School-based supervised therapy programs to improve asthma outcomes: current perspectives

Guadalupe Salazar, Geeta Tarwala, Marina Reznik Division of Academic General Pediatrics, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA Background: Asthma is one of the most common chronic diseases of childhood affecting 6.2 million (8.4%) children (<18 years old) in the USA. Asthma is also a leading cause of school absenteeism. Daily administration of preventive asthma medications improves asthma control. However, poor medication adherence is one of the barriers in achieving improved asthma outcomes. School-based supervised asthma therapy programs have been implemented to address this barrier. Objectives: To conduct a review of the literature on school-based supervised asthma therapy interventions and the effect on outcomes in children with persistent asthma. Methods: We conducted a literature search using electronic search engines (ie, PubMed and Cochrane) and combinations of different search terms “school-based asthma,” “school-based asthma therapy,” and “school-based supervised asthma therapy.” Inclusion criteria were school-based interventions with supervised asthma medication administration conducted in the USA, measuring asthma outcomes. From 443 titles and abstracts, 9 studies met the inclusion criteria. Results: School-based interventions with supervised asthma medication administration revealed improvement in asthma outcomes, including improved medication adherence, increased symptom-free days, decreased daytime and nighttime symptoms, decreased use of rescue medication, decreased asthma-related health care utilization, fewer exacerbations requiring treatment with prednisone, decreased school absenteeism due to asthma, fewer days of activity limitation, improved quality of life, and improvement in both pulmonary inflammatory markers and peak flow readings. Conclusion: Our literature review demonstrated that school-based supervised asthma therapy improves asthma outcomes in urban children with persistent asthma. Schools are an ideal setting for implementation of asthma interventions for children and adolescents. Keywords: directly observed therapy, inhaled corticosteroids, medication adherence, interventions, children, school

Mechanism Design for Haptic Handwriting Assistance Device

One of the applications of haptic technology is in education and training. Handwriting for first year-elementary students has been included in the curriculum for some years in Turkey as the first and only writing skill to be taught. Providing these students with a haptic assistance device during the handwriting learning process is the global aim of this work. Among the other components of the design such as electronics, controls and communication, mechanism design is a critical component to be considered for optimization of the device at different levels. This paper aims to address a solution to meet the design criteria through ergonomic design for user along with optimized force exertion capabilities