Medicine and Health Sciences Commons^™

Addressing Air Quality Mitigation As A Key Factor In Asthma Management And Prevention, Julia Buckles, Jewel Radford

Doctor of Nursing Practice Projects

Asthma is the most prevalent disease in childhood and disproportionately affects African American (AA) populations in terms of prevalence and frequency of exacerbations. Air quality and environmental factors are strongly associated with the diagnosis and management of asthma and AA children are more likely to live in areas with poor air quality. An air quality flag program was implemented in a daycare located in a county with a predominantly AA population with a high prevalence of asthma diagnoses. The goal of the intervention was to increase staff awareness of air quality and the impact it can have on asthma diagnosis …

Association Between Medication Adherence And Asthma Among Latinos In The United States, Denisse Silva

Walden Dissertations and Doctoral Studies

Prior research has shown that Latinos in the United States face disproportionate challenges in managing their asthma symptoms. Therefore, this study aimed to identify factors that may influence medication adherence and asthma episodes among Latinos in the United States and was guided by Andersen’s health behavior theory. Data from 2020 Latinos who participated in the National Health Interview System in 2020 were analyzed. Findings indicated that nearly 23% of respondents reported an asthma episode. Approximately 25% of the sample reported an asthma episode during the last 12 months. A total of 43.6% of the sample reported not taking medication every …

Cognitive Functioning In Well-Controlled Asthma, Erin Walsh

West Chester University Doctoral Projects

Asthma is a common lung disease that impacts lung functioning through inflammatory based mechanisms. Past research suggests that decreased blood oxygenation due to asthma attacks may impair cognitive capabilities (Irani et al., 2017). Moreover, the observed differences in cognition between those with and without asthma may be associated with disease severity or asthma control respectively in asthma populations. The current study explored differences in cognitive functioning between college students with and without self-reported asthma. Sociodemographic data, self-reported asthma severity, and measures of asthma control were collected. The current study did not find significant differences in measures of cognitive efficiency between …

Exploring The Impact Of Swimming On Asthma Management In Asian Americans, Trishtine Tran

Nursing | Senior Theses

Asthma is a respiratory disease that leads to narrowing of the airways in the lungs due to inflammation and mucus. Common symptoms include cough, wheezing, asthma attacks, excess mucus production, and decreased exercise tolerance. Pharmacological treatment methods for asthma include bronchodilators, corticosteroids, and allergy medications. Nonpharmaceutical treatments include monitoring of exposure to allergens and breathing exercises, however swimming is not as commonly suggested. The purpose of this study is to investigate whether implementation of a swimming education class will influence the effectiveness of swimming on asthma management in Asian Americans. This study aims to examine quality of life, changes in …

An Interdisciplinary Education And Service Bundle To Reduce Hospital Resource Utilization And Decrease Pediatric Asthma-Related Morbidity And Mortality, Emily Yates

Seton Hall University Dissertations and Theses (ETDs)

The purpose of this quality improvement project was to reduce hospital resource utilization and improve health outcomes for children with asthma by providing an evidence-based, interdisciplinary education and service bundle to patients and families admitted to a Children’s Hospital in Northern New Jersey with a primary diagnosis of asthma. The 2020 Asthma Management Guidelines published by the U.S. Department of Health and Human Services (2020), the Global Initiative for Asthma (GINA) and a modified systematic review identified common themes among children at risk for asthma-related morbidity and mortality and high hospital resource utilization. These themes included medication misuse, asthma trigger …

Implementing Community Health Workers To Improve The Management Of Chronic Non-Communicable Diseases In Children, Julia L. Newell

Doctor of Nursing Practice (DNP) Projects

Background: Childhood obesity, asthma, and untreated mental health conditions are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Minority children from low-income families, especially those with environmental disadvantages, face additional risk factors for the development of these diseases. Community health workers (CHWs) are in a unique position to help address these negative health externalities by being attuned with the linguistic, cultural, and socioemotional needs of members of their communities. Research has demonstrated success in CHW-led interventions curtailing the negative impacts associated with these diseases in low-income, minority communities.

Methods: A literature …

Community Health Worker Program: Chronic Non-Communicable Diseases In Children, Julia L. Newell

DNP Qualifying Manuscripts

Abstract

Background: Childhood obesity, asthma, and untreated mental health conditions, are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Community health workers (CHWs) are in a unique position to address these negative health externalities by leveraging linguistic, cultural, and socioemotional connectedness within their communities.

Local Problem: Minority children in the Central Valley of California, face additional risk factors for the development of CNDs. CHWs working in this area require enhanced training on CNDs to improve their practice.

Methods: In partnership with Save the Children (STC), the University of San Francisco (USF) …

Improving Pediatric Asthma Outcomes Through Pictorial Asthma Action Plans, Julia Donovan

Dissertations

Problem: Asthma is the leading chronic disease of children and the leading cause of childhood emergency department (ED) visits, hospitalizations, and missed school days. Asthma action plans (AAPs), including photographs or pictures of asthma medications, symptoms, triggers, and devices, have improved parents’ understanding of their child’s asthma and have increased their comfort level in caring for their child.

Methods: An interventional pre-post study with a mixed-method research design, at a large, urban, primary care pediatric clinic with two locations, evaluated the effectiveness of a pictorial AAP on a child’s asthma control. A pictorial AAP was provided, and a childhood asthma …

Implementation Of A Structured Discharge Checklist For Children Admitted To The Hospital With Acute Asthma, Nicholas Fleming

Dissertations

Abstract

Problem: The transition process from a hospital setting to home is critical for pediatric patients and their families. However, there is no standardized process to ensure asthma discharge orders and asthma action plans are printed at the time of discharge

Methods: This observational quality improvement project utilized a pre-and-postimplementation of the Kamishibai Card (K-Card) process for pediatric discharge checklist compliance in an inpatient pediatric general medicine unit. This project used a sample of all children aged 2 years to 21 years with an asthma diagnosis admitted to the inpatient general medicine pediatric unit. This project included an …

Novel Natural Compounds Derived From Tcm In The Treatment Of Food Induced Anaphylaxis, Ibrahim Musa

NYMC Student Theses and Dissertations

Food allergy is a highly prevalent disease affecting about 30 million people in the U.S. It is managed primarily by food avoidance due to lack of promising treatment options. ASHMI (anti-asthma herbal intervention) which consists of three components, Sophorae flavescentis, Ganoderma lucidum, Glycyrrhiza uralensis has been shown to inhibit allergic lung inflammation in antigen sensitized and challenged mice. In this study we isolate and identify the active compound in Sophorae flavescentis, characterized the mechanism of IgE inhibitory effect, biomarkers and potential to prevent food anaphylaxis.

To separate and identify the compounds we used column chromatography, high-performance liquid chromatography, mass …

Evaluation Of A Place-Based Asthma Reduction Initiative On Asthma-Related Morbidity Among Children In East Harlem And The Impact Of The Covid-19 Pandemic On Health Care Utilization And Medication Adherence Among Medicaid-Enrolled Children, Sarah C. Walters

Dissertations and Theses

Background: In New York City, asthma continues to be the leading cause of hospitalizations and emergency department (ED) visits among children, and disproportionally burdens Black and Latino children in low-income neighborhoods. Place-based, or geographically targeted, programs offer upstream strategies for addressing public health issues in these underserved neighborhoods, and given their targeted nature, quasi-experimental or other observational methods are needed to rigorously evaluate their impact. This dissertation uses multiple methodological approaches to assess the impact of the East Harlem Asthma Center of Excellence (EHACE) – an equity-focused, multi-faceted, place-based asthma mitigation initiative in the East Harlem neighborhood of a New …

The Impact Of The Covid-19 Pandemic On Pediatric Emergency Department Visits For Asthma: A Scoping Review, Peyton Law, Robin Dawson

Senior Theses

Background & Objective: Prior to the onset of the COVID-19 pandemic, the most common reasons for ED visits among children ages 0-18 were acute upper respiratory infections and asthma, a chronic disease that causes narrowing and swelling in the airways of the lungs. Asthma has various triggers, one of the most common being respiratory tract infections that further impair the airways (Busse et al., 2010). Caused by SARS-CoV-2, COVID-19 infection is associated with respiratory symptoms including shortness of breath, congestion, coughing, and sore throat. While there was a sharp decline in the number of total pediatric ED after the …

Improving Asthma Management Behaviors In School Nurses Through Facilitator Training And Supported Implementation, Mary D. Hacker-Taylor

Doctor of Nursing Practice Projects

Uncontrolled asthma in middle school age children and adolescents results in increased morbidity and often impairs a student’s ability to participate in school activities. School absenteeism is an unintended consequence which in turn can impact academic success. School nurses can improve student asthma outcomes through effective asthma management behaviors (AMB’s). The purpose of this multi-phase quality improvement DNP project was to improve both knowledge and confidence, and thereby improve AMB’s in Kentucky school nurses. A convenience sample of twelve nurses participated in the project. The American Lung Association’s (ALA) Kickin’ Asthma training was extended to all Kentucky school nurses who …

The Impact Of Flooding Events In Kentucky Counties On Preventable Asthma Hospitalizations, Mckaylee Copher

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective: Given the frequency and intensity of flooding, along with the disparities in respiratory illnesses in Kentucky, this study aims to determine if there is an association between flooding and asthma is crucial to the health of the state population.

Methods: Preventable asthma hospitalizations in adults aged 18-39 were obtained from the Kentucky Cabinet of Health and Family Services, Health and Facility Services Data and included the count of admissions of an ICD-9 diagnosis of asthma, as determined by hospital discharge data. FEMA disaster declarations were used to identify 69 counties that had floods during the period of 2008-2015. A …

Isoprenylation Inhibition Significantly Reduces Ige Mediated Mast Cell Function And Allergic Disease, Jordan Dailey

Theses and Dissertations

Allergic disease is the 6^th leading cause of chronic illness in the US and accounts for billions of dollars in healthcare annually. Mast cells are tissue resident innate immune cells linked to allergic disease and activated by IgE and other ligands. Upon activation, they release histamine, cytokines, chemokines, proteases, and lipid mediators evoking allergic symptoms. New ways of targeting mast cells could greatly benefit allergic disease therapy. Previous findings supported repurposing statin drugs, such as Fluvastatin, as a therapeutic treatment of allergic disease reduced allergic symptoms in vitro and in vivo. We found that Fluvastatin suppressed IgE-mediated mast cell …

Identifying A Glucocorticoid-Activated Gpcr That Rapidly And Non-Genomically Increases Camp Levels In Mammalian Cells, Francisco Nunez

Pharmaceutical Sciences (PhD) Dissertations

Glucocorticoids (GCs) are steroid hormones that regulate diverse physiological processes. Synthetic versions of GCs are commonly used to treat inflammatory diseases such as asthma by modulating gene expression to suppressing several inflammatory activities. However, it is estimated that 5-10% of asthmatics are unresponsive to GCs, which may be explained by receptor desensitization and/or the presence of a neutrophilic endotype. One understudied phenomenon of GCs is their ability to induce rapid, non-genomic actions. For example, GCs can acutely modulate calcium concentrations levels, induce smooth muscle relaxation and modulate nitric oxide synthase activity, within minutes and sometimes seconds, which is too rapid …

Implementation And Evaluation Of Asthma Education Cell Phone Application: Asthmaxcel, Within An Allergy And Asthma Specialty Practice., Michael Stefan Swift

Doctor of Nursing Practice Papers

Abstract

Background: Asthma is the leading chronic illness among pediatric patients. One of the most significant obstacles facing asthma care is adherence to asthma management plans. In the pediatric population, adolescents (ages 12-17) traditionally have poor asthma management. Research shows that adolescents respond well to technology-based education and that improving adolescent healthcare literacy leads to better asthma control.

Environment: This project took place at an allergy and asthma specialists office. This private practice includes primary care allergy, asthma, and immunology services that follows roughly 120 adolescents with asthma.

Purpose: The purpose of this project was to provide the allergy and …

The Relationship Between Pm2.5 And Chronic Respiratory Disease In Senegal, Bailey Glenn

Masters Theses

Chronic respiratory diseases such as asthma and chronic bronchitis have significantly increased in prevalence in Africa over the past 10 years. Recent studies have demonstrated that exposure to air pollution may be associated with an increased risk of chronic respiratory diseases. However, such studies have predominantly been conducted in western societies or often used urbanicity as a proxy for exposure to air pollution. Therefore, we evaluated the association between PM_2.5 exposure and asthma/chronic bronchitis in Senegal. A cross-sectional study was conducted for the time period of 3 October 2010 to 28 April 2011 using annual concentrations of PM_{2.5 …}

Investigation Of Cumulative Genetic Risk And Cc16 In Adult Asthma And Copd Populations, Kelli C. Gribben

Theses & Dissertations

INVESTIGATION OF CUMULATIVE GENETIC RISK AND CC16 IN ADULT ASTHMA AND COPD POPULATIONS

Kelli C. Gribben, Ph.D.

University of Nebraska Medical Center, 2022

Supervisors: Paraskevi A. Farazi and Tricia D. LeVan, Ph.D.

Asthma and Chronic Obstructive Pulmonary Disease (COPD) have complex etiologies and lack biological predictors that can be used for primary prevention, early detection, progression, or monitoring. Genetic risk scores (GRS) aggregate genetic effects from GWAS-identified susceptibility variants associated with a trait. GRS may provide opportunities to improve disease prediction to inform public health and clinical interventions. Asthma GRS studies utilizing multi-ethnic populations are scarce and there is a …

Asthma Care By Unlicensed Personnel In The Elementary School Setting: A Training Program, Teresa Eligio

Doctoral Projects

This Quality Improvement project (QI) aims to improve the competence and confidence of unlicensed school health staff in identifying asthma symptoms, reading an asthma action plan, asthma care, emergency response, medication delivery tools, and trigger reduction in the school setting. The QI project transpired in an Elementary School District in Los Angeles County, CA. The Project Manager, an asthma instructor trained by the American Lung Association, provided evidence-based Asthma-Basics training for health clerks (HCs), substitute health clerks (SHCs), licensed vocational nurse health clerks (LVN HCs), school office coordinators (SOCs), school office attendance clerks (SOAs), and substitute school office staff (SDO). …

Comparative Effects Of High-Intensity Interval Warm-Up Exercise And Bronchodilator On Exercise-Induced Bronchoconstriction In Children With Mild Asthma, Michael Wong

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The troubling link between obesity and asthma in children, along with greater associated detrimental health effects, warrants investigation to better understand the mechanisms driving this relationship as well as its consequences, especially during exercise. Bronchodilators and interval warm-up exercises are recommended by the American Thoracic Society to prevent exercise-induced bronchoconstriction (EIB). Whether interval warm-up exercise can prevent EIB to the same extent as bronchodilators in asthmatic children is unknown but clinically important. Therefore, the first purpose of this study is to investigate the effects of obesity on pulmonary function, exercise tolerance, and exercise-induced bronchoconstriction in asthmatic children. The second …

Development Of New Treatments For Asthma And Neuropathic Pain Based On Ɣ-Aminobutyric Acid A Receptor (Gabaar) Ligands, Nicolas Mark Zahn

Theses and Dissertations

The γ-aminobutyric acid A receptor (GABAAR) is a ligand-gated pentameric chloride channel consisting of several identified subunits: α1-6, β1-3, γ1-3, δ, ε, π, θ, ρ1-3.1-2 Typical arrangement of subunits consists of two α subunits, two β subunits, and one γ subunit.3 GABAARs have two binding sites for the endogenous ligand γ-aminobutyric acid (GABA), between the α and β subunits. GABAARs also have a binding site for positive allosteric modulators, such as benzodiazepines, between the α and γ subunits.4-5 Due to their ability to treat anxiety, epilepsy, insomnia, and muscle relaxation, benzodiazepines are widely prescribed pharmaceuticals.6-7 Still, adverse effects result from …

Evaluation Of Early Primary Care Implementation Of Point Of Care Ultrasound In Outcomes Of Patients With Dyspnea As Compared To Standard Diagnostic Exams, Mcglinchey Chase

Physician Assistant Scholarly Project Papers

The purpose of this systematic literature review is to evaluate the applicability of point of care ultrasound (POCUS) in rural primary care. More specifically, the review seeks to evaluate the use of POCUS regarding outcomes in patients with dyspnea. Six of the most common and potentially life-threatening causes of dyspnea were chosen to review. They are asthma, heart failure, chronic obstructive pulmonary disease (COPD), pneumonia, pneumothorax, and pulmonary embolism. In this review, a literature search was performed using the following electronic databases: PubMed, Cochran Review, and Google Scholar. Only articles since 2011 were selected for review with the majority being …

Factors Affecting Quality Of Life And Asthma Control In Older Adults With Asthma., Karen Schuckmann

Electronic Theses and Dissertations

Introduction: Approximately 7.7 percent of adults over the age of 65 have asthma in the United States (U.S), further, the population of older adults in the U.S. will increase to 20% by 2030. Health Related Quality of Life is low for this age group and asthma is often misdiagnosed and undertreated creating a need for research to improve factors that influence Asthma Quality of Life. Aims: This study explored two aims. The first aim evaluates the relationship between medication numeracy and asthma self-management knowledge with asthma self-efficacy. The second aim evaluates medication numeracy, asthma self-management knowledge, asthma self-efficacy, and asthma …

Perceived Discrimination As A Moderator Of The Relationship Between Allostatic Load And Asthma Control, Vera Kern

Walden Dissertations and Doctoral Studies

While asthma prevalence in the United States is generally declining, African Americans tend to experience poorer outcomes regarding asthma severity and control. The purpose of the present study was to test whether discrimination (everyday and lifetime) moderated the relationship between allostatic load and asthma severity/asthma control (dyspnea and peak flow). In previous literature, researchers established the relationship between allostatic load and asthma severity/asthma control among African Americans. The biopsychosocial model and allostatic load theory served as the theoretical frameworks for this study. In this cross-sectional, nonexperimental, quantitative design, 201 African Americans between the ages of 34 and 82 years were …

Effects Of Indoor Air Pollutants On Childhood Asthma: African American Parents’ Perspective, Marcia Maureen Haughton Lewis

Walden Dissertations and Doctoral Studies

AbstractIndoor air pollution has been implicated in many chronic health conditions, including childhood asthma, which is more prevalent among African American children. Children are more susceptible than adults to the effects of exposure to indoor air pollution; however, many parents may not be aware of the polluting impacts of products in their homes and are inadvertently placing their families at risk for adverse health outcomes. Understanding parents’ perceptions and experiences is essential for planning and developing educational programs and interventions for improving indoor environment management as part of asthma management in children. This descriptive phenomenological study aimed to explore parents’ …

Improving The Healthcare Transition For Adolescents With Asthma: Implementing A Transition Readiness Assessment, Andrea Pauley

DNP Projects

BACKGROUND: Asthma is the most common pediatric chronic disease in the United States and adolescence represents the highest prevalence among all age groups. Transition planning is recommended for all adolescents, especially those with special health care needs (SHCN). Only 17% of adolescents with SHCN receive adequate transition planning.

PURPOSE: The purpose of this study was to implement the Transition Readiness Assessment Questionnaire (TRAQ) for adolescents age 12 years and older with asthma to identify the current level of transition readiness and identify factors associated with readiness.

METHODS: This study was an exploratory, cross-sectional design to evaluate and describe participants’ level …

Adverse Childhood Experiences: Connecting The Dots Between Early Life Stress And Asthma Aming Children And Adolescents With Sickle Cell Disease, Brandi Mcclain Pernell

All ETDs from UAB

Sickle cell disease (SCD) is an inherited red blood cell disorder plagued by increased morbidity and premature mortality. Asthma disproportionally affects individuals with SCD and is strongly associated with an increased incidence of pain, acute lung complications and death among this high-risk population. Psychological stress is a well-established contributor and trigger for asthma development and exacerbations. Adverse Childhood Experiences (ACEs) are defined as traumatic experiences occurring before 18 years of age. ACEs occur at the individual, familial (Original-ACEs) and community level (Expanded-ACEs) and can accumulate with time. Chronic exposure to ACEs leads to toxic stress, widespread inflammation and risk for …

Examining The Pulmonary Response To Repeated Vishniacozyma Victoriae Exposure And Its Association With Allergic Airway Disease, Rachael Erin Rush

Graduate Theses, Dissertations, and Problem Reports

Allergic airway diseases such as asthma continue to increase in incidence in industrialized nations like the United States. These diseases are complex inflammatory processes involving numerous cells and mediators and are strongly influenced by fungal exposures. Recent developments in fungal detection methods have highlighted the contribution of Basidiomycota yeast species in indoor environments such as Vishniacozyma (syn. Cryptococcus) victoriae. However, despite the high levels of this yeast detected in indoor environments, very little is known about it or its role in respiratory morbidity. V. victoriae is phylogenetically similar to pathogenic Cryptococcus neoformans but lacks a capsule and is …

The Influence Of Comorbid Gad On Er Utilization In Urban Youth With Asthma, David A. Karpe

Theses and Dissertations

Current literature indicates a strong association between asthma and the early onset of comorbid generalized anxiety disorder (GAD) in minors and their primary caregivers. Studies show that asthma prevalence increases with certain demographic factors, such as ethnicity, socioeconomic status, and housing quality. Evidence also suggests that GAD influences decision-making, especially when deciding to utilize emergency room (ER) services for asthma-related concerns. This study analyzed the effect of comorbid GAD on minors with asthma and ER utilization. The data were provided by an earlier Stress & Justice Study (S&J) baseline survey, an investigation aimed at understanding the impact of parental criminal …