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Title: An investigation of the factors which influence children with asthma having an unscheduled medical contact around the start of the new school year
Author: Simpson, Rebecca M.
ISNI:       0000 0004 7428 2127
Awarding Body: University of Sheffield
Current Institution: University of Sheffield
Date of Award: 2018
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It has been proposed that the reported increase in the number of unscheduled medical contacts in September among school-aged children with asthma is caused by a viral challenge at the start of the school year. It has also been hypothesised that this challenge is compounded by children not taking their asthma medication over the summer holiday. The aim of this research was to identify which factors influence children with asthma having an unscheduled medical contact following the return to school in September. A mixed methods approach was used to investigate this aim using quantitative data from the PLEASANT (Preventing and Lessening Exacerbations of Asthma in School-age children Associated with a New Term) cluster-randomised intervention study combined with a qualitative study. The PLEASANT data analysis informed the development of a two stage qualitative study, before and after the school summer holidays. The qualitative results then informed further in depth analyses of the PLEASANT data to validate the qualitative results. Two large datasets were used for the analyses. Quantitative data included daily contacts for two years for approximately 12,000 school-aged children with asthma. Qualitative data came from semi-structured interviews conducted by the researcher from 38 school-aged children. The interviews were analysed thematically. Various methods were used to analyse the PLEASANT data such as mixed effects models and interrupted time series. From the results of the analyses, it is thought that exercise could play a key role in the September increase as some children with asthma may not exercise over the summer break. This sub-population of children could be at a higher risk. It was also found that females, primary school children and those who are in the transition from primary to secondary school year are potentially at higher risk of unscheduled medical contacts. The findings led to the suggestion that the children who do little exercise during the summer may benefit from an exercise based intervention over the summer holidays. Further work would be required to determine what intervention would be beneficial for females. The findings also suggested that primary school children, males and those who transitioned from primary to secondary school could benefit from continuing to receive the original PLEASANT intervention.
Supervisor: Julious, Steven A. ; Baird, Wendy O. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available