Search results for: childhood asthma
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 774

Search results for: childhood asthma

744 Serum Cortisol and Osteocalsin in Response to Eight Weeks Aerobic Training in Asthma Men with Mild to Moderate Intensity

Authors: Eizadi Mojtaba

Abstract:

This study aimed to evaluate the effect of 8 weeks aerobic training on serum osteocalsin as an osteoblasts hormone and cortisol in adult men with asthma. For this purpose, twenty four non-trained adult men with mild to moderate asthma were participated in study voluntarily and divided into exercise (aerobic training, 8 weeks/3 times per week) and control groups by randomly. Pre and post training of serum osteocalsin and cortisol were measured of two groups. Student’s paired ‘t’ test was applied to compare the pre and post training values. A p-value of less than 0.05 was considered to be statistically significant. There were no statistically significant differences with regard to all anthropometrical and biochemical markers between the exercise and control groups at baseline ( P > 0.05 ). Exercise training resulted in a significant increase in serum osteocalsin and decrease in cortisol ( P > 0.05 ), but not in control group. Based on these data, we concluded that aerobic training can be improved Processes of bone formation in asthma patients.

Keywords: osteoblasts, asthma, aerobic exercise, sedentary

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743 Effectiveness of Buteyko Method in Asthma Control and Quality of Life of School-Age Children

Authors: Romella C. Lina, Matthew Daniel V. Leysa, Zarah D. F. Libozada, Maria Francesca I. Lirio, Angelo A. Liwag, Gabriel D. Ramos, Margaret M. Natividad

Abstract:

This study aimed to determine the effectiveness of Buteyko Method in asthma control and quality of life of school-age children wherein a pretest-posttest design was utilized to measure the changes after the administration of Buteyko Method. Fourteen (14) subjects with bronchial asthma, aged 7-11 participated in the study. They were equally divided into two groups: the control group received no intervention while the experimental group was asked to attend sessions of Buteyko Method lecture and demonstration. The experimental group was visited for three (3) consecutive weeks to monitor their progress and compliance. Both groups were asked to answer ACQ pre- and post-intervention and PAQLQ before the start of the intervention phase and every week during the follow-up visits. In comparing the asthma control pre-test and post-test mean scores of the control group, no significant difference was noted (p=0.177) while the experimental group showed a significant difference after the administration of Buteyko Method (p=0.002). Moreover, the quality of life pre-test and post-test mean scores of the control group showed no significant difference in any week within one month of follow-up (p=0.736, 0.604, 0.689) while the experimental group showed a significant difference on the third week (p = 0.035) and fourth week (p=0.002) but no significant difference on the second week (p=0.111). Therefore, the use of Buteyko Method within 3-4 weeks as an adjunct to conventional management of asthma helps in improving asthma control and quality of life of school-age children.

Keywords: Buteyko Method, asthma, school-age children, asthma control, quality of life

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742 Progression of Trauma: Myth Mess Mastery, Addressing and Grooming

Authors: Stuart Bassman

Abstract:

Services that focus on the synthesis of research and clinical practice are vital in providing efficacious change for the men and women who have been victims of childhood sexual abuse. This study will address what processes have been helpful in being a catalyst in changing one’s inner life as well as providing meaningful applications and fulfilling experiences. Initially, we would focus on the Myths regarding childhood sexual abuse. This would include Grooming behaviors and Delayed Disclosures. Subsequently, we would address the Mess that follows from not recognizing the adverse impairments that result from Childhood Sexual Abuse. Finally, we would conclude by looking at the Mastery that could arise from moving from being a Victim to a Survivor and a Thriver.

Keywords: trauma, childhood, somatic, treatment

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741 The Most Effective Interventions to Prevent Childhood Obesity

Authors: Sarah-Anne Schumann, Chintan Shah, Sandeep Ponniah, Syeachia Dennis

Abstract:

Effective interventions to prevent childhood obesity include limiting sugar-sweetened beverage intake (SOR: B, longitudinal study), school and home based strategies to reduce total screen time and increase physical activity, behavioral and dietary counseling, and support for parents and families (SOR: A, meta-analysis of randomized and non-randomized controlled trials). Risk factors for childhood obesity include maternal pre-pregnancy weight, high infant birth weight, early infant rapid weight gain and maternal smoking during pregnancy which may provide opportunities to intervene and prevent childhood obesity (SOR: B, meta-analysis of observational studies).

Keywords: childhood, obesity, prevent obesity, interventions to prevent obesity

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740 Determinants of House Dust, Endotoxin, and β- (1→ 3)-D-Glucan in Homes of Turkish Children

Authors: Afsoun Nikravan, Parisa Babaei, Gulen Gullu

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We aimed to study the association between house dust endotoxin, β-(1→3)-D-glucan, and asthma in a sample representative of the Turkish population. We analyzed data from 240 participants. The house dust was collected from the homes of 110 asthmatics and 130 control (without asthma) school-aged children (6-11 years old). House dust from the living room and from bedroom floors were analyzed for endotoxin and beta-glucan contents. House dust was analyzed for endotoxin content by the kinetic limulus amoebocyte lysate assay and for β-(1→3)-D-glucan by the inhibition enzyme immunoassay. The parents answered questions regarding potential determinants. We found geometric means 187.5 mg/m² for dust. According to statistical values, the endotoxin geometric mean was 13.86×103 EU/g for the control group and 6.16×103 EU/g for the asthma group. As a result, the amount of bacterial endotoxin was measured at a higher level in the homes of children without asthma. The geometric mean for beta-glucan was 46.52 µg/g and 44.39 µg/g for asthma and control groups, respectively. No associations between asthma and microbial agents were observed in Turkish children. High correlations (r > 0.75) were found between floor dust and endotoxin loads, while endotoxin and β-(1→3)-D-glucan concentrations were not correlated. The type of flooring (hard-surface or textile) was the strongest determinant for loads of floor dust and concentrations of endotoxin. Water damage and dampness at home were determinants of β-(1→3)-D-glucan concentrations. Endotoxin and β-(1→3)-D-glucan concentrations in Turkish house dust might lower than concentrations seen in other European countries.

Keywords: indoor air quality, asthma, microbial pollutants, case-control

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739 Emerging Issues in Early Childhood Care and Development in Nigeria

Authors: Evelyn Fabian

Abstract:

The focus of this discussion centres on the emerging issues in Early Childhood Care and development in Nigeria. Early childhood care is the bedrock of Nigeria’s educational system. However, there are critical issues that had not been addressed and it is frustrating the entire educational process. Thus, this paper will show the inter-connectedness between these issues such as poor funding, trained skillful teachers that would supervise the learning process of the kids, unconducive learning environment and lack of relevant facilities. For a clear grasp of these issues, the researcher visited 36 early childhood centres distributed across the 36 spates of Nigeria. The findings which were expressed in simple percentages revealed a near total absence or government neglect of these critical areas. The findings equally showed a misplaced priority in the government allocation of funds to early child care education and development. The study concludes that this mismatch in the training of these categories of pupils, government should expedite action in addressing these emerging issues in early childhood care and development in Nigeria.

Keywords: early childhood, ECCE, education, emerging issues

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738 A Diagnostic Challenge of Drug Resistant Childhood Tuberculosis in Developing World

Authors: Warda Fatima, Hasnain Javed

Abstract:

The emerging trend of Drug resistance in childhood Tuberculosis is increasing worldwide and now becoming a priority challenge for National TB Control Programs of the world. Childhood TB accounts for 10-15% of total TB burden across the globe and same proportion is quantified in case of drug resistant TB. One third population suffering from MDR TB dies annually because of non-diagnosis and unavailability of appropriate treatment. However, true Childhood MDR TB cannot be estimated due to non-confirmation. Diagnosis of Pediatric TB by sputum Smear Microscopy and Culture inoculation are limited due to paucibacillary nature and difficulties in obtaining adequate sputum specimens. Diagnosis becomes more difficult when it comes to HIV infected child. New molecular advancements for early case detection of TB and MDR TB in adults have not been endorsed in children. Multi centered trials are needed to design better diagnostic approaches and efficient and safer treatments for DR TB in high burden countries. The aim of the present study is to sketch out the current situation of the childhood Drug resistant TB especially in the developing world and to highlight the classic and novel methods that are to be implemented in high-burden resource-limited locations.

Keywords: drug resistant TB, childhood, diagnosis, novel methods

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737 Developing Primary Care Datasets for a National Asthma Audit

Authors: Rachael Andrews, Viktoria McMillan, Shuaib Nasser, Christopher M. Roberts

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Background and objective: The National Review of Asthma Deaths (NRAD) found that asthma management and care was inadequate in 26% of cases reviewed. Major shortfalls identified were adherence to national guidelines and standards and, particularly, the organisation of care, including supervision and monitoring in primary care, with 70% of cases reviewed having at least one avoidable factor in this area. 5.4 million people in the UK are diagnosed with and actively treated for asthma, and approximately 60,000 are admitted to hospital with acute exacerbations each year. The majority of people with asthma receive management and treatment solely in primary care. This has therefore created concern that many people within the UK are receiving sub-optimal asthma care resulting in unnecessary morbidity and risk of adverse outcome. NRAD concluded that a national asthma audit programme should be established to measure and improve processes, organisation, and outcomes of asthma care. Objective: To develop a primary care dataset enabling extraction of information from GP practices in Wales and providing robust data by which results and lessons could be drawn and drive service development and improvement. Methods: A multidisciplinary group of experts, including general practitioners, primary care organisation representatives, and asthma patients was formed and used as a source of governance and guidance. A review of asthma literature, guidance, and standards took place and was used to identify areas of asthma care which, if improved, would lead to better patient outcomes. Modified Delphi methodology was used to gain consensus from the expert group on which of the areas identified were to be prioritised, and an asthma patient and carer focus group held to seek views and feedback on areas of asthma care that were important to them. Areas of asthma care identified by both groups were mapped to asthma guidelines and standards to inform and develop primary and secondary care datasets covering both adult and pediatric care. Dataset development consisted of expert review and a targeted consultation process in order to seek broad stakeholder views and feedback. Results: Areas of asthma care identified as requiring prioritisation by the National Asthma Audit were: (i) Prescribing, (ii) Asthma diagnosis (iii) Asthma Reviews (iv) Personalised Asthma Action Plans (PAAPs) (v) Primary care follow-up after discharge from hospital (vi) Methodologies and primary care queries were developed to cover each of the areas of poor and variable asthma care identified and the queries designed to extract information directly from electronic patients’ records. Conclusion: This paper describes the methodological approach followed to develop primary care datasets for a National Asthma Audit. It sets out the principles behind the establishment of a National Asthma Audit programme in response to a national asthma mortality review and describes the development activities undertaken. Key process elements included: (i) mapping identified areas of poor and variable asthma care to national guidelines and standards, (ii) early engagement of experts, including clinicians and patients in the process, and (iii) targeted consultation of the queries to provide further insight into measures that were collectable, reproducible and relevant.

Keywords: asthma, primary care, general practice, dataset development

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736 Sex Education: The Teacher’s Discourses About the Relation Between the Children and the Media, Concerning Sex Education and the Childhood

Authors: Katerina Samartzi

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This study focuses on the teacher’s discourses in Greece, about the relation between the children and the media, concerning sex education and widely the childhood. The teachers’ input reflect the anxieties and the dominant discourses that exist around these issues. The study begins with the critical discussion of the available literature concerning the potential impact of media and the ‘moral panics’, their role in sex education and the children’s use of sexual material. Moreover, the study analyses the social construction of childhood and sexuality. Given the lack of explicit and official protocol for the sex education in Greece and due the fact that the young people are familiar with all the material provided by the New Media and their part as an informal education, this project aims to point out the factors that reinforce these gaps. This study focuses on the way the adults and specifically teachers contextualize the children’s relation with media, their sexuality, the sex education, the use of sexual material and the childhood.

Keywords: childhood, children's sexuality, media, moral panics, pornography, sex education

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735 The Investigation of Predictor Affect of Childhood Trauma, Dissociation, Alexithymia, and Gender on Dissociation in University Students

Authors: Gizem Akcan, Erdinc Ozturk

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The purpose of the study was to determine some psychosocial variables that predict dissociation in university students. These psychosocial variables were perceived childhood trauma, alexithymia, and gender. 150 (75 males, 75 females) university students (bachelor, master and postgraduate) were enrolled in this study. They were chosen from universities in Istanbul at the education year of 2016-2017. Dissociative Experiences Scale (DES), Childhood Trauma Questionnaire (CTQ) and Toronto Alexithymia Scale were used to assess related variables. Demographic Information Form was given to students in order to have their demographic information. Frequency Distribution, Linear Regression Analysis, and t-test analysis were used for statistical analysis. Childhood trauma and alexithymia were found to have predictive value on dissociation among university students. However, physical abuse, physical neglect and emotional neglect sub dimensions of childhood trauma and externally-oriented thinking sub dimension of alexithymia did not have predictive value on dissociation. Moreover, there was no significant difference between males and females in terms of dissociation scores of participants.

Keywords: childhood trauma, dissociation, alexithymia, gender

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734 Low-Dose Chest Computed Tomography Can Help in Differential Diagnosis of Asthma–COPD Overlap Syndrome in Children

Authors: Frantisek Kopriva, Kamila Michalkova, Radim Dudek, Jana Volejnikova

Abstract:

Rationale: Diagnostic criteria of asthma–COPD overlap syndrome (ACOS) are controversial in pediatrics. Emphysema is characteristic of COPD and usually does not occur in typical asthma; its presence in patients with asthma suggests the concurrence with COPD. Low-dose chest computed tomography (CT) allows a non-invasive assessment of the lung tissue structure. Here we present CT findings of emphysematous changes in a child with ACOS. Patient and Methods: In a 6-year-old boy, atopy was confirmed by a skin prick test using common allergen extracts (grass and tree pollen, house dust mite, molds, cat, dog; manufacturer Stallergenes Greer, London, UK), where reactions over 3 mm were considered positive. Treatment with corticosteroids was started during the course of severe asthma. At 12 years of age, his spirometric parameters deteriorated despite treatment adjustment (VC 1.76 L=85%, FEV1 1.13 L=67%, TI%VCmax 64%, MEF25 19%, TLC 144%) and the bronchodilator test became negative. Results: Low-dose chest CT displayed irregular regions with increased radiolucency of pulmonary parenchyma (typical for hyperinflation in emphysematous changes) in both lungs. This was in accordance with the results of spirometric examination. Conclusions: ACOS is infrequent in children. However, low-dose chest CT scan can be considered to confirm this diagnosis or eliminate other diagnoses when the clinical condition is deteriorating and treatment response is poor.

Keywords: child, asthma, low-dose chest CT, ACOS

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733 Randomized Trial of Tian Jiu Therapy in San Fu Days for Patients with Chronic Asthma

Authors: Libing Zhu, Waichung Chen, Kwaicing Lo, Lei Li

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Background: Tian Jiu Therapy (a medicinal vesiculation therapy according to traditional Chinese medicine theory) in San Fu Days (the three hottest days in a year is calculated by the Chinese ancient calendar) is widely used by patients with chronic asthma in China although from modern medicine perspective there is insufficient evidence of its effectiveness and safety issues. We investigated the efficacy and safety of Tian Jiu Therapy compared with placebo in patients with chronic asthma. Methods: Patients with chronic asthma were randomly assigned to Tian Jiu treatment group (n=165), placebo control group (n=158). Registered Chinese Medicine practitioners, in Orthopedics-Traumatology, Acupuncture, and Tui-na Clinical Centre for Teaching and Research, School of Chinese Medicine, The University of Hong Kong, administered Tian Jiu Therapy and placebo treatment in 3 times over 2 months. Patients completed questionnaires and lung function test before treatment and after treatment, 3, 6, 9, and 11 months, respectively. The primary outcome was the no of asthma-related sub-healthy symptoms and the percentage of patients with twenty-three symptoms. Results: 451 patients were recruited totally, 111 patients refused or did not participate according the appointment time and 17 did not meet the inclusion criteria. Consequently, 323 of eligible patients were enrolled. There was nothing difference between Tian Jiu Therapy group and placebo control group at the end of all treatments neither primary nor secondary outcomes. While Tian Jiu Therapy as compared with placebo significantly reduced the percentage of participants who are susceptible waken up by asthma symptoms from 27% to 14% at 2nd follow-up (P < 0.05). Similarly, Tian Jiu Therapy significantly reduced the proportion of participants who had the symptom of running nose and sneezing before onset from 18% to 8% at 2nd follow-up (P < 0.05). Additionally, Tian Jiu Therapy significantly reduced the level of asthma, the proportion of participants who don’t need to processed during asthma attack increased from 6% to 15% at 1st follow-up and 0% to 7% at 3rd follow-up (P < 0.05). Improvements also occurred with Tian Jiu Therapy group, it reduced the proportion of participants who were spontaneously sweating at 3rd follow up and diarrhea after intake of oily food at 4th follow-up (P < 0.05). Conclusion: When added to a regimen of foundational therapy for chronic asthma participants, Tian Jiu Therapy further reduced the need for medications to control asthma, improved the quality of participants’ life, and significantly reduced the level of asthma. What is more, this benefit seems to have an accumulative effect over time was in accordance with the TCM theory of 'winter disease is being cured in summer'.

Keywords: asthma, Tian Jiu Therapy, San Fu Days, triaditional Chinese medicine, clinical trial

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732 Antigen Stasis can Predispose Primary Ciliary Dyskinesia (PCD) Patients to Asthma

Authors: Nadzeya Marozkina, Joe Zein, Benjamin Gaston

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Introduction: We have observed that many patients with Primary Ciliary Dyskinesia (PCD) benefit from asthma medications. In healthy airways, the ciliary function is normal. Antigens and irritants are rapidly cleared, and NO enters the gas phase normally to be exhaled. In the PCD airways, however, antigens, such as Dermatophagoides, are not as well cleared. This defect leads to oxidative stress, marked by increased DUOX1 expression and decreased superoxide dismutase [SOD] activity (manuscript under revision). H₂O₂, in high concentrations in the PCD airway, injures the airway. NO is oxidized rather than being exhaled, forming cytotoxic peroxynitrous acid. Thus, antigen stasis on PCD airway epithelium leads to airway injury and may predispose PCD patients to asthma. Indeed, recent population genetics suggest that PCD genes may be associated with asthma. We therefore hypothesized that PCD patients would be predisposed to having asthma. Methods. We analyzed our database of 18 million individual electronic medical records (EMRs) in the Indiana Network for Patient Care research database (INPCR). There is not an ICD10 code for PCD itself; code Q34.8 is most commonly used clinically. To validate analysis of this code, we queried patients who had an ICD10 code for both bronchiectasis and situs inversus totalis in INPCR. We also studied a validation cohort using the IBM Explorys® database (over 80 million individuals). Analyses were adjusted for age, sex and race using a 1 PCD: 3 controls matching method in INPCR and multivariable logistic regression in the IBM Explorys® database. Results. The prevalence of asthma ICD10 codes in subjects with a code Q34.8 was 67% vs 19% in controls (P < 0.0001) (Regenstrief Institute). Similarly, in IBM*Explorys, the OR [95% CI] for having asthma if a patient also had ICD10 code 34.8, relative to controls, was =4.04 [3.99; 4.09]. For situs inversus alone the OR [95% CI] was 4.42 [4.14; 4.71]; and bronchiectasis alone the OR [95% CI] =10.68 (10.56; 10.79). For both bronchiectasis and situs inversus together, the OR [95% CI] =28.80 (23.17; 35.81). Conclusions: PCD causes antigen stasis in the human airway (under review), likely predisposing to asthma in addition to oxidative and nitrosative stress and to airway injury. Here, we show that, by several different population-based metrics, and using two large databases, patients with PCD appear to have between a three- and 28-fold increased risk of having asthma. These data suggest that additional studies should be undertaken to understand the role of ciliary dysfunction in the pathogenesis and genetics of asthma. Decreased antigen clearance caused by ciliary dysfunction may be a risk factor for asthma development.

Keywords: antigen, PCD, asthma, nitric oxide

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731 Correlation between the Ratios of House Dust Mite-Specific IgE/Total IgE and Asthma Control Test Score as a Biomarker of Immunotherapy Response Effectiveness in Pediatric Allergic Asthma Patients

Authors: Bela Siska Afrida, Wisnu Barlianto, Desy Wulandari, Ery Olivianto

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Background: Allergic asthma, caused by IgE-mediated allergic reactions, remains a global health issue with high morbidity and mortality rates. Immunotherapy is the only etiology-based approach to treating asthma, but no standard biomarkers have been established to evaluate the therapy’s effectiveness. This study aims to determine the correlation between the ratios of serum levels of HDM-specific IgE/total IgE and Asthma Control Test (ACT) score as a biomarker of the response to immunotherapy in pediatric allergic asthma patients. Patient and Methods: This retrospective cohort study involved 26 pediatric allergic asthma patients who underwent HDM-specific subcutaneous immunotherapy for 14 weeks at the Pediatric Allergy Immunology Outpatient Clinic at Saiful Anwar General Hospital, Malang. Serum levels of HDM-Specific IgE and Total IgE were measured before and after immunotherapy using Chemiluminescence Immunoassay and Enzyme-linked Immunosorbent Assay (ELISA) method. Changes in asthma control were assessed using the ACT score. The Wilcoxon Signed Ranked Test and Spearman correlation test were used for data analysis. Results: There were 14 boys and 12 girls with a mean age of 6.48 ± 2.54 years. The study showed a significant decrease in serum HMD-specific levels before immunotherapy [9.88 ± 5.74 kuA/L] compared to those of 14 weeks after immunotherapy [4.51 ± 3.98 kuA/L], p = 0.000. Serum Total IgE levels significant decrease before immunotherapy [207.6 ± 120.8IU/ml] compared to those of 14 weeks after immunotherapy [109.83 ± 189.39 IU/mL], p = 0.000. The ratios of serum HDM-specific IgE/total IgE levels significant decrease before immunotherapy [0.063 ± 0.05] compared to those of 14 weeks after immunotherapy [0.041 ± 0.039], p = 0.012. There was also a significant increase in ACT scores before and after immunotherapy (each 15.5 ± 1.79 and 20.96 ± 2.049, p = 0.000). The correlation test showed a weak negative correlation between the ratios of HDM-specific IgE/total IgE levels and ACT score (p = 0.034 and r = -0.29). Conclusion: In conclusion, this study showed that a decrease in HDM-specific IgE levels, total IgE levels, and HDM-specific IgE/total IgE ratios, and an increase in ACT score, was observed after 14 weeks of HDM-specific subcutaneous immunotherapy. The weak negative correlation between the HDM-specific IgE/total IgE ratio and the ACT score suggests that this ratio can serve as a potential biomarker of the effectiveness of immunotherapy in treating pediatric allergic asthma patients.

Keywords: HDM-specific IgE/total IgE ratio, ACT score, immunotherapy, allergic asthma

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730 Asthma Nurse Specialist Improves the Management of Acute Asthma in a University Teaching Hospital: A Quality Improvement Project

Authors: T. Suleiman, C. Mchugh, H. Ranu

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Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.

Keywords: asthma, nurse specialist, clinical audit, quality improvement

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729 The Application of Local Wisdom in Health Care of Early Childhood at Ban Nam Chieo Community, Laem Ngop, Trat Province

Authors: Supalak Fakkhum, Wannita Pochanakul

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This research is qualitative research that aims to study the application of local wisdom in health care of early childhood at Ban Nam Chieo Community, Laem Ngop, Trat Province. The target is one folk medicine healer and 45 parents who have children or grandchildren aged between 0-5 years. The folk medicine healer was interviewed and observed during early childhood health care practice. Parents were interviewed. The results showed that local wisdom in health care of early childhood are as follows: 1. Local wisdom about early childhood diseases: It is believed that the disease was determined while the child was still in the womb, in the third month of pregnancy. When a child is born, they will have La, La-ong and Saang diseases, which are URI (upper respiratory infection) and DI (diarrhea) diseases. Supernatural aspect is also considered. 2. The treatment is chosen to match the symptoms of the disease. Caring for early childhood includes psychological therapy by rituals and spells. 3. For local wisdom concerning prevention and health promotion, parents normally bring their child to folk medicine healers for “throat paint” as an act of protection and health promotion. Folk healers often prescribe food according to belief and local wisdom.

Keywords: local wisdom, early childhood, folk medicine, healer

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728 The Role of Information and Communication Technology in Early Childhood Education as Perceived by Early Childhood Teachers

Authors: Rabia Khalil

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The aim of the study is to find out the perception of early childhood education teacher‘s about the role and implementation of information communication technology in early childhood education. The main purpose of the study is to investigate the role of information and communication technology in early childhood education as perceived by early childhood education teachers. The objectives of the study were to identify the roles of ICT in today’s early years and the impacts of Information communication technology in early childhood education. This study is to find out the role of ICT at ECE level & how it will be useful for teachers to implement this technique for the development of student skills. This is a quantitative research in which a survey study was conducted. The Population of the study was the primary teachers of the public and private primary schools of Lahore. By using random sampling technique the sample consists of 300 teachers but only 260 respond from 52 primary schools of Lahore. In this research, questionnaire was developed for primary school teachers. The questionnaires were based on liker type scale which comprises of section of strongly agree to strongly disagree. Data were analyzed by using descriptive analysis. The data was arranged and then entered in computer, having the software package for social sciences (SPSS) version 15. The importance of this study is to find out the role of ICT at ECE level & how it will be useful for teachers to implement this technique for the development of student skills.

Keywords: ECE, ICT, PC, C AI

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727 Predicting the Relationship Between Childhood Trauma on the Formation of Defense Mechanisms with the Mediating Role of Object Relations in Traders

Authors: Ahmadreza Jabalameli, Mohammad Ebrahimpour Borujeni

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According to psychodynamic theories, the major personality structure of individuals is formed in the first years of life. Trauma is an inseparable and undeniable part of everyone's life and they inevitably struggle with many traumas that can have a very significant impact on their lives. The present study deals with the relationship between childhood trauma on the formation of defense mechanisms and the role of object relations. The present descriptive study is a correlation with structural equation modeling (SEM). Sample selection is available and consists of 200 knowledgeable traders in Jabalameli Information Technology Company. The results indicate that the experience of childhood trauma with a demographic moderating effect, through the mediating role of object relations can lead to vulnerability to ego reality functionality and immature and psychically disturbed defense mechanisms. In this regard, there is a significant negative relationship between childhood trauma and object relations with mature defense mechanisms.

Keywords: childhood trauma, defense mechanisms, object relations, trade

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726 Enhancing Skills of Mothers of Asthmatic Children in Techniques of Drug Administration

Authors: Erna Judith Roach, Nalini Bhaskaranand

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Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.

Keywords: childhood asthma, drug administration, mothers of children, inhaler

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725 Transitioning Teacher Identity during COVID-19: An Australian Early Childhood Education Perspective

Authors: J. Jebunnesa, Y. Budd, T. Mason

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COVID-19 changed the pedagogical expectations of early childhood education as many teachers across Australia had to quickly adapt to new teaching practices such as remote teaching. An important factor in the successful implementation of any new teaching and learning approach is teacher preparation, however, due to the pandemic, the transformation to remote teaching was immediate. A timely question to be asked is how early childhood teachers managed the transition from face-to-face teaching to remote teaching and what was learned through this time. This study explores the experiences of early childhood educators in Australia during COVID-19 lockdowns. Data were collected from an online survey conducted through the official Facebook forum of “Early Childhood Education and Care Australia,” and a constructivist grounded theory methodology was used to analyse the data. Initial research results suggest changing expectations of teachers’ roles and responsibilities during the lockdown, with a significant category related to transitioning teacher identities emerging. The concept of transitioning represents the shift from the role of early childhood educator to educational innovator, essential worker, social worker, and health officer. The findings illustrate the complexity of early childhood educators’ roles during the pandemic.

Keywords: changing role of teachers, constructivist grounded theory, lessons learned, teaching during COVID-19

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724 Addressing the Silent Killer: The Shift in Local Governance to Combat Air Pollution

Authors: Jayati Das

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Kolkata, one of the fastest-growing metropolises in India, has been suffering from air pollution for many decades. Mismanagement of government and an increase in automobiles have been fuelling this problem. The study aims to portray the quality of air along with the influence of traffic flow and vehicular growth and the effects on human health. It further shows the correlation between the emission of pollution during weekdays and weekends with the help of a scatter diagram and trend line. An assessment of Kolkata air quality is done where the listed pollutants’ (RPM, SPM, NO2, and SO2) annual average concentrations are classified into four different categories. Our observed association between childhood Acute Respiratory disorder and early life exposure to traffic-related air pollutants is biologically plausible. The period of in utero and the first year of life is critical in the development of the immune and respiratory systems and potentially harmful effects of toxic pollutants during this period might result in the long-lasting impaired capacity to fight infections and increased risk of allergic manifestations. Up-to-date knowledge about the seasonal and spatial variation of asthma and studying the air quality of the area is done through Geographical Information System (GIS). Steps are taken by the government to control air pollution by alternative public transport like the metro and compulsory certification of period-driven vehicles which test for Carbon mono oxide.

Keywords: air pollution, asthma, GIS, hotspots, governance

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723 Omalizumab Therapy Experience for Asthma, at Zayed Military Hospital (ZMH) in United Arab Emirates

Authors: Shanza Akram, Samir Salah, Imran Saleem, Ashraf Alzaabi, Jassim Abdou

Abstract:

Introduction: 300 million people worldwide are affected by asthma .In UAE, prevalence is around 10% (900,000 people).Patients with persistent symptoms despite using high dose ICS plus a second controller +/- OCS are considered to have severe asthma. Omalizumab (Xolaire) an IgE monoclonal antibody is approved as add on therapy for severe allergic asthma. Objective: To determine the efficacy of omalizumab based on clinical outcomes in our cohort of patient pre and post 52 weeks of treatment to assess safety and tolerability of treatment. Methods: Medical records of patients receiving omalizumab therapy for asthma at ZMH ,Abu Dhabi were retrospectively analyzed.Patients fulfilling the criteria of severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months prior to and 12 months after commencement of omalizumab therapy was analysed by taking into account the number of exacerbations and hospitalizations in addition to maintenance of medication dosages, need for rescue reliever therapy and pulmonary function testing. Results: Total cohort of 21 patient (5 females), average age 41 years and av length of therapy 22 months were included. Seven patients (total 11/52%) managed to stop steroids on treatment while four were able to decrease the dosage. Mean exacerbation rate decreased from five/ year pre treatment to 1.36 while on treatment. Number of hospitalizations decreased from mean of two per year to 0.9 per year. Rescue reliever inhaler usage decreased from mean of 40 puffs to 15 puffs per week. 2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects including local irritation, severe limb and joint pains after 6 months. Conclusion: Treatment with omalizumab showed effect in terms of reduced number of exacerbations, maintenance therapy and reliever medications. However, no improvement was seen in PFTs.There is room for improved documentation in terms of symptom recording and use of rescue medicationas as well as for better patient education and counselling in order to improve compliance.

Keywords: asthma, omalizumab, severe allergic asthma, UAE

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722 Nurses’ Knowledge and Practice in the Management of Childhood Malnutrition in Selected Health Centers in Rwanda

Authors: Uwera Monique, Bagweneza Vedaste, Rugema Joselyne, Lakshmi Rajeswaran

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Background: Malnutrition contributes significantly to childhood morbidity and mortality. Nurses usually exhibit inadequate knowledge of childhood malnutrition management. Nurses require appropriate knowledge and skills to manage malnutrition using appropriate protocols. Objectives: The general objective of this study was to assess Nurses’ knowledge and practice in the management of childhood malnutrition in selected health centers in Rwanda. The specific objectives were to assess the level of nurses’ knowledge in the management of childhood malnutrition, to determine the level of practice in the management of childhood malnutrition in selected health centers in Rwanda, and to establish the relationship between the demographic profile and nurses’ knowledge in the management of childhood malnutrition in selected health centers in Rwanda. Methods: The study used a descriptive cross-sectional study design and quantitative approach among 196 nurses from 24 health centers in one district. A questionnaire was used to collect data on knowledge and practice towards childhood malnutrition management. The entire population was used, and SPSS version 25 helped to analyze data. Descriptive statistics helped to produce the frequencies and percentages, while chi-square helped to determine the relationship between demographic variables and knowledge and practice scores. Results: The study findings showed that of 196 participants, 48% had a high level of knowledge about malnutrition management with more than 75% score, and 17% and 35% had low and moderate levels of knowledge, respectively. 61% of them had a high level of practice in malnutrition management, as the acceptable score was 75%. 13% had a low level, while 26% had a moderate level of practice. Most socio-demographic characteristics have shown a statistical relationship with the level of knowledge. Conclusion: The study findings revealed that almost half of the nurses had good knowledge of childhood malnutrition management, and this was associated with many socio-demographic data, while more than half had good practice in that aspect. However, some nurses who still have gaps in knowledge and practice require necessary measures to boost these components.

Keywords: nurse, knowledge, practice, childhood malnutrition

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721 The Effect of Eight Weeks of Aerobic Training on Indices of Cardio-Respiratory and Exercise Tolerance in Overweight Women with Chronic Asthma

Authors: Somayeh Negahdari, Mohsen Ghanbarzadeh, Masoud Nikbakht, Heshmatolah Tavakol

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Asthma, obesity and overweight are the main factors causing change within the heart and respiratory airways. Asthma symptoms are normally observed during exercising. Epidemiological studies have indicated asthma symptoms occurring due to certain lifestyle habits; for example, a sedentary lifestyle. In this study, eight weeks of aerobic exercises resulted in a positive effect overall in overweight women experiencing mild chronic asthma. The quasi-experimental applied research has been done based on experimental and control groups. The experimental group (seven patients) and control group (n = 7) were graded before and after the test. According to the Borg dyspnea and fatigue Perception Index, the training intensity has determined. Participants in the study performed a sub-maximal aerobic activity schedule (45% to 80% of maximum heart rate) for two months, while the control group (n = 7) stayed away from aerobic exercise. Data evaluation and analysis of covariance compared both the pre-test and post-test with paired t-test at significance level of P≤ 0.05. After eight weeks of exercise, the results of the experimental group show a significant decrease in resting heart rate, systolic blood pressure, minute ventilation, while a significant increase in maximal oxygen uptake and tolerance activity (P ≤ 0.05). In the control group, there was no significant difference in these parameters ((P ≤ 0.05). The results indicate the aerobic activity can strengthen the respiratory muscles, while other physiological factors could result in breathing and heart recovery. Aerobic activity also resulted in favorable changes in cardiovascular parameters, and exercise tolerance of overweight women with chronic asthma.

Keywords: asthma, respiratory cardiac index, exercise tolerance, aerobic, overweight

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720 Coping Strategies of Parents of a Child with Asthma in Relation to the Child's Disease

Authors: Irma Nool, Katriin Saueauk, Ebe Siimson, Vlada Žukova, Elise Gertrud Vellet

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Background: Asthma is one of themostcommonchronicdiseases in children, whichcansignificantlyaffectchildren, and challengetheirfamilies. The unpredictability, frequency, and control of asthma attacks have a profound effect on the daily lives of familieswithasthmaticchildren. Thereis a growing body of researchshowingthatthequality of life of parents and childrenislinkedtothedevelopment of asthma. Theoretical and clinicalstudiesprovethat a positive and well-functioningfamilysystemhelpstocopebetterwiththediagnosis of the chronic disease. The aim of theresearchwastodescribethecopingstrategies of parents of a childwithasthmaconcerningthechild'sillness. Method: Theresearchwasanempirical, quantitative, descriptive study. Thesamplewastheparents of a child with asthma at the Tallinn Children'sHospital, whose child was in inpatienttreatmentbetween 07.04.2021 and 12.09.2021. This is a convenient sample. 59 parentsrepliedtothequestionnaire. The questionnaire “CopingInventoryforStressfulSituations” wasusedtocollectthedata, whichwastranslatedinto Estonian and Russian using a back-and-forthtranslationtechnique. Thequestionnairewasanswered on a 5-point Likert scale. Dataanalysiswasperformedusing SPSS 26.0, descriptive statistics, with mean values and standard deviation. The Mann-Whitney U test wasusedtocomparefathers and motherscopingstrategies. PermissiontoconductresearchhasbeenobtainedfromtheEthicsCommitteeforHuman Research of theInstituteforHealthDevelopment. Results: The mean age of the respondents was 40 ± 6.2 years (median 40), withtheyoungestbeing 27 yearsold and the oldest being 57 yearsold. Of the respondents, 51 (86.4%) were mothers, and 8 (13.6%) werefathers. Parentsusedthemosttask-orientedcopingstrategies (mean 3.35 ± 0.602) and theleastemotion-orientedcopingstrategies (mean 1.97 ± 0.526). Mothersusedmoretask-orientedcopingstrategies (p = 0.001) than fathers. Fathersusedemotion-orientedcopingstrategiesless (p = 0.024) than mothers. mothersplantheirtimebetter (p = 0.043), focus on the problem and look at how to solve it (p = 0.007), and makeanefforttogetthingsdone (p = 0.045). mothersblamethemselvesmorefornotknowingwhattodo (p = 0.045) and worryaboutwhattheyshoulddo (p = 0.027). mothers look more at the goods displayed in the shop windows (p = 0.018) and go for a walk (p = 0.007) compared to fathers. Conclusions: The results of theresearchshowedthatproblem-orientedcopingstrategiesare used the most and there are differences in the behavior of fathers and mothers. Thisshouldbetakenintoaccountwhenprovidingfamily-centered nursing care.

Keywords: asthma, coping strategies, parents, family

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719 Early Childhood Education: Working With Children, Families, and Communities for Collective Impact

Authors: Sunico Armie Flores

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Early childhood education (ECE) is pivotal in shaping the future of individuals and society. This paper explores the collaborative efforts required among educators, families, and communities to create a collective impact on young children’s development. It delves into the importance of these partnerships, effective strategies for engagement, and the challenges and opportunities inherent in fostering such collaboration. By examining current research and practices, the paper aims to highlight the essential role of an integrated approach in achieving significant and sustainable improvements in early childhood outcomes.

Keywords: early childhood education, collaborative efforts, family engagement, community partnerships, child development, educational outcomes, integrated approach, stakeholder collaboration, resource constraints

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718 An Exploration of the Integration of Guided Play With Explicit Instruction in Early Childhood Mathematics

Authors: Anne Tan, Kok-Sing Tang, Audrey Cooke

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Play has always been a prominent pedagogy in early childhood. However, there is growing evidence of success in students’ learning using explicit instruction, especially in literacy in the early years. There is also limited research using explicit instruction in early childhood mathematics, and play is usually prominently mentioned. This proposed research aims to investigate the possibilities and benefits of integrating guided play with explicit instruction in early childhood mathematics education. While play has traditionally been a prominent pedagogy in early childhood, there is growing evidence of success in student learning through explicit instruction, particularly in literacy. However, limited research exists on the integration of explicit instruction in early childhood mathematics, where play remains prominently mentioned. This study utilises a multiple case study methodology to gather data and provide immediate opportunities for curriculum improvement. The research will commence with semi-structured interviews to gain insights into educators' background knowledge. Highly structured observations will be conducted to record the frequency and manner in which guided play is integrated with specific elements of explicit instruction during mathematics teaching in early childhood. To enhance the observations, video recordings will be made using cameras with video settings and Microsoft Teams meeting recordings. In addition to interviews and observations, educators will maintain journals and use the Microsoft Teams platform for self-reflection on the integration of guided play and explicit instruction in their classroom practices and experiences. The study participants will include educators with early childhood degrees and students in years one and two. The primary goal of this research is to inform the benefits of integrating two high-impact pedagogies, guided play, and explicit instruction, for enhancing student learning outcomes in mathematics education. By exploring the integration of these pedagogical approaches, this study aims to contribute to the development of effective instructional strategies in early childhood mathematics education.

Keywords: early childhood, early childhood mathematics, early childhood numbers, guided play, play-based learning, explicit instruction

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717 Application of Artificial Neural Network Technique for Diagnosing Asthma

Authors: Azadeh Bashiri

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Introduction: Lack of proper diagnosis and inadequate treatment of asthma leads to physical and financial complications. This study aimed to use data mining techniques and creating a neural network intelligent system for diagnosis of asthma. Methods: The study population is the patients who had visited one of the Lung Clinics in Tehran. Data were analyzed using the SPSS statistical tool and the chi-square Pearson's coefficient was the basis of decision making for data ranking. The considered neural network is trained using back propagation learning technique. Results: According to the analysis performed by means of SPSS to select the top factors, 13 effective factors were selected, in different performances, data was mixed in various forms, so the different models were made for training the data and testing networks and in all different modes, the network was able to predict correctly 100% of all cases. Conclusion: Using data mining methods before the design structure of system, aimed to reduce the data dimension and the optimum choice of the data, will lead to a more accurate system. Therefore, considering the data mining approaches due to the nature of medical data is necessary.

Keywords: asthma, data mining, Artificial Neural Network, intelligent system

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716 Management of Severe Asthma with Omalizumab in United Arab Emirates

Authors: Shanza Akram, Samir Salah, Imran Saleem, Jassim Abdou, Ashraf Al Zaabi

Abstract:

Estimated prevalence of asthma in UAE is around 10% (900,000 people). Patients with persistent symptoms despite using high dose ICS plus a second controller +/- Oral steroids are considered to have severe asthma. Omalizumab (Xolair) is an anti-IgE monoclonal antibody approved as add-on therapy for severe allergic asthma. The objective of our study was to obtain baseline characteristics of our local cohort, to determine the efficacy of omalizumab based on clinical outcomes pre and post 52 weeks of treatment and to assess safety and tolerability. Medical records of patients receiving omalizumab therapy for asthma at Zayed Military Hospital, Abu Dhabi were retrospectively reviewed. Patients fulfilling the criteria for severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months pre and post omalizumab were analyzed by taking into account the number of exacerbations, hospitalizations, maintenance of medication dosages, the need for reliever therapy and PFT’s. 21 patients (5 females) with mean age 41 years were included. The mean duration of therapy was 22 months. 19 (91%) patients had Allergic Rhinitis/Sinusitis. Mean serum total IgE level was 648 IU/ml (65-1859). 11 (52%) patients were on oral maintenance steroids pre-treatment. 7 patients managed to stop steroids on treatment while 4 were able to decrease the dosage. Mean exacerbation rate decreased from 5 per year pre-treatment to 1.36 while on treatment. The number of hospitalizations decreased from a mean of 2 per year to 0.9 per year. Reliever inhaler usage decreased from mean of 40 to 15 puffs per week.2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects. Patient compliance was poor in some cases. Treatment with omalizumab reduced the number of exacerbations, hospitalizations, maintenance and reliever medications, and is generally well tolerated. Our results show that there is room for improved documentation in terms of symptom recording and use of rescue medication at our institution. There is also need for better patient education and counseling in order to improve compliance.

Keywords: asthma, exacerbations, omalizumab, IgE

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715 Extremely Low-Frequency Magnetic Field; An Invisible Risk Association between High Power Transmission Lines and Childhood Leukemia and Adult Brain Cancer: Literature Review

Authors: Ali Azeem, Seung-Cheol Hong

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This study focuses on the epidemiological association between childhood leukaemia & adult brain cancer to offer strong evidence that extremely low-frequency magnetic field (ELF-MF) produced from power lines caused cancer. It also gives a comprehensive literature review on epidemiological studies of ELF-MF risk associated with HVTL and childhood leukaemia & adult brain cancer. From the literature review, it is concluded that there is a weak association present between ELF-MF and childhood leukaemia. No consistent association was present between brain cancer and ELF-MF. This study is done on Scielo data and PubMed using the terms extremely low-frequency magnetic field (ELF-MF+cancer), adult brain cancer, high power transmission lines, etc., for the past 10 years.

Keywords: childhood leukaemia, high voltage transmission lines, acute lymphoblastic leukaemia, power lines

Procedia PDF Downloads 195