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Asthma is a high-stress, chronic medical condition; 1 in 12 adults in the United States combat the bronchoconstriction from asthma. However, there are very few strong studies indicating any alternative therapy for asthmatics, particularly following a cold incidence. Vitamin C has been proven to be effective for other high-stress populations, but the asthmatic population has not yet been trialed. This study examined the effectiveness of vitamin C supplementation during the cold season on cold incidence and asthmatic symptoms. Asthmatics, otherwise-healthy, who were non-smokers and non-athletes between the ages of 18 and 55 with low plasma vitamin C concentrations were separated by anthropometrics and vitamin C status into two groups: either vitamin C (500 mg vitamin C capsule consumed twice per day) or control (placebo capsule consumed twice per day). Subjects were instructed to complete the Wisconsin Upper Respiratory Symptom Survey-21 and a short asthma symptoms questionnaire daily along with a shortened vitamin C Food Frequency Questionnaire and physical activity questionnaire weekly for eight weeks. Blood samples were drawn at Week 0 (baseline), Week 4, and Week 8. Compliance was monitored through a calendar check sheet. The vitamin C levels of both groups increased from Week 0 to Week 4, but decreased in the vitamin C group at Week 8. The vitamin C group had a 19% decrease in plasma histamine while the control group had a 53% increase in plasma histamine at the end of the trial, but this was not statistically significant (p>0.05). Total symptoms recorded from WURSS-21 were 129.3±120.7 for the vitamin C and 271.0±293.9, but the difference was not statistically significant (p=0.724). Total asthma symptoms also slightly varied between the groups, but again was not statistically significant (p=0.154). These results were hindered by the low number of subjects recruited. Continued research in this study approach is necessary to definitively reject or accept the potential role of vitamin C in asthma and cold care.
Asthma is a high-stress, chronic medical condition; 1 in 12 adults in the United States combat the bronchoconstriction from asthma. However, there are very few strong studies indicating any alternative therapy for asthmatics, particularly following a cold incidence. Vitamin C has been proven to be effective for other high-stress populations, but the asthmatic population has not yet been trialed. This study examined the effectiveness of vitamin C supplementation during the cold season on cold incidence and asthmatic symptoms. Asthmatics, otherwise-healthy, who were non-smokers and non-athletes between the ages of 18 and 55 with low plasma vitamin C concentrations were separated by anthropometrics and vitamin C status into two groups: either vitamin C (500 mg vitamin C capsule consumed twice per day) or control (placebo capsule consumed twice per day). Subjects were instructed to complete the Wisconsin Upper Respiratory Symptom Survey-21 and a short asthma symptoms questionnaire daily along with a shortened vitamin C Food Frequency Questionnaire and physical activity questionnaire weekly for eight weeks. Blood samples were drawn at Week 0 (baseline), Week 4, and Week 8. Compliance was monitored through a calendar check sheet. The vitamin C levels of both groups increased from Week 0 to Week 4, but decreased in the vitamin C group at Week 8. The vitamin C group had a 19% decrease in plasma histamine while the control group had a 53% increase in plasma histamine at the end of the trial, but this was not statistically significant (p>0.05). Total symptoms recorded from WURSS-21 were 129.3±120.7 for the vitamin C and 271.0±293.9, but the difference was not statistically significant (p=0.724). Total asthma symptoms also slightly varied between the groups, but again was not statistically significant (p=0.154). These results were hindered by the low number of subjects recruited. Continued research in this study approach is necessary to definitively reject or accept the potential role of vitamin C in asthma and cold care.
ContributorsEarhart, Kathryn Michelle (Author) / Johnston, Carol (Thesis advisor) / Sweazea, Karen (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2015
Description
The common cold is a significant cause of morbidity world-wide, with human rhinovirus infections accounting for a majority colds suffered each year. While the symptoms of the common cold are generally mild and self-limiting, vulnerable populations such as individuals with asthma can experience severe secondary complications including acute asthma exacerbation which can result in severe morbidity. Most human rhinovirus types utilize Intercellular Adhesion Molecule-1 (ICAM-1) as a receptor to enter cells and initiate infection. Expression of this cell-surface protein is elevated in the respiratory tract of asthma patients. The theoretical basis for this research is the observation that plasma measures of the soluble form of Intercellular Adhesion Molecule-1 (sICAM-1) decrease in response to vitamin C supplementation. As rhinovirus infection occurs in the upper respiratory tract, the primary aim of this study was to evaluate change in sICAM-1 concentration in nasal lavage of asthmatic individuals in response to vitamin C supplementation. Otherwise healthy asthmatic adults between the ages of 18-65 years who were not currently using steroidal nasal sprays, smoking, or actively training for competitive sports were recruited from a university community and surrounding area to participate in an 18-day double-blind randomized placebo-controlled supplement study with a parallel arm design. 13 subjects were stratified based on age, gender, BMI and baseline plasma vitamin C level to receive either 500 mg vitamin C twice daily (VTC, n=7) or placebo (PLC, n=6). Biochemical measures included nasal lavage sICAM-1, plasma sICAM-1, plasma histamine, and plasma vitamin C. Survey measures included Wisconsin Upper Respiratory Symptom Survey-21 to assess colds, Daytime Symptom Diary Scale to assess asthma symptoms, and measures of diet quality including a vitamin C food frequency questionnaire and Rapid Eating Assessment for Participants. No between group comparison of means reached significance (Mann-Whitney U test, p>0.05). Nasal lavage sICAM-1 levels were decreased in VTC group by 37% at study day 4, although this finding did not reach significance. Findings in this study can be used to develop future investigations into the response of nasal lavage sICAM-1 to vitamin C supplementation.
ContributorsGnant, Lindsay (Author) / Johnston, Carol (Thesis advisor) / Sweazea, Karen (Committee member) / Chang, Yung (Committee member) / Arizona State University (Publisher)
Created2014
Description
Windows based mobile application for m-health and environmental monitoring sensor devices were developed and tested. With the number of smartphone users exponentially increasing, the applications developed for m-health and environmental monitoring devices are easy to reach the general public, if the applications are simple, user-friendly and personalized. The sensing device uses Bluetooth to communicate with the smartphone, providing mobility to the user. Since the device is small and hand-held, the user can put his smartphone in his pocket, connected to the device in his hand and can move anywhere with it. The data processing performed in the applications is verified against standard off the shelf software, the results of the tests are discussed in this document. The user-interface is very simple and doesn't require many inputs from the user other than during the initial setting when they have to enter their personal information for the records. The m-health application can be used by doctors as well as by patients. The response of the application is very quick and hence the patients need not wait for a long time to see the results. The environmental monitoring device has a real-time plot displayed on the screen of the smartphone showing concentrations of total volatile organic compounds and airborne particle count in the environment at the location of the device. The programming was done with Microsoft Visual Studio and was written on VB.NET platform. On the applications, the smartphone receives data as raw binary bytes from the device via Bluetooth and this data is processed to obtain the final result. The final result is the concentration of Nitric Oxide in ppb in the Asthma Analyzer device. In the environmental monitoring device, the final result is the concentration of total Volatile Organic Compounds and the count of airborne Particles.
ContributorsGanesan, Srisivapriya (Author) / Tao, Nongjian (Thesis advisor) / Zhang, Yanchao (Committee member) / Tsow, Tsing (Committee member) / Arizona State University (Publisher)
Created2012
Description
In the United States, more than 22 million people are estimated to be affected by the chronic illness, asthma (American Lung Association [ALA], 2014). Of those 22 million, approximately 7.1 million are children (ALA, 2014). An important factor in trying to curb the frequency of asthma attacks is education. Particular elements of asthma education include symptom recognition, self-management skills, correct administration, and understanding how medications are used to control asthma. A review of the literature shows that multimedia education holds some promise in increasing asthma-knowledge retention. This creative project involved the creation of an asthma-education video with a concomitant asthma-education comic book. Of the two creations, the asthma-education video was used in a former Doctorate of Nursing Practice (DNP) student’s study to supplement a session at a clinic with an asthma educator. The tools included in the study, the Asthma Medication Use Questionnaire (Moya, 2014) and the Asthma Control TestTM (ACTTM; QualityMetric Incorporated, 2002), were completed by the participants prior to and after the implementation of the session that incorporated the video. The results suggested that the video had an effect on asthma control as measured by the ACTTM (QualityMetric Incorporated, 2002), but not on daily preventative asthma inhaler usage as measured by the Asthma Medication Use Questionnaire (Moya, 2014). The comic book has not been evaluated yet. Both multimedia education tools—the comic book and the video—were created as a requirement for the Barrett thesis.
ContributorsVanhkham, Sophia (Co-author) / Wells, Amanda (Co-author) / Stevens, Carol (Thesis director) / Vana, Kimberly (Committee member) / Barrett, The Honors College (Contributor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Department of English (Contributor) / School of Art (Contributor)
Created2015-05
Description
Objective: To explain the origins of the pediatric asthma cluster present in south and central phoenix, and propose potential solutions to combat this cluster. Methods: A comprehensive literature review of the different factors that contribute to asthma starting at a national level and working down to the Maricopa county level was conducted. Afterwards a literature review of past pediatric asthma intervention case studies was conducted. The results of both literature reviews were synthesized in regards to applicability in south and central phoenix. Results: A combined targeted intervention in health care delivery, patient/clinician education, and housing status/infrastructure could yield promising results in regards to combatting the pediatric asthma cluster in south and central phoenix.
ContributorsOmole, Toluwa Daniel (Author) / Reddy, Swapna (Thesis director) / White, Adrienne (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
There is a higher incidence of asthma, worse outcomes, and a higher burden of disease in Black Americans compared to white Americans. This thesis aims to understand asthma disparities in the Black population by analyzing a variety of social determinants of health and genetic factors that may contribute to these racial health disparities. Based on the evidence collected, a variety of interventions are discussed that explore potential solutions to address the critical issue.
ContributorsHaldorsen, Kamilla (Author) / Lynch, John (Thesis director) / Hendrickson, Kirstin (Committee member) / Department of Psychology (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description
Objectives: Asthma education is essential for every pediatric asthma management plan. This Doctor of Nursing Practice (DNP) Quality Improvement (QI) project, guided by the Social Cognitive Theory, aims to explore effective and innovative interventions for asthma management and determine if telehealth is an effective way to deliver asthma education to parents.
Methods: Parents (n = 5) of children with asthma at an urban pediatric primary care clinic were recruited to attend four weekly, 60-minute asthma education sessions over Zoom®. Participants were recruited with flyers and clinic referrals. Participants answered pre- and post-intervention online questionnaires following informed consent, including the Parental Asthma Management Self-Efficacy Scale (PAMSES), the Asthma Control Test (ACT), and a parent program evaluation. Paired sample t-tests were conducted to analyze data and measure mean differences in pre-and post-parent self-efficacy and asthma control in their child.
Results: The results include a statistically significant change in pre-intervention and post-intervention mean PAMSES scores. There was no significant difference between pre-intervention and post-intervention ACT scores; however, there was an increase in mean ACT scores from baseline.
Conclusions: Telehealth is a practical and cost-effective way to address gaps in asthma education and improve patient outcomes. The use of telehealth may be an effective way to address gaps in parent/patient education regarding the prevention of and management of asthma symptoms. Ongoing assessment is needed to evaluate if asthma telehealth education can be effective in other settings, languages, and age groups.
ContributorsFlores, M. Cynthia (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Eosinophil peroxidase (EPX) is a marker of eosinophilic inflammation in allergic diseases. Currently, measuring EPX in nasal swabs as a surrogate for airway eosinophil levels is completed using a gold standard enzyme-linked immunosorbent assay (ELISA) lab test. The purpose of this project was to develop and validate a novel lateral flow assay (LFA) that measures EPX with the same sensitivity and range of detection as the gold standard EPX ELISA, but that can be efficiently used in clinical settings. The results of this project show that the EPX LFA is a promising method for measuring EPX in nasal swab samples. While future studies are needed for further validation, the EPX LFA could provide rapid point-of-care EPX measurements for clinicians and patients suffering with eosinophil-associated diseases.
ContributorsGibson, Jessica (Author) / Lisenbee, Cayle (Thesis director) / Jacobsen, Elizabeth (Committee member) / Barrett, The Honors College (Contributor) / School of Molecular Sciences (Contributor) / College of Health Solutions (Contributor)
Created2022-05
Description
Purpose: To educate clinic staff on interventions and education materials which are suitable for implementation in a pediatric primary care setting, and to improve delivery and documentation of appropriate asthma interventions and inhaler/spacer education.
Background: Asthma is a chronic illness that impacts 10.9% of the pediatric population in Arizona. Poor asthma understanding and management leads to high-utilization of emergency rooms and urgent care clinics, negatively impacting the healthcare economy. Poor asthma management also leads to decreased health outcomes and impacts on the child’s academic functioning, mental health, and overall quality of life. Current evidence supports use of written asthma action plans (WAAP) and inhaler/spacer instruction to improve asthma management.
Methods: The intervention was an evidence-based educational session provided to the staff of a military, pediatric primary care clinic in southwest Arizona regarding the use of WAAP, the Asthma Control Test (ACT) and integrated inhaler/spacer instruction. Chart reviews were conducted to evaluate the documentation of use of WAAP, ACT, and inhaler/spacer education.
Results: Charts were collected from pre-intervention (n = 33) and post-intervention (n = 18). Data analysis demonstrated a statistically significant higher use of WAAP (U = 0.008, p < 0.05, d = 0.83). Although there was not a statistically significant change in use of ACT tool, Cohen’s value (d = 0.48) suggested a moderate positive effect. A Pearson correlation coefficient was also calculated for the relationship between use of ACT tool and use of WAAP, demonstrating a moderate positive correlation (r (49) = .372, p < .01).
Conclusions: An evidence-based education session for pediatric staff members is a cost-effective and simple method of improving pediatric asthma management practices.
Background: Asthma is a chronic illness that impacts 10.9% of the pediatric population in Arizona. Poor asthma understanding and management leads to high-utilization of emergency rooms and urgent care clinics, negatively impacting the healthcare economy. Poor asthma management also leads to decreased health outcomes and impacts on the child’s academic functioning, mental health, and overall quality of life. Current evidence supports use of written asthma action plans (WAAP) and inhaler/spacer instruction to improve asthma management.
Methods: The intervention was an evidence-based educational session provided to the staff of a military, pediatric primary care clinic in southwest Arizona regarding the use of WAAP, the Asthma Control Test (ACT) and integrated inhaler/spacer instruction. Chart reviews were conducted to evaluate the documentation of use of WAAP, ACT, and inhaler/spacer education.
Results: Charts were collected from pre-intervention (n = 33) and post-intervention (n = 18). Data analysis demonstrated a statistically significant higher use of WAAP (U = 0.008, p < 0.05, d = 0.83). Although there was not a statistically significant change in use of ACT tool, Cohen’s value (d = 0.48) suggested a moderate positive effect. A Pearson correlation coefficient was also calculated for the relationship between use of ACT tool and use of WAAP, demonstrating a moderate positive correlation (r (49) = .372, p < .01).
Conclusions: An evidence-based education session for pediatric staff members is a cost-effective and simple method of improving pediatric asthma management practices.
ContributorsBrown, Jennifer (Author) / Bay, Sarah (Thesis advisor)
Created2019-05-02
Description
Purpose and Aims: An Asthma Project team was assembled and created an Asthma Clinical Practice guideline with the most current literature. The purpose of the Doctor of Nursing Practice (DNP) project is to introduce the Asthma Clinical Practice guidelines and discuss how to maintain a reliable system to sustain positive change created by implementing the project.
ContributorsFoote, Brianna (Author)
Created2016-05-06