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Gómez Silva G, García Magán C, Rodríguez Núñez A. Safe schooling for asthmatic children. An Pediatr (Barc) 2024; 100:e36-e37. [PMID: 38575477 DOI: 10.1016/j.anpede.2024.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/02/2021] [Indexed: 04/06/2024] Open
Affiliation(s)
- Graciela Gómez Silva
- Área de Pediatría, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain; Grupos de Investigación CLINURSID (Universidade de Santiago de Compostela) y Soporte Vital y Simulación (Fundación IDIS), Santiago de Compostela, La Coruña, Spain.
| | - Carlos García Magán
- Unidad de Alergia y Neumología Pediátrica, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain; Grupos de Investigación CLINURSID (Universidade de Santiago de Compostela) y Soporte Vital y Simulación (Fundación IDIS), Santiago de Compostela, La Coruña, Spain
| | - Antonio Rodríguez Núñez
- Área de Pediatría, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain; Grupos de Investigación CLINURSID (Universidade de Santiago de Compostela) y Soporte Vital y Simulación (Fundación IDIS), Santiago de Compostela, La Coruña, Spain; Facultad de Enfermería, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain; Instituto de Salud Carlos III (ISCIII), Spain
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Ramdzan SN, Khoo EM, Liew SM, Cunningham S, Pinnock H. Stakeholders' views of supporting asthma management in schools with a school-based asthma programme for primary school children: a qualitative study in Malaysia. BMJ Open 2022; 12:e052058. [PMID: 35131821 PMCID: PMC8823135 DOI: 10.1136/bmjopen-2021-052058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE The WHO Global School Health Initiative aimed to improve child and community health through health promotion programmes in schools, though most focus on preventing communicable disease. Despite WHO recommendations, no asthma programme is included in the Malaysian national school health service guideline. Therefore, we aimed to explore the views of school staff, healthcare professionals and policy-makers about the challenges of managing asthma in schools and the potential of a school asthma programme for primary school children. DESIGN A focus group and individual interview qualitative study using purposive sampling of participants to obtain diverse views. Data collection was guided by piloted semistructured topic guides. The focus groups and interviews were audiorecorded, transcribed verbatim and analysed using inductive thematic analysis. We completed data collection once data saturation was reached. SETTING Stakeholders in education and health sectors in Malaysia. PARTICIPANTS Fifty-two participants (40 school staff, 9 healthcare professionals and 3 policy-makers) contributed to nine focus groups and eleven individual interviews. RESULTS School staff had limited awareness of asthma and what to do in emergencies. There was no guidance on asthma management in government schools, and teachers were unclear about their role in school children's health. These uncertainties led to delays in the treatment of asthma symptoms/attacks, and suggestions that an asthma education programme and a school plan would improve asthma care. Perceived challenges in conducting school health programmes included a busy school schedule and poor parental participation. A tailored asthma programme in partnerships with schools could facilitate the programme's adoption and implementation. CONCLUSIONS Identifying and addressing issues and challenges specific to the school and wider community could facilitate the delivery of a school asthma programme in line with the WHO School Health Initiative. Clarity over national policy on the roles and responsibilities of school staff could support implementation and guide appropriate and prompt response to asthma emergencies in schools.
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Affiliation(s)
- Siti Nurkamilla Ramdzan
- Department of Primary Care Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Su May Liew
- Department of Primary Care Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Steve Cunningham
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
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Caruana M, Bonnici West LM, Cordina M. School practices in supporting children with asthma in Malta. J Asthma 2021; 59:1742-1749. [PMID: 34347559 DOI: 10.1080/02770903.2021.1964523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objective of this study was to obtain information about teachers' knowledge, attitudes, practices and beliefs about medication related to working with children having asthma in state primary schools in Malta. This study provides information about management in a country with a high prevalence of asthma among children, and limited availability of school nurses. METHODS A cross-sectional electronic survey investigating beliefs about medicines, asthma knowledge, attitude toward students with asthma, self-efficacy and practice in an asthma exacerbation, current practices, views, experiences and training relating to asthma was sent to all participating state primary schools in Malta. RESULTS A total of 167 teachers from 26 schools answered the questionnaire. The majority of respondents (56%) were unaware of children's conditions and limited information about children's asthma was provided to them. Only 20% of teachers reported receiving training on how to support children with asthma. Overall, teachers reported low asthma knowledge scores (mean score of 5.5 ± 3.3 out of a possible maximum of 14), and poor self-efficacy with only 6% agreeing that they can support a student having an asthma exacerbation on their own rather than sending the student to hospital. The study also demonstrated a strong interest by teachers to receive asthma education. CONCLUSIONS Interventions with regard to identifying students with asthma, asthma training for teachers, individualized asthma action plans, enhanced communication between school staff, parents and the medical team, and standard guidelines/policy are needed to provide a supportive school environment for primary school children with asthma.
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Affiliation(s)
- Maria Caruana
- Medicines Use Research Group, Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Lorna M Bonnici West
- Applied Research & Innovation Centre, Malta College of Arts, Science and Technology, Paola, Malta
| | - Maria Cordina
- Medicines Use Research Group, Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Gómez Silva G, García Magán C, Rodríguez Núñez A. Escolarización segura de los niños con asma. Respuesta de los autores. An Pediatr (Barc) 2021. [DOI: 10.1016/j.anpedi.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Caruana M, West LM, Cordina M. Current Asthma Management Practices by Primary School Teaching Staff: A Systematic Review. THE JOURNAL OF SCHOOL HEALTH 2021; 91:227-238. [PMID: 33594691 DOI: 10.1111/josh.12992] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/25/2020] [Accepted: 10/25/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The likelihood of children with asthma experiencing an exacerbation at school is significantly high when considering that they spend a substantial part of their day at school. This study, therefore, aimed to systematically review the literature to determine current asthma management practices by primary school teaching staff and any existing supporting legislation/policies/guidelines. METHODS Search terms were adapted to search literature across databases: CINAHL, Cochrane Library, Education Database-ProQuest, IPA, MEDLINE, SCI. Primary research studies, reviews, systematic reviews, and meta-analyses in English about primary school teaching staff dated between 2007 and 2017 were included. Primary outcomes comprised teaching staff' practices regarding asthma management and supporting guidelines, policies, or legislation. RESULTS Analysis of the 13 papers eligible for full review identified that: teachers were unable to deal with an asthma exacerbation; they lacked knowledge regarding exercise-induced asthma and that there was poor communication between schools and parents of children with asthma. The only documented relevant asthma legislation found pertained to New York schools. CONCLUSIONS Limited evidence regarding asthma management practices and inadequate asthma management knowledge amongst teaching staff highlight the need for supporting teaching staff with asthma policies and guidelines to minimize risks associated with inappropriate asthma management.
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Affiliation(s)
- Maria Caruana
- Biology Teacher, , University of Malta, MSD 2080, Msida, Malta
| | - Lorna M West
- Senior Research Officer, , Malta College of Arts, Science and Technology, Paola, Malta
| | - Maria Cordina
- Associate Professor, , University of Malta, MSD 2080, Msida, Malta
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Alsharnoubi J, Alkharbotly A, Waheed H, Elkhayat Z, Hussein DY. Could we diagnose childhood asthma by LIBS technique? Lasers Med Sci 2019; 35:807-812. [PMID: 31463818 DOI: 10.1007/s10103-019-02866-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 08/16/2019] [Indexed: 11/25/2022]
Abstract
Asthma affects children related to trace elements. Our aim was to investigate the levels of trace elements using laser-induced breakdown spectroscopy (LIBS). The study included 120 children aged 4-12 years from both sexes. They were divided into three groups: Group 1 of 40 children was diagnosed as cases of controlled asthma. Group 2 consisted of 40 children diagnosed as cases of uncontrolled asthma. Group 3 consisted of 40 children as normal control. Asthmatic children were classified according to GINA 2015. They were analyzed for serum levels of total IgE, eosinophil count, and trace metals (Zn, Cu, Pb, Mg, and Fe) by using LIBS. There was significant decrease in serum levels of Zn, Mg and Fe in children with asthma than in normal children. There was a significant decrease in uncontrolled asthmatic children than in controlled asthmatic children. But the Cu and Pb concentration in children with asthma was significantly higher than that in normal children, and there was a significant increase in uncontrolled asthmatic children than in controlled asthmatic children. Furthermore, we examined the peak flow meter, eosinophil count, and total IgE and found that the peak flow metric study had shown a significant difference in controlled cases, total eosinophil count, and IgE; the difference was more significant in the uncontrolled group than in the controlled group, and the total levels were higher in the uncontrolled group. Asthma is a common pediatric disease that is related to deficiency of Fe, Zn, and Mg and occurs with increased Pb and Cu. LIBS is a safe and rapid technique that helps in detecting asthma.
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Affiliation(s)
- Jehan Alsharnoubi
- National Institute of Laser Enhanced Sciences, Cairo University, House 2 street 6 Zahraa Helwan, Cairo, Egypt.
| | - Ahmed Alkharbotly
- National Institute of Laser Enhanced Sciences, Cairo University, House 2 street 6 Zahraa Helwan, Cairo, Egypt
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Pham MN, Wang J. Management of food allergies and asthma in schools. Ann Allergy Asthma Immunol 2019; 121:391-399. [PMID: 30290894 DOI: 10.1016/j.anai.2018.07.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/23/2018] [Accepted: 07/23/2018] [Indexed: 01/12/2023]
Affiliation(s)
- Michele N Pham
- Division of Allergy and Immunology, Department of Pediatrics, The Elliot and Roslyn Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, New York
| | - Julie Wang
- Division of Allergy and Immunology, Department of Pediatrics, The Elliot and Roslyn Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, New York.
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McClelland QYL, Avalos MI, Reznik M. Asthma management in New York City schools: A physical education teacher perspective. J Asthma 2019; 56:422-430. [PMID: 29667459 PMCID: PMC6295268 DOI: 10.1080/02770903.2018.1463380] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 03/22/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Physical education (PE) teachers may be the first to assist students with asthma attacks during PE class. This study explores the PE teachers' perspectives on in-school asthma management and barriers to physical activity (PA) in children with asthma attending urban elementary schools. METHODS We conducted qualitative semi-structured interviews with 16 PE teachers from 10 Bronx, NY elementary schools. Interviews were recorded, transcribed, and independently coded. Content analysis was used to identify 10 major themes common across interviews which were then categorized into 3 domains. RESULTS Three domains were identified: 1) school procedures and policies for asthma management; 2) role of PE teachers in asthma management; and 3) barriers to PA for students. Most PE teachers were unaware of written procedures for acute asthma management and did not receive asthma-specific training. Many PE teachers expressed confidence regarding asthma management. PE teachers identified students with asthma most commonly through communication with students. The PE teachers utilized various methods to manage asthma but all relied on the nurse to handle acute asthma symptoms. Several barriers to PA were determined, including PE teachers' unawareness of NYS PE requirements, lack of gym facilities, inclement weather, inconsistent PE class time, asthma diagnosis, and having no asthma inhalers at the nurse's office. CONCLUSIONS PE teachers' perspectives on asthma management may influence the way asthma is handled at school. The results from this study highlight several barriers that can be targeted in future interventions to improve asthma management.
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Affiliation(s)
- Qi Ying Li McClelland
- Pediatrics, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Maria Ivanna Avalos
- Pediatrics, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Marina Reznik
- Pediatrics, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
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Langton CR, Hollenbach JP, Simoneau T, Cloutier MM. Asthma management in school: parents' and school personnel perspectives. J Asthma 2019; 57:295-305. [PMID: 30676162 DOI: 10.1080/02770903.2019.1568455] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Effective asthma management at school can help students with asthma stay healthy, learn better and participate fully during their school day. This study sought to understand school-based asthma care from the perspective of parents and school personnel to improve asthma care at school. Methods: A cross-sectional study was conducted in Hartford, CT. School personnel from 59 schools and 322 parents/guardians were invited to participate. Four cross-sectional surveys using Likert-type scales assessed parental and school personnel satisfaction, confidence in managing asthma, policy awareness, management of asthma during physical activity, and perceived gaps surrounding school-based asthma care. Results: 263/322 (82%) eligible parents of children with asthma (mean age 8.5 ± 4.3, 56% Hispanic, 30% African American) completed surveys. Thirty six school nurses (62%), 131 teachers (8%), 14 coaches (14%), and 17 school principals (29%) participated. 90% of parents were satisfied with asthma management in school. School nurses were more aware of asthma policies than teachers (74% vs. 24%, p < 0.001). 34% of school nurses, 30% of teachers and 36% of coaches were unaware of asthma-related absences. 14% of physical education teachers/coaches reported no asthma training. Conclusion: In this convenience sample of parents and school personnel, parents reported overall satisfaction regarding the asthma care their children receive at school, yet a number of gaps pertaining to school-based asthma care were identified. Increased asthma training and enhanced communication among school personnel is needed to address these gaps. National guidelines and resources are readily available to improve asthma care at school.
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Affiliation(s)
| | - Jessica P Hollenbach
- Asthma Center, Connecticut Children's Medical Center, Hartford, CT, USA.,Department of Pediatrics, UCONN Health, Farmington, CT, USA
| | - Tregony Simoneau
- Asthma Center, Connecticut Children's Medical Center, Hartford, CT, USA.,Department of Pediatrics, UCONN Health, Farmington, CT, USA
| | - Michelle M Cloutier
- Asthma Center, Connecticut Children's Medical Center, Hartford, CT, USA.,Department of Pediatrics, UCONN Health, Farmington, CT, USA.,Department of Medicine, UCONN Health, Farmington, CT, USA
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Urrutia-Pereira M, Mocellin L, de Oliveira R, Simon L, Lessa L, Solé D. Knowledge on asthma, food allergies, and anaphylaxis: Assessment of elementary school teachers, parents/caregivers of asthmatic children, and university students in Uruguaiana, in the state of Rio Grande do Sul, Brazil. Allergol Immunopathol (Madr) 2018; 46:421-430. [PMID: 29338962 DOI: 10.1016/j.aller.2017.09.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 09/14/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Allergic diseases have become an increasingly common reality in the last years, extending beyond the family context. OBJECTIVE Assessing the level of knowledge on asthma, food allergies and anaphylaxis of asthmatic children's parents/caregivers (PC), elementary school teachers (EST) and university students (US) in Uruguaiana, RS, Brazil. METHOD 577 individuals (PC - N=111; EST - N=177; US - N=299) took part in the study, answering the Newcastle Asthma Knowledge Questionnaire (validated for Portuguese) and another questionnaire on Food Allergy (FA) and anaphylaxis. RESULTS Although PC have asthmatic children, their asthma knowledge level was average, slightly above that of EST and EU. The lack of knowledge on passive smoking, use of medications and their side effects should be highlighted. US have shown to be better informed about FA and anaphylaxis. However, even though a significant proportion of respondents know the most common symptoms of FA and anaphylaxis, few named subcutaneous adrenaline as the drug of choice for treating anaphylaxis. Although a significant number of respondents know about the possibility of anaphylactic reactions happening at school or in activities outside the school, we were surprised by the absence of conditions in schools to provide emergency care to such students. CONCLUSION Despite the high prevalence of allergic diseases in childhood, asthmatic children's parents/caregivers, elementary school teachers and university students have inadequate levels of knowledge to monitor these patients.
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Ruvalcaba E, Chung SE, Rand C, Riekert KA, Eakin M. Evaluating the implementation of a multicomponent asthma education program for Head Start staff. J Asthma 2018. [PMID: 29543493 DOI: 10.1080/02770903.2018.1443467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Asthma disproportionately affects minority groups, low income populations, and young children under 5. Head Start (HS) programs predominantly serve this high-risk population, yet staff are not trained on asthma management. The objective of this study was to assess a 5-year, multicomponent HS staff asthma education program in Baltimore City HS programs. METHODS All HS programs were offered annual staff asthma education by a medical research team that included didactic lectures and hands-on training. Attendees received continuing education credits. HS staff were anonymously surveyed on asthma knowledge and skills and asthma medication management practices in Year 1 (preimplementation) and Year 5. RESULTS There was an estimated response rate of 94% for Year 1 and 82% for Year 5. Compared to staff in Year 1, Year 5 staff were significantly more likely to report they had very good knowledge and skills related to asthma [odds ratio (OR) 1.63; p < 0.05] and were engaged in asthma care activities (OR 2.02; p < 0.05). Self-reported presence of asthma action plans for all children with asthma was 82% at Year 1 and increased to 89% in Year 5 (p = 0.064). CONCLUSIONS Year 5 HS staff reported higher self-assessed knowledge and skills, self-reports of asthma medication management practices, and self-reports of asthma activities compared to Year 1 staff. HS serves high-risk children with asthma, and a multicomponent program can adequately prepare staff to manage asthma in the child care setting. Our results indicate the feasibility of providing efficacious health skill education into child care provider training to reduce asthma knowledge gaps.
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Affiliation(s)
- Elizabeth Ruvalcaba
- a Division of Pulmonary and Critical Care Medicine , Johns Hopkins School of Medicine , Baltimore , MD , USA
| | - Shang-En Chung
- a Division of Pulmonary and Critical Care Medicine , Johns Hopkins School of Medicine , Baltimore , MD , USA
| | - Cynthia Rand
- a Division of Pulmonary and Critical Care Medicine , Johns Hopkins School of Medicine , Baltimore , MD , USA
| | - Kristin A Riekert
- a Division of Pulmonary and Critical Care Medicine , Johns Hopkins School of Medicine , Baltimore , MD , USA
| | - Michelle Eakin
- a Division of Pulmonary and Critical Care Medicine , Johns Hopkins School of Medicine , Baltimore , MD , USA
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Abstract
BACKGROUND Teachers and school staff should be competent in managing asthma in schools. Demonstrated low levels of asthma knowledge mean that staff may not know how best to protect a child with asthma in their care, or may fail to take appropriate action in the event of a serious attack. Education about asthma could help to improve this knowledge and lead to better asthma outcomes for children. OBJECTIVES To assess the effectiveness and safety of asthma education programmes for school staff, and to identify content and attributes underpinning them. SEARCH METHODS We conducted the most recent searches on 29 November 2016. SELECTION CRITERIA We included randomised controlled trials comparing an intervention to educate school staff about asthma versus a control group. We included studies reported as full text, those published as abstract only and unpublished data. DATA COLLECTION AND ANALYSIS At least two review authors screened the searches, extracted outcome data and intervention characteristics from included studies and assessed risk of bias. Primary outcomes for the quantitative synthesis were emergency department (ED) or hospital visits, mortality and asthma control; we graded the main results and presented evidence in a 'Summary of findings' table. We planned a qualitative synthesis of intervention characteristics, but study authors were unable to provide the necessary information.We analysed dichotomous data as odds ratios, and continuous data as mean differences or standardised mean differences, all with a random-effects model. We assessed clinical, methodological and statistical heterogeneity when performing meta-analyses, and we narratively described skewed data. MAIN RESULTS Five cluster-RCTs of 111 schools met the review eligibility criteria. Investigators measured outcomes in participating staff and often in children or parents, most often at between 1 and 12 months.All interventions were educational programmes but duration, content and delivery varied; some involved elements of training for pupils or primary care providers. We noted risk of selection, performance, detection and attrition biases, although to a differing extent across studies and outcomes.Quanitative and qualitative analyses were limited. Only one study reported visits to the ED or hospital and provided data that were too skewed for analysis. No studies reported any deaths or adverse events. Studies did not report asthma control consistently, but results showed no difference between groups on the paediatric asthma quality of life questionnaire (mean difference (MD) 0.14, 95% confidence interval (CI) -0.03 to 0.31; 1005 participants; we downgraded the quality of evidence to low for risk of bias and indirectness). Data for symptom days, night-time awakenings, restricted activities of daily living and school absences were skewed or could not be analysed; some mean scores were better in the trained group, but most differences between groups were small and did not persist to 24 months.Schools that received asthma education were more adherent to asthma policies, and staff were better prepared; more schools that had received staff asthma training had written asthma policies compared with control schools, more intervention schools showed improvement in measures taken to prevent or manage exercise-induced asthma attacks and more staff at intervention schools reported that they felt able to administer salbutamol via a spacer. However, the quality of the evidence was low; results show imbalances at baseline, and confidence in the evidence was limited by risk of bias and imprecision. Staff knowledge was higher in groups that had received asthma education, although results were inconsistent and difficult to interpret owing to differences between scales (low quality).Available information about the interventions was insufficient for review authors to conduct a meaningful qualitative synthesis of the content that led to a successful intervention, or of the resources required to replicate results accurately. AUTHORS' CONCLUSIONS Asthma education for school staff increases asthma knowledge and preparedness, but studies vary and all available evidence is of low quality. Studies have not yet captured whether this improvement in knowledge has led to appreciable benefits over the short term or the longer term for the safety and health of children with asthma in school. Randomised evidence does not contribute to our knowledge of content or attributes of interventions that lead to the best outcomes, or of resources required for successful implementation.Complete reporting of the content and resources of educational interventions is essential for assessment of their effectiveness and feasibility for implementation. This applies to both randomised and non-randomised studies, although the latter may be better placed to observe important clinical outcomes such as exacerbations and mortality in the longer term.
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Affiliation(s)
- Kayleigh M Kew
- BMJ Knowledge CentreBritish Medical Journal Technology Assessment Group (BMJ‐TAG)BMA HouseTavistock SquareLondonUKWC1H 9JR
| | - Robin Carr
- 28 Beaumont Street Medical PracticeOxfordUK
| | - Tim Donovan
- University of CumbriaMedical and Sport SciencesLancasterUK
| | - Morris Gordon
- University of Central LancashireSchool of MedicinePrestonUK
- Blackpool Victoria HospitalFamilies DivisionBlackpoolUK
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Urrutia-Pereira M, To T, Cruz Á, Solé D. The school as a health promoter for children with asthma: The purpose of an education programme. Allergol Immunopathol (Madr) 2017; 45:93-98. [PMID: 27475777 DOI: 10.1016/j.aller.2016.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 04/01/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Not only is asthma one of the leading causes of hospitalisation in children under 15 years and one of the main reasons for primary care outpatient visits, it also accounts for 13 million lost days of school annually, which can affect children's learning, integration at school and overall academic achievements. MATERIAL AND METHODS This review article highlights the important role of the school in helping children and adolescents to control and manage their asthma through integrated and coordinated actions of health professionals, school staff, family, and the community. RESULTS We recommended key elements for a multidisciplinary team asthma school programme that can be replicated and implemented especially in developing countries where children and adolescents are in a more disadvantaged environment. CONCLUSION This multidisciplinary asthma school intervention when demonstrated with efficacy can be applied in the context of the real world, where many children and families who need care the most currently do not receive it.
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Carvalho Coelho AC, Barretto Cardoso LS, de Souza-Machado C, Souza-Machado A. The Impacts of Educational Asthma Interventions in Schools: A Systematic Review of the Literature. Can Respir J 2016; 2016:8476206. [PMID: 27656097 PMCID: PMC5021513 DOI: 10.1155/2016/8476206] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 07/07/2016] [Accepted: 08/07/2016] [Indexed: 01/22/2023] Open
Abstract
Objective. To review the literature on the impact of educational asthma interventions in schools regarding the knowledge and morbidity of the disease among children and adolescents. Methods. A systematic review was conducted for controlled clinical trials investigating the effectiveness of educational asthma interventions for students, asthmatic or nonasthmatic, families, and school staff. Databases were CENTRAL, PubMed, LILACS, MEDLINE, and SciELO. Articles published in any language were considered, in the period from 2005 to 2014, according to the PRISMA guidelines. Results. Seventeen articles were selected (N = 5,879 subjects). 94% of the interventions (16 of 17 studies) were applied in developed countries that were led by health professionals and most of them targeted asthmatics. Asthma education promotes the improvement of knowledge about the disease in at least one of the evaluated areas. 29% of the interventions (5 of 17 studies) showed a reduction of the asthma symptoms, 35% (6 of 17 studies) reduction of the hospitalization instances and emergency visits, 29% (5 of 17 studies) reduction of school absenteeism, and 41% (7 of 17 studies) increase in the quality of life of the individuals. Conclusions. Educational interventions in schools raise the awareness of asthma and weaken the impact of morbidity indicators.
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Affiliation(s)
- Ana Carla Carvalho Coelho
- Escola de Enfermagem, Universidade Federal da Bahia, Salvador, BA, Brazil
- ProAR, Programa para o Controle da Asma na Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
- Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | | | - Carolina de Souza-Machado
- Escola de Enfermagem, Universidade Federal da Bahia, Salvador, BA, Brazil
- ProAR, Programa para o Controle da Asma na Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
- Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Adelmir Souza-Machado
- ProAR, Programa para o Controle da Asma na Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
- Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, BA, Brazil
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Varela ALS, Esteban SR, Díaz SP, Murúa JK, Fernández-Oliva CRR, Jiménez JS, Sansano MIU, Bernabé JJM, López BI, Gómez MM, Piñana JMR. Knowledge of asthma in school teachers in nine Spanish cities. Pediatr Pulmonol 2016; 51:678-87. [PMID: 26720303 DOI: 10.1002/ppul.23363] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 11/05/2015] [Accepted: 11/29/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To analyze the knowledge of asthma and its management in Spanish school teachers using the Newcastle Asthma Questionnaire (NAKQ). DESIGN Descriptive, observational prevalence study, using a self-report questionnaire on knowledge about childhood asthma and its management by teachers in pre-school, primary, and secondary schools in nine Spanish cities. Age, sex, academic training, teaching experience, courses in which they taught, and personal and family history of asthma, were collected from each teacher. For knowledge determination, the validated Spanish version of the NAKQ was used. RESULTS A total of 208 centers participated, including 7,494 teachers. The questionnaire was completed by 4,679 teachers (62.4%). The mean score of correct responses was 16.0 ± 4.8 points out of 31 (median = 17, range: 0-30). Only 6.8% of teachers were capable of pointing out the three main symptoms of the disease; 1.5% knew the triggering factors of an asthma attack; 8.6% knew two medicines useful during an asthma attack; 32.7% knew that inhaled medications had less side effects than pills, and only 3.8% knew of ways to prevent asthma attacks during exercise. In the multivariate analysis, variables significantly associated with a higher questionnaire score were a "lower age" (Beta coefficient = -0.09), "male gender" (Beta = 0.77), "being asthmatic" (Beta = 2.10), or "having close relatives with asthma" (Beta = 1.36) and "teaching in a private school" (Beta = 0.66) or in "compulsory secondary education" (Beta = 0.59). CONCLUSIONS Teachers have a low level of knowledge about asthma, with an important limitation in some aspects of the disease. They should be trained to recognize the main symptoms of the disease, on how to act in the event of symptoms, and the early identification of situations in which the pupils require health care assistance. Pediatr Pulmonol. 2016;51:678-687. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Santiago Rueda Esteban
- Division of Respiratory Medicine, Department of Pediatrics, Hospital Clínico San Carlos, Madrid, Spain
| | - Sonia Pértega Díaz
- Clinical Epidemiology and Biostatistics Research Group, Hospital Universitario A Coruña, A Coruña, Spain
| | - Javier Korta Murúa
- Division of Respiratory Medicine, Department of Pediatrics, Hospital Donostia, San Sebastian, Spain
| | | | | | | | | | | | - Máximo Martínez Gómez
- Department of Pediatric Pneumology, Hospital Nuestra Señora de las Nieves, Granada, Spain
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Cain A, Reznik M. Asthma management in New York City schools: A classroom teacher perspective. J Asthma 2016; 53:744-50. [PMID: 27031532 DOI: 10.3109/02770903.2015.1135946] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Classroom teachers play an important role in facilitating asthma management in school but little is known about their perspectives around asthma management. We examined the perspectives of classroom teachers around barriers to school asthma management. METHODS We conducted key informant interviews with 21 inner-city classroom teachers from 3rd to 5th grades in 10 Bronx, New York elementary schools. Sampling continued until thematic saturation was reached. Interviews were recorded, transcribed, and independently coded for common themes. We used thematic and content review to analyze interview data. RESULTS Seven themes representing teachers' perspectives on in-school asthma management emerged: (1) the problematic process of identifying students with asthma; (2) poor familiarity with the city health department's asthma initiative and poor general knowledge of school policies on asthma management; (3) lack of competency in managing an acute asthma attack in the classroom and poor recognition of symptoms of an asthma attack; (4) lack of confidence in dealing with a hypothetical asthma attack in the classroom; (5) lack of quick access to asthma medication in school; (6) limited communication between school staff; and (7) enthusiasm about learning more about asthma management. CONCLUSIONS Our results revealed several barriers contributing to suboptimal in-school asthma management: ineffective ways of identifying students with asthma, lack of teacher knowledge of guidelines on asthma management, lack of comfort in managing students' asthma, inadequate access to asthma medication in school, and limited communication between school staff. These issues should be considered in the design of interventions to improve in-school asthma management.
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Affiliation(s)
- Agnieszka Cain
- a Medical School, Albert Einstein College of Medicine , Bronx , NY , USA
| | - Marina Reznik
- b Department of Pediatrics , Children's Hospital at Montefiore, Albert Einstein College of Medicine , Bronx , NY , USA
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Hauptman M, Phipatanakul W. The school environment and asthma in childhood. Asthma Res Pract 2015; 1:12. [PMID: 26523228 PMCID: PMC4627718 DOI: 10.1186/s40733-015-0010-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 09/18/2015] [Indexed: 01/25/2023] Open
Abstract
In this article, we discuss the relationship between environmental exposures within the school environment and pediatric asthma morbidity. This article will conclude by reviewing novel school based asthma education and therapeutic programs and environmental interventions designed to help mitigate pediatric asthma morbidity.
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Affiliation(s)
- Marissa Hauptman
- Division of General Pediatrics, Boston Children’s Hospital, Boston, MA USA
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA USA
- Harvard Medical School, Boston, MA USA
- Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, MA USA
- Boston Children’s Hospital, 300 Longwood Ave., Boston, MA 02115 USA
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA USA
- Harvard Medical School, Boston, MA USA
- Boston Children’s Hospital, 300 Longwood Ave., Boston, MA 02115 USA
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