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Rivera Rivera NY, Lamadrid-Figueroa H, Mercado Garcia A, Alcala CS, Schnaas L, Hernández-Chávez C, Téllez-Rojo MM, Wright RO, Wright RJ, Rosa MJ, Tamayo-Ortiz M. Associations between psychosocial stress, child's anxiety, and lung function in mid-childhood. Ann Allergy Asthma Immunol 2024:S1081-1206(24)00484-8. [PMID: 39117147 DOI: 10.1016/j.anai.2024.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 07/10/2024] [Accepted: 07/30/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND Reducing the risk of respiratory disease during the plastic stages of lung development could have long-term health impacts. Psychosocial stress has been previously linked to adverse childhood respiratory outcomes, but the influence of child's anxiety and sex differences has not been completely elucidated. OBJECTIVE To evaluate the association among maternal stress, child anxiety, and lung function in children and to explore differences by sex. METHODS Cross-sectional analyses included 294 mother-child pairs from the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) birth cohort in Mexico City. Children's lung function was tested once at ages 8 to 13 years of age, and height- and sex-adjusted z-scores were estimated for forced vital capacity, forced expiratory volume in 1 second, forced expiratory volume in 1 second/forced vital capacity and forced expiratory flow between 25% and 75%. Maternal stress was assessed through the Crisis in Family Systems-Revised (CRISYS-R) survey, used to report negative life events experienced in the past 6 months and dichotomized at the median (<3 and ≥3). Child's self-reported anxiety was assessed using the Revised Children's Manifest Anxiety Scale short form and dichotomized at the clinically relevant cutoff (T-score ≥ 60). The association among maternal stress, child anxiety, and lung function outcomes was evaluated using linear models. Effect modification by sex was evaluated with interaction terms and in stratified analyses. RESULTS We did not find any association between maternal stress and any lung function outcome. Clinically elevated child anxiety symptoms were associated with lower forced expiratory volume in 1 second (β = -0.36, 95% CI -0.69 to -0.02). We found no evidence of effect modification by sex. CONCLUSION Results highlight the importance of considering childhood mental health in relation to lung function outcomes.
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Affiliation(s)
- Nadya Y Rivera Rivera
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Hector Lamadrid-Figueroa
- Department of Perinatal Health, Center for Population Health Research, National Institute of Public Health (INSP), Cuernavaca, Mexico
| | - Adriana Mercado Garcia
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Cecilia Sara Alcala
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lourdes Schnaas
- Department of Developmental Neurobiology, National Institute of Perinatology, Mexico City, Mexico
| | - Carmen Hernández-Chávez
- Department of Developmental Neurobiology, National Institute of Perinatology, Mexico City, Mexico
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Robert O Wright
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Developmental Neurobiology, National Institute of Perinatology, Mexico City, Mexico; Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Rosalind J Wright
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, New York; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Maria José Rosa
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Marcela Tamayo-Ortiz
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
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Titus AR, Terlizzi K, Conderino S, Ðoàn LN, Kim B, Thorpe LE. Patterns and drivers of disparities in pediatric asthma outcomes among Medicaid-enrolled children living in subsidized housing in NYC. Prev Med 2024; 185:108023. [PMID: 38908569 DOI: 10.1016/j.ypmed.2024.108023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 05/13/2024] [Accepted: 05/29/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVE There are persistent disparities in pediatric asthma morbidity in the U.S. We linked claims data with information on neighborhood-level risk factors to explore drivers of asthma disparities among Medicaid-enrolled children in New York City subsidized housing. METHODS We constructed a cohort of Medicaid-enrolled children living in public or other subsidized housing, based on residential address, in NYC between 2016 and 2019 (n = 108,969). We examined claims-derived asthma prevalence across age and racial and ethnic groups, integrating census tract-level information and using the Bayesian Improved Surname Geocoding (BISG) algorithm to address high rates of missing data in self-reported race and ethnicity. We used inverse probability weighting (IPW) to explore the extent to which disparities persisted when exposure to asthma risk factors - related to the built environment, neighborhood poverty, and air quality - were balanced across groups. This analysis was conducted in 2022-2023. RESULTS Claims-derived asthma prevalence was highest among children <7 years at baseline and among non-Hispanic Black and Hispanic children. For example, among children aged 3-6 years at baseline, claims-derived prevalence was 17.3% and 18.1% among non-Hispanic Black and Hispanic children, respectively, compared to 9.3% and 9.0% among non-Hispanic White and non-Hispanic Asian American/Pacific Islander children. Using IPW to balance exposure to asthma risk factors across racial and ethnic groups attenuated, but did not eliminate, disparities in asthma prevalence. CONCLUSIONS We found high asthma burden among children living in subsidized housing. Modifiable place-based characteristics may be important contributors to pediatric asthma disparities.
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Affiliation(s)
- Andrea R Titus
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States of America.
| | - Kelly Terlizzi
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Sarah Conderino
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Lan N Ðoàn
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Byoungjun Kim
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Lorna E Thorpe
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States of America
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Frueh L, Sharma R, Sheffield PE, Clougherty JE. Community violence and asthma: A review. Ann Allergy Asthma Immunol 2024:S1081-1206(24)00453-8. [PMID: 39038705 DOI: 10.1016/j.anai.2024.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/28/2024] [Accepted: 07/11/2024] [Indexed: 07/24/2024]
Abstract
Over the past 2 decades, epidemiologic studies have identified significant associations between exposure to violence, as a psychosocial stressor, and the incidence or exacerbation of asthma. Across diverse populations, study designs, and measures of community violence, researchers have consistently identified adverse associations. In this review, the published epidemiologic evidence is summarized with special attention to research published in the last 5 years and seminal papers. Hypothesized mechanisms for the direct effects of violence exposure and for how such exposure affects susceptibility to physical agents (eg, air pollution and extreme temperature) are discussed. These include stress-related pathways, behavioral mechanisms, and epigenetic mechanisms. Finally, clinical implications and recommendations are discussed.
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Affiliation(s)
- Lisa Frueh
- Department of Environmental and Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania.
| | - Rachit Sharma
- Department of Environmental and Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Perry E Sheffield
- Departments of Environmental Medicine and Climate Science and Public Health and Pediatrics, Mount Sinai Icahn School of Medicine, New York, New York
| | - Jane E Clougherty
- Department of Environmental and Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
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Martinez A, Ye M, Hessler D, de la Rosa R, Benson M, Gilgoff R, Koita K, Bucci M, Harris NB, Long D, Thakur N. Adverse Childhood Experiences and Related Events are Associated with Asthma Symptoms in Children. Acad Pediatr 2024; 24:669-676. [PMID: 38246348 DOI: 10.1016/j.acap.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/02/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024]
Abstract
OBJECTIVE To examine the association between adverse childhood experiences (ACEs) and related events and asthma symptom burden in children. METHODS This is a cross-sectional study of baseline data from 147 participants with asthma from a cohort of children enrolled in the Pediatric ACEs Screening and Resiliency Study. Participants completed the PEdiatric ACEs and Related Life Events Screener (PEARLS) tool, a 17-item questionnaire, capturing 3 domains of childhood adversity-child maltreatment, household challenges, and social context. Asthma symptom burden was assessed using the International Study of Asthma and Allergies in Childhood core questionnaire, which asks participants to identify the presence and frequency of severe wheezing that limits speech, wheezing with exercise, nocturnal wheezing, and nocturnal cough in the last 12 months. Using multivariable logistical regression models, we examined the relationship between reported PEARLS and asthma symptoms. RESULTS Of children with asthma, 86% reported at least 1 adversity, with 48% reporting 4 or more. The odds of severe wheeze limiting speech increased by 19% with each additional reported adversity captured by the PEARLS tool (95% confidence intervals (CI) 1.01-1.41). Increasing PEARLS scores were also associated with 16% increased odds of reporting wheeze with exercise (95% CI 1.03-1.31). Wheezing with exercise was associated with the household challenges domain (odds ratio (OR) 1.34; 95% CI 1.05-1.72), while severe wheeze limiting speech was associated with the social context domain (OR 1.75; 95%CI 1.02-3.02). CONCLUSIONS Childhood adversities are associated with increased asthma symptom burden, suggesting the tool may be helpful in identifying children at risk for poorly controlled asthma.
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Affiliation(s)
- Adali Martinez
- University of California San Francisco, School of Medicine (A Martinez, Y Ye, D Hessler, R de la Rosa, and N Thakur)
| | - Morgan Ye
- University of California San Francisco, School of Medicine (A Martinez, Y Ye, D Hessler, R de la Rosa, and N Thakur)
| | - Danielle Hessler
- University of California San Francisco, School of Medicine (A Martinez, Y Ye, D Hessler, R de la Rosa, and N Thakur)
| | - Rosemarie de la Rosa
- University of California San Francisco, School of Medicine (A Martinez, Y Ye, D Hessler, R de la Rosa, and N Thakur)
| | - Mindy Benson
- UCSF Benioff Children's Hospital Oakland (M Benson and D Long), Oakland, Calif
| | - Rachel Gilgoff
- Center for Youth Wellness (R Gilgoff, K Koita, M Bucci, and NB Harris), San Francisco, Calif
| | - Kadiatou Koita
- Center for Youth Wellness (R Gilgoff, K Koita, M Bucci, and NB Harris), San Francisco, Calif
| | - Monica Bucci
- Center for Youth Wellness (R Gilgoff, K Koita, M Bucci, and NB Harris), San Francisco, Calif
| | - Nadine Burke Harris
- Center for Youth Wellness (R Gilgoff, K Koita, M Bucci, and NB Harris), San Francisco, Calif
| | - Dayna Long
- UCSF Benioff Children's Hospital Oakland (M Benson and D Long), Oakland, Calif
| | - Neeta Thakur
- University of California San Francisco, School of Medicine (A Martinez, Y Ye, D Hessler, R de la Rosa, and N Thakur).
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Demirel S, Roke Y, Hoogendoorn AW, Hoefakker J, Hoeberichts K, van Harten PN. Assessing the Effectiveness of STAPP@Work, a Self-Management Mobile App, in Reducing Work Stress and Preventing Burnout: Single-Case Experimental Design Study. J Med Internet Res 2024; 26:e48883. [PMID: 38275128 PMCID: PMC10940977 DOI: 10.2196/48883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 12/06/2023] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Work-related stress and burnout remain common problems among employees, leading to impaired health and higher absenteeism. The use of mobile health apps to promote well-being has grown substantially; however, the impact of such apps on reducing stress and preventing burnout is limited. OBJECTIVE This study aims to assess the effectiveness of STAPP@Work, a mobile-based stress management intervention, on perceived stress, coping self-efficacy, and the level of burnout among mental health employees. METHODS The study used a single-case experimental design to examine the use of STAPP@Work among mental health employees without a known diagnosis of burnout (N=63). Participants used the app for 1 week per month repeatedly for a period of 6 months. Using a reversal design, the participants used the app 6 times to assess replicated immediate (1 week after use) and lasting (3 weeks after use) effects. The Perceived Stress Scale, the Coping Self-Efficacy Scale, and the Burnout Assessment Tool were used to measure the outcomes. Linear mixed models were used to analyze the data. RESULTS After 6 months of app use for 1 week per month, the participants showed a statistically significant decrease in perceived stress (b=-0.38, 95% CI -0.67 to -0.09; P=.01; Cohen d=0.50) and burnout symptoms (b=-0.31, 95% CI -0.51 to -0.12; P=.002; Cohen d=0.63) as well as a statistically significant improvement in problem-focused coping self-efficacy (b=0.42, 95% CI 0-0.85; P=.049; Cohen d=0.42). Long-term use of the app provided consistent reductions in burnout symptoms over time, including in the level of exhaustion and emotional impairment. CONCLUSIONS The use of an app-based stress management intervention has been shown to reduce burnout symptoms and enhance coping self-efficacy among mental health workers. Prevention of burnout and minimization of work-related stress are of utmost importance to protect employee health and reduce absenteeism.
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Affiliation(s)
- Sevda Demirel
- Expertise Center for Autism Spectrum Disorder, GGz Centraal, Almere, Netherlands
| | - Yvette Roke
- Expertise Center for Autism Spectrum Disorder, GGz Centraal, Almere, Netherlands
| | - Adriaan W Hoogendoorn
- Department of Psychiatry, Amsterdam Universitair Medische Centra, Amsterdam, Netherlands
- Mental Health Program, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | | | - Kirsten Hoeberichts
- Expertise Center for Autism Spectrum Disorder, GGz Centraal, Almere, Netherlands
| | - Peter N van Harten
- Department of Psychiatry, GGz Centraal, Amersfoort, Netherlands
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
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Tamayo JM, Osman HC, Schwartzer JJ, Ashwood P. The influence of asthma on neuroinflammation and neurodevelopment: From epidemiology to basic models. Brain Behav Immun 2024; 116:218-228. [PMID: 38070621 DOI: 10.1016/j.bbi.2023.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/08/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
Asthma is a highly heterogeneous inflammatory disease that can have a significant effect on both the respiratory system and central nervous system. Population based studies and animal models have found asthma to be comorbid with a number of neurological conditions, including depression, anxiety, and neurodevelopmental disorders. In addition, maternal asthma during pregnancy has been associated with neurodevelopmental disorders in the offspring, such as autism spectrum disorders and attention deficit hyperactivity disorder. In this article, we review the most current epidemiological studies of asthma that identify links to neurological conditions, both as it relates to individuals that suffer from asthma and the impacts asthma during pregnancy may have on offspring neurodevelopment. We also discuss the relevant animal models investigating these links, address the gaps in knowledge, and explore the potential future directions in this field.
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Affiliation(s)
- Juan M Tamayo
- Department of Medical Microbiology and Immunology, and the M.I.N.D. Institute, University of California at Davis, CA 95817, USA
| | - Hadley C Osman
- Department of Medical Microbiology and Immunology, and the M.I.N.D. Institute, University of California at Davis, CA 95817, USA
| | - Jared J Schwartzer
- Program in Neuroscience and Behavior, Department of Psychology and Education, Mount Holyoke College, 50 College Street, South Hadley, MA 01075, USA
| | - Paul Ashwood
- Department of Medical Microbiology and Immunology, and the M.I.N.D. Institute, University of California at Davis, CA 95817, USA.
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Shahunja KM, Sly PD, Mamun A. Trajectories of psychosocial environmental factors and their associations with asthma symptom trajectories among children in Australia. Pediatr Pulmonol 2024; 59:151-162. [PMID: 37882548 DOI: 10.1002/ppul.26733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION Several psychosocial factors, such as maternal mental health and parents' financial hardship, are associated with asthma symptoms among children. So, we aim to investigate the changing patterns of important psychosocial environmental factors and their associations with asthma symptom trajectories among children in Australia. METHODS We considered asthma symptoms as wheezing (outcome) and psychosocial environmental factors (exposures) from 0/1 year to 14/15 years of the participants from the "Longitudinal Study of Australian Children (LSAC)" for this study. We used group-based trajectory modeling to identify the trajectory groups for both exposure and outcome variables. Associations between psychosocial factors and three distinct asthma symptom trajectories were assessed by multivariable logistic regression. RESULTS We included 3917 children from the LSAC birth cohort in our study. We identified distinct trajectories for maternal depression, parents' financial hardship, parents' stressful life events and parents' availability to their children from birth to 14/15 years of age. Compared to the "low/no" asthma symptom trajectory group, children exposed to a "moderate & increasing" maternal depression, "moderate & declining" parents' financial hardship, and "moderate & increasing" parents' stressful life events were significantly associated (relative risk ratio [RRR]: 1.55, 95% confidence interval [CI]: 1.27, 1.91; RRR: 1.40, 95%; CI: 1.15, 1.70; RRR: 1.77, 95%; CI: 1.45, 2.16) with "persistent high" asthma symptom trajectory. CONCLUSION Several psychosocial factors that are potential stressors for mental health increase the risk of having an adverse asthma symptom trajectory during childhood. Further attention should be given to reducing exposure to maternal depression, parents' financial hardship, and parents' stressful live events for long-term asthma control in children.
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Affiliation(s)
- K M Shahunja
- UQ Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, Queensland, Australia
| | - Peter D Sly
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Abdullah Mamun
- UQ Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, Queensland, Australia
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Robert P, Lévesque B, Bourbeau J, Ahmad Khan F, Boulet LP, Dubé MA, Proulx JF, Ayotte P. Respiratory health and its determinants among Nunavimmiut: results from the Qanuilirpitaa? 2017 Nunavik Health Survey. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:136-151. [PMID: 36624337 PMCID: PMC10830964 DOI: 10.17269/s41997-022-00722-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/09/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Respiratory diseases are the leading cause of hospitalization in Nunavik (northern Québec, Canada) and contribute to disparities in life expectancy with the rest of Canada. As part of Qanuilirpitaa? 2017, a cross-sectional population-based health survey, we sought to describe the prevalence of respiratory health indicators, including the first estimate of airway obstruction based on spirometry in an Inuit population, and explore their associated characteristics. METHODS We analyzed data from 1296 participants aged 16 years and older, using multivariate logistic regression to assess characteristics associated with spirometry-determined airway obstruction and self-reported respiratory symptoms, i.e., wheezing in the last year and chronic cough during at least 3 months. RESULTS In this relatively young population (83% aged 16 to 54), the prevalences of wheezing, chronic cough, and airway obstruction were, respectively, 27% (95% CI 24-30), 21% (18-23), and 17% (14-20). These estimates are prone to biases due to the relatively low participation rate (about 37%). The most consistent associations were with smoking (≥ 15 pack-years; odds ratio [OR] 3.13, 3.39, and 2.86 for the three indicators, respectively) and food security (OR 0.55 with wheezing and OR 0.26 with chronic cough), as defined in the Household Food Security Survey Module. Wheezing was also associated with allergic sensitization to dogs (2.60) and obesity (2.18). Chronic cough was associated with respiratory infections during childhood (2.12), housing in need of major repairs (1.72), and housing crowding (1.50), and was negatively associated with participation to traditional activities (0.62) and going on the land (0.64). Airway obstruction was associated with being underweight (3.84) and post-secondary education (0.40). Among young adults and women, wheezing was also associated with any inhalation of solvents for recreational purposes during their lifetime (2.62 and 1.56, respectively), while airway obstruction was associated with regular marijuana use (2.22 and 1.84, respectively). CONCLUSION Smoking and food insecurity are both highly prevalent and strongly associated with respiratory symptoms in Nunavik. Together with essential smoking prevention and cessation programs, our findings suggest that solving food security and housing crises, improving socioeconomic conditions, and promoting traditional lifestyle may improve respiratory health in Nunavik.
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Affiliation(s)
- Philippe Robert
- Institut national de santé publique du Québec, Quebec City, QC, Canada
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Quebec City, QC, Canada
| | - Benoît Lévesque
- Institut national de santé publique du Québec, Quebec City, QC, Canada
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Quebec City, QC, Canada
| | - Jean Bourbeau
- Respiratory Epidemiology and Clinical Research Unit, Department of Medicine, McGill University, Montreal, QC, Canada
- Research Institute, McGill University Health Centre, Montreal Chest Institute, Montreal, QC, Canada
| | - Faiz Ahmad Khan
- Respiratory Epidemiology and Clinical Research Unit, Department of Medicine, McGill University, Montreal, QC, Canada
- Research Institute, McGill University Health Centre, Montreal Chest Institute, Montreal, QC, Canada
- McGill International TB Centre, Montreal, QC, Canada
| | - Louis-Philippe Boulet
- Institut universitaire de cardiologie et de pneumologie de Québec, Quebec City, QC, Canada
- Département de médecine, Université Laval, Quebec City, QC, Canada
| | - Marc-André Dubé
- Institut national de santé publique du Québec, Quebec City, QC, Canada
| | - Jean-François Proulx
- Department of Public Health, Nunavik Regional Board of Health and Social Services, Kuujjuaq, QC, Canada
| | - Pierre Ayotte
- Institut national de santé publique du Québec, Quebec City, QC, Canada.
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada.
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Quebec City, QC, Canada.
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Wisnivesky JP, Agrawal N, Ankam J, Gonzalez A, Busse P, Lin J, Federman A, Feldman J, Weiss JJ, Markowitz SB. World Trade Center workers with asthma and post-traumatic stress disorder perceive airflow limitation more accurately. Ann Allergy Asthma Immunol 2024; 132:62-68. [PMID: 37580015 DOI: 10.1016/j.anai.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/04/2023] [Accepted: 08/04/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a major risk factor for increased asthma morbidity among World Trade Center (WTC) workers. OBJECTIVE To investigate whether differences in perception of airflow limitation mediate the association of PTSD with worse asthma control in WTC workers. METHODS We collected data from WTC workers on asthma control (Asthma Control Questionnaire and Asthma Quality of Life Questionnaire) and daily peak expiratory flow (PEF) measures over 6 weeks. Perception of airway limitation was assessed by comparing guessed vs actual PEF values. Post-traumatic stress disorder was diagnosed using the Structured Clinical Interview. We used unadjusted and adjusted models to compare PEF and perception measures in WTC workers with PTSD with those of workers without PTSD. RESULTS Overall, 25% of 224 participants had PTSD. Post-traumatic stress disorder was associated with worse Asthma Control Questionnaire (2.2±0.8 vs 1.1±0.9, P < .001) and Asthma Quality of Life Questionnaire (3.9±1.1 vs 5.4±1.1, P < .001) scores. Adjusted analyses showed no significant differences in PEF between WTC workers with (351.9±143.3 L/min) and those without PTSD (364.6±131.6 L/min, P = .55). World Trade Center workers with PTSD vs those without PTSD had increased proportion of accurate perception (67.0±37.2% vs 53.5±38.1%, P = .01) and decreased underperception (23.3.0±32.1% vs 38.9±37.5%, P = .004) of airflow limitation during periods of limitation. Similar results were obtained in adjusted analyses. CONCLUSION This study indicates that differences in perception of airflow limitation may mediate the relationship of PTSD and increased asthma symptoms, given WTC workers with PTSD have worse self-reported asthma control, an increased proportion of accurate perception, and decreased underperception, despite no differences in daily PEF measures.
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Affiliation(s)
- Juan P Wisnivesky
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Division of Pulmonary and Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Nikita Agrawal
- Division of Pulmonary and Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jyoti Ankam
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Adam Gonzalez
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, New York
| | - Paula Busse
- Division of Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jenny Lin
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alex Federman
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jonathan Feldman
- Ferkauf Graduate School of Psychology, Albert Einstein College of Medicine, Bronx, New York; Division of Academic General Pediatrics, Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York; Division of Academic General Pediatrics, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York
| | - Jeffrey J Weiss
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Steven B Markowitz
- Barry Commoners Center for Health and Environment, Queens College, City University of New York, New York
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Berger S, Pini N, Lucchini M, Nugent JD, Acosta L, Angal J, Rauh VA, Elliott AJ, Myers MM, Fifer WP, Perzanowski MS. Neonatal rhinorrhea, heart rate variability, and childhood exercise-induced wheeze. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2023; 2:100149. [PMID: 37781655 PMCID: PMC10509928 DOI: 10.1016/j.jacig.2023.100149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/19/2023] [Accepted: 06/20/2023] [Indexed: 10/03/2023]
Abstract
Background There is increasing evidence linking infant rhinorrhea to school-age exercise-induced wheeze (EIW) via a parasympathetic nervous system pathway. The ratio of the root mean square of successive differences in heart beats (RMSSD) measured in quiet sleep versus active sleep (RMSSDQS:AS) is a novel biomarker in asthma. Objective We tested the hypotheses that (1) neonatal rhinorrhea predicts childhood EIW independent of other neonatal respiratory symptoms, (2) neonatal RMSSDQS:AS predicts childhood EIW, and (3) RMSSDQS:AS mediates the association between neonatal rhinorrhea and childhood EIW. Methods Participants from the Safe Passage/Environmental Influences on Child Health Outcomes (PASS/ECHO) prospective birth cohort had heart rate variability extracted from electrocardiogram traces acquired in the first month of life. Parents reported on rhinorrhea in their child at age 1 month and on EIW in their child at ages 4 to 11 years. Results In models (N = 831) adjusted for potential confounders and covariates, including neonatal wheeze, cough and fever, neonatal rhinorrhea-predicted childhood EIW (relative risk [RR] = 2.22; P = .040), specifically, among females (RR = 3.38; P = .018) but not males (RR = 1.39; P = .61). Among participants contributing data in both active and quiet sleep (n = 231), RMSSDQS:AS predicted EIW (RR = 2.36; P = .003) and mediated the effect estimate of neonatal rhinorrhea predicting EIW among females. Half of the females with a higher RMSSDQS:AS and neonatal rhinorrhea (n = 5 of 10) developed EIW as compared with 1.8% of the other females (n = 2 of 109) (P < .001). Conclusions Our findings support dysregulation of the parasympathetic nervous system in infancy as one of the possible underlying mechanisms for the development of EIW later in childhood among females, which could aid in the development of future interventions.
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Affiliation(s)
- Sophie Berger
- Division of Pulmonology, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY
| | - Nicolò Pini
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY
| | - Maristella Lucchini
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY
| | - J. David Nugent
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY
| | - Luis Acosta
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, Sioux Falls, SD
| | | | - Virginia A. Rauh
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, Sioux Falls, SD
| | | | - Michael M. Myers
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY
- Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY
| | - William P. Fifer
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY
- Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY
| | - Matthew S. Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, Sioux Falls, SD
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Sharma R, Humphrey JL, Frueh L, Kinnee EJ, Sheffield PE, Clougherty JE. Neighborhood violence and socioeconomic deprivation influence associations between acute air pollution and temperature on childhood asthma in New York city. ENVIRONMENTAL RESEARCH 2023; 231:116235. [PMID: 37244495 PMCID: PMC10364588 DOI: 10.1016/j.envres.2023.116235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 05/29/2023]
Abstract
Ambient air pollution, temperature, and social stressor exposures are linked with asthma risk, with potential synergistic effects. We examined associations for acute pollution and temperature exposures, with modification by neighborhood violent crime and socioeconomic deprivation, on asthma morbidity among children aged 5-17 years year-round in New York City. Using conditional logistic regression in a time-stratified, case-crossover design, we quantified percent excess risk of asthma event per 10-unit increase in daily, residence-specific exposures to PM2.5, NO2, SO2, O3, and minimum daily temperature (Tmin). Data on 145,834 asthma cases presenting to NYC emergency departments from 2005 to 2011 were obtained from the New York Statewide Planning and Research Cooperative System (SPARCS). Residence- and day-specific spatiotemporal exposures were assigned using the NYC Community Air Survey (NYCCAS) spatial data and daily EPA pollution and NOAA weather data. Point-level NYPD violent crime data for 2009 (study midpoint) was aggregated, and Socioeconomic Deprivation Index (SDI) scores assigned, by census tract. Separate models were fit for each pollutant or temperature exposure for lag days 0-6, controlling for co-exposures and humidity, and mutually-adjusted interactions (modification) by quintile of violent crime and SDI were assessed. We observed stronger main effects for PM2.5 and SO2 in the cold season on lag day 1 [4.90% (95% CI: 3.77-6.04) and 8.57% (5.99-11.21), respectively]; Tmin in the cold season on lag day 0 [2.26% (1.25-3.28)]; and NO2 and O3 in the warm season on lag days 1 [7.86% (6.66-9.07)] and 2 [4.75% (3.53-5.97)], respectively. Violence and SDI modified the main effects in a non-linear manner; contrary to hypotheses, we found stronger associations in lower-violence and -deprivation quintiles. At very high stressor exposures, although asthma exacerbations were highly prevalent, pollution effects were less apparent-suggesting potential saturation effects in socio-environmental synergism.
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Affiliation(s)
- Rachit Sharma
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
| | - Jamie L Humphrey
- Center for Health Analytics, Media & Policy, RTI International, Research Triangle Park, NC, USA
| | - Lisa Frueh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Ellen J Kinnee
- University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, PA, USA
| | - Perry E Sheffield
- Department of Environmental Medicine and Public Health, and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jane E Clougherty
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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12
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Schacter HL, D Ehrhardt A, MacDonell KE. Associations between peer experiences and health outcomes among adolescents and young adults with asthma. J Asthma 2023; 60:1359-1368. [PMID: 36369912 DOI: 10.1080/02770903.2022.2147080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 10/20/2022] [Accepted: 11/09/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Although peer relationships become increasingly important across adolescence and early adulthood, research examining links between peer relationships and the health outcomes of young people with asthma is scarce. Using a large sample of adolescents and young adults (AYAs) with asthma, the current study assessed whether positive and negative peer experiences are associated with AYAs' asthma control, asthma self-efficacy, and internalizing symptoms. METHODS In this cross-sectional study, a national sample of 440 diverse adolescents and young adults with asthma completed an online survey. Questionnaires assessed general and asthma-specific peer experiences (i.e. peer victimization; peer support; asthma-related peer problems) and health indicators (i.e. asthma control; asthma self-efficacy; internalizing symptoms). Regression analyses were performed to examine associations between peer experiences and health while controlling for participant age, gender, race/ethnicity, and age of asthma diagnosis. RESULTS Results from separate regression models indicated that adolescents who experienced greater peer victimization, less peer support, and more asthma-related peer problems also reported worse asthma control, lower asthma self-efficacy, and more severe internalizing symptoms. Follow-up exploratory analyses indicated that peer victimization and asthma-related peer problems were the strongest predictors of asthma control and internalizing, whereas peer support and asthma-related peer problems were the strongest predictors of asthma self-efficacy. CONCLUSIONS This study underscores connections between peer relationships and health outcomes among AYAs with asthma. Interventions that leverage peer support and mitigate peer stress may offer a developmentally appropriate approach for mitigating physical and psychological distress among adolescents and young adults with asthma.
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Affiliation(s)
| | | | - Karen E MacDonell
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, FL, USA
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13
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Sato S, Kawano T, Ike E, Takahashi K, Sakurai J, Miyasaka T, Miyauchi Y, Ishizawa F, Takayanagi M, Takahashi T. IL-1β Derived Th17 Immune Responses Are a Critical Factor for Neutrophilic-Eosinophilic Airway Inflammation on Psychological Stress-Induced Immune Tolerance Breakdown in Mice. Int Arch Allergy Immunol 2023; 184:797-807. [PMID: 37231861 PMCID: PMC10413803 DOI: 10.1159/000529108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/30/2022] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION Asthma is an inflammatory reaction mediated by type 2 helper T (Th2) cells and is known to increase eosinophil levels. Our previous study showed that stress-related asthma can cause neutrophilic and eosinophilic airway inflammation by suppressing immune tolerance. However, the mechanism of stress-induced neutrophilic and eosinophilic airway inflammation remains unclear. Therefore, to elucidate the cause of neutrophilic and eosinophilic inflammation, we investigated the immune response during the induction of airway inflammation. In addition, we focused on the relationship between immune response modulation immediately after stress exposure and the development of airway inflammation. METHODS Asthmatic mice were induced by three phases using female BALB/c mice. During the first phase, the mice were made to inhale ovalbumin (OVA) to induce immune tolerance before sensitization. Some mice were exposed to restraint stress during the induction of immune tolerance. In the second phase, the mice were sensitized with OVA/alum intraperitoneal injections. In the final phase, onset of asthma was induced through OVA exposure. Asthma development was evaluated based on airway inflammation and T-cell differentiation. Microarray and qPCR analyses were used to enumerate candidate factors to investigate the starting point of immunological modification immediately after stress exposure. Furthermore, we focused on interleukin-1β (IL-1β), which initiates these immune modifications, and performed experiments using its receptor blocker interleukin-1 receptor antagonist (IL-1RA). RESULTS Stress exposure during immune tolerance induction increased eosinophil and neutrophil airway infiltration. This inflammation was associated with decreased T regulatory cell levels and increased Th2 and Th17 levels in bronchial lymph node cells. Microarray and qPCR analyses showed that the initiation of Th17 differentiation might be triggered by stress exposure during tolerance induction. IL-1RA administration during stress exposure suppressed neutrophilic and eosinophilic airway inflammation via Th17 reduction and Treg increase. CONCLUSIONS Our results show that psychological stress causes both eosinophilic and neutrophilic inflammatory responses due to the breakdown of immune tolerance. Furthermore, stress-induced inflammation can be abolished using IL-1RA.
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Affiliation(s)
- Shinsuke Sato
- Division of Pathophysiology, Department of Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Department of Pharmacy, Tohoku Medical Pharmaceutical University Wakabayashi Hospital, Sendai, Japan
| | - Tasuku Kawano
- Division of Pathophysiology, Department of Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Erina Ike
- Division of Pathophysiology, Department of Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Kento Takahashi
- Division of Pathophysiology, Department of Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Junji Sakurai
- Department of Pharmacy, Tohoku Medical Pharmaceutical University Wakabayashi Hospital, Sendai, Japan
| | - Tomomitsu Miyasaka
- Center for Medical Education, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yasuo Miyauchi
- Department of Pharmacy, Tohoku Medical Pharmaceutical University Wakabayashi Hospital, Sendai, Japan
| | - Fumiaki Ishizawa
- Department of Pharmacy, Tohoku Medical Pharmaceutical University Wakabayashi Hospital, Sendai, Japan
| | - Motoaki Takayanagi
- Division of Pathophysiology, Department of Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Tomoko Takahashi
- Division of Pathophysiology, Department of Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai, Japan
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14
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Dileep A, Warren C, Bilaver LA, Stephen E, Andy-Nweye AB, Fox S, Jiang J, Newmark PJ, Chura A, Abdikarim I, Nimmagadda SR, Sharma HP, Tobin MC, Assa'ad AH, Gupta RS, Mahdavinia M. Assessing Disparities in the Prevalence of Atopic Comorbidities Among Food-Allergic Children. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:1169-1176. [PMID: 36720389 PMCID: PMC10085831 DOI: 10.1016/j.jaip.2023.01.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/23/2022] [Accepted: 01/17/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND Previous studies have reported that Black children with food allergy (FA) have higher risk of atopic comorbidities than White children. OBJECTIVE Our study sought to understand if disparities in the prevalence of atopic comorbidities among children with FA are driven by individual and community-level socioeconomic status (SES). METHODS We analyzed data from a prospective, multicenter cohort investigating the natural history of pediatric atopy: the Food Allergy Outcomes Related to White and African American Racial Differences (FORWARD) study. A validated, multicomponent area deprivation index (ADI) percentile score was tabulated by the census block group for each subject's home address. The association of ADI with atopic comorbidities in FA was assessed via multivariable regression analysis. RESULTS Of the 700 children in this study, the mean ADI was 37.7 (95% confidence interval: 35.6-39.7). The mean ADI was higher in children with asthma (43.3) compared with those without asthma (31.8), which remained significant after adjusting for race (P < .0001). Children with allergic rhinitis (AR) had a higher mean ADI (39.1) compared with those without (33.4) (P = .008). ADI was associated with secondhand smoking, parents' education, and household income. Black children had a higher risk for asthma after adjusting for ADI and SES-related factors. CONCLUSION The independent association of ADI with asthma and AR, regardless of race, suggests a role of neighborhood-level socioeconomic deprivation in the development of these conditions among children with FA. Black children with FA remained at higher risk for asthma after adjusting for SES-related variables, which can indicate an independent risk for asthma in these children.
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Affiliation(s)
- Anandu Dileep
- Division of Allergy and Immunology, Rush University Medical Center, Chicago, Ill
| | - Christopher Warren
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Allergy and Immunology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Lucy A Bilaver
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Ellen Stephen
- Division of Allergy and Immunology, Rush University Medical Center, Chicago, Ill
| | - Aame B Andy-Nweye
- Division of Allergy and Immunology, Rush University Medical Center, Chicago, Ill
| | - Susan Fox
- Division of Allergy and Immunology, Rush University Medical Center, Chicago, Ill
| | - Jialing Jiang
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Pamela J Newmark
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Annika Chura
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Iman Abdikarim
- Division of Allergy and Immunology, Children's National Health Systems, Washington DC
| | - Sai R Nimmagadda
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Allergy and Immunology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Hemant P Sharma
- Division of Allergy and Immunology, Children's National Health Systems, Washington DC
| | - Mary C Tobin
- Division of Allergy and Immunology, Rush University Medical Center, Chicago, Ill
| | - Amal H Assa'ad
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Ruchi S Gupta
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Allergy and Immunology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Mahboobeh Mahdavinia
- Division of Allergy and Immunology, Rush University Medical Center, Chicago, Ill.
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15
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Lu C, Liu Z, Liao H, Yang W, Li Q, Liu Q. Effects of early life exposure to home environmental factors on childhood allergic rhinitis: Modifications by outdoor air pollution and temperature. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 244:114076. [PMID: 36113271 DOI: 10.1016/j.ecoenv.2022.114076] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There is growing evidence that allergic rhinitis (AR) is associated with indoor environmental factors, but their role in childhood AR during early life remains unclear. OBJECTIVE To investigate the association of preconceptional, prenatal, early postnatal, and current exposure to home environmental factors with childhood AR, and to further explore whether this association can be interacted by outdoor air pollution and temperature. METHODS A retrospective cohort study of 8689 preschool children was conducted during 2019-2020 in Changsha, China. A standard questionnaire was used to collect data on each family's health outcomes and home environments. We considered home environmental exposures during one year before conception, pregnancy, first year of life, and past year. Associations of indoor air pollution and allergens with AR were assessed by multiple logistic regression models. RESULTS Pre-birth exposure to indoor air pollution emitted by new furniture or redecoration and dampness related allergen derived from mold/damp stains and mold/damp clothes or bedding during 1 year before conception and pregnancy was significantly associated with increased AR, with adjusted ORs (95% CI) ranging from 1.35 (1.05-1.75) to 1.87 (1.55-2.27). Childhood AR was also significantly related with post-birth exposure to dampness related indoor allergen including mold/damp stains and mold/damp clothes or bedding in first year and past year and pollen allergen including total and nonflowing plants in past year, with a range of ORs (95% CI) from 1.20 (1.01-1.42) to 1.79 (1.42-2.27). We identified that pre-birth, particularly in utero exposure to both indoor air pollution from renovation and dampness related allergens, played a key role in AR development compared to post-birth exposures, and accumulative effect was observed with the highest risk of AR. High exposure to traffic-related air pollution (TRAP) including outdoor PM2.5, NO2, CO, and O3, as well as living near traffic road not only significantly increased adverse effect of home environmental factors but also decreased protective effect of household dogs on childhood AR. Early life exposure to low temperature in pregnancy and high temperature in first year significantly increased AR risk of home environmental exposure. Sensitivity analysis indicated that some sub-groups were more susceptible to AR risk of home environmental exposure. CONCLUSION Our study suggests that pre-birth exposure to home environmental factors played an important role in AR development and this effect can be interacted by TRAP and temperature, which supports a hypothesis of "(pre)fetal origin of childhood AR".
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Zijing Liu
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Hongsen Liao
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Wenhui Yang
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Qin Li
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Qin Liu
- XiangYa School of Public Health, Central South University, Changsha, China.
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16
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Lynch T, Davis SL, Johnson AH, Gray L, Coleman E, Phillips SR, Soistmann HC, Rice M. Definitions, theories, and measurement of stress in children. J Pediatr Nurs 2022; 66:202-212. [PMID: 35868219 PMCID: PMC10085063 DOI: 10.1016/j.pedn.2022.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 11/28/2022]
Abstract
PROBLEM Stress in children remains a complex concept to examine due to the inherent subjectivity and lack of specific manifestations, as well as the multiple ways stress can be defined and measured in children. Because stress is multifactorial,is experienced daily by children, and undergirds adolescent health and early mental illness, it is crucial to have a clear understanding of stress and the effects of stress in children from infancy through age twelve years. ELIGIBILITY CRITERIA To be included in this review, literature must pertain to and highlight theories, definitions/classifications, and measurements of stress in children from infancy to 12 years of age. SAMPLE The most pertinent articles identified through database searches (PubMed, Scopus, PsycINFO, CINAHL, Google Scholar), gray literature sources (e.g., child health websites), and reference lists of identified articles were included in this narrative overview. RESULTS The results of this review are organized by themes and include: classifications and definitions of stress, stress-related theories, and tools to measure stress in children. CONCLUSIONS Research addressing stressors and stress in children is limited, and there is wide variation in how researchers define and classify stress in children. Existing measures of stress in children younger than 12 address physiological, psychological, and observational components, but may be inconsistent and threaten validity of otherwise well-designed and well-executed studies. IMPLICATIONS Improving the understanding and accurate measurement of stress in children enables researchers and clinicians to curtail undesirable health outcomes.
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Affiliation(s)
- Thuy Lynch
- University of Alabama in Huntsville, 301 Sparkman Drive, Huntsville, AL 35899, USA.
| | - Sara L Davis
- University of South Alabama, 5721 USA Drive, N., Mobile, AL 36688, USA.
| | - Ann Hammack Johnson
- Harris College of Nursing and Health Sciences, Texas Christian University, 2800 S. University Drive, Fort Worth, TX 76109, USA.
| | - Laura Gray
- Gordon E. Inman College of Health Sciences and Nursing, Belmont University, 1900 Belmont Boulevard, Nashville, TN 37212, USA.
| | - Elizabeth Coleman
- University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL 35294, USA.
| | | | - Heather C Soistmann
- Penn State Health Children's Hospital, 500 University Drive, Hershey, PA 17033, USA.
| | - Marti Rice
- University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL 35294, USA.
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17
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Leonard SI, Turi ER, Powell JS, Usseglio J, MacDonell KK, Bruzzese JM. Associations of asthma self-management and mental health in adolescents: A scoping review. Respir Med 2022; 200:106897. [PMID: 35714575 PMCID: PMC9871877 DOI: 10.1016/j.rmed.2022.106897] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/19/2022] [Accepted: 05/31/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Adolescent asthma is highly prevalent and frequently uncontrolled despite control being achievable with good self-management. Anxiety, depression, and stress are associated with worse asthma outcomes, and may impact self-management; no previous review has examined this relationship. AIM This scoping review assessed the nature of the current literature on mental health and asthma self-management among adolescents ages 11 to 24 and synthesized their relationships. METHODS Guided by the PRISMA-ScR guidelines, we systematically searched the literature using MEDLINE, Embase, CINAHL, PsycInfo, and Scopus in September 2020 and updated it in June 2021. Included studies examined associations between anxiety, depression, and/or stress and asthma self-management in adolescents ages 11-24. We did not restrict study design, location, or date. RESULTS Out of 1559 records identified, 14 met inclusion criteria. Types of self-management included trigger control, healthcare adherence, and overall symptom prevention and management. Anxiety symptoms were associated with poorer asthma self-management in four studies, but better in three. Depressive symptoms were associated with poorer asthma self-management in five studies, but better in two. Stress was associated with poorer self-management in one study. Mental health symptoms were nearly universally associated with poorer trigger control, but associations with healthcare adherence and overall symptom prevention and management varied. CONCLUSION Mental health symptoms may facilitate or hinder asthma self-management depending on the types of mental health and self-management. Further research is needed to better understand this relationship and inform future interventions. Providers might assess mental health as a potential barrier to adolescent asthma self-management.
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Affiliation(s)
- Sarah I Leonard
- Office of Scholarship and Research, Columbia University School of Nursing, United States
| | - Eleanor R Turi
- Office of Scholarship and Research, Columbia University School of Nursing, United States
| | - Jennifer S Powell
- Division of Global and Community Health, Medical University of South Carolina, United States
| | - John Usseglio
- Augustus C. Long Health Sciences Library, Columbia University Irving Medical Center, United States
| | | | - Jean-Marie Bruzzese
- Office of Scholarship and Research, Columbia University School of Nursing, United States.
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18
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Ryklief Z, Suliman S, Hemmings SMJ, van den Heuvel LL, Seedat S. Rates of and factors associated with atopy and allergies in posttraumatic stress disorder as compared to controls. J Psychosom Res 2022; 158:110938. [PMID: 35580455 DOI: 10.1016/j.jpsychores.2022.110938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 02/25/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Several studies suggest a relationship between atopy and psychiatric disorders, but few have investigated the association between atopic conditions and posttraumatic stress disorder (PTSD). We sought to compare the rates of atopy and allergies in a South African case-control study of 220 patients with PTSD (mean age 41.7 years, SD = 11.7) and 196 trauma exposed controls (TEC, mean age 45.4 years, SD = 14.7) conducted in Cape Town, South Africa from May 2014 to June 2017. METHODS Self-reported atopic conditions and allergies were regressed on PTSD, as determined with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), in multivariate logistic regression models, controlling for age, gender, body mass index, physical activity, lifetime and childhood trauma, and time since index trauma. RESULTS Rates of lifetime atopy (p = 0.03), current asthma (p = 0.04), lifetime allergic rhinitis (p = 0.002), and current allergic rhinitis (p = 0.004) were significantly higher in patients than TEC on bivariate analysis. On multivariate analysis, rates of current atopy (Cohen's d = 0.26, p = 0.04) and current allergic rhinitis (Cohen's d = 0.34, p = 0.012) were significantly higher in patients with PTSD than in TEC. Current eczema (p = 0.24), current asthma (p = 0.26), and allergies (p = 0.59) were not associated with PTSD. CONCLUSIONS Rates of atopy are higher in participants with PTSD than TEC, and this effect is related to higher rates of allergic rhinitis. Further studies are needed to elucidate the pathways linking allergic rhinitis and PTSD.
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Affiliation(s)
- Zulfa Ryklief
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg 7505, Cape Town, South Africa
| | - Sharain Suliman
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg 7505, Cape Town, South Africa; South African Medical Research Council, Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sian M J Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg 7505, Cape Town, South Africa; South African Medical Research Council, Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Leigh L van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg 7505, Cape Town, South Africa; South African Medical Research Council, Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg 7505, Cape Town, South Africa; South African Medical Research Council, Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
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Change in Asthma Is Associated with Change in PTSD in World Trade Center Health Registrants, 2011 to 2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137795. [PMID: 35805453 PMCID: PMC9266235 DOI: 10.3390/ijerph19137795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 11/21/2022]
Abstract
The WTC Health Registry (WTCHR) is a closed, longitudinal cohort of rescue/recovery workers and survivors exposed to the 11 September 2001 disaster. WTCHR enrollees diagnosed with asthma after 11 September 2001 continued to experience poor control despite treatment. Asthma is associated with mental problems, although their bidirectional movement has not been studied. This study tested whether a clinical change in mental problems was associated with a difference in asthma control, and whether a change in asthma control varied with a change in quality of life (QoL). Difference in the Asthma Control Test (ACT) on the WTCHR from 2011-12 to 2015-16 was compared with the change in the Post-traumatic Stress Disorder Checklist (PCL-17), the Patient Health Questionnaire depression scale, self-reported heartburn, and change of physical and mental QoL over this period. In adjusted multinomial multivariable logistic regression, improved PCL-17 was associated with a better ACT score, odds ratio (OR) = 1.42 (95% C.I. 1.01, 1.99), and a worsened PCL-17 score was associated with a worsened ACT score, OR = 1.77 (95% C.I. 1.26, 2.50). Decreased ACT was associated with poor physical QoL, OR = 1.97 (95% C.I. 1.48, 2.62). Change in mental health measures tracked with change in asthma control, which correlated with a change in QoL. Careful follow-up and treatment of all three are indicated to improve these inter-related issues.
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Calderon JL, Sorensen C, Lemery J, Workman CF, Linstadt H, Bazilian MD. Managing upstream oil and gas emissions: A public health oriented approach. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 310:114766. [PMID: 35228168 DOI: 10.1016/j.jenvman.2022.114766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 02/08/2022] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
Oil and natural gas are the largest primary global energy sources, and upstream gas emissions from these fuels can impact global climate change and local public health. This paper employs a public health-oriented perspective that reviews grey and academic literature, industry data, technical reports, and policy trends to highlight issues of emissions monitoring. We identify gaps in the existing landscape of emissions reduction strategies and highlight options for addressing them. Policy recommendations include the use of new digital monitoring technologies to better understand causes of emission events, to create data-driven oil and gas regulations, and to begin accurately measuring the volumes of gases released during oil and gas production. Areas for future research relating to emissions and public health impacts are outlined to further enable oil and gas policy discussions.
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Affiliation(s)
- Jordan L Calderon
- The Payne Institute for Public Policy, Colorado School of Mines, 816 15th St, Golden, CO, USA.
| | - C Sorensen
- School of Medicine, University of Colorado, 13001 East 17th Place, Aurora, CO, USA
| | - J Lemery
- School of Medicine, University of Colorado, 13001 East 17th Place, Aurora, CO, USA
| | - C F Workman
- The Payne Institute for Public Policy, Colorado School of Mines, 816 15th St, Golden, CO, USA
| | - H Linstadt
- School of Medicine, University of Colorado, 13001 East 17th Place, Aurora, CO, USA
| | - M D Bazilian
- The Payne Institute for Public Policy, Colorado School of Mines, 816 15th St, Golden, CO, USA
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21
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Fieten KB, Drijver‐Messelink MT, Cogo A, Charpin D, Sokolowska M, Agache I, Taborda‐Barata LM, Eguiluz‐Gracia I, Braunstahl GJ, Seys SF, den Berge M, Bloch KE, Ulrich S, Cardoso‐Vigueros C, Kappen JH, Brinke AT, Koch M, Traidl‐Hoffmann C, da Mata P, Prins DJ, Pasmans SGMA, Bendien S, Rukhadze M, Shamji MH, Couto M, Oude Elberink H, Peroni DG, Piacentini G, Weersink EJM, Bonini M, Rijssenbeek‐Nouwens LHM, Akdis CA. Alpine altitude climate treatment for severe and uncontrolled asthma: An EAACI position paper. Allergy 2022; 77:1991-2024. [PMID: 35113452 PMCID: PMC9305916 DOI: 10.1111/all.15242] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/14/2022] [Accepted: 01/30/2022] [Indexed: 12/30/2022]
Abstract
Currently available European Alpine Altitude Climate Treatment (AACT) programs combine the physical characteristics of altitude with the avoidance of environmental triggers in the alpine climate and a personalized multidisciplinary pulmonary rehabilitation approach. The reduced barometric pressure, oxygen pressure, and air density, the relatively low temperature and humidity, and the increased UV radiation at moderate altitude induce several physiological and immunological adaptation responses. The environmental characteristics of the alpine climate include reduced aeroallergens such as house dust mites (HDM), pollen, fungi, and less air pollution. These combined factors seem to have immunomodulatory effects controlling pathogenic inflammatory responses and favoring less neuro‐immune stress in patients with different asthma phenotypes. The extensive multidisciplinary treatment program may further contribute to the observed clinical improvement by AACT in asthma control and quality of life, fewer exacerbations and hospitalizations, reduced need for oral corticosteroids (OCS), improved lung function, decreased airway hyperresponsiveness (AHR), improved exercise tolerance, and improved sinonasal outcomes. Based on observational studies and expert opinion, AACT represents a valuable therapy for those patients irrespective of their asthma phenotype, who cannot achieve optimal control of their complex condition despite all the advances in medical science and treatment according to guidelines, and therefore run the risk of falling into a downward spiral of loss of physical and mental health. In the light of the observed rapid decrease in inflammation and immunomodulatory effects, AACT can be considered as a natural treatment that targets biological pathways.
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22
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Hoque S, Goulding M, Hazeltine M, Ferrucci KA, Trivedi M, Liu SH. Caregiver-perceived neighborhood safety and pediatric asthma severity: 2017-2018 National Survey of Children's Health. Pediatr Pulmonol 2022; 57:376-385. [PMID: 34796705 PMCID: PMC8792337 DOI: 10.1002/ppul.25762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine the association between caregiver-perceived neighborhood safety and pediatric asthma severity using a cross-sectional, nationally representative sample. STUDY DESIGN Using data from the 2017-2018 National Survey of Children's Health, children aged 6-17 years with primary caregiver report of a current asthma diagnosis were included (unweighted N = 3209; weighted N = 3,909,178). Perceived neighborhood safety, asthma severity (mild vs. moderate/severe), demographic, household, and health/behavioral covariate data were collected from primary caregiver report. Poisson regression with robust error variance was used to estimate the association between perceived neighborhood safety and caregiver-reported pediatric asthma severity. RESULTS Approximately one-third of children studied had moderate/severe asthma. A total of 42% of children with mild asthma and 52% of children with moderate/severe asthma identified as Hispanic or non-Hispanic Black. Nearly 20% of children with mild asthma and 40% of children with moderate/severe asthma were from families living below the federal poverty level (FPL). Children living in neighborhoods perceived by their caregiver to be unsafe had higher prevalence of moderate/severe asthma compared to those in the safest neighborhoods (adjusted prevalence ratio: 1.34; 95% confidence interval: 1.04-1.74). This association was found to be independent of race/ethnicity, household FPL, household smoking, and child's physical activity level after adjusting for covariates. CONCLUSIONS Children living in neighborhoods perceived by their caregiver to be unsafe have higher prevalence of moderate or severe asthma. Further investigation of geographic context and neighborhood characteristics that influence childhood asthma severity may inform public health strategies to reduce asthma burden and improve disease outcomes.
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Affiliation(s)
- Shushmita Hoque
- University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, USA
| | - Melissa Goulding
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, USA
| | - Max Hazeltine
- Department of Surgery, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, USA
| | - Katarina A. Ferrucci
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, USA
| | - Michelle Trivedi
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, USA
- Department of Pediatric Pulmonology, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, USA
| | - Shao-Hsien Liu
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, USA
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Vafaee F, Shirzad S, Shamsi F, Boskabady MH. Neuroscience and treatment of asthma, new therapeutic strategies and future aspects. Life Sci 2021; 292:120175. [PMID: 34826435 DOI: 10.1016/j.lfs.2021.120175] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 12/14/2022]
Abstract
AIMS Asthma is an airway inflammatory disease that is affected by neurological and psychological factors. The aim of present review is to investigating the relationship between neural functions and neurobiological changes and asthma symptoms. MAIN METHODS The information in this article is provided from articles published in English and reputable database using appropriate keywords from 1970 to October 2020. KEY FINDINGS The symptoms of asthma such as cough, difficult breathing, and mucus secretion get worse when a person is suffering from stress, anxiety, and depression. The function of the insula, anterior cingulate cortex, and hypothalamic-pituitary-adrenal axis changes in response to stress and psychological disease; then the stress hormones are produced from neuroendocrine system, which leads to asthma exacerbation. The evidence represents that psychological therapies or neurological rehabilitation reduces the inflammation through modulating the activity of neurocircuitry and the function of brain centers involved in asthma. Moreover, the neurotrophins and neuropeptides are the key mediators in the neuro-immune interactions, which secrete from the airway nerves in response to brain signals, and they could be the target of many new therapies in asthma. SIGNIFICANCE This review provides an insight into the vital role of the central and peripheral nervous system in development and exacerbation of asthma and provides practical approaches and strategies on neural networks to improve the airway inflammation and asthma severity.
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Affiliation(s)
- Farzaneh Vafaee
- Neuroscience Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Neuroscience, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shima Shirzad
- Neuroscience Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Neuroscience, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Shamsi
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran; Neuroscience Laboratory (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Boskabady
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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24
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Martinez A, de la Rosa R, Mujahid M, Thakur N. Structural racism and its pathways to asthma and atopic dermatitis. J Allergy Clin Immunol 2021; 148:1112-1120. [PMID: 34743832 DOI: 10.1016/j.jaci.2021.09.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/03/2021] [Accepted: 09/20/2021] [Indexed: 12/31/2022]
Abstract
Black, Latinx, and Indigenous people in the United States experience a disproportionate burden of asthma and atopic dermatitis. The study of these disease disparities has focused on proximal socioenvironmental exposures and on the biomechanistic (including genetic) differences between racial and ethnic groups. Although biomedical research in allergy and immunology stands to benefit from the inclusion of diverse study populations, the narrow focus on biologic mechanisms disregards the complexity of interactions across biologic and structural factors, including the effects of structural racism. Structural racism is the totality of ways in which society fosters discrimination by creating and reinforcing inequitable systems through intentional policies and practices sanctioned by government and institutions. It is embedded across multiple levels, including the economic, educational, health care, and judicial systems, which are manifested in inequity in the physical and social environment. In this review, we present a conceptual framework and pull from the literature to demonstrate how structural racism is a root cause of atopic disease disparities by way of residential segregation, socioeconomic position, and mass incarceration, which may lead to aberrations in the innate and adaptive immune response and the augmentation of physiologic stress responses, contributing to a disproportionate disease burden for racial and ethnic populations.
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Affiliation(s)
- Adali Martinez
- School of Medicine, the University of California San Francisco, San Francisco, Calif
| | | | - Mahasin Mujahid
- School of Public Health, University of California Berkeley, Berkeley, Calif
| | - Neeta Thakur
- School of Medicine, the University of California San Francisco, San Francisco, Calif.
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25
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Bierstetel SJ, Jiang Y, Slatcher RB, Zilioli S. Parent-child conflict and physical health trajectories among youth with asthma. J Psychosom Res 2021; 150:110606. [PMID: 34560405 PMCID: PMC8559307 DOI: 10.1016/j.jpsychores.2021.110606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 09/02/2021] [Accepted: 09/05/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the role of caregiver- and youth-reports of parent-child conflict on trajectories of asthma-related health outcomes over 2 years. METHODS In a sample of 193 youth with asthma (42.7% female; M age = 12.78) and their primary caregivers, we used a multi-method and multi-informant approach to assess self-reported parent-child conflict from youth and caregivers at both the daily and global levels at baseline. Next, we annually assessed subjective (i.e., youth self-reported asthma symptoms) and clinical (i.e., peak flow) asthma health outcomes for 2 years. RESULTS Latent growth curve models revealed an effect of baseline youth-reported global family conflict on peak flow trajectories such that youth who reported greater parent-child conflict at baseline experienced less of an increase in peak flow over time than youth who reported less parent-child conflict at baseline (standardized β = -0.27, p = .003). CONCLUSIONS Youth with asthma who perceive greater overall conflict with their caregivers experience less improvement in peak flow as they age. The research and clinical implications of these findings are discussed.
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26
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Chronic Stress, Exercise and Cardiovascular Disease: Placing the Benefits and Risks of Physical Activity into Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189922. [PMID: 34574843 PMCID: PMC8471640 DOI: 10.3390/ijerph18189922] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 12/18/2022]
Abstract
Chronic stress, which has been exacerbated worldwide by the lingering COVID pandemic, has been strongly linked to cardiovascular disease (CVD). In addition, autonomic dysregulation via sustained sympathetic activity has been shown to increase the risk of arrhythmias, platelet aggregation, acute coronary syndromes and heart failure. Fortunately, effective coping strategies have been shown to attenuate the magnitude of hyperarousal associated with the stress response, including moderate-to-vigorous lifestyle activity and/or structured exercise. A good-to-excellent level of cardiorespiratory fitness also appears to be highly cardioprotective. These beneficial effects have been substantiated by numerous studies that have evaluated the levels of stress reactivity and stress recovery in physically active individuals versus matched sedentary controls, as well as before and after exercise interventions. On the other hand, unaccustomed strenuous exercise in habitually sedentary persons with underlying CVD is associated with a disproportionate incidence of acute cardiac events. Moreover, extreme exercise regimens appear to increase coronary calcification and the likelihood of developing atrial fibrillation. This review summarizes these relations and more, with specific reference to placing the benefits and risks of physical activity into perspective.
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27
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Curry CW, Felt D, Kan K, Ruprecht M, Wang X, Phillips G, Beach LB. Asthma Remission Disparities Among US Youth by Sexual Identity and Race/Ethnicity, 2009-2017. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2021; 9:3396-3406. [PMID: 33964511 PMCID: PMC8434969 DOI: 10.1016/j.jaip.2021.04.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/13/2021] [Accepted: 04/18/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Sexual minority and racial/ethnic minority youth experience a higher burden of asthma. The frameworks of minority stress theory and intersectionality suggest that sexual minority and racial/ethnic minority youth may experience disparities in nonremitting asthma. OBJECTIVE To examine adjusted odds of nonremitting asthma by sexual identity, race/ethnicity, and their intersections, along with their relationship with traditional nonremitting asthma risk factors (weight status and smoking) and victimization (bullying, cyberbullying, and forced sex). METHODS We used data from the Youth Risk Behavior Survey pooled across 41 jurisdiction-years (biennially, 2009-2017), resulting in a sample of 21,789 US youth. The prevalence of nonremitting asthma was examined by sexual identity, race/ethnicity, and their intersections, stratified by sex. Bivariate associations and backward logistic regression models, stratified by sex, were built to examine nonremitting asthma disparities and the effects of selected traditional correlates and victimization variables. RESULTS At the intersections, 8 sexual minority and racial/ethnic minority subpopulations were significantly more likely to have nonremitting asthma compared with White heterosexual sex-matched peers. White gay males and Black lesbian females had the highest odds of nonremitting asthma. Traditional risks of nonremitting asthma and victimization were associated with attenuated odds of nonremitting asthma. CONCLUSIONS Many sexual minority and racial/ethnic youth subpopulations are more likely to have nonremitting asthma. Evidence suggests that traditional nonremitting asthma risk factors and victimization may partly explain disparities in nonremitting asthma. Asthma management guidelines should be updated to include population health disparities of sexual and racial/ethnic minorities.
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Affiliation(s)
- Caleb W. Curry
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- College of Arts and Sciences, Case Western Reserve University, Cleveland, OH
| | - Dylan Felt
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Kristin Kan
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
| | - Megan Ruprecht
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Xinzi Wang
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Gregory Phillips
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lauren B. Beach
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
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Intimate Partner Violence and Adult Asthma Morbidity: A Population-Based Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:4300-4309.e7. [PMID: 34364825 DOI: 10.1016/j.jaip.2021.06.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/01/2021] [Accepted: 06/16/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND The etiologies for difficult-to-control asthma are complex and incompletely understood. Intimate partner violence (IPV) is a pervasive problem and may play a role in difficult-to-control asthma. IPV is associated with increased prevalence of asthma. There are no prior studies evaluating IPV's association with adult asthma exacerbations. OBJECTIVE This study hypothesized that IPV exposure would be associated with increased asthma exacerbations, higher symptom burden, and poorer asthma control among adults. METHODS Analyses are based on 2634 adults who participated in the 2005 Behavioral Risk Factor Surveillance System survey, reported active asthma, and completed the asthma and IPV questions. We used multivariate logistic regression to examine the association of IPV with asthma morbidity outcomes while controlling for the following potential confounders: sex, race, education, health care coverage, smoking status, age, and body mass index. RESULTS The prevalence of IPV was 32.4%. IPV was associated with increased odds of an asthma exacerbation (adjusted odds ratio [AOR] = 1.75, 95% confidence interval [CI] = 1.26-2.43), higher symptom burden (AOR = 2.33, 95% CI = 1.53-3.55), and lack of asthma control (AOR = 2.23, 95% CI = 1.22-4.09) when using composite measures for these outcomes. When using single-item measures for outcomes, IPV was also associated with increased asthma-related emergency department or urgent care visits (AOR = 2.35, 95% CI = 1.56-3.54), other urgent provider visits (AOR = 1.84, 95% CI = 1.28-2.64), perceived asthma attacks (AOR = 1.53, 95% CI = 1.12-2.09), limitations (AOR = 2.07, 95% CI = 1.49-2.89), daytime symptoms (AOR = 1.92, 95% CI = 1.35-2.72), and nocturnal awakenings (AOR = 1.88, 95% CI = 1.32-2.69). CONCLUSIONS IPV is prevalent in adult asthmatics and consistently and significantly associated with worsened adult asthma morbidity, even after adjusting for key confounders. Further research is needed to more fully understand the mechanisms underlying these relationships.
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Ross MK, Romero T, Szilagyi PG. Adverse Childhood Experiences and Association With Pediatric Asthma Severity in the 2016-2017 National Survey of Children's Health. Acad Pediatr 2021; 21:1025-1030. [PMID: 33940207 PMCID: PMC8947844 DOI: 10.1016/j.acap.2021.04.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 04/14/2021] [Accepted: 04/23/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Prior studies have found that adverse childhood experiences (ACEs) are associated with asthma prevalence and onset, presumably related to stress and increased inflammation. We hypothesized that ACEs may be associated with asthma severity as well. We studied the 2016-2017 US National Survey of Children's Health dataset to explore the relationship between ACEs and pediatric asthma severity. METHODS We analyzed children ages 0 to 17 years old who had current caregiver-reported asthma diagnosed by a healthcare provider. We reported descriptive characteristics using chi-square analysis of variance (ANOVA) and used multivariable regression analysis to assess the relationship of cumulative and individual ACEs with asthma severity. Survey sampling weights and SAS survey procedures were implemented to produce nationally representative results. RESULTS Our analysis included 3691 children, representing a population of 5,465,926. Unadjusted analysis demonstrated that ACEs - particularly household economic hardship, parent/guardian served time in jail, witnessed household violence, or victim/witness of neighborhood violence - were each associated with higher odds of moderate/severe caregiver-reported asthma. After controlling for confounders possibly associated with both exposure (ACEs) and outcome (asthma severity), children who witnessed parent/adult violence had higher adjusted odds of caregiver-reported moderate/severe asthma. (1.67, confidence interval 1.05-2.64, P = .03) CONCLUSIONS: Intrafamilial witnessed household violence is significantly associated with caregiver-reported moderate/severe asthma.
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Affiliation(s)
- Mindy K. Ross
- University of California Los Angeles, Department of Pediatrics, Pediatric Pulmonology and Sleep Medicine, Los Angeles, Calif
| | - Tahmineh Romero
- University of California Los Angeles, Department of Medicine, Statistical Core, Los Angeles, Calif
| | - Peter G Szilagyi
- University of California Los Angeles, Department of Pediatrics, General Pediatrics, Los Angeles, Calif
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30
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Liu S, Lim YH, Pedersen M, Jørgensen JT, Amini H, Cole-Hunter T, Mehta AJ, So R, Mortensen LH, Westendorp RGJ, Loft S, Bräuner EV, Ketzel M, Hertel O, Brandt J, Jensen SS, Christensen JH, Sigsgaard T, Geels C, Frohn LM, Brborić M, Radonić J, Sekulic MT, Bønnelykke K, Backalarz C, Simonsen MK, Andersen ZJ. Long-term exposure to ambient air pollution and road traffic noise and asthma incidence in adults: The Danish Nurse cohort. ENVIRONMENT INTERNATIONAL 2021; 152:106464. [PMID: 33684733 DOI: 10.1016/j.envint.2021.106464] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Ambient air pollution is likely a risk factor for asthma, and recent evidence suggests the possible relevance of road traffic noise. OBJECTIVES We examined the associations of long-term exposure to air pollution and road traffic noise with adult-asthma incidence. METHODS We followed 28,731 female nurses (age > 44 years) from the Danish Nurse Cohort, recruited in 1993 and 1999, for first hospital contact for asthma from 1977 until 2015. We estimated residential annual mean concentrations of particulate matter with diameter < 2.5 µm (PM2.5) since 1990 and nitrogen dioxide (NO2) since 1970 with the Danish DEHM/UBM/AirGIS modeling system, and road traffic noise (Lden) since 1970 with the Nord2000 model. Time-varying Cox regression models were used to associate air pollution and road traffic noise exposure with asthma incidence. RESULTS During 18.6 years' mean follow-up, 528 out of 23,093 participants had hospital contact for asthma. The hazard ratios (HR) and 95% confidence intervals for asthma incidence associated with 3-year moving average exposures were 1.29 (1.03, 1.61) per 6.3 µg/m3 for PM2.5, 1.16 (1.07, 1.27) per 8.2 µg/m3 for NO2, and 1.12 (1.00, 1.25) per 10 dB for Lden. The HR for NO2 remained unchanged after adjustment for either PM2.5 or Lden, while the HRs for PM2.5 and Lden attenuated to unity after adjustment for NO2. CONCLUSIONS Long-term exposure to air pollution was associated with adult-asthma incidence independently of road traffic noise, with NO2 most relevant. Road traffic noise was not independently associated with adult-asthma incidence.
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Affiliation(s)
- Shuo Liu
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marie Pedersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jeanette T Jørgensen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Heresh Amini
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Thomas Cole-Hunter
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Centre for Air pollution, energy and health Research (CAR), University of Sydney, Sydney, Australia
| | - Amar J Mehta
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Statistics Denmark, Copenhagen, Denmark
| | - Rina So
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Laust H Mortensen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Statistics Denmark, Copenhagen, Denmark
| | - Rudi G J Westendorp
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Elvira V Bräuner
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, University of Copenhagen, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, United Kingdom
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate, Aarhus University, Roskilde, Denmark
| | - Steen S Jensen
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | | | - Torben Sigsgaard
- Department of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Lise M Frohn
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Maja Brborić
- University of Novi Sad, Faculty of Technical Sciences, Department of Environmental Engineering and Occupational Safety and Health, Novi Sad, Serbia
| | - Jelena Radonić
- University of Novi Sad, Faculty of Technical Sciences, Department of Environmental Engineering and Occupational Safety and Health, Novi Sad, Serbia
| | - Maja Turk Sekulic
- University of Novi Sad, Faculty of Technical Sciences, Department of Environmental Engineering and Occupational Safety and Health, Novi Sad, Serbia
| | - Klaus Bønnelykke
- COPSAC (Copenhagen Prospective Studies on Asthma in Childhood), Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Mette K Simonsen
- Diakonissestiftelsen, Frederiksberg, Denmark; The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Zorana J Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
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Dong Y, Liu H, Zheng T. Association between Green Space Structure and the Prevalence of Asthma: A Case Study of Toronto. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5852. [PMID: 34072529 PMCID: PMC8199317 DOI: 10.3390/ijerph18115852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 12/21/2022]
Abstract
Asthma is a chronic inflammatory disease that can be caused by various factors, such as asthma-related genes, lifestyle, and air pollution, and it can result in adverse impacts on asthmatics' mental health and quality of life. Hence, asthma issues have been widely studied, mainly from demographic, socioeconomic, and genetic perspectives. Although it is becoming increasingly clear that asthma is likely influenced by green spaces, the underlying mechanisms are still unclear and inconsistent. Moreover, green space influences the prevalence of asthma concurrently in multiple ways, but most existing studies have explored only one pathway or a partial pathway, rather than the multi-pathways. Compared to greenness (measured by Normalized Difference Vegetation Index, tree density, etc.), green space structure-which has the potential to impact the concentration of air pollution and microbial diversity-is still less investigated in studies on the influence of green space on asthma. Given this research gap, this research took Toronto, Canada, as a case study to explore the two pathways between green space structure and the prevalence of asthma based on controlling the related covariates. Using regression analysis, it was found that green space structure can protect those aged 0-19 years from a high risk of developing asthma, and this direct protective effect can be enhanced by high tree diversity. For adults, green space structure does not influence the prevalence of asthma unless moderated by tree diversity (a measurement of the richness and diversity of trees). However, this impact was not found in adult females. Moreover, the hypothesis that green space structure influences the prevalence of asthma by reducing air pollution was not confirmed in this study, which can be attributed to a variety of causes.
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Affiliation(s)
- Yuping Dong
- School of Architecture and Urban Planning, Huazhong University of Science and Technology, Wuhan 430074, China; (Y.D.); (T.Z.)
- Center for Urban and Rural Planning Support Research, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Helin Liu
- School of Architecture and Urban Planning, Huazhong University of Science and Technology, Wuhan 430074, China; (Y.D.); (T.Z.)
- Center for Urban and Rural Planning Support Research, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Tianming Zheng
- School of Architecture and Urban Planning, Huazhong University of Science and Technology, Wuhan 430074, China; (Y.D.); (T.Z.)
- Center for Urban and Rural Planning Support Research, Huazhong University of Science and Technology, Wuhan 430074, China
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Nishioka D, Saito J, Ueno K, Kondo N. Single-parenthood and health conditions among children receiving public assistance in Japan: a cohort study. BMC Pediatr 2021; 21:214. [PMID: 33941113 PMCID: PMC8091550 DOI: 10.1186/s12887-021-02682-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/14/2021] [Indexed: 11/23/2022] Open
Abstract
Background Children’s healthy development is important. While governmental public assistance benefits financially troubled families, it cannot compensate for a lack of social support. Single-parenthood is a health risk factor for children owing to low-income-associated food insecurity and stress. No study has investigated the association between single-parenthood and health status in children from families receiving public assistance. This study aimed to examine the association between single-parent households and children’s health among public assistance recipients in Japan by using linkage data of two municipal public assistance databases and administrative medical assistance data. Methods We performed a retrospective cohort study. Public assistance for households below the poverty line ensures income security and medical care. The study population included all children aged 15 or younger availing public assistance in January 2016. We extracted recipients’ sociodemographic factors from January 2016 and identified the incidence of childhood diseases’ diagnosis until December 2016 as the outcome, including 1) acute upper respiratory infections; 2) influenza and pneumonia; 3) injuries, including fractures; 4) intestinal infectious diseases; 5) conjunctivitis; 6) asthma; 7) allergic rhinitis; 8) dermatitis and eczema, including atopic dermatitis; and 9) diseases of the oral cavities, salivary glands, and jaws, such as tooth decay or dental caries. Results Among the 573 children, 383 (66.8%) lived in single-parent households. A multivariable Poisson regression, with a robust standard error estimator, showed that single-parenthood is associated with a higher prevalence of asthma (incidence ratio [IR] = 1.62; 95% confidence interval [CI], 1.16–2.26), allergic rhinitis (IR = 1.41; 95% CI, 1.07–1.86), dermatitis and eczema (IR = 1.81; 95% CI, 1.21–2.70), and dental diseases (IR = 1.79; 95% CI, 1.33–2.42) compared to non-single parent households, whereas little association was found between single-parenthood and children’s acute health conditions. Conclusions Among public assistance recipients, living in single-parent households may be a risk factor for children’s chronic diseases. The Japanese public assistance system should provide additional social care for single-parent households. Further investigations are necessary using more detailed longitudinal data, including environmental factors, the severity of children’s health conditions, contents of medical treatments, and broader socioeconomic factors. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02682-4.
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Affiliation(s)
- Daisuke Nishioka
- Department of Medical Statistics Research & Development Center, Osaka Medical and Pharmaceutical University, Daigakumachi 2-7, Takatsuki-shi, Osaka, Japan.,Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-0033, Japan.,Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Junko Saito
- Behavioral Science Division, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Keiko Ueno
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-0033, Japan.,Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Naoki Kondo
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-0033, Japan. .,Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.
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Asthmatic Symptoms in Children and Adolescents: the Role of Maternal Experiences of Racial Discrimination. J Racial Ethn Health Disparities 2021; 9:938-945. [PMID: 33821449 DOI: 10.1007/s40615-021-01032-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 03/11/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
Emerging evidence suggests that vicarious racial experiences of discrimination may negatively influence child health. Few studies have focus on childhood asthma symptoms and potential moderators of such relationship. METHODS We used two population-based cross-sectional studies from the Social Change Allergy and Asthma in Latin America project in Salvador, Brazil. A total of 1003 children and mothers interviewed in 2006 were included, of whom 873 were reached again in 2013. Vicarious racial discrimination was assessed in mothers by applying the Experiences of Discrimination scale. Data on wheeze and environmental exposures were collected with standardized questionnaires. Levels of allergen-specific IgE were measured to identify atopy. Generalized estimating equations were used to estimate the association between maternal discrimination and wheezing and asthma phenotypes. Interaction terms were evaluated to identify whether mothers' mental health and family social support modified such associations. RESULTS Children whose mothers reported racial discrimination had greater odds of have asthma symptoms (OR 1.75; 95% CI 1.15-2.67) and non-atopic asthma (OR 1.92; 95% CI 1.09-3.40). When we considered effect modification by social support, we found a higher ORs when the level of social support was lower (OR 2.43; 95% IC 1.19-4.97) than when the level of social support was higher (OR 1.12; CI 0.64-1.96). CONCLUSION Maternal discrimination was associated with asthma symptoms and with non-atopic phenotype among their children. Enjoying wider social support network appears to buffer the effect on asthmatic symptoms. Intervention on childhood asthma needs to incorporate strategies that target the family.
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The Association between Vigorous Physical Activity and Stress in Adolescents with Asthma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073467. [PMID: 33810531 PMCID: PMC8036664 DOI: 10.3390/ijerph18073467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 01/14/2023]
Abstract
Asthma is a very common condition that affects 5-10% of the global population, and its prevalence is increasing. Vigorous physical activity (PA) is effective in improving cardiorespiratory fitness and managing stress. This study aimed to investigate the association between vigorous PA and stress among Korean adolescents with asthma using large-scale survey data. The questionnaire data of 57,303 adolescents were analyzed using raw data from the 2019 Korea Youth Risk Behavior Web-Based Survey. We performed logistic regression analysis to calculate the stress odds ratios (ORs) and 95% confidence intervals (CIs) for asthma and non-asthma groups using models 1 and 2. We also performed logistic regression analysis to calculate the stress OR for the asthma group with vigorous PA and non-vigorous PA using models 1, 2, and 3. Model 1 was adjusted for age, sex, obesity, smoking, and alcohol status; model 2 was further adjusted for household income, academic achievement, and comorbidities. Model 3 was further adjusted for moderate activity and resistance exercise. The OR of stress was 20% higher in the asthma group than in the non-asthma group (p < 0.05). In the fully adjusted models, the OR for the non-asthma group with vigorous PA versus non-vigorous PA was 0.89 (95% CI: 0.84-0.94). However, the OR for the asthma group with vigorous PA versus non-vigorous PA was 0.70 (95% CI: 0.57-0.86), indicating that adolescents who engage in vigorous PA had lower stress in the asthma group (p < 0.05). This study demonstrated that adolescents with asthma had higher stress levels than those without asthma; however, vigorous PA was associated with lower stress. These effects were more pronounced in adolescents with asthma.
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Compounding Effects of Social Vulnerability and Recurring Natural Disasters on Mental and Physical Health. Disaster Med Public Health Prep 2021; 16:1013-1021. [PMID: 33757617 DOI: 10.1017/dmp.2020.476] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study evaluated the relationships between the occurrence of recent and recurring natural disasters on the incidence of acute and chronic health outcomes at the census tract level in 500 cities across the United States between 2001 and 2015. METHODS Using the Centers for Disease Control and Prevention (CDC) 500 cities data set, the CDC Social Vulnerability Index, and the US Small Business Administration (SBA) Disaster Loan Database, we modeled the incidence of self-reported, poor mental and physical health, or a clinical diagnosis of high blood pressure or asthma in census tracts (N = 27 204 tracts in 500 cities) that had experienced recent or recurring natural disasters while controlling for social and environmental risk factors. RESULTS Communities that experienced a natural disaster in the previous 5 years compared to those that had not had a higher incidence of poor mental health (RR: 1.02, 95% CI: 1.01-1.02), poor physical health (RR: 1.03, 95% CI: 1.02-1.04), high blood pressure (RR: 1.04, 95% CI: 1.02-1.05), and asthma (RR: 1.01, 95% CI: 1.01-1.02). The incidence of these poor health outcomes increased 1-2% with each additional year that a community experienced a disaster. CONCLUSIONS Prevention and preparedness plans that work to build resilience in communities before disasters should focus on closing the gap in environmental and social determinants that have been linked with disproportionate health burdens and slow recovery post-disaster.
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Sharma VK, Singh TG. Navigating Alzheimer's Disease via Chronic Stress: The Role of Glucocorticoids. Curr Drug Targets 2021; 21:433-444. [PMID: 31625472 DOI: 10.2174/1389450120666191017114735] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/24/2019] [Accepted: 09/25/2019] [Indexed: 12/22/2022]
Abstract
Alzheimer's disease (AD) is a chronic intensifying incurable progressive disease leading to neurological deterioration manifested as impairment of memory and executive brain functioning affecting the physical ability like intellectual brilliance, common sense in patients. The recent therapeutic approach in Alzheimer's disease is only the symptomatic relief further emerging the need for therapeutic strategies to be targeted in managing the underlying silent killing progression of dreaded pathology. Therefore, the current research direction is focused on identifying the molecular mechanisms leading to the evolution of the understanding of the neuropathology of Alzheimer's disease. The resultant saturation in the area of current targets (amyloid β, τ Protein, oxidative stress etc.) has led the scientific community to rethink of the mechanistic neurodegenerative pathways and reprogram the current research directions. Although, the role of stress has been recognized for many years and contributing to the development of cognitive impairment, the area of stress has got the much-needed impetus recently and is being recognized as a modifiable menace for AD. Stress is an unavoidable human experience that can be resolved and normalized but chronic activation of stress pathways unsettle the physiological status. Chronic stress mediated activation of neuroendocrine stimulation is generally linked to a high risk of developing AD. Chronic stress-driven physiological dysregulation and hypercortisolemia intermingle at the neuronal level and leads to functional (hypometabolism, excitotoxicity, inflammation) and anatomical remodeling of the brain architecture (senile plaques, τ tangles, hippocampal atrophy, retraction of spines) ending with severe cognitive deterioration. The present review is an effort to collect the most pertinent evidence that support chronic stress as a realistic and modifiable therapeutic earmark for AD and to advocate glucocorticoid receptors as therapeutic interventions.
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Affiliation(s)
- Vivek Kumar Sharma
- Government College of Pharmacy, Rohru, District Shimla, Himachal Pradesh-171207, India.,Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab-140401, India
| | - Thakur Gurjeet Singh
- Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab-140401, India
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The Association of Asthma, Sexual Identity, and Inhaled Substance Use among U.S. Adolescents. Ann Am Thorac Soc 2021; 18:273-280. [PMID: 33027599 DOI: 10.1513/annalsats.202001-062oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Rationale: Minority sexual identity appears to confer asthma risks. Although associations between inhaled substances and asthma are established, these have not been examined among sexual minority youths. Given sexual minority adolescents' disproportionately high rates of substance use, research is needed to fill this important gap.Objectives: Using a representative sample of adolescents from the United States, we 1) examined associations among asthma, sexual identity, and inhaled substance use and tested 2a) whether sexual identity moderates relationships between asthma and inhaled substance use and 2b) whether inhaled substance use mediates associations between sexual identity and asthma.Methods: Data are from the 2015 and 2017 Youth Risk Behavior Surveillance Survey. Adolescents (n = 30,113) reported if they were ever diagnosed with asthma, current use of cigarettes, cigars and/or cigarillos, marijuana, and electronic vapor products and if they ever used inhalants or synthetic marijuana. We used logistic regression to examine associations between asthma, sexual identity, and inhaled substance use controlling for age, race or ethnicity, and body mass index percentile, stratified by sex.Results: Lesbian, gay, and bisexual respondents had higher relative risks for asthma than heterosexual youth. Sexual minority female youths had significantly higher relative risks than heterosexual female youths for use of every inhaled substance. There were few sexual identity differences in inhaled substance use among male youths. Inhaled substance use was significantly associated with higher risks for asthma. In general, associations between each individual inhaled substance and asthma did not differ between sexual minority and heterosexual youths. However, when all inhaled substances were added into the models concurrently, inhaled substance use appeared to mediate associations with asthma among lesbian and bisexual female youths, and partially mediated these associations among sexual minority male youths.Conclusions: Sexual identity and inhaled substance use appear to play important roles in asthma risk. However, these variables do not fully explain the risk, suggesting that other unmeasured variables (e.g., stress and victimization) may be implicated in risks for both inhaled substance use and asthma. It is important that clinicians providing care to adolescents ask about sexual identity and inhaled substance use. Effective approaches to reducing inhaled substance use among adolescents, especially sexual minorities, are needed.
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Spellenberg C, Heusser P, Büssing A, Savelsbergh A, Cysarz D. Binary symbolic dynamics analysis to detect stress-associated changes of nonstationary heart rate variability. Sci Rep 2020; 10:15440. [PMID: 32963263 PMCID: PMC7509783 DOI: 10.1038/s41598-020-72034-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/24/2020] [Indexed: 11/25/2022] Open
Abstract
Psychological stress may have harmful physiological effects and result in deteriorating health. Acute psychological stress acts also on cardiac autonomic regulation and may lead to nonstationarities in the interbeat interval series. We address the requirement of stationary RR interval series to calculate frequency domain parameters of heart rate variability (HRV) and use binary symbolic dynamics derived from RR interval differences to overcome this obstacle. 24 healthy subjects (12 female, 20–35 years) completed the following procedure: waiting period, Trier Social Stress Test to induce acute psychological stress, recovery period. An electrocardiogram was recorded throughout the procedure and HRV parameters were calculated for nine 5-min periods. Nonstationarities in RR interval series were present in all periods. During acute stress the average RR interval and SDNN decreased compared to rest before and after the stress test. Neither low frequency oscillations (LF), high frequency oscillations (HF) nor LF/HF could unambiguously reflect changes during acute stress in comparison to rest. Pattern categories derived from binary symbolic dynamics clearly identified acute stress and accompanying alterations of cardiac autonomic regulation. Methods based on RR interval differences like binary symbolic dynamics should be preferred to overcome issues related to nonstationarities.
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Affiliation(s)
- Conrad Spellenberg
- Medical Anthropology, Institute of Integrative Medicine, Witten/Herdecke University, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany.
| | - Peter Heusser
- Medical Anthropology, Institute of Integrative Medicine, Witten/Herdecke University, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany
| | - Arndt Büssing
- Medical Anthropology, Institute of Integrative Medicine, Witten/Herdecke University, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany.,Quality of Life, Spirituality and Coping, Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Germany
| | - Andreas Savelsbergh
- Division of Functional Genomics, Center for Biomedical Research and Education ZBAF, Witten/Herdecke University, Witten, Germany
| | - Dirk Cysarz
- Integrated Curriculum for Anthroposophic Medicine, Witten/Herdecke University, Herdecke, Germany.,Physiologic Rhythm Research, Witten/Herdecke University, Herdecke, Germany
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da Costa ADPV, Dos Santos LM, Feitosa CA, de Miranda CT. Maternal common mental disorder over time and asthma control: The role of social support. Pediatr Allergy Immunol 2020; 31:628-635. [PMID: 32202344 DOI: 10.1111/pai.13249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite therapeutic advances, asthma prevalence remains high. Psychosocial factors, including maternal mental disorders, may be involved. This study aims to evaluate the association of maternal common mental disorders (CMDs) and their change over time with asthma morbidity in the child and to observe the effect of social support on this association. METHODS This prospective study involved 189 dyads of mothers and their asthmatic children aged between 2 and 14 years, assisted in specialized outpatient clinics. We measured the association of maternal CMD evolution (absent, maintained, or improved over time) with asthma control and visits to the emergency department (ED) due to asthma attacks through Poisson regression analysis. We further stratified the sample according to social support levels to identify a possible effect of this variable on the association of maternal psychological symptoms with asthma morbidity. RESULTS Compared with mothers who maintained CMD over time, maternal CMD absence had a protective effect on the occurrence of visits to the ED (RR: 0.45; 95% CI: 0.26-0.79) and maternal CMD improvement was associated with lower risk of uncontrolled asthma in the child (RR: 0.60; 95% CI: 0.37-0.97). There was a stronger association of maternal CMD improvement with asthma control in the child only for the stratum of mothers with high social support in its three dimensions (affective-social interaction, emotional-informational, and material dimensions). CONCLUSIONS Maternal CMD absence and improvement over the study period were protective factors for uncontrolled asthma in the child, mainly in the presence of high social support.
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Affiliation(s)
| | - Leticia Marques Dos Santos
- Institute of Humanities Arts and Sciences Professor Milton Santos, Federal University of Bahia, Salvador, Brazil
| | - Caroline Alves Feitosa
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil.,UNIFESP, Federal University of São Paulo, São Paulo, Brazil
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Sourg HAA, Ahmed ABM, Elhakeem RF, Lutfi MF. Indicators of metabolic syndrome in normotensive normoglycemic asthmatic patients. J Clin Transl Res 2020; 6:27-35. [PMID: 33330745 PMCID: PMC7735662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/22/2020] [Accepted: 07/07/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Pathophysiology of hypertension and bronchial asthma (BA) shares many similarities, especially those related to the metabolic syndrome (MS). AIM In this study, the indicators of the MS were evaluated in normoglycemic normotensive asthmatic patients to clarify if the components of the MS can still interact to increase the risk of BA, provided that blood pressure and glucose level are kept within the normal physiological ranges. METHODS Body mass index (BMI), waist circumference (WC), mean arterial blood pressure (MABP), fasting blood glucose (FBG) and fasting blood insulin (FBI) levels, the quantitative insulin sensitivity check index (QUICKI), serum lipid profile, and spirometric measurements were all compared between 120 asthmatic patients and 59 non-asthmatic subjects. Cigarette smoking, pregnancy, age below 20 years or above 40 years, diabetes mellitus and hypertension, and other chronic diseases were excluded from all studied groups. RESULTS Asthmatic patients demonstrated higher WC (median [25th-75th interquartile]=88.50 [78.00-101.75], FBI [19.98 (11.12-40.14)], and triglyceride (TG) level [109.5 (76.50-134.0)]) compared with non-asthmatic subjects (81.00 [72.00-92.00], 13.78 [8.84-30.24], and 89.00 [64.25-104], P<0.05). QUICKI and MABP were lower in asthmatic patients (0.310 [0.283-0.338] and 86.66 [83.33-93.33]) compared with non-asthmatic subjects (0.320 [0.297-0.353] and 93.33 [83.33-93.33]), (P<0.05). BMI, FBG, low-density lipoprotein, high-density lipoprotein, and total cholesterol levels were comparable in the studied groups. CONCLUSIONS The present finding gives further evidence for higher WC, FBI, TG level, and insulin resistance in normotensive, normoglycemic asthmatic patients compared to healthy controls. RELEVANCE FOR PATIENTS The findings of this study suggested that abdominal obesity, hypertriglyceridemia, hyperinsulinemia, and insulin resistance may still be interacting and hence increase the risk of BA in normotensive, normoglycemic subjects.
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Affiliation(s)
- Hanadi Abdelgadir Ahmed Sourg
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
- Faculty of Medicine, Al Neelain University, Khartoum, Sudan
| | | | | | - Mohamed Faisal Lutfi
- College of Medicine, Qassim University, Qassim, KSA
- Nile College of Medicine Khartoum, Sudan
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López-Lois B, González-Barcala FJ, Facal D. Application of mindfulness techniques in patients with asthma or COPD. J Asthma 2020; 58:1237-1246. [PMID: 32475186 DOI: 10.1080/02770903.2020.1776729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Mindfulness is the ability to pay attention to the present moment without judgment. Mindfulness interventions have proved to be effective in improving the management of psychological symptoms of chronic patients. The objective of this work is to update the evidence about the effects of mindfulness interventions on psychological symptoms in patients with asthma and chronic obstructive pulmonary disease (COPD). METHODOLOGY Data sources were PubMed and PsycInfo. From a first set of 109 articles, 12 about mindfulness-interventions in adult populations with asthma or COPD were finally included in the review. RESULTS Of the total of 12 studies included, 5 were qualitative and 6 quantitative (5 randomized controlled trials). One quantitative study reported long-term psychological effects in asthma patients, two studies reported short-term psychological effects in COPD patients. Relevant themes identified in qualitative studies included increased awareness, development of new relationships with dyspnea, including new cognitive strategies, and slowing down. CONCLUSIONS Mindfulness interventions could increase psychological resources in situations related to asthma and COPD symptoms. More randomized control trials are needed.
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Affiliation(s)
- Begoña López-Lois
- Departamento de Psicoloxía Evolutiva, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Francisco-Javier González-Barcala
- Department of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Spanish Biomedical Research Networking Centre-CIBERES, Madrid, Spain.,Department of Respiratory Medicine, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - David Facal
- Departamento de Psicoloxía Evolutiva, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
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Curry CW, Felt D, Beach LB, Ruprecht MM, Wang X, Phillips GL. Lifetime Asthma Prevalence and Correlates Among US Youths by Sexual Identity and Race/Ethnicity, 2009-2017. Am J Public Health 2020; 110:e1-e8. [PMID: 32437280 PMCID: PMC7287544 DOI: 10.2105/ajph.2020.305664] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2020] [Indexed: 12/28/2022]
Abstract
Objectives. To comprehensively assess asthma disparities and identify correlates in youths at the intersections of sex, sexual identity, and race/ethnicity in the United States.Methods. We obtained a diverse sample of youths (n = 307 073) from the Centers for Disease Control and Prevention's Youth Risk Behavior Survey. We pooled data across 107 jurisdiction-years (2009-2017). We calculated lifetime asthma prevalence by sexual identity, race/ethnicity, and their intersections-stratified by sex. We developed multivariable weighted logistic regression models to examine the impact of selected correlates on lifetime asthma prevalence.Results. Lesbian, gay, and bisexual youths have significant disparities in asthma prevalence compared with heterosexual peers. Moreover, across sex, higher prevalence of lifetime asthma was seen for most sexual identity and race/ethnicity subpopulations (27 of 30) when compared with White heterosexual sex-matched participants. Selected traditional risk factors (overweight, obese, and smoking) and bullying tended to attenuate odds among groups, especially those with a minority sexual identity.Conclusions. Asthma inequities at the intersection of sexual identity and race/ethnicity are substantive. Future studies should investigate the mechanisms contributing to these disparities to promote health equity among vulnerable youth populations. (Am J Public Health. Published online ahead of print May 21, 2020: e1-e8. doi:10.2105/AJPH.2020.305664).
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Affiliation(s)
- Caleb W Curry
- Caleb W. Curry, Dylan Felt, Lauren B. Beach, Megan M. Ruprecht, Xinzi Wang, and Gregory L. Phillips II are with the Department of Medical Social Sciences and the Evaluation, Data Integration, and Technical Assistance Program at Northwestern University, Chicago, IL. Caleb W. Curry is also affiliated with Case Western Reserve University, Cleveland, OH
| | - Dylan Felt
- Caleb W. Curry, Dylan Felt, Lauren B. Beach, Megan M. Ruprecht, Xinzi Wang, and Gregory L. Phillips II are with the Department of Medical Social Sciences and the Evaluation, Data Integration, and Technical Assistance Program at Northwestern University, Chicago, IL. Caleb W. Curry is also affiliated with Case Western Reserve University, Cleveland, OH
| | - Lauren B Beach
- Caleb W. Curry, Dylan Felt, Lauren B. Beach, Megan M. Ruprecht, Xinzi Wang, and Gregory L. Phillips II are with the Department of Medical Social Sciences and the Evaluation, Data Integration, and Technical Assistance Program at Northwestern University, Chicago, IL. Caleb W. Curry is also affiliated with Case Western Reserve University, Cleveland, OH
| | - Megan M Ruprecht
- Caleb W. Curry, Dylan Felt, Lauren B. Beach, Megan M. Ruprecht, Xinzi Wang, and Gregory L. Phillips II are with the Department of Medical Social Sciences and the Evaluation, Data Integration, and Technical Assistance Program at Northwestern University, Chicago, IL. Caleb W. Curry is also affiliated with Case Western Reserve University, Cleveland, OH
| | - Xinzi Wang
- Caleb W. Curry, Dylan Felt, Lauren B. Beach, Megan M. Ruprecht, Xinzi Wang, and Gregory L. Phillips II are with the Department of Medical Social Sciences and the Evaluation, Data Integration, and Technical Assistance Program at Northwestern University, Chicago, IL. Caleb W. Curry is also affiliated with Case Western Reserve University, Cleveland, OH
| | - Gregory L Phillips
- Caleb W. Curry, Dylan Felt, Lauren B. Beach, Megan M. Ruprecht, Xinzi Wang, and Gregory L. Phillips II are with the Department of Medical Social Sciences and the Evaluation, Data Integration, and Technical Assistance Program at Northwestern University, Chicago, IL. Caleb W. Curry is also affiliated with Case Western Reserve University, Cleveland, OH
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Landeo-Gutierrez J, Forno E, Miller GE, Celedón JC. Exposure to Violence, Psychosocial Stress, and Asthma. Am J Respir Crit Care Med 2020; 201:917-922. [PMID: 31801032 PMCID: PMC7159436 DOI: 10.1164/rccm.201905-1073pp] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 12/04/2019] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jeremy Landeo-Gutierrez
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania; and
| | - Erick Forno
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania; and
| | - Gregory E. Miller
- Institute for Policy Research and Department of Psychology, Northwestern University, Evanston, Illinois
| | - Juan C. Celedón
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania; and
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Miadich SA, Everhart RS, Greenlee J, Winter MA. The impact of cumulative stress on asthma outcomes among urban adolescents. J Adolesc 2020; 80:254-263. [PMID: 32222611 PMCID: PMC11467749 DOI: 10.1016/j.adolescence.2019.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 12/11/2019] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Many families living in low-income, urban areas experience a number of stressors (e.g., poverty, neighborhood stress, family functioning) that place adolescents at risk for worse asthma outcomes. Adolescents may face additional challenges (e.g., peer pressure, school stress) that add to their overall stress and influence their disease care and health outcomes. The current study examined the impact of a cumulative risk model of stressors including poverty, neighborhood stress, school stress, peer pressure, and caregiver-adolescent conflict on asthma outcomes (e.g., emergency department [ED] visits, asthma control, quality of life [QOL]) among urban adolescents (13-17 years). METHODS Data were collected from 61 urban families of adolescents with asthma (54.1% female; 93.4% African American) in the United States. Caregivers and adolescents completed questionnaires assessing stressors and asthma outcomes separately during a research session. RESULTS Cumulative risk was significantly associated with worse adolescent QOL and asthma control, and more ED visits. The cumulative risk index was also a more robust predictor of QOL and asthma control than any one individual predictor. Poverty, neighborhood stress, and school stress emerged as individual predictors of ED visits. Further, adolescents with well-controlled asthma had significantly lower neighborhood and school-related stress scores. CONCLUSIONS Findings suggest that beyond the risk conferred by individual risk factors, an accumulation of stress can have an especially negative impact on asthma outcomes for urban adolescents. Future intervention work aimed at improving asthma outcomes should consider incorporating strategies for minimizing overlapping sources of stress in adolescents' daily lives.
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Affiliation(s)
- Samantha A Miadich
- Department of Psychology, Arizona State University, Tempe, AZ, USA; Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Richmond, 23284-2018, VA, USA.
| | - Robin S Everhart
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Richmond, 23284-2018, VA, USA
| | | | - Marcia A Winter
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Richmond, 23284-2018, VA, USA
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Abstract
Several factors have been associated with the development of asthma and asthma-related morbidity and mortality. Exposures in the environment such as allergens and air pollutants have traditionally been linked to the risk of asthma and asthma outcomes. More recent literature has identified chronic psychosocial stress as an additional environmental exposure to consider in relation to asthma. Adverse childhood events (ACEs) and chronic and toxic stress have been associated with chronic diseases such as cardiovascular disease, cancer, and chronic obstructive pulmonary disease. Chronic stress has also been shown to result in biological changes such as expression of immunologic genes, changes in expression of the beta-adrenergic (B2AR) and the glucocorticoid receptor (GR-α) genes, cytokine regulation, and alterations in the hypothalamic pituitary axis and cortisol levels which all may affect asthma pathophysiology and therapeutic response among patients exposed to chronic stress. Recent research has revealed associations between ACEs and chronic and toxic stress and asthma risk in pre-conception to early childhood as well as morbidity and response to asthma treatments among pediatric and adult age groups. As some populations are more significantly impacted by asthma such as racial and ethnic minority groups, the influence of psychosocial stress has also been explored as a potential factor responsible for observed disparities in asthma prevalence and outcomes among these groups which also experience higher rates of psychosocial stress. Racial discrimination has specifically been shown to affect asthma-related outcomes among minority groups. Interventions to address the impact of chronic and toxic stress such as yoga and meditation have been shown to improve asthma outcome measures. Chronic and toxic stress is an important environmental exposure to further consider as we continue to explore the differences in underlying asthma pathophysiology leading to various disease phenotypes among patients and clinical/therapeutic response to interventions and treatments.
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M. M, K. M, M. B, B. H. Effect of 6 months of yoga practice on quality of life among patients with asthma: A randomized control trial. ADVANCES IN INTEGRATIVE MEDICINE 2019. [DOI: 10.1016/j.aimed.2018.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sohn KH, Song WJ, Kim SH, Jang HC, Kim KW, Chang YS. Chronic cough, not asthma, is associated with depression in the elderly: a community-based population analysis in South Korea. Korean J Intern Med 2019; 34:1363-1371. [PMID: 31610633 PMCID: PMC6823556 DOI: 10.3904/kjim.2018.187] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 09/27/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND/AIMS Depression and allergic diseases, including asthma, are frequently reported as comorbid conditions. However, their associations have been rarely examined in community-based elderly populations. METHODS The analyses were performed using the baseline data set of the Korean Longitudinal Study of Health and Aging, which consists of 1,000 elderly participants (aged > 65 years) randomly recruited from an urban community. Depression was assessed using the Geriatric Depression Scale, Center for Epidemiologic Studies Depression Scale, and Hamilton Rating Scale for Depression. Major and minor depressive disorders were diagnosed by psychiatrists. Allergic conditions were assessed using structured questionnaires, lung function, and skin prick test. Quality of life and comorbidities were assessed using structured questionnaires. RESULTS Prevalence of asthma and major depressive disorder were 5.4% and 5.3%, respectively. The rate of depression was not significantly different between the non-asthmatic and asthmatic groups. No correlation was observed between the scores obtained using the depression scales and self-reported asthma. However, chronic, frequent, and nocturnal cough were significantly associated with depression and scores obtained using the depression scales, which remained significant in multivariate logistic regression analyses (chronic cough: odds ratio [OR], 3.23; 95% confidence interval [CI], 2.57 to 12.74; p = 0.04). Rhinitis was independently associated with high Mini-Mental State Examination scores (OR, 1.11; 95% CI, 1.05 to 1.17; p < 0.001) and low 36-item short-form (OR, 0.96; 95% CI, 0.80 to 0.98; p = 0.002). CONCLUSION Depression may not be significantly associated with asthma and allergic diseases in elderly populations, but cough is a significant factor affecting depression.
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Affiliation(s)
- Kyoung-Hee Sohn
- Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Woo-Jung Song
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Allergy and Immunology, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sae-Hoon Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hak-Chul Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Endocrinology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yoon-Seok Chang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Correspondence to Yoon-Seok Chang, M.D. Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea Tel: +82-31-787-7023 Fax: +82-31-716-8349 E-mail:
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Underner M, Goutaudier N, Peiffer G, Perriot J, Harika-Germaneau G, Jaafari N. [Influence of post-traumatic stress disorder on asthma]. Presse Med 2019; 48:488-502. [PMID: 31005500 DOI: 10.1016/j.lpm.2019.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/04/2019] [Accepted: 03/05/2019] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Exposure to a traumatic event may not only lead to a large variety of mental disorders, such as post-traumatic stress disorder (PTSD) but also respiratory symptoms and/or respiratory diseases, as asthma. OBJECTIVES Systematic literature review of data on the impact of post-traumatic stress disorder on asthma. DOCUMENTARY SOURCES Medline, on the period 1980-2018 with the following keywords: "PTSD" or "post-traumatic stress disorder" or "post-traumatic stress disorder" and "asthma", limits "title/abstract"; the selected languages were English or French. Among 141 articles, 23 abstracts have given use to a dual reading to select 14 studies. RESULTS While PTSD may develop 4 weeks after being exposed to a traumatic event during which the physical integrity of the person has been threatened, it might also develop several months or years later. PTSD has been reported to be a risk factor for asthma and also a factor that might enhance a preexisting asthma. It is also important to note that this relation has been highlighted among several populations, traumatic events and regardless the gender and/or cultural factors. Despite its impact on the development of asthma, in asthmatic patients, PTSD may be responsible for poor asthma control, increased rates of healthcare use (visit in the emergency department and/or hospitalization for asthma) and poor asthma-related quality of life. The study of the association between PTSD and asthma have to take into account some potentially confounding factors, such as smoking status and dust exposure (e.g.: asthma following the terrorist attacks of the World Trade Center). Less is known regarding the potential mechanisms involved in the association between PTSD and asthma. Several factors including the nervous system, the hypothalamo-pituitary-adrenal axis, the inflammatory response and the immune system may explain the association. CONCLUSION PTSD is a risk factor for the development of asthma and for the worsening of preexisting asthma. In asthmatic patients, it is of primary importance to systematically screen potential PTSD that might be developed after a traumatic event or a preexisting traumatic condition. Moreover, after exposure to a traumatic event, a special attention needs to be paid to somatic reactions such as asthma. The majority of studies having been conducted on American samples, replicating studies among European samples appears of prime importance in order to add a body of knowledge on the association between somatic and psychiatric conditions.
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Affiliation(s)
- Michel Underner
- Université de Poitiers, centre hospitalier Henri-Laborit, unité de recherche clinique, 86021 Poitiers, France.
| | - Nelly Goutaudier
- Université de Poitiers, centre de recherches sur la cognition et l'apprentissage, UMR CNRS 7295 MSHS, 86073 Poitiers cedex 9, France
| | - Gérard Peiffer
- CHR Metz-Thionville, service de pneumologie, 57038 Metz, France
| | - Jean Perriot
- Centre de tabacologie, dispensaire Émile-Roux, 63100 Clermont-Ferrand, France
| | - Ghina Harika-Germaneau
- Université de Poitiers, centre hospitalier Henri-Laborit, unité de recherche clinique, 86021 Poitiers, France
| | - Nematollah Jaafari
- Université de Poitiers, centre hospitalier Henri-Laborit, unité de recherche clinique, 86021 Poitiers, France
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Duerson W, Lafer M, Ahmed O, Bandler I, Wang B, Lieberman S, Lebowitz R. Health Care Disparities in Patients Undergoing Endoscopic Sinus Surgery for Chronic Rhinosinusitis: Differences in Disease Presentation and Access to Care. Ann Otol Rhinol Laryngol 2019; 128:608-613. [PMID: 30832483 DOI: 10.1177/0003489419834947] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Data on health care disparities by socioeconomic status for chronic rhinosinusitis (CRS) are lacking, and the available literature shows mixed results. The aim of this study was to evaluate several indicators of disease complexity in patients with CRS undergoing endoscopic sinus surgery between a private and a public hospital to determine if there are any disparities in the severity of disease presentation or in access to care. METHODS Two hundred patients with CRS who underwent endoscopic sinus surgery from 2015 to 2017 were retrospectively reviewed. Demographics, disease-specific data, and pre- and postoperative management were collected. RESULTS Public hospital patients (n = 100) were significantly more likely to be non-Caucasian (73.0% vs 25.0%, P < .0001) and to have Medicaid or no insurance (86.0% vs 4.0%, P < .0001). Patients from the public hospital were more likely to have CRS with nasal polyposis (85.0% vs 60.0%, P < .0001) and to have longer wait times for surgery (68 vs 45 days, P < .0001) and were more likely to be lost to follow-up (26.0% vs 16.0%, P = .031). Patients at the public hospital had CRS symptoms 21% longer ( P = .0206), and if a patient carried a diagnosis of asthma, he or she had on average more severe asthma ( P = .0021). CONCLUSIONS This study suggests that patients of lower socioeconomic status had a longer duration of disease prior to surgery, more often had nasal polyposis, and had decreased access to care, as indicated by increased surgical wait times and being lost to follow-up. Acting as a foundation for further investigation, the ultimate intent of this study is to improve care for all patients.
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Affiliation(s)
- Wes Duerson
- 1 Department of Otolaryngology Head Neck Surg., Division of Rhinology and Skull Base Surgery, New York University School of Medicine, New York, NY, USA
| | - Marissa Lafer
- 1 Department of Otolaryngology Head Neck Surg., Division of Rhinology and Skull Base Surgery, New York University School of Medicine, New York, NY, USA
| | - Omar Ahmed
- 1 Department of Otolaryngology Head Neck Surg., Division of Rhinology and Skull Base Surgery, New York University School of Medicine, New York, NY, USA
| | - Ilana Bandler
- 1 Department of Otolaryngology Head Neck Surg., Division of Rhinology and Skull Base Surgery, New York University School of Medicine, New York, NY, USA
| | - Binhuan Wang
- 2 Department of Population Health, Division of Biostatistics, New York University School of Medicine, New York, NY, USA
| | - Seth Lieberman
- 1 Department of Otolaryngology Head Neck Surg., Division of Rhinology and Skull Base Surgery, New York University School of Medicine, New York, NY, USA
| | - Richard Lebowitz
- 1 Department of Otolaryngology Head Neck Surg., Division of Rhinology and Skull Base Surgery, New York University School of Medicine, New York, NY, USA
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Han YY, Forno E, Celedón JC. Health risk behaviors, violence exposure, and current asthma among adolescents in the United States. Pediatr Pulmonol 2019; 54:237-244. [PMID: 30614209 PMCID: PMC7032019 DOI: 10.1002/ppul.24236] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/27/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Asthma may worsen during adolescence, due to both health risk behaviors and psychosocial stressors commonly encountered during this life stage. METHODS Cross-sectional study of 24 612 high school students who participated in the 2009 and 2011 National Youth Risk Behavior Survey. Multivariable logistic regression was used to examine the relation between self-reported health risk behaviors or psychosocial stressors and current asthma. Mediation analysis was performed to assess whether depressive symptoms or suicidal behavior contribute to the link between psychosocial stressors and asthma. RESULTS Current asthma was reported by 13.1% of the study participants. In a multivariable analysis, female sex, obesity, shorter sleep duration, frequent soda/pop consumption, and marijuana use were each significantly associated with 14-36% increased odds of asthma. Any violent behavior (adjusted odds ratio [OR] = 1.12, 95% confidence interval [CI] = 1.02-1.24), any victimization (OR = 1.43, 95%CI = 1.29-1.58), any suicidal behavior (OR = 1.41, 95%CI = 1.22-1.64) and having felt sad or hopeless in the past year (OR = 1.57, 95%CI = 1.40-1.75) were each associated with current asthma. In a mediation analyses, having felt sad/hopeless and suicidal behaviors accounted for 21% and 14%, respectively, of the victimization-asthma association. CONCLUSION Potentially modifiable risk factors, including obesity, short sleep duration, frequent soda/pop consumption, and psychosocial stressors are associated with asthma in US adolescents. Promoting healthier lifestyles, as well as screening for violence exposure and treating depressive symptoms, could help reduce asthma burden in this population.
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Affiliation(s)
- Yueh-Ying Han
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erick Forno
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
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