Effects of Symptom Perception Interventions on Trigger Identification and Quality of Life in Children with Asthma

Background. Management of individual triggers is suboptimal in practice. In this project, we investigated the impact of symptom perception interventions on asthma trigger identification and self-reported asthma quality of life. Methods. Children with asthma ( = 227) participated in three asthma education sessions and then were randomized first to one of three home monitoring conditions (symptom monitoring and peak flow training with feedback, peak flow training without feedback, or no peak flow training) and then subsequently to one of three resistive load discrimination training conditions (signal detection training with feedback, signal detection training without feedback, or no training). Triggers were reported at enrollment, following home monitoring, and following discrimination training; quality of life was measured after home monitoring and after resistive load testing. Results. Symptom perception interventions resulted in increases in reported triggers, which increased reliably as a function of home monitoring, and increased further in participants who completed discrimination training with feedback. Increases in the number of reported asthma triggers were associated with decreases in quality of life. Discussion. Patients may benefit from strategies that make trigger-symptom contingencies clear. Complementary strategies are needed to address changes in the perceived burden of asthma which comes from awareness of new asthma triggers

The Capstone ePortfolio in an Undergraduate Public Health Program: Accreditation, Assessment, and Audience

The Bachelor of Science in Public Health (BSPH) degree program at the University of North Carolina at Charlotte (UNC Charlotte) was launched in 2007, and was initially accredited by the Council on Education for Public Health in 2009. We admit approximately 40–45 students each fall to the upper division major, through a competitive admissions process. During the junior and senior years, BSPH majors complete a core set of required courses including internship; 18 credit hours of restricted electives; and any minor offered by the university (except public health). During 2014–2015, the Department of Public Health Sciences was one of five campus units supported by UNC General Administration to pilot the use of ePortfolios as a tool to help students integrate learning across the courses that make up the major. The pilot program continued for 2 additional years, to promote enduring faculty efforts. We subsequently outline the development and implementation of ePortfolio pedagogy in the BSPH program at UNC Charlotte, including preliminary assessment of outcomes the past 3 years. The adoption of ePortfolios has been instrumental in students' educational experiences for over 2 decades. The Association of American Colleges and Universities (AAC&U) has advocated that “ePortfolios allow faculty and other educational professionals to help students organize their learning; preserve the variety of forms in which their learning occurs; and reflect upon their learning.” We have learned that effective student ePortfolios do not arise in a vacuum. In collaboration with like-minded campus colleagues including those associated with the university's Communication Across the Curriculum program, we have encountered contributing forces related to the process of “collection, selection, and reflection” including intentional assignments that yield effective student artifacts; and authentic feedback to students through adoption and modification of the AAC&U VALUE rubrics. We conclude that internal and external forces drive the development of ePortfolio content; students embrace opportunities to document learning when those opportunities are structured; the development of the ePortfolio is relational—consistent with student attributes; and ePortfolios enable evidence-based approaches to meet accreditation demands, assessment needs, and workforce expectations

Effects of Symptom Perception Interventions on Trigger Identification and Quality of Life in Children with Asthma

Background. Management of individual triggers is suboptimal in practice. In this project, we investigated the impact of symptom perception interventions on asthma trigger identification and self-reported asthma quality of life. Methods. Children with asthma ( = 227) participated in three asthma education sessions and then were randomized first to one of three home monitoring conditions (symptom monitoring and peak flow training with feedback, peak flow training without feedback, or no peak flow training) and then subsequently to one of three resistive load discrimination training conditions (signal detection training with feedback, signal detection training without feedback, or no training). Triggers were reported at enrollment, following home monitoring, and following discrimination training; quality of life was measured after home monitoring and after resistive load testing. Results. Symptom perception interventions resulted in increases in reported triggers, which increased reliably as a function of home monitoring, and increased further in participants who completed discrimination training with feedback. Increases in the number of reported asthma triggers were associated with decreases in quality of life. Discussion. Patients may benefit from strategies that make trigger-symptom contingencies clear. Complementary strategies are needed to address changes in the perceived burden of asthma which comes from awareness of new asthma triggers.status: publishe

Descriptors of breathlessness in children with persistent asthma

In adult patients, the consistent use of language to describe dyspnea enhances patient-provider communication and contributes to diagnostic and therapeutic decisions. The objective of this research was to determine whether pediatric patients similarly display consistency in the language used to describe "uncomfortable awareness of breathing." One hundred children between the ages of 8 and 15 years with moderate to severe persistent asthma enrolled in an asthma education research program completed questionnaires regarding descriptors of asthma on each of two occasions. In addition to the breathlessness questionnaires, demographic information, self-reported asthma severity, ED visits, missed school days, anthropometrics, and spirometry were obtained for each participant. Children were reliable in their choice of the descriptors that they applied to their breathing discomfort across two occasions, and they selected the same descriptors that were used by adults with asthma in previous studies. Children with greater self-reported asthma severity endorsed more descriptors to characterize breathing discomfort than did children with less severe asthma, but no differences were found among children based on demographic or anthropometric variables. Children with moderate to severe persistent asthma are reliable in their choice of descriptors of breathlessness. Knowledge of their experience of symptoms may be helpful clinically in the assessment and management of asthma