**1. Introduction**

Synchrotron X-ray lithography (XRL) uses a hard X-ray source to fabricate nano/microstructures of various shapes [1,2]. Synchrotron XRL has been used to create high aspect ratio structures with good sidewall roughness; synchrotron X-rays are highly collimated, pass through thick polymers and other plastic materials, and exhibit high flux and intensity, the pattern accuracy of XRL is very high. Synchrotron XRL was first developed to fabricate uranium-separation nozzles, and several other applications have been found since. For example, synchrotron XRL has been used to fabricate high-density magnetic dot arrays [3], a vertical stepper [4], and micromechanical components [5].

Ultraviolet (UV) light is employed in conventional photolithography. The photomask pattern is copied to photoresist (PR) with various ratios, and a two-dimensional (2D) microstructure is formed on a flat substrate. Various techniques are used to create three-dimensional (3D) features on 2D substrates. Micro stereo lithography [6], 3D printing [7], oblique lithography [8], PR reflow [9], backside exposure lithography [10], grayscale lithography [11], nanoimprint lithography [12,13], nanosphere lithography [14], colloidal lithography [15], block copolymer lithography [16], and e-beam lithography [17] all allow extensive shaping. However, it is complicated to fabricate the desired structures using these techniques.

In 2011, Jongho et al. prepared copper microstructures on curved substrates via optical soft lithography and metal electroplating [18]. The microstructures had high aspect ratios, throughput was good, cost was low, and reproducibility was high.

Microcontact printing using cylindrical polydimethylsiloxane (PDMS) stamps has since been reported [19]. However, it was not possible to create various angles on a single substrate by flattening the curved substrates bearing the microstructures.

Here, we develop a method by which to fabricate tilted microstructures of various angles and shapes on a single substrate using synchrotron XRL. Synchrotron X-rays are highly collimated; they pass through polymers (because of their short wavelength). Such a unique feature of hard X-rays allows the fabrication of microstructures on curved substrates. The fabrication technique on curved substrates could be applied to the fabrication of precision optical elements [20] and the micromachining of ultraprecise molds on curved or cylindrical structures.


**3. Results**

#### **3.1 Selection of the studies**

After removing duplicates, 81 articles were screened. Forty-two articles were removed since they were published before 2010. After the analysis of the full-text articles, 17 articles were excluded since they did not meet the inclusion criteria. Finally, 22 articles were included in this literature review.

#### **3.2 Characteristics of the included studies**

**Table 1** shows that 9 studies were randomized controlled trials (RCT). The sample sizes of the reviewed studies ranged from 14 to 167 children with asthma, with a total of 1087 participants. The major target group of the educational interventions was asthmatic school-aged children and their families [13, 15–25]. Some studies included teachers [13], and asthma physicians [20]. Most of the educational sessions were conducted in groups. The duration of sessions varied between 30 and 120 minutes. The assessment time ranged from 2 weeks to 12 months.

The topics discussed in almost 90% of the educational sessions were asthma pathophysiology, triggers identification, symptoms recognition, effective response during exacerbations, asthma action plan, types of asthma medications and their correct use, and communication with care providers [16–25].

Five interventions were conducted by the research team of the trial [16–18, 22, 25]. Other interventions were carried out by a multidisciplinary team [24], and certified educators of asthma [15, 20].

**Table 2** shows the outcomes assessed in each study and their assessment tools. The Pediatric Asthma Quality of Life Questionnaire and the Pediatric Asthma Caregiver Quality of Life Questionnaire were used to assess the QOL of children and their parents in all studies respectively. Different tools were used for symptoms control assessment. The Asthma Control Test (ACT) was commonly used.

#### **3.3 Impact of educational interventions on asthma-related health outcomes**

#### *3.3.1 Quality of life*

As shown in **Table 2**, five studies assessed the QOL of children with asthma, and three studies assessed the QOL of parents. One RCT [25] and two quasiexperimental studies [16, 17] referred to family empowerment in school-age children with asthma and their parents. Improved QOL scores were observed after implementing family empowerment interventions in Tunisia, Egypt, and Iran. Furthermore, the "Healthy Breathing Program" implemented by Grover and colleagues in children with asthma aged 7–12 years and their parents in India led to a significant improvement in the QOL scores of parents at six-month follow-up in the intervention group (p < .001) [18]. Similarly, the self-care education program contributed to improved QOL scores of children in Iran [23]. Montalbano et al. conducted a therapeutic asthma education that combines a multidisciplinary education with a smartphone application in school-age children with asthma and their parents in Italy. The program contributed to higher scores of QOL in the intervention and the control group at the three-month follow-up (Intervention group, p = .014; Control group, p = .046) [24].

### *Effect of Family Education on Clinical Outcomes in Children with Asthma: A Review DOI: http://dx.doi.org/10.5772/intechopen.105205*

*New Perspectives on Asthma*

*Effect of Family Education on Clinical Outcomes in Children with Asthma: A Review DOI: http://dx.doi.org/10.5772/intechopen.105205*

*New Perspectives on Asthma*

*Effect of Family Education on Clinical Outcomes in Children with Asthma: A Review DOI: http://dx.doi.org/10.5772/intechopen.105205*

**Table 1.**

 *Description of the characteristics of family asthma educational interventions.*

#### *New Perspectives on Asthma*


**4. Diaphragmatic or hiatal hernia**

The diaphragm consists of striated muscle and has a collagenous central tendon, which is cranially blended with the pericardium. The esophageal hiatus is a 2-3 cm long muscular tunnel with a diameter of 3.5 cm, located 2-3 cm to the left at the peripheral muscular part of the diaphragm. The right crus and dorsal median arcuate ligament encircle the esophagus. Through the esophageal hiatus, besides the esophagus, pass the vagus trunks, sensory phrenico-abdominal branch of left phrenic nerve to the pancreas and peritoneum, esophageal vessels and retro-esophageal fat.

The natural anti-reflux mechanism is complex with several synergistic elements. A crucial element in preventing reflux is the circular muscular lower esophageal sphincter (LES) of 3.5 cm, extending from the distal esophagus down to the angle of His. The LES is autonomically controlled by vagal stimulation through intramural plexuses and enterohormones. Normally at least 1 cm of the LES is held intra-abdominally by the circular bilaminar phrenico-esophageal ligament. The ventral descending leaf connects the adventitia and muscular coat of the distal esophagus to the hiatus and is continuous with the lesser omentum at the right side of the esophagus. The supradiaphragmatic ascending leaf is

hernia can be difficult to visualize due to lack of peritoneal involvement through the hernia defect. Frequently epigastric hernias present incarcerated and in general only contain omentum or preperitoneal fat. Because of the small defect the hernia defect mostly need to

A Spigelian hernia is relatively rare, but more often diagnosed since the introduction of CTscan and laparoscopy. The Spigelian hernia occurs along the semilunar line at the level of the absence of the posterior rectus sheath (semicircular line, below the umbilicus). Almost all Spigelian hernias are interparietal due to the intact external oblique aponeurosis covering the hernia. A large Spigelian hernia is most often found laterally and inferior to its defect in

The Spigelian hernia has different factors of etiology (Lange & Kleinrensink, Surgical

Muscular gap between linea semilunaris and medial boundaries of oblique and

Maximal width of aponeurosis of transversus abdominis muscle at crossing of

Parallelism of fibers of internal oblique and transversus abdominis muscles between

Blending of aponeuroses of internal oblique and transversus abdominis muscle into one

Clinical diagnosis of a Spigelian hernia is challenging, but imaging with ultrasonography or CT-scan will confirm the presence of the hernia. Up to 20% of Spigelian hernias present incarcerated and therefore elective repair is indicated when diagnosed. The technique of laparoscopic repair is similar to other ventral hernia repairs. Compared to open repair, laparoscopic repair of Spigelian hernias is associated with a decreased morbidity, shorter

The diaphragm consists of striated muscle and has a collagenous central tendon, which is cranially blended with the pericardium. The esophageal hiatus is a 2-3 cm long muscular tunnel with a diameter of 3.5 cm, located 2-3 cm to the left at the peripheral muscular part of the diaphragm. The right crus and dorsal median arcuate ligament encircle the esophagus. Through the esophageal hiatus, besides the esophagus, pass the vagus trunks, sensory phrenico-abdominal branch of left phrenic nerve to the pancreas and peritoneum,

The natural anti-reflux mechanism is complex with several synergistic elements. A crucial element in preventing reflux is the circular muscular lower esophageal sphincter (LES) of 3.5 cm, extending from the distal esophagus down to the angle of His. The LES is autonomically controlled by vagal stimulation through intramural plexuses and enterohormones. Normally at least 1 cm of the LES is held intra-abdominally by the circular bilaminar phrenico-esophageal ligament. The ventral descending leaf connects the adventitia and muscular coat of the distal esophagus to the hiatus and is continuous with the lesser omentum at the right side of the esophagus. The supradiaphragmatic ascending leaf is

be enlarged to reduce the hernial sac and its content.

the space directly posterior to the external oblique muscle.

Anatomy of the Abdomen, Elsevier gezondheidszorg, 2002):

semicircular and semilunar lines.

**4. Diaphragmatic or hiatal hernia**

esophageal vessels and retro-esophageal fat.

arcuate line and Hesselbach's triangle.

separate structure, caudally to arcuate line.

transversus abdominis muscles, caudally to umbilicus,

hospital stay and low recurrence rate (Moreno-Egea et al., 2002).

**3.6 Spigelian hernia**

elastic and permits movement during swallowing and breathing. The extrinsic component of the anti-reflux mechanism is the pinching action of the right crus of the diaphragm. The right crus narrows the hiatus and increases the angle between the ventrally bended distal esophagus and the cardia. The LES and crus normally supplement each other in preventing acid reflux during swallowing or acute increased intra-abdominal pressure (Lange & Kleinrensink, Surgical Anatomy of the Abdomen, Elsevier gezondheidszorg, 2002).

A diaphragmatic or hiatal hernia occurs after enlargement of the hiatus and is a common disorder of the digestive tract. Cranial movement of the esophagus with protrusion of abdominal content (stomach in general) into the thoracic cavity can occur through the widened hiatus. This natural antireflux function is often disrupted by the presence of a hiatal hernia and is strongly associated with gastro-esophageal reflux disease (GERD). Hiatal hernias larger than 3 cm are a risk factor for erosive GERD and Barrett's esophagus.


2.4.1. The Piecewise Linear State-Space Switched Model Close to the Maximum Power Point

The periodic equation to be considered for our purposes will be expressed in the state-space representation (or matrix representation). This form lends itself well to the calculation of the solution of a differential equation system. The dynamics will be expressed as a function of a vector of variables, which we will call the state vector. Assuming that our subsystem is linear and time-invariant, the evolution of each subsystem is defined by:

$$\begin{aligned} \dot{\mathfrak{x}} &= A\_1 \mathfrak{x} + B\_1 W \text{ if } \mathfrak{u} = 1, \\ \dot{\mathfrak{x}} &= A\_0 \mathfrak{x} + B\_0 W \text{ if } \mathfrak{u} = 0. \end{aligned} \tag{12}$$

where *x* = (*x*1*x*2*x*3*x*4) *T*, *A*1, *B*1, *A*0, *B*0 are the state and input matrices corresponding to the different switch states and the external input parameters vector are given by:

$$A\_1 = \begin{pmatrix} -\frac{1}{\mathcal{R}\_{pN}\mathcal{C}\_1} & -\frac{1}{\mathcal{C}\_1} & 0 & 0\\ \frac{1}{L} & -\frac{1}{L}r & 0 & 0\\ 0 & 0 & -\frac{1}{\mathcal{R}\mathcal{C}\_2} & 0\\ 0 & w\_ck\_p & 0 & -w\_c \end{pmatrix} \tag{13}$$

$$A\_0 = \begin{pmatrix} 1 & 0 & 0 \\ -\frac{1}{\mathcal{R}\_{pN}\mathbb{C}\_1} & -\frac{1}{\mathcal{C}\_1} & 0 & 0 \\ \frac{1}{L} & -\frac{1}{L}r & -\frac{1}{L} & 0 \\ 0 & \frac{1}{\mathcal{C}\_2} & -\frac{1}{\mathcal{R}\mathcal{C}\_2} & 0 \\ 0 & w\_c k\_p & 0 & -w\_c \end{pmatrix} \tag{14}$$

$$B\_1 = \begin{pmatrix} \frac{2}{C\_1} & 0\\ 0 & 0\\ 0 & \frac{1}{\overline{\mathcal{R}C\_2}}\\ 0 & 0 \end{pmatrix} \tag{15}$$

$$B\_0 = \begin{pmatrix} \frac{2}{\overline{\mathbb{C}\_1}} & 0 \\ 0 & 0 \\ 0 & \frac{1}{\overline{\mathbb{R} \mathbb{C}\_2}} \\ 0 & 0 \end{pmatrix}' \tag{16}$$

$$\mathcal{W} = \begin{pmatrix} i\_{mpp} \\ E \end{pmatrix}. \tag{17}$$

The switching condition in Figure 2 is given by:

$$h(\mathbf{x}, t) = R\_s \left( i\_{ref} - \mathbf{K} \mathbf{x} \right) - \frac{V\_M}{T} t\_\prime \tag{18}$$

with *VM T t* = *Vramp*, the vector K is given by:

$$K = \begin{pmatrix} 0 \\ 0 \\ 0 \\ -1 \end{pmatrix}^T. \tag{19}$$


salutogenesis model 23 sanctions 16 school 25 school social work 71 scrounger 45 self-control 16 self-efficacy 11, 31, 54, 55, 70, 88, 90, 93 self-responsibility 16, 38 shirkers 45 social coping 24 social inequality 14, 21, 23, 24, 25, 95 social investment 15, 33, 36, 42, 46 social investment approach 14, 34, 75 social investment state 14, 86 social pedagogy 16, 38, 54, 88, 91, 96 social policy 14, 18, 34, 40 social work 15, 16, 31, 38, 52, 88, 91, 96 sociological theory of inequality 21 spectrum of resources 18, 26, 31, 95, 98 SPÖ (Austrian Social Democratic Party) 19, 46, 57, 60, 61, 96 street-level bureaucracy 33, 44, 90 Supra-Company Training (SCT) 53, 61, 65, 66, 69, 72, 83, 92, 104, 106 theory of resource conservation 23 theory of social inequality 21, 22, 24 training guarantee 15, 45, 62, 63, 75

training obligation (Ausbildung bis 18) 15, 45, 46, 61, 62 Training up to 18 46, 53, 62, 64, 74, 85 transactional resource concept 30 transformation 13, 22 transition 11 triple mandate 31 types of capital (Bourdieu) 23, 24, 26 Tyrol 65 unemployment 12, 37, 44, 45, 48, 58, 62, 68, 71, 74, 83, 86, 99, 102, 104 unemployment assistance 15 unemployment benefits 15 unemployment rates 12 Vienna 14, 65, 91, 92 vocational education and training 11, 15 Vocational Youth Welfare (Jugendberufshilfe) 15, 18 Vorarlberg 65 welfare regimes 35 welfare state 13, 14, 40, 81 welfare state 'from below' 81 women-at-the-stove policy 41 work-first policy 15 Youth Coaching 50, 51, 52, 54, 61, 62, 83, 84, 89, 93, 97, 104, 106 Youth Confidence Councils (Jugendvertrauensräte) 75, 91 youth councils 91 youth parliaments 91

Elina Fonsén | Raisa Ahtiainen Marja Heikkinen | Lauri Heikonen Petra Strehmel | Emanuel Tamir (eds.)

# **Early Childhood Education Leadership in Times of Crisis**

International Studies During the COVID-19

*2023 • 264 pp. • Paperback • 39,90 € (D) • 41,10 € (A) ISBN 978-3-8474-2683-7 • also available as e-book in open access*

The COVID-19 pandemic has dramatically affected all aspects of professional and private life worldwide, including the field of early childhood education and care (ECE). This volume sheds light on leadership in ECE: How did leaders experience the challenges they were facing and what coping strategies did they apply in order to deal with the changes in everyday life and practices in ECE centres? Authors from twelve countries present empirical findings gaining information on different crisis management mechanisms in ECE systems around the world.

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