Medicine and Health Sciences Commons^™

Building Allas: Creation Of An Asthma And Allergies App, Benjamin J. Cochran

Doctor of Nursing Practice Scholarly Project

The purpose of this project was to determine the potential need for an app to allow patients to self-manage their asthma and allergies. Through a substantial literature review, the need for an app as well as a desire for this population to manage their disease was demonstrated. Determination was made to have three separate components to create an all-inclusive app, an education component, an asthma tracker, and a personalized allergy profile. The app was storyboarded before being sent to providers and small focus group for proof of concept and functionality of components. The app, ALLAS, was constructed and housed on …

Aligning Asthma Education Across The Continuum Of Physician Education: Impact On Clinical Metrics, Lisa Sullivan Vedder, Deborah Simpson, Jacob L. Bidwell, John R. Brill, Theresa Frederick

Aurora Family Medicine Residents

Background: All trainees entering family medicine residency training programs after June 1, 2012, must complete the same American Board of Family Medicine (ABFM) Maintenance of Certification (MOC) requirements as practicing physicians. These shared requirements provide an opportunity to align physician education initiatives across the continuum focused around a clinical care topic to improve health care system metrics. Purpose: To assess the initial effectiveness of an ABFM Asthma Part IV approved MOC module, aligned to meet residency and medical student program accreditation requirements, on health care system metrics. Methods: An ABFM Asthma Part IV MOC module was implemented for family medicine …

Indoor Tobacco Legislation Is Associated With Fewer Emergency Department Visits For Asthma Exacerbation In Children., Christina E. Ciaccio, Tami Gurley-Calvez, Theresa I. Shireman

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: During the past 3 decades, numerous cities and states have adopted laws that ban smoking in public indoor spaces. The rationale for these policies has been to protect nonsmokers from the adverse health effects of secondhand smoke.

OBJECTIVE: To determine whether the implementation of indoor smoking legislation is associated with a decrease in emergency department visits for asthma in children.

METHODS: This retrospective analysis used a natural experiment to estimate the impact of clean indoor air legislation on the rate of emergency department admissions for asthma exacerbation in children. Data were obtained from the Pediatric Health Information System. A …

Multi-Nuclear Magnetic Resonance Imaging Of Obstructive Lung Disease, Khadija Sheikh

Electronic Thesis and Dissertation Repository

Obstructive lung diseases such as chronic-obstructive-lung-disease (COPD), bronchiectasis, and asthma are characterized by airflow obstruction. They affect over six million Canadians costing the economy $12 billion/year. Despite decades of research, therapies that modify obstructive-lung-disease progression and control are lacking because patient diagnosis, monitoring, and response to therapy are currently made using airflow measurements that may conceal the independent contributions of underlying pathologies. One goal of obstructive-lung-disease research is to develop ways to identify patients with specific underlying pathological phenotypes to improve patient care and outcomes. Thoracic computed-tomography (CT) and magnetic-resonance-imaging (MRI) provide ways to regionally identify the underlying pathologies associated …

Asthma, Kayla Phipps

Student Brochures

No abstract provided.

Asthma—Inpatient, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Clinical Practice Guidelines)

No abstract provided.

Airway Secretory Micrornaome Changes During Rhinovirus Infection In Early Childhood, Maria J. Gutierrez, Jose L. Gomez, Geovanny F. Perez, Krishna Pancham, Stephanie Val, Dinesh K. Pillai, Mamta Giri, Sarah Ferrante, Robert Freishtat, Mary C. Rose, Diego Preciado, Gustavo Nino

Pediatrics Faculty Publications

Background Innate immune responses are fine-tuned by small noncoding RNA molecules termed microRNAs (miRs) that modify gene expression in response to the environment. During acute infections, miRs can be secreted in extracellular vesicles (EV) to facilitate cell-to-cell genetic communication. The purpose of this study was to characterize the baseline population of miRs secreted in EVs in the airways of young children (airway secretory microRNAome) and examine the changes during rhinovirus (RV) infection, the most common cause of asthma exacerbations and the most important early risk factor for the development of asthma beyond childhood.

Methods Nasal airway secretions were obtained from …

Mt1a Mrna Expression In Human Lung Cells (Beas 2b) After Airborne Pm10 And Copper Exposure: A Possible Biomarker For Asthma, Mariela Rosa-Casillas, Noé Crespo-Hernández, Bs, Mario Ortiz-Martínez, Braulio Jiménez-Vélez

Journal of Health Disparities Research and Practice

Puerto Ricans have the highest prevalence, morbidity and mortality of asthma than any other ethnic group in the U.S. and can be triggered by different stimuli such as airborne Particle pollution (PM). PM transfers transition metals, including cooper, to the human airways generating reactive oxygen species (ROS). Metallothionein protein (MT1A) is a free radical scavenger expected to be induced in lung cells by PM exposure; however, this has never been proven nor demonstrated. The hypothesis involves the amounts of PM₁₀ in 2004, which would be significantly higher in the urban sites during months of March and June, thereby increasing …

Implementing Spirometry-Driven Evidence-Based Asthma Care In A Primary Care Practice, Douglas C. Rau

Doctoral Projects

This project was a quality improvement initiative employing an educational intervention to increase the awareness and stress the importance of utilizing spirometry in the diagnosis, treatment, and management of asthma. Clinical support staff received training on how to perform spirometry and providers received education on the interpretation and utility of spirometry results to drive care to improve outcomes for clients with asthma. Project outcomes examined the self-rated confidence to perform and interpret spirometry before and after the intervention and the subsequent utilization pattern of office-based spirometry at the primary care clinic. For clinical support staff, the self-comfort level at performing …

Preterm Birth And Air Pollution: Critical Windows Of Exposure For Women With Asthma, Pauline Mendola, Maeve Wallace, Beom Seuk Hwang, Danping Liu, Candace Robledo, Tuija Männistö

School of Medicine Publications and Presentations

Background: Ambient air pollutants may increase preterm birth (PTB) risk, but critical exposure windows are uncertain. The interaction of asthma and pollutant exposure is rarely studied.

Objective: We sought to assess the interaction of maternal asthma and air pollutant exposures in relation to PTB risk.

Methods: Electronic medical records for 223,502 US deliveries were linked with modified Community Multiscale Air Quality model outputs. Logistic regression with generalized estimating equations estimated the odds ratio and 95% CIs for PTB on the basis of the interaction of maternal asthma and particulate matter with aerodynamic diameter of less than 2.5 microns and particulate …

A Feasibility Study Of Just-In-Time Asthma Self-Management Intervention, Phillip Charles Scruggs

Masters Theses

Quality asthma care requires not only an initial diagnosis, but long term follow up care and education on long term control. Preventable symptoms continue to reduce the quality of life for chronic asthma sufferers and place an unnecessary burden on emergency services and the health care system at large. A mobile health (mHealth) solution is proposed to effectively improve outcomes for patients while ultimately reducing the overall burden of mismanagement on the healthcare system as a whole. The Just-in-Time Asthma Self- Management and Intervention (JASMIN) system provides a way for a patient or user to track, self-manage, and interact with …

A Central Georgia Asthma Prevalence Assessment Of School-Age Children And Compliance With Senate Bill 472, Cheryl L.R. Gaddis, Jimmie Smith

Journal of the Georgia Public Health Association

Background: A common theme among the counties of the North Central Health District is the disparity between the number of asthma-related visits of African-American and white children ages 1-14 to the emergency department. In 2013, 858 children ages 1-14 in the district had emergency room visits related to asthma. The purpose of this study was to assess North Central Health District (NCHD) schools to determine the prevalence of self-reported asthma by parents and school age children and the adequacy of students’ access to maintenance inhalers at school, and to identify schools that qualify for Asthma Friendly School Recognition.

Methods: The …

Air Pollution Exposure And Preeclampsia Among Us Women With And Without Asthma, Pauline Mendola, Maeve Wallace, Danping Liu, Candace Robledo, Tuija Männistö, Katherine Grantz

School of Medicine Publications and Presentations

Maternal asthma and air pollutants have been independently associated with preeclampsia but rarely studied together. Our objective was to comprehensively evaluate preeclampsia risk based on the interaction of maternal asthma and air pollutants. Preeclampsia and asthma diagnoses, demographic and clinical data came from electronic medical records for 210,508 singleton deliveries. Modified Community Multiscale Air Quality models estimated preconception, first and second trimester and whole pregnancy exposure to: particulate matter (PM)<2.5 and <10µm, ozone, nitrogen oxides (NOx), sulfur dioxide (SO2) and carbon monoxide (CO); PM2.5 constituents; volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs). Asthma-pollutant interaction adjusted relative risks (RR) and 95% confidence intervals (CI) for preeclampsia were calculated by interquartile range for criteria pollutants and high exposure (≥75th percentile) for PAHs and VOCs. Asthmatics had higher risk associated with first trimester NOx and SO2 and whole pregnancy elemental carbon (EC) exposure than non-asthmatics, but only EC significantly increased risk (RR=1.11, CI:1.03-1.21). Asthmatics also had a 10% increased risk associated with second trimester CO. Significant interactions were observed for nearly all VOCs and asthmatics had higher risk during all time windows for benzene, ethylbenzene, m-xylene, o-xylene, p-xylene and toluene while most PAHs did not increase risk.

Identifying Risk Factors For Bronchospasms In The Pediatric Patient, Kayla D. Stiles

Nursing Capstones

No abstract provided.

Sleep Duration Patterns From Adolescence To Young Adulthood And Their Impact On Asthma And Inflammation, Chighaf Bakour

USF Tampa Graduate Theses and Dissertations

This dissertation includes three studies that examined the impact of inadequate sleep duration in adolescents and young adults on asthma and systemic inflammation. We used data from the Florida Youth Risk Behavior Survey (YRBS), years 2009-2013, and from the National Longitudinal Study of Adolescent to Adult Health (Add health), which was conducted between 1994 and 2008.

The first study used data from 16,738 high school students participating in the Florida YRBS. We examined the cross-sectional association between sleep duration and asthma, and the interactive effects of sleep duration and BMI. We found that short and long sleep durations were associated …

Asthma Control Screening Using The Electronic Health Record, Accursia A. Baldassano, Jonathon Mack

Doctor of Nursing Practice Final Manuscripts

ABSTRACT

Experts in asthma care globally recommend screening for asthma control in all patients with asthma through the use of an evidence-based tool. This project embedded the Asthma Control Test (ACT) in the electronic health record to determine if screening for control would change compared to standard care.

Methods

An electronic template of the ACT was embedded in the electronic health record system for a community faith-based family medicine clinic. All patients 12 years and older with a previous diagnosis of asthma were included in this project. These patients were screened for asthma control using the template at every appointment. …

Shared Medical Appointments For Pediatric Asthma, Casey Mcginnis, Kathleen Sweeney Cpnp

Doctor of Nursing Practice Final Manuscripts

No abstract provided.

A Quality Improvement Project On Diagnosis And Management Of Asthma In A Private Pediatric Setting., Sosamma Ashley

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Although national guidelines exist for the diagnosis and management of asthma, general practice differs significantly from recommendations. Quality improvement methodology when implemented can narrow quality gaps.

Objective: The objective of the project was to create and implement a plan of action to address identified gaps in key clinical activities of asthma care among pediatric population in a private pediatric setting in Northern California

Methods: The project was centered on the use of Education in Quality Improvement for Pediatric Practice (EQIPP), a program of the American Academy of the Pediatrics. Both the pediatrician and the DNP student took this …

A Link Between Paediatric Asthma And Obesity: Are They Caused By The Same Environmental Conditions?, Phylicia Gonsalves

Electronic Thesis and Dissertation Repository

The highly associated paediatric conditions of asthma and overweight have seen dramatic increases over the past few decades. This thesis explored air pollution exposure as a potential underlying mechanism of co-morbid asthma and overweight among adolescents aged 12 to 18 years. Data from the Canadian Community Health Survey were merged with a database containing estimates of air pollution as assessed by particulate matter ≤ 2.5 microns (PM_2.5) concentrations at the postal code centroid in southwestern Ontario. Logistic regression was used to conduct the analysis. Adolescents were more likely to be overweight as PM_2.5 concentrations increased. There was …

The Potentiating Effects Of Acetaminophen On Oxidant Air Pollutant Sensory Irritation And The Onset Of Asthma, Bennett J. Doughty

Honors Scholar Theses

Through its toxic metabolites, acetaminophen can cause oxidative injury in the liver. This damage has not yet been investigated in the respiratory tract. If acetaminophen also causes oxidative stress and injury here, this widely used antipyretic could potentiate the adverse effects of oxidant air pollutants. Thus, the primary goal of this project is to determine if low non-hepatotoxic doses of APAP is correlated with an increase of oxidative stress in the airways, possibly linking APAP to the onset of asthma. Using data that reflected murine breathing patterns, the addition of acetaminophen greatly increased the reflex irritant response to ETS through …

Aligning Asthma Education Across The Continuum Of Physician Education: Impact On Clinical Metrics, Lisa Sullivan Vedder, Deborah Simpson, Jacob L. Bidwell, John R. Brill, Theresa Frederick

Lisa Sullivan Vedder, MD

Background: All trainees entering family medicine residency training programs after June 1, 2012, must complete the same American Board of Family Medicine (ABFM) Maintenance of Certification (MOC) requirements as practicing physicians. These shared requirements provide an opportunity to align physician education initiatives across the continuum focused around a clinical care topic to improve health care system metrics.

Purpose: To assess the initial effectiveness of an ABFM Asthma Part IV approved MOC module, aligned to meet residency and medical student program accreditation requirements, on health care system metrics.

Methods: An ABFM Asthma Part IV MOC module was implemented for family medicine …

Effect Of Natural Products Against Growth Of Three Allergenic And Toxigenic Molds, Brittany Loadholt, Teyaijah Givens, Nosa Lloyd Nwaonumah, Bushra Shah, Atin Adhikari

GS4 Georgia Southern Student Scholars Symposium

Dampness and fungal exposures in buildings are widespread, with estimates ranging from 18% to 50% of buildings being affected. Of the 21.8 million people reported to have asthma in the USA, approximately 4.6 million cases are attributable to dampness and mold exposure in the home. Consequent national annual cost of asthma is about $3.5 billion. Several fungal genera from damp environments were reported to be associated with allergy and/or asthma and some species can release mycotoxins in the environment. Although there are several mold inhibitor or disinfectant solutions and sprays available in the market for cleaning and inhibiting mold growth, …

Effect Of Air Flow Rates In Versatrap Slit Impactor Cassettes On The Collection Of Atmospheric Mold Spores In A Rural Community, Bushra Shah, Tedd Gandy, Oreoluwa Adeyinka, Galela Shebani, Atin Adhikari

GS4 Georgia Southern Student Scholars Symposium

Exposure to mold allergens including mold spores and hyphal fragments are associated with allergic sensitization which is a risk factor for asthma in a community. Smaller aerodynamic size of spores (åµm) allows them to penetrate and settle in the lower airways and produce damaging byproducts (allergens, glucans, mycotoxins, and other immunomodulators). Usually mold spores in ambient atmosphere are collected by impactors in air monitoring stations and in most cases these impactors are operated in a single standard air flow rate. However, sampling efficiency of an impactor can change in different air flow rates and since spore aerodynamic sizes vary a …

Hyperpolarized 3he Magnetic Resonance Imaging Ventilation Defects In Asthma: Relationship To Airway Mechanics, Del Leary, Sarah Svenningsen, Fumin Guo, Swati Bhatawadekar, Grace Parraga, Geoffrey N Maksym

Medical Biophysics Publications

In patients with asthma, magnetic resonance imaging (MRI) provides direct measurements of regional ventilation heterogeneity, the etiology of which is not well-understood, nor is the relationship of ventilation abnormalities with lung mechanics. In addition, respiratory resistance and reactance are often abnormal in asthmatics and the frequency dependence of respiratory resistance is thought to reflect ventilation heterogeneity. We acquiredMRIventilation defect maps, forced expiratory volume in one-second (FEV1), and airways resistance (Raw) measurements, and used a computational airway model to explore the relationship of ventilation defect percent (VDP) with simulated measurements of respiratory system resistance (Rrs) and reactance (Xrs).MRIventilation defect maps were …

Evaluating The Use Of The Asthma Action Plan And The Asthma Control Test By Providers In A Primary Care Office After Implementation Into The Electronic Health Record, Claudia N. Turkson-Ocran

Doctoral Projects

Asthma is a life-long chronic lung disease that inflames and narrows a person’s airway. Asthma results in recurring periods of chest tightness, wheezing with inspiration and/or expiration, shortness of breath, nighttime or early morning coughing, and trouble sleeping as a result of coughing and wheezing. An asthma exacerbation occurs when asthma symptoms worsen enough to require medical intervention or self-administration of oral corticosteroids. Exacerbations can be graded in severity as mild, moderate, severe, and life threatening. An asthma action plan (AAP) is a written treatment plan developed collaboratively between the health care professional and the patient for self-management and maintenance …

Is Dietary Intervention A Viable Method For Improving Outcomes In Adult Patients With Asthma?, Jennifer Grolimund

Senior Honors Theses

Asthma is a disease process characterized by episodic inflammation of the lower airway in response to various triggers. Those with asthma have trouble breathing effectively during an acute episode, making asthma a potentially life threatening condition. Standard medical treatment of asthma, including medications and environmental changes, can be effective at reducing or eliminating negative outcomes in patients with asthma. However, a holistic approach to patient care, including an examination of dietary influence, may also be useful for patients trying to manage the course of their illness. Variations in intake of individual nutrients or in total dietary patterns may play a …

"Mi Niño Con Asma": Hispanic/Latina Mothers, Environmental Justice, And Photovoice At The Front Lines Of The Asthma Epidemic, Robin A. Evans-Agnew Rn, Phd, Julie Postma Rn, Phd, Lee Sledd M. Ed

Journal of Health Disparities Research and Practice

Asthma is an important environmental justice concern for first generation Mexican-Americans. Families experience disparities in housing conditions, access to care, and legal marginalization. Little is known about how Hispanic/Latina mothers of children with asthma navigate these oppressions.

Problem: The purpose of this paper is to describe the discourses of environmental justice of a group Hispanic/Latina caregivers of children with asthma.

Method: A photovoice design was used with Hispanic/Latina mothers (n=11) in Tacoma, Washington, to take, discuss, select and display phototexts to policymakers that communicated their experiences and opinions in managing asthma for their child. Using critical narrative analysis, phototexts were …

Aligning Asthma Education Across The Continuum Of Physician Education: Impact On Clinical Metrics, Lisa Sullivan Vedder, Deborah Simpson, Jacob L. Bidwell, John R. Brill, Theresa Frederick

Deborah Simpson, PhD

Background: All trainees entering family medicine residency training programs after June 1, 2012, must complete the same American Board of Family Medicine (ABFM) Maintenance of Certification (MOC) requirements as practicing physicians. These shared requirements provide an opportunity to align physician education initiatives across the continuum focused around a clinical care topic to improve health care system metrics.

Purpose: To assess the initial effectiveness of an ABFM Asthma Part IV approved MOC module, aligned to meet residency and medical student program accreditation requirements, on health care system metrics.

Methods: An ABFM Asthma Part IV MOC module was implemented for family medicine …

Association Between High School Students’ Cigarette Smoking, Asthma And Related Beliefs: A Population-Based Study, Resa M. Jones, Kara P. Wiseman, Marina Kharitonova

Family Medicine and Population Health Publications

Background

Smoking has a detrimental effect on the symptoms and severity of asthma, a common chronic disease among adolescents. The purpose of this study was to examine the association between asthma and smoking among high school students and assess provider-patient communication with asthmatic adolescents regarding smoking and adolescents’ beliefs about the harms of smoking.

Methods

In fall 2014, data from high school students, ages 14–18 years, completing the 2009-2010 Virginia Youth Tobacco Survey (N = 1796) were used in descriptive analyses and multivariable logistic regression models adjusting for model-specific confounders as appropriate.

Results

Overall, an estimated 19 % of …

Is The Addition Of Vitamin D In Treatment For Asthma Effective In Children Less Than 18 Years Old?, Danielle M. Read

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the addition of vitamin D in treatment for asthma is effective in children less than 18 years old.

STUDY DESIGN: Review of three English language, randomized, controlled, double blind studies after 1999.

DATA SOURCES: Randomized, controlled double blind studies comparing the addition of vitamin D with an inhaled corticosteroid in treatment of asthma with a control group of inhaled corticosteroid alone. All articles were found in PubMed.

OUTCOMES MEASURED: Each study assessed the number of asthma exacerbations or symptoms in the control group and in the …