classification of asthma self-management behaviors (P < 0.05) than those children who did not use the program. Conclusion: The WDTA is an intrinsically motivating educational program that has the ability to effect determinants of asthma self-management behavior in 9- to 13-year-old children with asthma. This, coupled with its reported effectiveness in enhancing patient outcomes in clinical settings, indicates that this program has application in pediatric asthma education. PMID:11141512

  12. Partners in School Asthma Management: Evaluation of a Self-Management Program for Children with Asthma

    ERIC Educational Resources Information Center

    Bartholomew, L. Kay; Sockrider, Marianna M.; Abramson, Stuart L.; Swank, Paul R.; Czyzewski, Danita I.; Tortolero, Susan R.; Markham, Christine M.; Fernandez, Maria E.; Shegog, Ross; Tyrrell, Shellie

    2006-01-01

    The "Partners in School Asthma Management" program for inner-city elementary school children comprises (1) case finding; (2) linkage of school nurses, parents, and clinicians; (3) a computer-based tailored educational program; and (4) school environmental assessment and intervention. Case finding identified 1730 children in 60 elementary schools…

  13. Controlled studies of childhood asthma self-management in Italy using the "open airways" and "living with asthma" programs: a preliminary report.

    PubMed

    Indinnimeo, L; Midulla, F; Hindi-Alexander, M; Bonci, E; Tancredi, G C; Cutrera, R; Zicari, A M; Evans, D; Ronchetti, R

    1987-01-01

    The concept of self-management for childhood asthma was introduced to Italy through a scientific exchange agreement with the United States. Two self-management programs, Living with Asthma (LWA) and Open Airways (OA), are being evaluated in three studies, two of which (Pilot and Atri-Viterbo) were conducted by the Respiratory Service of the Pediatric Department of the University "La Sapienza" in Rome and one by 14 Italian university pediatric respiratory centers (Project Italia). In October 1985, 20 children and their 40 parents were enrolled in the Pilot Study. One hundred percent of the mothers and children and 70% of the fathers attended all of the sessions. Theoretical knowledge about asthma and knowledge of asthma self-management behavior were assessed three times by a questionnaire: at the beginning of the program, at the end of the program and one year later. Significant improvements in knowledge of asthma and in knowledge of asthma self-management behavior were demonstrated by both parents and children at the end of the program and one year later. Analysis of clinical symptoms and drug consumption indicated a statistically nonsignificant trend towards a reduction of asthma severity in the year after the program. In the Atri-Viterbo study 8229 children were initially screened by a questionnaire. One hundred eighty-two children with asthma (2.4%) were identified and invited to participate in a self-management program. Open Airways was used in a shortened version. Only 29 families in Atri (22% of the eligible families) and 24 families in Viterbo (50%) ultimately agreed to participate in the program. A comparison of these families with those who did not participate showed that higher social status (p less than 0.001) and more severe asthma (p less than 0.05) were significantly associated with participation. Attendance by mothers and children was 78% in Atri and 61% in Viterbo. Only 5% of the fathers regularly attended the program. Parents who received the

  14. Asthma and Adolescents: Review of Strategies to Improve Control

    ERIC Educational Resources Information Center

    Hennessy-Harstad, Ellen

    2013-01-01

    One of every 10 adolescents in the United States has asthma. Adolescents who lack asthma control are at increased risk for severe asthma episodes and death. The National Heart, Lung, and Blood Institute 2007 asthma guidelines and research studies indicated that school nurses are instrumental in assisting adolescents to monitor their asthma, learn…

  15. Watch, Discover, Think, and Act: Evaluation of Computer-Assisted Instruction To Improve Asthma Self-Management in Inner-City Children.

    ERIC Educational Resources Information Center

    Bartholomew, L. K.; Gold, R. S.; Parcel, G. S.; Czyzewski, D. I.; Sockrider, M. M.; Fernandez, M.; Shegog, R.; Swank, P.

    2000-01-01

    An interactive multimedia computer game to enhance self-management skills and thereby improve asthma outcomes in inner city children with asthma was evaluated. Results find that the intervention was associated with fewer hospitalizations, better symptom scores, increased functional status, greater knowledge of asthma management, and better child…

  16. PERCEPTIONS OF BARRIERS AND FACILITATORS: SELF-MANAGEMENT DECISIONS BY OLDER ADOLESCENTS AND ADULTS WITH CF

    PubMed Central

    George, Maureen; Rand-Giovannetti, Devin; Eakin, Michelle N.; Borrelli, Belinda; Zettler, Melissa; Riekert, Kristin A.

    2010-01-01

    Background Adherence to CF treatments is poor, which can lead to negative health outcomes. The objective of our study was to qualitatively investigate the barriers and facilitators of self management among older adolescents and adults with CF. Methods Individual semi-structured interviews were conducted, audio-taped, transcribed verbatim and coded to identify common themes. Results Twenty-five patients were interviewed. Four broad themes were identified: Barriers to Self-Management (e.g., treatment burden (identified by 64% of patients), accidental or purposeful forgetting (60%), no perceived benefit (56%)), Facilitators of Self-Management (e.g., CF clinic visits (76%), social support (68%), perceived benefit (68%)), Substitution of Alternative Approaches to Conventional Management (36%) and Planned Nonadherence (32%). Conclusions Older adolescents and adults with CF identified many barriers and facilitators of adherence that may be amenable to self-management counseling strategies, particularly the use of health feedback. PMID:20846910

  17. Evaluation of an Educational Program for Adolescents with Asthma

    ERIC Educational Resources Information Center

    Berg, Jill; Tichacek, Mary J.; Theodorakis, Renee

    2004-01-01

    In addition to challenges of adolescence itself, teens with asthma face demands of asthma management and risks of asthma sequelae, including fatalities. Few asthma educational programs specifically address their needs. In response to school nurse concern, this pilot study evaluated an adolescent asthma education program, the "Power Breathing[TM]…

  18. Posttraumatic Stress in Adolescents with Asthma and Their Parents

    ERIC Educational Resources Information Center

    Kean, Emily Millikan; Kelsay, Kimberly; Wamboldt, Frederick; Wamboldt, Marianne Z.

    2006-01-01

    Objective: To assess posttraumatic stress (PTS) symptoms in adolescents with and without asthma and their parents and the relationship between PTS symptoms and asthma morbidity. Method: Three groups of adolescents (12-18 years) participated: adolescents who had experienced a life-threatening asthma episode (n = 49), asthma controls (n = 71), and…

  19. Development and pilot testing of a mobile health solution for asthma self-management: Asthma action plan smartphone application pilot study

    PubMed Central

    Licskai, Christopher J; Sands, Todd W; Ferrone, Madonna

    2013-01-01

    BACKGROUND: Collaborative self-management is a core recommendation of national asthma guidelines; the written action plan is the knowledge tool that supports this objective. Mobile health technologies have the potential to enhance the effectiveness of the action plan as a knowledge translation tool. OBJECTIVE: To design, develop and pilot a mobile health system to support asthma self-management. METHODS: The present study was a prospective, single-centre, nonrandomized, pilot preintervention-postintervention analysis. System design and development were guided by an expert steering committee. The network included an agnostic web browser-based asthma action plan smart-phone application (SPA). Subjects securely transmitted symptoms and peak flow data daily, and received automated control assessment, treatment advice and environmental alerts. RESULTS: Twenty-two adult subjects (mean age 47 years, 82% women) completed the study. Biophysical data were received on 84% of subject days (subject day = 1 subject × 1 day). Subjects viewed their action plan current zone of control on 54% and current air quality on 61% of subject days, 86% followed self-management advice and 50% acted to reduce exposure risks. A large majority affirmed ease of use, clarity and timeliness, and 95% desired SPA use after the study. At baseline, 91% had at least one symptom criterion for uncontrolled asthma and 64% had ≥2, compared with 45% (P=0.006) and 27% (P=0.022) at study close. Mean Asthma Quality of Life Questionnaire score improved from 4.3 to 4.8 (P=0.047). CONCLUSIONS: A dynamic, real-time, interactive, mobile health system with an integrated asthma action plan SPA can support knowledge translation at the patient and provider levels. PMID:23936890

  20. A pilot study assessing the impact of a learner-centered adult asthma self-management program on psychological outcomes.

    PubMed

    Tousman, Stuart; Zeitz, Howard; Taylor, Linda D

    2010-02-01

    The purpose of the research was to determine if an adult asthma self-management program could significantly improve psychological outcomes for participants. Small groups of adults met for 2 hours for 7 consecutive weeks. Intervention techniques included interactive discussions, problem solving, social support, and a behavior modification procedure. The behavior modification procedure consisted of homework assignments in which participants were asked to self-monitor and record asthma-specific behaviors (peak expiratory flow monitoring, avoidance/removal of asthma triggers, and controller medication adherence) and general lifestyle behaviors (drinking water, washing hands, and exercising). Paired sample t tests indicated statistically significant improvements for the outcomes of quality of life, depression, and self-efficacy. Significant increases were found in knowledge and behaviors, such as peak-flow monitoring and frequency of daily exercise. These results provide initial evidence that our program was effective, although the small sample size and lack of control group indicate the need for further research. PMID:19933878

  1. Adolescents and Asthma: Why Bother with Our Meds?

    PubMed Central

    Naimi, David R.; Freedman, Tovia G.; Ginsburg, Kenneth R.; Bogen, Daniel; Rand, Cynthia S.; Apter, Andrea J.

    2011-01-01

    Background Adherence to inhaled steroid regimens for asthma is poor in adults and children. Although it is assumed that nonadherence contributes to morbidity in older adolescents, investigation is limited. Objective To describe adherence to preventive asthma medications and explore relevant beliefs and attitudes in older urban adolescents including their ideas for improving adherence. Methods Quantitative and qualitative methods were employed to collect data from a convenience sample of adolescents with asthma previously prescribed fluticasone/salmeterol. Two semi-structured face-to-face interviews were conducted one month apart and analyzed for themes. Fluticasone/salmeterol use was electronically monitored between visits and calculated as the number of actuations divided by the number of inhalations prescribed. Results 40 participants, 15–18 years, 19 female, 30 Black/African-American, 11 Medicaid-insured, 24 previously hospitalized for asthma, median FEV1 98% predicted, (range 67%–127%), had median adherence 43% (range 4%–89%). Adherence was not associated with FEV1 or ED visits. Themes emerged from interviews: teens 1) take fluticasone/salmeterol inconsistently; 2) believe fluticasone/salmeterol is “supposed to help me breathe”; 3) dislike its taste; 4) are “too busy” and “forget”; and 5) recommend “reminder” solutions to poor adherence. 20% believed that taking fluticasone/salmeterol was unnecessary and another 18% expressed ambivalence about its benefits. Conclusion Adherence was poor. Examining and acknowledging health beliefs of older teens in the context of their complicated lives may facilitate discussions about self-management. PMID:19395075

  2. Topical Review: Adolescent Self-Regulation as a Foundation for Chronic Illness Self-Management

    PubMed Central

    Lansing, Amy Hughes

    2014-01-01

    Objective To illustrate adolescent self-regulation as a foundation for both individual and interpersonal processes in adolescent chronic illness self-management. Method Literature review. Results Research has identified multiple individual (e.g., self-efficacy, coping, and adherence) and interpersonal factors (parental monitoring and friend support) that are sources of risk and resilience to adolescent chronic illness self-management. In this article, we highlight literature consistent with the idea that self-regulation (including cognitive, emotional, and behavioral regulation) underlies both individual and interpersonal sources of risk and resilience across development. Conclusions This self-regulation approach has multiple benefits: A parsimonious construct for explaining both individual and interpersonal processes that contribute to risk and resilience for chronic illness self-management, the incorporation of methods used in developmental and health psychology research, including performance-based, physiological, daily, and ecological momentary assessment, and a new look to interventions that target self-regulation as a way to improve individual and interpersonal processes in chronic illness self-management. PMID:25214646

  3. Correlates of functional status, self-management, and developmental competence outcomes in adolescents with spina bifida.

    PubMed

    Sawin, Kathleen J; Buran, Constance F; Brei, Timothy J; Fastenau, Philip S

    2003-01-01

    Adolescents with spina bifida (SB), a congenital spinal cord impairment, are at high risk for negative outcomes. Even those with favorable cognitive status often fail to achieve independence, exhibiting poor functional and psychosocial outcomes. The purpose of this study was to examine the relationship between adaptation outcomes (functional status, self-management, and developmental competence) and SB condition-specific, adolescent protective factors, and family protective factors in a sample of adolescents with SB. Individual, interpersonal, and social developmental competence were explored. Sixty-six adolescent/parent pairs were interviewed. Data analysis included descriptive statistics, Cronbach alpha coefficients, and partial correlations controlling for age. All instruments had acceptable reliabilities. Factors associated with outcomes generally fell into two patterns. SB condition-specific variables and adolescent activities (e.g., decision-making, household responsibilities) were related to functional status, self-management, and social competence. In contrast, adolescent beliefs (hope, attitude, and communication efficacy) were predominantly related to individual, interpersonal, and overall developmental competence. PMID:14626030

  4. Adolescents and Exercise Induced Asthma

    ERIC Educational Resources Information Center

    Hansen, Pamela; Bickanse, Shanna; Bogenreif, Mike; VanSickle, Kyle

    2008-01-01

    This article defines asthma and exercise induced asthma, and provides information on the triggers, signs, and symptoms of an attack. It also gives treatments for these conditions, along with prevention guidelines on how to handle an attack in the classroom or on the practice field. (Contains 2 tables and 1 figure.)

  5. ERICA: prevalence of asthma in Brazilian adolescents

    PubMed Central

    Kuschnir, Fábio Chigres; Gurgel, Ricardo Queiroz; Solé, Dirceu; Costa, Eduardo; Felix, Mara Morelo Rocha; de Oliveira, Cecília Lacroix; de Vasconcellos, Maurício Teixeira Leite; Kuschnir, Maria Cristina Caetano

    2016-01-01

    ABSTRACT OBJECTIVE To describe the prevalence of asthma and physician-diagnosed asthma in Brazilian adolescents. METHODS Cross-sectional, national, school-based study with adolescents from 12 to 17 years old, participants in the Study of Cardiovascular Risks in Adolescents (ERICA). The study stratified the sample by region and grouped according to schools and classes with representativeness to the set of cities with more than 100,000 inhabitants of the Country, macro-regions, capitals, and Federal District. A questionnaire collected data through a self-filled in method. We calculated the prevalences and their confidence intervals of 95% (95%CI) according to sex, age group, type of school and skin color. RESULTS Between 2013 and 2014, 74,589 adolescents were evaluated, 55.3% of the female sex. The total prevalence of active asthma was of 13.1% (95%CI 12.1-13.9), being higher in girls (14.8%; 95%CI 13.7-16.0) when compared to boys (11.2%; 95%CI 10.3-12.2) in all geographical strata examined. It was also higher between students of private schools (15.9%; 95%CI 14.2-17.7) when compared to public ones (12.4%; 95%CI 11.4-13.4). It was higher in the Southeast region (14.5%; 95%CI 12.9-16.1), and in the city of Sao Paulo (16.7%; 95%CI 14.7-18.7). The lowest prevalence was observed in North region (9.7%; 95%CI 9.7-10.5), and in Teresina (6.3%; 95%CI 4.9-7.7). The prevalence of physician-diagnosed asthma was of 8.7% (95%CI 8.2-9.1); higher in the North region (13.5%; 95%CI 12.7-14.2), and in Porto Alegre (19.8%; 95%CI 17.5-22.3). It was lower in the Midwest (6.9%; 95%CI 6.0-7.8), and in Cuiaba (4.8%; 95%CI 3.8-5.9). We found no significant difference in the expression of this rate between the sexes, as well as in other variables evaluated by the study. CONCLUSIONS The prevalence of asthma in Brazilian adolescents is high. Rates of active asthma and physician-diagnosed asthma vary widely in different regions and capitals evaluated by the ERICA. These results may assist in the

  6. ERICA: prevalence of asthma in Brazilian adolescents.

    PubMed

    Kuschnir, Fábio Chigres; Gurgel, Ricardo Queiroz; Solé, Dirceu; Costa, Eduardo; Felix, Mara Morelo Rocha; Oliveira, Cecília Lacroix de; Vasconcellos, Maurício Teixeira Leite de; Kuschnir, Maria Cristina Caetano

    2016-02-01

    OBJECTIVE To describe the prevalence of asthma and physician-diagnosed asthma in Brazilian adolescents. METHODS Cross-sectional, national, school-based study with adolescents from 12 to 17 years old, participants in the Study of Cardiovascular Risks in Adolescents (ERICA). The study stratified the sample by region and grouped according to schools and classes with representativeness to the set of cities with more than 100,000 inhabitants of the Country, macro-regions, capitals, and Federal District. A questionnaire collected data through a self-filled in method. We calculated the prevalences and their confidence intervals of 95% (95%CI) according to sex, age group, type of school and skin color. RESULTS Between 2013 and 2014, 74,589 adolescents were evaluated, 55.3% of the female sex. The total prevalence of active asthma was of 13.1% (95%CI 12.1-13.9), being higher in girls (14.8%; 95%CI 13.7-16.0) when compared to boys (11.2%; 95%CI 10.3-12.2) in all geographical strata examined. It was also higher between students of private schools (15.9%; 95%CI 14.2-17.7) when compared to public ones (12.4%; 95%CI 11.4-13.4). It was higher in the Southeast region (14.5%; 95%CI 12.9-16.1), and in the city of Sao Paulo (16.7%; 95%CI 14.7-18.7). The lowest prevalence was observed in North region (9.7%; 95%CI 9.7-10.5), and in Teresina (6.3%; 95%CI 4.9-7.7). The prevalence of physician-diagnosed asthma was of 8.7% (95%CI 8.2-9.1); higher in the North region (13.5%; 95%CI 12.7-14.2), and in Porto Alegre (19.8%; 95%CI 17.5-22.3). It was lower in the Midwest (6.9%; 95%CI 6.0-7.8), and in Cuiaba (4.8%; 95%CI 3.8-5.9). We found no significant difference in the expression of this rate between the sexes, as well as in other variables evaluated by the study. CONCLUSIONS The prevalence of asthma in Brazilian adolescents is high. Rates of active asthma and physician-diagnosed asthma vary widely in different regions and capitals evaluated by the ERICA. These results may assist in the

  7. The Development of a Motivational Interviewing Intervention to Promote Medication Adherence among Inner-City, African-American Adolescents with Asthma

    PubMed Central

    Riekert, Kristin A.; Borrelli, Belinda; Bilderback, Andrew; Rand, Cynthia S.

    2010-01-01

    Objectives To develop and assess the feasibility of a motivational interviewing (MI) based asthma self-management program for inner-city, African-American, adolescents with asthma. Methods 37 African-American adolescents (age 10-15 years) recently seen in an inner-city emergency department for asthma and prescribed an asthma controller medication participated in the newly developed program consisting of 5 home visits. Adolescents and their caregivers completed phone-based surveys before and after the intervention. Results 95% of the adolescents completed all 5 sessions; 89% of caregivers and 76% of adolescents believed other families would benefit from the intervention. Caregivers were more likely to report 100% adherence post-intervention compared to pre-intervention and reported a trend for adolescents taking greater responsibility for their asthma. There were no pre-post differences in adolescent-reported medication adherence, but adolescents did reported increased motivation and readiness to adhere to treatment. Caregivers and adolescents each reported statistically significant increases in their asthma quality of life. Conclusions The findings from this pilot study suggest that MI is a feasible and promising approach for increasing medication adherence among inner-city adolescents with asthma and is worthy of further evaluation in a randomized trial. PMID:20371158

  8. Self-Management in Early Adolescence and Differences by Age at Diagnosis and Duration of Type 1 Diabetes

    PubMed Central

    Chao, Ariana; Whittemore, Robin; Minges, Karl E.; Murphy, Kathryn M.; Grey, Margaret

    2014-01-01

    Purpose The purpose of the study was to describe the frequency of diabetes self-management activities, processes, and goals among early adolescents. In addition, differences in self-management by age at diagnosis and duration of diabetes were explored. Methods A cross-sectional design was used to analyze baseline data from 320 adolescents with T1DM enrolled in a multisite clinical trial. Participants completed questionnaires on demographic/clinical characteristics and self-management. Results There was a transitional pattern of self-management with a high frequency of diabetes care activities, problem solving, and goals and variable amounts of collaboration with parents. After controlling for therapy type and age, youth with short diabetes duration reported performing significantly more diabetes care activities than individuals with a longer duration. Individuals with short diabetes duration had more frequent communication than individuals with a longer duration, which was associated with diagnosis in adolescence. Among those diagnosed as school age children, those with short diabetes duration reported significantly more diabetes goals than those with a longer duration. Conclusions A more specific understanding of self-management may help clinicians provide more targeted education and support. Adolescents with a long duration of diabetes need additional self-management support, particularly for diabetes care activities and communication. PMID:24470042

  9. Effects of Time Management Instruction on Adolescents' Ability to Self-Manage Time in a Vocational Setting

    ERIC Educational Resources Information Center

    DiPipi-Hoy, Caroline; Jitendra, Asha K.; Kern, Lee

    2009-01-01

    This study investigated the effectiveness of a time self-management intervention in the work setting of four adolescents with developmental disabilities. A multiple baseline across participants design was used to examine the adolescents' ability to independently identify time and initiate work-related activities. Intervention was delivered by…

  10. Evaluation of quality of life according to asthma control and asthma severity in children and adolescents

    PubMed Central

    Matsunaga, Natasha Yumi; Ribeiro, Maria Angela Gonçalves de Oliveira; Saad, Ivete Alonso Bredda; Morcillo, André Moreno; Ribeiro, José Dirceu; Toro, Adyléia Aparecida Dalbo Contrera

    2015-01-01

    ABSTRACT OBJECTIVE: To evaluate quality of life according to the level of asthma control and degree of asthma severity in children and adolescents. METHODS: We selected children and adolescents with asthma (7-17 years of age) from the Pediatric Pulmonology Outpatient Clinic of the State University of Campinas Hospital de Clínicas, located in the city of Campinas, Brazil. Asthma control and asthma severity were assessed by the Asthma Control Test and by the questionnaire based on the Global Initiative for Asthma, respectively. The patients also completed the Paediatric Asthma Quality of Life Questionnaire (PAQLQ), validated for use in Brazil, in order to evaluate their quality of life. RESULTS: The mean age of the patients was 11.22 ± 2.91 years, with a median of 11.20 (7.00-17.60) years. We selected 100 patients, of whom 27, 33, and 40 were classified as having controlled asthma (CA), partially controlled asthma (PCA), and uncontrolled asthma (UA), respectively. As for asthma severity, 34, 19, and 47 were classified as having mild asthma (MiA), moderate asthma (MoA), and severe asthma (SA), respectively. The CA and the PCA groups, when compared with the NCA group, showed higher values for the overall PAQLQ score and all PAQLQ domains (activity limitation, symptoms, and emotional function; p < 0.001 for all). The MiA group showed higher scores for all of the PAQLQ components than did the MoA and SA groups. CONCLUSIONS: Quality of life appears to be directly related to asthma control and asthma severity in children and adolescents, being better when asthma is well controlled and asthma severity is lower. PMID:26785958

  11. Usability Testing of an Online Self-management Program for Adolescents With Juvenile Idiopathic Arthritis

    PubMed Central

    McGrath, Patrick; Hodnett, Ellen; Feldman, Brian; Duffy, Ciaran; Huber, Adam; Tucker, Lori; Hetherington, Ross; Tse, Shirley; Spiegel, Lynn; Campillo, Sarah; Gill, Navreet; White, Meghan

    2010-01-01

    Background A new bilingual (English and French) Internet-based self-management program, Teens Taking Charge: Managing Arthritis Online, for adolescents with arthritis and their parents was developed following a needs assessment. Objectives This study explored the usability (user performance and satisfaction) of the self-management program for youth with juvenile idiopathic arthritis (JIA) and their parents to refine the health portal prototype. Methods A qualitative study design with semi-structured, audio taped interviews and observation by a trained observer was undertaken with two iterative cycles to determine the usability (ease of use, efficiency, errors, and user satisfaction) of the user interface and content areas of the intervention. A purposive sample of English-speaking (n = 11; mean age = 15.4, standard deviation [SD] 1.7) and French-speaking (n = 8; mean age = 16.0, SD 1.2) adolescents with JIA and one of their respective parents/caregivers were recruited from 2 Canadian tertiary care centers. Descriptive statistics and simple content analyses were used to organize data into categories that reflected the emerging usability themes. Results All of the participants had access to a computer/Internet at home; however, adolescents were more comfortable using the computer/Internet than their parents. Adolescents and parents provided similar as well as differing suggestions on how the website user interface could be improved in terms of its usability (navigation; presentation and control usage errors; format and layout; as well as areas for further content development). There were no major differences in usability issues between English- and French-speaking participants. Minor changes to the website user interface were made and tested in a second cycle of participants. No further usability problems were identified in the second iterative cycle of testing. Teens and parents responded positively to the appearance and theme of the website (ie, promoting self-management

  12. The Association between Asthma and Sleep in Urban Adolescents with Undiagnosed Asthma

    ERIC Educational Resources Information Center

    Koinis Mitchell, Daphne; Kopel, Sheryl J.; Williams, Brittney; Cespedes, Amarilis; Bruzzese, Jean-Marie

    2015-01-01

    Background: We examined associations between asthma and sleep in a sample of inner-city adolescents with asthma-like symptoms who are undiagnosed, and to assess the extent to which youth's report of perceived stress moderates this association. Methods: A total of 349 adolescents (83% girls), with a mean age of 15.8 years, and their primary…

  13. The Relationship between Asthma and Obesity in Urban Early Adolescents

    PubMed Central

    Jay, Melanie; Wijetunga, N. Ari; Stepney, Cesalie; Dorsey, Karen; Chua, Danica Marie

    2012-01-01

    Asthma and obesity, which have reached epidemic proportions, impact urban youth to a great extent. Findings are inconsistent regarding their relationship; no studies have considered asthma management. We explored the association of obesity and asthma-related morbidity, asthma-related health care utilization, and asthma management in urban adolescents with uncontrolled asthma. We classified 373 early adolescents (mean age=12.8 years; 82% Hispanic or Black) from New York City public middle schools into 4 weight categories: normal (body mass index [BMI]<85th percentile); overweight (85th percentile≤BMI<95th percentile); obese (95th percentile≤BMI<97th percentile); and very obese (BMI≥97th percentile). We compared sample obesity prevalence to national estimates, and tested whether weight categories predicted caregiver reported asthma outcomes, adjusting for age and race/ethnicity. Obesity prevalence was 37%, with 28% of the sample being very obese; both rates were significantly higher than national estimates. We found no significant differences in asthma-related health care utilization or asthma management between weight categories, and a few differences in asthma-related morbidity. Relative to normal weight and obese youth, overweight youth had higher odds of never having any days with asthma-related activity limitations. They also had higher odds of never having asthma-related school absences compared with obese youth. Overweight youth with asthma-related activity limitations had more days with limitations compared with normal weight youth. Overweight, but not obese youth, missed more school due to asthma than normal weight youth. Overweight and obesity prevalence was very high in urban, Hispanic, and Black adolescents with uncontrolled asthma, but not strongly associated with asthma-related morbidity, asthma-related health care utilization, or asthma management practices. PMID:22970423

  14. Building evidence for peer-led interventions: assessing the cost of the Adolescent Asthma Action program in Australia.

    PubMed

    Otim, Michael E; Jayasinha, Ranmalie; Forbes, Hayley; Shah, Smita

    2015-01-01

    Asthma is the most common chronic illness among adolescents in Australia. Aboriginal and Torres Strait Islander adolescents, in particular, face substantial inequalities in asthma-related outcomes. Triple A (Adolescent Asthma Action) is a peer-led education intervention, which aims to improve asthma self-management and reduce the uptake of smoking among adolescents. The aim of this study was to determine the cost of implementing the Triple A program in Australia. Standard economic costing methods were used. It involved identifying the resources that were utilised (such as personnel and program materials), measuring them and then valuing them. We later performed sensitivity analysis so as to identify the cost drivers and a stress test to test how the intervention can perform when some inputs are lacking. Results indicate that the estimated cost of implementing the Triple A program in five schools was $41060, assuming that the opportunity cost of all the participants and venues was accounted for. This translated to $8212 per school or $50 per target student. From sensitivity analysis and a stress test, it was identified that the cost of the intervention (in practice) was $14 per student. This appears to be a modest cost, given the burden of asthma. In conclusion, the Triple A program is an affordable intervention to implement in high schools. The potential asthma cost savings due to the program are significant. If the Triple A program is implemented nation-wide, the benefits would be substantial. PMID:25230153

  15. Usability testing of an online self-management program for adolescents with cancer.

    PubMed

    Stinson, Jennifer; Gupta, Abha; Dupuis, France; Dick, Bruce; Laverdière, Caroline; LeMay, Sylvie; Sung, Lillian; Dettmer, Elizabeth; Gomer, Stephanie; Lober, Janie; Chan, Carol Y

    2015-01-01

    The objective of this study was to explore the usability of a bilingual (English and French) Internet-based self-management program for adolescents with cancer and their parents and refine the Internet program. A qualitative study design with semistructured, audio-taped interviews and observation was undertaken with 4 iterative cycles. A purposive sample of English-speaking and French-speaking adolescents with cancer and one of their parents/caregivers was recruited. Adolescents and parents provided similar feedback on how to improve the usability of the Internet program. Most changes to the website were completed after the initial cycles of English and French testing. Both groups also found information presented on the website to be appropriate, credible, and relevant to their experiences of going through cancer. Participants reported the program would have been extremely helpful when they were first diagnosed with cancer. Usability testing uncovered some issues that affected the usability of the website that led to refinements in the online program. PMID:25037173

  16. Internet-based self-management support for adults with asthma: a qualitative study among patients, general practitioners and practice nurses on barriers to implementation

    PubMed Central

    van Gaalen, Johanna L; van Bodegom-Vos, Leti; Bakker, Moira J; Snoeck-Stroband, Jiska B; Sont, Jacob K

    2016-01-01

    Objectives The aim of this study was to explore barriers among patients, general practitioners (GPs) and practice nurses to implement internet-based self-management support as provided by PatientCoach for asthma in primary care. Setting Primary care within South Holland, the Netherlands. Participants Twenty-two patients (12 women, mean age 38 years), 21 GPs (6 women, mean age 52 years) and 13 practice nurses (all women, mean age 41 years). Design A qualitative study using focus groups and interviews. Outcomes Barriers as perceived by patients, GPs and practice nurses to implementation of PatientCoach. Methods 10 focus groups and 12 interviews were held to collect data: 4 patient focus groups, 4 GP focus groups, 2 practice nurse focus group, 2 patient interviews, 5 GP interviews and 5 practice nurse interviews. A prototype of PatientCoach that included modules for coaching, personalised information, asthma self-monitoring, medication treatment plan, feedback, e-consultations and a forum was demonstrated. A semistructured topic guide was used. Directed content analysis was used to analyse data. Reported barriers were classified according to a framework by Grol and Wensing. Results A variety of barriers emerged among all participant groups. Barriers identified among patients include a lack of a patient–professional partnership in using PatientCoach and a lack of perceived benefit in improving asthma symptoms. Barriers identified among GPs include a low sense of urgency towards asthma care and current work routines. Practice nurses identified a low level of structured asthma care and a lack of support by colleagues as barriers. Among all participant groups, insufficient ease of use of PatientCoach, lack of financial arrangements and patient characteristics such as a lack of asthma symptoms were reported as barriers. Conclusions We identified a variety of barriers to implementation of PatientCoach. An effective implementation strategy for internet-based self-management

  17. Adolescence and asthma management: the perspective of adolescents receiving primary health care☆

    PubMed Central

    Araújo, Alisson; Rocha, Regina Lunardi; Alvim, Cristina Gonçalves

    2014-01-01

    Objective: To study the influence of adolescence characteristics on asthma management. Methods: This was a qualitative study conducted in the city of Divinópolis, Minas Gerais, Southeast Brazil. Data were collected through semistructured interviews guided by a questionnaire with seven asthmatic adolescents followed-up in the primary public health care service of the city. Results: Using content analysis, three thematic categories were observed in the adolescents' responses: 1) family relationships in the treatment of asthma in adolescence; 2) the asthmatic adolescents and their peers; and 3) the role of the school for the asthmatic adolescents. Conclusions: The results demonstrated that peers, family, and school should be more valued by health professionals and by health care services when treating asthmatic adolescents, as these social relationships are closely associated with the adolescent and have an important role in asthma management. Attempts to meet the demands of adolescents contribute to improve asthma management. PMID:25479845

  18. Quality of Life in Adolescents With Mild Asthma

    PubMed Central

    Hallstrand, Teal S.; Curtis, J. Randall; Aitken, Moira L.; Sullivan, Sean D.

    2007-01-01

    Summary The majority of individuals with asthma have mild disease, often in conjunction with allergic rhinitis and exercise-induced bronchoconstriction (EIB). Although health-related quality-of-life (HRQoL) is reduced in moderate to severe asthma and allergic rhinitis, little is known about the effect of mild asthma, mild allergic rhinitis, and EIB on HRQoL outcomes. The objective of this study was to determine the effect of mild asthma, allergic rhinitis, and EIB on HRQoL. A cross-sectional study was conducted of 160 adolescent athletes participating in a screening program to detect EIB. Generic HRQoL was assessed with the teen version of the pediatric quality-of-life inventory (PedsQL™). Prior diagnoses of asthma, allergic rhinitis, and EIB, and current symptoms of dyspnea during exercise and asthma, were recorded. Lung function and the presence of EIB were determined by spirometry before and after an exercise challenge test. Adolescent athletes with a prior physician diagnosis of asthma had a lower HRQoL scale summary score (P < 0.01) and lower physical functioning, emotional functioning, and school functioning domain scores (P values, 0.01–0.02) in comparison to adolescent athletes with no prior diagnosis of these disorders. Athletes with a prior diagnosis of asthma reported dyspnea during exercise more frequently than did those without asthma (P < 0.001). Adolescent athletes with dyspnea during exercise had a lower scale summary score, and lower physical functioning, general well-being, and emotional functioning domain scores (P values, 0.02–0.03). These data show that mild asthma and dyspnea without asthma significantly affect HRQoL. Symptoms of dyspnea during exercise are common in asthma and are associated with lower HRQoL. The clinical significance of these differences in HRQoL is unclear. PMID:14618647

  19. Health Beliefs, Treatment Preferences and Complementary and Alternative Medicine for Asthma, Smoking and Lung Cancer Self-Management in Diverse Black Communities

    PubMed Central

    George, Maureen

    2012-01-01

    Objectives The purpose of this literature review is to characterize unconventional health beliefs and complementary and alternative medicine (CAM) for asthma, smoking and lung cancer as those that are likely safe and those that likely increase risk in diverse Black communities. These findings should provide the impetus for enhanced patient-provider communication that elicits patients’ beliefs and self-management preferences so that they may be accommodated, or when necessary, reconciled through discussion and partnership. Methods Original research articles relevant to this topic were obtained by conducting a literature search of the PubMed Plus, PsychINFO and SCOPUS databases using combinations of the following search terms: asthma, lung cancer, emphysema, chronic obstructive pulmonary disease (COPD), smoking, beliefs, complementary medicine, alternative medicine, complementary and alternative medicine (CAM), explanatory models, African American, and Black. Results Using predetermined inclusion and exclusion criteria, 51 original research papers were retained. Taken together, they provide evidence that patients hold unconventional beliefs about the origins of asthma and lung cancer and the health risks of smoking, have negative opinions of standard medical and surgical treatments, and have favorable attitudes about using CAM. All but a small number of CAM and health behaviors were considered safe. Conclusions When patients’ unconventional beliefs and preferences are not identified and discussed, there is an increased risk that standard approaches to self-management of lung disease will be sub-optimal, that potentially dangerous CAM practices might be used and that timely medical interventions may be delayed. Practice implications Providers need effective communication skills as the medical dialogue forms the basis of patients’ understanding of disease and self-management options. The preferred endpoint of such discussions should be agreement around an

  20. Asthma and Suicidal Ideation and Behavior among Puerto Rican Adolescents

    PubMed Central

    Bandiera, Frank C.; Ramirez, Rafael; Arheart, Kristopher L.; Canino, Glorisa; Goodwin, Renee D.

    2013-01-01

    There is growing evidence of a positive association between asthma and suicidal ideation and behavior in the general community, although information on this potential association is scarce among adolescents and Puerto Ricans, groups at-risk for both conditions. Data came from wave three of the Boricua Youth Study, a longitudinal study of youth in the Bronx and San Juan conducted from 2000–2004. Logistic regressions for correlated data (GEE) were conducted with asthma predicting suicidal ideation and behavior among participants aged 11 years or older. After adjustment for survey design, age, gender, poverty, DSM-IV mental disorders, cigarette smoking, and stressful life events, asthma was positively associated with suicidal ideation and behavior among Puerto Rican adolescents. Public health interventions targeting Puerto Rican adolescents with asthma and future studies investigating potential biological and psychological mechanisms of association are warranted. PMID:23817156

  1. Evaluating the Validity of an Automated Device for Asthma Monitoring for Adolescents: Correlational Design

    PubMed Central

    Belyea, Michael J; Sterling, Mark; Bocko, Mark F

    2015-01-01

    Background Symptom monitoring is a cornerstone of asthma self-management. Conventional methods of symptom monitoring have fallen short in producing objective data and eliciting patients’ consistent adherence, particularly in teen patients. We have recently developed an Automated Device for Asthma Monitoring (ADAM) using a consumer mobile device as a platform to facilitate continuous and objective symptom monitoring in adolescents in vivo. Objective The objectives of the study were to evaluate the validity of the device using spirometer data, fractional exhaled nitric oxide (FeNO), existing measures of asthma symptoms/control and health care utilization data, and to examine the sensitivity and specificity of the device in discriminating asthma cases from nonasthma cases. Methods A total of 84 teens (42 teens with a current asthma diagnosis; 42 without asthma) aged between 13 and 17 years participated in the study. All participants used ADAM for 7 consecutive days during which participants with asthma completed an asthma diary two times a day. ADAM recorded the frequency of coughing for 24 hours throughout the 7-day trial. Pearson correlation and multiple regression were used to examine the relationships between ADAM data and asthma control, quality of life, and health care utilization at the time of the 7-day trial and 3 months later. A receiver operating characteristic (ROC) curve analysis was conducted to examine sensitivity and specificity based on the area under the curve (AUC) as an indicator of the device’s capacity to discriminate between asthma versus nonasthma cases. Results ADAM data (cough counts) were negatively associated with forced expiratory volume in first second of expiration (FEV1) (r=–.26, P=.05), forced vital capacity (FVC) (r=–.31, P=.02), and overall asthma control (r=–.41, P=.009) and positively associated with daily activity limitation (r=.46, P=.01), nighttime (r=.40, P=.02) and daytime symptoms (r=.38, P=.02), and health care

  2. Effects of physical conditioning on children and adolescents with asthma.

    PubMed

    Welsh, Liam; Kemp, Justin G; Roberts, Richard G D

    2005-01-01

    More than 40 years ago, the effects of exertional dyspnoea and the associated fear of an asthma attack usually lead to an avoidance of physical activity amongst asthmatic children. This issue still exists today, particularly in children with severe asthma. This article presents a comprehensive review of published information concerning the effects of training programmes on children and adolescents with asthma. The primary focus of these investigations was to examine the effects of physical conditioning on aerobic fitness, the severity and incidence of exercise-induced asthma (EIA) and asthma symptoms. The large majority of training studies of asthmatic children and adolescents demonstrate significant increases in aerobic fitness post-training or the achievement of normal levels of aerobic fitness. While there are a few reports of a reduced severity in EIA symptoms post-training, the majority of studies demonstrate no change in the occurrence or degree of EIA. However, a number of these studies have reported some reductions in hospitalisations, wheeze frequency, school absenteeism, doctor consultations and medication usage. It is, therefore, recommended that children and adolescents with asthma should participate in regular physical activity. This may improve asthma management and associated general health benefits, whilst minimising inactivity-related health risks. PMID:15707377

  3. A job description for the effective self-management of a long-term condition: experiences of living with difficult asthma.

    PubMed

    Deacon, Maureen; Rickards, Emma

    2013-04-01

    This paper concerns a study exploring the salience of a 'job description' for the effective self-management of a long-term condition to the experiences of a group of women living with difficult asthma. This is a life-threatening disease. It has been claimed that sufferers are a marginalised, misunderstood, mistreated and vulnerable group. The method involved secondary analysis of focus group data. The job description has been developed as a tool to enable nurses to facilitate and support effective self-management. This study was designed to examine the application of this tool to a particular case. Long-term conditions are a growing feature of the developed world and are strongly implicated in health inequalities. They are more prevalent in socially and economically disadvantaged populations and therefore add further burden to already vulnerable people. Effective self-management is critical to adapting and adjusting to the experience of a long-term condition and nurses have a responsibility to promote this process. PMID:23721390

  4. Therapeutic drug monitoring of alprazolam in adolescents with asthma.

    PubMed

    DeVane, C L; Hill, M; Antal, E J

    1998-06-01

    Children and adolescents with severe asthma frequently experience anxiety or depression with anxiety, which can undermine their response to treatment. In addition, these patients often receive theophylline and a variety of adrenergic stimulants, which can exacerbate or worsen anxiety. Such children occasionally are candidates for treatment with anxiolytic therapy. There is a paucity of drug disposition data in adolescents for benzodiazepines, the most frequently used antianxiety drugs. The authors monitored the steady state alprazolam plasma concentration in six children with severe asthma who were administered standard doses of alprazolam. In one patient administered concurrent therapy with troleandomycin, a recognized cytochrome 3A4 inhibitor, alprazolam plasma concentration was markedly elevated. Overall, the disposition data of alprazolam was consistent with data previously reported in adults. Alprazolam appeared to be safe and effective for use in adolescents with asthma. PMID:9631921

  5. Peer stress-related coping activities in young adolescents' asthma management.

    PubMed

    Yang, TienYu Owen; Lunt, Ingrid; Sylva, Kathy

    2009-08-01

    Managing asthma around peers can be stressful for young adolescents (age 9-14). However, the contexualised coping activities under asthma management-related peer stress is under-investigated. The study aims to explore the peer stress-related coping strategies young adolescents adopt in asthma management. Thirty-four young adolescents were interviewed with semi-structured storytelling protocols. Young adolescents expressed their opinions about four scenarios where the characters had difficulties managing asthma among peers. Interviews were transcribed, and qualitative data were analysed with analytical induction and constant comparison to generate themes that described the coping activities young adolescents adopted in four asthma management scenarios. Young adolescents' responses in each scenario were summarised. The coping activities adolescents adopted were cognitive justifying, explaining, outsourcing and undisclosing. Despite the limitations in a scenario-based qualitative study, the results may be useful for teachers and health professionals in social skill interventions for asthma management in early adolescence. PMID:19657905

  6. Issues in adolescent asthma: what are the needs?

    PubMed Central

    Price, J F

    1996-01-01

    In the UK most children with asthma do not attend hospital clinics and continuity of care is provided by their general practitioner. However, those with severe asthma, most of whom will not grow out of their symptoms, need hospital-based care as well. As they progress through adolescence teenagers become increasingly uncomfortable in paediatric wards and outpatient clinics. They need clinics where they can meet the chest physician who will take on their care before they transfer to a clinic for adults (table 5). Adolescent asthmatic patients are a distinct group of patients with different treatment requirements from either paediatric or adult patients. It is important that physicians recognise adolescent needs and the importance of regular health checks, smoking, peer pressure, and the negotiation of treatment plans in this group of patients. PMID:8658384

  7. InSpire to Promote Lung Assessment in Youth: Evolving the Self-Management Paradigms of Young People With Asthma

    PubMed Central

    Elias, Pierre; Rajan, Nithin O; Dacso, Clifford C

    2013-01-01

    Background Asthma is the most common chronic disease in childhood, disproportionately affecting urban, minority, and disadvantaged children. Individualized care plans supported by daily lung-function monitoring can reduce morbidity and mortality. However, despite 20 years of interventions to increase adherence, only 50% of US youth accurately follow their care plans, which leads to millions of preventable hospitalizations, emergency room visits, and sick days every year. We present a feasibility study of a novel, user-centered approach to increasing young people’s lung-function monitoring and asthma self-care. Promoting Lung Assessment in Youth (PLAY) helps young people become active managers of their asthma through the Web 2.0 principles of participation, cocreation, and information sharing. Specifically, PLAY combines an inexpensive, portable spirometer with the motivational power and convenience of mobile phones and virtual-community gaming. Objective The objective of this study was to develop and pilot test InSpire, a fully functional interface between a handheld spirometer and an interactive game and individualized asthma-care instant-messaging system housed on a mobile phone. Methods InSpire is an application for mobile smartphones that creates a compelling world in which youth collaborate with their physicians on managing their asthma. Drawing from design-theory on global timer mechanics and role playing, we incentivized completing spirometry maneuvers by making them an engaging part of a game young people would want to play. The data can be sent wirelessly to health specialists and return care recommendations to patients in real-time. By making it portable and similar to applications normally desired by the target demographic, InSpire is able to seamlessly incorporate asthma management into their lifestyle. Results We describe the development process of building and testing the InSpire prototype. To our knowledge, the prototype is a first-of-its kind

  8. Integrating visual dietary documentation in mobile-phone-based self-management application for adolescents with type 1 diabetes.

    PubMed

    Frøisland, Dag Helge; Årsand, Eirik

    2015-05-01

    The goal of modern diabetes treatment is to a large extent focused on self-management to achieve and maintain a healthy, low HbA1c. Despite all new technical diabetes tools and support, including advanced blood glucose meters and insulin delivery systems, diabetes patients still struggle to achieve international treatment goals, that is, HbA1c < 7.5 in children and adolescents. In this study we developed and tested a mobile-phone-based tool to capture and visualize adolescents' food intake. Our aim was to affect understanding of carbohydrate counting and also to facilitate doctor-adolescent communication with regard to daily treatment. Furthermore, we wanted to evaluate the effect of the designed tool with regard to empowerment, self-efficacy, and self-treatment. The study concludes that implementing a visualization tool is an important contribution for young people to understand the basics of diabetes and to empower young people to define their treatment challenges. By capturing a picture of their own food, the person's own feeling of being in charge can be affected and better self-treatment achieved. PMID:25901020

  9. The Use of Behavior Change Theory in Internet-Based Asthma Self-Management Interventions: A Systematic Review

    PubMed Central

    Torio, Monika-Bianca; Cafazzo, Joseph A

    2015-01-01

    Background The high prevalence rate of asthma represents a major societal burden. Advancements in information technology continue to affect the delivery of patient care in all areas of medicine. Internet-based solutions, social media, and mobile technology could address some of the problems associated with increasing asthma prevalence. Objective This review evaluates Internet-based asthma interventions that were published between 2004 and October 2014 with respect to the use of behavioral change theoretical frameworks, applied clinical guidelines, and assessment tools. Methods The search term (Asthma AND [Online or Internet or Mobile or Application or eHealth or App]) was applied to six bibliographic databases (Ovid MEDLINE, PubMed, BioMed Central, ProQuest Computing, Web of Knowledge, and ACM Digital Library) including only English-language articles published between 2004 and October 2014. In total, 3932 articles matched the priori search terms and were reviewed by the primary reviewer based on their titles, index terms, and abstracts. The matching articles were then screened by the primary reviewer for inclusion or exclusion based on their abstract, study type, and intervention objectives with respect to the full set of priori inclusion and exclusion criteria; 331 duplicates were identified and removed. A total of 85 articles were included for in-depth review and the remaining 3516 articles were excluded. The primary and secondary reviewer independently reviewed the complete content of the 85 included articles to identify the applied behavioral change theories, clinical guidelines, and assessment tools. Findings and any disagreement between reviewers were resolved by in-depth discussion and through a consolidation process for each of the included articles. Results The reviewers identified 17 out of 85 interventions (20%) where at least one model, framework, and/or construct of a behavioral change theory were applied. The review identified six clinical guidelines

  10. The value of usability testing for Internet-based adolescent self-management interventions: “Managing Hemophilia Online”

    PubMed Central

    2013-01-01

    Background As adolescents with hemophilia approach adulthood, they are expected to assume responsibility for their disease management. A bilingual (English and French) Internet-based self-management program, “Teens Taking Charge: Managing Hemophilia Online,” was developed to support adolescents with hemophilia in this transition. This study explored the usability of the website and resulted in refinement of the prototype. Methods A purposive sample (n=18; age 13–18; mean age 15.5 years) was recruited from two tertiary care centers to assess the usability of the program in English and French. Qualitative observations using a “think aloud” usability testing method and semi-structured interviews were conducted in four iterative cycles, with changes to the prototype made as necessary following each cycle. This study was approved by research ethics boards at each site. Results Teens responded positively to the content and appearance of the website and felt that it was easy to navigate and understand. The multimedia components (videos, animations, quizzes) were felt to enrich the experience. Changes to the presentation of content and the website user-interface were made after the first, second and third cycles of testing in English. Cycle four did not result in any further changes. Conclusions Overall, teens found the website to be easy to use. Usability testing identified end-user concerns that informed improvements to the program. Usability testing is a crucial step in the development of Internet-based self-management programs to ensure information is delivered in a manner that is accessible and understood by users. PMID:24094082

  11. [Asthma training in children and adolescents].

    PubMed

    Laub, O

    2000-07-27

    In Germany, asthma training courses have been available for a number of years now. The efficacy of these courses in terms of quality of life improvement and the economics of such training has been demonstrated unequivocally. In the present study, the development of asthma training in Germany is discussed. In recent years, in particular, it has been shown that the involvement of the patient's family is of considerable importance. In addition, in the practical work of the asthma trainer, instruments for quality testing and quality control of presently established concepts have been developed, which guarantee a high standard of most pediatric training programs. The interdisciplinary aspect has an eminently important role to play: the cooperation on equal footing of various occupational groups enables the team to adopt a number of different options with regard to their pupils and their families. A model providing a description of coping with the disease on a number of different levels has been worked out (8-level model). In the concept developed by the pediatric hospital in Osnabrück, the social aspect in relation to the child takes pride of place. PMID:15700489

  12. Integrating Visual Dietary Documentation in Mobile-Phone-Based Self-Management Application for Adolescents With Type 1 Diabetes

    PubMed Central

    Frøisland, Dag Helge; Årsand, Eirik

    2015-01-01

    The goal of modern diabetes treatment is to a large extent focused on self-management to achieve and maintain a healthy, low HbA1c. Despite all new technical diabetes tools and support, including advanced blood glucose meters and insulin delivery systems, diabetes patients still struggle to achieve international treatment goals, that is, HbA1c < 7.5 in children and adolescents. In this study we developed and tested a mobile-phone-based tool to capture and visualize adolescents’ food intake. Our aim was to affect understanding of carbohydrate counting and also to facilitate doctor–adolescent communication with regard to daily treatment. Furthermore, we wanted to evaluate the effect of the designed tool with regard to empowerment, self-efficacy, and self-treatment. The study concludes that implementing a visualization tool is an important contribution for young people to understand the basics of diabetes and to empower young people to define their treatment challenges. By capturing a picture of their own food, the person’s own feeling of being in charge can be affected and better self-treatment achieved. PMID:25901020

  13. Psychosocial issues in the management and treatment of children and adolescents with asthma.

    PubMed

    Malhi, P

    2001-09-01

    Asthma is one of the most common chronic childhood illness. Studies have reported higher incidence of psychosocial adaptation problems in children with asthma, particularly severe asthma, than children in the general population. Increased psychosocial problems in children with asthma have been ascribed to adverse developmental impact of having a chronic health problems, increased demands on the family and dysfunctional familial interactional patterns. Treatment models include education and self management training programs, family therapy, relaxation therapy and biofeedback. These programs have been found to produce improved adjustment, increased medication compliance and greater perceived self competence in managing symptoms and decreased use of medical services. It is concluded that children with asthma require a comprehensive management strategy that pays attention not only to physiological control of asthma symptoms but also emotional and behavioural problems of children and their families. PMID:11980469

  14. A Mindfulness-Based Strategy for Self-Management of Aggressive Behavior in Adolescents with Autism

    ERIC Educational Resources Information Center

    Singh, Nirbhay N.; Lancioni, Giulio E.; Manikam, Ramasamy; Winton, Alan S. W.; Singh, Ashvind N. A.; Singh, Judy; Singh, Angela D. A.

    2011-01-01

    Some individuals with autism engage in physical aggression to an extent that interferes with not only their quality of life, but also that of their parents and siblings. Behavioral and psychopharmacological treatments have been the mainstay of treatments for aggression in children and adolescents with autism. We evaluated the effectiveness of a…

  15. Use of Commonly Available Technologies for Diabetes Information and Self-Management Among Adolescents With Type 1 Diabetes and Their Parents: A Web-Based Survey Study

    PubMed Central

    Vaala, Sarah E; Hood, Korey K; Laffel, Lori; Kumah-Crystal, Yaa A; Lybarger, Cindy K

    2015-01-01

    Background For individuals with Type 1 diabetes (T1D), following a complicated daily medical regimen is critical to maintaining optimal health. Adolescents in particular struggle with regimen adherence. Commonly available technologies (eg, diabetes websites, apps) can provide diabetes-related support, yet little is known about how many adolescents with T1D use them, why they are used, or relationships between use and self-management. Objective This study examined adolescent and parent use of 5 commonly available technologies for diabetes, including proportions who use each technology, frequency of use, and number of different technologies used for diabetes. Analyses also investigated the reasons adolescents reported for using or not using technologies for diabetes, and factors correlated with adolescents’ technology use. Finally, this study examined relationships between the type and number of technologies adolescents use for diabetes and their self-management and glycemic control. Methods Adolescents (12-17 years) and their parents (N=174 pairs), recruited from a pediatric diabetes clinic (n=134) and the Children with Diabetes community website (n=40), participated in this Web-based survey study. Glycosylated hemoglobin (A1C) values were obtained from medical records for pediatric clinic patients. Adolescents reported their use of 5 commonly available technologies for diabetes (ie, social networking, diabetes websites, mobile diabetes apps, text messaging, and glucometer/insulin pump software), reasons for use, and self-management behavior (Self-Care Inventory-Revised, SCI-R). Results Most adolescents and parents used at least one of the 5 technologies for diabetes. Among adolescents, the most commonly used technology for diabetes was text messaging (53%), and the least commonly used was diabetes websites (25%). Most adolescents who used diabetes apps, text messaging, or pump/glucometer software did so more frequently (≥2 times per week), compared to social

  16. Urban Adolescents Readily Comply with a Complicated Asthma Research Protocol

    PubMed Central

    Lovinsky-Desir, Stephanie; Folch, Candace; Jung, Kyung Hwa; Torrone, David; Gil, Eric; Perera, Frederica; Miller, Rachel L; Chillrud, Steven N

    2014-01-01

    PURPOSE Adolescents are often cited as having poor rates of compliance with medical regimens and research protocols. We quantified compliance in a cohort of urban adolescents participating in a complex research protocol in which measures were obtained without direct supervision by research personnel. METHODS A total of 54 early adolescents ages 10–13 were asked to wear a vest containing a personal air pollutant exposure monitor for two 24-hour periods and to perform daily peak expiratory flow (PEF) for six consecutive days. Compliance with wearing the vest was measured by comparing accelerometer data from a device within the vest to one worn continuously on the child’s wrist. Daily PEF data were recorded using an electronic meter. RESULTS A priori definition of compliance was met by 85% of the adolescents by wearing the exposure monitoring vest and 72% by performing PEF. CONCLUSIONS These findings suggest that early adolescents can be compliant with complex research protocols that are needed to help bridge gaps in pediatric asthma research. PMID:24683308

  17. The Effects of Self-Management in General Education Classrooms on the Organizational Skills of Adolescents With ADHD

    ERIC Educational Resources Information Center

    Gureasko-Moore, Sammi; DuPaul, George J.; White, George P.

    2006-01-01

    Self-management procedures have been used in school settings to successfully reduce problem behaviors, as well as to reinforce appropriate behavior. A multiple-baseline across participants design was applied in this study to evaluate the effects of using a self-management procedure to enhance the classroom preparation skills of secondary school…

  18. Self-Management of Classroom Preparedness and Homework: Effects on School Functioning of Adolescent with Attention Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Gureasko-Moore, Sammi; DuPaul, George; White, George P.

    2007-01-01

    Self-management procedures have been used in school settings to successfully reduce problem behaviors and increase appropriate behavior. Two multiple-baseline across-participants designs were applied to evaluate the effects of self-management procedures to enhance classroom preparation skills and homework completion behaviors of middle school…

  19. Socioeconomic and environmental determinants of adolescent asthma in urban Latin America: an ecological analysis.

    PubMed

    Fattore, Gisel Lorena; Santos, Carlos Antonio de Souza Teles; Barreto, Mauricio Lima

    2015-11-01

    The prevalence of asthma is high in urban areas of many Latin-American countries where societies show high levels of inequality and different levels of development. This study aimed to examine the relationship between asthma symptoms prevalence in adolescents living in Latin American urban centers and socioeconomic and environmental determinants measured at the ecological level. Asthma prevalence symptoms were obtained from the International Study of Asthma and Allergies in Childhood (ISAAC) phase III. A hierarchical conceptual framework was defined and the explanatory variables were organized in three levels: distal, intermediate, proximal. Linear regression models weighed by sample size were undertaken between asthma prevalence and the selected variables. Asthma prevalence was positively associated with Gini index, water supply and homicide rate, and inversely associated with the Human Development Index, crowding and adequate sanitation. This study provides evidence of the potential influence of poverty and social inequalities on current wheezing in adolescents in a complex social context like Latin America. PMID:26840816

  20. Physical Deconditioning as a Cause of Breathlessness among Obese Adolescents with a Diagnosis of Asthma

    PubMed Central

    Herring, Richard C.; Weltman, Judith; Patrie, James T.; Weltman, Arthur L.; Platts-Mills, Thomas A.

    2013-01-01

    Background Obese children frequently complain of breathlessness. Asthma and obesity can both contribute to the symptoms during exercise, and this symptom can contribute to a diagnosis of asthma in these children. Despite the high prevalence of obesity few studies have investigated the cardiopulmonary physiology of breathlessness in obese children with a diagnosis of asthma. Methods In this case-control study, thirty adolescents between age 12 and 19 were studied with baseline spirometry and a cardiopulmonary exercise test. Ten adolescents were normal controls, ten had obesity without a diagnosis of asthma, and ten had obesity with a history of physician-diagnosed asthma. Results Baseline characteristics including complete blood count and spirometry were comparable between obese adolescents with and without a diagnosis of asthma. During exercise, obese asthmatic and obese non-asthmatic adolescents had significantly reduced physical fitness compared to healthy controls as evidenced by decreased peak oxygen uptake after adjusting for actual body weight (21.7±4.5 vs. 21.4±5.4 vs. 35.3±5.8 ml/kg/min, respectively). However, pulmonary capacity at the peak of exercise was comparable among all three groups as evidenced by similar pulmonary reserve. Conclusion In this study, breathlessness was primarily due to cardiopulmonary deconditioning in the majority of obese adolescents with or without a diagnosis of asthma. PMID:23637784

  1. Asthma in children and adolescents in Brazil: contribution of the International Study of Asthma and Allergies in Childhood (ISAAC)

    PubMed Central

    Solé, Dirceu; Camelo-Nunes, Inês Cristina; Wandalsen, Gustavo Falbo; Mallozi, Marcia Carvalho

    2014-01-01

    Objective: To assess asthma among Brazilian pediatric population applying the International Study of Asthma and Allergies in Childhood (ISAAC), an internationally standardized and validated protocol. Data sources: ISAAC was conceived to maximize the value of epidemiologic studies on asthma and allergic diseases, establishing a standardized method (self-applicable written questionnaire and/or video questionnaire) capable to facilitate the international collaboration. Designed to be carried out in three successive and dependent phases, the ISAAC gathered a casuistic hitherto unimaginable in the world and in Brazil. This review included data gathered from ISAAC official Brazilian centers and others who used this method. Data synthesis: At the end of the first phase, it has been documented that the prevalence of asthma among Brazilian schoolchildren was the eighth among all centers participating all over the world. Few centers participated in the second phase and investigated possible etiological factors, especially those suggested by the first phase, and brought forth many conjectures. The third phase, repeated seven years later, assessed the evolutionary trend of asthma and allergic diseases prevalence in centers that participated simultaneously in phases I and III and in other centers not involved in phase I. Conclusions: In Brazil, the ISAAC study showed that asthma is a disease of high prevalence and impact in children and adolescents and should be seen as a Public Health problem. Important regional variations, not well understood yet, and several risk factors were found, which makes us wonder: is there only one or many asthmas in Brazil? PMID:24676199

  2. Asthma

    MedlinePlus

    ... Got Homework? Here's Help White House Lunch Recipes Asthma KidsHealth > For Kids > Asthma Print A A A ... it can take several days. continue Who Gets Asthma? No one really knows why one person's airways ...

  3. Risk factors for non-atopic asthma/wheeze in children and adolescents: a systematic review

    PubMed Central

    2014-01-01

    Background The study of non-atopic asthma/wheeze in children separately from atopic asthma is relatively recent. Studies have focused on single risk factors and had inconsistent findings. Objective To review evidence on factors associated with non-atopic asthma/wheeze in children and adolescents. Methods A review of studies of risk factors for non-atopic asthma/wheeze which had a non-asthmatic comparison group, and assessed atopy by skin-prick test or allergen-specific IgE. Results Studies of non-atopic asthma/wheeze used a wide diversity of definitions of asthma/wheeze, comparison groups and methods to assess atopy. Among 30 risk factors evaluated in the 43 studies only 3 (family history of asthma/rhinitis/eczema, dampness/mold in the household, and lower respiratory tract infections in childhood) showed consistent associations with non-atopic asthma/wheeze. No or limited period of breastfeeding was less consistently associated with non-atopic asthma/wheeze. The few studies examining the effects of overweight/obesity and psychological/social factors showed consistent associations. We used a novel graphical presentation of different risk factors for non-atopic asthma/wheeze, allowing a more complete perception of the complex pattern of effects. Conclusions More research using standardized methodology is needed on the causes of non-atopic asthma. PMID:24963333

  4. The Seattle–King County Healthy Homes II Project: A Randomized Controlled Trial of Asthma Self-management Support Comparing Clinic-Based Nurses and In-Home Community Health Workers

    PubMed Central

    Krieger, James; Takaro, Tim K.; Song, Lin; Beaudet, Nancy; Edwards, Kristine

    2009-01-01

    Objective To compare the marginal benefit of in-home asthma self-management support provided by community health workers (CHWs) with standard asthma education from clinic-based nurses. Design Randomized controlled trial. Setting Community and public health clinics and homes. Participants Three hundred nine children aged 3 to 13 years with asthma living in low-income households. Interventions All participants received nurse-provided asthma education and referrals to community resources. Some participants also received CHW-provided home environmental assessments, asthma education, social support, and asthma-control resources. Outcome Measures Asthma symptom–free days, Pediatric Asthma Caretaker Quality of Life Scale score, and use of urgent health services. Results Both groups showed significant increases in caretaker quality of life (nurse-only group: 0.4 points; 95% confidence interval [CI], 0.3–0.6; nurse + CHW group: 0.6 points; 95% CI, 0.4–0.8) and number of symptom-free days (nurse only: 1.3 days; 95% CI, 0.5–2.1; nurse + CHW: 1.9 days; 95% CI, 1.1–2.8), and absolute decreases in the proportion of children who used urgent health services in the prior 3 months (nurse only: 17.6%; 95% CI, 8.1%–27.2%; nurse + CHW: 23.1%; 95% CI, 13.6%–32.6%). Quality of life improved by 0.22 more points in the nurse + CHW group (95% CI, 0.00–0.44; P=.049). The number of symptom-free days increased by 0.94 days per 2 weeks (95% CI, 0.02–1.86; P = .046), or 24.4 days per year, in the nurse + CHW group. While use of urgent health services decreased more in the nurse + CHW group, the difference between groups was not significant. Conclusion The addition of CHW home visits to clinic-based asthma education yielded a clinically important increase in symptom-free days and a modest improvement in caretaker quality of life. PMID:19188646

  5. Obesity and Bronchodilator Response in Black and Hispanic Children and Adolescents With Asthma

    PubMed Central

    Castellanos, Elizabeth; Thakur, Neeta; Oh, Sam S.; Eng, Celeste; Davis, Adam; Meade, Kelley; LeNoir, Michael A.; Avila, Pedro C.; Farber, Harold J.; Serebrisky, Denise; Brigino-Buenaventura, Emerita; Rodriguez-Cintron, William; Kumar, Rajesh; Bibbins-Domingo, Kirsten; Thyne, Shannon M.; Sen, Saunak; Rodriguez-Santana, Jose R.; Borrell, Luisa N.; Burchard, Esteban G.

    2015-01-01

    BACKGROUND: Obesity is associated with poor asthma control, increased asthma morbidity, and decreased response to inhaled corticosteroids. We hypothesized that obesity would be associated with decreased bronchodilator responsiveness in children and adolescents with asthma. In addition, we hypothesized that subjects who were obese and unresponsive to bronchodilator would have worse asthma control and would require more asthma controller medications. METHODS: In the Study of African Americans, Asthma, Genes, and Environments (SAGE II) and the Genes-environments and Admixture in Latino Americans (GALA II) study, two identical, parallel, case-control studies of asthma, we examined the association between obesity and bronchodilator response in 2,963 black and Latino subjects enrolled from 2008 to 2013 using multivariable logistic regression. Using bronchodilator responsiveness, we compared asthma symptoms, controller medication usage, and asthma exacerbations between nonobese (< 95th% BMI) and obese (≥ 95th% BMI) subjects. RESULTS: The odds of being bronchodilator unresponsive were 24% (OR, 1.24; 95% CI, 1.03-1.49) higher among obese children and adolescents compared with their not obese counterparts after adjustment for age, race/ethnicity, sex, recruitment site, baseline lung function (FEV1/FVC), and controller medication. Bronchodilator-unresponsive obese subjects were more likely to report wheezing (OR, 1.38; 95% CI, 1.13-1.70), being awakened at night (OR, 1.34; 95% CI, 1.09-1.65), using leukotriene receptor inhibitors (OR, 1.33; 95% CI, 1.05-1.70), and using inhaled corticosteroid with long-acting β2-agonist (OR, 1.37; 95% CI, 1.05-1.78) than were their nonobese counterpart. These associations were not seen in the bronchodilator-responsive group. CONCLUSIONS: Obesity is associated with bronchodilator unresponsiveness among black and Latino children and adolescents with asthma. The findings on obesity and bronchodilator unresponsiveness represent a unique

  6. Maternal and paternal beliefs, support and parenting as determinants of sport participation of adolescents with asthma

    PubMed Central

    Tiggelman, Dana; van de Ven, Monique O. M.; van Schayck, Onno C. P.; Engels, Rutger C. M. E.; van Sluijs, Esther M.F.

    2016-01-01

    Rationale Few studies have examined determinants of physical activity in patients with chronic illnesses, like asthma. The aim of the present study was to examine whether baseline maternal and paternal beliefs, support and parenting were associated with changes in sport participation of adolescents with asthma, and investigate the moderating effect of sex. Methods In a population-based cohort study 253 adolescents completed a questionnaire assessing their sport participation during home visits in 2012 and 2013. Both parents reported their sport-specific parenting (support, general and asthma-specific beliefs, self-efficacy to encourage sport participation). The collected data were described using descriptive statistics. Path and multi-group analyses were used to examine whether baseline parental factors predicted change in adolescent sport participation, multi-group analyses examined the moderating effect of sex. For all analyses probability p value less than the accepted level of significance α = 0.05 (p < 0.05) were taken as significant effects. Results Few parental factors associated with changes in sport participation of the adolescents, sex did not moderate the associations. In the fully adjusted models, only maternal asthma-specific beliefs about sport participation was significantly positively associated with change in adolescent sport participation. Conclusion Sport-specific parenting does not appear to be a determinant of sport participation in adolescents with asthma. Future research should consider other individual, social and environmental determinants to inform intervention development. PMID:25402625

  7. Self-Management of On-Task Homework Behavior: A Promising Strategy for Adolescents with Attention and Behavior Problems

    ERIC Educational Resources Information Center

    Axelrod, Michael I.; Zhe, Elizabeth J.; Haugen, Kimberly A.; Klein, Jean A.

    2009-01-01

    Students with attention and behavior problems oftentimes experience difficulty finishing academic work. On-task behavior is frequently cited as a primary reason for students' failure to complete homework assignments. Researchers have identified self-monitoring and self-management of on-task behavior as effective tools for improving homework…

  8. Prevalence of self-reported smoking experimentation in adolescents with asthma or allergic rhinitis

    PubMed Central

    Fernandes, Silvia de Sousa Campos; de Andrade, Cláudia Ribeiro; Caminhas, Alessandra Pinheiro; Camargos, Paulo Augusto Moreira; Ibiapina, Cássio da Cunha

    2016-01-01

    Objective: To determine the prevalence of smoking experimentation among adolescents with asthma or allergic rhinitis. Methods: This was a cross-sectional study involving adolescent students (13-14 years of age) in the city of Belo Horizonte, Brazil. The participants completed the Centers for Disease Control and Prevention and International Study of Asthma and Allergies in Childhood questionnaires, both of which have been validated for use in Brazil. We calculated the prevalence of smoking experimentation in the sample as a whole, among the students with asthma symptoms, and among the students with allergic rhinitis symptoms, as well as in subgroups according to gender and age at smoking experimentation. Results: The sample comprised 3,325 adolescent students. No statistically significant differences were found regarding gender or age. In the sample as a whole, the prevalence of smoking experimentation was 9.6%. The mean age for smoking experimentation for the first time was 11.1 years of age (range, 5-14 years). Among the adolescents with asthma symptoms and among those with allergic rhinitis symptoms, the prevalence of self-reported smoking experimentation was 13.5% and 10.6%, respectively. Conclusions: The proportion of adolescents with symptoms of asthma or allergic rhinitis who reported smoking experimentation is a cause for concern, because there is strong evidence that active smoking is a risk factor for the occurrence and increased severity of allergic diseases. PMID:27167427

  9. Asthma

    MedlinePlus

    Asthma is a chronic disease that affects your airways. Your airways are tubes that carry air in and out ... you have asthma, the inside walls of your airways become sore and swollen. That makes them very ...

  10. Temporal trends in the prevalence of asthma and rhinoconjunctivitis in adolescents

    PubMed Central

    Wilmer, Fernanda Agapito Pássaro; Maurici, Rosemeri; Nazário, Carlos Alberto Kuntz; Nazário, Kahio César Kuntz; Pássaro, Paula Fernanda Agapito; Piazza, Helena Elisa; Bertoldi, Rennan Almir; Pizzichini, Emílio; Pizzichini, Márcia Margaret Menezes

    2016-01-01

    ABSTRACT OBJECTIVE To analyze the temporal trend of asthma and rhinoconjunctivitis prevalences as well as their symptoms in adolescents. METHODS Two cross-sectional studies were conducted using the same methodology and questionnaire as was used for adolescents aged 12 to 14 years in the Brazilian city of Florianopolis, SC, Southern Brazil. Based on the international protocol of the International Study of Asthma and Allergies in Childhood (ISAAC) study, adolescents were evaluated in 2001 and 3,150 in 2012. The schools included in this study were the same as in the 2001 study. These schools were randomly selected after stratification by network (public and private) and geographic location. The total average percentage variation was estimated for the prevalence of asthma and rhinoconjunctivitis and their symptoms. RESULTS The prevalence of reported asthma was 10.9% in 2001 and 14.8% in 2012, with an average variation of 2.8% in the period. The highest average variation in the period was observed among female adolescents (4.1%). In parallel a significant increase occurred in reported physician-diagnosed asthma, 7.3% in 2001 and 11,1% in 2012, with an annual variation of 4.5%. The largest increases in reported physician-diagnosed asthma were seen in female (5.9%) and male (4.5%) public school pupils. In addition, a significant increase in reported rhinoconjunctivitis occurred, with the average variation in the period being 5.2%. Reports of severe asthma symptoms remained unchanged during the period, while the annual variation for reported current wheezing (-1.3%) and wheezing during exercise (-1.2%) decreased. CONCLUSIONS The results showed a significant increase in the annual average variation for asthma and rhinoconjunctivitis prevalence during the 2001 to 2012 period. PMID:26786471

  11. Asthma

    MedlinePlus

    ... Month with a Google+ Hangout on Air for parents and caregivers to learn how to help control a child's asthma so that they can breathe ... parents build up their asthma team. Jose, his parents, a doctor and a nurse, ... forces to help Jose control his asthma. The video is recorded in Spanish ...

  12. Patient–Clinician Mobile Communication: Analyzing Text Messaging Between Adolescents with Asthma and Nurse Case Managers

    PubMed Central

    Kim, Soo Yun; Hong, Yangsun; Chih, Ming-Yuan; Shah, Dhavan V.; Gustafson, David H.

    2015-01-01

    Abstract Background: With the increasing penetration of digital mobile devices among adolescents, mobile texting messaging is emerging as a new channel for patient–clinician communication for this population. In particular, it can promote active communication between healthcare clinicians and adolescents with asthma. However, little is known about the content of the messages exchanged in medical encounters via mobile text messaging. Therefore, this study explored the content of text messaging between clinicians and adolescents with asthma. Materials and Methods: We collected a total of 2,953 text messages exchanged between 5 nurse case managers and 131 adolescents with asthma through a personal digital assistant. The text messages were coded using a scheme developed by adapting categories from the Roter Interaction Analysis System. Results: Nurse case managers sent more text messages (n=2,639) than adolescents with asthma. Most messages sent by nurse case managers were targeted messages (n=2,475) directed at all adolescents with asthma, whereas there were relatively few tailored messages (n=164) that were created personally for an individual adolescent. In addition, both targeted and tailored messages emphasized task-focused behaviors over socioemotional behaviors. Likewise, text messages (n=314) sent by adolescents also emphasized task-focused over socioemotional behaviors. Conclusions: Mobile texting messaging has the potential to play an important role in patient–clinician communication. It promotes not only active interaction, but also patient-centered communication with clinicians. In order to achieve this potential, healthcare clinicians may need to focus on socioemotional communication as well as task-oriented communication. PMID:25401324

  13. A pedometer based physical activity self-management program for children and adolescents with physical disability – design and methods of the StepUp study

    PubMed Central

    2014-01-01

    Background Physical activity affords a wide range of physiological and psychological benefits for children and adolescents, yet many children with physical disabilities are insufficiently active to achieve these benefits. The StepUp program is a newly developed 6-week pedometer-based self-management program for children and adolescents with physical disability. Participants use a pedometer to undertake a 6-week physical activity challenge, with personalised daily step count goals set in consultation with a physiotherapist. The study aims to evaluate the effectiveness of the StepUp program, using a randomised control trial design. Methods/design A target sample of 70 young people with physical disabilities (aged 8–17 years, ambulant with or without aid, residing in Adelaide) will be recruited. Participants will be randomly allocated to either intervention or control following completion of baseline assessments. Assessments are repeated at 8 weeks (immediately post intervention) and 20 weeks (12 weeks post intervention). The primary outcome is objective physical activity determined from 7 day accelerometry, and the secondary outcomes are exercise intention, physical self-worth, quality of life and fatigue. Analyses will be undertaken on an intention-to-treat basis using random effects mixed modelling. Discussion This study will provide information about the potential of a low-touch and low-cost physical activity intervention for children and adolescents with cerebral palsy. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12613000023752. PMID:24490871

  14. Intensive upper limb intervention with self-management training is feasible and promising for older children and adolescents with unilateral cerebral palsy.

    PubMed

    Geerdink, Yvonne; Aarts, Pauline; van der Burg, Jan; Steenbergen, Bert; Geurts, Alexander

    2015-01-01

    This study explored the feasibility and preliminary effectiveness of a short (one week) intensive intervention combining Constraint Induced Movement Therapy (CIMT) and bimanual training (BiT) to improve upper limb capacity and bimanual performance guided by individual goal setting in children and adolescents with unilateral cerebral palsy aged 8-18 years. Self-management training was added to the intervention to maximize the effect of training and to empower the participants in self-monitoring the effective use of their affected hand. Functional goals (Canadian Occupational Performance Measure), unimanual capacity (Box and Block Test), bimanual performance (ABILHAND-Kids, Children's Hand-use Experience Questionnaire (CHEQ)) and amount of use (Video Observation Aarts and Aarts - determine developmental disregard (VOAA-DDD-R)) were measured at baseline, one week and four months post intervention. Twenty children (mean age 9.5 years) participated. Repeated measures ANOVA was used to measure effects over time. Compared to baseline, there were significant improvements on all outcome measures. The largest effect sizes were found for the COPM-performance and COPM-satisfaction (Cohen's d=2.09 and d=2.42, respectively). The effect size was large for the ABILHAND-Kids (d=0.86), moderate for the CHEQ (d=0.70) and Box and Block Test (d=0.56), and small for the VOAA-DDD-R (d=0.33). All effects were retained at the four months post intervention assessment. The results of this study indicate that one-week (36h) intensive CIMT-BiT combined with self-management training is a feasible and promising intervention for improving the capacity of the upper limb and its use in bimanual activities in older children and adolescents with unilateral CP. PMID:26164301

  15. Seasonal Patterns of Asthma in Children and Adolescents Presenting at Emergency Departments in Korea

    PubMed Central

    Won, Youn Kyoung; Hwang, Tae ho; Roh, Eui Jung

    2016-01-01

    Purpose Seasonal variations in asthma-related hospitalizations and emergency department visits have long been recognized. This study aimed to investigate the seasonal patterns of asthma in children and adolescents who presented at emergency departments in Korea. Methods We analyzed the National Emergency Department Information System records from 117 emergency departments in Korea that comprised all of the patients with asthma who were aged 3-18 years and who presented at the emergency departments from 2007 to 2012. The children and adolescents were divided into 3 groups based on their ages, namely, 3-6 years, 7-12 years, and 13-18 years. The data were tabulated, and graphs were created to show the seasonal trends in the monthly numbers of emergency department visits as a consequence of asthma. Results A total of 41,128 subjects were identified, and the male-to-female ratio was 1:0.5. General ward admissions comprised 42.6% (n=17,524 patients) of the emergency department visits, and intensive care unit admissions comprised 0.8% (n=335 patients) of the emergency department visits. The monthly numbers of emergency department visits for asthma varied according to the season, with high peaks during fall, which was from September to November, and low levels in summer, which was from June to August. Conclusions Important differences in the seasonal patterns of emergency department visits for asthma were evident in children and adolescents. Identifying seasonal trends in asthma-related emergency department visits may help determine the causes and reduce the likelihood of asthma exacerbation. PMID:26922932

  16. Self-Surveillance by Adolescents and Young Adults Transitioning to Self-Management of a Chronic Genetic Disorder

    ERIC Educational Resources Information Center

    Giarelli, Ellen; Bernhardt, Barbara A.; Pyeritz, Reed E.

    2010-01-01

    Adolescents and young adults with Marfan syndrome (MFS) use information from self-surveillance to manage their disorder. Thirty-seven male and female adolescents with MFS aged 14 to 21 years were interviewed. They identified 58 distinct self-surveillance behaviors that fell into four categories and multiple subcategories (SCs): tracking phenotype…

  17. Association between indoor and outdoor air pollution and adolescent asthma from 1995 to 1996 in Taiwan

    SciTech Connect

    Wang, T.N.; Ko, Y.C.; Chao, Y.Y.; Huang, C.C.; Lin, R.S.

    1999-10-01

    The study aim was to estimate the contribution of indoor and outdoor air pollution to the 1-year prevalence of adolescent asthma after personal susceptibility and other potential risk factors were taken into account. A large-scaled cross-sectional study was conducted among 165,173 high school students aged 11 to 16 years in the different communities of Kaohsiung and Pintong in Taiwan, from October 1995 to June 1996. Each student and his/her parents participating in the study completed a video and a written International Study of Asthma and Allergies in Childhood questionnaire about symptoms of wheezing and allergies, passive smoking, and demographic variables. After adjustment for potential confounders, adolescents exposed to cigarette smoking and environmental tobacco smoke were found to suffer from asthma at an increased frequency. The authors observed a statistically significant association between outdoor air pollution and asthma, after controlling for potential confound variables. Total suspended particulate, nitrogen dioxide, carbon monoxide, ozone, and airborne dust particles all displayed an independent association with asthma, respectively. There were no selection biases in this community-based study, which provides evidence that passive smoking and long-term, high average outdoor air pollution are independent risk factors of asthma.

  18. Asthma in children and adolescents: a comprehensive approach to diagnosis and management.

    PubMed

    Chang, Christopher

    2012-08-01

    Asthma is a chronic disease that has a significant impact on quality of life and is particularly important in children and adolescents, in part due to the higher incidence of allergies in children. The incidence of asthma has increased dramatically during this time period, with the highest increases in the urban areas of developed countries. It seems that the incidence in developing countries may follow this trend as well. While our knowledge of the pathophysiology of asthma and the available of newer, safer medication have both improved, the mortality of the disease has undergone an overall increase in the past 30 years. Asthma treatment goals in children include decreasing mortality and improving quality of life. Specific treatment goals include but are not limited to decreasing inflammation, improving lung function, decreasing clinical symptoms, reducing hospital stays and emergency department visits, reducing work or school absences, and reducing the need for rescue medications. Non-pharmacological management strategies include allergen avoidance, environmental evaluation for allergens and irritants, patient education, allergy testing, regular monitoring of lung function, and the use of asthma management plans, asthma control tests, peak flow meters, and asthma diaries. Achieving asthma treatment goals reduces direct and indirect costs of asthma and is economically cost-effective. Treatment in children presents unique challenges in diagnosis and management. Challenges in diagnosis include consideration of other diseases such as viral respiratory illnesses or vocal cord dysfunction. Challenges in management include evaluation of the child's ability to use inhalers and peak flow meters and the management of exercise-induced asthma. PMID:22187333

  19. Innovations in technology: social media and mobile technology in the care of adolescents with asthma.

    PubMed

    Nickels, Andrew; Dimov, Vesselin

    2012-12-01

    This literature review analyzed technological interventions in the adolescent asthmatic population. A PubMed search was performed with terms of asthma, adolescents, social media, Internet, website, mobile phone, text messaging, SMS, Facebook, Twitter, MySpace, and Technology during a 2.5-year period and identified 64 abstracts. Three studies fulfilled the criteria for adolescent intervention using Internet-based sites but did not provide evidence for effectiveness. Two studies focused on mobile technology. One study included text message reminders for controller medication use in asthma patients. Perceived usefulness, satisfaction, and ease of use of text messages were high, but there was no improvement in asthma control. The literature search did not find any studies exploring the use of smartphone applications or social media services. Current studies of technology use in adolescents with asthma do not provide consistent evidence of effectiveness. The positive attitude toward use of social media or mobile technology opens the possibility for future studies to further explore the potential benefits of such interventions. PMID:22976493

  20. Asthma.

    PubMed

    Bergmann, Karl-Christian

    2014-01-01

    'Asthma' is derived from the Greek root ασθμαινω, meaning 'gasp for breath'. The term originally did not define a disease, but was employed to describe respiratory symptoms of a variety of pulmonary conditions. Over the centuries, several models have been proposed to understand the pathophysiologic abnormalities of asthma. By the beginning of the 20th century, asthma was seen to be a unique illness characterized by 'spasmodic afflictions of the bronchial tubes'. Consistent with the nature of asthma as a complex disease, the models for asthma pathogenesis have become increasingly complex. Research has moved from antiquated ideas to a descriptive functional approach to one that relies on pathophysiology in cellular and molecular biology, immunology, microbiology and genetics/genomics. As more advanced technologies for measuring lung function were developed, the features of asthma were steadily unraveled and its pathophysiology clarified. Asthma was shown to be associated with transient increases in airway resistance, reductions in forced expiratory volumes and flows, hyperinflation of the lungs and increased work of breathing, as well as abnormalities in the distribution of ventilation, perfusion and arterial blood gases. Today, asthma is seen as a chronic inflammatory disease which is not yet fully understood in its pathophysiology; therefore, therapy is still on the path to becoming optimal. PMID:24925386

  1. Self-Management Tactics.

    ERIC Educational Resources Information Center

    Lovitt, Thomas C.; Ballew, Constance

    This collection of self-management tactics is intended for teachers to use in helping secondary school students acquire and improve their self-management skills. The tactics are subdivided into sections devoted to self-recording, self-evaluating, self-selecting, using combinations of individual self-management tactics, and training. The following…

  2. Physicians' perceptions of mobile technology for enhancing asthma care for youth.

    PubMed

    Schneider, Tali; Panzera, Anthony Dominic; Martinasek, Mary; McDermott, Robert; Couluris, Marisa; Lindenberger, James; Bryant, Carol

    2016-06-01

    This study assessed physicians' receptivity to using mobile technology as a strategy in patient care for adolescents with asthma. Understanding physicians' perceived barriers and benefits of integrating mobile technology in adolescents' asthma care and self-management is an initial step in enhancing overall patient and disease outcomes. We conducted in-depth interviews with second- and third-year pediatric residents and attending physicians who oversee pediatric residents in training (N = 27) at an academic medical center in the southeastern United States. We identified both benefits from and barriers to broader use of mobile technologies for improving asthma outcomes in adolescents. Resident physicians demonstrated greater readiness for integrating these technologies than did attending physicians. Prior to adoption of mobile technologies in the care of adolescent asthma patients, barriers to implementation should be understood. Prior to widespread adoption, such systems will need to be evaluated against traditional care for demonstration of patient outcomes that improve on the current situation. PMID:25427556

  3. Effect of peer led programme for asthma education in adolescents: cluster randomised controlled trial

    PubMed Central

    Shah, Smita; Peat, Jennifer K; Mazurski, Evalynn J; Wang, Han; Sindhusake, Doungkamol; Bruce, Colleen; Henry, Richard L; Gibson, Peter G

    2001-01-01

    Objective To determine the effect of a peer led programme for asthma education on quality of life and related morbidity in adolescents with asthma. Design Cluster randomised controlled trial. Setting Six high schools in rural Australia. Participants 272 students with recent wheeze, recruited from a cohort of 1515 students from two school years (mean age 12.5 and 15.5 years); 251 (92.3%) completed the study. Intervention A structured education programme for peers comprising three steps (the “Triple A Program”). Main outcome measures Quality of life, school absenteeism, asthma attacks, and lung function. Results When adjusted for year and sex, mean total quality of life scores showed significant improvement in the intervention than control group. Clinically important improvement in quality of life (>0.5 units) occurred in 25% of students with asthma in the intervention group compared with 12% in the control group (P=0.01). The number needed to treat was 8 (95% confidence interval 4.5 to 35.7). The effect of the intervention was greatest in students in year 10 and in females. Significant improvements occurred in the activities domain (41% v 28%) and in the emotions domain (39% v 19%) in males in the intervention group. School absenteeism significantly decreased in the intervention group only. Asthma attacks at school increased in the control group only. Conclusion The triple A programme leads to a clinically relevant improvement in quality of life and related morbidity in students with asthma. Wider dissemination of this programme in schools could play an important part in reducing the burden of asthma in adolescents. PMID:11238152

  4. Asthma

    MedlinePlus

    ... for Parents for Kids for Teens Teens Home Body Mind Sexual Health Food & Fitness Diseases & Conditions Infections Q& ... exercise. It's a great way to keep the body and mind healthy, so if you get exercise-induced asthma ...

  5. Design of an mHealth App for the Self-management of Adolescent Type 1 Diabetes: A Pilot Study

    PubMed Central

    Casselman, Mark; Hamming, Nathaniel; Katzman, Debra K; Palmert, Mark R

    2012-01-01

    Background The use of mHealth apps has shown improved health outcomes in adult populations with type 2 diabetes mellitus. However, this has not been shown in the adolescent type 1 population, despite their predisposition to the use of technology. We hypothesized that a more tailored approach and a strong adherence mechanism is needed for this group. Objective To design, develop, and pilot an mHealth intervention for the management of type 1 diabetes in adolescents. Methods We interviewed adolescents with type 1 diabetes and their family caregivers. Design principles were derived from a thematic analysis of the interviews. User-centered design was then used to develop the mobile app bant. In the 12-week evaluation phase, a pilot group of 20 adolescents aged 12–16 years, with a glycated hemoglobin (HbA1c) of between 8% and 10% was sampled. Each participant was supplied with the bant app running on an iPhone or iPod Touch and a LifeScan glucometer with a Bluetooth adapter for automated transfers to the app. The outcome measure was the average daily frequency of blood glucose measurement during the pilot compared with the preceding 12 weeks. Results Thematic analysis findings were the role of data collecting rather than decision making; the need for fast, discrete transactions; overcoming decision inertia; and the need for ad hoc information sharing. Design aspects of the resultant app emerged through the user-centered design process, including simple, automated transfer of glucometer readings; the use of a social community; and the concept of gamification, whereby routine behaviors and actions are rewarded in the form of iTunes music and apps. Blood glucose trend analysis was provided with immediate prompting of the participant to suggest both the cause and remedy of the adverse trend. The pilot evaluation showed that the daily average frequency of blood glucose measurement increased 50% (from 2.4 to 3.6 per day, P = .006, n = 12). A total of 161 rewards (average of

  6. Asthma.

    PubMed Central

    Calverley, P. M.

    1996-01-01

    Bronchial asthma is now recognised to be a major cause of morbidity and even mortality in people of all ages. Two important ideas have changed our approach to asthma management. The first is understanding that asthma is a chronic inflammatory disorder which needs regular treatment with anti-inflammatory drugs such as inhaled corticosteroids to prevent further attacks. The second development is the availability of prescribable peak flow meters, which allows both confident diagnosis and early prediction of relapse. Asthma management guidelines provide a logical treatment framework for most patients, but a few difficult cases still consume large amounts of medical time. The commonest problem is one of compliance with treatment which may respond to patient education, although this is not universally so. Other problems include misdiagnosis, acid reflux and, rarely, true corticosteroid-resistant asthma. Several potentially important new treatments have been developed. These include longer acting anticholinergic drugs, drugs with bronchodilator and some anti-inflammatory properties which antagonise or inhibit the production of leukotrienes, sub-types of phosphodiesterase inhibitor with anti-inflammatory properties and immunosuppressive drugs such as cyclosporin. Ultimately these new treatments must be rigorously tested and integrated into a care plan that remains centred on patient education. PMID:8746278

  7. Influence of Asthma on the Longitudinal Trajectories of Cigarette Use Behaviors From Adolescence to Adulthood Using Latent Growth Curve Models

    PubMed Central

    Bae, Jisuk

    2015-01-01

    Objectives: While epidemiologic research indicates that the prevalence of risk-taking behaviors including cigarette smoking among young people with asthma is substantial, the longitudinal patterns of cigarette smoking in this vulnerable population have received little attention. The aim of this study was to evaluate differences in the longitudinal trajectories of cigarette use behaviors from adolescence to adulthood between young people with and without asthma. Methods: Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) during the years 1994 to 1995 (Wave I, adolescence), 2001 to 2002 (Wave III, young adulthood), and 2007 to 2008 (Wave IV, adulthood) were analyzed (n=12 244). Latent growth curve models were used to examine the longitudinal trajectories of cigarette use behaviors during the transition to adulthood according to asthma status. Results: Regardless of asthma status, the trajectory means of cigarette use behaviors were found to increase, and then slightly decrease from adolescence to adulthood. In total participants, there were no statistically significant differences in initial levels and changes in cigarette use behaviors according to asthma status. However, in select sex and race subgroups (i.e., females and non-whites), former asthmatics showed greater escalation in cigarette use behaviors than did non-asthmatics or current asthmatics. Conclusions: This study indicated that the changing patterns of cigarette use behaviors during the transition to adulthood among young people with asthma are comparable to or even more drastic than those among young people without asthma. PMID:25857649

  8. Prevalences of asthma and rhinitis among adolescents in the city of Fortaleza, Brazil: temporal changes *

    PubMed Central

    de Luna, Maria de Fátima Gomes; Fischer, Gilberto Bueno; de Luna, João Rafael Gomes; da Silva, Marcelo Gurgel Carlos; de Almeida, Paulo César; Chiesa, Daniela

    2013-01-01

    OBJECTIVE: To describe the prevalences of asthma and rhinitis in adolescents (13-14 years of age) in the city of Fortaleza, Brazil, in 2010, comparing the results with those obtained in a prevalence survey conducted in 2006-2007. METHODS: This was a cross-sectional study involving probabilistic samples of 3,015 and 3,020 adolescents in surveys conducted in 2006-2007 and 2010, respectively. The International Study of Asthma and Allergies in Childhood protocol was used on both occasions. RESULTS: Comparing the two periods, there were no significant differences regarding cumulative wheezing, active asthma, four or more wheezing attacks within the last year, sleep disturbed by wheezing more than one night per week, and speech-limiting wheezing. The prevalences of exercise-induced wheezing, dry cough at night, and physician-diagnosed asthma were significantly higher in 2010 than in the 2006-2007 period (p < 0.01 for all). The prevalence of physician-diagnosed rhinitis was significantly lower in 2010 (p = 0.01), whereas there were no significant differences between the two periods regarding cumulative rhinitis, current rhinitis, and rhinoconjunctivitis. In both periods, dry cough at night, current rhinitis, and rhinoconjunctivitis were significantly more prevalent in females than in males (p < 0.01 for all). Also in both periods, active asthma, current rhinitis, and rhinoconjunctivitis were more prevalent in private school students than in public school students (p < 0.01 for all). CONCLUSIONS: Our data show that the prevalences of asthma and rhinitis symptoms remain high among 13- and 14-year-olds in Fortaleza, predominantly among females and private school students. PMID:23670497

  9. Relationship between exercise capacity and quality of life in adolescents with asthma *

    PubMed Central

    Basso, Renata Pedrolongo; Jamami, Mauricio; Labadessa, Ivana Gonçalves; Regueiro, Eloisa Maria Gatti; Pessoa, Bruna Varanda; de Oliveira, Antônio Delfino; Lorenzo, Valéria Amorim Pires Di; Costa, Dirceu

    2013-01-01

    OBJECTIVE: To determine whether the quality of life of adolescents with asthma correlates with parameters obtained prior to and after the six-minute step test (6MST); spirometric results after the 6MST; and level of physical activity. METHODS: Nineteen adolescents with asthma, ranging from 11-15 years of age, were assessed with spirometry, 6MST, the International Physical Activity Questionnaire (IPAQ), the Pediatric Asthma Quality of Life Questionnaire (PAQLQ), and the 10-point Borg category-ratio scale. RESULTS: Sensation of dyspnea correlated negatively with the total PAQLQ score (r = −0.54) and with the scores of its activity limitation (AL) and symptoms domains (r = −0.64 and r = −0.63, respectively), leg fatigue also correlating negatively with those same domains (r = −0.49 and r = −0.56, respectively). The total IPAQ score correlated with the total PAQLQ score (r = 0.47) and with the PAQLQ AL domain (r = 0.51); IPAQ time spent walking correlated with the PAQLQ symptoms domain (r = 0.45); and IPAQ time spent in vigorous activity correlated with the AL domain (r = 0.50). In the regression analysis, only sensation of dyspnea remained significantly correlated with the total PAQLQ score and the PAQLQ AL domain; leg fatigue remained significantly correlated with the symptoms domain. CONCLUSIONS: Higher levels of physical activity indicate better quality of life, as do lower perception of dyspnea and less leg fatigue. The 6MST proved to be a viable option for evaluating exercise capacity in adolescents with asthma, because it reflects the discomfort that asthma causes during activities of daily living. PMID:23670496

  10. Do Variants in GSTs Modify the Association between Traffic Air Pollution and Asthma in Adolescence?

    PubMed Central

    Bowatte, Gayan; Lodge, Caroline J.; Lowe, Adrian J.; Erbas, Bircan; Dennekamp, Martine; Marks, Guy B.; Perret, Jennifer; Hui, Jennie; Wjst, Matthias; Gurrin, Lyle C.; Allen, Katrina J.; Abramson, Michael J.; Matheson, Melanie C.; Dharmage, Shyamali C.

    2016-01-01

    Polymorphisms in genes involved in the oxidative stress response may partially explain the documented heterogeneous associations between traffic-related air pollution (TRAP) exposure and asthma and allergies in children. We investigated whether the GSTT1, GSTM1 and GSTP1 gene polymorphisms modified the associations between TRAP exposure during the first year of life and asthma, wheeze and hay fever in adolescence. We used a birth cohort of 620 high risk infants from the Melbourne Atopy Cohort Study. TRAP exposure during the first year of life was defined as the cumulative length of major roads within 150 m of each participant’s residence during the first year of life. Wheeze, asthma and hay fever were measured at ages 12 (n = 370) and 18 (n = 434) years. The associations and interactions with glutathione S-transferases (GST s) were investigated using regression models. Overall, there was no relationship between TRAP exposure during the first year of life and current asthma, wheeze and hay fever at ages 12 or 18 years. However, in GSTT1 null carriers, every 100 m increase in cumulative lengths of major road exposure during the first year of life was associated with a 2.31-fold increased risk of wheeze and a 2.15-fold increased risk of asthma at 12 years. TRAP is associated with some respiratory outcomes in carriers of genetic polymorphisms in oxidative stress metabolism genes. PMID:27043549

  11. [Systematic literature review on interventions in rehabilitation for children and adolescents with asthma bronchiale].

    PubMed

    Ahnert, J; Löffler, S; Müller, J; Vogel, H

    2010-06-01

    Relevant data bases were used to collect and evaluate guidelines, meta-analyses, and reviews as well as primary studies dealing with asthma therapy for children and adolescents. Treatment approaches whose effectiveness with regard to bronchial asthma was empirically verified (i. e., evidence-based) were identified (medical and diagnostic procedures as well as drug trials were excluded from the analysis). 152 methodically sound studies referring to asthma treatment of children and adolescents were selected. Strong evidence was found for patient education, parent education, exercise therapy, inhalation, and tobacco withdrawal. Nutritional counseling and avoidance of allergens showed limited evidence. Psychotherapy, relaxation techniques, breathing exercises, climate therapy, clinical social work (social and legal counseling services, vocational reintegration counseling, aftercare) and integration counseling showed inconsistent evidence. No evidence was found for alternative medicine. Challenges regarding the development of treatment standards for children and adolescent rehabilitation are highlighted; these refer to limitations in report quality in some of the studies, the validity of treatments for comorbid conditions, a lack of differentiation for different age groups, and transferability of outpatient or international study results to inpatient rehabilitation. PMID:20533145

  12. Asthma

    MedlinePlus

    ... Burks AW, et al, eds. In: Middleton's Allergy Principles and Practice . 8th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 55. Lugogo N, Que LG, Gilstrap DL, Kraft M. Asthma: clinical diagnosis and management. In: Broaddus VC, Mason RJ, Ernst JD, et ...

  13. Asthma treatment in children and adolescents in an urban area in southern Brazil: popular myths and features

    PubMed Central

    Roncada, Cristian; de Oliveira, Suelen Goecks; Cidade, Simone Falcão; Rafael, Joseane Guimarães; Ojeda, Beatriz Sebben; dos Santos, Beatriz Regina Lara; Gustavo, Andréia da Silva; Pitrez, Paulo Márcio

    2016-01-01

    Objective: To describe the frequency of popular myths about and features of asthma treatment in children and adolescents in an urban area in southern Brazil. Methods: The parents or legal guardians of public school students (8-16 years of age) completed a specific questionnaire regarding their understanding of asthma, asthma control, and treatment characteristics. The sample included parents or legal guardians of students with asthma (n = 127) and healthy controls (n = 124). Results: The study involved 251 parents or legal guardians, of whom 127 (68.5%) were the mothers and 130 (51.8%) were White. The mean age of these participants was 38.47 ± 12.07 years. Of the participants in the asthma and control groups, 37 (29.1%) and 26 (21.0%), respectively, reported being afraid of using asthma medications, whereas 61 (48%) and 56 (45.2%), respectively, believed that using a metered dose inhaler can lead to drug dependence. However, only 17 (13.4%) and 17 (13.7%) of the participants in the asthma and control groups, respectively, reported being afraid of using oral corticosteroids. In the asthma group, 55 students (43.3%) were diagnosed with uncontrolled asthma, only 41 (32.3%) had a prescription or written treatment plan, and 38 (29.9%) used asthma medications regularly. Conclusions: Popular myths about asthma treatment were common in our sample, as were uncontrolled asthma and inappropriate asthma management. Further studies in this field should be conducted in other developing countries, as should evaluations of pediatric asthma treatment programs in public health systems. PMID:27167435

  14. The prevalence and risk factors of asthma and allergic diseases among working adolescents.

    PubMed

    Cakir, Erkan; Ersu, Refika; Uyan, Zeynep Seda; Oktem, Sedat; Varol, Nezih; Karakoc, Fazilet; Karadag, Bulent; Akyol, Mesut; Dagli, Elif

    2010-01-01

    Certain occupational groups are known to be at particularly high risk of developing allergic diseases. The objective of the present study was to evaluate the prevalence of allergic diseases among working adolescents. The International Study of Asthma and Allergies in Childhood questionnaire was used. Four hundred and thirty six adolescents working in motor, lathe-finish, coiffure and textile and 366 high school students as control group were enrolled to the study. Mean age was 16.8 +/- 1.2 years and 82.9% of them were male. There was no significant difference among groups for ever and current wheezing while doctor diagnosed asthma was higher in lathe- finish group (p = 0.036). Family history of allergy, history of allergic rhinitis, and active smoking were found to be risk factors for asthma and related symptoms. Working in coiffure (p = 0.054), and textile (p = 0.003) were significant risk factors for ever allergic rhinitis. Working in lathe finish (p = 0.023), coiffure (p = .002), and textile (p < 0.001) were associated with a higher risk for current allergic rhinitis. Working in coiffure was a risk factor for ever eczema (p = 0.008) and doctor diagnosed eczema (p = 0.014). It was concluded that working in lathe-finish was associated with doctor diagnosed asthma and active smoking was a risk factor for asthma and related symptoms. Working in coiffure, textile and lathe- finish were risk factors for rhinitis, and working in coiffure was a risk factor for eczema. Preventive measures should be taken at the onset of employment in order to prevent or reduce the detrimental effects of exposures in these occupational groups. PMID:21038780

  15. Caries prevalence, caries-related factors and plaque pH in adolescents with long-term asthma.

    PubMed

    Stensson, M; Wendt, L-K; Koch, G; Oldaeus, G; Lingström, P; Birkhed, D

    2010-01-01

    The aim of the present case-control study was to investigate dental caries, various caries-related factors as well as gingival condition, in 12- to 16-year-olds with long-term asthma (n = 20) and a matched healthy control group (n = 20). Data on dietary and oral hygiene habits, numbers of mutans streptococci and lactobacilli in saliva were also obtained. The plaque pH drop after a sucrose rinse was measured up to 40 min at 2 approximal tooth sites. A lower salivary flow rate was found in the asthma group compared to the control group (p < 0.05). The mean (± SD) of DFS, including manifest and initial caries, was 4.9 ± 5.5 in the asthma and 1.4 ± 2.3 (p < 0.01) in the control group. Only 1 adolescent in the asthma group was caries free compared to 13 in the control group. Concerning pH in plaque, adolescents with asthma had a lower initial value (p < 0.01) and final pH (p < 0.05) than the control group. The Cariogram data showed that 55% of the subjects in the control group had 'a high chance of avoiding caries' compared to 10% in the asthma group (p < 0.01). The asthmatic adolescents had higher numbers of sites with gingival bleeding (p < 0.01). To conclude, adolescents with long-term asthma had a higher total DFS and caries risk (according to Cariogram), decreased salivary rate, more gingival bleeding and lower plaque pH than adolescents without asthma. PMID:21051892

  16. Youth and Parent Versions of the Asthma-Related Anxiety Scale: Development and Initial Testing

    PubMed Central

    Unikel, Lynne H.; Shrout, Patrick E.; Klein, Rachel G.

    2011-01-01

    Among adults, anxiety related to asthma has been acknowledged to influence asthma self-management. However, it has not been addressed in pediatric samples and there have been no measures developed to assess asthma-related anxiety in youth or parents. The objective of this study was to develop and test the psychometric properties of novel instruments assessing asthma-related anxiety: the Youth Asthma-Related Anxiety Scale (YAAS) and Parent Asthma-Related Anxiety Scale (PAAS). Scale items were analyzed for content validity. We determined the factor structure using exploratory factor analysis and tested the scales' psychometric properties with 285 Hispanic and African American early adolescents with uncontrolled asthma (mean age=12.8) and their parents (n=230) who participated in a larger randomized control trial testing the efficacy of an asthma intervention; control group families (134 youth and 103 parents) provided follow-up data to assess temporal stability. Both the YAAS and PAAS contained 2 factors with Cronbach alpha coefficients ranging from 0.75 to 0.90. The 2 factors, anxiety about asthma severity and about disease-related restrictions, were highly correlated within each measure. The measures displayed content and construct validity and demonstrated moderate temporal stability over 2–3 months (range: 0.36–0.42). The YAAS and PAAS have adequate psychometric properties and can meaningfully contribute to the assessment of asthma-related anxiety in adolescents and their parents, filling a clinical need in this population. PMID:22276225

  17. Mine dumps, wheeze, asthma, and rhinoconjunctivitis among adolescents in South Africa: any association?

    PubMed Central

    Nkosi, Vusumuzi; Wichmann, Janine; Voyi, Kuku

    2015-01-01

    The study investigated the association between community proximity to mine dumps, and current wheeze, rhinoconjunctivitis, and asthma among adolescents. This study was conducted during May–November 2012 around five mine dumps in South Africa. Communities in close proximity to mine dumps had an increased likelihood of current wheeze OR 1.38 (95 % CI: 1.10–1.71), rhinoconjunctivitis OR 1.54 (95 % CI: 1.29–1.82), and a protective association with asthma OR 0.29 (95 % CI: 0.23–0.35). Factors associated with health outcomes included other indoor and outdoor pollution sources. Wheeze and rhinoconjunctivitis appear to be a public health problem in these communities. The findings of this study serve as a base for further detailed epidemiological studies for communities in close proximity to the mine dumps e.g. a planned birth cohort study. PMID:25537069

  18. Influence of childhood growth on asthma and lung function in adolescence

    PubMed Central

    Sonnenschein-van der Voort, Agnes M.M.; Howe, Laura D.; Granell, Raquel; Duijts, Liesbeth; Sterne, Jonathan A.C.; Tilling, Kate; Henderson, A. John

    2015-01-01

    Background Low birth weight and rapid infant growth in early infancy are associated with increased risk of childhood asthma, but little is known about the role of postinfancy growth in asthmatic children. Objectives We sought to examine the associations of children's growth patterns with asthma, bronchial responsiveness, and lung function until adolescence. Methods Individual growth trajectories from birth until 10 years of age were estimated by using linear spline multilevel models for 9723 children participating in a population-based prospective cohort study. Current asthma at 8, 14, and 17 years of age was based on questionnaires. Lung function and bronchial responsiveness or reversibility were measured during clinic visits at 8 and 15 years of age. Results Rapid weight growth between 0 and 3 months of age was most consistently associated with increased risks of current asthma at the ages of 8 and 17 years, bronchial responsiveness at age 8 years, and bronchial reversibility at age 15 years. Rapid weight growth was associated with lung function values, with the strongest associations for weight gain between 3 and 7 years of age and higher forced vital capacity (FVC) and FEV1 values at age 15 years (0.12 [95% CI, 0.08 to 0.17] and 0.11 [95% CI, 0.07 to 0.15], z score per SD, respectively) and weight growth between 0 and 3 months of age and lower FEV1/FVC ratios at age 8 and 15 years (−0.13 [95% CI, −0.16 to −0.10] and −0.04 [95% CI, −0.07 to −0.01], z score per SD, respectively). Rapid length growth was associated with lower FVC and FVC1 values at age 15 years. Conclusion Faster weight growth in early childhood is associated with asthma and bronchial hyperresponsiveness, and faster weight growth across childhood is associated with higher FVC and FEV1 values. PMID:25577593

  19. Acetaminophen intake and risk of asthma, hay fever and eczema in early adolescence.

    PubMed

    Vlaski, Emilija; Stavric, Katerina; Isjanovska, Rozalinda; Seckova, Lidija; Kimovska, Milica

    2007-09-01

    A positive association between acetaminophen intake and allergic diseases has recently been reported in developed countries with impaired oxidant/antioxidant balance and promotion of atopy as proposed underlying mechanisms. The aim of the study was to explore the relationship between acetaminophen intake and asthma, hay fever, and eczema in The Republic of Macedonia as a country with acetaminophen intake not physician-controlled, high passive smoke exposure and dietary antioxidant intake, and moderately low prevalence of allergic diseases. Self-reported data obtained through the standardized International Study of Asthma and Allergies in Childhood Phase Three written questionnaires of 3026 adolescents aged 13/14 years from randomly selected schools in Skopje, the capital of Macedonia, were used. The frequency of current acetaminophen intake--both unadjusted and adjusted for confounding factors--was correlated to current and ever-diagnosed asthma, hay fever and eczema by odds ratios (OR, 95% CI) in binary logistic regression. Use of acetaminophen at least once monthly increased the risk of current wheeze (adjusted OR 2.04, 1.31-3.20 p = 0.002), asthma 'ever' (adjusted OR 2.77, 1.06-7.26 p=0.039), current allergic rhinoconjunctivitis (adjusted OR 2.95, 1.79-4.88 p=0.000) and hay fever 'ever' (adjusted OR 2.25, 1.36-3.70 p=0.002). A significant association between frequent acetaminophen intake and atopic eczema and also between infrequent acetaminophen intake and investigated allergic diseases was not established. The findings suggest an increased risk of asthma and hay fever, but not atopic eczema associated with frequent acetaminophen use in a developing country. PMID:17893435

  20. Adolescent boys with asthma – a pilot study on embodied gendered habits

    PubMed Central

    Westergren, Thomas; Lilleaas, Ulla-Britt

    2012-01-01

    Purpose Asthma is a common chronic disease with gender differences in terms of severity and quality of life. This study aimed to understand the gendered practices of male asthmatic adolescents in terms of living with and managing their chronic disease. The study applied a sociological perspective to identify the gender-related practices of participants and their possible consequences for health and disease. Patients and methods The study used a combined ethnomethodology and grounded theory design, which was interpreted using Bourdieu’s theory of practice. We aimed to discover how participants interpreted their social worlds to create a sense of meaning in their everyday lives. The study was based on multistage focus group interviews with five adolescent participants at a specialist center for asthmatic children and youths. We took necessary precautions to protect the participants, according to the principles of the Declaration of Helsinki. The study protocol was approved by the Regional Committee for Medical Research Ethics and the hospital’s research department. Results The core concept for asthmatic male adolescents was being men. They were focused on being nonasthmatic, and exhibited ambivalence towards the principles of the health services. Physical activity supported their aim of being men and being nonasthmatic, as well as supported their treatment goals. Being fearless, unconcerned, “cool,” and dependent also supported the aim of being men and being nonasthmatic, but not the health service principle of regular medication. Occasionally, the participants were asthmatic when they were not able to or gained no advantages from being nonasthmatic. Their practice of being men independently of being asthmatic emphasized their deeply gendered habits. Conclusion Understanding gender differences in living with and managing asthma is important for health workers. Knowledge of embodied gendered habits and their reproduction in social interactions and clinical

  1. [Intermittent or persistent rhinitis in children and adolescents with Asthma: «the Swiss LARA paediatrics survey»].

    PubMed

    Leuppi, J D; Wildhaber, J H; Spertini, F; Helbling, A

    2011-10-01

    Asthma and allergic rhinitis are chronic inflammatory airway diseases which often occur concomitantly. The objective of the LARA program was to identify the comorbidities and characteristics of asthma (A), intermittent or persistent rhinitis (IPR) and physician defined atopic dermatitis (AD) in 6- to 16-year old asthmatic Swiss children and adolescents. Overall, 126 general practitioners and paediatricians collected the data of 670 asthmatics. Approximately one third of the asthmatic children in Switzerland had well-controlled asthma. Almost two thirds of these asthmatics suffered from concomitant IPR. The latter presented with significantly less symptoms while the treatment rates with inhaled corticosteroids (approximately 90%) and leukotriene-receptorantagonists (approximately 50%) were comparable. However, there were almost twice as many passive smokers in the less well-controlled group. The prevalence of AD was similar in both groups. IPR and AD may play an important role as risk factors in the future development of asthma. PMID:21971616

  2. Barriers to the implementation of self management support in long term lung conditions.

    PubMed

    Roberts, N J; Younis, I; Kidd, L; Partridge, M R

    2012-01-01

    Background Self-management improves outcomes in asthma and COPD and is strongly recommended in national and international guidelines; however implementation of the guidelines such as use of written action plans in practice is often poor. Setting A questionnaire survey was undertaken to identify the healthcare professional barriers to implementation of self-management for asthma and COPD in West London. Question Why is self-management education not being undertaken in respiratory conditions? Methods A questionnaire was designed to elicit healthcare professionals' views about barriers to implementation of self-management in asthma and COPD. Results Response rates were 33% (58/175). Results showed strong support for guideline recommendations, however implementation was patchy. Seventy six percent of respondents discussed asthma self-management with patients; however only 47.8% of patients received a written action plan. For COPD patients, 55.1% discussed self-management, with 41% receiving a written action plan. In COPD, there was greater GP involvement and less delegation of self-management. Barriers to implementation included patient factors (compliance, literacy and patient understanding), time constraints and insufficient resources. Those who believed they had witnessed improved health outcomes with self-management (53%, 31/58) were more likely to give written action plans (78%, 24/31, 'nearly always/sometimes' gave written action plans), Nearly a third of healthcare professionals reported lacking confidence in constructing written action plans (33% 19/58; GPs 43%, nurses 43%). Conclusion Despite overwhelming evidence self-management support is still not being implemented into routine clinical practice, identified barriers included time constraints, lack of training, lack of belief in patients ability to self-manage and lack of confidence completing self-management plans. Practice implications These issues need to be addressed if self-management support is to be

  3. Barriers to the implementation of self management support in long term lung conditions

    PubMed Central

    Roberts, NJ; Younis, I; Kidd, L

    2012-01-01

    Background Self-management improves outcomes in asthma and COPD and is strongly recommended in national and international guidelines; however implementation of the guidelines such as use of written action plans in practice is often poor. Setting A questionnaire survey was undertaken to identify the healthcare professional barriers to implementation of self-management for asthma and COPD in West London. Question Why is self-management education not being undertaken in respiratory conditions? Methods A questionnaire was designed to elicit healthcare professionals' views about barriers to implementation of self-management in asthma and COPD. Results Response rates were 33% (58/175). Results showed strong support for guideline recommendations, however implementation was patchy. Seventy six percent of respondents discussed asthma self-management with patients; however only 47.8% of patients received a written action plan. For COPD patients, 55.1% discussed self-management, with 41% receiving a written action plan. In COPD, there was greater GP involvement and less delegation of self-management. Barriers to implementation included patient factors (compliance, literacy and patient understanding), time constraints and insufficient resources. Those who believed they had witnessed improved health outcomes with self-management (53%, 31/58) were more likely to give written action plans (78%, 24/31, ‘nearly always/sometimes’ gave written action plans), Nearly a third of healthcare professionals reported lacking confidence in constructing written action plans (33% 19/58; GPs 43%, nurses 43%). Conclusion Despite overwhelming evidence self-management support is still not being implemented into routine clinical practice, identified barriers included time constraints, lack of training, lack of belief in patients ability to self-manage and lack of confidence completing self-management plans. Practice implications These issues need to be addressed if self-management support is to

  4. Effect of Orem’s Self-Care Model on Self-Esteem of Adolescents with Asthma Referred to an Asthma and Allergy Clinic in Isfahan

    PubMed Central

    Hemati, Zeinab; Mosaviasl, Fatemeh Sadat; Abasi, Samira; Ghazavi, Zohre

    2015-01-01

    Introduction: Acquisition of chronic diseases such as asthma leads to psychological, mental and physical complications in adolescents, and hence their self-esteem may be compromised. Therefore, the present study was conducted to assess the effect of Orem’s self-care model on self-esteem of adolescents with asthma. Materials and Methods: This semi-experimental study enrolled 64 asthmatic adolescents referred to Shariati Hospital, Isfahan. Subjects were assigned to two groups of control and intervention consecutively. Then, the self-care training program was conducted according to Orem’s self-care model in eight two-hour sessions based on self-care needs, and self-esteem was measured in the two groups prior to and two months after the last training session. The data were collected by a questionnaire of demographic characteristics and the Coopersmith Self-Esteem Inventories (CSEI) and analyzed by SPSS version 20. Results: Independent t-test showed a significant difference in the mean score of self-esteem between the intervention and control groups after the training (P<0.05), but the difference was not statistically significant prior to the intervention. Paired t-test showed a significant difference in the mean score of self-esteem before and after the training in the intervention group (P<0.01), but this difference was not statistically significant in the control group (P>0.05). Conclusion: Regarding the effect of Orem’s self-care model on self-esteem of adolescents with asthma, we recommend the use of this model as a care intervention in healthcare centers to promote adolescents’ health. PMID:27114724

  5. Childhood wheezing phenotypes influence asthma, lung function and exhaled nitric oxide fraction in adolescence.

    PubMed

    Duijts, Liesbeth; Granell, Raquel; Sterne, Jonathan A C; Henderson, A John

    2016-02-01

    The objective of this study was to examine the associations of childhood wheezing phenotypes with asthma, lung function and exhaled nitric oxide fraction (FeNO) in adolescence.In a population-based, prospective cohort study of 6841 children, we used latent class analysis to identify wheezing phenotypes during the first 7 years of life. Physician-diagnosed asthma, spirometry and FeNO were assessed at 14-15 years.Compared with never/infrequent wheeze, intermediate-onset and persistent wheeze were consistently strongest associated with higher risk of asthma (risk ratio (95% CI) 10.9 (8.97-13.16) and 9.13 (7.74-10.77), respectively), lower forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio (mean difference in standard deviation units (SDU) (95% CI) -0.34 (-0.54- -0.14) and -0.50 (-0.62- -0.38), respectively), lower forced expiratory flow at 25-75% of FVC (FEF25-75%) (mean difference in SDU (95% CI) -0.30 (-0.49- -0.10) and -0.42 (-0.54- -0.30), respectively) and increased FEV1 bronchodilator reversibility (mean difference in SDU (95% CI) 0.12 (0.02-0.22) and 0.13 (0.06-0.19), respectively). Prolonged early and persistent wheeze were associated with a decline in FEV1/FVC ratio and FEF25-75% between 8-9 and 14-15 years. Intermediate-onset, late-onset and persistent wheeze were associated with higher FeNO ratios (ratio of geometric means (95% CI) 1.90 (1.59-2.29), 1.57 (1.39-1.77) and 1.37 (1.22-1.53), respectively, compared with never/infrequent wheeze).Early-onset wheezing phenotypes persisting after 18 months of age show the strongest associations with asthma, lower lung function, even worsening from mid-childhood, and higher FeNO levels in adolescence. PMID:26647439

  6. The In Vivo Adherence Intervention For at Risk Adolescents With Asthma: Report of a Randomized Pilot Trial

    PubMed Central

    D'Amico, Elizabeth J.; Varni, James W.; Munafo, Jennifer K.; Britto, Maria T.; Kercsmar, Carolyn M.; Drotar, Dennis; King, Eileen C.; Darbie, Lynn

    2012-01-01

    Objective Low-income and minority adolescents are at high risk for poor asthma outcomes, due in part to adherence. We tested acceptability, feasibility, and effect sizes of an adherence intervention for low socioeconomic status (SES) minority youth with moderate- and severe-persistent asthma. Design and Methods Single-site randomized pilot trial: intervention (n = 12; asthma education, motivational interviewing, problem-solving skills training, 1 month cell-phone with tailored text messaging) versus control (n = 14; asthma education; cell-phone without tailored messaging). Calculated effect-sizes of relative change from baseline (1 and 3 months). Results Intervention was judged acceptable and feasible by participants. Participants (12–18 years, mean = 15.1, SD = 1.67) were 76.9% African-American, 80.7% public/no insurance. At 1 and 3 months, asthma symptoms (Cohen's d's = 0.40, 0.96) and HRQOL (PedsQL™; Cohen's d's = 0.23, 1.25) had clinically meaningful medium to large effect sizes. Conclusions This intervention appears promising for at-risk youth with moderate- and severe-persistent asthma. PMID:22167121

  7. Interrelationships between diagnosed asthma, asthma-like symptoms, and abnormal airway behaviour in adolescence: the Odense Schoolchild Study.

    PubMed Central

    Siersted, H. C.; Mostgaard, G.; Hyldebrandt, N.; Hansen, H. S.; Boldsen, J.; Oxhøj, H.

    1996-01-01

    BACKGROUND: The diagnosis of asthma is based on several characteristics including symptoms and suitable tests of airway lability. However, it is neither clear to what degree various tests and symptoms identify the same subjects, nor how these characteristics are best combined to diagnose asthma. The interrelationships between physician-diagnosed asthma, asthma-like symptoms, and abnormal airway function, as defined by four commonly used tests, have therefore been assessed. METHODS: A population based sample of 495 Danish schoolchildren aged 12-15 years, comprising 292 randomly selected subjects and 203 subjects considered at risk of having or developing asthma, was examined. Symptoms and background information were recorded by questionnaire. The test panel consisted of baseline forced expiratory volume in one second (FEV1%), provocation with treadmill exercise (EXE) and with inhaled methacholine (PD15), and monitoring of peak expiratory flow (PEF) twice daily for two weeks. RESULTS: The sensitivity for diagnosed asthma was highest for PD15 followed by PEF monitoring, whereas specificity for asthma or asthma-like symptoms was marginally higher with the other two tests. Most symptomatic subjects with any positive test were identified by PD15 alone (75%) or in combination with PEF monitoring (89%). PEF variability was more susceptible to treatment with inhaled steroids than the PD15 index. Although inter-test agreement was weak (kappa < 0.40 for all pairs), significant associations were found between PD15 and EXE, PEF and EXE, and FEV1% and PD15. CONCLUSIONS: The agreement between the four tests was weak. In particular, PEF variability and methacholine responsiveness seem to identify different varieties of airway pathophysiology. The combined use of methacholine provocation testing and PEF monitoring may be helpful as an epidemiological screening tool for asthma. PMID:8711678

  8. Clinical characteristics of children and adolescents with severe therapy-resistant asthma in Brazil *

    PubMed Central

    Rodrigues, Andrea Mendonça; Roncada, Cristian; Santos, Giovana; Heinzmann-Filho, João Paulo; de Souza, Rodrigo Godinho; Vargas, Mauro Henrique Moraes; Pinto, Leonardo Araújo; Jones, Marcus Herbert; Stein, Renato Tetelbom; Pitrez, Paulo Márcio

    2015-01-01

    Abstract Objective: To describe the clinical characteristics, lung function, radiological findings, and the inflammatory cell profile in induced sputum in children and adolescents with severe therapy-resistant asthma (STRA) treated at a referral center in southern Brazil. Methods: We retrospectively analyzed children and adolescents (3-18 years of age) with uncontrolled STRA treated with high-dose inhaled corticosteroids and long-acting ß2 agonists. We prospectively collected data on disease control, lung function, skin test reactivity to allergens, the inflammatory cell profile in induced sputum, chest CT findings, and esophageal pH monitoring results. Results: We analyzed 21 patients (mean age, 9.2 ± 2.98 years). Of those, 18 (86%) were atopic. Most had uncontrolled asthma and near-normal baseline lung function. In 4 and 7, induced sputum was found to be eosinophilic and neutrophilic, respectively; the inflammatory cell profile in induced sputum having changed in 67% of those in whom induced sputum analysis was repeated. Of the 8 patients receiving treatment with omalizumab (an anti-IgE antibody), 7 (87.5%) showed significant improvement in quality of life, as well as significant reductions in the numbers of exacerbations and hospitalizations. Conclusions: Children with STRA present with near-normal lung function and a variable airway inflammatory pattern during clinical follow-up, showing a significant clinical response to omalizumab. In children, STRA differs from that seen in adults, further studies being required in order to gain a better understanding of the disease mechanisms. PMID:26398754

  9. Self-management interventions for chronic illness.

    PubMed

    Newman, Stanton; Steed, Liz; Mulligan, Kathleen

    An increasing number of interventions have been developed for patients to better manage their chronic illnesses. They are characterised by substantial responsibility taken by patients, and are commonly referred to as self-management interventions. We examine the background, content, and efficacy of such interventions for type 2 diabetes, arthritis, and asthma. Although the content and intensity of the programmes were affected by the objectives of management of the illness, the interventions differed substantially even within the three illnesses. When comparing across conditions, it is important to recognise the different objectives of the interventions and the complexity of the issues that they are attempting to tackle. For both diabetes and asthma, the objectives are concerned with the underlying control of the condition with clear strategies to achieve the desired outcome. By contrast, strategies to deal with symptoms of pain and the consequences of disability in arthritis can be more complex. The interventions that were efficacious provide some guidance as to the components needed in future programmes to achieve the best results. But to ensure that these results endure over time remains an important issue for self-management interventions. PMID:15500899

  10. An Integration of Parents’ and Best Friends’ Smoking, Smoking-Specific Cognitions, and Nicotine Dependence in Relation to Readiness to Quit Smoking: A Comparison between Adolescents with and without Asthma

    PubMed Central

    Engels, Rutger C. M. E.; Kleinjan, Marloes; van den Eijnden, Regina J. J. M.

    2008-01-01

    Objective To study the impact of parents’ and best friends’ smoking, nicotine dependence, and craving on smoking-specific cognitions, and readiness to quit in adolescents with and without asthma. Methods Structural equation analyses were applied to data from a sample of 1,120 daily smoking adolescents, 83 of whom had asthma. Results Adolescents with asthma felt more ready to quit, and cognitions were more strongly related to readiness to quit among adolescents with asthma than among adolescents without asthma. Moreover, best friends’ smoking seemed more relevant to the cognitions of adolescents with asthma. Nicotine dependence and craving were strongly related to cognitions, and to readiness to quit in both groups. The relation between craving and readiness to quit, however, was stronger among participants with asthma. Conclusions Reduction of nicotine dependence and craving is essential for both groups. Youth with asthma may benefit even more from cognitive-based cessation services than healthy youth. The finding that adolescents with asthma are relatively more ready to quit, and that their cognitions are more easily affected can be turned into advantages in asthma-specific cessation services. PMID:18287108

  11. Asthma Education Programme in Russia: Educating Patients.

    ERIC Educational Resources Information Center

    Maslennikova, G. Ya.; Morosova, M. E.; Salman, N. V.; Kulikov, S. M.; Oganov, R. G.

    1998-01-01

    U.S. recommendations for asthma management were adapted for use in educating Moscow families with children with asthma (N=252). Use of anti-inflammatory drugs, doctor visits, peak flow rates, and daily peak flow were also measured. One-year follow up showed significant improvement in asthma self-management skills among the education group.…

  12. Adolescent decision-making about use of inhaled asthma controller medication: Results from focus groups with participants from a prior longitudinal study

    PubMed Central

    Wamboldt, Frederick S.; Bender, Bruce G.; Rankin, Allison E.

    2011-01-01

    Background Adherence with inhaled controller medications for asthma is known to be highly variable with many patients taking fewer doses than recommended for consistent control of lung inflammation. Adherence also worsens as children become teenagers, although the exact causes are not well established. Objective To use focus group methodology to examine beliefs, feelings, and behaviors about inhaled asthma controller medication in adolescents and young adults who had previously participated in a longitudinal study of asthma treatment adherence and outcome in order to develop more effective management strategies. Methods Twenty-six subjects participated in 6 focus groups comprised of 3-5 young adults (age range 12-20 years). Verbatim transcripts of these groups were analyzed using the long-table method of content analysis to identify key themes raised by participants. Results A variety of beliefs, feelings and behaviors influence the adolescent’s decision about how to use their asthma medication. Some of the adolescents understood the importance of daily medication and were committed to the treatment plan prescribed by their provider. Poorer adherence was the product of misinformation, incorrect assumptions about their asthma, and current life situations. Conclusions These results, by highlighting potential mechanisms underlying both better and worse adherence inform the development of strategies to improve adherence behavior in adolescents and young adults with asthma. Knowledge of the specific beliefs, feelings and behaviors that underlie adolescents’ use of inhaled asthma controller medication will help providers maximize treatment adherence in this notoriously difficult patient population. PMID:21854323

  13. Asthma Symptoms Among Adolescents Who Attend Public Schools That Are Located Near Confined Swine Feeding Operations

    PubMed Central

    Mirabelli, Maria C.; Wing, Steve; Marshall, Stephen W.; Wilcosky, Timothy C.

    2015-01-01

    OBJECTIVES Little is known about the health effects of living in close proximity to industrial swine operations. We assessed the relationship between estimated exposure to airborne effluent from confined swine feeding operations and asthma symptoms among adolescents who were aged 12 to 14 years. METHODS During the 1999–2000 school year, 58 169 adolescents in North Carolina answered questions about their respiratory symptoms, allergies, medications, socioeconomic status, and household environments. To estimate the extent to which these students may have been exposed during the school day to air pollution from confined swine feeding operations, we used publicly available data about schools (n = 265) and swine operations (n = 2343) to generate estimates of exposure for each public school. Prevalence ratios and 95% confidence intervals for wheezing within the past year were estimated using random-intercepts binary regression models, adjusting for potential confounders, including age, race, socioeconomic status, smoking, school exposures, and household exposures. RESULTS The prevalence of wheezing during the past year was slightly higher at schools that were estimated to be exposed to airborne effluent from confined swine feeding operations. For students who reported allergies, the prevalence of wheezing within the past year was 5% higher at schools that were located within 3 miles of an operation relative to those beyond 3 miles and 24% higher at schools in which livestock odor was noticeable indoors twice per month or more relative to those with no odor. CONCLUSIONS Estimated exposure to airborne pollution from confined swine feeding operations is associated with adolescents’ wheezing symptoms. PMID:16818539

  14. Effect of Orem’s Self-Care Model on Perceived Stress in Adolescents with Asthma Referring the Asthma and Allergy Clinic, Isfahan, 2014

    PubMed Central

    Hemati, Zeinab; Abasi, Samira; Mosaviasl, Fatemehsadat; Shakerian, Behzad; Kiani, Davood

    2016-01-01

    Background: Incidence of asthma in adolescents leads to variations in family status, roles and interaction with peers for them, which could be a source of stress and psychological tensions in them. Therefore, the present study was conducted to investigate the effect of Orem’s self-care model on perceived stress in adolescents with asthma. Methods: In this semi-experimental study conducted from April 2013 to February 2014, 64 asthmatic adolescents referring Shariati Hospital, Isfahan were enrolled by simple random sampling and the patients were assigned to two groups of control and intervention. Then, Orem’s self-care model-based training was implemented throughout eight sessions of two hours each and the Cohen Perceived Stress Scale was administered to both groups prior to and two months after the completion of the training. The data were analyzed by descriptive and analytical statistics consisting of paired t-test, independent t-test, Chi-square and Mann-Whitney using SPSS Version 20. Results: Mean age of the participants was 14.15±3.12 years in the intervention group and 15.21±3.09 years in the control groups. 68.8% and 59.4% of the participants were male in the intervention and control groups, respectively. Independent t-test indicated a significant difference in the mean scores of perceived stress in the intervention (25.46±5.31) and control groups (28.90±5.27) after the training. Also, the result of paired t-test indicated a significant difference in the mean score of perceived stress between before (29.18±5.27) and after (25.46±5.31) training. Conclusion: As the training based on Orem’s model had a positive effect on declining perceived stress in asthmatic adolescents, continuation of using these training interventions could contribute to ultimately achieving positive outcomes in health functions of these patients. PMID:27382591

  15. Asthma morbidity among inner-city adolescents receiving guidelines-based therapy: Role of predictors in the setting of high adherence

    PubMed Central

    Gruchalla, Rebecca S.; Sampson, Hugh A.; Matsui, Elizabeth; David, Gloria; Gergen, Peter J.; Calatroni, Agustin; Brown, Mark; Liu, Andrew H.; Bloomberg, Gordon R.; Chmiel, James F.; Kumar, Rajesh; Lamm, Carin; Smartt, Ernestine; Sorkness, Christine A.; Steinbach, Suzanne F.; Stone, Kelly D.; Szefler, Stanley J.; Busse, William W.

    2009-01-01

    Background With the expanding effort to provide guidelines-based therapy to adolescents with asthma, attention must be directed to evaluating which factors predict future asthma control when guidelines-based management is applied. Objective We evaluated the role of FeNO, markers of allergic sensitization, airway inflammation and measures of asthma severity in determining future risk of asthma symptoms and exacerbations in adolescents and young adults participating in the Asthma Control Evaluation (ACE) study. Methods Five hundred forty-six inner-city residents, ages 12 through 20 years, with persistent asthma were extensively evaluated at study entry for predictors of future symptoms and exacerbations over the subsequent 46-weeks during which guidelines-based, optimal asthma management was offered. Baseline measurements included: FeNO, total IgE, allergen-specific IgE, allergen skin test reactivity, asthma symptoms, lung function, peripheral blood eosinophils, and, for a subset, airway hyperresponsiveness and sputum eosinophils. Results The baseline characteristics we examined accounted for only a small portion of the variance for future maximum symptom days and exacerbations, 11.4% and 12.6%, respectively. Future exacerbations were somewhat predicted by asthma symptoms, albuterol use, previous exacerbations and lung function while maximum symptom days were predicted , also to a modest extent, by symptoms, albuterol use and previous exacerbations but not lung function. Conclusion Our findings demonstrate that the usual predictors of future disease activity have little predictive power when applied to a highly-adherent, persistent asthma population that is receiving guidelines-based care. Thus, new predictors need to be identified that will be able to measure the continued fluctuation of disease that persists in highly adherent, well-treated populations such as the one studied. PMID:19615730

  16. Comprehensive Self-Management Strategies.

    PubMed

    Bourbeau, J; Lavoie, K L; Sedeno, M

    2015-08-01

    In this article, we provide a review of the literature on self-management interventions and we are giving some thought to how, when, and by whom they should be offered to patients. The present literature based on randomized clinical trials has demonstrated benefits (reduced hospital admissions and improved health status) for chronic obstructive pulmonary disease (COPD) patients undergoing self-management interventions, although there are still problems with the heterogeneity among interventions, study populations, follow-up time, and outcome measures that make generalization difficult in real life. Key to the success, self-management intervention has to target behavior change. Proper self-management support is a basic prerequisite, for example, techniques and skills used by health care providers "case manager" to instrument patients with the knowledge, confidence, and skills required to effectively self-manage their disease. To improve health behaviors and engagement in self-management, self-management interventions need to target enhancing intrinsic motivation to change. This will best be done using client-centered communication (motivational communication) that encourages patients to express what intrinsically motivates them (e.g., consistent with their values or life goals) to adopt certain health behavior, with the goal of helping them overcome their ambivalence about change. Finally, if we want to be able to design and implement self-management interventions that are integrated, coherent, and have a strong likelihood of success, we need to take a more careful look and give more attention at the case manager, the patient (patient evaluation), and the quality assurance. PMID:26238647

  17. Incidence of exercise-induced asthma in adolescent athletes under different training and environmental conditions.

    PubMed

    Sidiropoulou, Maria P; Kokaridas, Dimitrios G; Giagazoglou, Paraskevi F; Karadonas, Michalis I; Fotiadou, Eleni G

    2012-06-01

    The aim of this study was to establish if there were differences in the incidence of exercise-induced bronchospasm between athletes in different sports, which take place under different environmental conditions such as open places, closed courses, and swimming pools with similar exercise intensity (football, basketball, water polo) using the free running test. The study included 90 adolescents (3 groups of 30) aged 14-18 years recruited from academies in northern Greece. All the participants were initially subjected to (a) a clinical examination and cardiorespiratory assessment by a physician and (b) free running test of a 6-minute duration and measurement with a microspirometer of the forced expiratory volume in 1 second (FEV₁). Only the participants who had measured a decrease in FEV₁ ≥ 10% were reevaluated with the microspirometer during a training session. The examination of all the participants during the free running test showed that 22 athletes, that is, 9, 8, and 5 of football, basketball, and water polo athletes, respectively, demonstrated an FEV₁ ≥ 10 drop. Reevaluation of the 22 participants during training showed that 5 out 9 (55%) football athletes, 4 out of 8 basketball athletes (50%), and none of the 5 athletes of the water polo team displayed a drop of FEV₁ ≥ 10%. Despite the absence of any significant statistical differences between the 3 groups, the analysis of variances did show a trend of a lower incidence of EIA in the water polo athletes. It was found that a football or basketball game can induce EIA in young athletes but to a lesser degree than the free running test can induce. The water polo can be a safer sport even for participants with a medical history of asthma or allergies. PMID:21912293

  18. Dose-response relationships between mouse allergen exposure and asthma morbidity among urban children and adolescents.

    PubMed

    Torjusen, E N; Diette, G B; Breysse, P N; Curtin-Brosnan, J; Aloe, C; Matsui, E C

    2013-08-01

    Home mouse allergen exposure is associated with asthma morbidity, but little is known about the shape of the dose-response relationship or the relevance of location of exposure within the home. Asthma outcome and allergen exposure data were collected every 3 months for 1 year in 150 urban children with asthma. Participants were stratified by mouse sensitization, and relationships between continuous measures of mouse allergen exposure and outcomes of interest were analyzed. Every tenfold increase in the bed mouse allergen level was associated with an 87% increase in the odds of any asthma-related health care use among mouse-sensitized [Odds Ratio (95% CI): 1.87 (1.21-2.88)], but not non-mouse-sensitized participants. Similar relationships were observed for emergency department visit and unscheduled doctor visit among mouse-sensitized participants. Kitchen floor and bedroom air mouse allergen concentrations were also associated with greater odds of asthma-related healthcare utilization; however, the magnitude of the association was less than that observed for bed mouse allergen concentrations. In this population of urban children with asthma, there is a linear dose-response relationship between mouse allergen concentrations and asthma morbidity among mouse-sensitized asthmatics. Bed and bedroom air mouse allergen exposure compartments may have a greater impact on asthma morbidity than other compartments. PMID:23067271

  19. Beta 2-adrenergic receptor gene association with overweight and asthma in children and adolescents and its relationship with physical fitness

    PubMed Central

    Leite, Neiva; Lazarotto, Leilane; Milano, Gerusa Eisfeld; Titski, Ana Claudia Kapp; Consentino, Cássio Leandro Mühe; de Mattos, Fernanda; de Andrade, Fabiana Antunes; Furtado-Alle, Lupe

    2015-01-01

    Objective: To investigate the association of Arg16Gly and Gln27Glu polymorphisms of β2-adrenergic receptor gene (ADRB2) with the occurrence of asthma and overweight and the gene's influence on anthropometric, clinic, biochemical and physical fitness variables in children and adolescents. Methods: Subjects were evaluated for allelic frequencies of the β2-adrenergic receptor gene, height, weight, body mass index (BMI), BMI Z-score, waist circumference (WC), pubertal stage, resting heart rate (HRres), blood pressure (BP), total cholesterol (TC), glucose, insulin, high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), triglyceride (TG), Homeostasis Metabolic Assessment (HOMA2-IR), Quantitative Insulin Sensitivity Check Index (QUICKI) and maximal oxygen uptake (VO2max). The participants were divided in four groups: overweight asthmatic (n=39), overweight non-asthmatic (n=115), normal weight asthmatic (n=12), and normal weight non-asthmatic (n=40). Results: Regarding the Gln27Glu polymorphism, higher total cholesterol was observed in usual genotype individuals than in genetic variant carriers (p=0.04). No evidence was found that the evaluated polymorphisms are influencing the physical fitness. The Arg16 allele was found more frequently among the normal weight asthmatic group when compared to the normal weight non-asthmatic group (p=0.02), and the Glu27 allele was more frequently found in the overweight asthmatics group when compared to the normal weight non-asthmatic group (p=0.03). Conclusions: The association of Arg16 allele with the occurrence of asthma and of the Glu27 allele with overweight asthmatic adolescents evidenced the contribution of the β2-adrenergic receptor gene to the development of obesity and asthma. PMID:26409918

  20. Asthma is more prevalent in elite swimming adolescents despite better mental and physical health.

    PubMed

    Romberg, K; Tufvesson, E; Bjermer, L

    2012-06-01

    An increased risk of developing asthma has been reported among swimmers exposed to chloramine in pool arenas. The aim of the present study was to compare the prevalence of asthma and respiratory symptoms among elite aspiring swimmers compared with age-matched controls with different degrees of physical activity. We also aimed to relate these findings to mental and psychosocial factors. One hundred and one elite swimmers and 1628 age-matched controls answered a questionnaire containing questions about respiratory symptoms, lifestyle factors, mental and physical well-being. The controls were divided into three different groups according to the degree of physical activity, no physical activity, recreational training and elite training. Swimmers reported significantly more asthma symptoms, with 36.6% having physician-diagnosed asthma, compared with 16.2% among the controls. Use of regular medication was more common (14.9% vs 8.0%) and more swimmers reported an exacerbation of their asthma during the previous 12 months (16.8%) vs (5.8%) for the controls. Despite an increased prevalence of asthma symptoms, the swimmers reported best physical performance and best mental and physical well-being. They also had a healthier lifestyle without smoking and low alcohol consumption. PMID:20807384

  1. Self-Managed Skill Retention.

    ERIC Educational Resources Information Center

    Marx, Robert D.

    1986-01-01

    Presents the Relapse Prevention model, which provides the structure in which managers can analyze potential lapses in their own skill retention. Discusses training goals, self-management, specific strategies, choosing a skill to retain, imagery and prediction, and holistic training. (CT)

  2. Pharmacokinetics and pharmacodynamics of an extrafine fixed pMDI combination of beclometasone dipropionate/formoterol fumarate in adolescent asthma

    PubMed Central

    Kuna, Piotr; Govoni, Mirco; Lucci, Germano; Scuri, Mario; Acerbi, Daniela; Stelmach, Iwona

    2015-01-01

    Aim The aim was to investigate the pharmacokinetics and pharmacodynamics of an extrafine pressurized metered-dose inhaler (pMDI) fixed combination of beclometasone dipropionate (BDP)/formoterol fumarate (FF) in adolescent and adult asthma. Methods This was a three-way crossover study, on 30 asthmatic adolescents receiving BDP/FF pMDI with or without a valved holding chamber (VHC) or a free licenced combination of BDP pMDI and FF pMDI plus a parallel arm of 30 asthmatic adults receiving BDP/FF pMDI. All patients received a single dose of BDP and FF of 400 µg and 24 µg, for each treatment, respectively. Assessments were performed over 8 hours. Results In adolescents, the 90% confidence intervals (CIs) for the systemic exposure (AUC(0,t)) geometric mean ratio of the fixed combination with or without VHC vs. the free combination were within the bioequivalence range 0.80–1.25, both for beclometasone-17-monopropionate (B17MP, the active metabolite of BDP) and formoterol. Pharmacodynamic variables for plasma potassium and glucose, pulse rate and pulmonary function in adolescents were equivalent between treatments, 95% CI within 0.9, 1.09. The upper level of 90% CIs for AUC(0,t) geometric mean ratio adolescents : adults of B17MP and formoterol after treatment with BDP/FF pMDI was lower than 1.25, 90% CI 0.78, 1.04 and 0.86, 1.17, respectively. Conclusions In adolescents the pharmacodynamics and the overall systemic exposure to the active ingredients of an extrafine fixed combination of BDP/FF pMDI with or without a VHC was equivalent to that of a free licenced combination of pMDIs of established safety and efficacy profiles. The systemic exposure in adolescents was not higher than in adults. These results support the indication for use of inhaled corticosteroid/long acting β2-adrenoceptor agonist pMDIs in adolescents at the same dosage as in adults. PMID:25808292

  3. Examining mediators of housing mobility on adolescent asthma: Results from a housing voucher experiment

    PubMed Central

    Schmidt, Nicole M.; Lincoln, Alisa K.; Nguyen, Quynh C.; Acevedo-Garcia, Dolores; Osypuk, Theresa L.

    2014-01-01

    Literature on neighborhood effects on health largely employs non-experimental study designs and does not typically test specific neighborhood mediators that influence health. We address these gaps using the Moving to Opportunity (MTO) housing voucher experiment. Research has documented both beneficial and adverse effects on health in MTO, but mediating mechanisms have not been tested explicitly. We tested mediation of MTO effects on youth asthma (n = 2829). MTO randomized families living in public housing to an experimental group receiving a voucher to subsidize rental housing, or a control group receiving no voucher, and measured outcomes 4–7 years following randomization. MTO had a harmful main effect vs. controls for self-reported asthma diagnosis (b = 0.24, p = 0.06), past-year asthma attack (b = 0.44, p = 0.02), and past-year wheezing (b = 0.17, p = 0.17). Using Inverse Odds Weighting mediation we tested mental health, smoking, and four housing dimensions as potential mediators of the MTO–asthma relationship. We found no significant mediation overall, but mediation may be gender-specific. Gender-stratified models displayed countervailing mediation effects among girls for asthma diagnosis by smoking (p = 0.05) and adult-reported housing quality (p = 0.06), which reduced total effects by 35% and 42% respectively. MTO treatment worsened boys’ mental health and mental health reduced treatment effects on asthma diagnosis by 27%. Future research should explore other potential mediators and gender-specific mediators of MTO effects on asthma. Improving measurement of housing conditions and other potential mediators may help elucidate the “black box” of neighborhood effects. PMID:24607675

  4. Examining mediators of housing mobility on adolescent asthma: results from a housing voucher experiment.

    PubMed

    Schmidt, Nicole M; Lincoln, Alisa K; Nguyen, Quynh C; Acevedo-Garcia, Dolores; Osypuk, Theresa L

    2014-04-01

    Literature on neighborhood effects on health largely employs non-experimental study designs and does not typically test specific neighborhood mediators that influence health. We address these gaps using the Moving to Opportunity (MTO) housing voucher experiment. Research has documented both beneficial and adverse effects on health in MTO, but mediating mechanisms have not been tested explicitly. We tested mediation of MTO effects on youth asthma (n = 2829). MTO randomized families living in public housing to an experimental group receiving a voucher to subsidize rental housing, or a control group receiving no voucher, and measured outcomes 4-7 years following randomization. MTO had a harmful main effect vs. controls for self-reported asthma diagnosis (b = 0.24, p = 0.06), past-year asthma attack (b = 0.44, p = 0.02), and past-year wheezing (b = 0.17, p = 0.17). Using Inverse Odds Weighting mediation we tested mental health, smoking, and four housing dimensions as potential mediators of the MTO-asthma relationship. We found no significant mediation overall, but mediation may be gender-specific. Gender-stratified models displayed countervailing mediation effects among girls for asthma diagnosis by smoking (p = 0.05) and adult-reported housing quality (p = 0.06), which reduced total effects by 35% and 42% respectively. MTO treatment worsened boys' mental health and mental health reduced treatment effects on asthma diagnosis by 27%. Future research should explore other potential mediators and gender-specific mediators of MTO effects on asthma. Improving measurement of housing conditions and other potential mediators may help elucidate the "black box" of neighborhood effects. PMID:24607675

  5. Safety of long-acting beta agonists and inhaled corticosteroids in children and adolescents with asthma

    PubMed Central

    Xia, Ying; Kelton, Christina M. L.; Xue, Liang; Bian, Boyang; Wigle, Patricia R.

    2013-01-01

    The introduction of long-acting beta agonists (LABAs) was considered a major advance in bronchodilator therapy for adult, as well as pediatric, patients with asthma. However, the use of LABAs has raised safety concerns, especially the potential for severe asthma exacerbations (SAEs) resulting in hospitalizations or even death. Meanwhile, the use of inhaled corticosteroids (ICSs), a cornerstone in the treatment of mild-to-severe persistent asthma, has been associated with growth suppression in children. The purpose of this review was to identify and discuss the major published safety studies surrounding LABA, ICS, and combined LABA/ICS usage in children. By way of a critical search for influential published clinical trials, meta-analyses, and observational studies, six studies relevant to the safety of LABA monotherapy, seven studies relevant to ICS monotherapy, and four studies on the subject of LABA/ICS combination usage were identified and reviewed. Based on the reviewed literature, the controversy surrounding these anti-asthma medications was clearly exposed. On the one hand, there is some evidence that LABA monotherapy may be associated with SAEs and asthma-related death, while ICS monotherapy may be associated with a higher risk of growth suppression. On the other hand, the concurrent use of a LABA with an ICS has been associated with positive outcomes including symptom reduction and reduced rate and severity of exacerbations. Further clinical research is warranted and has been called for by the US Food and Drug Administration. PMID:25114786

  6. Self-management and creativity

    NASA Astrophysics Data System (ADS)

    Medvedev, B. A.; Skaptsov, A. A.; Polikarpov, M. A.

    2008-06-01

    How to improve physicist's creativity? How one can make himself an instrument for creativity? What is the role of the humanities in initiation of intuitive moments in thinking? The problems are discussed in terms of such modern conception as Self-management, in context of the dialogue between nature and human being by Prigogine, "Farther reaches of human nature" by Maslow, and mathematical approach for modeling of mental structure elements.

  7. The Impact of Peer Support and mp3 Messaging on Adherence to Inhaled Corticosteroids in Minority Adolescents with Asthma: A Randomized Controlled Trial

    PubMed Central

    Mosnaim, Giselle; Li, Hong; Martin, Molly; Richardson, DeJuran; Belice, Paula Jo; Avery, Elizabeth; Ryan, Norman; Bender, Bruce; Powell, Lynda

    2013-01-01

    Background Poor adherence to inhaled corticosteroids (ICS) is a critical risk factor contributing to asthma morbidity among low-income minority adolescents. Objective This trial tested whether peer support group meetings and peer asthma messages delivered via mp3 players improved adherence to ICS. Methods Low-income African American and/or Hispanic adolescents, ages 11–16, with persistent asthma, and poor (≤ 48%) adherence to prescription ICS during the 3-week run-in were randomized to intervention or attention control groups (ATG) for the 10-week treatment. During treatment, the intervention arm participated in weekly coping peer group support sessions and received mp3 peer-recorded asthma messages promoting adherence. The ATG participated in weekly meetings with a research assistant and received an equivalent number of mp3 doctor-recorded asthma messages. Adherence was measured using self-report and the DoserCT, (Meditrac, Inc.), an electronic dose counter. The primary outcome was the difference in adherence at 10 weeks between the two arms. Results Thirty-four subjects were randomized to each arm. At 10 weeks, no statistical difference in objectively measured adherence could be detected between the two arms adjusting for baseline adherence (P = 0.929). Adherence declined in both groups over the course of the active treatment period. Participants’ in both study arms self-reported adherence was significantly higher than their objectively measured adherence at week 10 (P < 0.0001). Conclusion Improving medication adherence in longitudinal studies is challenging. Peer support and mp3-delivered peer asthma messages may not be of sufficient dose to improve outcomes. PMID:24565620

  8. Development and preliminary evaluation of the participation in life activities scale for children and adolescents with asthma: an instrument development study

    PubMed Central

    Kintner, Eileen K

    2008-01-01

    Background Being able to do things other kids do is the desire of school-age children and adolescents with asthma. In a phenomenology study, adolescents identified participation in life activities as the outcome variable and primary motivator for behavioral changes in coming to accept asthma as a chronic condition. In preparation for testing an acceptance model for older school-age children and early adolescents diagnosed with asthma, the Participation in Life Activities Scale was developed. The purposes of this paper are to describe development, and report on face and content validity of the scale designed to measure one aspect of quality of life defined as level of unrestricted involvement in chosen pursuits. Methods Items generated for the instrument evolved from statements and themes extracted from qualitative interviews. Face and content validity were evaluated by eight lay reviewers and 10 expert reviewers. Rate of accurate completion was computed using a convenience, cross-section sample consisting of 313 children and adolescents with asthma, ages 9–15 years, drawn from three studies. Preliminary cross-group comparisons of scores were assessed using t-tests and analysis of variance. Results Face and content validity were determined to be highly acceptable and relevant, respectively. Completion rate across all three studies was 97%. Although cross-group comparisons revealed no significant differences in overall participation scores based on age, race or residence groupings (p > .05), significant difference were indicated between males and females (p = .02), as well as the highest and lowest socioeconomic groups (p = .002). Conclusion Assessing content validity was the first step in evaluating properties of this newly developed instrument. Once face and content validity were established, psychometric evaluation related to internal consistency reliability and construct validity using factor analysis procedures was begun. Results will be reported elsewhere

  9. Influence of two different geo-climatic zones on the prevalence and time trends of asthma symptoms among Spanish adolescents and schoolchildren

    NASA Astrophysics Data System (ADS)

    García-Marcos, Luis; Batllés-Garrido, José; Blanco-Quirós, Alfredo; García-Hernández, Gloria; Guillén-Grima, Francisco; González-Díaz, Carlos; García-Merino, Águeda; Arnedo-Pena, Alberto; Busquets-Monge, Rosa M.; Morales-Suárez-Varela, María; López-Silvarrey-Varela, Ángel; García-Andoin, Nekane

    2009-01-01

    Few studies have focused on the long-term influence of the climate on the prevalence of asthma. The aim of this study is to establish the influence of geo-climatic conditions on the prevalence of asthma symptoms both in adolescents and schoolchildren, and to discover if this influence is associated with their time trends. Eight centres in Spain performed both ISAAC phases I (1994) and III (2002) in children 13-14 years old. Six of them also surveyed children 6-7 years old. For each age group and phase, about 3,000 children were surveyed per centre. This study examines the prevalence of current wheeze and severe current wheeze in two different geo-climatic zones, coast and plateau, considering their relative humidity and temperature range. In both age groups, the mean asthma prevalence on the coast, for phase I and III, was significantly higher than on the plateau. Living on the plateau was an independent protective factor for current wheeze and severe current wheeze for the two age groups. Within the coastal centres, the increase of the annual relative humidity was a statistical significant risk factor for current wheeze, the same trend existing for current severe wheeze. These effects were independent of the sex and of the phase of the study. The prevalence of asthma and severe asthma symptoms is more frequent on the coast of Spain as compared to the inner plateau. This finding was repeated both in 1994 and in 2002.

  10. Self-management for people with inflammatory bowel disease.

    PubMed

    Saibil, F; Lai, E; Hayward, A; Yip, J; Gilbert, C

    2008-03-01

    In North America and the United Kingdom, we are in the age of self-management. Many patients with chronic diseases are ready to participate in the therapeutic decision-making process, and join their physicians in a co-management model. It is particularly useful to consider this concept at a time when physician shortages and waiting times are on the front page every day, with no immediate prospect of relief. Conditions such as diabetes, asthma, chronic obstructive pulmonary disease, recurrent urinary tract infections and others lend themselves to this paradigm of medical care for the informed patient. The present paper reviews some of the literature on self-management for the patient with inflammatory bowel disease (IBD), and provides a framework for the use of self-management in the IBD population, with emphasis on the concept of a patient passport, and the use of e-mail, supported by an e-mail contract, as proposed by the Canadian Medical Protective Association. Examples of specific management strategies are provided for several different IBD scenarios. Eliminating the need for some office visits has clear environmental and economical benefits. Potential negative consequences of this form of patient care are also discussed. PMID:18354757

  11. Increasing Availability to and Ascertaining Value of Asthma Action Plans in Schools through Use of Technology and Community Collaboration

    ERIC Educational Resources Information Center

    Hanson, Tabitha K.; Aleman, Martha; Hart, Lacey; Yawn, Barbara

    2013-01-01

    Background: Approximately 9% of school-aged children in the United States have asthma. Since 1997, the Asthma Action Plan (AAP) has been recommended as an asthma self-management tool for individuals with asthma. In the school setting, the use of the AAP has been primarily dependent on communication between the family and the school through a paper…

  12. Development and Validation of PRISM: A Survey Tool to Identify Diabetes Self-Management Barriers

    PubMed Central

    Cox, Elizabeth D.; Fritz, Katie A.; Hansen, Kristofer W.; Brown, Roger L.; Rajamanickam, Victoria; Wiles, Kaelyn E.; Fate, Bryan H.; Young, Henry N.; Moreno, Megan A.

    2014-01-01

    Aims Although most children with type 1 diabetes don’t achieve optimal glycemic control, no systematic method exists to identify and address self-management barriers. This study develops and validates PRISM (Problem Recognition in Illness Self-Management), a survey-based tool for efficiently identifying self-management barriers experienced by children/adolescents with diabetes and their parents. Methods Adolescents 13 years and older and parents of children 8 years and older visiting for routine diabetes management (n=425) were surveyed about self-management barriers. HbA1c was abstracted from the electronic health record. To develop PRISM, exploratory and confirmatory factor analyses were used. To assess validity, the association of PRISM scores with HbA1c was examined using linear regression. Results Factor analyses of adolescent and parent data yielded well-fitting models of self-management barriers, reflecting the following domains: 1) Understanding and Organizing Care, 2) Regimen Pain and Bother, 3) Denial of Disease and Consequences, and 4) Healthcare Team, 5) Family, or 6) Peer Interactions. All models exhibited good fit, with X2 ratios<2.21, root mean square errors of approximation<0.09, Confirmatory Fit Indices and Tucker-Lewis Indices both >0.92, and weighted root mean square residuals<1.71. Greater PRISM barrier scores were significantly associated with higher HbA1cs. Conclusions Our findings suggest at least six different domains exist within self-management barriers, nearly all of which are significantly related to HbA1c. PRISM could be used in clinical practice to identify each child and family’s unique self-management barriers, allowing existing self-management resources to be tailored to the family’s barriers, ultimately improving effectiveness of such services. PMID:24552680

  13. Occupational asthma

    MedlinePlus

    Asthma - occupational exposure; Irritant-induced reactive airways disease ... the workplace can trigger asthma symptoms, leading to occupational asthma. The most common triggers are wood dust, grain ...

  14. Self-management in patients with inflammatory bowel disease: strategies, outcomes, and integration into clinical care

    PubMed Central

    Plevinsky, Jill M; Greenley, Rachel N; Fishman, Laurie N

    2016-01-01

    Self-management, including medication adherence, is associated with improved health and outcomes for patients with inflammatory bowel disease. The concept of self-management is complex, but can be divided into those aspects that involve the individual patient, those that involve the provider–patient relationship, and those that encompass the social environment. At the individual level, enhancing problem-solving skills and self-efficacy have both been shown to improve self-management tasks, particularly adherence to treatment. However, it is critical to consider these domains from a lifespan perspective because these processes by which self-management can be improved are distinct for children, adolescents, young adults, and adults. A particular emphasis is placed on strategies to improve self-management of older adolescents and young adults as they transition from pediatric to adult providers. The review concludes with recommendations for providers, including rationale and techniques for assessing and promoting patient self-efficacy, encouraging the development of problem-solving skills, improving the patient–provider relationship, and enhancing social support. Providers are encouraged to utilize elements of problem-solving skills training, engage in collaborative relationships with their patients, and offer their patients recommendations for how to increase the quality of their social support networks as ways of increasing overall self-management. PMID:27601930

  15. Self-management in patients with inflammatory bowel disease: strategies, outcomes, and integration into clinical care.

    PubMed

    Plevinsky, Jill M; Greenley, Rachel N; Fishman, Laurie N

    2016-01-01

    Self-management, including medication adherence, is associated with improved health and outcomes for patients with inflammatory bowel disease. The concept of self-management is complex, but can be divided into those aspects that involve the individual patient, those that involve the provider-patient relationship, and those that encompass the social environment. At the individual level, enhancing problem-solving skills and self-efficacy have both been shown to improve self-management tasks, particularly adherence to treatment. However, it is critical to consider these domains from a lifespan perspective because these processes by which self-management can be improved are distinct for children, adolescents, young adults, and adults. A particular emphasis is placed on strategies to improve self-management of older adolescents and young adults as they transition from pediatric to adult providers. The review concludes with recommendations for providers, including rationale and techniques for assessing and promoting patient self-efficacy, encouraging the development of problem-solving skills, improving the patient-provider relationship, and enhancing social support. Providers are encouraged to utilize elements of problem-solving skills training, engage in collaborative relationships with their patients, and offer their patients recommendations for how to increase the quality of their social support networks as ways of increasing overall self-management. PMID:27601930

  16. Teaching Self-Management: The Design and Implementation of Self-Management Tutorials

    ERIC Educational Resources Information Center

    Gerhardt, Megan

    2007-01-01

    Learning the skills of self-management is an essential task for students in the 21st century. A total of 223 undergraduate students participated in 4 self-management tutorials that presented the components of understanding and mastering self-management skills including (a) self-assessment, (b) goal setting, (c) time management, and (d)…

  17. Reconceptualizing the Self-Managing School

    ERIC Educational Resources Information Center

    Caldwell, Brian J.

    2008-01-01

    Contrary to the claims of its critics, the introduction of self-managing schools under the ERA and its counterpart in other countries did not lead to the privatization of public education. Self-managing schools have been one manifestation of a general trend to decentralization in public education in many countries since the late 1960s. The…

  18. Leading the Self-Managing School.

    ERIC Educational Resources Information Center

    Caldwell, Brian J.; Spinks, Jim M.

    This book focuses on the requirements for leadership in self-managing schools. It contains 9 chapters divided among 3 main parts. The first part is entitled "A New Context and a Refined Model for Self-Management." Chapter 1 uses the concept of megatrend to describe developments in Australia, Britain, Canada, New Zealand, and the United States.…

  19. Developing Self-Managed Action Learning (SMAL)

    ERIC Educational Resources Information Center

    Bourner, Tom

    2011-01-01

    This article provides an account of self-managed action learning (SMAL), where it came from and how it has been implemented in practice. Self-managed action learning offers a way of realising action learning without the continuing presence of a set advisor in set meetings to facilitate the process. It enables participants to manage and facilitate…

  20. Self-Managed Studying in College Courses.

    ERIC Educational Resources Information Center

    Edwards, K. Anthony

    In an introductory psychology course, students were taught some principles of "adjustment" using self-management techniques and were required to conduct a self-management project. The four student projects reported herein were specifically designed to improve study skills through use of Premack's principle and stimulus control. Course materials…

  1. The Influence of Health Education on Family Management of Childhood Asthma.

    ERIC Educational Resources Information Center

    Brazil, Kevin; McLean, Leslie; Abbey, David; Musselman, Carol

    1997-01-01

    Differences in asthma management among families with a child who has moderate to severe asthma were examined when they participated in an in-patient versus a day-camp program. Two broad categories of outcome were examined: illness and self-management skills. Findings and observations regarding children's feelings about asthma are discussed.…

  2. Reliability and construct validity of the Participation in Life Activities Scale for children and adolescents with asthma: an instrument evaluation study

    PubMed Central

    Kintner, Eileen K; Sikorskii, Alla

    2008-01-01

    Background The purpose of this study was to evaluate the reliability and construct validity of the Participation in Life Activities Scale, an instrument designed to measure older school-age child and early adolescent level of involvement in chosen pursuits. Methods A cross-sectional design was used. The convenience sample consisted of 313 school-age children and early adolescents with asthma, ages 9–15 years. The self-report summative scale of interest is a 3-indicator survey. Higher scores are reflective of higher levels of participation. Internal consistency reliability and construct validity for the entire sample and sub groups of the sample were evaluated. Results The instrument was deemed sound for the entire sample as well as sub groups based on sex, race, age, socioeconomic status, and severity of illness. Cronbach's alpha coefficient for internal consistency reliability for the entire sample was .74. Exploratory factor analysis indicated a single component solution (loadings .79–.85) accounting for 66% of the explained variance. Construct validity was established by testing the posed relationship between participation in life activities scores and severity of illness. Confirmatory factor analysis revealed a good fit between the data and specified model, χ2(10, n = 302) = 8.074, p = .62. Conclusion This instrument could be used (a) in clinical settings to diagnose restricted participation in desired activities, guide decision-making about treatment plans to increase participation, and motivate behavioral change in the management of asthma; and (b) in research settings to explore factors influencing and consequences of restricted and unrestricted participation, and as an outcome measure to evaluate the effectiveness of programs designed to foster child and early adolescent management of asthma. PMID:18533017

  3. Development and Validation of the Composite Asthma Severity Index – An Outcome Measure for use in Children and Adolescents

    PubMed Central

    Wildfire, Jeremy J.; Gergen, Peter J.; Sorkness, Christine A.; Mitchell, Herman E.; Calatroni, Agustin; Kattan, Meyer; Szefler, Stanley J.; Teach, Stephen J.; Bloomberg, Gordon R.; Wood, Robert A.; Liu, Andrew H.; Pongracic, Jacqueline A.; Chmiel, James F.; Conroy, Kathleen; Rivera-Sanchez, Yadira; Morgan, Wayne J.; Busse, William W.

    2012-01-01

    Background Asthma severity is reflected in many aspects of the disease, including impairment and future risks, particularly for exacerbations. According to the EPR-3, however, to assess more comprehensively the severity of asthma the level of current treatment needed to maintain a level of control should be included. Objective Development and validation of a new instrument, the Composite Asthma Severity Index (CASI), which can quantify disease severity by taking into account impairment, risk and the amount of medication needed to maintain control. At present, there is no instrument available to measure and assess the multidimensional nature of asthma. Methods Twenty-six established asthma investigators, who are part of the NIH-supported Inner City Asthma Consortium (ICAC), participated in a modified Delphi consensus process to identify and weight the dimensions of asthma. Factor analysis was performed to identify independent domains of asthma using the Asthma Control Evaluation (ACE) trial. CASI was validated using the Inner City Anti-IgE Therapy for Asthma (ICATA) trial. Results CASI scores include five domains: day symptoms and albuterol use, night symptoms and albuterol use, controller treatment, lung function measures, and exacerbations. At ACE enrollment, CASI ranged from 0 to 17 with a mean of 6.2. CASI was stable, with minimal change in variance after 1 year of treatment. In external validation, CASI detected a 32% larger improvement than symptoms alone. Conclusion CASI retained its discriminatory ability even with low levels of symptoms reported after months of guidelines-directed care. Thus, CASI has the ability to determine the level of asthma severity, and provide a composite clinical characterization of asthma. PMID:22244599

  4. Elderly self-management: a qualitative study

    PubMed Central

    Ravanipour, Maryam; Salehi, Shayesteh; Taleghani, Fariba; Abedi, Heidar Ali

    2010-01-01

    BACKGROUND: The population of elderly in Iran and in the world is increasing. It is predicted that the population of elderly reaches to 10 millions in Iran by the year 2019. Elders more than other age groups are at risk of chronic diseases and health problems; and elderly affects their self-management and makes them feel disabled. Since the knowledge of self-management for Iranian elderly is not well developed, this paper aimed to determine the concept of self-management for Iranian elders. METHODS: This was a qualitative study with grounded theory approach on Iranian elderly self-management. Data were collected through deep interviews with 26 participants in a period of one year and were analyzed using a Strauss Corbin analysis method. RESULTS: Self-management in the context of power means using different managing methods in dealing with daily life needs, especially in interactions with others in a way that accelerates affairs with efficiency and satisfaction. The main categories emerged from this qualitative study included: managing plans, managing life goals and policies, persuading the desired goals, managing self-care, directing others, coordinating and consulting with others. CONCLUSIONS: The findings of this study provided a deep understanding of elderly perceptions of self-management in their lives. These findings can be a baseline for future researches on developing effective health interventions such as developing a nursing model for increasing the elderly self-management abilities in Iran. Such a model can provide a strong basis for nursing care. PMID:21589781

  5. The Saudi Initiative for Asthma

    PubMed Central

    Al-Moamary, Mohamed S.; Al-Hajjaj, Mohamed S.; Idrees, Majdy M.; Zeitouni, Mohamed O.; Alanezi, Mohammed O.; Al-Jahdal, Hamdan H.; Al Dabbagh, Maha

    2009-01-01

    The Saudi Initiative for Asthma (SINA) provides up-to-date guidelines for healthcare workers managing patients with asthma. SINA was developed by a panel of Saudi experts with respectable academic backgrounds and long-standing experience in the field. SINA is founded on the latest available evidence, local literature, and knowledge of the current setting in Saudi Arabia. Emphasis is placed on understanding the epidemiology, pathophysiology, medications, and clinical presentation. SINA elaborates on the development of patient-doctor partnership, self-management, and control of precipitating factors. Approaches to asthma treatment in SINA are based on disease control by the utilization of Asthma Control Test for the initiation and adjustment of asthma treatment. This guideline is established for the treatment of asthma in both children and adults, with special attention to children 5 years and younger. It is expected that the implementation of these guidelines for treating asthma will lead to better asthma control and decrease patient utilization of the health care system. PMID:19881170

  6. A Brief Report on the Effects of a Self-Management Treatment Package on Stereotypic Behavior

    ERIC Educational Resources Information Center

    Moore, Timothy R.

    2009-01-01

    We evaluated the effects of a self-management treatment package (SMTP) on the stereotypic behavior of an adolescent with Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS). Latency to stereotypy was systematically increased in the training setting (academic) and the effectiveness of the SMTP was evaluated within a multiple-probe…

  7. Asthma Management Disparities: A Photovoice Investigation with African American Youth

    ERIC Educational Resources Information Center

    Evans-Agnew, Robin

    2016-01-01

    Disparities in asthma management are a burden on African American youth. The objective of this study is to describe and compare the discourses of asthma management disparities (AMDs) in African American adolescents in Seattle to existing youth-related asthma policies in Washington State. Adolescents participated in a three-session photovoice…

  8. Prevalence, Patterns and Correlates of Cigarette Smoking in Male Adolescents in Northern Jordan, and the Influence of Waterpipe Use and Asthma Diagnosis: A Descriptive Cross-Sectional Study

    PubMed Central

    Al-Sheyab, Nihaya; Alomari, Mahmoud A.; Shah, Smita; Gallagher, Patrick; Gallagher, Robyn

    2014-01-01

    Our study investigates the prevalence, patterns and predictors of tobacco smoking among early adolescent males in Northern Jordan and whether asthma diagnosis affects smoking patterns. A descriptive cross sectional design was used. Males in grades 7 and 8 from four randomly selected high schools in the city of Irbid were enrolled. Data on waterpipe (WP) use and cigarette smoking patterns were obtained (n = 815) using a survey in Arabic language. The overall prevalence of ever having smoked a cigarette was 35.6%, with 86.2% of this group smoking currently. Almost half of the sample reported WP use. The most common age in which adolescents started to experiment with cigarettes was 11–12 years old (49.1%), although 10 years was also common (25.3%). Significant predictors of male cigarette smoking were WP use (OR = 4.15, 95% CI = 2.99–5.76), asthma diagnosis (OR = 2.35, 95% CI = 1.46–3.78), grade 8 (OR = 1.52, 95% CI = 1.10–2.11), and having a sibling who smokes (OR = 2.23, 95% CI = 1.53–3.24). However, this cross-sectional study cannot establish causality, thus longitudinal studies are needed. Public health programs and school-based anti-tobacco smoking interventions that target children in early years at high schools are warranted to prevent the uptake of tobacco use among this vulnerable age group. High school students with asthma should be specifically targeted. PMID:25257355

  9. Asthma and Rhinitis Are Associated with Less Objectively-Measured Moderate and Vigorous Physical Activity, but Similar Sport Participation, in Adolescent German Boys: GINIplus and LISAplus Cohorts

    PubMed Central

    Berdel, Dietrich; Bauer, Carl-Peter; Koletzko, Sibylle; Nowak, Dennis; Heinrich, Joachim; Schulz, Holger

    2016-01-01

    Introduction Physical activity (PA) protects against most noncommunicable diseases and has been associated with decreased risk of allergic phenotype, which is increasing worldwide. However, the association is not always present; furthermore it is not clear whether it is strongest for asthma, rhinitis, symptoms of these, or atopic sensitization; which sex is most affected; or whether it can be explained by either avoidance of sport or exacerbation of symptoms by exercise. Interventions are thus difficult to target. Methods PA was measured by one-week accelerometry in 1137 Germans (mean age 15.6 years, 47% boys) from the GINIplus and LISAplus birth cohorts, and modeled as a correlate of allergic symptoms, sensitization, or reported doctor-diagnosed asthma or rhinitis. Results 8.3% of children had asthma, of the remainder 7.9% had rhinitis, and of the remainder 32% were sensitized to aero-allergens (atopic). 52% were lung-healthy controls. Lung-healthy boys and girls averaged 46.4 min and 37.8 min moderate-to-vigorous PA per day, of which 14.6 and 11.4 min was vigorous. PA in allergic girls was not altered, but boys with asthma got 13% less moderate and 29% less vigorous PA, and those with rhinitis with 13% less moderate PA, than lung-healthy boys. Both sexes participated comparably in sport (70 to 84%). Adolescents with wheezing (up to 68%, in asthma) and/or nose/eye symptoms (up to 88%, in rhinitis) were no less active. Conclusions We found that asthma and rhinitis, but not atopy, were independently associated with low PA in boys, but not in girls. These results indicate that allergic boys remain a high-risk group for physical inactivity even if they participate comparably in sport. Research into the link between PA and allergy should consider population-specific and sex-specific effects, and clinicians, parents, and designers of PA interventions should specifically address PA in allergic boys to ensure full participation. PMID:27560942

  10. Asthma Quiz

    MedlinePlus

    ... Asthma is a chronic disease that requires ongoing management. Personalized plans for treatment may include medications, an asthma action plan, and environmental control measures to avoid your child's asthma triggers. ...

  11. Medication adherence in the asthmatic child and adolescent.

    PubMed

    Desai, Mauli; Oppenheimer, John J

    2011-12-01

    Asthma is a common inflammatory condition affecting more than 7 million children in the United States alone, and tens of millions more globally. Despite effective preventive medications, medication nonadherence in children and adolescents is alarmingly high. Nonadherence can result in poor asthma control, which leads to decreased quality of life, lost productivity, increased health care utilization, and even the risk of death. Nonadherence in children and adolescents deserves special attention because they face unique barriers to adherence that change with age. Young children depend on adults for the delivery of asthma care, and their care is strongly influenced by parental motivation and attitudes and the home environment. As these children enter adolescence, they typically assume responsibility for their asthma care at the same time that they are claiming their independence and possibly experimenting with high-risk behaviors. Morbidity and mortality, as well as nonadherence, appear to be greatest among adolescents and minority children. Although no perfect tool for measuring adherence exists, objective methods, such as electronic monitoring, can provide valuable information to health care providers. Beyond asthma self-management and education, no specific resource-heavy adherence interventions have proven consistently helpful. However, large-scale, well-designed studies on this subject are lacking. In light of the fact that nonadherence is a potentially modifiable factor that impacts on morbidity and mortality, it is worth pursuing further research to determine better interventions. It is likely, however, that no one answer exists, and interventions will need to be tailored to specific at-risk populations. PMID:21968618

  12. Asthma - control drugs

    MedlinePlus

    Asthma - inhaled corticosteroids; Asthma - long-acting beta-agonists; Asthma - leukotriene modifiers; Asthma - cromolyn; Bronchial asthma-control drugs; Wheezing - control drugs; Reactive airway disease - control drugs

  13. Respiratory Conditions Update: Asthma.

    PubMed

    Zeller, Timothy A

    2016-09-01

    Asthma is a chronic respiratory disease characterized by chronic airway inflammation and variable expiratory airflow limitation. Related clinical features include wheezing, dyspnea, chest tightness, and cough that worsens at night or in the early morning, and that varies over time and in intensity. A finding of variable expiratory airflow limitation on spirometry confirms the diagnosis. A forced expiratory volume in 1 second to forced vital capacity ratio less than the level predicted for the patient's age is suggestive of airflow limitation. Variability also must be confirmed. Updated guidelines recommend control-based management administered in a stepwise manner, with goals of achieving symptom control and minimizing the risks of exacerbations, future fixed airway limitation, and adverse effects of therapy. There is good evidence for the effectiveness of asthma education and self-management plans. Short-acting bronchodilators should be used as needed for symptom relief, with the addition of an inhaled corticosteroid early as maintenance therapy if symptoms are not well controlled. If asthma remains uncontrolled despite therapy, patients should be referred for more specialized treatment. Biomarkers, biologic drugs, and endoscopic treatments are being studied in the management of severe asthma, and ongoing research may determine which patients might benefit most from these emerging therapies. PMID:27576231

  14. Occupational asthma.

    PubMed

    Kenyon, Nicholas J; Morrissey, Brian M; Schivo, Michael; Albertson, Timothy E

    2012-08-01

    Occupational asthma is the most common occupational lung disease. Work-aggravated asthma and occupational asthma are two forms of asthma causally related to the workplace, while reactive airways dysfunction syndrome is a separate entity and a subtype of occupational asthma. The diagnosis of occupational asthma is most often made on clinical grounds. The gold standard test, specific inhalation challenge, is rarely used. Low molecular weight isocyanates are the most common compounds that cause occupational asthma. Workers with occupational asthma secondary to low molecular weight agents may not have elevated specific IgE levels. The mechanisms of occupational asthma associated with these compounds are partially described. Not all patients with occupational asthma will improve after removal from the workplace. PMID:21573916

  15. Attitudes antecedent to transition to self-management of a chronic genetic disorder.

    PubMed

    Giarelli, E; Bernhardt, B A; Pyeritz, R E

    2008-10-01

    Marfan syndrome (MFS) is the exemplar of chronic genetic disorders that require multiorgan system management by health care providers (HCPs) and lifelong self-management by affected individuals. This article describes the ways to facilitate transition to self-management (TSM) by the adolescent with MFS. This thematic content analysis uses data collected for a larger grounded theory investigation of TSM of a chronic genetic disorder in adolescents and focuses on the system issues related to transition. A total sample of 107 included three groups of participants: parents (n = 39), adolescents (n = 37, ages 14-21 years) and young adults (n = 16, ages 22-34 years) with MFS, and HCPs (n = 15), including physicians, genetic counselors, and nurses. Data were derived from 180 transcripts of audiotaped interviews and a sociodemographic survey. Frames of mind that are antecedent to transition were belief in the diagnosis, wanting to understand and appreciate the cause and effect of MFS, and willing to share responsibility in problem solving. These frames of mind occurred primarily within the context of the family relationship. Parents taught children self-surveillance as 'listening to one's body'. The parent's fears and need to stay involved in the child's health care slowed the child's independent work on self-management responsibilities. A systematic, institutionalized transition program for adolescents might involve parents and the child soon after diagnosis and incrementally build acknowledgment, understanding, and rapport. PMID:18616734

  16. Community Perceptions of Self-Managing Schools.

    ERIC Educational Resources Information Center

    Townsend, Tony

    In Victoria, Australia, every government school in the state is a self-managing school. The Victorian system of school-based management is called "Schools of the Future." This paper presents findings of a study that sought opinions of the school community toward various aspects of the Schools of the Future program and its outcomes. A questionnaire…

  17. Beyond Quality Circles: Self-Managing Teams.

    ERIC Educational Resources Information Center

    Sims, Henry P., Jr.; Dean, James W., Jr.

    1985-01-01

    This article reviews the quality circle concept, shows why its characteristics appeal to American executives, and examines some of its limitations. It looks at self-managing teams and discusses the reasons that adoptions have been relatively few. It then shows what organizational conditions are necessary for quality circles to evolve into teams.…

  18. Self Directed Learning and Self Management. Symposium.

    ERIC Educational Resources Information Center

    2002

    This document contains three papers from a symposium on self-directed learning and self-management. "Validating a More-Dimensional Conception of Self-Directed Learning" (Gerald A. Straka, Cornelia Schaefer) discusses the development and validation of a conception of self-directed learning as a dynamic interplay between behavior, information,…

  19. Community Readiness for Self-Managed School

    ERIC Educational Resources Information Center

    Rajbhandari, Mani Man Singh

    2007-01-01

    The concept of Self-managing schools involving local community members, teachers and parents with the formation of School Management Committee is gaining ground in Nepal after the world conference on education for all (WCEFA) held in Jomtien, Thailand in the year 1990. Transferring the management of public schools in the hand of willing community…

  20. Information requirements of self-managing teams

    SciTech Connect

    Van Aken, E.M.

    1992-12-31

    In response to the significant challenges organizations face today, many managers have put in place continuous improvement efforts to help the organization on enhance its competitive position. A key element of continuous improvement efforts is employee involvement, and one of the most complex, mature, and effective forms of employee involvement is self-managing teams. A self-managing team is a group of employees, usually eight to fifteen, which is responsible for planning, implementing, controlling, and improving work processes. There are many characteristics of self-managing teams which are discussed frequently in the literature and are common topics of seminars and workshops on SMTs, including the role of the first-line supervisor, the structure of teams, the training necessary, and the pay system for SMTs. However, one area which has not been as widely researched is the role of information - what types of information do self-managing teams need? This paper addresses this question. Results from a multiple case study research project focusing on the information requirements of SMTs are presented. Specifically, seven types of information SMTs need are identified, as well as general characteristics of the information system. By information system, I mean very broadly, the system (both formal and informal) which provides information of any kind to a self-managing team. The results of this research can be thought of as ``design features`` for an information system to support SMTs. Practicing managers can use these design features in two ways: they can design them into beginning SMT efforts; or, for SMTs already established, managers can compare them to the existing information system and adjust accordingly.

  1. Information requirements of self-managing teams

    SciTech Connect

    Van Aken, E.M.

    1992-01-01

    In response to the significant challenges organizations face today, many managers have put in place continuous improvement efforts to help the organization on enhance its competitive position. A key element of continuous improvement efforts is employee involvement, and one of the most complex, mature, and effective forms of employee involvement is self-managing teams. A self-managing team is a group of employees, usually eight to fifteen, which is responsible for planning, implementing, controlling, and improving work processes. There are many characteristics of self-managing teams which are discussed frequently in the literature and are common topics of seminars and workshops on SMTs, including the role of the first-line supervisor, the structure of teams, the training necessary, and the pay system for SMTs. However, one area which has not been as widely researched is the role of information - what types of information do self-managing teams need This paper addresses this question. Results from a multiple case study research project focusing on the information requirements of SMTs are presented. Specifically, seven types of information SMTs need are identified, as well as general characteristics of the information system. By information system, I mean very broadly, the system (both formal and informal) which provides information of any kind to a self-managing team. The results of this research can be thought of as design features'' for an information system to support SMTs. Practicing managers can use these design features in two ways: they can design them into beginning SMT efforts; or, for SMTs already established, managers can compare them to the existing information system and adjust accordingly.

  2. Asthma Management Disparities: A Photovoice Investigation With African American Youth.

    PubMed

    Evans-Agnew, Robin

    2016-04-01

    Disparities in asthma management are a burden on African American youth. The objective of this study is to describe and compare the discourses of asthma management disparities (AMDs) in African American adolescents in Seattle to existing youth-related asthma policies in Washington State. Adolescents participated in a three-session photovoice project and presented their phototexts to the Washington State asthma planning committee. Critical discourse analysis methodology was used to analyze adolescent phototexts and the State asthma plan. We found that the State plan did not address AMD in African American adolescents. Adolescents discussed more topics on AMD than the State plan presented, and they introduced new topics concerning residential mobility, poor nutrition, inadequate athletic opportunities, and schools with stairs. Current health policy may be constraining effective responses to asthma disparities in youth. School nursing leadership can use photovoice to advance youth voice in transforming structural inequities in urban school environments. PMID:26059203

  3. Effect of Two Educational Interventions on Pharmacy Students' Confidence and Skills in Dealing with Adolescents with Asthma

    ERIC Educational Resources Information Center

    Donnelly, Amy; Shah, Smita; Bosnic-Anticevich, Sinthia

    2013-01-01

    Objectives: The aim of this study was: (1) to investigate the feasibility of incorporating the Triple A programme into the undergraduate pharmacy curriculum; (2) to compare the effect of the Triple A programme versus problem-based learning methods on the asthma knowledge of final-year pharmacy students and their perceived confidence in dealing…

  4. Is asthma prevalence still increasing?

    PubMed

    Lundbäck, Bo; Backman, Helena; Lötvall, Jan; Rönmark, Eva

    2016-01-01

    Increased awareness of asthma in society and altered diagnostic practices makes evaluation of data on prevalence change difficult. In most parts of the world the asthma prevalence seems to still be increasing. The increase is associated with urbanization and has been documented particularly among children and teenagers in urban areas of middle- and low-level income countries. Use of validated questionnaires has enabled comparisons of studies. Among adults there are few studies based on representative samples of the general population which allow evaluation of time trends of prevalence. This review focuses mainly on studies of asthma prevalence and symptoms among adults. Parallel with increased urbanization, we can assume that the increase in asthma prevalence in most areas of the world will continue. However, in Australia and North-West Europe studies performed, particularly among children and adolescents, indicate that the increase in asthma prevalence may now be leveling off. PMID:26610152

  5. Childhood Asthma

    MedlinePlus

    ... Share your child's asthma management plan with the school nurse and any coaches who oversee your child. With the approval of physicians and parents, school-age children with asthma should be allowed to ...

  6. My child is diagnosed with asthma, now what?: motivating parents to help their children control asthma.

    PubMed

    Stepney, Cesalie; Kane, Katelyn; Bruzzese, Jean-Marie

    2011-10-01

    Pediatric asthma is often undiagnosed, and therefore untreated. It negatively impacts children's functioning, including school attendance and performance, as well as quality of life. Schoolwide screening for asthma is becoming increasingly common, making identification of possible asthma particularly relevant for school nurses. Nurses may need to help parents cope with the new diagnosis, and teach them skills to manage the illness. The aim of this article is to present a three-phase model of how parents cope with a newly diagnosed pediatric chronic illness. Using asthma as an example, we describe these phases (Emotional Crisis, Facing Reality, and Reclaiming Life), illustrate how parents progress through the phases, and discuss situations associated with possible regression. Next, we offer strategies framed around a theory of asthma self-management to assist school nurses and other medical providers to motivate parents to develop successful disease management skills. PMID:21467551

  7. Utilizing Self-Management to Teach Independence on the Job.

    ERIC Educational Resources Information Center

    Lagomarcino, Thomas R.; And Others

    1989-01-01

    The paper presents a seven-step model that job coaches may use to teach self-management to employees with severe disabilities in supported employment settings. Steps include: identifying the problem, establishing a range of acceptable behavior, selecting self-management procedures, training self-management skills by withdrawing external…

  8. Oxidant and acid aerosol exposure in healthy subjects and subjects with asthma. Part 1. Effects of oxidants, combined with sulfuric or nitric acid, on the pulmonary function of adolescents with asthma. Part 2. Effects of sequential sulfuric acid and ozone exposures on the pulmonary function of healthy subjects and subjects with asthma. Research report, February 1989-April 1994

    SciTech Connect

    Koenig, J.Q.; Covert, D.S.; Pierson, W.E.; Hanley, Q.S.; Rebolledo, V.

    1994-11-01

    The study investigated the pulmonary effects of acid summer haze in a controlled laboratory setting. Of 28 adolescent subjects with allergic asthma, exercise-induced bronchospasm, and a positive response to a standardized methacholine challenge enrolled in the study, 22 completed the study. For two consecutive days each subject inhaled each of four test atmospheres by mouthpiece. The order of exposure to the four test atmospheres was assigned via a random protocol; air, oxidants (0.12 parts per million (ppm) ozone plus 0.30 ppm nitrogen dioxide), oxidants plus sulfuric acid at 70 micro/m3 of air, or oxidants plus 0.05 ppm nitric acid. Exposure to each of the different atmospheres was separated by at least one week. A postexposure methacholine challenge was performed on Day 3.

  9. An Evaluation of Asthma Interventions for Preteen Students

    ERIC Educational Resources Information Center

    Clark, Noreen M.; Shah, Smita; Dodge, Julia A.; Thomas, Lara J.; Andridge, Rebecca R.; Little, Roderick J. A.

    2010-01-01

    Background: Asthma is a serious problem for low-income preteens living in disadvantaged communities. Among the chronic diseases of childhood and adolescence, asthma has the highest prevalence and related health care use. School-based asthma interventions have proven successful for older and younger students, but results have not been demonstrated…

  10. Targeted therapeutics for severe refractory asthma: monoclonal antibodies.

    PubMed

    Grainge, Christopher L; Maltby, Steven; Gibson, Peter G; Wark, Peter A B; McDonald, Vanessa M

    2016-07-01

    Severe asthma is a complex multifactorial disease that requires specialist multidisciplinary input for optimal clinical outcomes. Following multidimensional assessment for optimisation of current therapy, self-management skills and comorbidities, all patients should be accurately phenotyped. Only after this assessment has been completed should new monoclonal antibody therapies be considered. In this review, we summarise the new antibody approaches targeting identified pathological pathways in severe refractory asthma. PMID:27018798

  11. Is Rural School-aged Children's Quality of Life Affected by Their Responses to Asthma?

    PubMed Central

    Horner, Sharon D.; Brown, Sharon A.; Walker, Veronica García

    2011-01-01

    The unpredictable nature of asthma makes it stressful for children and can affect their quality of life. An exploratory analysis of 183 rural school-aged children's data was conducted to determine relationships among demographic factors, children's responses to asthma (coping, asthma self-management), and their quality of life (QOL). Coping frequency, asthma severity, and race/ethnicity significantly predicted children's asthma-related QOL. Children reported more frequent coping as asthma-related QOL worsened (higher scores). Children with more asthma severity had worse asthma-related QOL. Post-hoc analyses showed that racial/ethnic minorities reported worse asthma-related QOL scores than did non-Hispanic Whites. PMID:22920660

  12. Asthma Outcomes: Asthma Symptoms

    PubMed Central

    Krishnan, Jerry A.; Lemanske, Robert F.; Canino, Glorisa J.; Elward, Kurtis S.; Kattan, Meyer; Matsui, Elizabeth C.; Mitchell, Herman; Sutherland, E. Rand; Minnicozzi, Michael

    2014-01-01

    Background Respiratory symptoms are commonly used to assess the impact of patient-centered interventions. Objective At the request of National Institutes of Health (NIH) institutes and other federal agencies, an expert group was convened to propose which measurements of asthma symptoms should be used as a standardized measure in future clinical research studies. Methods Asthma symptom instruments were classified as daily diaries (prospectively recording symptoms between research visits) or retrospective questionnaires (completed at research visits). We conducted a systematic search in PubMed and a search for articles that cited key studies describing development of instruments. We classified outcome instruments as either core (required in future studies), supplemental (used according to study aims and standardized), or emerging (requiring validation and standardization). This work was discussed at an NIH-organized workshop in March 2010 and finalized in September 2011. Results Four instruments (3 daily diaries, 1 for adults and 2 for children; and 1 retrospective questionnaire for adults) were identified. Minimal clinically important differences have not been established for these instruments, and validation studies were only conducted in a limited number of patient populations. Validity of existing instruments may not be generalizable across racial-ethnic or other subgroups. Conclusions An evaluation of symptoms should be a core asthma outcome measure in clinical research. However, available instruments have limitations that preclude selection of a core instrument. The working group participants propose validation studies in diverse populations, comparisons of diaries versus retrospective questionnaires, and evaluations of symptom assessment alone versus composite scores of asthma control. PMID:22386505

  13. Improving asthma self-efficacy: Developing and testing a pilot community-based asthma intervention for African American adults

    PubMed Central

    Martin, Molly A.; Catrambone, Catherine D.; Kee, Romina A.; Evans, Arthur T.; Sharp, Lisa K.; Lyttle, Christopher; Rucker-Whitaker, Cheryl; Weiss, Kevin B.; Shannon, John Jay

    2009-01-01

    Background Low-income African American adults in Chicago have disproportionately high asthma morbidity and mortality rates. Interventions that improve asthma self-efficacy for appropriate self-management behaviors may ultimately improve asthma control in this population. Objective To pilot test an intervention to improve asthma self-efficacy for appropriate self-management behaviors. Methods Participants for this trial were recruited through two primary care clinics located in the largest African American community in Chicago. Participants were then randomized into two groups. The control group received mailed asthma education. The intervention group was offered 4 group sessions lead by a community social worker and 6 home visits by community health workers. Telephone interviews were conducted at baseline (pre-intervention), 3 months (post-intervention), and 6 months (maintenance). Results The 42 participants were predominantly African American, low income, and had poorly controlled persistent asthma. The intervention group had significantly higher asthma self-efficacy at 3 months (p<0.001) after the completion of the intervention. Asthma action plans were more common in the intervention group at 3 months (p=0.06). At 6 months, the intervention group had improved asthma quality of life (p=0.002), and improved coping (p=0.01) compared to controls. Trends in behavioral and clinical outcomes favored the intervention group but were not statistically significant. Conclusions This community-based asthma intervention improved asthma self-efficacy, self-perceived coping skills, and asthma quality of life for low income African American adults. Larger trials are needed to test the efficacy of this intervention to reduce asthma morbidity in similar high-risk populations. PMID:19130936

  14. The relationships between asthma control, daytime sleepiness, and quality of life among children with asthma: a path analysis

    PubMed Central

    Li, Zheng; Huang, I-Chan; Thompson, Lindsay; Tuli, Sanjeev; Huang, Shih-Wen; DeWalt, Darren; Revicki, Dennis; Shenkman, Elizabeth

    2013-01-01

    Objectives We aimed to examine the relationships between asthma control, daytime sleepiness, and asthma-specific health-related quality of life (HRQOL) among children with asthma. Path analyses were conducted to test if daytime sleepiness can mediate the effect of asthma control status on asthma-specific HRQOL. Methods 160 dyads of asthmatic children and their parents were collected for analyses. The Asthma Control and Communication Instrument (ACCI) was used to categorize adequate and poor asthma control status. The Cleveland Adolescent Sleepiness Questionnaire (CASQ) was used to measure children’s daytime sleepiness, including sleep in school, awake in school, sleep in evening, and sleep during transport. The Patient-Reported Outcomes Measurement Information System (PROMIS) Asthma Impact Scale was used to measure asthma-specific HRQOL. Results Poorly controlled asthma was associated with daytime sleepiness and impaired asthma-specific HRQOL. Asthma control status was directly associated with asthma-specific HRQOL (P<.05), whereas sleep in school and sleep in evening domains of daytime sleepiness significantly mediated the relationship between poor asthma control and impaired HRQOL (P<.01). Conclusions Asthma control status was associated with pediatric asthma-specific HRQOL, and the association was significantly mediated by daytime sleepiness. Healthcare providers need to address pediatric sleep needs related to poor asthma control to reduce the impact on HRQOL. PMID:23684939

  15. Benefits and Barriers of Pediatric Healthcare Providers toward Using Social Media in Asthma Care

    ERIC Educational Resources Information Center

    Martinasek, Mary P.; Panzera, Anthony D.; Schneider, Tali; Lindenberger, James H.; Bryant, Carol A.; McDermott, Robert J.; Couluris, Marisa

    2011-01-01

    Background: Adolescents with asthma are the least compliant age group for asthma management. Purpose: The purpose of this study was to explore attitudes, beliefs and perceptions of two pediatric physician groups towards using social media technology (SMT) to improve asthma management in adolescents. Methods: We employed in-depth interviews and a…

  16. Impact of Student Pharmacist-Delivered Asthma Education on Child and Caregiver Knowledge

    PubMed Central

    Marcotullio, Nicole; Skoner, David P.; Lunney, Phil; Gentile, Deborah A.

    2014-01-01

    Objective. To evaluate the effectiveness of asthma education delivered by student pharmacists and to assess the impact of child and caregiver baseline asthma knowledge on asthma control in children. Design. Student pharmacists developed and implemented asthma self-management education interventions for children and their caregivers and performed asthma screenings for children at a series of asthma camps. Assessment. Eighty-seven children, ages 5-17 years, and their caregivers were enrolled in this study. A previously validated asthma questionnaire was modified to assess asthma knowledge among children and adults. Asthma knowledge increased significantly in children following participation in the education intervention (p<0.001). The education intervention, however, did not increase caregiver knowledge of asthma. A significant association was observed between caregiver baseline asthma knowledge and better asthma control in their children (p=0.019). Conclusion. The results of this study demonstrate that student pharmacist-delivered asthma education can positively impact asthma knowledge in children, and that caregivers’ knowledge of asthma is strongly correlated with better asthma control in their children. PMID:25657375

  17. Asthma Medications and Pregnancy

    MedlinePlus

    ... Asthma: Associated Conditions Asthma and Pregnancy Asthma Medications Asthma Medications Make an Appointment Refer a Patient Ask ... make sure you are using it correctly. Other Asthma Related Medication Treatment Annual influenza vaccine (flu shot) ...

  18. National and regional asthma programmes in Europe.

    PubMed

    Selroos, Olof; Kupczyk, Maciej; Kuna, Piotr; Łacwik, Piotr; Bousquet, Jean; Brennan, David; Palkonen, Susanna; Contreras, Javier; FitzGerald, Mark; Hedlin, Gunilla; Johnston, Sebastian L; Louis, Renaud; Metcalf, Leanne; Walker, Samantha; Moreno-Galdó, Antonio; Papadopoulos, Nikolaos G; Rosado-Pinto, José; Powell, Pippa; Haahtela, Tari

    2015-09-01

    This review presents seven national asthma programmes to support the European Asthma Research and Innovation Partnership in developing strategies to reduce asthma mortality and morbidity across Europe. From published data it appears that in order to influence asthma care, national/regional asthma programmes are more effective than conventional treatment guidelines. An asthma programme should start with the universal commitments of stakeholders at all levels and the programme has to be endorsed by political and governmental bodies. When the national problems have been identified, the goals of the programme have to be clearly defined with measures to evaluate progress. An action plan has to be developed, including defined re-allocation of patients and existing resources, if necessary, between primary care and specialised healthcare units or hospital centres. Patients should be involved in guided self-management education and structured follow-up in relation to disease severity. The three evaluated programmes show that, thanks to rigorous efforts, it is possible to improve patients' quality of life and reduce hospitalisation, asthma mortality, sick leave and disability pensions. The direct and indirect costs, both for the individual patient and for society, can be significantly reduced. The results can form the basis for development of further programme activities in Europe. PMID:26324809

  19. Self-Management Strategies Mediate Self-Efficacy and Physical Activity

    PubMed Central

    Dishman, Rod K.; Motl, Robert W.; Sallis, James F.; Dunn, Andrea L.; Birnbaum, Amanda S.; Welk, Greg J.; Bedimo-Rung, Ariane L.; Voorhees, Carolyn C.; Jobe, Jared B.

    2008-01-01

    Background Self-efficacy theory proposes that girls who have confidence in their capability to be physically active will perceive fewer barriers to physical activity or be less influenced by them, be more likely to pursue perceived benefits of being physically active, and be more likely to enjoy physical activity. Self-efficacy is theorized also to influence physical activity through self-management strategies (e.g., thoughts, goals, plans, and acts) that support physical activity, but this idea has not been empirically tested. Methods Confirmatory factor analysis was used to test the factorial validity of a measure of self-management strategies for physical activity. Next, the construct validity of the measure was tested by examining whether self-management strategies mediated the relationship between self-efficacy and self-reported physical activity, independently of several social-cognitive variables (i.e., perceived barriers, outcome expectancy value, and enjoyment), among cross-sectional samples of 6th grade (n =309) and 8th grade (n =296) girls tested between February 14 and March 17, 2002. Data were analyzed in 2004. Results Consistent with theory, self-efficacy had direct effects on the social-cognitive variables. The primary novel finding is that self-management strategies mediated the association of self-efficacy with physical activity in both samples. Conclusions The measure of self-management strategies for physical activity yields valid scores among adolescent girls and warrants experimental study as a mediator of the influence of efficacy beliefs on physical activity. PMID:15958246

  20. Contribution of income to self-management and health outcomes in pediatric type 1 diabetes.

    PubMed

    Rechenberg, Kaitlyn; Whittemore, Robin; Grey, Margaret; Jaser, Sarah

    2016-03-01

    Low income has been established as a risk factor for poorer outcomes in youth with type 1 diabetes; however, the effect of moderate income has not been studied. The purpose of this secondary analysis of baseline data from a multi-site study was to compare glycemic control, self-management, and psychosocial outcomes [depression, stress, and quality of life (QOL)] at different income levels in adolescents with type 1 diabetes. Youth (n = 320, mean age = 12.3 + 1.1, 55% female, 64% white, mean A1C = 8.3 ± 1.4) completed established self-management and psychosocial measures. A1C levels were collected from medical records. Caregivers reported annual family income, categorized as high (>$80K), moderate ($40-80K), or low (<$40K). Youth from high-income families had significantly lower A1C (mean = 7.9 ± 1.2) than those from the moderate-income group (8.6 ± 1.7, p < 0.001) or the low-income group (mean A1C = 8.6 ± 1.5, p = 0.003). Youth from the high-income group reported significantly better diabetes problem solving and more self-management goals than those from the moderate- or low-income groups (both p < 0.01). Youth from the high-income group also reported significantly fewer symptoms of depression, lower levels of perceived stress, and better QOL than those in the moderate or low-income groups (all p < 0.05). Multivariate linear regression models were used to test psychological and behavioral predictors of A1C and QOL. Parents' education status (p < 0.05) and self-management activities (p < 0.01) were significant predictors of hemoglobin A1c, while income (p < 0.01) and self-management activities (p < 0.05) were significant predictors of QOL. PMID:25545117

  1. Use of Gaming in Self-Management of Diabetes in Teens.

    PubMed

    Swartwout, Ellen; El-Zein, Ashley; Deyo, Patricia; Sweenie, Rachel; Streisand, Randi

    2016-07-01

    With the growing prevalence of diabetes in teens and frequent concomitant problems with adherence, adolescents are a frequent target for diabetes self-management support and education. Due to widespread use of technology among teens in general, the use of serious games, games used for purposes beyond entertainment with the intention to educate and support health behavior for teens with diabetes self-management, is an emerging and promising practice. This report explores games intended for teens with diabetes, how the use of games may enhance clinical practice, and provides suggestions for future research and better utilization of these technologies. Current research on the use of gaming for promoting diabetes management in teens is fairly limited, with some initial support for improvements in both behavioral and clinical outcomes among teens. More research is clearly needed in order to further determine how gaming can best be utilized to impact health outcomes in these teens, as well as potential mechanisms of change. PMID:27155609

  2. Psychological considerations of the child with asthma.

    PubMed

    Peters, Todd E; Fritz, Gregory K

    2010-04-01

    Asthma, the most common chronic disease in children and adolescents in industrialized countries, is typified by airway inflammation and obstruction leading to wheezing, dyspnea, and cough. However, the effect of asthma does not end with pulmonary changes. Research has shown a direct link between asthma and stress and psychiatric illness, which if untreated results in heightened morbidity and effects on society. The link between asthma and psychiatric illness, however, is often underappreciated by many pediatric and child mental health professionals. This article reviews the diagnosis and treatment of asthma as well as the correlation between asthma and psychiatric illness in children in an effort to improve management and treatment strategies for this prevalent disease. PMID:20478502

  3. Occupational asthma.

    PubMed Central

    Chan-Yeung, M

    1995-01-01

    Many toxic compounds found in air emissions may induce bronchoconstriction. In the workplace, workers are exposed to these compounds, often in much higher concentrations. Some of these compounds act as sensitizers. Of these, some compounds induce asthma by producing specific IgE antibodies to the compound or its protein conjugate, while others induce asthma through yet unidentified immunologic mechanisms. Some compounds, when inhaled in high concentrations, act as irritants and produce bronchoconstriction probably by inducing acute airway inflammation. The latter condition is called Reactive Airways Dysfunction Syndrome (RADS) or irritant-induced asthma. Occupational asthma is an excellent model to study the pathogenesis and the natural history of adult onset asthma because the responsible agent can be identified, complete avoidance is possible, and exposure can be measured or estimated. PMID:8549481

  4. Asthma in childhood.

    PubMed

    Ellis, E F

    1983-11-01

    Asthma is defined as an obstructive disease of the pulmonary airways resulting from spasm of airway muscle, increased mucus secretion, and inflammation. The airways of asthmatic individuals are hyperresponsive to a variety of stimuli including cold air, atmospheric irritants, pharmacologically active chemicals, various drugs, and hyperventilation. The fundamental abnormality underlying the hyperresponsiveness appears to be genetically determined; two theories explaining the abnormality have received the most attention. One theory suggests that asthma is due to abnormal beta-adrenergic receptor-adenylate cyclase function with decreased adrenergic responsiveness. An alternate theory proposes that increased cholinergic activity in the airway is the fundamental defect in the disease. The true prevalence of asthma has been difficult to determine owing to uncertainties regarding the definition of the disease. Prevalence in various populations of children ranged from 1.37% to 11.4% or higher. Most studies report a preponderance of asthma in boys over girls, with ratios varying from 1.3:1 to 3.3:1. Risk factors for the disease include a history of atopy, acute lower respiratory tract disease, parental cigarette smoking, and bronchiolitis or croup. The spectrum of asthma is that of an illness beginning early in life and persisting, in some cases, through adulthood. Signs of the disease may be apparent in the first 2 yr of life and are often associated with viral respiratory infections. Disproportionate narrowing of peripheral airways and decreased static elastic recoil properties of the lung predispose infants and young children to asthma. During midchildhood there is a tendency toward improvement, with continued improvement during adolescence. The goal of management of the child with asthma is to reduce symptoms sufficiently so that the child can regularly attend school, engage in play activities, and sleep through the night uninterrupted, while avoiding unacceptable

  5. Exploration of the Genetic Epidemiology of Asthma: A Review, with a Focus on Prevalence in Children and Adolescents in the Caribbean

    PubMed Central

    Mohan, A; Roberto, AJ; Whitehill, BC; Mohan, A; Kumar, A

    2014-01-01

    ABSTRACT Asthma is a chronic disease caused by the inflammation of the main air passages of the lungs. This paper outlines a review of the published literature on asthma. While a few studies show a trend of rising asthma cases in the Caribbean region, even fewer have explored the genetic epidemiological factors of asthma. This is a literature review that seeks to sum the body of knowledge on the epidemiology of asthma. Specifically, the major objective of the literature review is to provide a unified information base on the current state of factors involved in the genetic epidemiology of asthma. The review is a simple, yet detailed summary of the literature sources and their methodology and findings on the genetic epidemiology of asthma. Further, it seeks to direct this effort to the Caribbean region. The paper then reviews a summarized and synthesized collection of the body of previous research. Of specific interest are peer-reviewed sources that have been published in recent times. The paper provides more recent insight and recapitulates on the previous research, while tracing the intellectual progress on the debate. Where possible, reviewing and discussing the results of the previous literature, this review singles out the gaps and potential future research directions for studying the genetic epidemiology of asthma. Overall, we hope to contribute to a more synthesized knowledge and improved understanding of the previous literature and future potential direction of genetic and epidemiological asthma research. PMID:25867554

  6. Moving from Token Economies to Teaching Self-Management.

    ERIC Educational Resources Information Center

    Scott, Terance M.

    1998-01-01

    Shows how moving away from the token economy and contingency-contracting concepts of behavior management in the classroom is an effective way to teach self management skills to students with Attention Deficit/Hyperactivity Disorder. Supplies detailed instructions for implementing a successful self-management program. (MKA)

  7. Improving Academic and Behavior Skills through Self-Management Procedures.

    ERIC Educational Resources Information Center

    Prater, Mary Anne

    1994-01-01

    Techniques for developing self-management skills in students with learning and/or behavioral difficulties are explained, including self-monitoring and self-instruction. Development of self-management skills is seen to facilitate mainstreaming and provide prereferral intervention assistance. (DB)

  8. Wellness and illness self-management skills in community corrections.

    PubMed

    Kelly, Patricia J; Ramaswamy, Megha; Chen, Hsiang-Feng; Denny, Donald

    2015-02-01

    Community corrections provide a readjustment venue for re-entry between incarceration and home for inmates in the US corrections system. Our goal was to determine how self-management skills, an important predictor of re-entry success, varied by demographic and risk factors. In this cross-sectional study, we analyzed responses of 675 clients from 57 community corrections programs run by the regional division of the Federal Bureau of Prisons. A self-administered survey collected data on self-management skills, demographics, and risk factors; significant associations were applied in four regression models: the overall self-management score and three self-management subscales: coping skills, goals, and drug use. Over one-quarter (27.2%/146) of participants had a mental health history. White race, no mental health history and high school education were associated with better overall self-management scores; mental health history and drug use in the past year were associated with lower coping scores; female gender and high school education were associated with better self-management goals; female gender was associated with better self-management drug use scores. Self-management programs may need to be individualized for different groups of clients. Lower scores for those with less education suggest an area for targeted, nurse-led interventions. PMID:25625708

  9. Self-Management Patient Education and Weight Loss

    ERIC Educational Resources Information Center

    Stombaugh, Angela M.

    2010-01-01

    Self-management of a disease is defined as "having or being able to obtain, the skills and resources necessary to best accommodate to the chronic disease and its consequences" (Holman & Lorig, 1992, p. 309). Self-management has been used in the management of several chronic conditions and this model may be useful in the management of weight loss.…

  10. Self-Managed Career Services: A Team Approach.

    ERIC Educational Resources Information Center

    Nonnamaker, John; Hagenbaugh, Stacie; Grote, Ann DiMeola; Denon, Gregory; Jessup, Kara

    2001-01-01

    Taking a lead from corporate culture, many colleges and universities are experimenting with the self-managed team model, an alternative to traditional hierarchical structures. This article discusses Boston's Emerson College career services staff's experience with becoming a self-managed team. They were able to improve service delivery, reduce…

  11. The Misunderstood Asthma of Theodore Roosevelt.

    PubMed

    Camargo, Carlos A; Roosevelt, Tweed

    2015-01-01

    In this special article, we examine the asthma of President Theodore "TR" Roosevelt (1858-1919). Through a comprehensive review of thousands of source documents, and a modern understanding of asthma, we examine several misunderstandings, including the longstanding assertion that TR's illness was "psychosomatic." TR's respiratory problems began in early childhood, and the historical record provides strong evidence for poorly controlled, persistent asthma. Like many patients, his asthma entered a relatively quiescent stage during adolescence, coincident with initiation of a vigorous exercise program when TR was 12 years old. Nevertheless, TR continued to suffer serious asthma exacerbations, both in adolescence and adulthood. Although psychosocial issues affect most chronic diseases, there is little (if any) support for assertions that TR's asthma was psychosomatic. We believe that TR's childhood struggles with asthma, and the misconception that he vanquished his illness through exercise, were experiences that profoundly affected his worldview. TR is known for his appreciation of life's struggles and for a bedrock belief that people can create major change with sufficient motivation and hard work. In different ways, misunderstandings about asthma contributed to the early development of these personal characteristics. Together with later experiences, they contributed to a lifetime of action that changed modern history. PMID:26271837

  12. What Is Asthma?

    MedlinePlus

    ... Current Issue Past Issues Special Section What Is Asthma? Past Issues / Fall 2007 Table of Contents For ... major trigger for asthma. Photo: iStock Who Gets Asthma? People get asthma because of an interaction between ...

  13. Exercise and Asthma

    MedlinePlus

    ... Issues Listen Español Text Size Email Print Share Exercise and Asthma Page Content Article Body Almost every ... children more likely to develop asthma. How does exercise cause asthma symptoms? The symptoms of asthma are ...

  14. Asthma and allergy - resources

    MedlinePlus

    Resources - asthma and allergy ... The following organizations are good resources for information on asthma and allergies : Allergy and Asthma Network Mothers of Asthmatics -- www.aanma.org American Academy of Allergy, Asthma ...

  15. Asthma and Hispanic Americans

    MedlinePlus

    ... and Data > Minority Population Profiles > Hispanic/Latino > Asthma Asthma and Hispanic Americans In 2014, 2.1 million Hispanics reported that they currently have asthma. Puerto Rican Americans have almost twice the asthma ...

  16. Diagnosing Asthma

    MedlinePlus

    ... Health Issues Conditions Abdominal ADHD Allergies & Asthma Autism Cancer Chest & Lungs Chronic Conditions Cleft & Craniofacial Developmental Disabilities Ear Nose & Throat Emotional Problems Eyes Fever From Insects or Animals Genitals and Urinary Tract Glands & Growth Head Neck & ...

  17. Asthma Inhalers

    MedlinePlus

    ... reduce the release of chlorofluorocarbons (CFCs) into the atmosphere when taking certain asthma medications. Until recently, most ... hydrofluoroalkane (HFA) inhalers, that do not rob the atmosphere of ozone. “The FDA [Food and Drug Administration] ...

  18. Asthma Basics

    MedlinePlus

    ... KidsHealth in the Classroom What Other Parents Are Reading Upsetting News Reports? What to Say Vaccines: Which ... of asthma. The doctor may take a spirometer reading, give the child an inhaled medication that opens ...

  19. Childhood asthma.

    PubMed Central

    Clark, N M; Brown, R W; Parker, E; Robins, T G; Remick, D G; Philbert, M A; Keeler, G J; Israel, B A

    1999-01-01

    Asthma prevalence in children has increased 58% since 1980. Mortality has increased by 78%. The burden of the disease is most acute in urban areas and racial/ethnic minority populations. Hospitalization and morbidity rates for nonwhites are more than twice those for whites. Asthma is characterized by recurrent wheezing, breathlessness, chest tightness, and coughing. Research in the past decade has revealed the importance of inflammation of the airways in asthma and clinical treatment to reduce chronic inflammation. Asthma is associated with production of IgE to common environmental allergens including house dust mite, animal dander, cockroach, fungal spores, and pollens. Some interventions to reduce symptoms through control of dust mite and animal dander have had positive results. Control of symptoms through interventions to reduce exposures to cockroach antigen has not been reported. Studies illustrating causal effects between outdoor air pollution and asthma prevalence are scant. Increases in asthma prevalence have occurred at the same time as general improvements in air quality. However, air quality appears to exacerbate symptoms in the child who already has the disease. Decreased pulmonary function has been associated with exposure to particulates and bronchial hyperresponsiveness to smoke, SO(2) and NO(2). Symptoms have been correlated with increased levels of respirable particulates, ozone, and SO(2). Interventions that reduce the negative outcomes in asthma associated with outdoor environmental factors have not been reported. Control of asthma in children will entail the collaborative efforts of patients, family, clinical professionals, and school personnel, as well as community-wide environmental control measures and conducive national and local policies based on sound research. Images Figure 1 PMID:10423388

  20. Self-managed work teams: what works?

    PubMed

    Yeatts, D E; Schulz, E

    1998-01-01

    Case studies have shown that under the right circumstances, employees within self-managed work teams (SMWTs) produce more at work than employees organized in a more hierarchical, traditional structure because they perform not only technical skills, but management skills as well. The purpose of this article is to clarify the specific factors most important to an SMWT's success. The information shared here comes from three sources. The primary source is a research project funded by a 3-year grant (1994-1997) from the National Science Foundation. The primary factors found to affect the success of SMWTs formed five groups. Work process factors include those that are needed when actually performing the work, such as the appropriate resources, talent, procedures, and effort. Interpersonal process factors include communication and both positive and negative conflict. Environmental factors include those within the SMWT'S organization, such as management support and the reward system, as well as factors outside the organization, such as suppliers and the market. Team design factors and team member characteristics were found to be equally important to the high performance of the SMWT. PMID:10178700

  1. The Saudi initiative for asthma – 2012 update: Guidelines for the diagnosis and management of asthma in adults and children

    PubMed Central

    Al-Moamary, Mohamed S.; Alhaider, Sami A.; Al-Hajjaj, Mohamed S.; Al-Ghobain, Mohammed O.; Idrees, Majdy M.; Zeitouni, Mohammed O.; Al-Harbi, Adel S.; Al Dabbagh, Maha M.; Al-Matar, Hussain; Alorainy, Hassan S.

    2012-01-01

    This an updated guidelines for the diagnosis and management of asthma, developed by the Saudi Initiative for Asthma (SINA) group, a subsidiary of the Saudi Thoracic Society. The main objective of SINA is to have updated guidelines, which are simple to understand and easy to use by non-asthma specialists, including primary care and general practice physicians. This new version includes updates of acute and chronic asthma management, with more emphasis on the use of Asthma Control Test in the management of asthma, and a new section on “difficult-to-treat asthma.” Further, the section on asthma in children was re-written to cover different aspects in this age group. The SINA panel is a group of Saudi experts with well-respected academic backgrounds and experience in the field of asthma. The guidelines are formatted based on the available evidence, local literature, and the current situation in Saudi Arabia. There was an emphasis on patient–doctor partnership in the management that also includes a self-management plan. The approach adopted by the SINA group is mainly based on disease control as it is the ultimate goal of treatment. PMID:23189095

  2. The Saudi initiative for asthma - 2012 update: Guidelines for the diagnosis and management of asthma in adults and children.

    PubMed

    Al-Moamary, Mohamed S; Alhaider, Sami A; Al-Hajjaj, Mohamed S; Al-Ghobain, Mohammed O; Idrees, Majdy M; Zeitouni, Mohammed O; Al-Harbi, Adel S; Al Dabbagh, Maha M; Al-Matar, Hussain; Alorainy, Hassan S

    2012-10-01

    This an updated guidelines for the diagnosis and management of asthma, developed by the Saudi Initiative for Asthma (SINA) group, a subsidiary of the Saudi Thoracic Society. The main objective of SINA is to have updated guidelines, which are simple to understand and easy to use by non-asthma specialists, including primary care and general practice physicians. This new version includes updates of acute and chronic asthma management, with more emphasis on the use of Asthma Control Test in the management of asthma, and a new section on "difficult-to-treat asthma." Further, the section on asthma in children was re-written to cover different aspects in this age group. The SINA panel is a group of Saudi experts with well-respected academic backgrounds and experience in the field of asthma. The guidelines are formatted based on the available evidence, local literature, and the current situation in Saudi Arabia. There was an emphasis on patient-doctor partnership in the management that also includes a self-management plan. The approach adopted by the SINA group is mainly based on disease control as it is the ultimate goal of treatment. PMID:23189095

  3. Self-Management and Self-Management Support Outcomes: A Systematic Review and Mixed Research Synthesis of Stakeholder Views

    PubMed Central

    Boger, Emma; Ellis, Jaimie; Latter, Sue; Foster, Claire; Kennedy, Anne; Jones, Fiona; Fenerty, Vicky; Kellar, Ian; Demain, Sara

    2015-01-01

    Introduction Self-management has received growing attention as an effective approach for long-term condition management. Little is known about which outcomes of supported self-management are valued by patients, their families, health professionals and those who commission self-management services. This study systematically reviewed published empirical evidence in accordance with PRISMA guidelines to determine the outcomes of self-management valued by these key stakeholder groups, using three prominent exemplar conditions: colorectal cancer, diabetes and stroke. Aim To systematically review the literature to identify which generic outcomes of self-management have been targeted and are considered important using three exemplar conditions (colorectal cancer, diabetes and stroke), which collectively have a range of features that are likely to be representative of generic self-management issues. Methods Systematic searching of nine electronic databases was conducted in addition to hand searches of review articles. Abstracts were identified against inclusion criteria and appraised independently by two reviewers, using a critical appraisal tool. Synthesis of findings was conducted using mixed research synthesis. Results Over 20,536 abstracts were screened. 41 studies which met the review criteria were fully retrieved and appraised. The majority of evidence related to diabetes. Few studies directly focussed on stakeholders’ views concerning desired self-management outcomes; the majority of evidence was derived from studies focusing upon the experience of self-management. The views of health care commissioners were absent from the literature. We identified that self-management outcomes embrace a range of indicators, from knowledge, skills, and bio-psychosocial markers of health through to positive social networks. Conclusions Patients’, families’, health professionals’ and commissioners’ views regarding which outcomes of self-management are important have not been

  4. Self-management education and support in chronic disease management.

    PubMed

    McGowan, Patrick T

    2012-06-01

    With the changing health care environment, prevalence of chronic health conditions, and burgeoning challenges of health literacy, obesity, and homelessness, self-management support provides an opportunity for clinicians to enhance effectiveness and, at the same time, to engage patients to participate in managing their own personal care. This article reviews the differences between patient education and self-management and describes easy-to-use strategies that foster patient self-management and can be used by health care providers in the medical setting. It also highlights the importance of linking patients to nonmedical programs and services in the community. PMID:22608868

  5. [Occupational asthma].

    PubMed

    Pauli, G; Bessot, J C; Gourdon, C

    1992-12-01

    The diagnosis of occupational asthma requires the integration of a multiplicity of data; the history, cutaneous skin tests, biological tests, respiratory function tests and non-specific tests of bronchial hyperreactivity and specific bronchial provocation test. The history search for the presence of an atopic state, the occurrence of similar disorders in members of the same firm and also the timing of symptoms in relation to the occupational activities. Cutaneous tests are particularly helpful in IgE-mediated asthma in relation to the inhalation of animal or vegetable materials of glycoprotein origin. For haptens, the need for their prior coupling to a protein carrier causes problems which have not been entirely resolved. Laboratory tests run into the same snags. Respiratory function and non-specific bronchial provocation tests, confirm the diagnosis of asthma and enable the medium and long term prognostic to be assessed. Specific bronchial provocation tests are the most appropriate tests to establish an aetiological diagnosis in occupational asthma. Different technical methods are possible: quantitative administration of allergen aerosols, realistic tests, and tests using exposure chambers to achieve true test doses. The products responsible for occupational asthma are multiple. The different substances are characterised in a simplified manner: first animal matter (mammalian and arthropod allergens), secondly substances of vegetable origin (roots, leaves, flowers, grain and flour, wood and its derivates) and finally chemical products. The chemical products are primarily from the pharmaceutical and metal industries and above all from the plastics industry. PMID:1296320

  6. Asthma and physical activity.

    PubMed

    Oseid, S

    1982-01-01

    Physical activity regularly leads to a decline in lung function in children and adolescents with asthma. This decline is a consequence of what is known as exercise-induced asthma (EIA), and can be determined and graded with the help of lung function tests before and after submaximal workloads on the ergometer cycle or the treadmill. Typical EIA appears in asthmatic individuals with entirely normal lung function before the effort, but EIA may also become clinically manifest with exercise in patients who have a subclinical degree of obstruction. The grade of EIA is essentially dependent on the duration and intensity of effort but also on the type of exercise. For example, free running causes much greater bronchoconstriction than swimming. The temperature and humidity of the inspired air may partially explain this difference. At the Voksentoppen Allergy Institute we find that about 85% of children develop a fall in lung function of 15% or more after a six minute ergometer cycle test. With typical EIA the fall may be totally or partially abolished by prophylactic medication 10 minutes before the start of the test. Disodium cromoglycate (Intal) and/or beta-adrenergic drugs are regularly used before all physical activity. Training programmes must be based on the interval principle. Swimming, ball games, relay races and dancing are examples of useful activities in the training and rehabilitation of children and adolescents with asthma. Through prophylactic medication and physical training, the aerobic work capacity, muscle strength and lung function in asthmatic children is improved. Training also leads to a significant mobilisation of mental resources and an increase in social integration. PMID:6958045

  7. Self-management and self-management support on functional ablement in chronic low back pain.

    PubMed

    Kawi, Jennifer

    2014-03-01

    This study examined self-management (SM), self-management support (SMS), and functional ablement in chronic low back pain (CLBP) patients and the role of SM in explaining the relationship of SMS to functional ablement. The pervasiveness of CLBP is alarming in today's health care. Although the literature is beginning to explicate the impact of SM and SMS in other chronic illnesses, these are yet to be clarified in CLBP. The adapted chronic care model guided this study. A nonexperimental, cross-sectional, descriptive design with mediation analysis was used. Through convenience sampling, 110 participants were recruited from two pain centers that used similar multimodal pain management practices. Although the findings showed lack of mediation, it was found that SM and SMS were strongly correlated. Furthermore, overall health was found to be a significant covariate to the functional ablement of CLBP patients. This study assists in advancing knowledge and contributing toward understanding SM, SMS, and functional ablement in CLBP. It is important to engage patients and health care providers in SM and SMS. More exploration is necessary to assess the influences of SM and SMS in CLBP outcomes toward improving the complex care of these patients. PMID:24602423

  8. Self-Management: Taking Charge of Your Health

    MedlinePlus

    ... management of chronic illness means that you take responsibility for doing what it takes to manage your ... As part of self-management, it’s also your responsibility to ask for the help you need to ...

  9. Didgeridoo Playing and Singing to Support Asthma Management in Aboriginal Australians

    ERIC Educational Resources Information Center

    Eley, Robert; Gorman, Don

    2010-01-01

    Context: Asthma affects over 15% of Australian Aboriginal people. Compliance in asthma management is poor. Interventions that will increase compliance are required. Purpose: The purpose of the study was to determine whether Aboriginal children, adolescents and adults would engage in music lessons to increase their knowledge of asthma and support…

  10. Integrating the Revised Asthma Guidelines into School Nursing Scope and Standards of Practice

    ERIC Educational Resources Information Center

    Crowder, Sharron J.

    2010-01-01

    Asthma, a major health problem, is the most common chronic illness of school-aged children and adolescents, with an estimated 6.8 million students affected in the United States. Asthma is the leading cause of school absenteeism, with an estimated 14 million lost school days per year. In August 2007, the National Asthma Education and Prevention…

  11. Occupational asthma.

    PubMed Central

    Chan-Yeung, M.; Grzybowski, S.

    1976-01-01

    Occupational asthma is probably much more common than is generally realized. Though many causes have been described, undoubtedly many more are yet to be recognized. One of the diagnostic difficulties lies in the fact that in most forms of this disease a late asthmatic reaction occurs in the evening rather than at work. The pathogenetic mechanisms differ in various forms of occupational asthma. In some, an immunologic mechanism is likely; in others, a "pharmacologic" action of the offending agent is implicated. Asthma due to inhalation of dusts of western red cedar, isocyanates, detergent enzymes and textiles is considered in detail. Periodic examination of workers at risk is of value for early diagnosis and prevention of irrversible airway obstruction. PMID:766943

  12. Beliefs About Dysmenorrhea and Their Relationship to Self-Management.

    PubMed

    Chen, Chen X; Kwekkeboom, Kristine L; Ward, Sandra E

    2016-08-01

    Dysmenorrhea is highly prevalent and is the leading cause of work and school absences among women of reproductive age. However, self-management of dysmenorrhea is not well understood in the US, and little evidence is available on factors that influence dysmenorrhea self-management. Guided by the Common Sense Model, we examined women's representations of dysmenorrhea (beliefs about causes, symptoms, consequences, timeline, controllability, coherence, and emotional responses), described their dysmenorrhea self-management behaviors, and investigated the relationship between representations and self-management behaviors. We conducted a cross-sectional, web-based survey of 762 adult women who had dysmenorrhea symptoms in the last six months. Participants had varied beliefs about the causes of their dysmenorrhea symptoms, which were perceived as a normal part of life. Dysmenorrhea symptoms were reported as moderately severe, with consequences that moderately affected daily life. Women believed they understood their symptoms moderately well and perceived them as moderately controllable but them to continue through menopause. Most women did not seek professional care but rather used a variety of pharmacologic and complementary health approaches. Care-seeking and use of self-management strategies were associated with common sense beliefs about dysmenorrhea cause, consequences, timeline, and controllability. The findings may inform development and testing of self-management interventions that address dysmenorrhea representations and facilitate evidence-based management. © 2016 Wiley Periodicals, Inc. PMID:27177093

  13. Long-Term Budesonide or Nedocromil Treatment, Once Discontinued, Does Not Alter the Course of Mild to Moderate Asthma in Children and Adolescents

    PubMed Central

    Bender, Bruce; Sternberg, Alice L; Strunk, Robert C; Szefler, Stanley J; Tonascia, James; Zeiger, Robert S

    2010-01-01

    Objectives To determine whether long-term, continuous use of inhaled anti-inflammatory medications affects asthma outcomes in children with mild-moderate asthma after use is discontinued. Study design Of 1,041 participants in the Childhood Asthma Management Program randomized clinical trial, 941 (90%) were followed to determine whether 4.3 years of twice daily budesonide or nedocromil (each compared with placebo) affected subsequent asthma outcomes during a 4.8 year post-trial period in which treatment was managed by the participant's physician. Results The groups treated continuously during the trial with either budesonide or nedocromil did not differ from placebo in lung function, control of asthma, or psychological status at the end of 4.8 years of post-trial follow-up; however, the decreased mean height in the budesonide group relative to the placebo group at the end of the trial (1.1 cm, P=0.005) remained statistically significant (0.9 cm, P=0.01) after an additional 4.8 years and was more pronounced in girls (1.7 cm; P=0.001) than boys (0.3 cm; P=0.49). Participants used inhaled corticosteroids during 30% of the post-trial period in all groups. Conclusions Clinically meaningful improvements in control of asthma and improvements in airway responsiveness achieved during continuous treatment with inhaled corticosteroids do not persist after continuous treatment is discontinued. PMID:19167726

  14. Asthma - children

    MedlinePlus

    ... BS, Burks AW, et al, eds. Middleton's Allergy Principles and Practice . 8th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 53. Lugogo N, Que LG, Gilstrap DL, Kraft M. Asthma: clinical diagnosis and management. In: Broaddus VC, Mason RJ, Ernst JD, et ...

  15. Thunderstorm asthma.

    PubMed

    2014-10-01

    AN ASSOCIATION between asthma and thunderstorms based on retrospective data has been noted in several papers. This study, however, draws on almost-real-time, anonymised attendance data from 35 emergency departments (EDs) in the UK, and lightning-strike plots from the Met Office. PMID:25270814

  16. Non-adherence in children with asthma reviewed: The need for improvement of asthma care and medical education.

    PubMed

    Klok, Ted; Kaptein, Adrian A; Brand, Paul L P

    2015-05-01

    Adherence to daily inhaled corticosteroid therapy is a key determinant of asthma control. Therefore, improving adherence to inhaled corticosteroids is the most effective method through which healthcare providers can help children with uncontrolled asthma. However, identifying non-adherent patients is difficult, and electronic monitoring is the only reliable method to assess adherence. (Non-)adherence is a complex behavioural process influenced by many interacting factors. Intentional barriers to adherence are common; driven by illness perceptions and medication beliefs, patients and parents deliberately choose not to follow the doctor's recommendations. Common non-intentional barriers are related to family routines, child-raising issues, and to social issues such as poverty. Effective interventions improving adherence are complex, because they take intentional and non-intentional barriers to adherence into account. There is evidence that comprehensive, guideline-based asthma self-management programmes can be successful, with excellent adherence and good asthma control. Patient-centred care focused on healthcare provider-patient/parent collaboration is the key factor determining the success of guided self-management programmes. Such care should focus on shared decision-making as this has been shown to improve adherence and healthcare outcomes. Current asthma care falls short because many physicians fail to adhere to asthma guidelines in their diagnostic approach and therapeutic prescriptions, and because of the lack of application of patient-centred health care. Increased awareness of the importance of patient-centred communication and increased training in patient-centred communication skills of undergraduates and experienced attending physicians are needed to improve adherence to daily controller therapy and asthma control in children with asthma. PMID:25704083

  17. Effect of a home intervention program on pediatric asthma in an environmental justice community.

    PubMed

    Shani, Zalika; Scott, Richard G; Schofield, Lynne Steuerle; Johnson, John H; Williams, Ellen R; Hampton, Janiene; Ramprasad, Vatsala

    2015-03-01

    Asthma prevalence rates are at an all-time high in the United States with over 25 million persons diagnosed with asthma. African Americans and other minorities have higher asthma prevalence and higher exposure to environmental factors that worsen asthma as compared to Caucasians. This article describes the evaluation of an inner-city home-based asthma education and environmental remediation program that addressed both indoor and outdoor triggers through collaboration between a health system and local environmental justice organization. The program enrolled 132 children older than 2.5 years and centers on a 4- to 6-week intervention with peer counselors using the U.S. Environmental Protection Agency Asthma Home Environment Checklist and the You Can Control Asthma curriculum. Families receive asthma-friendly environmental home kits. Peer counselors reinforce key asthma management messages and facilitate the completion of Asthma Action Plans. The environmental justice community partner organized block cleanups to reduce outdoor triggers. The evaluation used a pretest-posttest design to assess changes in client behavior and asthma symptoms. Data were collected at baseline and during a 6-month postintervention period. Participants saw enhanced conditions on asthma severity and control. The improvement was greatest for children whose asthma was considered "severe" based on the validated Asthma Control Test. Other positive results include the following: greater completion of Asthma Action Plans, significant reduction in the number of emergency room visits (p = .006), and substantial decreases in school absenteeism (p = .008) and use of rescue medications (p = .049). The evaluation suggests that the program was effective in improving asthma self-management in a high-risk population living within an environmental justice community. PMID:24733733

  18. Time for a new language for asthma control: results from REALISE Asia

    PubMed Central

    Price, David; David-Wang, Aileen; Cho, Sang-Heon; Ho, James Chung-Man; Jeong, Jae-Won; Liam, Chong-Kin; Lin, Jiangtao; Muttalif, Abdul Razak; Perng, Diahn-Warng; Tan, Tze-Lee; Yunus, Faisal; Neira, Glenn

    2015-01-01

    Purpose Asthma is a global health problem, and asthma prevalence in Asia is increasing. The REcognise Asthma and LInk to Symptoms and Experience Asia study assessed patients’ perception of asthma control and attitudes toward treatment in an accessible, real-life adult Asian population. Patients and methods An online survey of 2,467 patients with asthma from eight Asian countries/regions, aged 18–50 years, showed greater than or equal to two prescriptions in previous 2 years and access to social media. Patients were asked about their asthma symptoms, exacerbations and treatment type, views and perceptions of asthma control, attitudes toward asthma management, and sources of asthma information. Results Patients had a mean age of 34.2 (±7.4) years and were diagnosed with asthma for 12.5 (±9.7) years. Half had the Global Initiative for Asthma-defined uncontrolled asthma. During the previous year, 38% of patients visited the emergency department, 33% were hospitalized, and 73% had greater than or equal to one course of oral corticosteroids. About 90% of patients felt that their asthma was under control, 82% considered their condition as not serious, and 59% were concerned about their condition. In all, 66% of patients viewed asthma control as managing attacks and 24% saw it as an absence of or minimal symptoms. About 14% of patients who correctly identified their controller inhalers had controlled asthma compared to 6% who could not. Conclusion Patients consistently overestimated their level of asthma control contrary to what their symptoms suggest. They perceived control as management of exacerbations, reflective of a crisis-oriented mind-set. Interventions can leverage on patients’ trust in health care providers and desire for self-management via a new language to generate a paradigm shift toward symptom control and preventive care. PMID:26445555

  19. Asthma and school

    MedlinePlus

    Asthma action plan - school; Wheezing - school; Reactive airway disease - school; Bronchial asthma - school ... Your child's school asthma action plan should include: Phone ... nurse, parents, and guardians A brief history of your child's ...

  20. Sleep in asthma.

    PubMed

    Khan, Wajahat H; Mohsenin, Vahid; D'Ambrosio, Carolyn M

    2014-09-01

    Many patients with asthma experience worsening of symptoms at night. Understanding the mechanism of nocturnal asthma and the factors that exacerbate asthma during sleep would lead to better management of the condition. PMID:25156764

  1. Asthma: Basic Information

    MedlinePlus

    ... 1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Learn How to Control Asthma Language: ... common triggers are tobacco smoke, dust mites, outdoor air pollution, cockroach allergen, pets, mold, and smoke from burning ...

  2. Asthma - child - discharge

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000001.htm Asthma - child - discharge To use the sharing features on ... for your child. Take charge of your child's asthma at home Make sure you know the asthma ...

  3. Asthma in Children

    MedlinePlus

    ... have asthma. Nearly 9 million of them are children. Children have smaller airways than adults, which makes asthma especially serious for them. Children with asthma may experience wheezing, coughing, chest tightness, ...

  4. Factors Associated with Chronic Kidney Disease Self-Management.

    PubMed

    Washington, Tiffany; Zimmerman, Sheryl; Browne, Teri

    2016-01-01

    Chronic kidney disease (CKD) affected 26 million U.S. adults. Many end-stage CKD patients undergoing hemodialysis experience self-management challenges. However, factors associated with CKD self-management are under-identified. This article describes a mixed-methods study to identify factors associated with self-management in end-stage CKD patients undergoing hemodialysis. A total of 107 patients age 50 and older were interviewed. Overall, participants had low mean scores for exercise (2.46), communication with physicians (2.50), and cognitive symptom management (0.89) and were adherent for greater than 11 days in a 2-week period with fluid (11.86) and diet (11.65) regimens. There were statistically significant age group differences in the self-management behavior of fluid adherence (p < .05) and communication with physicians (p = .05). None of the respondents discussed communicating with their physicians or cognitive symptom management, yet 90% and 77% of the respondents reported engaging in these behaviors, respectively. The findings from this study support the need for public health social work interventions aimed at increasing self-management behaviors in end-stage CKD patients. PMID:26799496

  5. Nurses' perceptions of self-management in renal care.

    PubMed

    Matthews, Theresa; Trenoweth, Steve

    Self-management is vital for patients with long-term conditions in order to ensure wellbeing. It needs to be supported by a healthcare workforce who are knowledgeable and able to work in collaboration with individuals. In this study, ten nurses were selected by means of exclusion/inclusion criteria and then interviewed with a semi-structured approach. Following analysis of the data with an open, axial and selective coding process, clear themes emerged: expectation of roles, lack of confidence and concerns with risk-taking. There were a number of concerns around engaging with self-management for this group of nurses, including a lack of knowledge and skills to assess the suitability of patients for self-management and subsequently to offer support, and concerns that self-management would be too unsafe in a renal setting. This study suggests that nurses would need education in strategies to support and implement self-management. Further studies should be undertaken to explore this possibility with renal patients admitted to the ward. PMID:26500125

  6. Self-management of vaginal pessaries for pelvic organ prolapse

    PubMed Central

    Kearney, Rohna; Brown, Claire

    2014-01-01

    Two thirds of women opt to use a vaginal pessary initially to manage the symptoms of pelvic organ prolapse. In the UK most women attend a health care professional at least every six months to change the pessary. This represents a significant burden both economically to the health care system and personally for the woman. Annually there are more than 300 appointments for pessary changes at our hospital. We developed a programme to teach women to self-manage their pessaries with the aim of improving patient experience and reducing outpatient attendances to free up outpatient capacity for new referrals. A physiotherapist was recuited to deliver this programme involving a one to one training session supplemented with written materials and an online video. Women using pessaries were offered the option of self-management. Eighty-eight women aged between 29 to 84 years enrolled in the programme. Sixty-three women (73% of those enrolled) successfully continued with self-management at six months, creating 126 extra outpatient appointment capacity in one year alone. Women self-managing reported higher levels of convenience (94% vs 81%), accessibility (97% vs 73%), support (100% vs. 83%), and comfort (86% vs. 53%) than those attending the hospital for GP practice for pessary change. Self-management appears to be an acceptable option for many women using vaginal pessaries, with personal benefits to the women and economic benefits to the hospital and commissioners.

  7. Self-management of medical abortion: a qualitative evidence synthesis.

    PubMed

    Wainwright, Megan; Colvin, Christopher J; Swartz, Alison; Leon, Natalie

    2016-05-01

    Medical abortion is a method of pregnancy termination that by its nature enables more active involvement of women in the process of managing, and sometimes even administering the medications for, their abortions. This qualitative evidence synthesis reviewed the global evidence on experiences with, preferences for, and concerns about greater self-management of medical abortion with lesser health professional involvement. We focused on qualitative research from multiple perspectives on women's experiences of self-management of first trimester medical abortion (<12weeks gestation). We included research from both legal and legally-restricted contexts whether medical abortion was accessed through formal or informal systems. A review team of four identified 36 studies meeting inclusion criteria, extracted data from these studies, and synthesized review findings. Review findings were organized under the following themes: general perceptions of self-management, preparation for self-management, logistical considerations, issues of choice and control, and meaning and experience. The synthesis highlights that the qualitative evidence base is still small, but that the available evidence points to the overall acceptability of self-administration of medical abortion. We highlight particular considerations when offering self-management options, and identify key areas for future research. Further qualitative research is needed to strengthen this important evidence base. PMID:27578349

  8. Exercise and asthma: an overview.

    PubMed

    Del Giacco, Stefano R; Firinu, Davide; Bjermer, Leif; Carlsen, Kai-Håkon

    2015-01-01

    The terms 'exercise-induced asthma' (EIA) and 'exercise-induced bronchoconstriction' (EIB) are often used interchangeably to describe symptoms of asthma such as cough, wheeze, or dyspnoea provoked by vigorous physical activity. In this review, we refer to EIB as the bronchoconstrictive response and to EIA when bronchoconstriction is associated with asthma symptoms. EIB is a common occurrence for most of the asthmatic patients, but it also affects more than 10% of otherwise healthy individuals as shown by epidemiological studies. EIA and EIB have a high prevalence also in elite athletes, especially within endurance type of sports, and an athlete's asthma phenotype has been described. However, the occurrence in elite athletes shows that EIA/EIB, if correctly managed, may not impair physical activity and top sports performance. The pathogenic mechanisms of EIA/EIB classically involve both osmolar and vascular changes in the airways in addition to cooling of the airways with parasympathetic stimulation. Airways inflammation plays a fundamental role in EIA/EIB. Diagnosis and pharmacological management must be carefully performed, with particular consideration of current anti-doping regulations, when caring for athletes. Based on the demonstration that the inhaled asthma drugs do not improve performance in healthy athletes, the doping regulations are presently much less strict than previously. Some sports are at a higher asthma risk than others, probably due to a high environmental exposure while performing the sport, with swimming and chlorine exposure during swimming as one example. It is considered very important for the asthmatic child and adolescent to master EIA/EIB to be able to participate in physical activity on an equal level with their peers, and a precise early diagnosis with optimal treatment follow-up is vital in this aspect. In addition, surprising recent preliminary evidences offer new perspectives for moderate exercise as a potential therapeutic tool for

  9. Diabetes: Christian Worldview, Medical Distrust & Self-Management

    PubMed Central

    Newlin Lew, Kelley; Arbuah, Nancy; Banach, Paul; Melkus, Gail

    2015-01-01

    To inform development of a combined diabetes prevention and self-management intervention in partnership with church communities, this study sampled African American church leaders and members (N=44) to qualitatively study religious beliefs and practices, diabetes prevention and self-management behaviors, and related community actions. Prior to commencing the study, internal review board approval was obtained. Although not required, community consent was officially provided by the church pastors. Individual consent was subsequently obtained from eligible community members who expressed an interest in participating in the study. Following a participatory action research approach, the inquiry group method was used. Qualitative data were analyzed with content analysis. Findings revealed Christian worldview, medical mistrust, and self-management as prominent themes. Findings suggest diabetes providers address religious orientation in the provision of care with attention to rebuilding trust with the African American community to improve health outcomes. PMID:25735754

  10. Diabetes: Christian worldview, medical distrust and self-management.

    PubMed

    Newlin Lew, Kelley; Arbauh, Nancy; Banach, Paul; Melkus, Gail

    2015-06-01

    To inform the development of a combined diabetes prevention and self-management intervention in partnership with church communities, this study sampled African American church leaders and members (N = 44) to qualitatively study religious beliefs and practices, diabetes prevention and self-management behaviors, and related community actions. Prior to commencing the study, internal review board approval was obtained. Although not required, community consent was officially provided by the church pastors. Individual consent was subsequently obtained from eligible community members who expressed an interest in participating in the study. Following a participatory action research approach, the inquiry group method was used. Qualitative data were analyzed with content analysis. Findings revealed Christian worldview, medical distrust and self-management as prominent themes. Findings suggest that diabetes providers address religious orientation in the provision of care with attention to rebuilding trust with the African-American community to improve health outcomes. PMID:25735754

  11. Effect of depressive symptoms on asthma intervention in urban teens

    PubMed Central

    Guglani, Lokesh; Havstad, Suzanne L.; Johnson, Christine Cole; Ownby, Dennis R.; Joseph, Christine L. M.

    2014-01-01

    Background The literature suggests that depression is an important comorbidity in asthma that can significantly influence disease management and quality of life (QOL). Objective To study the effect of coexisting depressive symptoms on the effectiveness of self-management interventions in urban teens with asthma. Methods We analyzed data from a randomized controlled trial of Puff City, a web-based, tailored asthma management intervention for urban teens, to determine whether depression modulated intervention effectiveness for asthma control and QOL outcomes. Teens and caregivers were classified as depressed based on responses collected from baseline questionnaires. Result Using logistic regression analysis, we found that a lower percentage of treatment students had indicators of uncontrolled asthma compared with controls (adjusted odds ratios <1). However, for teens depressed at baseline, QOL scores at follow-up were significantly higher in the treatment group compared with the control group for the emotions domain (adjusted relative risk, 2.08; 95% confidence interval, 1.2–3.63; P = .01; interpreted as emotional QOL for treatment students increased by a factor of 2.08 above controls). Estimates for overall QOL and symptoms QOL were borderline significant (adjusted relative risk, 1.57; 95% confidence interval, 0.93–2.63; P = .09; and adjusted relative risk, 1.72; 95% confidence interval, 0.94–3.15; P = .08; respectively). Among teens not depressed at baseline, no significant differences were observed between treatment and control groups in QOL domains at follow-up. Conclusion Our results suggest that depression modified the relationship between the effectiveness of an asthma intervention and emotional QOL in urban teens. Further assessment of self-management behavioral interventions for asthma should explore the mechanism by which depression may alter the intervention effect. PMID:23010228

  12. Mobile Applications for Diabetes Self-Management: Status and Potential

    PubMed Central

    El-Gayar, Omar; Timsina, Prem; Nawar, Nevine; Eid, Wael

    2013-01-01

    Background Advancements in smartphone technology coupled with the proliferation of data connectivity has resulted in increased interest and unprecedented growth in mobile applications for diabetes self-management. The objective of this article is to determine, in a systematic review, whether diabetes applications have been helping patients with type 1 or type 2 diabetes self-manage their condition and to identify issues necessary for large-scale adoption of such interventions. Methods The review covers commercial applications available on the Apple App Store (as a representative of commercially available applications) and articles published in relevant databases covering a period from January 1995 to August 2012. The review included all applications supporting any diabetes self-management task where the patient is the primary actor. Results Available applications support self-management tasks such as physical exercise, insulin dosage or medication, blood glucose testing, and diet. Other support tasks considered include decision support, notification/alert, tagging of input data, and integration with social media. The review points to the potential for mobile applications to have a positive impact on diabetes self-management. Analysis indicates that application usage is associated with improved attitudes favorable to diabetes self-management. Limitations of the applications include lack of personalized feedback; usability issues, particularly the ease of data entry; and integration with patients and electronic health records. Conclusions Research into the adoption and use of user-centered and sociotechnical design principles is needed to improve usability, perceived usefulness, and, ultimately, adoption of the technology. Proliferation and efficacy of interventions involving mobile applications will benefit from a holistic approach that takes into account patients’ expectations and providers’ needs. PMID:23439183

  13. [Severe asthma].

    PubMed

    González, Claudio D

    2016-01-01

    The objectives of this work were to investigate the frequency of severe asthma (SA) according to WHO definition and to compare SA patients' characteristics with those of non-severe asthma (NSA); secondly, to investigate the level of control reached throughout a period of regular treatment. Between 1-1-2005 and 12-31-2014, 471 medical records from patients with bronchial asthma assisted in Buenos Aires City were analyzed. SA frequency was 40.1% (189/471), being significantly higher among patients from the public health system (47.7%, 108/226 vs. 33%, 81/245, p = 0.001). SA patients were older than NSA ones (51.3 ± 17.4 vs. 42.6 ± 17.1 years, p = 0.000), presented longer time since onset of the disease (median 30 vs. 20 years, p = 0.000), lower educational levels (secondary level or higher 41.7% vs. 58.1%, p = 0.000), lower frequency of rhinitis (47% vs. 60.6%, p = 0.004), more severe levels of airway obstruction (FEV% 50.2 ± 13.7 vs. 77.7 ± 12.4, p = 0.000), more frequent antecedents of Near Fatal Asthma (11.1% vs. 2.8%, p = 0.000), higher levels of serum IgE (median of 410 vs. 279 UI/l, p = 0.01) and higher demand of systemic steroids requirements and hospitalizations (68.7% vs. 50.7%, p = 0.000 and 37.5% vs. 15.9%, p = 0.000, respectively). A 30.6% of SA patients (58/189) reached a follow-up period of 12 months, 13 (22.5%) of whom reached the controlled asthma level. The frequency of SA found seems to be considerable. Multicenter studies to investigate the levels of control reached by SA patients with access to proper treatment are recommended. PMID:26826988

  14. Self-managing teams: a strategy for quality improvement.

    PubMed

    Feifer, Chris; Nocella, Kiki; DeArtola, Ignacio; Rowden, Suzanne; Morrison, Stephen

    2003-01-01

    Organizations are impacted by their environments, and health care settings are no different. Individuals charged with improving a practice are often impeded by environmental barriers, including incomplete information for decision making. One strategy to empower an organization for change is to form a self-managing team. This paper discusses the self-managing team concept and uses a case study to illustrate its application in primary care. Factors contributing to team success are presented as a guide, and a reminder--there is more to an effective team than gathering people in a room. PMID:12674392

  15. Interactive Multimedia Tailored to Improve Diabetes Self-Management.

    PubMed

    Wood, Felecia G; Alley, Elizabeth; Baer, Spencer; Johnson, Rebecca

    2015-09-01

    A pilot program was initiated to improve self-management of type 2 diabetes by rural adults. Using an iOS-based, individually tailored pre-/postintervention to improve diabetes self-management, undergraduate students developed a native mobile application to help participants effectively manage their diabetes. Brief quizzes assessed diabetes knowledge. A diabetes dictionary and physical activity assessment provided additional support to users of the app. On completion of the pilot, data analysis indicated increased diabetes knowledge and self-efficacy, and ease of use of the technology. Native app technology permits ready access to important information for those living with type 2 diabetes. PMID:26333610

  16. Biologically-Inspired Concepts for Self-Management of Complexity

    NASA Technical Reports Server (NTRS)

    Sterritt, Roy; Hinchey, G.

    2006-01-01

    Inherent complexity in large-scale applications may be impossible to eliminate or even ameliorate despite a number of promising advances. In such cases, the complexity must be tolerated and managed. Such management may be beyond the abilities of humans, or require such overhead as to make management by humans unrealistic. A number of initiatives inspired by concepts in biology have arisen for self-management of complex systems. We present some ideas and techniques we have been experimenting with, inspired by lesser-known concepts in biology that show promise in protecting complex systems and represent a step towards self-management of complexity.

  17. Parental resolution and the adolescent's health and adjustment: The case of adolescents with type 1 diabetes.

    PubMed

    Goldberg, Alon; Wiseman, Hadas

    2016-02-01

    This study examines the association between parents' resolution of their adolescent child's diagnosis of type 1 diabetes and the health and mental adjustment of the adolescents themselves. Parents of 75 adolescents with type 1 diabetes were interviewed using the Reaction to Diagnosis Interview. Parents and adolescents completed questionnaires regarding the child's physical health, self-management of the disease, and behavioral and emotional problems. Physicians reported adolescents' HbA1c levels. Results showed that adolescents whose fathers were resolved with the diagnosis exhibited better diabetes self-management and adolescents whose mothers were resolved with the diagnosis exhibited fewer internalizing and externalizing problems. The findings highlight the different role of mothers and fathers in the treatment of adolescents with diabetes and provide a basis for clinical intervention that focuses not only on adolescent health, but also on parental state of mind regarding the resolution with the disease. PMID:26684497

  18. INFLUENCES OF ASTHMA AND HOUSEHOLD ENVIRONMENT ON LUNG FUNCTION OF CHILDREN AND ADOLESCENTS: THE THIRD NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY

    EPA Science Inventory

    We examined influences of asthma and household environment (passive smoking, gas stove use, and having a dog or cat), on seven measures of spirometric lung function in 8-16 yearold subjects, as measured in the Third National Health and Nutrition Examination Survey (NHANES III). ...

  19. Self-management of diabetes in children and young adults using technology and smartphone applications.

    PubMed

    Sheehy, Siobhan; Cohen, Georgia; Owen, Katharine R

    2014-01-01

    Treatment compliance and adherence are often a challenge in patients with type 1 diabetes, particularly for adolescent and young adult patients. With the availability of the internet and smart phone applications (apps) there is a hope that such technology could provide a means to encourage treatment adherence in this group of patients. This review focuses on whether telemedicine and smartphone technology in diabetes can influence self-management in young people with diabetes. A large number of smartphone apps are targeted at people with diabetes, but a limited number of well designed evaluation studies have been performed. As our review shows, the evidence base for efficacy of most of these applications is minimal and improvement in hard outcomes such as HbA1c and complication development is largely lacking. PMID:25311195

  20. Self-Management Procedures: A Comparison across the Autism Spectrum

    ERIC Educational Resources Information Center

    Southall, Candice M.; Gast, David L.

    2011-01-01

    Individuals with autism spectrum disorders (ASD) have difficulty generalizing learned behavior to varied environments with independence. This review of 24 empirical studies compares self-management as a systematic procedure for modifying one's own behavior, to increase target behaviors in students with either autistic disorder (AD) or…

  1. Have Students Self-Manage Their Academic Performance

    ERIC Educational Resources Information Center

    Joseph, Laurice M.; Konrad, Moira

    2009-01-01

    Self-management skills are critical to achieving academic success, yet students with disabilities often fail to execute these skills because they have not learned appropriate strategies. After a thorough review of the professional literature, several conversations with educators, and observations of students, the authors identified many effective…

  2. Self Management Techniques and Disclosure of Sero Status

    ERIC Educational Resources Information Center

    Falaye, Ajibola; Afolayan, Joel Adeleke

    2015-01-01

    This study looked at using Self Management Technique (SMT) to promote self-disclosure of Sero status in Kwara State, Nigeria. A pre-test, post-test and control group quasi experimental design using a 2x2x2 factorial matrix was adopted. Sixty participants were sampled by balloting from two HIV/AIDS screening centres. Four instruments were used such…

  3. Self-Management in Children Labeled Learning Disabled

    ERIC Educational Resources Information Center

    Edwards, Joseph S.

    1976-01-01

    Available from: Psychonomic Society, 1108 W. 34th Street, Austin, Texas 78705. Studied with 10 learning disabled children (5-9 years old) was the development of self-management skills without direct teacher supervision through the use of operant reinforcement procedures. (IM)

  4. Adoption of Self-management Interventions for Prevention and Care

    PubMed Central

    Rotheram-Borus, Mary Jane; Ingram, Barbara L.; Swendeman, Dallas; Lee, Adabel

    2013-01-01

    Seventy-five percent of spiraling healthcare costs can be attributed to chronic diseases, making prevention and management of chronic conditions one of our highest healthcare priorities, especially as we organize for patient-centered medical homes. Collaborative patient self-management in primary care has been repeatedly demonstrated to be efficacious in reducing both symptoms and increasing quality of life, yet there is no consensus on what, how, when, and by whom self-management programs are best implemented. In this article, we argue that self-management interventions effectively span the continuum of prevention and disease management. Self-management interventions rest on a foundation of five core actions: 1) activate motivation to change; 2) apply domain-specific information from education and self-monitoring; 3) develop skills; 4) acquire environmental resources; and 5) build social support. A range of delivery vehicles, including group interventions, primary care providers, and advanced wireless technology, are described and evaluated in terms of diffusion and cost-containment goals. PMID:23148958

  5. Covert Conditioning: Case Studies in Self-Management.

    ERIC Educational Resources Information Center

    Yager, Geoffrey G.

    The self-management of thoughts and mental images was used in a series of empirical case studies to influence behavior changes. The target behaviors in the cases reported were smoking, overeating, fingernail biting, thinking self-depreciative thoughts, and responding assertively. Self-monitoring, covert positive reinforcement, covert…

  6. Use of Medicare's Diabetes Self-Management Training Benefit

    ERIC Educational Resources Information Center

    Strawbridge, Larisa M.; Lloyd, Jennifer T.; Meadow, Ann; Riley, Gerald F.; Howell, Benjamin L.

    2015-01-01

    Medicare began reimbursing for outpatient diabetes self-management training (DSMT) in 2000; however, little is known about program utilization. Individuals diagnosed with diabetes in 2010 were identified from a 20% random selection of the Medicare fee-for-service population (N = 110,064). Medicare administrative and claims files were used to…

  7. String Quartets as Self-Managed Teams: An Interdisciplinary Perspective

    ERIC Educational Resources Information Center

    Gilboa, Avi; Tal-Shmotkin, Malka

    2012-01-01

    This article examines empirically and systematically whether a string quartet (SQ) ensemble is perceived as a self-managed team (SMT). SMTs, which were initially employed in the industrial world, are groups of employees that have a total responsibility for a defined project. The hypothesis that the SQ would exhibit more typical SMT characteristics…

  8. Managing epilepsy well: self-management needs assessment.

    PubMed

    Fraser, Robert T; Johnson, Erica K; Miller, John W; Temkin, Nancy; Barber, Jason; Caylor, Lisa; Ciechanowski, Paul; Chaytor, Naomi

    2011-02-01

    Epilepsy self-management interventions have been investigated with respect to health care needs, medical adherence, depression, anxiety, employment, and sleep problems. Studies have been limited in terms of representative samples and inconsistent or restricted findings. The direct needs assessment of patients with epilepsy as a basis for program design has not been well used as an approach to improving program participation and outcomes. This study investigated the perceived medical and psychosocial problems of adults with epilepsy, as well as their preferences for self-management program design and delivery format. Results indicated a more psychosocially challenged subgroup of individuals with significant depressive and cognitive complaints. A self-management program that involves face-to-face individual or group meetings led by an epilepsy professional and trained peer leader for 60 minutes weekly was preferred. Six to eight sessions focused on diverse education sessions (e.g., managing disability and medical care, socializing on a budget, and leading a healthy lifestyle) and emotional coping strategies delivered on weeknights or Saturday afternoons were most highly endorsed. Emotional self-management and cognitive compensatory strategies require special emphasis given the challenges of a large subgroup. PMID:21273135

  9. Planning Self-Managed Work Groups. Features of Self-Managed Work Groups. Results of Using Self-Managed Work Groups. Issues and Implications in Using Self-Managed Work Groups. Status of Ohio Manufacturing Companies.

    ERIC Educational Resources Information Center

    Smylie, Patrick E.; Jacobs, Ronald L.

    A study was conducted to describe the present status of self-managed work groups in Ohio manufacturing companies. Data for the study were gathered through lengthy interviews and site visits with 45 manufacturing companies in the state, 24 employing 2,000-14,000 workers and 21 employing 300 to 1,900 workers. The results of the study are presented…

  10. Arthritis Self-Management Studies: A Twelve-Year Review.

    ERIC Educational Resources Information Center

    Lorig, Kate; Holman, Halsted

    1993-01-01

    Studies of the Arthritis Self-Management Program conclude that (1) it improves patient behaviors and self-efficacy; (2) formal reinforcement does not improve long-term outcomes; (3) improvement gains have both clinical and cost-saving effects; and (4) changes in health status are more closely linked to self-efficacy than to behavior. (SK)

  11. Partnership as an Intervention Strategy in Self-Managing Schools.

    ERIC Educational Resources Information Center

    Timperley, Helen S.; Robinson, Viviane M. J.

    2003-01-01

    Describes strategy used by New Zealand Ministry of Education to intervene in 26 self-managing schools by developing a partnership with the schools and their communities. Documents difficulties encountered in the first phase (year one) of the intervention and the successes of the second phase (year two). (Contains 1 figure, 3 tables, and 27…

  12. Training Professionals to Engage with and Promote Self-Management

    ERIC Educational Resources Information Center

    Kennedy, Anne; Gask, Linda; Rogers, Anne

    2005-01-01

    We have set out to investigate an approach to improve patients' ability to self-manage chronic illness. For effective health care in chronic disease, we believe patients need to work in partnership with their doctor; patient-centred consultations are one way to achieve this. This report describes our experience of training specialists in…

  13. Diabetes Self-Management Education in the Home

    PubMed Central

    Zeitoun, Joanah; Stern, Marianne; Butkiewicz, Elise; Wegner, Elfie; Reinisch, Courtney

    2016-01-01

    Purpose Diabetes self-management education and home visits have been found to improve clinical outcomes in individuals living with diabetes. The purpose of this pilot project was to evaluate the feasibility and effectiveness of conducting self-management education in patients' homes. Methods Baseline biometric data was collected from a cohort of adult patients with diabetes. Home visits to 19 patients were conducted by doctoral students from Rutgers University School of Nursing. The visits included knowledge assessment, review of foods in the home, diabetes self-management education, and teaching the proper use of monitoring tools such as the glucometer and blood pressure monitor. Biomarkers were obtained post-intervention and were compared to baseline biomarkers. Descriptive lifestyle data was collected and opportunities for customized patient education were provided. Results The biomarkers improved overall during the four months after the education intervention. The mean A1C reduced 12% (p=0.0107), the mean glucose reduced 12% (p=0.0994), the mean BMI reduced 2% (p=0.1490), the systolic pressure reduced 1% (p=0.4196), and the diastolic pressure remained stable. Specific goal setting further increased the improvement in the area the individual planned to address.  Conclusions This project supports prior studies that found that in-home educational programs can improve the self-management of diabetes and lead to improvement in health indicators. The benefits of the study included personal attention in ensuring the correct use of home health monitoring devices, building self-management confidence, and identifying treatment barriers that may not be easily discerned in a clinic setting. PMID:27588231

  14. An Internet Intervention to Improve Asthma Management: Rationale and Protocol of a Randomized Controlled Trial

    PubMed Central

    Lau, Annie YS; Dennis, Sarah; Liaw, Siaw-Teng; Coiera, Enrico

    2013-01-01

    Background Many studies have shown the effectiveness of self-management for patients with asthma. In particular, possession and use of a written asthma action plan provided by a doctor has shown to significantly improve patients’ asthma control. Yet, uptake of a written asthma action plan and preventative asthma management is low in the community, especially amongst adults. Objective A Web-based personally controlled health management system (PCHMS) called Healthy.me will be evaluated in a 2010 CONSORT-compliant 2-group (static websites verse PCHMS) parallel randomized controlled trial (RCT) (allocation ratio 1:1). Methods The PCHMS integrates an untethered personal health record with consumer care pathways and social forums. After eligibility assessment, a sample of 300 adult patients with moderate persistent asthma will be randomly assigned to one of these arms. After 12 months of using either Healthy.me or information websites (usual care arm), a post-study assessment will be conducted. Results The primary outcome measure is possession of or revision of an asthma action plan during the study. Secondary outcome measures include: (1) adherence to the asthma action plan, (2) rate of planned and unplanned visits to healthcare providers for asthma issues, (3) usage patterns of Healthy.me and attrition rates, (4) asthma control and asthma exacerbation scores, and (5) impact of asthma on life and competing demands, and days lost from work. Conclusions This RCT will provide insights into whether access to an online PCHMS will improve uptake of a written asthma action plan and preventative asthma actions. Trial Registration Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12612000716864; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=362714 (Archived by WebCite at http://www.webcitation.org/6IYBJGRnW). PMID:23942523

  15. Imaging of Asthma.

    PubMed

    Richards, John Caleb; Lynch, David; Koelsch, Tilman; Dyer, Debra

    2016-08-01

    Asthma is one of the most common diseases of the lung. Asthma manifests with common, although often subjective and nonspecific, imaging features at radiography and high-resolution computed tomography. The primary role of imaging is not to make a diagnosis of asthma but to identify complications, such as allergic bronchopulmonary aspergillosis, or mimics of asthma, such as hypersensitivity pneumonitis. This article reviews the imaging features of asthma as well as common complications and mimics. PMID:27401624

  16. School Empowerment through Self-Managing Teams: Leader Behavior in Developing Self-Managing Work Groups in Schools.

    ERIC Educational Resources Information Center

    Short, Paula M.

    In searching for avenues to create a collaborative school environment in which autonomous teachers impact the outcomes of schooling and students become independent learners, there is increasing interest in "self-managing work groups." This paper presents findings of a study that examined the role of the principal in the development of…

  17. Exercise and asthma: an overview

    PubMed Central

    Giacco, Stefano R. Del; Firinu, Davide; Bjermer, Leif; Carlsen, Kai-Håkon

    2015-01-01

    The terms ‘exercise-induced asthma’ (EIA) and ‘exercise-induced bronchoconstriction’ (EIB) are often used interchangeably to describe symptoms of asthma such as cough, wheeze, or dyspnoea provoked by vigorous physical activity. In this review, we refer to EIB as the bronchoconstrictive response and to EIA when bronchoconstriction is associated with asthma symptoms. EIB is a common occurrence for most of the asthmatic patients, but it also affects more than 10% of otherwise healthy individuals as shown by epidemiological studies. EIA and EIB have a high prevalence also in elite athletes, especially within endurance type of sports, and an athlete's asthma phenotype has been described. However, the occurrence in elite athletes shows that EIA/EIB, if correctly managed, may not impair physical activity and top sports performance. The pathogenic mechanisms of EIA/EIB classically involve both osmolar and vascular changes in the airways in addition to cooling of the airways with parasympathetic stimulation. Airways inflammation plays a fundamental role in EIA/EIB. Diagnosis and pharmacological management must be carefully performed, with particular consideration of current anti-doping regulations, when caring for athletes. Based on the demonstration that the inhaled asthma drugs do not improve performance in healthy athletes, the doping regulations are presently much less strict than previously. Some sports are at a higher asthma risk than others, probably due to a high environmental exposure while performing the sport, with swimming and chlorine exposure during swimming as one example. It is considered very important for the asthmatic child and adolescent to master EIA/EIB to be able to participate in physical activity on an equal level with their peers, and a precise early diagnosis with optimal treatment follow-up is vital in this aspect. In addition, surprising recent preliminary evidences offer new perspectives for moderate exercise as a potential therapeutic

  18. A Qualitative Exploration of Motivation to Self-Manage and Styles of Self-Management amongst People Living with Type 2 Diabetes.

    PubMed

    Newton, Paul; Asimakopoulou, Koula; Scambler, Sasha

    2015-01-01

    The study examined the motives that people living with type 2 diabetes (T2D) had for self-managing their condition and ways they used to assess the success of their self-management efforts. Using semistructured interviews (N = 25), focus groups (3 × N = 12 participants), and open-ended questionnaires (N = 6), people living with and self-managing T2D were recruited from a community-based T2D participation group. Most participants were older (aged 60+) and lived in a socioeconomically deprived area in the United Kingdom. Data were analysed thematically using framework analysis. Patients' motives for self-management included (i) concern about the anticipative effects of T2D; (ii) wishing to "stay well"; (iii) maintaining independence; (iv) reducing the need for healthcare professionals; and (v) improving quality of life. Six self-management styles were found and pertained to self-managing: (i) through routinisation; (ii) as a burden; (iii) as maintenance; (iv) through delegation; (v) through comanagement; and (vi) through autonomy. Motivators for self-management shaped the criteria people used to judge the success of their self-management practices and influenced their self-management style. The findings show that styles of T2D self-management are mediated and moderated by sociocontextual issues. Healthcare professionals should take these into account when supporting people living with T2D. PMID:26075285

  19. Measuring HIV Self-Management in Women Living with HIV/AIDS: A Psychometric Evaluation Study of the HIV Self-Management Scale

    PubMed Central

    Webel, Allison R.; Asher, Alice; Cuca, Yvette; Okonsky, Jennifer G.; Kaihura, Alphoncina; Rose, Carol Dawson; Hanson, Jan E.; Salata, Robert A.

    2012-01-01

    Objective To develop and validate the HIV Self-Management Scale for women, a new measure of HIV self-management, defined as the day-to-day decisions that individuals make to manage their illness. Methods The development and validation of the scale was undertaken in three phases: focus groups, expert review and psychometric evaluation. Focus groups identified items describing the process and context of self-management in women living with HIV/AIDS (WLHA). Items were refined using expert review and were then administered to WLHA in two sites in the U.S. (n=260). Validity of the scale was assessed through factor analyses, model fit statistics, reliability testing, and convergent and discriminate validity. Results The final scale consists of 3-domains with 20 items describing the construct of HIV self-management. Daily self-management health practices, Social support and HIV self-management, and Chronicity of HIV self-management comprise the three domains. These domains explained 48.6% of the total variance in the scale. The item mean scores ranged from 1.7-2.77, and each domain demonstrated acceptable reliability (0.72-0.86) and stability (0.61-0.85). Conclusions Self-management is critical for WLHA, who constitute over 50% of PLWHA and have poorer health outcomes than their male counterparts. Methods to assess the self-management behavior of WLHA are needed to enhance their health and well-being. Presently no scales exist to measure HIV self-management. Our new 20-item HIV Self-Management Scale is a valid and reliable measure of HIV self-management in this population. Differences in aspects of self-management may be related to social roles and community resources and interventions targeting these factors may decrease morbidity in WLHA. PMID:22569267

  20. [Challenges of adolescents' adherence to therapy].

    PubMed

    Brand, P L P; Kaptein, A A; Janssens, L P F; Klok, T

    2016-01-01

    Non-adherence occurs at any age, in all chronic diseases, and has a major impact on clinical outcomes. Non-adherence is primarily determined by perceptions of illness and medication beliefs. During puberty, adolescents attain independence from their parents and attach to their peers. This complicates successful self-management of chronic illness, because the adolescents avoid standing out from their peers. Discussion of barriers hindering successful self-management in adolescents can be promoted by seeing the patient alone, without the parents being present, and by acknowledging the patient's independence and responsibilities. PMID:27581866

  1. The Saudi Initiative for Asthma - 2016 update: Guidelines for the diagnosis and management of asthma in adults and children

    PubMed Central

    Al-Moamary, Mohamed S.; Alhaider, Sami A.; Idrees, Majdy M.; Al Ghobain, Mohammed O.; Zeitouni, Mohammed O.; Al-Harbi, Adel S.; Yousef, Abdullah A.; Al-Matar, Hussain; Alorainy, Hassan S.; Al-Hajjaj, Mohamed S.

    2016-01-01

    This is an updated guideline for the diagnosis and management of asthma, developed by the Saudi Initiative for Asthma (SINA) group, a subsidiary of the Saudi Thoracic Society. The main objective of SINA is to have guidelines that are up to date, simple to understand and easy to use by nonasthma specialists, including primary care and general practice physicians. SINA approach is mainly based on symptom control and assessment of risk as it is the ultimate goal of treatment. The new SINA guidelines include updates of acute and chronic asthma management, with more emphasis on the use of asthma control in the management of asthma in adults and children, inclusion of a new medication appendix, and keeping consistency on the management at different age groups. The section on asthma in children is rewritten and expanded where the approach is stratified based on the age. The guidelines are constructed based on the available evidence, local literature, and the current situation in Saudi Arabia. There is also an emphasis on patient–doctor partnership in the management that also includes a self-management plan. PMID:26933455

  2. Stay away from asthma triggers

    MedlinePlus

    Asthma triggers - stay away from; Asthma triggers - avoiding; Reactive airway disease - triggers; Bronchial asthma - triggers ... to them. Have someone who does not have asthma cut the grass, or wear a facemask if ...

  3. Wheezing and Asthma in Infants

    MedlinePlus

    ... Things to Know About Zika & Pregnancy Wheezing and Asthma in Infants KidsHealth > For Parents > Wheezing and Asthma ... of asthma.) My Baby Is Wheezing. Is It Asthma? If your baby has a cold and is ...

  4. Psychological Factors in Asthma

    PubMed Central

    2008-01-01

    Asthma has long been considered a condition in which psychological factors have a role. As in many illnesses, psychological variables may affect outcome in asthma via their effects on treatment adherence and symptom reporting. Emerging evidence suggests that the relation between asthma and psychological factors may be more complex than that, however. Central cognitive processes may influence not only the interpretation of asthma symptoms but also the manifestation of measurable changes in immune and physiologic markers of asthma. Furthermore, asthma and major depressive disorder share several risk factors and have similar patterns of dysregulation in key biologic systems, including the neuroendocrine stress response, cytokines, and neuropeptides. Despite the evidence that depression is common in people with asthma and exerts a negative impact on outcome, few treatment studies have examined whether improving symptoms of depression do, in fact, result in better control of asthma symptoms or improved quality of life in patients with asthma. PMID:20525122

  5. Thunderstorm asthma.

    PubMed

    Taylor, Philip E; Jonsson, Haflidi

    2004-09-01

    Thunderstorms have often been linked to epidemics of asthma, especially during the grass flowering season; however, the precise mechanisms explaining this phenomenon are unknown. Evidence of high respirable allergen loadings in the air associated with specific meteorologic events combined with an analysis of pollen physiology suggests that rupture of airborne pollen can occur. Strong downdrafts and dry, cold outflows distinguish thunderstorm rain from frontal rain. The weather system of a mature thunderstorm likely entrains grass pollen into the cloud base, where pollen rupture would be enhanced, then transports the respirable-sized fragments of pollen debris to ground level where outflows distribute them ahead of the rain. The conditions occurring at the onset of a thunderstorm might expose susceptible people to a rapid increase in concentrations of pollen allergens in the air that can readily deposit in the lower airways and initiate asthmatic reactions. PMID:15283882

  6. Is Chronic Asthma Associated with Shorter Leukocyte Telomere Length at Midlife?

    PubMed Central

    Shalev, Idan; Sears, Malcolm R.; Hancox, Robert J.; Lee Harrington, Hona; Houts, Renate; Moffitt, Terrie E.; Sugden, Karen; Williams, Benjamin; Poulton, Richie; Caspi, Avshalom

    2014-01-01

    Rationale: Asthma is prospectively associated with age-related chronic diseases and mortality, suggesting the hypothesis that asthma may relate to a general, multisystem phenotype of accelerated aging. Objectives: To test whether chronic asthma is associated with a proposed biomarker of accelerated aging, leukocyte telomere length. Methods: Asthma was ascertained prospectively in the Dunedin Multidisciplinary Health and Development Study cohort (n = 1,037) at nine in-person assessments spanning ages 9–38 years. Leukocyte telomere length was measured at ages 26 and 38 years. Asthma was classified as life-course-persistent, childhood-onset not meeting criteria for persistence, and adolescent/adult-onset. We tested associations between asthma and leukocyte telomere length using regression models. We tested for confounding of asthma-leukocyte telomere length associations using covariate adjustment. We tested serum C-reactive protein and white blood cell counts as potential mediators of asthma-leukocyte telomere length associations. Measurements and Main Results: Study members with life-course-persistent asthma had shorter leukocyte telomere length as compared with sex- and age-matched peers with no reported asthma. In contrast, leukocyte telomere length in study members with childhood-onset and adolescent/adult-onset asthma was not different from leukocyte telomere length in peers with no reported asthma. Adjustment for life histories of obesity and smoking did not change results. Study members with life-course-persistent asthma had elevated blood eosinophil counts. Blood eosinophil count mediated 29% of the life-course-persistent asthma-leukocyte telomere length association. Conclusions: Life-course-persistent asthma is related to a proposed biomarker of accelerated aging, possibly via systemic eosinophilic inflammation. Life histories of asthma can inform studies of aging. PMID:24956257

  7. Multimodal Self-Management: An Holistic Approach to Teaching Self-Improvement.

    ERIC Educational Resources Information Center

    O'Keefe, Edward J.

    This paper describes an innovative approach to teaching a college course on self-management/self-control. Following a brief background statement on the history and applications of self-management, as well as the deficits of traditional self-management instruction, multimodal therapy (Lazarus, 1976, 1981) is discussed as the conceptual framework…

  8. Web-Based Self-Management in Chronic Care: A Study of Change in Patient Activation

    ERIC Educational Resources Information Center

    Solomon, Michael R.

    2010-01-01

    Web-based self-management interventions (W-SMIs) are designed to help a large number of chronically ill people become more actively engaged in their health care. Despite the potential to engage more patients in self-managing their health, the use of W-SMIs by patients and their clinicians is low. Using a self-management conceptual model based on…

  9. Extending Self-Management Strategies: The Use of a Classwide Approach

    ERIC Educational Resources Information Center

    Hoff, Kathryn E.; Ervin, Ruth A.

    2013-01-01

    Notwithstanding the wealth of research that documents the effectiveness of self-management programs in the classroom, few investigations have explored classwide use of self-management procedures as a universal intervention. To extend existing research in this area, we examined the effectiveness of a classwide self-management intervention for…

  10. 42 CFR 414.63 - Payment for outpatient diabetes self-management training.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for outpatient diabetes self-management... SERVICES Physicians and Other Practitioners § 414.63 Payment for outpatient diabetes self-management..., payment for outpatient diabetes self-management training is made under the physician fee schedule...

  11. 42 CFR 410.141 - Outpatient diabetes self-management training.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Outpatient diabetes self-management training. 410... HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.141 Outpatient diabetes self-management...

  12. 42 CFR 414.63 - Payment for outpatient diabetes self-management training.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Payment for outpatient diabetes self-management... SERVICES Physicians and Other Practitioners § 414.63 Payment for outpatient diabetes self-management..., payment for outpatient diabetes self-management training is made under the physician fee schedule...

  13. 42 CFR 410.141 - Outpatient diabetes self-management training.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Outpatient diabetes self-management training. 410... HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.141 Outpatient diabetes self-management...

  14. Middleware Architecture Evaluation for Dependable Self-managing Systems

    SciTech Connect

    Liu, Yan; Babar, Muhammad A.; Gorton, Ian

    2008-10-10

    Middleware provides infrastructure support for creating dependable software systems. A specific middleware implementation plays a critical role in determining the quality attributes that satisfy a system’s dependability requirements. Evaluating a middleware architecture at an early development stage can help to pinpoint critical architectural challenges and optimize design decisions. In this paper, we present a method and its application to evaluate middleware architectures, driven by emerging architecture patterns for developing self-managing systems. Our approach focuses on two key attributes of dependability, reliability and maintainability by means of fault tolerance and fault prevention. We identify the architectural design patterns necessary to build an adaptive self-managing architecture that is capable of preventing or recovering from failures. These architectural patterns and their impacts on quality attributes create the context for middleware evaluation. Our approach is demonstrated by an example application -- failover control of a financial application on an enterprise service bus.

  15. Self-Management of Heart Disease in Older Adults.

    PubMed

    Huynh-Hohnbaum, Anh-Luu T; Marshall, Lia; Villa, Valentine M; Lee, Gi

    2015-01-01

    The American Heart Association estimates that 81% of people who die of coronary heart disease are 65 years old or older. The leading risk health behaviors include physical inactivity, poor diet, smoking, and binge drinking. Using the 2011-2012 California Health Interview Survey (CHIS), this study looked at how self-management, which includes a plan developed by a medical professional and the confidence to manage one's disease, may decrease negative risk behaviors in older adults. The presence of a plan and increased self-efficacy decreased engagement in negative dietary behaviors and low physical activity. Implications for strategies that address heart disease and self-management are discussed. PMID:26566582

  16. Children's Roles in Parents’ Diabetes Self-Management

    PubMed Central

    Laroche, Helena H.; Davis, Matthew M.; Forman, Jane; Palmisano, Gloria; Reisinger, Heather Schacht; Tannas, Cheryl; Spencer, Michael; Heisler, Michele

    2010-01-01

    Background Family support is important in diabetes self-management. However, children as providers of support have received little attention. This study examines the role of children in their parents’ diabetes self-management, diet, and exercise. Methods This research used community-based participatory research principles. Researchers conducted semi-structured parallel interviews of 24 Latino and African-American adults with diabetes and with a child (age 10–17 years) in their home (2004–06). Interviews were transcribed, coded, and analyzed for themes (2004–07). Results Adults and children perceived that children play many roles related to adults’ diabetes self-management. Parents described children as monitoring parents’ dietary intake and reminding them what they should not be eating. Some children helped with shopping and meal preparation. Families described children reminding parents to exercise and exercising with their parent. Children reminded parents about medications and assisted with tasks such as checking blood sugar. Parents and children perceived that children played a role in tempting parents to stray from their diabetes diet, because children's diets included food that parents desired but tried to avoid. Conclusion Children and parents perceived that children have many roles in both supporting and undermining adults’ diabetes self-management. There is more to learn about the bidirectional relationships between adults and children in this setting and the most beneficial roles children can play. Health-care providers should encourage family lifestyle change, strengthen social support for families and direct children toward roles that are beneficial for both parent and child and do not place an unreasonable level of responsibility on the child. PMID:19896027

  17. Condition Self-Management in Pediatric Spina Bifida: A Longitudinal Investigation of Medical Adherence, Responsibility-Sharing, and Independence Skills

    PubMed Central

    Psihogios, Alexandra M.; Kolbuck, Victoria

    2015-01-01

    Objective This study aimed to evaluate rates of medical adherence, responsibility, and independence skills across late childhood and adolescence in youth with spina bifida (SB) and to explore associations among these disease self-management variables. Method 111 youth with SB, their parents, and a health professional participated at two time points. Informants completed questionnaires regarding medical adherence, responsibility-sharing, and child independence skills. Results Youth gained more responsibility and independence skills across time, although adherence rates did not follow a similar trajectory. Increased child medical responsibility was related to poorer adherence, and father-reported independence skills were associated with increased child responsibility. Conclusions This study highlights medical domains that are the most difficult for families to manage (e.g., skin checks). Although youth appear to gain more autonomy across time, ongoing parental involvement in medical care may be necessary to achieve optimal adherence across adolescence. PMID:26002195

  18. Development and Validation of the Diabetes Adolescent Problem Solving Questionnaire

    PubMed Central

    Mulvaney, Shelagh A.; Jaser, Sarah S.; Rothman, Russell L.; Russell, William; Pittel, Eric J.; Lybarger, Cindy; Wallston, Kenneth A.

    2014-01-01

    Objective Problem solving is a critical diabetes self-management skill. Because of a lack of clinically feasible measures, our aim was to develop and validate a self-report self-management problem solving questionnaire for adolescents with type 1 diabetes (T1D). Methods A multidisciplinary team of diabetes experts generated questionnaire items that addressed diabetes self-management problem solving. Iterative feedback from parents and adolescents resulted in 27 items. Adolescents from two studies (N=156) aged 13–17 were recruited through a pediatric diabetes clinic and completed measures through an online survey. Glycemic control was measured by HbA1c recorded in the medical record. Results Empirical elimination of items using Principal Components Analyses resulted in a 13-item unidimensional measure, the Diabetes Adolescent Problem Solving Questionnaire (DAPSQ) that explained 57% of the variance. The DAPSQ demonstrated internal consistency (Cronbach’s alpha = 0.92) and was correlated with diabetes self-management (r=0.53, p<.001), self-efficacy (r=0.54, p<.001), and glycemic control (r= −0.24, p<.01). Conclusion The DAPSQ is a brief instrument for assessment of diabetes self-management problem solving in youth with T1D associated with better self-management behaviors and glycemic control. Practice Implications The DAPSQ is a clinically feasible self-report measure that can provide valuable information regarding level of self-management problem solving and guide patient education. PMID:25063715

  19. [Self-Management in Patients With Chronic Kidney Disease].

    PubMed

    Chiou, Chou-Ping; Lu, Yung-Chuan; Hung, Shih-Yuan

    2016-04-01

    Chronic kidney disease (CKD) patients typically self-manage their disease-care program. Self-management requires the investment of considerable time and energy in health management and in following the multifaceted CKD treatment regimen. CKD, a progressive disease, is classified into five stages that correspond to the five stages of decline in kidney function, as measured using the glomerular filtration rate (GRF). Each of these stages requires that a patient modify his / her lifestyle and shoulder the responsibility for day-to-day health management tasks. Key to promoting self-management is the partnership and collaboration between healthcare providers and patients. Tasks in this partnership include patient assessment and communication, regimen adherence, emotional management, negotiation of care plans, and the enhancement of self-efficacy, with the aims of creating positive changes in behavior, promoting correct symptoms interpretation and reporting, and promoting the appropriate use of resources. Nurses may help patients maneuver this initially frightening and sometimes difficult terrain with strategies that are tailored to each CKD stage. PMID:27026551

  20. The Impact of Mental Wellness on HIV Self-Management.

    PubMed

    Webel, Allison R; Sattar, Abdus; Schreiner, Nate; Kinley, Bruce; Moore, Shirley M; Salata, Robert A

    2016-01-01

    As people living with HIV age, they face increasing self-management work related to HIV infection plus the prevention and mitigation of multiple chronic health conditions, including daily health practices (i.e., physical activity, nutrition), engaging in a supportive community, and accepting the chronicity of HIV. Our purpose was to describe the relationship between HIV self-management practices and mental wellness (depressive symptoms, perceived stress). Ninety-three adult people living with HIV on antiretroviral therapy were enrolled and completed a survey. We used descriptive statistics to summarize variables, and Spearman rank correlation and quantile regression to study associations between variables. Participants' average age was 48.6 years, 56% were male, and 87% were African American. Daily self-management practices were associated with depressive symptoms (r = -0.19; p ≤ .01) and perceived stress (r = -0.14; p = .06); engaging with a supportive community and accepting the chronicity of HIV were not associated with mental wellness (all p > .05). PMID:27066751

  1. Product self-management: evolution in recycling and reuse.

    PubMed

    Thomas, Valerie M

    2003-12-01

    This paper explores the potential to make product recycling and reuse easier by shifting responsibility for product management toward the product itself. Examples range from barcode-enabled Internet sales of used products to RFID-enabled garbage trucks that identify recyclable items and provide rebates. Initial steps toward product self-management have made opportunistic use of product bar codes and Internet markets. In the United States, Internet markets are driving increased reuse of products. In the European Union, recycling and waste management policy is driving the use of radio electronics in waste management. Prospects for product self-management are assessed from both a technological and an economic perspective. The technological analysis indicates that radio-frequency tags offer some advantages over bar codes, but their application to product self-management requires considerable investment in the waste management infrastructure. This suggests that early applications of advanced product tags are most suitable for Germany and other countries where the waste management industry has already integrated information technology into its operations. The economic analysis indicates that increased reuse of products can reduce consumption of new products and materials, although on a less than one-to-one basis, simultaneously reducing costs for consumers and deriving more value from existing products. PMID:14700313

  2. Smoking cessation strategies for patients with asthma: improving patient outcomes

    PubMed Central

    Perret, Jennifer L; Bonevski, Billie; McDonald, Christine F; Abramson, Michael J

    2016-01-01

    Smoking is common in adults with asthma, yet a paucity of literature exists on smoking cessation strategies specifically targeting this subgroup. Adverse respiratory effects from personal smoking include worse asthma control and a predisposition to lower lung function and chronic obstructive pulmonary disease. Some data suggest that individuals with asthma are more likely than their non-asthmatic peers to smoke regularly at an earlier age. While quit attempts can be more frequent in smokers with asthma, they are also of shorter duration than in non-asthmatics. Considering these asthma-specific characteristics is important in order to individualize smoking cessation strategies. In particular, asthma-specific information such as “lung age” should be provided and longer-term follow-up is advised. Promising emerging strategies include reminders by cellular phone and web-based interventions using consumer health informatics. For adolescents, training older peers to deliver asthma education is another promising strategy. For smokers who are hospitalized for asthma, inpatient nicotine replacement therapy and counseling are a priority. Overall, improving smoking cessation rates in smokers with asthma may rely on a more personalized approach, with the potential for substantial health benefits to individuals and the population at large. PMID:27445499

  3. Lay and health care professional understandings of self-management: A systematic review and narrative synthesis

    PubMed Central

    Wolfe, Charles DA; McKevitt, Christopher

    2014-01-01

    Objectives: Self-management is widely promoted but evidence of effectiveness is limited. Policy encourages health care professionals to support people with long-term conditions to learn self-management skills, yet little is known about the extent to which both parties share a common understanding of self-management. Thus, we compared health care professional and lay understandings of self-management of long-term conditions. Methods: Systematic review and narrative synthesis of qualitative studies identified from relevant electronic databases, hand-searching of references lists, citation tracking and recommendations by experts. Results: In total, 55 studies were included and quality was assessed using a brief quality assessment tool. Three conceptual themes, each with two subthemes were generated: traditional and shifting models of the professional–patient relationship (self-management as a tool to promote compliance; different expectations of responsibility); quality of relationship between health care professional and lay person (self-management as a collaborative partnership; self-management as tailored support) and putting self-management into everyday practice (the lived experience of self-management; self-management as a social practice). Conclusion: Self-management was conceptualised by health care professionals as incorporating both a biomedical model of compliance and individual responsibility. Lay people understood self-management in wider terms, reflecting biomedical, psychological and social domains and different expectations of responsibility. In different ways, both deviated from the dominant model of self-management underpinned by the concept of self-efficacy. Different understandings help to explain how self-management is practised and may help to account for limited evidence of effectiveness of self-management interventions. PMID:26770733

  4. Asthma triggers (image)

    MedlinePlus

    ... asthma triggers are mold, pets, dust, grasses, pollen, cockroaches, odors from chemicals, and smoke from cigarettes. ... asthma triggers are mold, pets, dust, grasses, pollen, cockroaches, odors from chemicals, and smoke from cigarettes.

  5. Allergies, asthma, and dust

    MedlinePlus

    Allergic rhinitis - dust ... make allergies or asthma worse are called triggers. Dust is a common trigger. When your asthma or allergies become worse due to dust, you are said to have a dust allergy. ...

  6. Test Your Asthma Knowledge

    MedlinePlus

    ... Current Issue Past Issues Special Section Test Your Asthma Knowledge Past Issues / Fall 2007 Table of Contents ... page please turn Javascript on. True or False? Asthma is caused by an inflammation of the inner ...

  7. Do Allergies Cause Asthma?

    MedlinePlus

    ... Size en español ¿Causan asma las alergias? My daughter has asthma and I'm worried that her ... a person who already has asthma, like your daughter, can have symptoms worsen if she's exposed to ...

  8. ASTHMA RESEARCH STRATEGY

    EPA Science Inventory

    In individuals susceptible to asthma, common aeroallergens can cause airway inflammation marked by episodes of wheezing, breathlessness, mucus secretion, chest tightness, and cough. While there is a definite genetic component to asthma, triggers include house dust mites, animal ...

  9. Managing Allergies, Asthma 101

    MedlinePlus

    ... gov/medlineplus/news/fullstory_158635.html Managing Allergies, Asthma 101 Doctor offers advice to students who will ... 3, 2016 (HealthDay News) -- Teens with allergies or asthma who are heading for college later this year ...

  10. Asthma triggers (image)

    MedlinePlus

    ... common asthma triggers are mold, pets, dust, grasses, pollen, cockroaches, odors from chemicals, and smoke from cigarettes. ... common asthma triggers are mold, pets, dust, grasses, pollen, cockroaches, odors from chemicals, and smoke from cigarettes.

  11. Allergies, asthma, and molds

    MedlinePlus

    Allergic rhinitis - mold ... make allergies or asthma worse are called triggers. Mold is a common trigger. When your asthma or allergies become worse due to mold, you are said to have a mold allergy. ...

  12. Paediatric asthma and obesity.

    PubMed

    Lucas, Sean R; Platts-Mills, Thomas A E

    2006-12-01

    None of the explanations proposed for the increase in paediatric asthma have been adequate. It is becoming apparent that the cause of the increase in asthma must be multi-factorial. Increasing attention has been focused on the role of lifestyle in the development of asthma. Lifestyle changes that have occurred in children are those in diet and decreased physical activity, with obesity being the product of these changes. The increase in asthma, obesity and a sedentary lifestyle have occurred together. However, a temporal relationship between asthma, obesity and decreased physical activity has not been determined in the paediatric literature. Limited data suggest that decreased physical activity could be playing a role in the aetiology of asthma independent of obesity. Furthermore, there has been substantial research on the benefits of exercise programmes for paediatric patients with asthma. Longitudinal trials monitoring physical activity, obesity and the development of asthma are needed. PMID:17098637

  13. Smoking and asthma

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000504.htm Smoking and asthma To use the sharing features on this page, ... enable JavaScript. Things that make your allergies or asthma worse are called triggers. Smoking is a trigger ...

  14. Asthma and Pregnancy

    MedlinePlus

    ... best live chat Live Help Fact Sheets Share Asthma and Pregnancy Saturday, 01 August 2015 In every ... her background risk. This sheet talks about whether asthma may increase the risk for birth defects over ...

  15. Managing Allergies, Asthma 101

    MedlinePlus

    ... of the American College of Allergy, Asthma and Immunology Public Relations Committee. "In addition to moving to ... in the journal Annals of Allergy, Asthma and Immunology . The first step, he said, is to meet ...

  16. Asthma - child - discharge

    MedlinePlus

    ... asthma symptoms worse. Know which triggers make your child's asthma worse and what to do when this happens. Common triggers include: Pets Smells from chemicals and cleaners Grass and weeds Smoke Dust Cockroaches Rooms that are moldy or damp Know ...

  17. Self-Management Support Interventions for Persons With Chronic Disease

    PubMed Central

    Franek, J

    2013-01-01

    Background Self-management support interventions such as the Stanford Chronic Disease Self-Management Program (CDSMP) are becoming more widespread in attempt to help individuals better self-manage chronic disease. Objective To systematically assess the clinical effectiveness of self-management support interventions for persons with chronic diseases. Data Sources A literature search was performed on January 15, 2012, using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database for studies published between January 1, 2000, and January 15, 2012. A January 1, 2000, start date was used because the concept of non-disease-specific/general chronic disease self-management was first published only in 1999. Reference lists were examined for any additional relevant studies not identified through the search. Review Methods Randomized controlled trials (RCTs) comparing self-management support interventions for general chronic disease against usual care were included for analysis. Results of RCTs were pooled using a random-effects model with standardized mean difference as the summary statistic. Results Ten primary RCTs met the inclusion criteria (n = 6,074). Nine of these evaluated the Stanford CDSMP across various populations; results, therefore, focus on the CDSMP. Health status outcomes: There was a small, statistically significant improvement in favour of CDSMP across most health status measures, including pain, disability, fatigue, depression, health distress, and self-rated health (GRADE quality low). There was no significant difference between modalities for dyspnea (GRADE quality very low). There was significant improvement in health-related quality of life according to the EuroQol 5-D in favour of CDSMP, but inconsistent findings across other quality-of-life measures. Healthy behaviour

  18. Childhood obesity and risk of allergy or asthma.

    PubMed

    Raj, Dinesh; Kabra, Sushil K; Lodha, Rakesh

    2014-11-01

    The simultaneous increment in the prevalence of obesity and allergic diseases suggests a possible link between them. This review focuses on the consequences of obesity on allergic diseases, especially asthma in children and adolescents, and evaluates the available evidence on the possible mechanisms. Obesity is related more strongly to nonatopic than atopic asthma, suggesting non-eosinophilic inflammation and Th1 polarization. Among other allergic diseases, the association is more consistent with eczema compared to allergic rhinitis/rhinoconjunctivitis. The mechanisms of asthma in obese individuals could involve mechanical effects of obesity on lung function, adipokines-mediated inflammation, shared factors (diet, genetics, sedentary lifestyle) and comorbidities. PMID:25282288

  19. Self-management in patients with COPD: theoretical context, content, outcomes, and integration into clinical care

    PubMed Central

    Kaptein, Ad A; Fischer, Maarten J; Scharloo, Margreet

    2014-01-01

    In this narrative review, we put self-management in the context of a 50-year history of research about how patients with COPD respond to their illness. We review a definition of self-management, and emphasize that self-management should be combined with disease management and the chronic care model in order to be effective. Reviewing the empirical status of self-management in COPD, we conclude that self-management is part and parcel of modern, patient-oriented biopsychosocial care. In pulmonary rehabilitation programs, self-management is instrumental in improving patients’ functional status and quality of life. We conclude by emphasizing how studying the way persons with COPD make sense of their illness helps in refining self-management, and thereby patient-reported outcomes in COPD. PMID:25214777

  20. Primary prevention of asthma.

    PubMed

    Becker, Allan B; Chan-Yeung, Moira

    2002-01-01

    There has been a dramatic increase in the prevalence of asthma over the last quarter century, particularly in the industrialized world. Although our understanding of asthma continues to improve, there is no cure for the disease. Primary prevention of asthma is the focus of this review. Asthma is a disease with multiple gene-environment interactions. Candidate genes for asthma are considered, and potential interaction between one of those genes, CD14, and an environmental factor, endotoxin, is reviewed as it relates to the hygiene hypothesis. Environmental risk factors for asthma including allergens, pollutants, infectious factors, and dietary modifications are considered, particularly their potential for primary prevention of asthma. Ongoing cohort studies including the Canadian Allergy and Asthma Prevention Study, the Manchester Allergy and Asthma Study, the Children's Asthma Prevention Study from Australia, and the Prevention and Incidence of Asthma and Mite Allergy Study from the Netherlands are briefly reviewed. A more definitive understanding of genetic background and environmental triggers and their interactions is required before any specific approach to the primary prevention of asthma can be championed aggressively. PMID:11753119

  1. How Is Asthma Diagnosed?

    MedlinePlus

    ... Month with a Google+ Hangout on Air for parents and caregivers to learn how to help control a child's asthma so that they can breathe ... parents build up their asthma team. Jose, his parents, a doctor and a nurse, ... forces to help Jose control his asthma. The video is recorded in Spanish ...

  2. Do Allergies Cause Asthma?

    MedlinePlus

    ... Help a Friend Who Cuts? Do Allergies Cause Asthma? KidsHealth > For Teens > Do Allergies Cause Asthma? Print A A A Text Size en español ¿Las alergias provocan asma? Do allergies cause asthma? The answer to that question is: yes and ...

  3. Strategies for Improving Self-Managing Behavior Skills among Second Grade Students: The Self-Management and Responsibility Training (SMART) Program.

    ERIC Educational Resources Information Center

    Flynn, Gina M.

    This practicum report describes a program in which strategies for improving self-managing behavior skills of second graders were designed and implemented. The goals of the Self-Management and Responsibility Training (SMART) Program were to improve students' behavior and encourage development of students' critical thinking skills. The four basic…

  4. Efficacy, safety and tolerability of GSK2190915, a 5-lipoxygenase activating protein inhibitor, in adults and adolescents with persistent asthma: a randomised dose-ranging study

    PubMed Central

    2013-01-01

    Background GSK2190915 is a high affinity 5-lipoxygenase-activating protein inhibitor being developed for the treatment of asthma. The objective of this study was to evaluate GSK2190915 efficacy, dose–response and safety in subjects with persistent asthma treated with short-acting beta2-agonists (SABAs) only. Methods Eight-week multicentre, randomised, double-blind, double-dummy, stratified (by age and smoking status), parallel-group, placebo-controlled study in subjects aged ≥12 years with a forced expiratory volume in 1 second (FEV1) of 50–85% predicted. Subjects (n = 700) were randomised to receive once-daily (QD) oral GSK2190915 (10–300 mg), twice-daily inhaled fluticasone propionate 100 μg, oral montelukast 10 mg QD or placebo. The primary endpoint was mean change from baseline (randomisation) in trough (morning pre-dose and pre-rescue bronchodilator) FEV1 at the end of the 8-week treatment period. Secondary endpoints included morning and evening peak expiratory flow, symptom-free days and nights, rescue-free days and nights, day and night-time symptom scores, day and night-time rescue medication use, withdrawals due to lack of efficacy, Asthma Control Questionnaire and Asthma Quality of Life Questionnaire scores. Results For the primary endpoint, there was no statistically significant difference between any dose of GSK2190915 QD and placebo. However, repeated measures sensitivity analysis demonstrated nominal statistical significance for GSK2190915 30 mg QD compared with placebo (mean difference: 0.115 L [95% confidence interval: 0.00, 0.23], p = 0.044); no nominally statistically significant differences were observed with any of the other doses. For the secondary endpoints, decreases were observed in day-time symptom scores and day-time SABA use for GSK2190915 30 mg QD versus placebo (p ≤ 0.05). No dose–response relationship was observed for the primary and secondary endpoints across the GSK2190915 dose range studied; the 10

  5. Domestic experiments: familial regimes of coping with childhood asthma in New Zealand.

    PubMed

    Trnka, Susanna

    2014-01-01

    In this article, I examine the self-positioning of many New Zealand mothers of children with asthma as parent-experts whose authority supersedes that of implementing the self-management strategies advocated by medical professionals. In a socio-political context that emphasizes neoliberal values of autonomy and self-responsibility, these parent-experts experiment with a variety of pharmaceutical regimes, determining familial modes of care that privilege the achievement of what they consider to be 'normal childhoods.' While some families accept asthma as a chronic condition and encourage children to adopt standardized, daily preventative regimes, others craft alternative strategies of pharmaceutical use that allow them to experientially maintain asthma as a sporadic and temporary, if frequent and sometimes dramatic, interruption of everyday life. Childhood asthma care practices are thus not only vested in kinship networks, but often arise out of familial-based experiments whose goal is to determine regimes that enable the preservation of 'normality.' PMID:24635761

  6. [Obesity and asthma].

    PubMed

    Vázquez García, Juan Carlos

    2002-01-01

    Obesity and asthma are two disorders of high and increasing worldwide prevalence. A consistent association between obesity and asthma has been recently found in case-control, cross-sectional and longitudinal studies. This association is more consistent in women after the puberty. Moreover, an improvement in the severity of asthma has been described after weight reduction in obese patients. A causal association between asthma and obesity may represent an additional respiratory work that could increase the morbidity and medical expenditures. The most striking studies which demonstrate association between obesity and asthma and the possible causal mechanisms are reviewed. PMID:12587420

  7. Asthma: beyond corticosteroid treatment

    PubMed Central

    Marandi, Yasser; Farahi, Neda

    2013-01-01

    Asthma is one of the most common chronic diseases in the world, affecting over 300 million people. It is an inflammatory disorder characterized by bronchoconstriction and airway hyperresponsiveness, followed by inflammatory manifestations in the respiratory system. The prevalence of asthma is rising and there is a clinical need to develop more effective treatments. While corticosteroids (glucocorticosteroids) remain the mainstay of asthma therapy, they have limitations because of their potentially severe side-effects and the presence of corticosteroid resistance in some patients. This review discusses current strategies in the treatment of asthma and considers new therapeutic regimens of asthma in the drug development pipeline. PMID:23847676

  8. Mepolizumab: A Review in Eosinophilic Asthma.

    PubMed

    Deeks, Emma D

    2016-08-01

    Mepolizumab (Nucala(®)) is a humanized monoclonal antibody against interleukin-5, a cytokine involved in the development, recruitment and activation of eosinophils (cellular mediators of airway inflammation, hyper-responsiveness and tissue remodelling). The drug is indicated as an add-on treatment for severe eosinophilic asthma, on the basis of its clinical benefit in this setting in the placebo-controlled DREAM, MENSA and SIRIUS trials. Based on the 52-week, phase II, DREAM study (which assessed varying intravenous mepolizumab dosages), intravenous mepolizumab 75 mg every 4 weeks (q4w) and the corresponding (recommended) subcutaneous dosage of 100 mg q4w were studied in the 32- and 24-week phase III MENSA and SIRIUS trials. In patients aged ≥12 years with severe eosinophilic asthma in the phase III studies, adding subcutaneous mepolizumab 100 mg q4w to current asthma therapy significantly reduced the rate of clinically relevant asthma exacerbations and, in those dependent on oral glucocorticoids (OCSs) for asthma control, enabled the daily OCS dose to be significantly reduced, relative to adding placebo. This mepolizumab regimen also significantly improved asthma control, health-related quality of life and (in one of the two studies) lung function, and had acceptable tolerability (with headache the most common adverse event). In the MENSA and SIRIUS extension, COSMOS, mepolizumab provided durable clinical benefit over up to 84 weeks' therapy with no new tolerability concerns. Thus, mepolizumab is a valuable add-on treatment option for adults and adolescents aged ≥12 years who have severe eosinophilic asthma despite optimized standard therapies. PMID:27311938

  9. Obesity and asthma.

    PubMed

    Gibson, Peter G

    2013-12-01

    There is a global epidemic of asthma and obesity that is concentrated in Westernized and developed countries. A causal association in some people with asthma is suggested by observations that obesity precedes the onset of asthma and that bariatric surgery for morbid obesity can resolve asthma. The obese asthma phenotype features poor asthma control, limited response to corticosteroids, and an exaggeration of the physiological effects of obesity on lung function, which includes a reduction in expiratory reserve volume and airway closure occurring during tidal breathing. Obesity has important implications for asthma treatment. Increasing corticosteroid doses based on poor asthma control, as currently recommended in guidelines, may lead to overtreatment with corticosteroids in obese asthma. Enhanced bronchodilation, particularly of the small airways, may reduce the component of airway closure due to increased bronchomotor tone and suggests that greater emphasis should be placed on long-acting bronchodilators in obese asthma. The societal implications of this are important: with increasing obesity there will be increasing asthma from obesity, and the need to identify successful individual and societal weight-control strategies becomes a key goal. PMID:24313764

  10. Asthma and pregnancy.

    PubMed

    Vatti, Rani Reddy; Teuber, Suzanne S

    2012-08-01

    Asthma is probably the most common serious medical disorder that may complicate pregnancy. A third of pregnant women with asthma will experience worsening of their symptoms, a third will see improvement of their symptoms and a third will see no change. The primary goal is to maintain optimal control of asthma for maternal health and well-being as well as fetal maturation. Vital patient education should cover the use of controller medication, avoidance of asthma triggers and early treatment of asthma exacerbations. Proper asthma management should ideally be started in the preconception period. Since smoking is probably the most modifiable risk factor of asthma, pregnant woman should avoid active and passive smoking. Acute asthma exacerbation during the first trimester is associated with an increased risk of congenital malformations. Poorly controlled asthma is associated with low birth weight, preeclampsia, and preterm birth. Medications used for asthma control in the non-pregnant population are generally the same in pregnancy with a few exceptions. Inhaled corticosteroids (ICS) are the preferred controller therapy. Budesonide is the preferred ICS. Long-acting B-agonists (LABA) are the preferred add-on therapy to medium to high dose ICS. Major triggers for asthma exacerbations during pregnancy are viral infections and ICS nonadherence. PMID:21858482

  11. Mechanisms of occupational asthma.

    PubMed

    Maestrelli, Piero; Boschetto, Piera; Fabbri, Leonardo M; Mapp, Cristina E

    2009-03-01

    Inhalation of agents in the workplace can induce asthma in a relatively small proportion of exposed workers. Like nonoccupational asthma, occupational asthma is probably the result of multiple genetic, environmental, and behavioral influences. It is important that occupational asthma be recognized clinically because it has serious medical and socioeconomic consequences. Environmental factors that can affect the initiation of occupational asthma include the intrinsic characteristics of causative agents as well as the influence of the level and route of exposure at the workplace. The identification of host factors, polymorphisms, and candidate genes associated with occupational asthma may improve our understanding of mechanisms involved in asthma. High-molecular-weight compounds from biological sources and low-molecular-weight chemicals cause occupational asthma after a latent period of exposure. Although the clinical, functional, and pathologic features of occupational asthma caused by low-molecular-weight agents resemble those of allergic asthma, the failure to detect specific IgE antibodies against most low-molecular-weight agents has resulted in a search for alternative or complementary physiopathologic mechanisms leading to airway sensitization. Recent advances have been made in the characterization of the immune response to low-molecular-weight agents. In contrast, the mechanism of the type of occupational asthma that occurs without latency after high-level exposure to irritants remains undetermined. PMID:19281901

  12. Serious Asthma Events with Budesonide plus Formoterol vs. Budesonide Alone.

    PubMed

    Peters, Stephen P; Bleecker, Eugene R; Canonica, Giorgio W; Park, Yong B; Ramirez, Ricardo; Hollis, Sally; Fjallbrant, Harald; Jorup, Carin; Martin, Ubaldo J

    2016-09-01

    Background Concerns remain about the safety of adding long-acting β2-agonists to inhaled glucocorticoids for the treatment of asthma. In a postmarketing safety study mandated by the Food and Drug Administration, we evaluated whether the addition of formoterol to budesonide maintenance therapy increased the risk of serious asthma-related events in patients with asthma. Methods In this multicenter, double-blind, 26-week study, we randomly assigned patients, 12 years of age or older, who had persistent asthma, were receiving daily asthma medication, and had had one to four asthma exacerbations in the previous year to receive budesonide-formoterol or budesonide alone. Patients with a history of life-threatening asthma were excluded. The primary end point was the first serious asthma-related event (a composite of adjudicated death, intubation, and hospitalization), as assessed in a time-to-event analysis. The noninferiority of budesonide-formoterol to budesonide was defined as an upper limit of the 95% confidence interval for the risk of the primary safety end point of less than 2.0. The primary efficacy end point was the first asthma exacerbation, as assessed in a time-to-event analysis. Results A total of 11,693 patients underwent randomization, of whom 5846 were assigned to receive budesonide-formoterol and 5847 to receive budesonide. A serious asthma-related event occurred in 43 patients who were receiving budesonide-formoterol and in 40 patients who were receiving budesonide (hazard ratio, 1.07; 95% confidence interval [CI], 0.70 to 1.65]); budesonide-formoterol was shown to be noninferior to budesonide alone. There were two asthma-related deaths, both in the budesonide-formoterol group; one of these patients had undergone an asthma-related intubation. The risk of an asthma exacerbation was 16.5% lower with budesonide-formoterol than with budesonide (hazard ratio, 0.84; 95% CI, 0.74 to 0.94; P=0.002). Conclusions Among adolescents and adults with predominantly

  13. [Influence of tobacco smoking on the risk of developing asthma].

    PubMed

    Underner, M; Perriot, J; Peiffer, G; Meurice, J-C

    2015-02-01

    The aim of this general review is to investigate the influence of active and passive smoking on the development of asthma in children and adults. Passive smoking during and after pregnancy facilitates the onset of childhood asthma and wheezing. In particular, smoking during pregnancy is associated with the occurrence of wheezing prior to the age of 4 years. In contrast, the results of studies on the relationship between parental smoking in the post-natal period and the onset of asthma or wheezing are discordant. Exposure to passive smoking during childhood facilitates the occurrence of asthma in adulthood. In adults and adolescents, active smoking appears to be a factor favoring the development of asthma. On the other hand, non-smoking adult subjects without history of asthma exposed to passive smoking have a risk of asthma. The pathophysiological mechanisms by which tobacco smoke is the cause of asthma are still poorly known. Smoking cessation is an essential component in the management of asthmatic subjects who smoke, facilitating the control of the disease. PMID:25765119

  14. PHYSICIAN-PHARMACIST COLLABORATIVE MANAGEMENT OF ASTHMA IN PRIMARY CARE

    PubMed Central

    Gums, Tyler H.; Carter, Barry L.; Milavetz, Gary; Buys, Lucinda; Rosenkrans, Kurt; Uribe, Liz; Coffey, Christopher; MacLaughlin, Eric J.; Young, Rodney B.; Ables, Adrienne Z.; Patel-Shori, Nima; Wisniewski, Angela

    2014-01-01

    Objective To determine if asthma control improves in patients who receive physician-pharmacist collaborative management (PPCM) during visits to primary care medical offices. Design Prospective pre-post study of patients who received the intervention in primary care offices for 9 months. The primary outcome was the sum of asthma-related emergency department (ED) visits and hospitalizations at 9 months before, 9 months during, and 9 months following the intervention. Events were analyzed using linear mixed effects regression. Secondary analysis was conducted for patients with uncontrolled asthma (Asthma Control Test [ACT]<20). Additional secondary outcomes included the ACT, the Asthma Quality of Life Questionnaire by Marks (AQLQ-M) scores, and medication changes. Intervention Pharmacists provided patients with an asthma self-management plan and education and made pharmacotherapy recommendations to physicians when appropriate. Results Of 126 patients, the number of emergency department (ED) visits and/or hospitalizations decreased 30% during the intervention (p=0.052) and then returned to pre-enrollment levels after the intervention was discontinued (p=0.83). Secondary analysis of patients with uncontrolled asthma at baseline (ACT<20), showed 37 ED visits and hospitalizations prior to the intervention, 21 during the intervention, and 33 after the intervention was discontinued (p=0.019). ACT and AQLQ-M scores improved during the intervention (ACT mean absolute increase of 2.11, AQLQ-M mean absolute decrease of 4.86, p<0.0001 respectively) and sustained a stable effect after discontinuation of the intervention. Inhaled corticosteroid use increased during the intervention (p=0.024). Conclusions The PPCM care model reduced asthma-related ED visits and hospitalizations and improved asthma control and quality of life. However, the primary outcome was not statistically significant for all patients. There was a significant reduction in ED visits and hospitalizations during

  15. Feasibility of Adapting Multisystemic Therapy to Improve Illness Management Behaviors and Reduce Asthma Morbidity in High Risk African American Youth: A Case Series

    ERIC Educational Resources Information Center

    Naar-King, Sylvie; Ellis, Deborah; Kolmodin, Karen; Cunningham, Phillippe; Secord, Elizabeth

    2009-01-01

    African-American adolescents have the highest rates of asthma morbidity and mortality, yet there are few successful behavioral interventions to improve illness management for this group. Mental health providers have an opportunity to expand their services and impact by targeting adolescents with poor asthma management. We describe the adaptation…

  16. Improving hypertension self-management with community health coaches.

    PubMed

    Dye, Cheryl J; Williams, Joel E; Evatt, Janet Hoffman

    2015-03-01

    Approximately two thirds of those older than 60 years have a hypertension diagnosis. The aim of our program, Health Coaches for Hypertension Control, is to improve hypertension self-management among rural residents older than 60 years through education and support offered by trained community volunteers called Health Coaches. Participants received baseline and follow-up health risk appraisals with blood work, educational materials, and items such as blood pressure monitors and pedometers. Data were collected at baseline, 8 weeks, and 16 weeks on 146 participants who demonstrated statistically significant increases in hypertension-related knowledge from baseline to 8 weeks that persisted at 16 weeks, as well as significant improvements in stage of readiness to change behaviors and in actual behaviors. Furthermore, clinically significant decreases in all outcome measures were observed, with statistically significant changes in systolic blood pressure (-5.781 mmHg; p = .001), weight (-2.475 lb; p < .001), and glucose (-5.096 mg/dl; p = .004) after adjusting for multiple comparisons. Although 40.4% of participants met the Healthy People 2020 definition of controlled hypertension at baseline, the proportion of participants meeting this definition at 16 weeks postintervention increased to 51.0%. This article describes a university-community-hospital system model that effectively promotes hypertension self-management in a rural Appalachian community. PMID:24837989

  17. Monitoring asthma in children.

    PubMed

    Pijnenburg, Mariëlle W; Baraldi, Eugenio; Brand, Paul L P; Carlsen, Kai-Håkon; Eber, Ernst; Frischer, Thomas; Hedlin, Gunilla; Kulkarni, Neeta; Lex, Christiane; Mäkelä, Mika J; Mantzouranis, Eva; Moeller, Alexander; Pavord, Ian; Piacentini, Giorgio; Price, David; Rottier, Bart L; Saglani, Sejal; Sly, Peter D; Szefler, Stanley J; Tonia, Thomy; Turner, Steve; Wooler, Edwina; Lødrup Carlsen, Karin C

    2015-04-01

    The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. To reach this goal in children with asthma, ongoing monitoring is essential. While all components of asthma, such as symptoms, lung function, bronchial hyperresponsiveness and inflammation, may exist in various combinations in different individuals, to date there is limited evidence on how to integrate these for optimal monitoring of children with asthma. The aims of this ERS Task Force were to describe the current practise and give an overview of the best available evidence on how to monitor children with asthma. 22 clinical and research experts reviewed the literature. A modified Delphi method and four Task Force meetings were used to reach a consensus. This statement summarises the literature on monitoring children with asthma. Available tools for monitoring children with asthma, such as clinical tools, lung function, bronchial responsiveness and inflammatory markers, are described as are the ways in which they may be used in children with asthma. Management-related issues, comorbidities and environmental factors are summarised. Despite considerable interest in monitoring asthma in children, for many aspects of monitoring asthma in children there is a substantial lack of evidence. PMID:25745042

  18. Asthma Research: The NIH–NJRC Connection

    MedlinePlus

    ... could help physicians decide definitively whether to prescribe antibiotics for asthma patients. ( See accompanying story. ) In pediatric asthma, doctors are studying and treating the progression of asthma, infant wheezing that leads to asthma, and severe asthma. ...

  19. Predicting Asthma in Preschool Children with Asthma-Like Symptoms

    MedlinePlus

    American Academy of Allergy Asthma & Immunology Menu Search Main navigation Skip to content Conditions & Treatments Allergies Asthma Primary Immunodeficiency Disease Related Conditions Drug Guide Conditions Dictionary Just ...

  20. Genetics Home Reference: allergic asthma

    MedlinePlus

    ... Understand Genetics Home Health Conditions allergic asthma allergic asthma Enable Javascript to view the expand/collapse boxes. Download PDF Open All Close All Description Asthma is a breathing disorder characterized by inflammation of ...

  1. Monitoring asthma in childhood.

    PubMed

    Lødrup Carlsen, Karin C; Pijnenburg, Mariëlle W

    2015-06-01

    The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. However, to date there is limited evidence on how to monitor patients with asthma. Childhood asthma introduces specific challenges in terms of deciding what, when, how often, by whom and in whom different assessments of asthma should be performed. The age of the child, the fluctuating course of asthma severity, variability in clinical presentation, exacerbations, comorbidities, socioeconomic and psychosocial factors, and environmental exposures may all influence disease activity and, hence, monitoring strategies. These factors will be addressed in herein. We identified large knowledge gaps in the effects of different monitoring strategies in children with asthma. Studies into monitoring strategies are urgently needed, preferably in collaborative paediatric studies across countries and healthcare systems. PMID:26028630

  2. Asthma in Latin America.

    PubMed

    Forno, Erick; Gogna, Mudita; Cepeda, Alfonso; Yañez, Anahi; Solé, Dirceu; Cooper, Philip; Avila, Lydiana; Soto-Quiros, Manuel; Castro-Rodriguez, Jose A; Celedón, Juan C

    2015-09-01

    Consistent with the diversity of Latin America, there is profound variability in asthma burden among and within countries in this region. Regional variation in asthma prevalence is likely multifactorial and due to genetics, perinatal exposures, diet, obesity, tobacco use, indoor and outdoor pollutants, psychosocial stress and microbial or parasitic infections. Similarly, non-uniform progress in asthma management leads to regional variability in disease morbidity. Future studies of distinct asthma phenotypes should follow-up well-characterised Latin American subgroups and examine risk factors that are unique or common in Latin America (eg, stress and violence, parasitic infections and use of biomass fuels for cooking). Because most Latin American countries share the same barriers to asthma management, concerted and multifaceted public health and research efforts are needed, including approaches to curtail tobacco use, campaigns to improve asthma treatment, broadening access to care and clinical trials of non-pharmacological interventions (eg, replacing biomass fuels with gas or electric stoves). PMID:26103996

  3. Asthma in Latin America

    PubMed Central

    Forno, Erick; Gogna, Mudita; Cepeda, Alfonso; Yañez, Anahi; Solé, Dirceu; Cooper, Philip; Avila, Lydiana; Soto-Quiros, Manuel; Castro-Rodriguez, Jose A.; Celedón, Juan C.

    2015-01-01

    Consistent with the diversity of Latin America, there is profound variability in asthma burden among and within countries in this region. Regional variation in asthma prevalence is likely multifactorial and due to genetics, perinatal exposures, diet, obesity, tobacco use, indoor and outdoor pollutants, psychosocial stress, and microbial or parasitic infections. Similarly, nonuniform progress in asthma management leads to regional variability in disease morbidity. Future studies of distinct asthma phenotypes should follow up well-characterized Latin American subgroups and examine risk factors that are unique or common in Latin America (e.g. stress and violence, parasitic infections and use of biomass fuels for cooking). Because most Latin American countries share the same barriers to asthma management, concerted and multifaceted public health and research efforts are needed, including approaches to curtail tobacco use, campaigns to improve asthma treatment, broadening access to care and clinical trials of non-pharmacologic interventions (e.g. replacing biomass fuels with gas or electric stoves). PMID:26103996

  4. Occupational asthma in Japan.

    PubMed

    Dobashi, Kunio

    2012-07-01

    Research into occupational asthma (OA) in Japan has been led by the Japanese Society of Occupational and Environmental Allergy. The first report about allergic OA identified konjac asthma. After that, many kinds of OA have been reported. Cases of some types of OA, such as konjac asthma and sea squirt asthma, have been dramatically reduced by the efforts of medical personnel. Recently, with the development of new technologies, chemical antigen-induced asthma has increased in Japan. Due to advances in anti-asthma medication, control by medical treatment tends to be emphasized and the search for causative antigens seems to be neglected. Furthermore, we do not have a Japanese guideline for diagnosis and management of OA. This article discusses the current state of OA in Japan. PMID:22872819

  5. Psychological aspects of asthma.

    PubMed

    Lehrer, Paul; Feldman, Jonathan; Giardino, Nicholas; Song, Hye-Sue; Schmaling, Karen

    2002-06-01

    Asthma can be affected by stress, anxiety, sadness, and suggestion, as well as by environmental irritants or allergens, exercise, and infection. It also is associated with an elevated prevalence of anxiety and depressive disorders. Asthma and these psychological states and traits may mutually potentiate each other through direct psychophysiological mediation, nonadherence to medical regimen, exposure to asthma triggers, and inaccuracy of asthma symptom perception. Defensiveness is associated with inaccurate perception of airway resistance and stress-related bronchoconstriction. Asthma education programs that teach about the nature of the disease, medications, and trigger avoidance tend to reduce asthma morbidity. Other promising psychological interventions as adjuncts to medical treatment include training in symptom perception, stress management, hypnosis, yoga, and several biofeedback procedures. PMID:12090377

  6. Self-Management in Daily Life with Psoriasis: An Integrative Review of Patient Needs for Structured Education

    PubMed Central

    Rasmussen, Gitte Susanne; Maindal, Helle Terkildsen; Lomborg, Kirsten

    2012-01-01

    The aim of this integrative review is to identify and discuss patient needs for education to support self-management in daily life with psoriasis. As psoriasis increasingly gains recognition as a serious chronic autoimmune skin disease with long-term impairment on the life course, and not mainly a cosmetic problem, nurses are highly challenged to develop efficient education to support patient self-management. The paper includes five stages: (1) problem identification, (2) literature search, (3) data evaluation, (4) data analysis and synthesis, and (5) presentation, based on theoretic scaffolding around the concept “need.” Nineteen of 164 original papers within nursing, medicine and psychology, and reflecting patient perspective were included. To capture the patients' cultural understanding of the implications of the disease and care, we developed an interlevel model indicating that self-experienced burden of disease and its visibility, personal conditions such as illness perception, and the patient's age at onset time are high-impact factors that should be addressed in future structured patient education programmes. The research on patient needs has hitherto focused on adults, but the problems and vulnerability associated with having a chronic and visible disease during adolescence must be acknowledged, and patient education initiatives designed for this young group are recommended. PMID:23304484

  7. Diabulimia: how eating disorders can affect adolescents with diabetes.

    PubMed

    Davidson, Jennifer

    2014-09-16

    Adherence to self-management and medication regimens is required to achieve optimal blood glucose control in adolescents with type 1 diabetes mellitus. Non-adherence places adolescents at serious risk of short and long-term health complications. Adherence difficulties may be exacerbated by concurrent eating disorders. Diabulimia is a term used to describe the deliberate administration of insufficient insulin to maintain glycaemic control for the purpose of causing weight loss. This article explores the concept of diabulimia and the compounding complications of an eating disorder on maintaining self-management regimens in adolescents with diabetes. PMID:25204951

  8. Endobronchial Tuberculosis Mimicking Asthma

    PubMed Central

    Argun Baris, Serap; Onyilmaz, Tuğba; Basyigit, Ilknur; Boyaci, Hasim

    2015-01-01

    Endobronchial tuberculosis (EBTB) is defined as tuberculosis infection of the tracheobronchial tree with microbial and histopathological evidence. The clinical symptoms of the diseases are nonspecific. Chronic cough is the major symptom of the disease. The diagnosis is often delayed due to its nonspecific presentation and misdiagnosed as bronchial asthma. This case is presented to recall the notion that the endobronchial tuberculosis can mimic asthma and the importance of bronchoscopic evaluation in a patient with chronic cough and treatment resistant asthma. PMID:26798513

  9. Teaching Your Child about Asthma

    MedlinePlus

    American Academy of Allergy Asthma & Immunology Menu Search Main navigation Skip to content Conditions & Treatments Allergies Asthma Primary Immunodeficiency Disease Related Conditions Drug Guide Conditions Dictionary Just ...

  10. Asthma in Olympians.

    PubMed

    Carlsen, Kai-Håkon

    2016-01-01

    High prevalence of asthma has been reported repeatedly among elite athletes, especially among endurance athletes. So many athletes used asthma drugs that the objective demonstration of bronchial hyperresponsiveness was required to obtain approval for their use in international sports until 2012 when the most used inhaled asthma drugs was allowed for free use, but with a maximum dose for inhaled β2-agonists. Several factors contribute to the development of asthma among the Olympians causing airways inflammation and bronchial hyper-responsiveness. PMID:26631837

  11. Asthma and the diver.

    PubMed

    Davies, Michael J; Fisher, Laura H; Chegini, Soheil; Craig, Timothy J

    2005-10-01

    Self-contained underwater breathing apparatus (scuba) diving has grown in popularity, with nearly 9 million sport divers in the United States alone. Approximately 7% of the population has been diagnosed with asthma, which is similar to the percentage of divers admitting they have asthma. Numerous concerns exist regarding subjects with asthma who choose to participate in recreational diving. Among these concerns are pulmonary barotrauma, pneumomediastinum, pneumothorax, arterial gas embolism, ear barotrauma, sinus barotrauma, and dental barotrauma. Despite these concerns, a paucity of information exists linking asthma to increased risk of diving complications. However, it has long been the norm to discourage individuals with asthma from participating in recreational scuba diving. This article examines the currently available literature to allow for a more informed decision regarding the possible risks associated with diving and asthma. It examines the underlying physiological principles associated with diving, including Henry's law and Boyle's law, to provide a more intimate understanding on physiological changes occurring in the respiratory system under compressive stress. Finally, this article offers a framework for guiding the patient with asthma who is interested in scuba diving. Under the right circumstances, the patient with asthma can safely participate in recreational diving without apparent increased risk of an asthma-related event. PMID:16251767

  12. Folate and asthma.

    PubMed

    Blatter, Joshua; Han, Yueh-Ying; Forno, Erick; Brehm, John; Bodnar, Lisa; Celedón, Juan C

    2013-07-01

    Findings from experimental studies and animal models led to the hypothesis that folic acid supplementation during pregnancy confers an increased risk of asthma. This review provides a critical examination of current experimental and epidemiologic evidence of a causal association between folate status and asthma. In industrialized nations, the prevalence of asthma was rising before widespread fortification of foodstuffs with folic acid or folate supplementation before or during pregnancy, thus suggesting that changes in folate status are an unlikely explanation for "the asthma epidemic." Consistent with this ecologic observation, evidence from human studies does not support moderate or strong effects of folate status on asthma. Given known protective effects against neural tube and cardiac defects, there is no reason to alter current recommendations for folic acid supplementation during conception or pregnancy based on findings for folate and asthma. Although we believe that there are inadequate data to exclude a weak effect of maternal folate status on asthma or asthma symptoms, such effects could be examined within the context of very large (and ongoing) birth cohort studies. At this time, there is no justification for funding new studies of folate and asthma. PMID:23650899

  13. Biomarkers in Severe Asthma.

    PubMed

    Wan, Xiao Chloe; Woodruff, Prescott G

    2016-08-01

    Biomarkers have been critical for studies of disease pathogenesis and the development of new therapies in severe asthma. In particular, biomarkers of type 2 inflammation have proven valuable for endotyping and targeting new biological agents. Because of these successes in understanding and marking type 2 inflammation, lack of knowledge regarding non-type 2 inflammatory mechanisms in asthma will soon be the major obstacle to the development of new treatments and management strategies in severe asthma. Biomarkers can play a role in these investigations as well by providing insight into the underlying biology in human studies of patients with severe asthma. PMID:27401625

  14. Home asthma triggers: barriers to asthma control in Chicago Puerto Rican children.

    PubMed

    Martin, Molly A; Thomas, Ann Marie; Mosnaim, Giselle; Greve, Matthew; Swider, Susan M; Rothschild, Steven K

    2013-05-01

    We sought objectively to measure, summarize, and contextualize the asthma triggers found in the homes of urban high-risk Puerto Rican children and adolescents with asthma in Chicago. Data were from the baseline home assessments of Project CURA. Research assistants interviewed caregivers, conducted a home visual inspection, and collected saliva samples for cotinine analysis. A trigger behavior summary score was created. The housing inspected was old with multiple units and obvious structural deficiencies. Many allergic and irritant triggers were observed. Having a controller medicine or private insurance was associated with lower trigger behavior summary scores; caregiver depression, caregiver perceived stress, and child negative life events were associated with high trigger scores. The final multivariate model retained had a controller medicine, private insurance, and caregiver perceived stress. The data from this high-risk cohort identified modifiable areas where environmental interventions could reduce morbidity in Puerto Rican children and adolescents. PMID:23728047

  15. Chronic Disease Self-Management by People With HIV.

    PubMed

    McDonald, Karalyn; Slavin, Sean; Pitts, Marian K; Elliott, Julian H

    2016-05-01

    As HIV has transitioned into a chronic disease, reappraisal of clinical management has occurred with chronic disease self-management (CDSM) as one possibility. However, despite extensive work on CDSM across a range of diseases, little attention has focused on psychosocial contexts of the lives of people for whom programs are intended. This article reports semi-structured interviews used to explore health practices and motivations of 33 people with HIV (PWHIV) in Australia. Within participants' accounts, different forms of subjectivity and agency emerged with implications for how they understood and valued health-related behaviors. Four themes arose: health support and disclosure, social support and stigma, employment/structure, and health decisions beyond HIV. The experience of stigma and its intersection with CDSM remains relatively un-chartered. This study found stigma shapes agency and engagement with health. Decisions concerning health behaviors are often driven by perceived social and emotional benefit embedded in concerns of disclosure and stigma. PMID:26290540

  16. Chronic Disease Self-Management: A Hybrid Concept Analysis

    PubMed Central

    Miller, Wendy R.; Lasiter, Sue; Ellis, Rebecca Bartlett; Buelow, Janice M.

    2014-01-01

    Background Chronic diseases require chronic disease self-management (CDSM). Existing CDSM interventions, while improving outcomes, often do not lead to long-lasting effects. To render existing and new CDSM interventions more effective, an exploration of the concept of CDSM from both the literature and patient perspectives is needed. Purpose To describe the current conceptualization of CDSM in the literature, identify potential inadequacies in this conceptualization based on a comparison of literature- and patient-based CDSM descriptions, and to offer a more comprehensive definition of CDSM. Method A hybrid concept analysis was completed. Discussion In the literature, CDSM is defined as behaviors influenced by individual characteristics. Patients in the fieldwork phase discussed aspects of CDSM not well-represented in the literature. Conclusions CDSM is a complex process involving behaviors at multiple levels of a person's environment. Pilot work to develop and test CDSM interventions based on both individual and external characteristics is needed. PMID:25241136

  17. Higher Prevalence of Obesity Among Children With Asthma

    PubMed Central

    Black, Mary Helen; Smith, Ning; Porter, Amy H.; Jacobsen, Steven J.; Koebnick, Corinna

    2012-01-01

    The aim of this study is to investigate the association between childhood obesity and asthma, and whether this relationship varies by race/ethnicity. For this population-based, cross-sectional study, measured weight and height, and asthma diagnoses were extracted from electronic medical records of 681,122 patients aged 6–19 years who were enrolled in an integrated health plan 2007–2009. Weight class was assigned based on BMI-for-age. Overall, 18.4% of youth had a history of asthma and 10.9% had current asthma. Adjusted odds of current asthma for overweight, moderately obese, and extremely obese youth relative to those of normal weight were 1.22 (95% confidence interval (CI): 1.20, 1.24), 1.37 (95% CI: 1.34, 1.40), and 1.68 (95% CI: 1.64, 1.73), respectively (P trend < 0.001). Black youth are nearly twice as likely (adjusted odds ratio (OR) = 1.93, 95% CI: 1.89, 1.99), and Hispanic youth are 25% less likely (adjusted OR = 0.75, 95% CI: 0.74, 0.77), to have current asthma than to non-Hispanic white youth. However, the relationship between BMI and asthma was strongest in Hispanic and weakest in black youth. Among youth with asthma, increasing body mass was associated with more frequent ambulatory and emergency department visits, as well as increased inhaled and oral corticosteroid use. In conclusion, overweight, moderate, and extreme obesity are associated with higher odds of asthma in children and adolescents, although the association varies widely with race/ethnicity. Increasing BMI among youth with asthma is associated with higher consumption of corticosteroids and emergency department visits. PMID:22252049

  18. Feasibility of a smartphone application based action plan and monitoring in asthma

    PubMed Central

    Kim, Mi-Yeong; Lee, Suh-Young; Jo, Eun-Jung; Lee, Seung-Eun; Kang, Min-Gyu; Song, Woo-Jung; Kim, Sae-Hoon; Cho, Sang-Heon; Min, Kyung-Up; Ahn, Ki-Hwan

    2016-01-01

    Background Asthma patients may experience acute episodic exacerbation. The guidelines recommend that written action plan should be given to asthma patients. However, no one can predict when and where acute exacerbation will happen. As people carry smart phone almost anytime and anywhere, smartphone application could be a useful tool in asthma care. We evaluated the feasibility of the ubiquitous healthcare system of asthma care using a smartphone application (snuCare) based on the self-management guideline or action plan. Methods Forty-four patients including fragile asthmatics were enrolled from Seoul National University Bundang Hospital between December 2011 and February 2012. They were randomly assigned into application user (n = 22) or application nonuser group (n = 22). We evaluated user-satisfaction, and clinical parameters such as asthma control, Quality of Life Questionnaire for Adult Korean Asthmatics, and the adherence of patients. Results The characteristics were similar at baseline between the 2 groups except those who treated with short-term systemic steroid or increased dose of systemic steroid during previous 8 weeks (user vs. nonuser: 31.8% vs. 4.5%, p = 0.020). Total of 2,226 signals was generated during 8 weeks including 5 risky states. After eight weeks, the users answered that it was very easy to use the application, which was shown in highest scores in terms of satisfaction (mean ± standard deviation, 4.3 ± 0.56). Seventy-three percent of patients answered that the application was very useful for asthma care. User group showed improved the adherence scores (p = 0.017). One patient in application user group could avoid Emergency Department visit owing to the application while a patient in nonuser group visited Emergency Department. Conclusion The ubiquitous healthcare system using a smartphone application (snuCare) based on the self-management guideline or action plan could be helpful in the monitoring and the management of asthma. PMID

  19. Subjective psychological symptoms in outpatient asthmatic adolescents.

    PubMed

    Lebowitz, M D; Thompson, H C; Strunk, R C

    1981-12-01

    Outpatient adolescent asthmatics were studied using the Asthma Symptom Checklist (ASC) of Kinsman et al. The study showed that outpatient asthmatic adolescents are similar in many respects to older institutionalized asthmatics, except that in the former, psychological symptoms are more diffuse and recognition of respiratory symptoms is less severe. Further studies are needed to determine which psychological symptoms are most important in predicting prognosis in affected asthmatics or the development of "psychosomatic" asthma. PMID:7338897

  20. The Breathe-Easy Home: The Impact of Asthma-Friendly Home Construction on Clinical Outcomes and Trigger Exposure

    PubMed Central

    Krieger, James; Song, Lin; Sharify, Denise; Beaudet, Nancy

    2011-01-01

    Objectives. We examined the asthma-control benefit of moving into an asthma-friendly Breathe-Easy home (BEH). Methods. We used a quasi-experimental design to compare the asthma outcomes of 2 groups of low-income children and adolescents with asthma: 34 participants who moved into a BEH, and a local matched cohort of 68 participants who had received a previous asthma-control intervention. Both groups received in-home asthma education. BEHs were constructed with moisture-reduction features, enhanced ventilation systems, and materials that minimized dust and off-gassing. Results. BEH residents’ asthma-symptom–free days increased from a mean of 8.6 per 2 weeks in their old home to 12.4 after 1 year in the BEH. The proportion of BEH residents with an urgent asthma-related clinical visit in the previous 3 months decreased from 62% to 21%. BEH caretakers’ quality of life increased significantly. The BEH group improved more than did the comparison group, but most differences in improvements were not significant. Exposures to mold, rodents, and moisture were reduced significantly in BEHs. Conclusions. Children and adolescents with asthma who moved into an asthma-friendly home experienced large decreases in asthma morbidity and trigger exposure. PMID:21148715

  1. Determinants of activation for self-management in patients with COPD

    PubMed Central

    Korpershoek, YJG; Bos-Touwen, ID; de Man-van Ginkel, JM; Lammers, J-WJ; Schuurmans, MJ; Trappenburg, JCA

    2016-01-01

    Background COPD self-management is a complex behavior influenced by many factors. Despite scientific evidence that better disease outcomes can be achieved by enhancing self-management, many COPD patients do not respond to self-management interventions. To move toward more effective self-management interventions, knowledge of characteristics associated with activation for self-management is needed. The purpose of this study was to identify key patient and disease characteristics of activation for self-management. Methods An explorative cross-sectional study was conducted in primary and secondary care in patients with COPD. Data were collected through questionnaires and chart reviews. The main outcome was activation for self-management, measured with the 13-item Patient Activation Measure (PAM). Independent variables were sociodemographic variables, self-reported health status, depression, anxiety, illness perception, social support, disease severity, and comorbidities. Results A total of 290 participants (age: 67.2±10.3; forced expiratory volume in 1 second predicted: 63.6±19.2) were eligible for analysis. While poor activation for self-management (PAM-1) was observed in 23% of the participants, only 15% was activated for self-management (PAM-4). Multiple linear regression analysis revealed six explanatory determinants of activation for self-management (P<0.2): anxiety (β: −0.35; −0.6 to −0.1), illness perception (β: −0.2; −0.3 to −0.1), body mass index (BMI) (β: −0.4; −0.7 to −0.2), age (β: −0.1; −0.3 to −0.01), Global Initiative for Chronic Obstructive Lung Disease stage (2 vs 1 β: −3.2; −5.8 to −0.5; 3 vs 1 β: −3.4; −7.1 to 0.3), and comorbidities (β: 0.8; −0.2 to 1.8), explaining 17% of the variance. Conclusion This study showed that only a minority of COPD patients is activated for self-management. Although only a limited part of the variance could be explained, anxiety, illness perception, BMI, age, disease severity

  2. Obstructive sleep apnea and asthma*

    PubMed Central

    Salles, Cristina; Terse-Ramos, Regina; Souza-Machado, Adelmir; Cruz, Álvaro A

    2013-01-01

    Symptoms of sleep-disordered breathing, especially obstructive sleep apnea syndrome (OSAS), are common in asthma patients and have been associated with asthma severity. It is known that asthma symptoms tend to be more severe at night and that asthma-related deaths are most likely to occur during the night or early morning. Nocturnal symptoms occur in 60-74% of asthma patients and are markers of inadequate control of the disease. Various pathophysiological mechanisms are related to the worsening of asthma symptoms, OSAS being one of the most important factors. In patients with asthma, OSAS should be investigated whenever there is inadequate control of symptoms of nocturnal asthma despite the treatment recommended by guidelines having been administered. There is evidence in the literature that the use of continuous positive airway pressure contributes to asthma control in asthma patients with obstructive sleep apnea and uncontrolled asthma. PMID:24310634

  3. Long-Acting Muscarinic Antagonists for Difficult-to-Treat Asthma: Emerging Evidence and Future Directions.

    PubMed

    Bulkhi, Adeeb; Tabatabaian, Farnaz; Casale, Thomas B

    2016-07-01

    Asthma is a complex disease where many patients remain symptomatic despite guideline-directed therapy. This suggests an unmet need for alternative treatment approaches. Understanding the physiological role of muscarinic receptors and the parasympathetic nervous system in the respiratory tract will provide a foundation of alternative therapeutics in asthma. Currently, several long-acting muscarinic antagonists (LAMAs) are on the market for the treatment of respiratory diseases. Many studies have shown the effectiveness of tiotropium, a LAMA, as add-on therapy in uncontrolled asthma. These studies led to FDA approval for tiotropium use in asthma. In this review, we discuss how the neurotransmitter acetylcholine itself contributes to inflammation, bronchoconstriction, and remodeling in asthma. We further describe the current clinical studies evaluating LAMAs in adult and adolescent patients with asthma, providing a comprehensive review of the current known physiological benefits of LAMAs in respiratory disease. PMID:27289376

  4. Reported Use and Acceptability of Self-Management Interventions to Target Behavioral Outcomes

    ERIC Educational Resources Information Center

    Briesch, Amy M.; Briesch, Jacquelyn M.; Mahoney, Corrine

    2014-01-01

    Although self-management interventions have a long history of empirical evaluation, attention has not been paid toward understanding actual use of this class of interventions. From a nationally representative sample of school psychology practitioners, a total of 295 respondents were presented with a description of a self-management intervention as…

  5. Effects and Implications of Self-Management for Students with Autism: A Meta-Analysis

    ERIC Educational Resources Information Center

    Lee, Suk-Hyang; Simpson, Richard L.; Shogren, Karrie A.

    2007-01-01

    Self-management for students with autism is important both as a management tool and as a means to enhance students' quality of life by empowering them to control their own behavior. This article reports the results of an examination of the efficacy of self-management for increasing appropriate behavior of children and youth with autism.…

  6. Integrating Self-Management and Exercise for People Living with Arthritis

    ERIC Educational Resources Information Center

    Mendelson, A. D.; McCullough, C.; Chan, A.

    2011-01-01

    The Program for Arthritis Control through Education and Exercise, PACE-Ex[TM}, is an arthritis self-management program incorporating principles and practice of self-management, goal setting and warm water exercise. The purpose of this program review is to examine the impact of PACE-Ex on participants' self-efficacy for condition management,…

  7. Cost Analysis of Chronic Disease Self-Management Programmes Being Delivered in South Florida

    ERIC Educational Resources Information Center

    Page, Timothy F.; Palmer, Richard C.

    2014-01-01

    Background: Chronic disease accounts for the majority of healthcare costs. The Chronic Disease Self-Management Programme (CDSMP) has been shown to be effective in reducing the burden of chronic disease. Objectives: The objective of this study was to measure the cost of delivering the Chronic Disease Self-Management Programme (CDSMP) in order to…

  8. Facilitating Self Management in Social Interactions Among the Profoundly Developmentally Disabled.

    ERIC Educational Resources Information Center

    Antonelli, Charles J.; Crowley, Robert

    The study examined the development of self management skills with a total of 59 profoundly retarded adult Ss participating in two projects designed to improve skill in following instructions, sharing materials, and performing a simple vocational task (sanding). Criteria for self management was the performance of a task or following of an…

  9. Exploring the Moderating Role of Self-Management of Learning in Mobile English Learning

    ERIC Educational Resources Information Center

    Huang, Rui-Ting

    2014-01-01

    Although a considerable number of studies have revealed that self-management of learning (SML) could be closely related to learning achievements, there is still a paucity of research investigating the moderating effect of self-management of learning on mobile learning outcomes. Accordingly, the primary purpose of this study was to explore the…

  10. The South Australia Health Chronic Disease Self-Management Internet Trial

    ERIC Educational Resources Information Center

    Lorig, Kate; Ritter, Philip L.; Plant, Kathryn; Laurent, Diana D.; Kelly, Pauline; Rowe, Sally

    2013-01-01

    Objectives: To evaluate the effectiveness of an online chronic disease self-management program for South Australia residents. Method: Data were collected online at baseline, 6 months, and 12 months. The intervention was an asynchronous 6-week chronic disease self-management program offered online. The authors measured eight health status measures,…

  11. The Impact of a Short Self-Management Training Intervention in a Retail Banking Environment

    ERIC Educational Resources Information Center

    Pattni, Indira; Soutar, Geoffrey N.; Klobas, Jane E.

    2007-01-01

    The study discussed in this article investigated the impact of a short self-management skills training course on frontline bank employees' learning about the use of self-management to overcome obstacles to the initiation of banking product sales, perceived self-efficacy in initiating the sale of a product, and performance in activities related to…

  12. The Benefits of Teaching Self-Management Skills to Students of Psychology

    ERIC Educational Resources Information Center

    Kazemi, Ellie; Rice, Brian; Rylander, Alyssa; Morgan, Shannon F.

    2011-01-01

    The various student gains and reported satisfaction with self-management projects have been well documented. However, we found that few psychology programs explicitly teach these skills. In this paper we demonstrate how self-management projects can meet nine out of the ten undergraduate student learning goals outlined by the APA Task Force (2002).…

  13. Self-Managing Work Groups: The Role of the External Leader.

    ERIC Educational Resources Information Center

    Bohannan, April

    1993-01-01

    Reviews the literature on self-managing teams to clarify the role of the external leader or coordinator of these groups. Conditions that aid in the development of self-management characteristics are identified; a model of group members and leader behavior is presented; and further areas of research are suggested. (14 references) (MES)

  14. Evaluation of WebEase: An Epilepsy Self-Management Web Site

    ERIC Educational Resources Information Center

    DiIorio, Colleen; Escoffery, Cam; McCarty, Frances; Yeager, Katherine A.; Henry, Thomas R.; Koganti, Archana; Reisinger, Elizabeth L.; Wexler, Bethany

    2009-01-01

    People with epilepsy have various education needs and must adopt many self-management behaviors in order to control their condition. This study evaluates WebEase, an Internet-based, theory-driven, self-management program for adults with epilepsy. Thirty-five participants took part in a 6-week pilot implementation of WebEase. The main components of…

  15. Self-Management Abilities of Diabetes in People with an Intellectual Disability Living in New Zealand

    ERIC Educational Resources Information Center

    Hale, Leigh A.; Trip, Henrietta T.; Whitehead, Lisa; Conder, Jenny

    2011-01-01

    Self-management of diabetes is encouraged; however, it is not an easy task and requires a good understanding of the disease. To determine how to improve the self-management abilities of diabetes in people with an intellectual disability (ID), this study explored the knowledge and understanding of diabetes held by a select group of adults with…

  16. Behavioural Change in Type 1 Diabetes Self-Management: Why and How?

    ERIC Educational Resources Information Center

    Wilson, Valerie L.

    2009-01-01

    Objective: To examine whether the communication process between diabetes health professionals and people intensively self-managing their type 1 diabetes influenced behavioural change. Design: Telephone interviews to provide insight into the communication process and its influence on diabetes intensive self-management behaviour. Setting:…

  17. Career-Self Management and Entrepreneurship: An Experience with PhD Students

    ERIC Educational Resources Information Center

    Pinto, Joana Carneiro; do Ceu Taveira, Maria; Sa, Elisabete

    2012-01-01

    Introduction: This study presents an experience developed with PhD students aimed to analyze the extent to which career self-management should be approached along with entrepreneurship issues to promote students' career development. Method: An intervention group who attended a Career Self-Management Seminar (EG1), a comparison group who attended…

  18. Employment and Self-Management: A Meta-Evaluation of Seven Literature Reviews

    ERIC Educational Resources Information Center

    Rusch, Frank R.; Dattilo, John

    2012-01-01

    Efforts focused on teaching individuals with intellectual disabilities to manage their own affairs have evolved over the past 30 years. Self-management strategies, in particular, hold much promise when the goal is to promote self-determination. In this article, the authors describe trends in the evolution of self-management strategies by analyzing…

  19. Self-Management of Sharing in Three Pre-Schoolers with Autism.

    ERIC Educational Resources Information Center

    Reinecke, Dana R.; Newman, Bobby; Meinberg, Deborah L.

    1999-01-01

    Use of a token economy to encourage self-management and spontaneous sharing behaviors by three preschool boys with autism was effective in increasing the frequency of sharing behaviors. However, the accuracy of the self-management component was not high, suggesting that the contingent relationship between token and response may not have been the…

  20. Increasing Academic Productivity of Severely Multi-Handicapped Children with Self-Management: Idiosyncratic Effects.

    ERIC Educational Resources Information Center

    Shapiro, Edward S.; And Others

    1984-01-01

    Productivity of four severely multiply disabled elementary students on a paper-and-pencil task was increased with an externally managed token economy. Ss were then instructed to self-manage the token economy. Two of the four subjects accurately self-managed the token economy, although all subjects maintained productivity levels. (Author/CL)

  1. 42 CFR 414.63 - Payment for outpatient diabetes self-management training.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Payment for outpatient diabetes self-management... HEALTH SERVICES Physicians and Other Practitioners § 414.63 Payment for outpatient diabetes self... this section, payment for outpatient diabetes self-management training is made under the physician...

  2. 42 CFR 414.63 - Payment for outpatient diabetes self-management training.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Payment for outpatient diabetes self-management... HEALTH SERVICES Physicians and Other Practitioners § 414.63 Payment for outpatient diabetes self... this section, payment for outpatient diabetes self-management training is made under the physician...

  3. 42 CFR 414.63 - Payment for outpatient diabetes self-management training.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Payment for outpatient diabetes self-management... HEALTH SERVICES Physicians and Other Practitioners § 414.63 Payment for outpatient diabetes self... this section, payment for outpatient diabetes self-management training is made under the physician...

  4. Occupational asthma: a review.

    PubMed Central

    Lombardo, L J; Balmes, J R

    2000-01-01

    Occupational asthma is the most common form of occupational lung disease in the developed world at the present time. In this review, the epidemiology, pathogenesis/mechanisms, clinical presentations, management, and prevention of occupational asthma are discussed. The population attributable risk of asthma due to occupational exposures is considerable. Current understanding of the mechanisms by which many agents cause occupational asthma is limited, especially for low-molecular-weight sensitizers and irritants. The diagnosis of occupational asthma is generally established on the basis of a suggestive history of a temporal association between exposure and the onset of symptoms and objective evidence that these symptoms are related to airflow limitation. Early diagnosis, elimination of exposure to the responsible agent, and early use of inhaled steroids may play important roles in the prevention of long-term persistence of asthma. Persistent occupational asthma is often associated with substantial disability and consequent impacts on income and quality of life. Prevention of new cases is the best approach to reducing the burden of asthma attributable to occupational exposures. Future research needs are identified. PMID:10931788

  5. Kerosene-induced asthma

    SciTech Connect

    Rodriguez de la Vega, A.; Casaco, A.; Garcia, M.; Noa, M.; Carvajal, D.; Arruzazabala, L.; Gonzalez, R. )

    1990-04-01

    Clinical evaluation of 286 asthmatic women showed 15.5% of those who improved clinically had contact with kerosene, while 43.9% of those who failed to improve used kerosene as fuel for cooking. In 16 women the onset of asthma occurred soon after they began to use kerosene. Kerosene can cause and aggravate asthma.

  6. Managing asthma in pregnancy

    PubMed Central

    2015-01-01

    Asthma is a common comorbidity during pregnancy and its prevalence is increasing in the community. Exacerbations are a major clinical problem during pregnancy with up to 45% of women needing to seek medical help, resulting in poor outcomes for mothers and their babies, including low birth weight and preterm delivery. The goals of effective asthma management in pregnancy are to maintain the best possible asthma control and prevent exacerbations. This is achieved by aiming to prevent day- and night-time symptoms, and maintain lung function and normal activity. In addition, maintaining fetal oxygenation is an important consideration in pregnancy. Guidelines recommend providing asthma advice and review prior to conception, and managing asthma actively during pregnancy, with regular 4-weekly review, provision of a written action plan, use of preventer medications as indicated for other adults with asthma, and management of comorbid conditions such as rhinitis. Improvements have been made in recent years in emergency department management of asthma in pregnancy, and multidisciplinary approaches are being proposed to optimise both asthma outcomes and perinatal outcomes. One strategy that has demonstrated success in reducing exacerbations in pregnancy is treatment adjustment using a marker of eosinophilic lung inflammation, the exhaled nitric oxide fraction (FeNO). The use of an algorithm that adjusted inhaled corticosteroids (ICS) according to FeNO and added long-acting β-agonists when symptoms remained uncontrolled resulted in fewer exacerbations, more women on ICS but at lower mean doses, and improved infant respiratory health at 12 months of age. Further evidence is needed to determine whether this strategy can also improve perinatal outcomes and be successfully translated into clinical practice. Key points Asthma is the most common chronic disease to affect pregnant women. Exacerbations occur in up to 45% of pregnant women with asthma. Asthma should be managed

  7. [Occupational asthma in Hungary].

    PubMed

    Endre, László

    2015-05-10

    Occupational asthma belongs to communicable diseases, which should be reported in Hungary. During a 24-year period between January 1990 and December 2013, 180 occupational asthma cases were reported in Hungary (52 cases between 1990 and 1995, 83 cases between 1996 and 2000, 40 cases between 2001 and 2006, and 5 cases between 2007 and 2013). These data are unusual, because according to the official report of the National Korányi Pulmonology Institute in Budapest, at least 14,000 new adult asthma cases were reported in every year between 2000 and 2012 in Hungary. Also, international data indicate that at least 2% of adult patients with asthma have occupational asthma and at least 50 out of 1 million employees develop occupational asthma in each year. In 2003, 631 new occupational asthma patients were reported in the United Kingdom, but only 7 cases in Hungary. Because it is unlikely that the occupational environment in Hungary is much better than anywhere else in the world, it seems that not all new occupational asthma cases are reported in Hungary. Of the 180 reported cases in Hungary, 55 were bakers or other workers in flour mills. There were 11 metal-workers, 10 health care assistants, 9 workers dealing with textiles (tailors, dressmakers, workers in textile industry) and 9 employees worked upon leather and animal fur. According to international data, the most unsafe profession is the animal keeper in scientific laboratories, but only 4 of them were reported as having occupational asthma during the studied 24 years in Hungary. Interestingly, 3 museologists with newly-diagnosed occupational asthma were reported in 2003, but not such cases occurred before or after that year. In this paper the Hungarian literature of occupational asthma is summarized, followed by a review on the classification, pathomechanism, clinical presentation, predisposing factors, diagnostics and therapeutic aspects of the disease. Epidemiological data of adult asthma in Hungary and data from

  8. The Digital Asthma Patient: The History and Future of Inhaler Based Health Monitoring Devices.

    PubMed

    Kikidis, Dimitrios; Konstantinos, Votis; Tzovaras, Dimitrios; Usmani, Omar S

    2016-06-01

    The wave of digital health is continuously growing and promises to transform healthcare and optimize the patients' experience. Asthma is in the center of these digital developments, as it is a chronic disease that requires the continuous attention of both health care professionals and patients themselves. The accurate and timely assessment of the state of asthma is the fundamental basis of digital health approaches and is also the most significant factor toward the preventive and efficient management of the disease. Furthermore, the necessity of inhaled medication offers a basic platform upon which modern technologies can be integrated, namely the inhaler device itself. Inhaler-based monitoring devices were introduced in the beginning of the 1980s and have been evolving but mainly for the assessment of medication adherence. As technology progresses and novel sensing components are becoming available, the enhancement of inhalers with a wider range of monitoring capabilities holds the promise to further support and optimize asthma self-management. The current article aims to take a step for the mapping of this territory and start the discussion among healthcare professionals and engineers for the identification and the development of technologies that can offer personalized asthma self-management with clinical significance. In this direction, a technical review of inhaler based monitoring devices is presented, together with an overview of their use in clinical research. The aggregated results are then summarized and discussed for the identification of key drivers that can lead the future of inhalers. PMID:26919553

  9. Characteristics of attenders and non-attenders at an asthma education programme.

    PubMed Central

    Yoon, R; McKenzie, D K; Miles, D A; Bauman, A

    1991-01-01

    BACKGROUND: A controlled trial of asthma education was conducted but only 51 out of 164 eligible patients participated. METHODS: Differences between subjects who participated in the trial and those who expressed initial interest but subsequently declined were studied. RESULTS: Women, non-smokers, and those whose attending physician was concerned in the study were significantly more likely to attend the programme. Higher socioeconomic status was associated with greater attendance, but this did not reach significance. Psychosocial malfunctioning due to asthma was also associated with attendance, but this was not significant when sex and education level were taken into account. There was no difference between attenders and non-attenders with respect to age, number of previous admissions, airway function, self reported asthma severity, knowledge about asthma, and self management practices. CONCLUSION: The results suggest that many asthmatic patients recovering from a severe exacerbation of airflow obstruction will not participate in hospital based health education programmes. Alternative strategies may be required to improve the self management behaviour of these patients. PMID:1792635

  10. Pneumothorax and asthma

    PubMed Central

    Porpodis, Konstantinos; Spyratos, Dionysios; Domvri, Kalliopi; Kioumis, Ioannis; Angelis, Nikolaos; Konoglou, Maria; Kolettas, Alexandros; Kessisis, Georgios; Beleveslis, Thomas; Tsakiridis, Kosmas; Katsikogiannis, Nikolaos; Kougioumtzi, Ioanna; Tsiouda, Theodora; Argyriou, Michael; Kotsakou, Maria; Zarogoulidis, Konstantinos

    2014-01-01

    This review is focused on the relationship between asthma, pneumothorax and pneumomediastinum while presenting a number of case reports that include these conditions. The association between pneumothorax and asthma is not widely known. While asthma includes a common disorder and is prevalent worldwide, its morbidity and mortality is high when is associated with pneumothorax. Furthermore, the delayed diagnosis of pneumothorax while focusing on asthma includes the higher risk of coincidental pneumothorax in asthmatic patients. In addition, pneumomediastinum is considered benign and self-limiting condition that responds to conservative therapy. Although it is rare, the concurrence of pneumomediastinum with pneumothorax may prove fatal during a serious asthma attack. In conclusion, the symptoms of chest pain, dyspnea or focal chest findings when presented in asthmatic patients, must always create suspicion of pneumothorax or pneumomediastinum to the physician. PMID:24672689

  11. Cough and Asthma

    PubMed Central

    Niimi, Akio

    2011-01-01

    Cough is the most common complaint for which patients seek medical attention. Cough variant asthma (CVA) is a form of asthma, which presents solely with cough. CVA is one of the most common causes of chronic cough. More importantly, 30 to 40% of adult patients with CVA, unless adequately treated, may progress to classic asthma. CVA shares a number of pathophysiological features with classic asthma such as atopy, airway hyper-responsiveness, eosinophilic airway inflammation and various features of airway remodeling. Inhaled corticosteroids remain the most important form of treatment of CVA as they improve cough and reduce the risk of progression to classic asthma most likely through their prevention of airway remodeling and chronic airflow obstruction. PMID:22081767

  12. Self-management among Chinese people with schizophrenia and their caregivers: a qualitative study.

    PubMed

    Zou, Haiou; Li, Zheng; Nolan, Marie; Wang, Hongxing; Hu, Lili

    2013-02-01

    This study explores the practice of self-management in Chinese people with schizophrenia and their caregivers. Twenty-one patients and 14 caregivers were interviewed. Four themes were identified, reflecting the practice of self-management from both the patients' and caregivers' perspective: managing medication, monitoring and dealing with symptoms, maintaining social relations, and seeking health information and maintaining medical appointments. In general, self-management practices among Chinese people with schizophrenia were not optimal. This study highlights the importance of developing and implementing family-based self-management programs for Chinese people with schizophrenia and their family in order to enhance their self-management abilities and improve care outcomes. PMID:23352024

  13. The costs of asthma.

    PubMed

    Barnes, P J; Jonsson, B; Klim, J B

    1996-04-01

    At present, asthma represents a substantial burden on health care resources in all countries so far studied. The costs of asthma are largely due to uncontrolled disease, and are likely to rise as its prevalence and severity increase. Costs could be significantly reduced if disease control is improved. A large proportion of the total cost of illness is derived from treating the consequences of poor asthma control-direct costs, such as emergency room use and hospitalizations. Indirect costs, which include time off work or school and early retirement, are incurred when the disease is not fully controlled and becomes severe enough to have an effect on daily life. In addition, quality of life assessments show that asthma has a significant socioeconomic impact, not only on the patients themselves, but on the whole family. Underuse of prescribed therapy, which includes poor compliance, significantly contributes towards the poor control of asthma. The consequences of poor compliance in asthma include increased morbidity and sometimes mortality, and increased health care expenditure. To improve asthma management, international guidelines have been introduced which recommend an increase in the use of prophylactic therapy. The resulting improvements in the control of asthma will reduce the number of hospitalizations associated with asthma, and may ultimately produce a shift within direct costs, with subsequent reductions in indirect costs. In addition, costs may be reduced by improving therapeutic interventions and through effective patient education programmes. This paper reviews current literature on the costs of asthma to assess how effectively money is spent and, by estimating the proportion of the cost attributable to uncontrolled disease, will identify where financial savings might be made. PMID:8726924

  14. Effect of a web-based chronic disease management system on asthma control and health-related quality of life: study protocol for a randomized controlled trial

    PubMed Central

    2011-01-01

    Background Asthma is a prevalent and costly disease resulting in reduced quality of life for a large proportion of individuals. Effective patient self-management is critical for improving health outcomes. However, key aspects of self-management such as self-monitoring of behaviours and symptoms, coupled with regular feedback from the health care team, are rarely addressed or integrated into ongoing care. Health information technology (HIT) provides unique opportunities to facilitate this by providing a means for two way communication and exchange of information between the patient and care team, and access to their health information, presented in personalized ways that can alert them when there is a need for action. The objective of this study is to evaluate the acceptability and efficacy of using a web-based self-management system, My Asthma Portal (MAP), linked to a case-management system on asthma control, and asthma health-related quality of life. Methods The trial is a parallel multi-centered 2-arm pilot randomized controlled trial. Participants are randomly assigned to one of two conditions: a) MAP and usual care; or b) usual care alone. Individuals will be included if they are between 18 and 70, have a confirmed asthma diagnosis, and their asthma is classified as not well controlled by their physician. Asthma control will be evaluated by calculating the amount of fast acting beta agonists recorded as dispensed in the provincial drug database, and asthma quality of life using the Mini Asthma Related Quality of Life Questionnaire. Power calculations indicated a needed total sample size of 80 subjects. Data are collected at baseline, 3, 6, and 9 months post randomization. Recruitment started in March 2010 and the inclusion of patients in the trial in June 2010. Discussion Self-management support from the care team is critical for improving chronic disease outcomes. Given the high volume of patients and time constraints during clinical visits, primary care

  15. Finding Meaning: HIV Self-Management and Wellbeing among People Taking Antiretroviral Therapy in Uganda.

    PubMed

    Russell, Steve; Martin, Faith; Zalwango, Flavia; Namukwaya, Stella; Nalugya, Ruth; Muhumuza, Richard; Katongole, Joseph; Seeley, Janet

    2016-01-01

    The health of people living with HIV (PLWH) and the sustained success of antiretroviral therapy (ART) programmes depends on PLWH's motivation and ability to self-manage the condition over the long term, including adherence to drugs on a daily basis. PLWH's self-management of HIV and their wellbeing are likely to be interrelated. Successful self-management sustains wellbeing, and wellbeing is likely to motivate continued self-management. Detailed research is lacking on PLWH's self-management processes on ART in resource-limited settings. This paper presents findings from a study of PLWH's self-management and wellbeing in Wakiso District, Uganda. Thirty-eight PLWH (20 women, 18 men) were purposefully selected at ART facilities run by the government and by The AIDS Support Organisation in and around Entebbe. Two in-depth interviews were completed with each participant over three or four visits. Many were struggling economically, however the recovery of health and hope on ART had enhanced wellbeing and motivated self-management. The majority were managing their condition well across three broad domains of self-management. First, they had mobilised resources, notably through good relationships with health workers. Advice and counselling had helped them to reconceptualise their condition and situation more positively and see hope for the future, motivating their work to self-manage. Many had also developed a new network of support through contacts they had developed at the ART clinic. Second, they had acquired knowledge and skills to manage their health, a useful framework to manage their condition and to live their life. Third, participants were psychologically adjusting to their condition and their new 'self': they saw HIV as a normal disease, were coping with stigma and had regained self-esteem, and were finding meaning in life. Our study demonstrates the centrality of social relationships and other non-medical aspects of wellbeing for self-management which ART

  16. Advances in Pediatric Asthma in 2013: Coordinating Asthma Care

    PubMed Central

    Szefler, Stanley J.

    2014-01-01

    Last year’s Advances in Pediatric Asthma: Moving Toward Asthma Prevention concluded that: “We are well on our way to creating a pathway around wellness in asthma care and also to utilize new tools to predict the risk for asthma and take steps to not only prevent asthma exacerbations but also to prevent the early manifestations of the disease and thus prevent its evolution to severe asthma.” This year’s summary will focus on recent advances in pediatric asthma on pre- and postnatal factors altering the natural history of asthma, assessment of asthma control, and new insights regarding potential therapeutic targets for altering the course of asthma in children as indicated in Journal of Allergy and Clinical Immunology publications in 2013 and early 2014. Recent reports continue to shed light on methods to understand factors that influence the course of asthma, methods to assess and communicate levels of control, and new targets for intervention as well as new immunomodulators. It will now be important to carefully assess risk factors for the development of asthma as well as the risk for asthma exacerbations and to improve the way we communicate this information in the health care system. This will allow parents, primary care physicians, specialists and provider systems to more effectively intervene in altering the course of asthma and to further reduce asthma morbidity and mortality. PMID:24581430

  17. The significance of early recurrent wheeze for asthma outcomes in late childhood.

    PubMed

    Hovland, Vegard; Riiser, Amund; Mowinckel, Petter; Carlsen, Kai-Håkon; Lødrup Carlsen, Karin C

    2013-04-01

    Recurrent early life wheeze is not always asthma, and up to 50% of children are reported to remit. With reports of adult asthma symptom relapse, we assessed the prognosis of recurrent bronchial obstruction (rBO) through adolescence in the Environment and Childhood Asthma (ECA) prospective birth cohort study. The present study is based on data from investigations at ages 2, 10 and 16 years of 550 young people (52% males) attending at 16 years of age. Based on the presence of rBO from 0-2 years, defined as recurrent (at least two episodes) doctor-diagnosed wheeze, and asthma from 2-10 years and 10-16 years, defined as at least two episodes of doctor-diagnosed asthma, symptoms and medication use, prognosis of rBO was assessed. Bronchial hyperresponsiveness (BHR) was diagnosed by a metacholine provocation dose ≤ 8 μmol that caused 20% reduction in the forced expiratory volume in 1 s. At 10-16 years, 34% of the 143 rBO children had asthma. All children with rBO had reduced lung function compared with the never asthmatics. Of the rBO children in remission, 48.4% had asthma symptoms, medication use and/or BHR compared with 26.7% with never asthma (p<0.001). Only 34.3% of rBO children were without asthma symptoms, medication use or BHR by 16 years, possibly indicating future asthma risk. PMID:22903966

  18. [Self management or managerial autonomy. SESPAS report, 2012].

    PubMed

    Ledesma Castelltort, Albert

    2012-03-01

    Western countries with strong primary care systems organize their health services around this healthcare modality, which serves as a gateway to the system and is characterized by multidisciplinary teamwork, management transferred to the teams and a broad services portfolio. The contractual relationship between professionals and the public health system is a useful tool to modulate the efficiency of services and their ability to meet the expectations of citizens and professionals. Some countries choose to contract professionals directly, either individually or through a professional organization, an option known as a self-management system. Others opt to contract public or private entities, which in turn recruit health professionals as employees. In the latter countries, the concept of management decentralization and managerial autonomy has arisen. In Spain, only Catalonia has enabled professional entities to be hired to provide public health services, through commercial formulas, i.e. in a competitive market relationship. This relationship allows the use of corporate governance mechanisms that are not subject to public control through state intervention. The other forms of management promoted in Spain to avoid the controls of state intervention - foundations or associations - have been unsuccessful, except in the autonomous region of Valencia and some models in the autonomous region of Madrid. PMID:22327059

  19. Adult asthma prevalence, morbidity and mortality and their relationships with environmental and medical care factors in Singapore.

    PubMed

    Ng, T P

    1999-09-01

    We have conducted a series of studies on adult asthma in Singapore that describe the prevalence, morbidity and mortality and their relationships with environmental and medical care factors. There was no evidence of a temporal increase of mortality from 1976 to 1995 for adults. The prevalence rate of asthma is 2.4% in men and 2.0% in women. There is considerable morbidity among asthmatics, corticosteroids are under-used, and patients' knowledge and self-management skills is poor. Increased morbidity is significantly associated with current keeping of pets, current smoking, and the patients' knowledge and self-management skills. Occupational exposure contributes up to a third of asthma morbidity. Malays and Indians have higher rates of asthma mortality and morbidity than Chinese. They have greater exposures to airborne allergens from keeping rugs or carpets, and pets. Malays experience the most morbidity from asthma, but make less use of health services, and receive less medical attention, than Indians or Chinese. PMID:10697250

  20. Cleaning agents and asthma.

    PubMed

    Quirce, S; Barranco, P

    2010-01-01

    Although cleaners represent a significant part of the working population worldwide, they remain a relatively understudied occupational group. Epidemiological studies have shown an association between cleaning work and asthma, but the risk factors are uncertain. Cleaning workers are exposed to a large variety of cleaning products containing both irritants and sensitizers, as well as to common indoor allergens and pollutants. Thus, the onset or aggravation of asthma in this group could be related to an irritant-induced mechanism or to specific sensitization. The main sensitizers contained in cleaning products are disinfectants, quaternary ammonium compounds (such as benzalkonium chloride), amine compounds, and fragrances.The strongest airway irritants in cleaning products are bleach (sodium hypochlorite), hydrochloric acid, and alkaline agents (ammonia and sodium hydroxide), which are commonly mixed together. Exposure to the ingredients of cleaning products may give rise to both new-onset asthma, with or without a latency period, and work-exacerbated asthma. High-level exposure to irritants may induce reactive airways dysfunction syndrome. Cleaning workers may also have a greater relative risk of developing asthma due to prolonged low-to-moderate exposure to respiratory irritants. In addition, asthma-like symptoms without confirmed asthma are also common after exposure to cleaning agents. In many cleaners, airway symptoms induced by chemicals and odors cannot be explained by allergic or asthmatic reactions. These patients may have increased sensitivity to inhaled capsaicin, which is known to reflect sensory reactivity, and this condition is termed airway sensory hyperreactivity. PMID:21313993

  1. Pharmacotherapy of Asthma

    PubMed Central

    2007-01-01

    The pharmacotherapy of asthma is a complex and evolving topic. A detailed understanding of the pathophysiologic processes involved in the asthmatic response forms the basis for understanding the actions of drugs used to treat this condition. Likewise, a solid comprehension of the medicinal chemistry and pharmacologic properties of the numerous agents involved in the treatment of asthma is critical for rationalizing drug choices and understanding potential side effects. Asthma is addressed at several points in the PharmD curriculum at South University including in the Pathophysiology (quarter 2), Integrated Sequence III (quarter 6), and Critical Care (quarter 9) courses. Various teaching strategies are employed throughout, along with weekly case-based recitations. The content presented here includes a synopsis of the pathophysiology and pharmacology from our Integrated Sequence III block on inflammatory diseases and asthma. A short review of pertinent pathophysiology is followed by a detailed presentation on the various classes of asthma drugs which includes their chemistry, mechanism of action, pharmacokinetics, toxicity, and interactions. This presentation is designed to prepare students for asthma therapeutics, which follows next in the schedule. The complexities of asthma pharmacotherapy are stressed along with current controversies and future drug development. PMID:17998995

  2. The future of asthma.

    PubMed Central

    Hall, I. P.

    1997-01-01

    Reports in the media describing the discovery of "the asthma gene" or "a new vaccine for asthma" may be inaccurate and often raise patients' hopes unjustifiably. This article is a personal view of key areas in current asthma research, and it examines how they may impinge on the care of asthmatic patients in the next decade. I have tried to explain the thinking behind some of the approaches under study. I discuss the potential contributions of genetic studies, immunological approaches, and new therapeutic approaches. PMID:9001482

  3. Eosinophilic Endotype of Asthma.

    PubMed

    Aleman, Fernando; Lim, Hui Fang; Nair, Parameswaran

    2016-08-01

    Asthma is a heterogeneous disease that can be classified into different clinical endotypes, depending on the type of airway inflammation, clinical severity, and response to treatment. This article focuses on the eosinophilic endotype of asthma, which is defined by the central role that eosinophils play in the pathophysiology of the condition. It is characterized by elevated sputum and/or blood eosinophils on at least 2 occasions and by a significant response to treatments that suppress eosinophilia. Histopathologic demonstration of eosinophils in the airways provides the most direct diagnosis of eosinophilic asthma; but it is invasive, thus, impractical in clinical practice. PMID:27401626

  4. Asthma outcome measures.

    PubMed

    Watkins, K D

    1999-08-01

    Annually, asthma accounts for 10.4 million physician visits, 468,000 hospitalizations, 1.8 million emergency room visits, and 10 million missed school days. According to the Centers for Disease Control and Prevention, the number of asthma deaths has increased progressively since 1978 form 1,800 to 5,400 per year. It is an expensive disease, accounting for about 1% of all health expenditure in the United States in 1990. Asthma has a significant impact on the patient and the community at large and the assessment of the clinical, physiologic, humanistic and economic outcomes will be measured. PMID:10563275

  5. Are Behavioural Interventions Doomed to Fail? Challenges to Self-Management Support in Chronic Diseases.

    PubMed

    Vallis, Michael

    2015-08-01

    Self-management and self-management support are concepts very familiar to those of us in diabetes care. These concepts require openness to understanding the behaviours of persons with diabetes broadly, not only behaviours restricted to the biomedical perspective. Understanding the importance of health behaviour change and working within the Expanded Chronic Care Model define the context within which self-management support should occur. The purpose of this perspective is to identify a potential limitation in existing self-management support initiatives. This potential limitation reflects provider issues, not patient issues; that is, true self-management support might require changes by healthcare providers. Specifically, although behavioural interventions within the context of academic research studies are evidence based, behaviour change interventions implemented in general practice settings might prove less effective unless healthcare providers are able to shift from a practice based on the biomedical model to a practice based on the self-management support model. The purpose of this article is to facilitate effective self-management support by encouraging providers to switch from a model of care based on the expert clinician encountering the uninformed help seeker (the biomedical model) to one guided by collaboration grounded in the principles of description, prediction and choice. Key to understanding the value of making this shift are patient-centered communication principles and the tenets of complexity theory. PMID:25837809

  6. Self-management and bipolar disorder--a clinician's guide to the literature 2011-2014.

    PubMed

    Janney, Carol A; Bauer, Mark S; Kilbourne, Amy M

    2014-09-01

    This review provides clinicians and individuals with bipolar disorder (BD) with an overview of evidence-based skills shown to be effective in BD and amenable to self-management including psychoeducation; monitoring moods, medications, and social function; sleep hygiene; setting goals and relapse plans; and healthy lifestyles (physical activity, healthy eating, weight loss and management, medical comorbidities). Currently available self-management resources for BD are summarized by mode of delivery (workbooks, mobile technologies, internet, and peer-led interventions). Regardless of the self-management intervention/topic, the research suggests that personally tailored interventions of longer duration and greater frequency may be necessary to achieve the maximal benefit among individuals with BD. Means to support these self-management interventions as self-sustaining identities are critically needed. Hopefully, the recent investment in patient-centered research and care will result in best practices for the self-management of BD by mode of delivery. Since self-management of BD should complement rather than replace medical care, clinicians need to partner with their patients to incorporate and support advances in self-management for individuals with BD. PMID:25123130

  7. Longitudinal feasibility of MINDSET: a clinic decision aid for epilepsy self-management.

    PubMed

    Begley, Charles; Shegog, Ross; Harding, Angelique; Goldsmith, Corey; Hope, Omotola; Newmark, Michael

    2015-03-01

    The purpose of this paper is to report on the development and feasibility of the longitudinal version of MINDSET, a clinical tool to assist patients and health-care providers in epilepsy self-management. A previous study described the feasibility of using MINDSET to identify and prioritize self-management issues during a clinic visit. This paper describes the development of the longitudinal version of MINDSET and feasibility test over multiple visits with a printed action plan for goal setting and the capacity for monitoring changes in self-management. Feasibility was assessed based on 1) postvisit patient and provider interviews addressing ease of use and usefulness, patient/provider communication, and shared decision-making and 2) the capacity of the tool to monitor epilepsy characteristics and self-management over time. Results indicate MINDSET feasibility for 1) identifying and facilitating discussion of self-management issues during clinic visits, 2) providing a printable list of prioritized issues and tailored self-management goals, and 3) tracking changes in epilepsy characteristics and self-management over time. PMID:25705825

  8. Self-management in heart failure: where have we been and where should we go?

    PubMed Central

    Gardetto, Nancy Jean

    2011-01-01

    Chronic conditions such as heart failure (HF) place a tremendous strain on patients, their families, the community, and the health care system because there are no real “cures”. Adding to the burden are longer life expectancies and increased numbers of people living with multiple chronic conditions. Today, whether engaging in a health-promoting activity, such as exercise, or living with a chronic disease such as HF, the individual is responsible for actively managing day-to-day activities, a concept referred to as self-management. Self-management emerged as the cornerstone for chronic care models and multidisciplinary disease-management strategies in chronic illness care. Moreover, self-management has been prioritized as a central pathway for improving the quality and effectiveness of most chronic HF care. Adherence to self-management is vital to optimize the treatment outcomes in HF patients, but implementing chronic disease self-management (CDSM) strategies and identifying the difficulties in self-management has proved to be a challenge. Understanding both where we have been and the future direction of self-management in HF care is not only timely, but a crucial aspect of improving long-term outcomes for people with HF and other chronic diseases. PMID:21544247

  9. Perspectives of Adults With Epilepsy and Their Support Persons on Self-Management Support

    PubMed Central

    Walker, Elizabeth Reisinger; Barmon, Christina; McGee, Robin E.; Engelhard, George; Sterk, Claire E.; DiIorio, Colleen; Thompson, Nancy J.

    2015-01-01

    Social support is an important mechanism for improving self-management, although little is known about its role in epilepsy self-management. We examined the type of support provided to people with epilepsy and its influence on self-management. We conducted in-depth interviews with 22 people with epilepsy and 16 support persons, representing 14 pairs and 10 unpaired individuals. We analyzed the data using principles of grounded theory. Supporters, who were mainly parents and spouses, aided people with epilepsy in every dimension of self-management. Support for self-management occurred along a continuum from person with epilepsy-led management to support person-led management. Where the pairs fell on the continuum depended on developmental stage, relationship type, and relationship dynamics. Seizure control shaped individuals' experiences with self-management and support within each group. The self-management continuum provides a new aspect that can be integrated into existing models of self-and family-management. PMID:25192759

  10. Enhancing Self-Efficacy for Optimized Patient Outcomes through the Theory of Symptom Self-Management

    PubMed Central

    Hoffman, Amy J.

    2012-01-01

    Background In today’s world, greater patient empowerment is imperative since 90 million Americans live with one or more chronic conditions such as cancer. Evidence reveals that healthy behaviors such as effective symptom self-management can prevent or reduce much of the suffering from cancer. Oncology nurses play a pivotal role in developing a symptom self-management plan that is critical to optimizing a patient’s symptom self-management behaviors. Objective This article uses exemplars to describe how oncology nurses can apply a tested middle-range theory, the Theory of Symptom Self-Management, to clinical practice by incorporating interventions to increase a patient’s perceived self-efficacy to optimize patient outcomes. Methods The Theory of Symptom Self-Management provides a means to understand the dynamic aspects of symptom self-management and provides a tested framework for the development of efficacy enhancing interventions for use by oncology nurses in clinical practice. Results Exemplars based on the Theory of Symptom Self-Management that depict how oncology nursing can use perceived self-efficacy enhancing symptom self-management interventions to improve the functional status and quality of life of their patients. Conclusion Guided by a theoretical approach, oncology nurses can have a significant positive impact on the lives of their patients by reducing the symptom burden associated with cancer and its treatment. Implications for Practice Oncology nurses can partner with their patients to design tailored approaches to symptom self-management. These tailored approaches provide the ability to implement patient specific behaviors that recognize, prevent, relieve, or decrease the timing, intensity, distress, concurrence, and unpleasant quality of symptoms. PMID:22495550

  11. The over time development of chronic illness self-management patterns: a longitudinal qualitative study

    PubMed Central

    2013-01-01

    Background There currently exists a vast amount of literature concerning chronic illness self-management, however the developmental patterns and sustainability of self-management over time remain largely unknown. This paper aims to describe the patterns by which different chronic illness self-management behaviors develop and are maintained over time. Method Twenty-one individuals newly diagnosed with chronic illnesses (e.g., diabetes, rheumatism, ischemic heart disease, multiple sclerosis, chronic renal disease, inflammatory bowel disease) were repeatedly interviewed over two-and-a-half years. The interviews were conducted in Sweden from 2006 to 2008. A total of 81 narrative interviews were analyzed with an interpretive description approach. Results The participants’ self-management behaviors could be described in four different developmental patterns: consistent, episodic, on demand, and transitional. The developmental patterns were related to specific self-management behaviors. Most participants took long-term medications in a consistent pattern, whereas exercise was often performed according to an episodic pattern. Participants managed health crises (e.g., angina, pain episodes) according to an on demand pattern and everyday changes due to illness (e.g., adaptation of work and household activities) according to a transitional pattern. All of the participants used more than one self-management pattern. Conclusion The findings show that self-management does not develop as one uniform pattern. Instead different self-management behaviors are enacted in different patterns. Therefore, it is likely that self-management activities require support strategies tailored to each behavior’s developmental pattern. PMID:23647658

  12. Using Teacher and Researcher Data to Evaluate the Effects of Self-Management in an Inclusive Classroom

    ERIC Educational Resources Information Center

    King-Sears, Margaret E.

    2008-01-01

    A student with moderate mental retardation included in a general education math setting was taught how to use self-management to increase his on-task behaviors. A researcher and special educator worked together to determine the content for self-management, and each collected 2 different types of data to monitor the impact of self-management.…

  13. A Two-Level Robustness Model for Self-Managing Software Systems

    NASA Astrophysics Data System (ADS)

    Bustard, David; Sterritt, Roy

    Potentially, software quality can be improved significantly by constructing systems that are self-managing. Such systems monitor both their internal state and operating environment during execution, and respond, as necessary, to any significant changes or problems detected. This chapter considers the role of robustness in the design and operation of self-managing systems. Robustness is discussed in relation to other general requirements of ideal systems and a basic design pattern developed. The resulting model includes a two-level user interface for communication with self-managing systems, which is illustrated with word processing and Web browser examples.

  14. Improving self-management for patients with long-term conditions.

    PubMed

    Davies, Nicola J

    An increasing number of people are living with long-term conditions. These conditions cannot be cured, but can be managed through education, health promotion, medication, therapy and self-management. Self-management involves people taking responsibility for their own health and wellbeing, as well as learning to manage any long-term illnesses. Nurses play a pivotal role in providing advice, guidance, education and support to people living with long-term conditions. Self-management is important as it not only benefits the patient, but also provides wider opportunities for community and specialist nurses to use and develop their clinical and interpersonal skills. PMID:20306844

  15. Precordial Catch Syndrome in Elite Swimmers With Asthma.

    PubMed

    Hayes, Don; Younger, Bradley R; Mansour, Heidi M; Strawbridge, Heather

    2016-02-01

    Precordial catch syndrome is a benign cause of chest pain in children and adolescents that remains underrecognized. Because of distinctive symptoms, precordial catch syndrome is not necessarily a diagnosis of exclusion. However, a detailed history eliciting diagnostic features is important, along with a physical examination excluding other pathologic disorders. We present the cases of 2 elite swimmers with asthma who had acute episodes of precordial catch syndrome, one associated with an acute asthma exacerbation and one not, while swimming during competitive swim meets that required rescue efforts for both and eventual evaluation in the emergency department. PMID:26835568

  16. National Asthma Control Program State Profiles

    MedlinePlus

    ... 1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health State Data Profiles (2011) Recommend on ... 1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health File Formats Help: How do I ...

  17. What's an Asthma Flare-Up?

    MedlinePlus

    ... Things to Know About Zika & Pregnancy What's an Asthma Flare-Up? KidsHealth > For Parents > What's an Asthma ... of a straw that's being pinched. Causes of Asthma Flare-Ups People with asthma have airways that ...

  18. Asthma - control drugs

    MedlinePlus

    ... Burks AW, et al., eds. In: Middleton's Allergy Principles and Practice . 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 55. Guidelines for the Diagnosis and Management of Asthma . Rockville, MD. National Heart, Lung, and ...

  19. Vitamin D and asthma

    PubMed Central

    Brown, Sheena D.; Calvert, H. Hardie; Fitzpatrick, Anne M.

    2012-01-01

    Asthma, one of the most prevalent diseases affecting people worldwide, is a chronic respiratory disease characterized by heightened airway inflammation, airway hyperresponsiveness and airflow obstruction in response to specific triggers. While the specific mechanisms responsible for asthma are not well understood, changing environmental factors associated with urban lifestyles may underlie the increased prevalence of the disorder. Vitamin D is of particular interest in asthma since vitamin D concentrations decrease with increased time spent indoors, decreased exposure to sunlight, less exercise, obesity, and inadequate calcium intake. Additionally, a growing body of literature suggests that there is a relationship between vitamin D status and respiratory symptoms, presumably through immunomodulatory effects of vitamin D. This review discusses vitamin D as it relates to asthma across the age spectrum, with a focus on human studies. PMID:22928069

  20. Asthma, Allergies and Pregnancy

    MedlinePlus

    ... Drug Guide Conditions Dictionary Just for Kids Library School Tools Videos Virtual Allergist Education & Training Careers in A/I Continuing Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation ...

  1. Skin Exposure and Asthma

    PubMed Central

    Redlich, Carrie A.

    2010-01-01

    Numerous occupational and environmental exposures that increase asthma risk have been identified. Research and prevention have focused primarily on the respiratory tract. However, recent studies suggest that the skin may also be an important route of exposure and site of sensitization that contributes to asthma development. Factors that impair skin barrier function, such as filaggrin gene mutations or skin trauma, may facilitate allergen entry and promote Th2-like sensitization and subsequent asthma. Animal studies demonstrate that skin exposure to chemical and protein allergens is highly effective at inducing sensitization, with subsequent inhalation challenge eliciting asthmatic responses. A similar role for human skin exposure to certain sensitizing agents, such as isocyanates, is likely. Skin exposure methodologies are being developed to incorporate skin exposure assessment into epidemiology studies investigating asthma risk factors. PMID:20427586

  2. Exercise-induced asthma

    MedlinePlus

    Wheezing - exercise-induced; Reactive airway disease - exercise ... Having asthma symptoms when you exercise does not mean you cannot or should not exercise. But be aware of your EIA triggers. Cold or dry air may ...

  3. Common Asthma Triggers

    MedlinePlus

    ... your bedding on the hottest water setting. Outdoor Air Pollution Outdoor air pollution can trigger an asthma attack. This pollution can ... your newspaper to plan your activities for when air pollution levels will be low. Cockroach Allergen Cockroaches and ...

  4. Asthma Medicines: Quick Relief

    MedlinePlus

    ... Advisory Board Sponsors Sponsorship Opporunities Spread the Word Shop AAP Find a Pediatrician Health Issues Conditions Abdominal ... Listen Español Text Size Email Print Share Asthma Medicines: Quick Relief Page Content Article Body Short-Acting ...

  5. Asthma and Food Allergies

    MedlinePlus

    ... Health Issues Conditions Abdominal ADHD Allergies & Asthma Autism Cancer Chest & Lungs Chronic Conditions Cleft & Craniofacial Developmental Disabilities Ear Nose & Throat Emotional Problems Eyes Fever From Insects or Animals Genitals and Urinary Tract Glands & Growth ...

  6. Asthma Action Plan

    MedlinePlus

    ... Cold or warm water used with detergent and bleach can also be effective. • Wash the sheets and ... hot water or cooler water with detergent and bleach. Ë Cockroaches Many people with asthma are allergic ...

  7. What Is Asthma?

    MedlinePlus

    ... common materials like house dust mites, cockroaches, and pollens—may cause the inflammation that leads to asthma ... dander from furred or feathered animals, fungi, and pollens are common allergens. Other Irritants : Tobacco smoke, industrial ...

  8. Allergies, asthma, and pollen

    MedlinePlus

    Allergic rhinitis - pollen ... them is your first step toward feeling better. Pollen is a trigger for many people who have allergies and asthma. The types of pollens that are triggers vary from person to person ...

  9. Smoking and asthma

    MedlinePlus

    ... your allergies or asthma worse are called triggers. Smoking is a trigger for many people who have ... do not have to be a smoker for smoking to cause harm. Exposure to someone else's smoking ( ...

  10. Asthma and school

    MedlinePlus

    ... Include a list of triggers that make your child's asthma worse, such as: Smells from chemicals and cleaning products Grass and weeds Smoke Dust Cockroaches Rooms that are moldy or damp Provide ...

  11. Racial Differences in Two Self Management Hypertension Interventions

    PubMed Central

    Bosworth, Hayden B.; Olsen, Maren K.; Grubber, Janet M.; Powers, Benjamin J.; Oddone, Eugene Z.

    2011-01-01

    Background Only one-half of Americans have their blood pressure controlled and there continue to be significant racial differences in blood pressure control. The goal of this study was to examine the effectiveness of two patient-directed interventions designed to improve blood pressure control within white and non-white subgroups (49% African Americans). Methods Post-hoc analysis of a 2 by 2 randomized trial with two-year follow-up in 2 university-affiliated primary care clinics. Within white and non-white patients (n=634), four groups were examined: 1) usual care; 2) home blood pressure monitoring (three times per week); 3) tailored behavioral self-management intervention administered via telephone by a nurse every other month; or, 4) a combination of the two interventions. Results The overall race by time by treatment group effect suggested differential intervention effects on blood pressure over time for whites and non-whites (systolic blood pressure, p=0.08; diastolic blood pressure, p=0.01). Estimated trajectories indicated that among the 308 whites, there was no significant effect on blood pressure at either 12 or 24 months for any intervention compared to control group. At 12 months, the non-whites (n=328) in all three intervention groups had systolic blood pressure decreases of 5.3–5.7 mm hg compared to usual care (p<0.05). At 24 months, in the combined intervention, non-whites had sustained lower systolic blood pressure as compared to usual care (7.5 mm hg; p<0.02). A similar pattern was observed for diastolic blood pressure. Conclusion Combined home blood pressure monitoring and a telephone tailored-behavioral intervention appeared to be particularly effective for improving blood pressure in non-white patients. PMID:21531237

  12. Care Utilization Patterns and Diabetes Self-Management Education Duration.

    PubMed

    Johnson, Tammie M; Richards, Jennifer; Churilla, James R

    2015-08-01

    Objective. Previous studies have shown that receiving diabetes self-management education (DSME) is associated with increased care utilization. However, the relationship between DSME duration and care utilization patterns remains largely unexamined. Our purpose is to characterize DSME duration and examine the relationship between DSME duration and clinical- and self-care utilization patterns. Methods. The study sample included 1,446 adults who were ≥18 years of age, had diabetes, and had participated in the 2008 Florida Behavioral Risk Factor Surveillance System survey. Clinical- and self-care outcomes were derived using responses to the survey's diabetes module and were based on minimum standards of care established by the American Diabetes Association. The outcomes examined included self-monitoring of blood glucose at least once per day; receiving at least one eye exam, one foot exam, A1C tests, and an influenza vaccination in the past year; and ever receiving a pneumococcal vaccination. DSME duration was categorized as no DSME, >0 to <4 hours, 4-10 hours, and >10 hours. Results. After adjusting for sociodemographic variables, compared to those who did not receive DSME, those who had 4-10 or 10+ hours of DSME were more likely to receive two A1C tests (odds ratio [95% CI] 2.69 [1.30-5.58] and 2.63 [1.10-6.31], respectively) and have a pneumococcal vaccination (1.98 [1.03-3.80] and 1.92 [1.01-3.64], respectively). Those receiving 10+ hours of DSME were 2.2 times (95% CI 1.18-4.09) as likely to have an influenza vaccination. Conclusion. These data reveal a positive relationship between DSME duration and utilization of some diabetes clinical care services. PMID:26300613

  13. Asthma in primary care.

    PubMed

    Usta, J; Mroueh, S

    2001-01-01

    Asthma is a chronic disease that cannot be cured but can be effectively controlled. Control is achieved through education of the patient, monitoring of symptoms and pulmonary functions, environmental modification and pharmacologic therapy. The latter should aim at providing control with the least amount of medications. Any form of asthma more severe than mild intermittent requires the use of long term anti-inflammatory medications. PMID:12243423

  14. Asthma Outcomes: Exacerbations

    PubMed Central

    Fuhlbrigge, Anne; Peden, David; Apter, Andrea J.; Boushey, Homer A.; Camargo, Carlos; Gern, James; Heymann, Peter W.; Martinez, Fernando D.; Mauger, David; Teague, William G.; Blaisdell, Carol

    2013-01-01

    Background The goals of asthma treatment include preventing recurrent exacerbations. Yet there is no consensus about the terminology for describing or defining “exacerbation,” or about how to characterize an episode’s severity. Objective National Institutes of Health (NIH) institutes and other federal agencies convened an expert group to propose how asthma exacerbation should be assessed as a standardized asthma outcome in future asthma clinical research studies. Methods We utilized comprehensive literature reviews and expert opinion to compile a list of asthma exacerbation outcomes, and classified them as either core (required in future studies), supplemental (used according to study aims and standardized), or emerging (requiring validation and standardization). This work was discussed at an NIH-organized workshop in March 2010 and finalized in September 2011. Results No dominant definition of “exacerbation” was found. The most widely used definitions included 3 components, all related to treatment, rather than symptoms: (1) systemic use of corticosteroids, (2) asthma-specific emergency department visits or hospitalization, and (3) use of short-acting β-agonists (SABAs) as quick-relief (sometimes referred to as “rescue” or “reliever”) medications. Conclusions The working group participants propose that the definition of “asthma exacerbation” be “a worsening of asthma requiring the use of systemic corticosteroids to prevent a serious outcome.” As core outcomes, they propose inclusion and separate reporting of several essential variables of an exacerbation. Further, they propose the development of a standardized, component-based definition of “exacerbation” with clear thresholds of severity for each component. PMID:22386508

  15. Neural mechanisms in asthma.

    PubMed

    Joos, G F; Germonpré, P R; Pauwels, R A

    2000-06-01

    Advances in the understanding of neural mechanisms in asthma may provide novel therapeutic approaches in the treatment of asthma. Excessive activity of cholinergic nerves may be important in asthma. Dysfunction of M2 muscarinic receptors in asthma may lead to excessive bronchoconstriction and mucus secretion and can be induced in animal models by a range of stimuli including allergen, viral infection, ozone, eosinophil products and cytokines. Cholinergic mechanisms may be especially important in certain types of patients and anticholinergic agents provide protection against bronchospasm due to psychogenic factors or beta2-blockers. Non-adrenergic non-cholinergic (NANC) mechanisms, both inhibitory (i-NANC) and excitatory (e-NANC), may play a significant role in the pathophysiology of asthma. The putative neurotransmitters, vasoactive interstinal polypeptide (VIP) and nitric oxide (NO), mediate neural bronchodilation in human airways. There does not appear to be a defect in the i-NANC system in moderate or severe asthma. e-NANC is mediated by the sensory neuropeptides substance P (SP) and the more potent bronchoconstrictor neurokinin A (NKA). Various studies suggest that the SP content of human airways is increased in asthma. Tachykinins are not only present in sensory nerves, but also are produced by inflammatory cells such as alveolar macrophages, dendritic cells, eosinophils, lymphocytes and neutrophils. They can be released into the airways by stimuli such as allergen and ozone. Evidence suggests that in addition to smooth muscle contraction, which is mediated mainly by NK2 receptors, tachykinins also cause mucus secretion, plasma extravasation and stimulate inflammatory and immune cells. These effects are mediated by NK1 receptors. Recent studies have shown that NK2 receptor antagonists such as saredutant partially inhibit NKA-induced bronchoconstriction in asthmatics. Thus, tachykinin receptor antagonists have potential as therapies for asthma. PMID:10849478

  16. Arginine metabolism in asthma.

    PubMed

    Scott, Jeremy A; Grasemann, Hartmut

    2014-11-01

    Nitric oxide (NO) is important in the regulation of airway tone and airway responsiveness. Alterations in the L-arginine metabolism resulting in reduced availability of the substrate L-arginine for NO synthases, as well as the presence of NO synthase inhibitors such as asymmetric dimethylarginine, contribute to the reduced NO formation and airway dysfunction in asthma. Therapeutic interventions aiming to modulate the impaired L-arginine metabolism may help correct the enhanced airway tone and responsiveness in asthma. PMID:25282289

  17. Performance and persistence of a blood pressure self-management intervention: telemonitoring and self-management in hypertension (TASMINH2) trial.

    PubMed

    Bray, E P; Jones, M I; Banting, M; Greenfield, S; Hobbs, F D R; Little, P; Williams, B; Mcmanus, R J

    2015-07-01

    This study aimed to evaluate, in detail, the implementation of the self-management intervention used in the TASMINH2 trial. The intervention, comprising self-monitoring for the first week of each month and an individualised treatment self-titration schedule, was developed from a previous trial of self-management. Two hundred and sixty-three patients with poorly controlled but treated hypertension were randomised to receive this intervention and underwent training over two or three sessions. Participants were followed up for 12 months during which time process data were collected regarding the persistence and fidelity of actual behaviour compared with intervention recommendations. Two hundred and forty-one (92%) patients completed training of whom 188 (72%) self-managed their BP and completed at least 90% of expected self-monitoring measurements for the full year of the study. Overall, 268/483 (55%) of recommended medication changes were implemented. Only 25 (13%) patients had controlled BP throughout the year and so were not recommended any medication changes. Adherence to the protocol reduced over time as the number of potential changes increased. Of those self-managing throughout, 131 (70%) made at least one medication change, with 77 (41%) implementing all their recommended changes. In conclusion, self-management of hypertension was possible in practice with most participants making at least one medication change. Although adherence to the intervention reduced over time, implementation of treatment recommendations appeared better than equivalent trials using physician titration. Future self-management interventions should aim to better support patients' decision making, perhaps through enhanced use of technology. PMID:25566874

  18. Asthma Therapies Revisited

    PubMed Central

    Lemanske, Robert F.

    2009-01-01

    Asthma is a heterogenous disorder related to numerous biologic, immunologic, and physiologic components that generate multiple clinical phenotypes. Further, genetic and environmental factors interact in ways that produce variability in both disease onset and severity and differential expression based on both the age and sex of the patient. Thus, the natural history of asthma is complex in terms of disease expression, remission, relapse, and progression. As such, therapy for asthma is complicated and has been approached from the standpoints of primary, secondary, and tertiary prevention. Presently, asthma cannot be cured but can be controlled in most patients, an indication that most of the success clinical research strategies have realized has been in the area of tertiary prevention. Since for many adult patients with asthma their disease had its roots in early life, much recent research has focused on events during early childhood that can be linked to subsequent asthma development with the hopes of creating appropriate interventions to alter its natural history of expression. These research approaches can be categorized into three questions. Who is the right patient to treat? When is the right time to begin treatment? And finally, what is the appropriate treatment to prescribe? PMID:19387036

  19. [Asthma, obesity and diet].

    PubMed

    Barranco, P; Delgado, J; Gallego, L T; Bobolea, I; Pedrosa, Ma; García de Lorenzo, A; Quirce, S

    2012-01-01

    Asthma and obesity have a considerable impact on public health and their prevalence has increased in recent years. Numerous studies have linked both disorders. Most prospective studies show that obesity is a risk factor for asthma and have found a positive correlation between baseline body mass index (BMI) and the subsequent development of asthma, although these results are not conclusive when studying the association between airway hyperresponsiveness with BMI. Furthermore, several studies suggest that whereas weight gain increases the risk of asthma, weight loss improves the course of the illness. Different factors could explain this association. Obesity is capable of reducing pulmonary compliance, lung volumes and the diameter of peripheral respiratory airways as well as affecting the volume of blood in the lungs and the ventilation-perfusion relationship. Furthermore, the increase in the normal functioning of adipose tissue in obese subjects leads to a systemic proinflammatory state, which produces a rise in the serum concentrations of several cytokines, the soluble fractions of their receptors and chemokines. Many of these mediators are synthesized and secreted by cells from adipose tissue and receive the generic name of adipokines, including IL-6, IL-10, eotaxin, TNF-α, TGF- 1, PCR, leptin y adiponectin. Finally, specific regions of the human genome which are related to both asthma and obesity have been identified. Most studies point out that obesity is capable of increasing the prevalence and incidence of asthma, although this effect appears to be modest. The treatment of obese asthmatics must include a weight control program. PMID:22566313

  20. Prognosis of occupational asthma.

    PubMed

    Paggiaro, P L; Vagaggini, B; Bacci, E; Bancalari, L; Carrara, M; Di Franco, A; Giannini, D; Dente, F L; Giuntini, C

    1994-04-01

    Several studies on the prognosis of occupational asthma have shown that a significant proportion of patients continue to experience asthmatic symptoms and nonspecific bronchial hyperresponsiveness after cessation of work. The determinants of this unfavourable prognosis of asthma are: long duration of exposure before the onset of asthma; long duration of symptoms before diagnosis; baseline airway obstruction; dual response after specific challenge test; and the persistence of markers of airway inflammation in bronchoalveolar lavage fluid and bronchial biopsy. The relevance of immunological markers in the outcome of occupational asthma has not yet been assessed. Further occupational exposure in sensitized subjects leads to persistence and sometimes to progressive deterioration of asthma, irrespective of the reduction of exposure to the specific sensitizer, and only the use of particular protective devices effectively prevents the progression of the disease. A long-term follow-up study of toluene diisocyanate (TDI)-induced asthma showed that the improvement in bronchial hyperresponsiveness to methacholine occurred in a small percentage of subjects and only a long time after work cessation. Bronchial sensitivity to TDI may disappear, but non-specific bronchial hyperresponsiveness often persists unchanged, suggesting a permanent deregulation of airway tone. Steroid treatment significantly reduces nonspecific bronchial hyperresponsiveness only when started immediately after diagnosis. PMID:8005260

  1. Asthma is Different in Women

    PubMed Central

    Erzurum, Serpil C.

    2015-01-01

    Gender differences in asthma incidence, prevalence and severity have been reported worldwide. After puberty, asthma becomes more prevalent and severe in women, and is highest in women with early menarche or with multiple gestations, suggesting a role for sex hormones in asthma genesis. However, the impact of sex hormones on the pathophysiology of asthma is confounded by and difficult to differentiate from age, obesity, atopy, and other gender associated environmental exposures. There are also gender discrepancies in the perception of asthma symptoms. Understanding gender differences in asthma is important to provide effective education and personalized management plans for asthmatics across the lifecourse. PMID:26141573

  2. Seasonal Risk Factors for Asthma Exacerbations among Inner City Children

    PubMed Central

    Teach, Stephen J.; Gergen, Peter J.; Szefler, Stanley J.; Mitchell, Herman E.; Calatroni, Agustin; Wildfire, Jeremy; Bloomberg, Gordon; Kercsmar, Carolyn; Liu, Andrew H.; Makhija, Melanie; Matsui, Elizabeth; Morgan, Wayne; O'Connor, George; Busse, William W.

    2015-01-01

    Background Exacerbations of asthma remain common even in children and adolescents despite optimal medical management. Identification of host risk factors for exacerbations is incomplete, particularly for seasonal episodes. Objective Define host risk factors for asthma exacerbations unique to their season of occurrence. Methods This is a retrospective analysis of patients aged 6-20 years who comprised the control groups of the Asthma Control Evaluation trial and the Inner City Anti-IgE Therapy for Asthma trial. Univariate and multivariate models were constructed to determine if patient demographic and historical factors, allergic sensitization, fractional exhaled nitric oxide, spirometric measurements, asthma control, and treatment requirements were associated with seasonal exacerbations. Results The analysis included 400 patients (54.5% male; 59.0% African American; median age 13 years). Exacerbations occurred in 37.5% of participants over the periods of observation and were most common in the fall (28.8% of participants). In univariate analysis, impaired pulmonary function was significantly associated with greater odds of exacerbations for all seasons, as was an exacerbation in the previous season for all seasons except spring. In multivariate analysis, exacerbation in the previous season was the strongest predictor in fall and winter while a higher requirement for inhaled corticosteroids was the strongest predictor in spring and summer. The multivariate models had the best predictive power for fall exacerbations (30.5% variance attributed). Conclusions Among a large cohort of inner city children with asthma, patient risk factors for exacerbations vary by season. Thus, individual patient information may be beneficial in strategies to prevent these seasonal events. Clinical Implications Inner city children remain at risk for asthma exacerbations despite appropriate therapy. Because their risk factors vary by season, strategies to prevent them may need to differ as

  3. Enhancing the Health Competence of School-Age Children through Behaviorial Self-Management Skills.

    ERIC Educational Resources Information Center

    Petosa, Rick

    1986-01-01

    For health instruction to be of benefit, personal practices must enhance health behavior. Self-management skills, stimilus control procedures, and reinforcement control procedures to make behavioral changes consistent with health-related decisions are described. (MT)

  4. Patient Self-Management of Diabetes Care in the Inpatient Setting: Con.

    PubMed

    Shah, Arti D; Rushakoff, Robert J

    2015-09-01

    Self-management of diabetes by inpatients can be problematic. People with type 1 diabetes often prefer to self-manage their diabetes in the inpatient setting. We report the case of a patient admitted to the surgical service who was self-administering his home insulin, often without telling his nurse or physician. He was aiming for tight glycemic control, which resulted in life-threatening hypoglycemia. While patients can often self-manage their diabetes in the outpatient setting, inpatient management of diabetes is very different. Patients may not be familiar with common scenarios requiring adjustments of insulin therapy. Therefore, we recommend against self-management of diabetes in the hospital. However, the patients should be involved in discussions about management of their diabetes in the hospital to allay their concerns about changes made to their insulin regimens. An example of successful cooperative management is with use of protocols that allow continued use of insulin pumps in the hospital. PMID:25990293

  5. Supporting self-management for patients with complex medical needs: recommendations of a working group.

    PubMed

    Bayliss, E A; Bosworth, H B; Noel, P H; Wolff, J L; Damush, T M; Mciver, L

    2007-06-01

    Increasing numbers of persons live with complex chronic medical needs and are at risk for poor health outcomes. These patients require unique self-management support, as they must manage many, often interacting, tasks. As part of a conference on Managing Complexity in Chronic Care sponsored by the Department of Veterans Affairs, a working group was convened to consider self-management issues specific to complex chronic care. In this paper, we assess gaps in current knowledge on self-management support relevant to this population, report on the recommendations of our working group, and discuss directions for future study. We conclude that this population requires specialized, multidimensional self-management support to achieve a range of patient-centred goals. New technologies and models of care delivery may provide opportunities to develop this support. Validation and quantification of these processes will require the development of performance measures that reflect the needs of this population, and research to prove effectiveness. PMID:18083671

  6. The Individual and Family Self-management Theory: Background and Perspectives on Context, Process, and Outcomes

    PubMed Central

    Ryan, Polly; Sawin, Kathleen J.

    2009-01-01

    Current evidence indicates that individuals and families who engage in self-management (SM) behaviors improve their health outcomes. While the results of these studies are promising, there is little agreement as to the critical components of SM or directions for future study. This paper offers an organized perspective of similar and divergent ideas related to SM. Unique contributions of prior work are highlighted and findings from studies are summarized. A new descriptive mid-range theory, Individual and Family Self-management Theory, is presented; assumptions identified, concepts defined, and proposed relationships outlined. This theory adds to the literature on self-management by focusing on individual, dyads within the family, or the family unit as a whole; explicating process components of self-management; and proposing use of proximal and distal outcomes. PMID:19631064

  7. Arthritis Self-Management: A Study of the Effectiveness of Patient Education for the Elderly.

    ERIC Educational Resources Information Center

    Lorig, Kate; And Others

    1984-01-01

    Assessed the effectiveness of an Arthritis Self Management course for people aged 55-95 (N=200). Results indicated significant gains in knowledge and pain reduction. Trends toward less disability were observed for participants under age 74. (JAC)

  8. Interventions to Promote Diabetes Self-Management in Children and Youth: A Scoping Review.

    PubMed

    Cahill, Susan M; Polo, Katie M; Egan, Brad E; Marasti, Nadia

    2016-01-01

    As children and youth with diabetes grow up, they become increasingly responsible for controlling and monitoring their condition. We conducted a scoping review to explore the research literature on self-management interventions for children and youth with diabetes. Eleven studies met the inclusion criteria. Some of the studies reviewed combined the participant population so that children with Type 1 as well as children with Type 2 diabetes were included. The majority of the studies focused on children age 14 yr or older and provided self-management education, self-management support, or both. Parent involvement was a key component of the majority of the interventions, and the use of technology was evident in 3 studies. The findings highlight factors that occupational therapy practitioners should consider when working with pediatric diabetes teams to select self-management interventions. PMID:27548858

  9. "This does my head in". Ethnographic study of self-management by people with diabetes

    PubMed Central

    2012-01-01

    Background Self-management is rarely studied 'in the wild'. We sought to produce a richer understanding of how people live with diabetes and why self-management is challenging for some. Method Ethnographic study supplemented with background documents on social context. We studied a socio-economically and ethnically diverse UK population. We sampled 30 people with diabetes (15 type 1, 15 type 2) by snowballing from patient groups, community contacts and NHS clinics. Participants (aged 5-88, from a range of ethnic and socio-economic groups) were shadowed at home and in the community for 2-4 periods of several hours (total 88 visits, 230 hours); interviewed (sometimes with a family member or carer) about their self-management efforts and support needs; and taken out for a meal. Detailed field notes were made and annotated. Data analysis was informed by structuration theory, which assumes that individuals' actions and choices depend on their dispositions and capabilities, which in turn are shaped and constrained (though not entirely determined) by wider social structures. Results Self-management comprised both practical and cognitive tasks (e.g. self-monitoring, menu planning, medication adjustment) and socio-emotional ones (e.g. coping with illness, managing relatives' input, negotiating access to services or resources). Self-management was hard work, and was enabled or constrained by economic, material and socio-cultural conditions within the family, workplace and community. Some people managed their diabetes skilfully and flexibly, drawing on personal capabilities, family and social networks and the healthcare system. For others, capacity to self-manage (including overcoming economic and socio-cultural constraints) was limited by co-morbidity, cognitive ability, psychological factors (e.g. under-confidence, denial) and social capital. The consequences of self-management efforts strongly influenced people's capacity and motivation to continue them. Conclusion Self-management

  10. A systematic review of self-management interventions for children and youth with physical disabilities

    PubMed Central

    Kingsnorth, Shauna; Mcdougall, Carolyn; Keating, Heather

    2014-01-01

    Purpose: Evidence shows that effective self-management behaviors have the potential to improve health outcomes, quality of life, self-efficacy and reduce morbidity, emergency visits and costs of care. A better understanding of self-management interventions (i.e. programs that help with managing symptoms, treatment, physical and psychological consequences) is needed to achieve a positive impact on health because most children with a disability now live well into adulthood. Method: A systematic review of self-management interventions for school age youth with physical disabilities was undertaken to assess their effectiveness. Comprehensive electronic searches using international web-based reference libraries were conducted for peer-reviewed and gray literature published between 1980 and January 2012. Eligible studies examined the effectiveness of self-management interventions for children and youth between 6 and 18 years of age with congenital or acquired physical disabilities. Studies needed to include a comparison group (e.g. single group pre/post-test design) and at least one quantifiable health-related outcome. Results: Of the 2184 studies identified, six met the inclusion criteria; two involved youth with spina bifida and four with juvenile arthritis. The majority of the interventions ran several sessions for at least 3 months by a trained interventionist or clinician, had one-to-one sessions and meetings, homework activities and parental involvement. Although outcomes varied between the studies, all of the interventions reported at least one significant improvement in either overall self-management skills or a specific health behavior. Conclusions: While self-management interventions have the potential to improve health behaviors, there were relatively few rigorously designed studies identified. More studies are needed to document the outcomes of self-management interventions, especially their most effective characteristics for children and youth with physical

  11. ‘Get Your Life Back’: process and impact evaluation of an asthma social marketing campaign targeting older adults

    PubMed Central

    2013-01-01

    Background Asthma in older adults is underdiagnosed and poorly self-managed. This population has little knowledge about the key symptoms, the prevalence among older adults, and the serious consequences of untreated asthma. The purpose of this study was to undertake a multifaceted evaluation of a social marketing campaign to increase asthma awareness among older adults in a regional Australian community. Methods A cohort of older adults in an intervention region (n = 316) and a control region (n = 394) were surveyed immediately prior to and following the social marketing campaign. Campaign awareness, message recall, materials recognition, and actions taken as a result of the campaign were assessed in both regions. Asthma knowledge and perceptions, experience of asthma symptoms, and general health were also assessed in both regions at baseline and follow-up. Analyses were conducted to explore the effects of the campaign in the intervention region, and to examine outcomes among different audience segments. Results The survey data showed that those in the target segments (Wheezers and Strugglers) had better message recall, and were more likely to report having taken action to control their respiratory symptoms. The campaign significantly increased the number of calls to an asthma information line from the target audience in the intervention community. Conclusions A theory-based social marketing campaign conducted over 3-months increased the asthma information seeking behaviours of older adults in the intervention community compared to the control community. Recommendations are outlined for future community health promotion campaigns targeting older adults. PMID:23947479

  12. From dictatorship to a reluctant democracy: stroke therapists talking about self-management

    PubMed Central

    Kilbride, Cherry

    2014-01-01

    Purpose Self-management is being increasingly promoted within chronic conditions including stroke. Concerns have been raised regarding professional ownership of some programmes, yet little is known of the professional’s experience. This paper aims to present the views of trained therapists about the utility of a specific self-management approach in stroke rehabilitation. Method Eleven stroke therapists trained in the self-management approach participated in semi-structured interviews. These were audio recorded, transcribed verbatim and analysed thematically. Results Two overriding themes emerged. The first was the sense that in normal practice therapists act as “benign dictators”, committed to help their patients, but most comfortable when they, the professional, are in control. Following the adoption of the self-management approach therapists challenged themselves to empower stroke survivors to take control of their own recovery. However, therapists had to confront many internal and external challenges in this transition of power resulting in the promotion of a somewhat “reluctant democracy”. Conclusions This study illustrates that stroke therapists desire a more participatory approach to rehabilitation. However, obstacles challenged the successful delivery of this goal. If self-management is an appropriate model to develop in post stroke pathways, then serious consideration must be given to how and if these obstacles can be overcome. Implications for Rehabilitation Stroke therapists perceive that self-management is appropriate for encouraging ownership of rehabilitation post stroke. Numerous obstacles were identified as challenging the implementation of self-management post stroke. These included: professional models, practices and expectations; institutional demands and perceived wishes of stroke survivors. For self-management to be effectively implemented by stroke therapists, these obstacles must be considered and overcome. This should be as part of

  13. Improving self-management of type 1 and type 2 diabetes.

    PubMed

    Phillips, Anne

    2016-01-01

    Diabetes is an increasingly common life-long condition, which has significant physical, psychological and behavioural implications for individuals. Self-management of type 1 and type 2 diabetes can be complex and challenging. A collaborative approach to care, between healthcare professionals and patients, is essential to promote self-management skills and knowledge to help patients engage in shared decision making and manage any difficulties associated with a diagnosis of diabetes. PMID:26938421

  14. Distinguishing adult-onset asthma from COPD: a review and a new approach

    PubMed Central

    Abramson, Michael J; Perret, Jennifer L; Dharmage, Shyamali C; McDonald, Vanessa M; McDonald, Christine F

    2014-01-01

    Adult-onset asthma and chronic obstructive pulmonary disease (COPD) are major public health burdens. This review presents a comprehensive synopsis of their epidemiology, pathophysiology, and clinical presentations; describes how they can be distinguished; and considers both established and proposed new approaches to their management. Both adult-onset asthma and COPD are complex diseases arising from gene–environment interactions. Early life exposures such as childhood infections, smoke, obesity, and allergy influence adult-onset asthma. While the established environmental risk factors for COPD are adult tobacco and biomass smoke, there is emerging evidence that some childhood exposures such as maternal smoking and infections may cause COPD. Asthma has been characterized predominantly by Type 2 helper T cell (Th2) cytokine-mediated eosinophilic airway inflammation associated with airway hyperresponsiveness. In established COPD, the inflammatory cell infiltrate in small airways comprises predominantly neutrophils and cytotoxic T cells (CD8 positive lymphocytes). Parenchymal destruction (emphysema) in COPD is associated with loss of lung tissue elasticity, and small airways collapse during exhalation. The precise definition of chronic airflow limitation is affected by age; a fixed cut-off of forced expiratory volume in 1 second/forced vital capacity leads to overdiagnosis of COPD in the elderly. Traditional approaches to distinguishing between asthma and COPD have highlighted age of onset, variability of symptoms, reversibility of airflow limitation, and atopy. Each of these is associated with error due to overlap and convergence of clinical characteristics. The management of chronic stable asthma and COPD is similarly convergent. New approaches to the management of obstructive airway diseases in adults have been proposed based on inflammometry and also multidimensional assessment, which focuses on the four domains of the airways, comorbidity, self-management, and

  15. Cross-site evaluation of a comprehensive pediatric asthma project: the Merck Childhood Asthma Network, Inc. (MCAN).

    PubMed

    Viswanathan, Meera; Mansfield, Carol; Smith, Lucia Rojas; Woodell, Carol; Darcy, Niamh; Ohadike, Yvonne U; Lesch, Julie Kennedy; Malveaux, Floyd J

    2011-11-01

    The Merck Childhood Asthma Network, Inc. (MCAN) initiative selected five sites that had high asthma burden and established asthma programs but were ready for greater program integration across schools, health care systems, and communities. MCAN supported a community-based approach that was tailored to the needs of each program site. As a result, each site was unique in its combination of interventions, but all sites served common goals of integration of care, incorporation of evidence-based programs, and improvement in knowledge, self-management, health, and quality of life. This case study of the MCAN cross-site evaluation discusses the challenges associated with evaluating interventions involving multiple stakeholders that have been adjusted to fit the unique needs of specific communities. The evaluation triangulates data from site-specific monitoring and evaluation data; site documents, site visits, and cross-site meetings; qualitative assessments of families, organizational partners, and other stakeholders; and quantitative data from a common instrument on health indicators before and after the intervention. The evaluation employs the RE-AIM framework--reach, effectiveness, adoption, implementation, and maintenance--to assess the barriers and facilitators of translation from theory into practice. Our experience suggests trade-offs between rigor of evaluation and burden of assessment that have applicability for other community-based translational efforts. PMID:22068358

  16. Comparative Effectiveness on Cognitive Asthma Outcomes of the SHARP Academic Asthma Health Education and Counseling Program and a Non-Academic Program.

    PubMed

    Kintner, Eileen; Cook, Gwendolyn; Marti, C Nathan; Stoddard, Debbie; Gomes, Melissa; Harmon, Phyllis; Van Egeren, Laurie A

    2015-12-01

    Asthma morbidity and mortality is higher among older school-age children and early adolescents than other age groups across the lifespan. NIH recommended expanding asthma education to schools and community settings to meet cognitive outcomes that have an impact on morbidity and mortality. Guided by the acceptance of asthma model, an evidence-guided, comprehensive school-based academic health education and counseling program, Staying Healthy-Asthma Responsible & Prepared™ (SHARP), was developed. The program complements existing school curricula by integrating biology, psychology, and sociology content with related spelling, math, and reading and writing assignments. Feasibility, benefits, and efficacy have been established. We compared the effectiveness of SHARP to a non-academic program, Open Airways for Schools, in improving asthma knowledge and reasoning about symptom management. A two-group, cluster-randomized, single-blinded design was used with a sample of 205 students in grades 4-5 with asthma and their caregivers. Schools were matched prior to randomization. The unit of analysis was the student. Certified elementary school teachers delivered the programs during instructional time. Data were collected from student/caregiver dyads at baseline and at 1, 12, and 24 months after the intervention. In multilevel modeling, students enrolled in the academic SHARP program demonstrated significant (p< .001) improvement in asthma knowledge and reasoning over students enrolled in the non-academic program. Knowledge advantages were retained at 24 months. Findings support delivery in schools of the SHARP academic health education program for students with asthma. PMID:26296595

  17. An empowerment-based approach to developing innovative e-health tools for self-management.

    PubMed

    Alpay, Laurence; van der Boog, Paul; Dumaij, Adrie

    2011-12-01

    E-health is seen as an important technological tool in achieving self-management; however, there is little evidence of how effective e-health is for self-management. Example tools remain experimental and there is limited knowledge yet about the design, use, and effects of this class of tools. By way of introducing a new view on the development of e-health tools dedicated to self-management we aim to contribute to the discussion for further research in this area. Our assumption is that patient empowerment is an important mechanism of e-health self-management and we suggest incorporating it within the development of self-management tools. Important components of empowerment selected from literature are: communication, education and health literacy, information, self-care, decision aids and contact with fellow patients. All components require skills of both patients and the physicians. In this discussion paper we propose how the required skills can be used to specify effective self-management tools. PMID:22193825

  18. Effectiveness of self-management promotion educational program among diabetic patients based on health belief model

    PubMed Central

    Jalilian, Farzad; Motlagh, Fazel Zinat; Solhi, Mahnaz; Gharibnavaz, Hasan

    2014-01-01

    Introduction: Diabetes is a chronic disease; it can cause serious complications. Diabetes self-management is essential for prevention of disease complications. This study was conducted to evaluate self-management promotion educational program intervention efficiency among diabetic patients in Iran and health belief model (HBM) was applied as a theoretical framework. Materials and Methods: Overall, 120 Type 2 diabetic patients referred to rural health centers in Gachsaran, Iran participated in this study as randomly divided into intervention and control group. This was a longitudinal randomized pre- and post-test series control group design panel study to implement a behavior modification based intervention to promotion self-management among diabetic patients. Cross-tabulation and t-test by using SPSS statistical package, version 16 was used for the statistical analysis. Results: Mean age was 55.07 years (SD = 9.94, range: 30-70). Our result shows significant improvements in average response for susceptibility, severity, benefit and self-management among intervention group. Additionally, after intervention, average response of the barrier to self-management was decreased among intervention group. Conclusion: Our result showed education program based on HBM was improve of self-management and seems implementing these programs can be effective in the and prevention of diabetes complications. PMID:24741654

  19. Self-management among Patients Living with Diabetes in the United States Virgin Islands

    PubMed Central

    Nunez, Maxine A.; Yarandi, Hossein; Nunez-Smith, Marcella

    2011-01-01

    The United States Virgin Islands (USVI) is facing a diabetes epidemic similar to the one on the U.S. mainland, yet little is known regarding the cultural context relevant to self-management in this U.S. territory. We conducted in-home interviews (n = 53) supplemented by self-administered questionnaire and A1c testing with U.S. Virgin Islanders to characterize self-management knowledge, attitudes, and behaviors among patients living with diabetes. The mean glycosylated hemoglobin (A1c) was 7.63 (Range = 5–13); a composite score of traditional self-management behaviors was not associated with A1c. Several recurrent themes emerged from qualitative analysis including: 1) cultural nuances shaped perspectives on self-management, 2) culturally-specific challenges were barriers to effective self-management, 3) medical homes were rarely viewed as the primary source of education and support, and 4) fear largely motivated or stalled self-management practices. This study highlights the need for culturally-tailored measures and interventions to address the specific needs within this population. PMID:21317521

  20. Development and Feasibility of a COPD Self-Management Intervention Delivered with Motivational Interviewing Strategies

    PubMed Central

    Benzo, Roberto; Vickers, Kristin; Ernst, Denise; Tucker, Sharon; McEvoy, Charlene; Lorig, Kate

    2013-01-01

    BACKGROUND Self-management (SM) is proposed as the standard of care in chronic obstructive pulmonary disease (COPD) but details of the process and training required to deliver effective SM are not widely available. In addition, recent data suggest that patient engagement and motivation are critical ingredients for effective self-management. This manuscript carefully describes a self-management intervention using Motivational Interviewing skills, aimed to increase engagement and commitment in severe COPD patients. METHODS The intervention was developed and pilot tested for fidelity to protocol, for patient and interventionist feedback (qualitative) and effect on quality of life. Engagement between patient and interventionists was measured by the Working Alliance Inventory. The intervention was refined based in the results of the pilot study and delivered in the active arm of a prospective randomized study. RESULTS The pilot study suggested improvements in quality of life, fidelity to theory and patient acceptability. The refined self-management intervention was delivered 540 times in the active arm of a randomized study. We observed a retention rate of 86% (patients missing or not available for only 14% the scheduled encounters). CONCLUSIONS A self-management intervention, that includes motivational interviewing as the way if guiding patient into behavior change, is feasible in severe COPD and may increase patient engagement and commitment to self-management. This provides a very detailed description of the SM process for (the specifics of training and delivering the intervention) that facilitates replicability in other settings and could be translated to cardiac rehabilitation. PMID:23434613

  1. Drugs for asthma

    PubMed Central

    Barnes, Peter J

    2006-01-01

    Current drug therapy for asthma is highly effective and has evolved from naturally occurring substances through logical pharmaceutical developments. Pharmacology has played a critical role in asthma drug development and several key experimental observations have been published in this journal. Understanding the pharmacology of effective drug therapies has also taught us much about the underlying mechanisms of asthma. β2-Adrenoceptor agonists are the most effective bronchodilators and evolved from catecholamines from the adrenal medulla, whereas corticosteroids, from the adrenal cortex, are by far the most effective controllers of the underlying inflammatory process in the airways. The current ‘gold standard' of asthma therapy is a combination inhaler containing a long-acting β2-agonist with a corticosteroid – an improved form of adrenal gland extract. Cromoglycate, derived from a plant product and theophylline, a dietary methyl xanthine, have also been extensively used in the therapy of asthma, but we still do not understand their molecular mechanisms. Pharmacology has played an important role in improving natural products to make effective long lasting and safe asthma therapies, but has so far been challenged to produce new classes of antiasthma therapy. The only novel class of antiasthma therapy introduced in the last 30 years are leukotriene antagonists, which are less effective than existing treatments. New, more specific, therapies targeted at specific cytokines are less effective than corticosteroids, whereas more effective therapies carry a risk of side effects that may not be acceptable. It seems likely that pharmacology, rather than molecular genetics, will remain the main approach to the further improvement of treatment for asthma. PMID:16402117

  2. Allergen-induced asthma

    PubMed Central

    Cockcroft, Donald W

    2014-01-01

    It was only in the late 19th century that specific allergens, pollen, animal antigens and, later, house dust mite, were identified to cause upper and lower airway disease. Early allergen challenge studies, crudely monitored before measurement of forced expiratory volume in 1 s became widespread in the 1950s, focused on the immediate effects but noted in passing prolonged and/or recurrent asthma symptoms. The late asthmatic response, recurrent bronchoconstriction after spontaneous resolution of the early responses occurring 3 h to 8 h or more postchallenge, has been identified and well characterized over the past 50 years. The associated allergen-induced airway hyper-responsiveness (1977) and allergen-induced airway inflammation (1985) indicate that these late sequelae are important in the mechanism of allergen-induced asthma. Allergens are now recognized to be the most important cause of asthma. A standardized allergen inhalation challenge model has been developed and is proving to be a valuable research tool in the investigation of asthma pathophysiology and of potential new pharmacological agents for the treatment of asthma. PMID:24791256

  3. [Immunological therapy in asthma].

    PubMed

    Matta Campos, Juan José

    2009-01-01

    The goals of pharmacological treatment of asthma is to achieve clinical control and prevent exacerbations with the minimal adverse effects. Pharmacologic therapies are categorized in two general classes: long-term and quick-relief medications. Local or systemic corticosteroids blockade the late phase reaction of the immunological inflammatory response and reduce airway hyperresponsiveness. This reaction can also be diminished by allergen specific immunotherapy, this treatment also create immunological tolerance for the allergen and prevents new sensitizations. Immunosuppressants and immunomodulators such as methotrexate can be used as part of therapy in patients who does not respond to the recommended treatment, these medications should be used only selected patients under the supervision of an asthma specialist, as their potential beneficial effect may not outweigh the risk of serious side effects. Biomolecular therapy medications, such as etarnecept, are not recommended, more studies are required. The anti-IgE monoclonal antibody, omalizumab, is recommended in adults and children over 12, who have allergy as an important cause of their asthma. In reference to childhood immunizations, there is no evidence of influence on the incidence of asthma, possible beneficial effect on asthma exacerbations with anti-influenzae vaccine. Finally we'll see some interesting points about pharmacogenetics. PMID:20873057

  4. Asthma in elite athletes.

    PubMed

    Elers, Jimmi; Pedersen, Lars; Backer, Vibeke

    2011-06-01

    Asthma is frequently found among elite athletes performing endurance sports such as swimming, rowing and cross-country skiing. Although these athletes often report symptoms while exercising, they seldom have symptoms at rest. Moreover, compared with nonathletic asthmatic individuals, elite athletes have been shown to have a different distribution of airway inflammation and unequal response to bronchial provocative test. Elite athletes display signs of exercise-induced symptoms, for example, nonasthmatic inspiratory wheeze, vocal cord dysfunction and cardiac arrhythmias, which could limit their physical capacity. Elite athletes should undergo comprehensive assessment to confirm an asthma diagnosis and determine its degree of severity. Treatment should be as for any other asthmatic individual, including the use of β2-agonist, inhaled steroid as well as leukotriene-antagonist. It should, however, be noted that daily use of β-agonists could expose elite athletes to the risk of developing tolerance towards these drugs. Use of β2-agonist should be replaced with daily inhaled corticosteroid treatment, the most important treatment of exercise-induced asthma. All physicians treating asthma should be aware of the doping aspects. Systemic β2-agonist intake is strictly prohibited, whereas inhaled treatment is allowed in therapeutic doses when asthma is documented and dispensation has been granted when needed. PMID:21702657

  5. The Microbiome in Asthma

    PubMed Central

    Huang, Yvonne J.; Boushey, Homer A.

    2014-01-01

    The application of recently developed sensitive, specific, culture-independent tools for identification of microbes is transforming concepts of microbial ecology, including concepts of the relationships between the vast, complex populations of microbes associated with ourselves and with states of health and disease. While most work initially focused on the community of microbes (microbiome) in the gastrointestinal tract and its relationships to gastrointestinal disease, interest has expanded to include study of the relationships of the microbiome of the airways to asthma and its phenotypes, and to the relationships between the gastrointestinal microbiome, development of immune function, and predisposition to development of allergic sensitization and asthma. We here provide our perspective on the findings of studies of differences in the airway microbiome in patients with asthma vs. healthy subjects, and of studies of relationships between environmental microbiota, gut microbiota, immune function, and the development of asthma, and additionally provide our perspective on how these findings suggest in broad outline a rationale for approaches involving directed manipulation of the gut and airway microbiome for treatment and prevention of allergic asthma. PMID:25567040

  6. Finding Meaning: HIV Self-Management and Wellbeing among People Taking Antiretroviral Therapy in Uganda

    PubMed Central

    Russell, Steve; Martin, Faith; Zalwango, Flavia; Namukwaya, Stella; Nalugya, Ruth; Muhumuza, Richard; Katongole, Joseph; Seeley, Janet

    2016-01-01

    The health of people living with HIV (PLWH) and the sustained success of antiretroviral therapy (ART) programmes depends on PLWH’s motivation and ability to self-manage the condition over the long term, including adherence to drugs on a daily basis. PLWH’s self-management of HIV and their wellbeing are likely to be interrelated. Successful self-management sustains wellbeing, and wellbeing is likely to motivate continued self-management. Detailed research is lacking on PLWH’s self-management processes on ART in resource-limited settings. This paper presents findings from a study of PLWH’s self-management and wellbeing in Wakiso District, Uganda. Thirty-eight PLWH (20 women, 18 men) were purposefully selected at ART facilities run by the government and by The AIDS Support Organisation in and around Entebbe. Two in-depth interviews were completed with each participant over three or four visits. Many were struggling economically, however the recovery of health and hope on ART had enhanced wellbeing and motivated self-management. The majority were managing their condition well across three broad domains of self-management. First, they had mobilised resources, notably through good relationships with health workers. Advice and counselling had helped them to reconceptualise their condition and situation more positively and see hope for the future, motivating their work to self-manage. Many had also developed a new network of support through contacts they had developed at the ART clinic. Second, they had acquired knowledge and skills to manage their health, a useful framework to manage their condition and to live their life. Third, participants were psychologically adjusting to their condition and their new ‘self’: they saw HIV as a normal disease, were coping with stigma and had regained self-esteem, and were finding meaning in life. Our study demonstrates the centrality of social relationships and other non-medical aspects of wellbeing for self-management

  7. Swimming pool-induced asthma.

    PubMed

    Beretta, S; Vivaldo, T; Morelli, M; Carlucci, P; Zuccotti, G V

    2011-01-01

    A 13-year-old elite swimmer presented with wheezing after indoor swimming training. On the basis of her clinical history and the tests performed, exercise-induced asthma and mold-induced asthma were ruled out and a diagnosis of chlorine-induced asthma was made. PMID:21548454

  8. Managing Asthma in the Classroom

    ERIC Educational Resources Information Center

    Hamm, Ellen M.

    2004-01-01

    Asthma is the most common chronic disease of childhood, affecting nearly 5 million children under the age of 18. Children with asthma account for 3 million hospital visits and 200,000 hospitalizations yearly. This adds up to an estimated $2 billion annually in health care costs (American Academy of Pediatrics, 1999). A child with asthma has three…

  9. Smoking and Asthma (For Teens)

    MedlinePlus

    ... I Help a Friend Who Cuts? Smoking and Asthma KidsHealth > For Teens > Smoking and Asthma Print A A A Text Size What's in ... the health problems it causes. If you have asthma, smoking is especially risky because of the damage ...

  10. Smoking and Asthma (For Parents)

    MedlinePlus

    ... Things to Know About Zika & Pregnancy Smoking and Asthma KidsHealth > For Parents > Smoking and Asthma Print A A A Text Size What's in ... unhealthy for everyone, but especially for someone with asthma. The lungs of a smoker, with or without ...

  11. Feasibility of Picture-Based Asthma Medication Plans in Urban Pediatric Outpatient Clinics

    PubMed Central

    Mitchell, Stephanie J.; Bilderback, Andrew L.

    2016-01-01

    Picture-based Asthma Action Plans show promise for overcoming parental literacy barriers and improving child asthma outcomes, but it is uncertain how parents respond to pictures of specific medications, which may be particularly important for improving disease self-management. Thus, we assessed parent attitudes toward an asthma-related picture-based medication plan (PBMP) in an urban academic pediatric clinic and examined attitudes by literacy level. Surveys were administered to a convenience sample of parents of children presenting to an urban pediatric pulmonary clinic for asthma consultation between March and August 2011. The Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF) was administered to parents. Parents indicated their level of agreement with 9 statements on the potential usefulness of the PBMP: (1) before being shown a PBMP; and (2) after seeing the doctor. McNemar's tests showed that the proportion of high-literate parents (≥9th grade reading level) who endorsed the potential benefits of the PBMP after the clinical encounter was significantly higher than before the clinical encounter. A high proportion of low-literate parents (<9th grade reading level) consistently endorsed the PBMP before and after the clinical encounter. Among a diverse sample seen in an urban asthma clinic, parents of all literacy levels endorse PBMPs as useful, especially after using them in clinical encounters.

  12. [Inhaled therapy in asthma].

    PubMed

    Plaza Moral, Vicente; Giner Donaire, Jordi

    2016-04-01

    Because of its advantages, inhaled administration of aerosolized drugs is the administration route of choice for the treatment of asthma and COPD. Numerous technological advances in the devices used in inhaled therapy in recent decades have boosted the appearance of multiple inhalers and aerosolized drugs. However, this variety also requires that the prescribing physician is aware of their characteristics. The main objective of the present review is to summarize the current state of knowledge on inhalers and inhaled drugs commonly used in the treatment of asthma. The review ranges from theoretical aspects (fundamentals and available devices and drugs) to practical and relevant aspects for asthma care in the clinical setting (therapeutic strategies, education, and adherence to inhalers). PMID:26683076

  13. Asthma and athletic performance.

    PubMed

    Fitch, K D; Godfrey, S

    1976-07-12

    Exercise-induced asthma (EIA) is a manifestation of bronchial hyper-reactivity that poses a special problem for the asthmatic engaging in competitive and recreational sports. Recent Olympic successes by swimmers with asthma are not surprising in view of the lessened asthmogenicity of swimming. Neither the cause of EIA nor the reason why some forms of exercise have a greater propensity to provoke EIA is known. Preexercise prophylactic medication with selective beta 2-sympathomimetic agents or cromolyn sodium will reduce or abolish EIA in the majority of asthmatics if administered just before the event. Other agents are less effective or as yet not fully evaluated. With suitable control of exercise-induced asthma, asthmatics should not be unnecessarily restricted, and competitive sports or physical recreation can then occupy an identical role in their lives as it does for their non-asthmatic contemporaries. PMID:819668

  14. A randomized controlled trial to assess the clinical and cost effectiveness of a nurse-led Antenatal Asthma Management Service in South Australia (AAMS study)

    PubMed Central

    2014-01-01

    sample size of 378 women will be sufficient to show an absolute reduction in asthma exacerbations during pregnancy of 20% (alpha 0.05 two-tailed, 90% power, 5% loss to follow-up). Discussion The integration of an asthma education program within the antenatal clinic setting has the significant potential to improve the participation of pregnant women in the self-management of their asthma, reduce asthma exacerbations and improve perinatal health outcomes. Trial registration ACTRN12613000244707 PMID:24401041

  15. Factors Influencing Self-Management in Chinese Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis

    PubMed Central

    Luo, Xiaoping; Liu, Tingting; Yuan, Xiaojing; Ge, Song; Yang, Jing; Li, Changwei; Sun, Wenjie

    2015-01-01

    Diabetes is a major public health problem in China. Diabetes self-management is critical for patients to achieved better health outcomes, however, previous studies have shown suboptimal diabetes self-management performance. We conducted a systematic review and meta-analysis to identify factors associated with diabetes self-management in Chinese adults. The results showed that confrontation, resignation, overall health beliefs, perceived susceptibility, perceived barriers, and self-efficacy were factors associated with overall diabetes self-management performance and six aspects of diabetes self-management behaviors. There is some limited evidence to suggest that provider-patient communication, married individuals, higher educational level, and higher household income level may also be linked to better diabetes self-management practice. Having healthcare insurance and utilizing chronic illness resources generally appeared to have a favorable effect on diabetes self-management performance. In addition, there were a number of factors for which the evidence is too limited to be able to ascertain its strength of association with diabetes self-management practice. The findings of this review suggest that diabetes self-management behaviors are affected by a wide range of personal and environmental factors, which allow health care providers to develop theory-based strategies to improve diabetes-self-management behaviors in this population. PMID:26378555

  16. Factors Influencing Self-Management in Chinese Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis.

    PubMed

    Luo, Xiaoping; Liu, Tingting; Yuan, Xiaojing; Ge, Song; Yang, Jing; Li, Changwei; Sun, Wenjie

    2015-09-01

    Diabetes is a major public health problem in China. Diabetes self-management is critical for patients to achieved better health outcomes, however, previous studies have shown suboptimal diabetes self-management performance. We conducted a systematic review and meta-analysis to identify factors associated with diabetes self-management in Chinese adults. The results showed that confrontation, resignation, overall health beliefs, perceived susceptibility, perceived barriers, and self-efficacy were factors associated with overall diabetes self-management performance and six aspects of diabetes self-management behaviors. There is some limited evidence to suggest that provider-patient communication, married individuals, higher educational level, and higher household income level may also be linked to better diabetes self-management practice. Having healthcare insurance and utilizing chronic illness resources generally appeared to have a favorable effect on diabetes self-management performance. In addition, there were a number of factors for which the evidence is too limited to be able to ascertain its strength of association with diabetes self-management practice. The findings of this review suggest that diabetes self-management behaviors are affected by a wide range of personal and environmental factors, which allow health care providers to develop theory-based strategies to improve diabetes-self-management behaviors in this population. PMID:26378555

  17. Creating 'good' self-managers?: Facilitating and governing an online self care skills training course

    PubMed Central

    Kennedy, Anne; Rogers, Anne; Sanders, Caroline; Gately, Claire; Lee, Victoria

    2009-01-01

    Background In chronic disease management, patients are increasingly called upon to undertake a new role as lay tutors within self-management training programmes. The internet constitutes an increasingly significant healthcare setting and a key arena for self-management support and communication. This study evaluates how a new quasi-professional health workforce – volunteer tutors – engage, guide and attempt to manage people with long-term conditions in the ways of 'good' self-management within the context of an online self-management course. Methods A qualitative analysis of postings to the discussion centre of 11 online classes (purposively selected from 27) run as part of the Expert Patients Programme. Facilitators (term for tutors online) and participants posted questions, comments and solutions related to self-management of long-term conditions; these were subjected to a textual and discursive analysis to explore: a) how facilitators, through the internet, engaged participants in issues related to self-management; b) how participants responded to and interacted with facilitators. Results Emergent themes included: techniques and mechanisms used to engage people with self-management; the process facilitators followed – 'sharing', 'modelling' and 'confirming'; and the emergence of a policing role regarding online disclosure. Whilst exchanging medical advice was discouraged, facilitators often professed to understand and give advice on psychological aspects of behaviour. Conclusion The study gave an insight into the roles tutors adopt – one being their ability to 'police' subjective management of long-term conditions and another being to attempt to enhance the psychological capabilities of participants. PMID:19505302

  18. Self-Management Support Interventions for Stroke Survivors: A Systematic Meta-Review

    PubMed Central

    Parke, Hannah L.; Epiphaniou, Eleni; Pearce, Gemma; Taylor, Stephanie J. C.; Sheikh, Aziz; Griffiths, Chris J.; Greenhalgh, Trish; Pinnock, Hilary

    2015-01-01

    Background There is considerable policy interest in promoting self-management in patients with long-term conditions, but it remains uncertain whether these interventions are effective in stroke patients. Design Systematic meta-review of the evidence for self-management support interventions with stroke survivors to inform provision of healthcare services. Methods We searched MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, BNI, Database of Abstracts of Reviews for Effectiveness, and Cochrane Database of Systematic Reviews for systematic reviews of self-management support interventions for stroke survivors. Quality was assessed using the R-AMSTAR tool, and data extracted using a customised data extraction form. We undertook a narrative synthesis of the reviews' findings. Results From 12,400 titles we selected 13 systematic reviews (published 2003-2012) representing 101 individual trials. Although the term ‘self-management’ was rarely used, key elements of self-management support such as goal setting, action planning, and problem solving were core components of therapy rehabilitation interventions. We found high quality evidence that supported self-management in the context of therapy rehabilitation delivered soon after the stroke event resulted in short-term (< 1 year) improvements in basic and extended activities of daily living, and a reduction in poor outcomes (dependence/death). There is some evidence that rehabilitation and problem solving interventions facilitated reintegration into the community. Conclusions Self-management terminology is rarely used in the context of stroke. However, therapy rehabilitation currently successfully delivers elements of self-management support to stroke survivors and their caregivers with improved outcomes. Future research should focus on managing the emotional, medical and social tasks of long-term survivorship. PMID:26204266

  19. Asthma Outcomes: Pulmonary Physiology

    PubMed Central

    Tepper, Robert S.; Wise, Robert S.; Covar, Ronina; Irvin, Charles G.; Kercsmar, Carolyn M.; Kraft, Monica; Liu, Mark C.; O’Connor, George T.; Peters, Stephen P.; Sorkness, Ronald; Togias, Alkis

    2014-01-01

    Background Outcomes of pulmonary physiology have a central place in asthma clinical research. Objective At the request of National Institutes of Health (NIH) institutes and other federal agencies, an expert group was convened to provide recommendations on the use of pulmonary function measures as asthma outcomes that should be assessed in a standardized fashion in future asthma clinical trials and studies to allow for cross-study comparisons. Methods Our subcommittee conducted a comprehensive search of PubMed to identify studies that focused on the validation of various airway response tests used in asthma clinical research. The subcommittee classified the instruments as core (to be required in future studies), supplemental (to be used according to study aims and in a standardized fashion), or emerging (requiring validation and standardization). This work was discussed at an NIH-organized workshop in March 2010 and finalized in September 2011. Results A list of pulmonary physiology outcomes that applies to both adults and children older than 6 years was created. These outcomes were then categorized into core, supplemental, and emerging. Spirometric outcomes (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], and FEV1/FVC) are proposed as core outcomes for study population characterization, for observational studies, and for prospective clinical trials. Bronchodilator reversibility and pre- and post-bronchodilator FEV1 also are core outcomes for study population characterization and observational studies. Conclusions The subcommittee considers pulmonary physiology outcomes of central importance in asthma and proposes spirometric outcomes as core outcomes for all future NIH-initiated asthma clinical research. PMID:22386510

  20. Asthma in Hispanics

    PubMed Central

    Hunninghake, Gary M.; Weiss, Scott T.; Celedón, Juan C.

    2006-01-01

    Hispanic individuals trace their ancestry to countries that were previously under Spanish rule, including Mexico, large parts of Central and South America, and some Caribbean islands. Most—but not all—Hispanics have variable proportions of European, Amerindian, and African ancestry. Hispanics are diverse with regard to many factors, including racial ancestry, country of origin, area of residence, socioeconomic status, education, and access to health care. Recent findings suggest that there is marked variation in the prevalence, morbidity, and mortality of asthma in Hispanics in the United States and in Hispanic America. The reasons for differences in asthma and asthma morbidity among and within Hispanic subgroups are poorly understood but are likely due to the interaction between yet-unidentified genetic variants and other factors, including environmental tobacco smoke exposure, obesity, allergen exposure, and availability of health care. Barriers to optimal management of asthma in Hispanics in the United States and in Hispanic America include inadequate access to health care, suboptimal use of antiinflammatory medications, and lack of reference values for spirometric measures of lung function in many subgroups (e.g., Puerto Ricans). Future studies of asthma in Hispanics should include large samples of subgroups that are well characterized with regard to self-reported ethnicity, country of origin, place of birth, area of residence, and indicators of socioeconomic status. Because Hispanics are disproportionately represented among the poor in the United States, implementation of adequate access to health care and social reforms (e.g., improving housing conditions) would likely have a major impact on reducing asthma morbidity in this population. PMID:16210666

  1. Are Students with Asthma at Increased Risk for Being a Victim of Bullying in School or Cyberspace? Findings from the 2011 Florida Youth Risk Behavior Survey

    ERIC Educational Resources Information Center

    Gibson-Young, Linda; Martinasek, Mary P.; Clutter, Michiko; Forrest, Jamie

    2014-01-01

    Background: Adolescents with asthma are at risk for psychological and behavioral problems. The aim of this study was to determine whether high school students with asthma are at increased risk for bullying in school and cyberspace, and to explore the role of depressive symptoms in moderating this association. Methods: A secondary data analysis was…

  2. What Works for Asthma Education Programs: Lessons from Experimental Evaluations of Social Programs and Interventions for Children. Fact Sheet. Publication #2012-01

    ERIC Educational Resources Information Center

    Chrisler, Alison

    2012-01-01

    Asthma is a chronic respiratory disease that affects millions of children and adolescents each year. In 2009, 7.1 million children ages 0 to 17 years were reported to have asthma. Unfortunately, when children and teens are unable to manage and cope with their disease, it can compromise their physical, academic, and social development. Therefore,…

  3. The influence of education on morbidity and mortality in asthma (including the use of open access hospital admission for severe attacks).

    PubMed

    Clark, C J

    1994-04-01

    Despite the availability of effective drugs, asthma morbidity and mortality are increasing. Undertreatment is a significant contributory factor providing the rationale for improved concentration on education of asthmatics. A review of asthma education programmes reveals improvements in a variety of outcome measures. However, the types of patients studied in these programmes are very variable and it remains an unproven assumption that previously non-compliant and undertreated patients are amenable to improving asthma through education. The problems of compliance are common both in childhood and adult asthma. Further concentration on strategies to improve the management of this particular sub-group require development. In general, education programmes appear more effective when they consist of specific self-management instructions rather than general education regarding the disease process. PMID:8049704

  4. Inner City Asthma

    PubMed Central

    Togias, Alkis

    2014-01-01

    SYNOPSIS The inner city has long been recognized as an area of high asthma morbidity and mortality. A wide range of factors interact to create this environment. These factors include well-recognized asthma risk factors that are not specific to the inner city, the structure and delivery of health care, the location and function of the urban environment, and social inequities. This article will review these facets and discuss successful and unsuccessful interventions in order to understand what is needed to solve this problem. PMID:25459579

  5. Inhalation treatment for asthma.

    PubMed Central

    Reiser, J; Warner, J O

    1986-01-01

    Inhaled medication has revolutionised the lives of many children with asthma. Despite this we see many children for whom appropriate inhaled medication has been prescribed but whose symptoms continue to be poorly controlled. In our experience this is often due to poor technique or inappropriately prescribed devices and an inadequate understanding of when and how to use the treatment. The prescribing physician must have a clear idea of the optimal inhalation technique. We have reviewed the standard devices available and our use of them in the treatment of childhood asthma. PMID:3082295

  6. Traditional Therapies for Severe Asthma.

    PubMed

    Wang, Eileen; Hoyte, Flavia C L

    2016-08-01

    Severe asthma is a complex and heterogeneous disease. The European Respiratory Society and American Thoracic Society guidelines define severe asthma for patients 6 years or older as "asthma which requires treatment with high-dose inhaled corticosteroids…plus a second controller or systemic corticosteroids to prevent it from becoming 'uncontrolled' or which remains 'uncontrolled' despite this therapy." This article reviews available traditional therapies, data behind their uses in severe asthma, and varying recommendations. As various asthma endotypes and phenotypes are better understood and characterized, targeted therapies should help improve disease outcomes, efficacy, and cost-effectiveness. PMID:27401628

  7. Pharmacogenetics of asthma in children

    PubMed Central

    Matsui, Eiko; Nishimura, Akane; Kaneko, Hideo

    2010-01-01

    Allergic diseases such as bronchial asthma and atopic dermatitis develop by a combination of genetic and environmental factors. Several candidate causative genes of asthma and atopy have been reported as the genetic factors. The clinical features of patients and causes of diseases vary. Therefore, personalized medicine (tailor-made medicine) is necessary for the improvement of quality of life (QOL) and for asthma cure. Pharmacogenetics is very important for personalized medicine. Here, we present the genetics and pharmacogenetics of asthma in children. Finally, we show the guideline for personalized medicine for asthma, particularly in childhood, including the pharmacogenetics of anti-asthmatic drugs, preliminarily produced by the authors. PMID:20224673

  8. The impact of social context on self-management in women living with HIV.

    PubMed

    Webel, Allison R; Cuca, Yvette; Okonsky, Jennifer G; Asher, Alice K; Kaihura, Alphoncina; Salata, Robert A

    2013-06-01

    HIV self-management is central to the health of people living with HIV and is comprised of the daily tasks individuals employ to manage their illness. Women living with HIV are confronted with social context vulnerabilities that impede their ability to conduct HIV self-management behaviors, including demanding social roles, poverty, homelessness, decreased social capital, and limited access to health care. We examined the relationship between these vulnerabilities and HIV self-management in a cross-sectional secondary analysis of 260 women living with HIV from two U.S. sites. All social context variables were assessed using validated self-report scales. HIV Self-Management was assessed using the HIV Self-Management Scale that measures daily health practices, HIV social support, and the chronic nature of HIV. Data were analyzed using appropriate descriptive statistics and multivariable regression. Mean age was 46 years and 65% of participants were African-American. Results indicated that social context variables, particularly social capital, significantly predicted all domains of HIV self-management including daily health practices (F = 5.40, adjusted R(2) = 0.27, p < 0.01), HIV social support (F = 4.50, adjusted R(2) = 0.22, p < 0.01), and accepting the chronic nature of HIV (F = 5.57, adjusted R(2) = 0.27, p < 0.01). We found evidence to support the influence of the traditional social roles of mother and employee on the daily health practices and the chronic nature of HIV domains of HIV self-management. Our data support the idea that women's social context influences their HIV self-management behavior. While social context has been previously identified as important, our data provide new evidence on which aspects of social context might be important targets of self-management interventions for women living with HIV. Working to improve social capital and to incorporate social roles into the daily health practices of women living with HIV may improve the health of

  9. The Impact of Social Context on Self-Management in Women Living with HIV

    PubMed Central

    Webel, Allison R.; Cuca, Yvette; Okonsky, Jennifer G.; Asher, Alice K.; Kaihura, Alphoncina; Salata, Robert A.

    2013-01-01

    HIV self-management is central to the health of people living with HIV and is comprised of the daily tasks individuals employ to manage their illness. Women living with HIV are confronted with social context vulnerabilities that impede their ability to conduct HIV self-management behaviors, including demanding social roles, poverty, homelessness, decreased social capital, and limited access to health care. We examined the relationship between these vulnerabilities and HIV self-management in a cross-sectional secondary analysis of 260 women living with HIV from two U.S. sites. All social context variables were assessed using validated self-report scales. HIV Self-Management was assessed using the HIV Self-Management Scale that measures daily health practices, HIV social support, and the chronic nature of HIV. Data were analyzed using appropriate descriptive statistics and multivariable regression. Mean age was 46 years and 65% of participants were African-American. Results indicated that social context variables, particularly social capital, significantly predicated all domains of HIV self-management including daily health practices (F=5.40, adjusted R2=0.27, p<0.01), HIV social support (F=4.50, adjusted R2=0.22, p<0.01), and accepting the chronic nature of HIV (F=5.57, adjusted R2=0.27, p<0.01). We found evidence to support the influence of the traditional social roles of mother and employee on the daily health practices and the chronic nature of HIV domains of HIV self-management. Our data support the idea that women’s social context influences their HIV self-management behavior. While social context has been previously identified as important, our data provide new evidence on which aspects of social context might be important targets of self-management interventions for women living with HIV. Working to improve social capital and to incorporate social roles into the daily health practices of women living with HIV may improve the health of this population. PMID

  10. Workplace respiratory irritants and asthma.

    PubMed

    Tarlo, S M

    2000-01-01

    Workplace respiratory irritants can have a variety of effects in relation to asthma. Very high exposures can cause new-onset asthma (reactive airways dysfunction syndrome or irritant-induced asthma) with or without concurrent sensitization, e.g., to diisocyanate. Aggravation of underlying asthma can result from moderate exposures. Adjuvant or other effects enhancing the risk of sensitization to high molecular weight allergens have occurred with chronic low-moderate exposures. Enhancement of airway responsiveness on a short-term basis can be produced by ozone and biological irritants such as endotoxin and beta 1-3 glucans. Production of nonasthmatic responses such as hyperventilation and vocal cord dysfunction can mimic asthma symptoms. Controversy exists as to whether moderate irritant exposures can cause asthma or long-term worsening of underlying asthma. PMID:10769351

  11. Adherence to evidence-based guidelines among diabetes self-management apps.

    PubMed

    Breland, Jessica Y; Yeh, Vivian M; Yu, Jessica

    2013-09-01

    Smartphone apps can provide real-time, interactive self-management aid to individuals with diabetes. It is currently unclear whether existing diabetes self-management apps follow evidence-based guidelines. The purpose of this study was to evaluate the extent to which existing diabetes self-management apps address the seven self-management behaviors recommended by the American Association of Diabetes Educators (the AADE7™). The term "diabetes" identified relevant self-management apps via the Apple App Store search engine in March 2012. Ratings were based on app descriptions and downloads. Chi-square analyses assessed differences in apps based on developer type. Apps promoted a median of two AADE7™ skills. Overall reliability between description and download ratings was good (kappa = .66). Reliability of individual skills was variable (kappa = .25 to .91). Most diabetes apps do not conform to evidence-based recommendations, and future app reviews would benefit from testing app performance. Future apps may also benefit from theory-based designs. PMID:24073179

  12. Complementary and Alternative Medicine Use as Health Self-Management: Rural Older Adults With Diabetes

    PubMed Central

    Arcury, Thomas A.; Bell, Ronny A.; Snively, Beverly M.; Smith, Shannon L.; Skelly, Anne H.; Wetmore, Lindsay K.; Quandt, Sara A.

    2006-01-01

    Objectives This study describes complementary and alternative medicine (CAM) use among rural older adults with diabetes, delineates the relationship of health self-management predictors to CAM therapy use, and furthers conceptual development of CAM use within a health self-management framework. Methods Survey interview data were collected from a random sample of 701 community dwelling African American, Native American, and White elders residing in two rural North Carolina counties. We summarize CAM use for general use and for diabetes care and use multiple logistic modeling to estimate the effects of health self-management predictors on use of CAM therapies. Results The majority of respondents used some form of CAM for general purpose, whereas far fewer used CAM for diabetes care. The most widely used CAM categories were food home remedies, other home remedies, and vitamins. The following health self-management predictors were related to the use of different categories of CAM therapies: personal characteristics (ethnicity), health status (number of health conditions), personal resources (education), and financial resources (economic status). Discussion CAM is a widely used component of health self-management among rural among older adults with diabetes. Research on CAM use will benefit from theory that considers the specific behavior and cognitive characteristics of CAM therapies. PMID:16497962

  13. Risk and self-managing chronic joint pain: looking beyond individual lifestyles and behaviour.

    PubMed

    Morden, Andrew; Jinks, Clare; Ong, Bie Nio

    2015-07-01

    Self-managing chronic musculoskeletal pain is predominantly framed within a discourse of modifying behaviour, or lifestyle risk factors such as diet, weight loss and exercise by policymakers, researcher and clinicians. Little research has been conducted which explores how 'risk' is understood or encountered by those with joint pain and how it may relate to self-management. Drawing from serial interviews and a diary study with 22 participants, the findings demonstrate that people with chronic pain engage in a process of assessing and adapting to hazardous or pain conferring situations in relation to daily activities. 'Risks' are embedded within a dialectic between corporeal experience and the design features of everyday social environments. Self-management, in this context, is not necessarily solely related to following clinical advice, rather it includes dealing with 'risks' of pain, hazards relating to bodily limitations and the environment, and ensuring the ability to continue with valued activities. Findings contribute to sociological understandings of self-management and risk while demonstrating the limits of viewing self-management as an individualised endeavour of changing behaviour. PMID:26171691

  14. Psychosocial issues in diabetes self-management: strategies for healthcare providers.

    PubMed

    Sabourin, Brigitte C; Pursley, Shannon

    2013-02-01

    Education and training for diabetes mellitus self-management is widely available and an essential part of many diabetes centres. Nonetheless, the majority of individuals with diabetes do not adhere to optimal self-management recommendations. It is believed that psychosocial issues play an important role in individuals' ability to undertake the extensive behavioural demands involved in managing diabetes. The goal of the present article is to provide an overview of psychosocial issues and suggest strategies for healthcare providers in supporting patients with the challenges of diabetes self-management. First, motivational enhancement strategies have the potential to augment patients' own motivation to engage in health behaviours. Second, behavior modification principles can increase patients' self-efficacy and their experiences of success. Third, managing distressing emotions, including anxiety, depression, distress specifically related to diabetes care, and fear of hypoglycemia, can facilitate motivation and ability to undertake diabetes self-management efforts. Recognizing and addressing psychosocial challenges allows healthcare providers to better support their patients in the demanding tasks of diabetes self-management. PMID:24070746

  15. Self-Management: Enabling and empowering patients living with cancer as a chronic illness

    PubMed Central

    McCorkle, Ruth; Ercolano, Elizabeth; Lazenby, Mark; Schulman-Green, Dena; Schilling, Lynne S.; Lorig, Kate; Wagner, Edward H.

    2010-01-01

    With recent improvements in early detection, diagnosis and treatment of cancer, people with cancer are living longer, and their cancer may be managed as a chronic illness. Cancer as a chronic illness places new demands on patients and families to manage their own care, and it challenges old paradigms that oncology's work is done after treatment. As a chronic illness, however, cancer care occurs on a continuum that stretches from prevention to the end of life, with early detection, diagnosis, treatment, and survivorship in between. In this paper, we review self-management interventions that enable patients and families to participate in managing their care along this continuum. We review randomized controlled trials of self-management interventions with cancer patients and families in the treatment, survivorship, and end-of-life phases of the cancer-care continuum. We also present the Chronic Care Model as a model of care that oncology practices can use to enable and empower patients and families to engage in self-management. We conclude that, the need for a common language by which to speak about self-management and a common set of self-management actions for cancer care notwithstanding, oncology practices can now build strong relationships with their patients and formulate mutually-agreed upon care plans that enable and empower patients to care for themselves in the way they prefer. PMID:21205833

  16. Coping strategies used by poorly adherent patients for self-managing bipolar disorder

    PubMed Central

    Blixen, Carol; Levin, Jennifer B; Cassidy, Kristin A; Perzynski, Adam T; Sajatovic, Martha

    2016-01-01

    Background Bipolar disorder (BD) is a chronic mental illness associated with reduced quality of life, high rates of suicide, and high financial costs. Evidence indicates that psychosocial stress might play an important role in the onset and course of BD. Objective The objective of this study was to address the gap between coping theory and the clinical use of coping strategies used to self-manage BD. Methods In-depth interviews were conducted with a sample of 21 poorly adherent patients with BD. All interviews were audiotaped, transcribed verbatim, and analyzed using content analysis with an emphasis on dominant themes. Results Transcript-based analysis generated two major domains of coping strategies used to self-manage BD: 1) problem focused (altering eating habits, managing mood-stabilizing medications, keeping psychiatric appointments, seeking knowledge, self-monitoring, and socializing) and 2) emotion focused (distracting activities, denial, isolation, modifying/avoiding, helping others, and seeking social support). Participants used both types of coping strategies to deal with stressful situations brought about by the internal and external demands associated with self-management of BD. Conclusion This qualitative study provided a first step in evaluating coping strategies as a possible mediator in the self-management of BD and has implications for health care providers. Being able to characterize an individual’s coping behaviors can help patients modify or replace more maladaptive coping with better coping strategies in the self-management of this chronic mental illness. PMID:27524888

  17. Efficacy of Nasal Mometasone for the Treatment of Chronic Sinonasal Disease in Inadequately Controlled Asthma

    PubMed Central

    Dixon, Anne E.; Castro, Mario; Cohen, Rubin I.; Gerald, Lynn B.; Holbrook, Janet T.; Irvin, Charles G.; Mohapatra, Shyam; Peters, Stephen P.; Rayapudi, Sobharani; Sugar, Elizabeth A.; Wise, Robert A.

    2014-01-01

    Background Chronic sinonasal disease is common in asthma and associated with poor asthma control; however there are no long term trials addressing whether chronic treatment of sinonasal disease improves asthma control. Objective To determine if treatment of chronic sinonasal disease with nasal corticosteroids improves asthma control as measured by the Childhood Asthma Control Test (cACT) and Asthma Control Test (ACT) in children and adults respectively. Methods A 24 week multi-center randomized placebo controlled double-blinded trial of placebo versus nasal mometasone in adults and children with inadequately controlled asthma. Treatments were randomly assigned with concealment of allocation. Results 237 adults and 151 children were randomized to nasal mometasone versus placebo, 319 participants completed the study. There was no difference in the cACT (difference in change with mometasone – change with placebo [ΔM - ΔP]: -0.38, CI: -2.19 to 1.44, p = 0.68 ages 6 to 11) or the ACT (ΔM - ΔP: 0.51, CI: -0.46 to 1.48, p = 0.30, ages 12 and older) in those assigned to mometasone versus placebo. In children and adolescents, ages 6 to 17, there was no difference in asthma or sinus symptoms, but a decrease in episodes of poorly controlled asthma defined by a drop in peak flow. In adults there was a small difference in asthma symptoms measured by the Asthma Symptom Utility Index (ΔM - ΔP: 0.06, CI: 0.01 to 0.11, p <0.01) and in nasal symptoms (sinus symptom score ΔM - ΔP: -3.82, CI: -7.19 to- 0.45, p =0.03), but no difference in asthma quality of life, lung function or episodes of poorly controlled asthma in adults assigned to mometasone versus placebo. Conclusions Treatment of chronic sinonasal disease with nasal corticosteroids for 24 weeks does not improve asthma control. Treatment of sinonasal disease in asthma should be determined by the need to treat sinonasal disease rather than to improve asthma control. PMID:25174863

  18. Research on psychosocial aspects of asthma in the Arab world: a literature review.

    PubMed

    Al-Khateeb, Anas J; Al Khateeb, Jamal M

    2015-01-01

    The importance of psychosocial factors in the management of bronchial asthma has long been recognized. This paper offers a review of research published in the English language related to psychosocial aspects of bronchial asthma in Arab countries. Several databases (PubMed, Science Direct, Springer Link, ERIC, and PsychInfo) were searched using the following keywords: bronchial asthma, Arab countries, Algiers, Bahrain, Comoros, Djibouti, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Mauritania, Morocco, Oman, Palestine (West Bank, Gaza), Qatar, Saudi Arabia, Syria, Tunisia, Sudan, Somalia; United Arab Emirates, and Yemen. Thirty-two studies were conducted in 9 Arab countries. Almost all studies found were published in the last fourteen years with an apparent increasing rate in the last five years. In descending order, these studies addressed: knowledge of and attitudes toward asthma, quality of life, behavioral and emotional problems and factors related to academic achievement. The main results of the studies reviewed were: (a) physicians', school staff's, and parents' knowledge of and attitudes toward asthma were generally unsatisfactory, (b) in-service asthma education programs significantly impacted parent and staff knowledge and attitudes, and asthma management practices, (c) quality of life in children and adolescents was significantly adversely affected by asthma, (d) asthma was a common cause of school absenteeism, and had a significant negative impact on academic achievement of students, and (e) students with asthma had significantly higher rates of behavioral and emotional difficulties compared to students without asthma. The paper concludes with a discussion about the implications of these results and a call for further research in this area. PMID:25905019

  19. Anthroposophic therapy for asthma: A two-year prospective cohort study in routine outpatient settings

    PubMed Central

    Hamre, Harald J; Witt, Claudia M; Kienle, Gunver S; Schnürer, Christof; Glockmann, Anja; Ziegler, Renatus; Willich, Stefan N; Kiene, Helmut

    2009-01-01

    Background: Anthroposophic treatment for asthma includes special artistic and physical therapies and special medications. Methods: We studied consecutive outpatients starting anthroposophic treatment for asthma under routine conditions in Germany. Main outcomes were average asthma severity (0–10, primary outcome); symptoms (1–4); and asthma-related quality of life at 12-month follow-up (Asthma Quality of Life Questionnaire [AQLQ] overall score, 1–7, for adults; KINDL Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, asthma module, 0–100, for children) at 12-month follow-up. Results: Ninety patients (54 adults, 36 children) were included. Anthroposophic treatment modalities used were medications (88% of patients, n = 79/90); eurythmy therapy (22%); art therapy (10%); and rhythmical massage therapy (1%). Median number of eurythmy/art/massage sessions was 12 (interquartile range 10–20), median therapy duration was 120 days (84–184). From baseline to 12-month follow-up, all outcomes improved significantly (P < 0.001 for all comparisons). Average improvements were: average asthma severity 2.61 points (95% confidence interval CI: 1.90–3.32); cough 0.93 (95% CI: 0.60–1.25); dyspnea 0.92 (95% CI: 0.56–1.28); exertion-induced symptoms 0.95 (95% CI: 0.64–1.25); frequency of asthma attacks 0.78 (95% CI: 0.41–1.14); awakening from asthma 0.90 (95% CI: 0.58–1.21); AQLQ overall score 1.44 (95% CI: 0.97–1.92); and KINDL asthma module 14.74 (95% CI: 9.70–19.78). All improvements were maintained until last follow-up after 24 months. Conclusions: Patients with asthma under anthroposophic treatment had long-term improvements of symptoms and quality of life. PMID:21437149

  20. Allergies, asthma, and pollen

    MedlinePlus

    ... Some trees Some grasses Weeds Ragweed Watch the weather and the season The amount of pollen in the air can affect whether you or your child has hay fever and asthma symptoms. On hot, dry, windy days, more pollen is in the air. ...