Evaluating outcomes of children's asthma self-management education through sustainable community-university partnerships.

OBJECTIVE: To evaluate the outcomes of a children's asthma management education program delivered through a community-university partnership. DESIGN: Quasi-experimental pretest/posttest. SAMPLE: Convenience sample of 50 children with asthma, grades 2-5, and their parent/caregiver from nine elementary schools in New York State. MEASUREMENTS: Child Asthma Management Self-Efficacy Survey, Child Asthma Control Test© , Parent Asthma Knowledge Test. INTERVENTION: Nursing students certified as Open Airways for Schools facilitators administered the program once weekly for 5 weeks. Parent handouts were sent home after each session. Pre/posttests for all measures were completed prior to Open Airways and at completion. RESULTS: Improved asthma management self-efficacy (p < .001) and improved asthma control (p = .013) for children with asthma were noted. Parent asthma knowledge was high pre- and posttest with no significant change. Parental knowledge regarding inhaled corticosteroids was consistently low. CONCLUSIONS: Collaboration between universities and local school systems allows for mutually beneficial exchange of knowledge and resources to address the need for asthma self-management for children with asthma. Nursing students trained in asthma management develop expertise and provide sustainable resources for this education.

Prediction of spontaneous preterm birth in asymptomatic twin pregnancies using the change in cervical length over time.

OBJECTIVE: We sought to evaluate the change in cervical length (CL) as a predictor of preterm birth in asymptomatic twin pregnancies. STUDY DESIGN: We studied a historical cohort of 121 twin pregnancies with CL testing between 18-24 weeks who had a follow-up CL 2-6 weeks after the initial CL. RESULTS: A total of 19 patients had their CL decrease by > or = 20% (shortened CL group) and 102 patients' CL decreased by less, or not at all (stable CL group). The shortened CL group had a significantly higher rate of spontaneous preterm birth <28 weeks, <30 weeks, <32 weeks, and <34 weeks. This remained true even when excluding patients with a short CL (< or = 25 mm) on the repeated CL. CONCLUSION: In twin pregnancies, a CL that decreases by 20% over 2 measurements is a significant predictor of very preterm birth, even in the setting of a normal CL. Serial CL measurements should be considered in twin pregnancies, starting <24 weeks.