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Chen E, Jiang T, Chen MA, Chiu RY, Miller GE. Resilience in children with chronic illness: Tests of the shift-and-persist and skin-deep resilience theories. Dev Psychopathol 2023; 35:2264-2274. [PMID: 37340834 DOI: 10.1017/s0954579423000603] [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] [Indexed: 06/22/2023]
Abstract
This study investigated, and discusses the integration of, the shift-and-persist (SAP) and skin-deep resilience (SDR) theories. The SAP theory states that the combination of shifting (adjusting oneself to stressful situations through strategies like emotion regulation) and persisting (enduring adversity with strength by finding meaning and maintaining optimism) will be beneficial to physical health in children experiencing adversity. The SDR theory states that high striving/self-control will be beneficial to mental health but detrimental to physical health among those confronting adversity. This study investigated 308 children ages 8-17 experiencing the adversity of a chronic illness (asthma). SAP and SDR (striving/self-control) were assessed via questionnaires, and physical health (asthma symptoms, inflammatory profiles), mental health (anxiety/depression, emotional functioning), and behavioral (medication adherence, activity limitations, collaborative relationships with providers) outcomes were measured cross-sectionally. SAP was associated with better physical health, whereas SDR was associated with worse physical health. Both were associated with better mental health. Only SDR was associated with better behavioral outcomes. Implications of findings and discussion of how to integrate these theories are provided. We suggest that future interventions might seek to cultivate both SAP and SDR to promote overall better health and well-being across multiple domains in children experiencing adversity.
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Affiliation(s)
- Edith Chen
- Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Tao Jiang
- Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Michelle A Chen
- Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Rachel Y Chiu
- Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Gregory E Miller
- Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, IL, USA
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2
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Hassan EEM, Abusaad FE, Mohammed BA. Effect of the Buteyko breathing technique on asthma severity control among school age children. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2022. [PMCID: PMC9308119 DOI: 10.1186/s43168-022-00149-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Asthma is a complex condition that can impair not only the child’s physical growth but also his optimal functional capacity and performance. Buteyko breathing technique is an exercise designed to regulate the breathing process. This study aimed to evaluate the effect of the Buteyko breathing technique on asthma severity control among school-age children. In Egypt, this technique was applied through five studies, four among adult patients and only one among children. In Mansoura University, only one study conducted among adult patients and no studies conducted among children. Therefore, to fulfill this gap of knowledge, it was necessary to study the effect of this technique on asthma severity control among school age children. Results The mean childhood asthma control pretest was significantly improved in the posttest with high mean percent change of posttest than pretest (p = 0.0001), which was clinically and statically high significant. There was a statistical significant increase in the mean of peak expiratory flow rate and control pause test at the fourth week than the first one (p = 0.0001), with a high significant mean percent of change. There was a significant decrease in the heart rate over the 4 weeks of follow-up with high mean percent changes at fourth week than the first one (p = 0.003). Conclusions This study supports the effectiveness of the Buteyko breathing technique in improving respiratory outcome and promoting asthma control among school-age children with bronchial asthma. Trial registration ClinicalTrials.gov, NCT05390554, registered on May 24 2022, retrospectively registered.
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3
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Deka H, Mahanta P, Ahmed SJ, Rajbangshi MC, Konwar R, Basumatari B. Risk Factors of Childhood Asthma Among Patients Attending a Tertiary Care Centre in North-East India. J Asthma Allergy 2022; 15:1293-1303. [PMID: 36132976 PMCID: PMC9482963 DOI: 10.2147/jaa.s374007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/31/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Asthma is a chronic lung illness marked by a reversible airway blockage. Both genetic and environmental factors influence higher asthma rates. The present study aims to assess the various socio-demographic and environmental factors influencing the causation of childhood asthma among patients attending the Paediatric Department of Gauhati Medical College and Hospital (GMCH), Assam. Materials and Methods A total of 150 clinically diagnosed asthma patients of 3–12 years as cases and patients of the same age group free from respiratory diseases with no history of asthma in a 1:1 ratio as controls were selected. A predesigned and pretested proforma was used to collect data, and written informed consent was obtained from all the legal guardians of the participants. Data were analyzed by chi-square test and binary logistic regression using SPSS V20, considering a p-value <0.05 significant. Results Urban and male children were found to be at higher risk of developing asthma. Children belonging to the urban locality (OR= 4.53; 95% CI: 1.57–13.09; p<0.05), damp environment (OR= 5.21; 95% CI: 1.23–22.10; p<0.05), lower socioeconomic status (OR= 3.48; 95% CI: 1.34–9.01; p<0.05), presence of pets (OR= 6.77; 95% CI: 1.76–25.99; p<0.05), family history of atopy/ allergy (OR= 43.29; 95% CI: 5.80–323.15 p<0.05), smoking/passive smoking (OR=23.54; 95% CI: 1.41–394.21 p<0.05) and mixed feeding (OR= 4.47; 95% CI: 1.46–13.63 p<0.05) were the significant risk factors of childhood asthma. Conclusion Children are vulnerable to environmental-induced asthma. Awareness and preventive measures are necessary to control and reduce the burden of childhood asthma.
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Affiliation(s)
- Himamoni Deka
- Depatment of Anatomy, Gauhati Medical College, Guwahati, Assam, India
| | - Putul Mahanta
- Department of Forensic Medicine and Toxicology, Assam Medical College, Dibrugarh, Assam, India
| | - Sultana Jesmin Ahmed
- Department of Community Medicine, Assam Medical College, Dibrugarh, Assam, India
| | - Madhab Ch Rajbangshi
- Department of Surgery, Tezpur Medical College and Hospital, Tezpur, Assam, India
| | - Ranjumoni Konwar
- Department of Radiology, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam, India
| | - Bharati Basumatari
- Department of Radiology, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam, India
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4
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Early life adversity, inflammation, and immune function: An initial test of adaptive response models of immunological programming. Dev Psychopathol 2022; 34:539-555. [PMID: 35152928 DOI: 10.1017/s095457942100170x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Much research indicates that exposure to early life adversity (ELA) predicts chronic inflammatory activity, increasing one's risk of developing diseases of aging later in life. Despite its costs, researchers have proposed that chronic inflammation may be favored in this context because it would help promote immunological vigilance in environments with an elevated risk of infection and injury. Although intuitively appealing, the assumption that exaggerated inflammatory activity predicts favorable immunological outcomes among those exposed to ELA has not been tested. Here, we seek to address this gap, examining the links between exposure to ELA, inflammation, and immune function. Consistent with others' work, results revealed that those from low socioeconomic status (SES) childhood environments exhibited exaggerated unstimulated inflammatory activity relative to what was observed among those from higher SES childhood environments. Further, results revealed that - although levels of inflammation predicted the magnitude of immunological responses in those from higher SES backgrounds - for those who grew up in low SES environments, higher levels of inflammation were unrelated to the magnitude of immunological responses. Results suggest that exaggerated inflammatory activity in the context of ELA may not predict improved ability to manage acute immunological threats.
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5
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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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6
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Cook Q, Argenio K, Lovinsky-Desir S. The impact of environmental injustice and social determinants of health on the role of air pollution in asthma and allergic disease in the United States. J Allergy Clin Immunol 2021; 148:1089-1101.e5. [PMID: 34743831 DOI: 10.1016/j.jaci.2021.09.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 02/07/2023]
Abstract
There is clear evidence that exposure to environmental air pollution is associated with immune dysregulation, asthma, and other allergic diseases. However, the burden of air pollution exposure is not equally distributed across the United States. Many social and environmental factors place communities of color and people who are in poverty at increased risk of exposure to pollution and morbidity from asthma and allergies. Here, we review the evidence that supports the relationship between air pollution and asthma, while considering the social determinants of health that contribute to disparities in exposures and outcomes.
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Affiliation(s)
- Quindelyn Cook
- Division of Pediatric Pulmonary and Allergy, Department of Pediatrics, Boston University School of Medicine, Boston, Mass
| | - Kira Argenio
- Division of Pediatric Pulmonology, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Stephanie Lovinsky-Desir
- Division of Pediatric Pulmonology, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY.
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7
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Gaietto K, Han YY, Forno E, Bacharier LB, Phipatanakul W, Guilbert TW, Cabana MD, Ross K, Blatter J, Acosta-Pérez E, Miller GE, de la Hoz RE, Rosser FJ, Durrani S, Canino G, Wisniewski SR, Celedón JC. Violence-related distress and lung function in two longitudinal studies of youth. Eur Respir J 2021; 59:13993003.02329-2021. [PMID: 34588198 PMCID: PMC8960476 DOI: 10.1183/13993003.02329-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/16/2021] [Indexed: 11/05/2022]
Abstract
Increasing violence-related distress over time was associated with worse lung function and worse asthma-related quality of life in youth with asthma despite treatment with low-dose inhaled corticosteroids.Exposure to violence has been associated with lower lung function in cross-sectional studies. We examined whether increasing violence-related distress over time is associated with worse lung function and worse asthma control or quality of life in a secondary analysis of a 48-week randomized clinical trial in 98 youth with asthma (ages 9-16 years) treated with low-dose inhaled corticosteroids (the Vitamin D Kids Asthma Study [VDKA]). We then replicated our findings for lung function in a prospective study of 232 Puerto Rican youth followed for an average of 5·4 years. Violence-related distress was assessed using the Checklist of Children's Distress Symptoms (CCDS) scale. Our outcomes of interest were percent predicted (%pred) lung function measures and (in VDKA only) asthma control (assessed using the Asthma Control Test) and asthma-related quality of life (assessed using the Pediatric Asthma Quality of Life questionnaire). In a multivariable analysis in VDKA, each 1-point increment in the CCDS score was associated with decrements of 3.27% in %predFEV1 (95% confidence interval [CI]=-6.44% to -0.22%, p=0.04) and a 2.65% decrement in percent predicted FVC (95% CI=-4.86% to -0.45%, p=0.02), and 0.30 points in the overall PAQLQ score (95% CI=-0.50 to -0.10, p<0.01). Similar findings for FEV1 and FVC were obtained in the prospective study of Puerto Rican youth. Our findings suggest that violence-related distress may worsen lung function and quality of life in youth with asthma (even those treated with low-dose inhaled corticosteroids) and further support policies to reduce exposure to violence among children in the U.S. and Puerto Rico.
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Affiliation(s)
- Kristina Gaietto
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA.,Shared first authors
| | - Yueh-Ying Han
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA.,Shared first authors
| | - Erick Forno
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Leonard B Bacharier
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, TN
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Theresa W Guilbert
- Division of Pulmonary Medicine, Department of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Michael D Cabana
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY
| | - Kristie Ross
- Division of Pediatric Pulmonology, UH Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Joshua Blatter
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Saint Louis Children's Hospital, Washington University at Saint Louis, Saint Louis, MO, USA
| | - Edna Acosta-Pérez
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | | | - Rafael E de la Hoz
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Franziska J Rosser
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sandy Durrani
- Division of Pulmonary Medicine, Department of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | | | - Juan C Celedón
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
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8
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Jiang Y, Farrell AK, Tobin ET, Mair-Meijers H, Wildman DE, Luca F, Slatcher RB, Zilioli S. Socioeconomic status, financial stress, and glucocorticoid resistance among youth with asthma: Testing the moderation effects of maternal involvement and warmth. Brain Behav Immun 2021; 96:92-99. [PMID: 34015429 PMCID: PMC8319072 DOI: 10.1016/j.bbi.2021.05.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES Children who grow up in more socioeconomically disadvantaged homes experience greater levels of inflammation and worse asthma symptoms than children from more advantaged families. However, recent evidence suggests that certain family-level factors can mitigate health disparities associated with socioeconomic status (SES). In a sample of youth with asthma, we investigated the potential buffering effects of maternal involvement and warmth on SES disparities in asthma-related immune responses, assessed via glucocorticoid resistance (GR) of immune cells. METHODS One hundred and forty-three youth (10-16 years of age) with asthma completed measures of maternal involvement and warmth, and their primary caregivers reported their levels of education, income, and financial stress. Peripheral blood mononuclear cells from youth's blood were isolated, cultured, and assayed to determine mitogen-stimulated (PMA/INO + Etho) and mitogen/hydrocortisone-stimulated (PMA/INO + Cort) levels of two Th-2 cytokines (i.e., interleukin-5, interleukin-13) and one Th-1 cytokine (i.e., interferon-γ). GR was calculated by subtracting log-transformed cytokine concentration in the PMA/INO + Etho samples from log-transformed cytokine concentration in the PMA/INO + Cort samples. RESULTS Both maternal involvement and warmth moderated the indirect pathway from family SES to GR of Th-2 cytokines via financial stress. Specifically, we found that low family SES was associated with elevated GR of Th-2 cytokines via increased financial stress among youth reporting low levels of maternal involvement and warmth, but not among those reporting high levels of maternal involvement or warmth. CONCLUSIONS These results highlight the protective role of maternal involvement and warmth in health-related biological processes modulated by family SES among youth with asthma.
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Affiliation(s)
- Yanping Jiang
- Department of Psychology, Wayne State University, United States.
| | | | - Erin T. Tobin
- Behavioral Health and General Internal Medicine, Henry Ford Health System
| | | | - Derek E. Wildman
- Genomics Program, College of Public Health, University of South Florida
| | - Francesca Luca
- Center for Molecular Medicine and Genetics, Wayne State University,Department of Obstetrics and Gynecology, Wayne State University
| | | | - Samuele Zilioli
- Department of Psychology, Wayne State University, United States; Department of Family Medicine and Public Health Sciences, Wayne State University, United States.
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9
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Davis CM, Apter AJ, Casillas A, Foggs MB, Louisias M, Morris EC, Nanda A, Nelson MR, Ogbogu PU, Walker-McGill CL, Wang J, Perry TT. Health disparities in allergic and immunologic conditions in racial and ethnic underserved populations: A Work Group Report of the AAAAI Committee on the Underserved. J Allergy Clin Immunol 2021; 147:1579-1593. [PMID: 33713767 DOI: 10.1016/j.jaci.2021.02.034] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/13/2021] [Accepted: 02/18/2021] [Indexed: 12/18/2022]
Abstract
Health disparities are health differences linked with economic, social, and environmental disadvantage. They adversely affect groups that have systematically experienced greater social or economic obstacles to health. Renewed efforts are needed to reduced health disparities in the United States, highlighted by the disparate impact on racial minorities during the coronavirus pandemic. Institutional or systemic patterns of racism are promoted and legitimated through accepted societal standards, and organizational processes within the field of medicine, and contribute to health disparities. Herein, we review current evidence regarding health disparities in allergic rhinitis, asthma, atopic dermatitis, food allergy, drug allergy, and primary immune deficiency disease in racial and ethnic underserved populations. Best practices to address these disparities involve addressing social determinants of health and adopting policies to improve access to specialty care and treatment for the underserved through telemedicine and community partnerships, cross-cultural provider training to reduce implicit bias, inclusion of underserved patients in research, implementation of culturally competent patient education, and recruitment and training of health care providers from underserved communities. Addressing health disparities requires a multilevel approach involving patients, health providers, local agencies, professional societies, and national governmental agencies.
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Affiliation(s)
- Carla M Davis
- Baylor College of Medicine, Houston, Tex; Texas Children's Hospital Food Allergy Program, Texas Children's Hospital, Houston, Tex.
| | - Andrea J Apter
- Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pa
| | - Adrian Casillas
- Texas Tech Health Sciences Center, Sierra Providence Medical Partners, El Paso, Tex
| | - Michael B Foggs
- Advocate Medical Group, Advocate Aurora Health Clinic, Chicago, Ill
| | - Margee Louisias
- Boston Children's Hospital, Harvard Medical School, Brigham and Women's Hospital, Boston, Mass
| | | | - Anil Nanda
- Asthma and Allergy Center, Lewisville, Tex; Asthma and Allergy Center, Flower Mound, Tex; University of Texas Southwestern Medical Center, Dallas, Tex
| | - Michael R Nelson
- Allergy-Immunology Service, Walter Reed National Military Medical Center, Bethesda, Md
| | - Princess U Ogbogu
- Case Western Reserve University-Rainbow Babies and Children/UH Cleveland Medical Center, Cleveland, Ohio
| | - Cheryl Lynn Walker-McGill
- Carolina Complete Health, Charlotte, NC; Wingate University Graduate School of Business, Charlotte, NC
| | - Julie Wang
- Elliot and Roslyn Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Tamara T Perry
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Research Institute, Little Rock, Ark
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10
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Wan MW, Janta-Lipinski M, Osam CS. Childhood Allergies: The Role of Maternal Depression and Anxiety, and Family Strain. CHILDREN-BASEL 2021; 8:children8030185. [PMID: 33804405 PMCID: PMC7999446 DOI: 10.3390/children8030185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/08/2021] [Accepted: 02/15/2021] [Indexed: 12/16/2022]
Abstract
Maternal mental disorder and a negative family emotional climate are a great source of stress for many children, yet their role in the childhood development or expression of asthma and allergies remains poorly understood, particularly beyond the first 1–2 years of life. The current study tested whether childhood allergy onset and symptomatology would be predicted by (1) perinatal and any time exposure to maternal depression or anxiety and (2) current family emotional strain (whole family, mother-child). UK mothers of children aged 2–12 years (N = 328) living with them completed an online survey of measures. Children exposed to maternal depression were almost twice as likely to be diagnosed and almost five times as likely to screen positive for an allergic disorder. Perinatal depression was linked to childhood allergies, but more moderately. Any anxiety exposure, and not specific to the perinatal period, predicted allergy status. Family emotional strain contributed independently to variance in concurrent child allergic symptomatology. All results were independent of potential confounders and current mental distress. The findings highlight the importance of maternal mental health and family function in the child’s neuro-immune development, and that these factors need to be addressed in the treatment of childhood allergic disorders.
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Affiliation(s)
- Ming Wai Wan
- Perinatal Mental Health and Parenting Research Unit (PRIME-RU), School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK;
- Centre for Women’s Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK;
- Correspondence:
| | - Molly Janta-Lipinski
- Perinatal Mental Health and Parenting Research Unit (PRIME-RU), School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK;
| | - Cemre Su Osam
- Centre for Women’s Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK;
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11
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Brigham E, Allbright K, Harris D. Health Disparities in Environmental and Occupational Lung Disease. Clin Chest Med 2021; 41:623-639. [PMID: 33153683 DOI: 10.1016/j.ccm.2020.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pulmonary health disparities disproportionately impact disadvantaged and vulnerable populations. This article focuses on disparities in disease prevalence, morbidity, and mortality for asthma, chronic obstructive pulmonary disease, pneumoconiosis, and lung cancer. Disparities are categorized by race, age, sex, socioeconomic status, and geographic region. Each category highlights differences in risk factors for the development and severity of lung disease. Risk factors include social, behavioral, economic, and biologic determinants of health (occupational/environmental exposures, psychosocial stressors, smoking, health literacy, health care provider bias, and health care access). Many of these risk factors are complex and inter-related; strategies proposed to decrease disparities require multilevel approaches.
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Affiliation(s)
- Emily Brigham
- Division of Pulmonary and Critical Care, Johns Hopkins University, 1830 East Monument Street 5th Floor, Baltimore, MD 21287, USA. https://twitter.com/emily_brigham
| | - Kassandra Allbright
- Department of Medicine, Johns Hopkins University, 1830 East Monument Street 5th Floor, Baltimore, MD 21287, USA
| | - Drew Harris
- Division of Pulmonary and Critical Care and Public Health Sciences, University of Virginia, Pulmonary Clinic 2nd Floor, 1221 Lee Street, Charlottesville, VA 22903, USA.
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12
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Yang-Huang J, van Grieken A, van Meel ER, He H, de Jongste JC, Duijts L, Raat H. Sociodemographic factors, current asthma and lung function in an urban child population. Eur J Clin Invest 2020; 50:e13277. [PMID: 32495383 PMCID: PMC7539956 DOI: 10.1111/eci.13277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 05/07/2020] [Accepted: 05/13/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND We aimed to assess which sociodemographic factors are associated with current asthma and indicators of lung function in 10-year-old children. METHODS We analysed data of 5237 children (Mean age: 9.7, SD: 0.3) from the Generation R Study (2012-2016), a population-based cohort study in the Netherlands. Indicators of sociodemographic factors included parental educational level, net household income, financial difficulties, parental employment status and child ethnic background. Current asthma (yes/no) was defined as ever doctor-diagnosed-asthma combined with wheezing symptoms or asthma-medication use in the past 12 months. Lung function was measured by spirometry and included forced expiratory volume in 1 second (FEV1 ), forced vital capacity (FVC), FEV1 /FVC, and forced expiratory flow after exhaling 75% of FVC (FEF75 ). Within-study sex-, height- and age-adjusted lung function measurements' z-scores were converted. RESULTS After adjustment for all sociodemographic factors, an independent association was observed between ethnic background with current asthma and lung function. Compared with children with a Dutch background, children with a nonwestern ethnic background had a higher odds of having current asthma (OR: 1.61, 95% CI: 1.02, 2.53), lower FVC z-score (-0.25, 95% CI: -0.35, -0.14), higher FEV1 /FVC z-score (0.26, 95% CI: 0.14, 0.37) and higher FEF75% z-score (0.15, 95% CI: 0.04, 0.25). CONCLUSIONS Among 10-year-old children, ethnic background was associated with current asthma and lung function after adjusting for a wide range of sociodemographic factors. No associations were found between socioeconomic status indicators and current asthma. Explanations for these associations such as language barriers, suboptimal care or pathophysiological differences require further investigation.
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Affiliation(s)
- Junwen Yang-Huang
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Amy van Grieken
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Evelien R van Meel
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Huan He
- School of Public Administration, Southwestern University of Finance and Economics, Sichuan, China
| | - Johan C de Jongste
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Liesbeth Duijts
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Neonatology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
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13
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McGovern C, Arcoleo K, Melnyk B. Sustained Effects From a School-Based Intervention Pilot Study for Children With Asthma and Anxiety. J Sch Nurs 2020; 38:347-357. [PMID: 32588717 DOI: 10.1177/1059840520934178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Children with chronic conditions (i.e., asthma) are more likely to have anxiety or depressive symptoms. Comorbid asthma and anxiety in children leads to increased morbidity, causing children to miss instructional time and parent/caregiver (CG) work absences. Asthma educational programs and mental health interventions have been developed, though no scalable programs integrate asthma education and mental health behavioral interventions for school-aged children. This study evaluated the sustained preliminary effects of an integrated asthma education and cognitive behavioral skills-building program, Creating Opportunities for Personal Empowerment for Asthma. Thirty-two children ages 8-12 years with asthma and symptoms of anxiety received the intervention. At 6-weeks postintervention, anxiety and CG-reported behavioral symptoms were significantly reduced, there were fewer missed doses of asthma controller medications, and asthma-related self-efficacy, personal beliefs, and the children's understanding of asthma significantly increased. Most children (n = 29, 91%) reported continued use of coping skills.
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Affiliation(s)
- Colleen McGovern
- School of Nursing, University of North Carolina at Chapel Hill, NC, USA
| | | | - Bernadette Melnyk
- College of Nursing, The Ohio State University, Columbus, OH, USA.,College of Medicine, The Ohio State University, Columbus, Ohio, USA
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14
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Lack S, Kinser PA. The modification of three vulnerability theories to assist nursing practice for school-age children with severe asthma. J SPEC PEDIATR NURS 2020; 25:e12280. [PMID: 31749322 DOI: 10.1111/jspn.12280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 11/01/2019] [Accepted: 11/06/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE Severe asthma is an inflammatory illness associated with adverse health outcomes and behaviors in children, such as decreased quality of life, impaired sleep, and increased medical costs and morbidity. CONCLUSIONS Children with severe asthma frequently exhibit a cycle of health and behaviors which contribute to these adverse health outcomes, consisting of decreased physical activity, increased stress, and increased airway inflammation and asthma exacerbations. School-age children, in particular, are a vulnerable population because they not only rely on others for their care but also suffer from a chronic illness and are at risk for unequal healthcare access and health outcomes. PRACTICE IMPLICATIONS Currently, there is no one nursing theory that adequately addresses the vulnerability, cycle of health and behaviors, and adverse health outcomes of children with severe asthma. By integrating key concepts from three vulnerability theories and presenting a modified conceptual framework, this paper aims to demonstrate how the use of this new conceptual framework may assist nurses in evaluating the unique needs of school-age children with severe asthma to provide best practices and develop appropriate interventions.
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Affiliation(s)
- Sharon Lack
- School of Nursing, Virginia Commonwealth University, Richmond, Virginia
| | - Patricia A Kinser
- School of Nursing, Virginia Commonwealth University, Richmond, Virginia
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15
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Skrzypek M, Kowalska M, Kobza J, Wypych A, Czech EM, Niewiadomska E, Bała MM. Community-based survey as a basis for evidence-based public health: children living in Upper Silesian Industrial Zone. Cent Eur J Public Health 2019; 26:171-176. [PMID: 30419617 DOI: 10.21101/cejph.a5130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of the study was to estimate changes in the prevalence of respiratory diseases and disorders between 2003/2004 and 2011/2012 in 13-16 years old children living in Bytom, one of the biggest cities in the Silesia agglomeration and provide the evidence for local policy makers. METHODS Data from two cross-sectional surveys, based on the Polish version of the International Study of Allergy and Asthma in Childhood (ISAAC) questionnaire, conducted in 2003/2004 and 2011/2012 was used. Response rate in the first and the second survey was 68% and 35%, respectively. The number of analyzed observations was 4,041 and 707 from the first and the second survey. The selection bias was controlled with the propensity score matching and potential determinants of analyzed respiratory diseases and disorders were controlled in the multivariable logistic regression model. RESULTS We found statistically significant increase in asthma ever diagnosed by medical doctor (4.5% vs. 9.6%; p < 0.01), seizures of dyspnea (8.2% vs. 27.7%; p < 0.01), and chest wheeze (9.6% vs. 19.2%; p < 0.01). CONCLUSION Our study revealed significant increase in the prevalence of respiratory diseases and disorders after 8 years in adolescents living in the Upper Silesian Industrial Zone. This is a relevant finding which provides the evidence for decision makers in the scope of local public health policies.
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Affiliation(s)
- Michał Skrzypek
- Department of Biostatistics, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
| | - Małgorzata Kowalska
- Department of Epidemiology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland
| | - Joanna Kobza
- Public Health Department, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
| | - Agata Wypych
- Department of Epidemiology, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
| | - Elżbieta M Czech
- Department of Biostatistics, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
| | - Ewa Niewiadomska
- Department of Biostatistics, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
| | - Małgorzata M Bała
- Department of Hygiene and Dietetics, Medical Faculty, Jagiellonian University Medical College, Krakow, Poland
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16
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McLaughlin KA, Lane RD, Bush NR. Introduction to the Special Issue of Psychosomatic Medicine: Mechanisms Linking Early-Life Adversity to Physical Health. Psychosom Med 2018; 78:976-978. [PMID: 27763992 PMCID: PMC5123679 DOI: 10.1097/psy.0000000000000420] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
| | - Richard D. Lane
- Department of Psychiatry, Psychology, and Neuroscience, University of Arizona
| | - Nicole R. Bush
- Department of Psychiatry, Departments of Psychiatry and Pediatrics, Center for Health and Community, Division of Developmental Medicine, University of California San Francisco
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17
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Wood BL, Brown ES, Lehman HK, Khan DA, Lee MJ, Miller BD. The effects of caregiver depression on childhood asthma: Pathways and mechanisms. Ann Allergy Asthma Immunol 2018; 121:421-427. [PMID: 29981440 DOI: 10.1016/j.anai.2018.06.031] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/14/2018] [Accepted: 06/28/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To review the literature regarding the effects of caregiver depression on childhood asthma and integrate the findings into a multilevel model of pathways by which these effects occur to further the understanding of the complex biopsychosocial nature of childhood asthma and the key role that is played by caregiver depression. DATA SOURCES PubMed was searched for articles published from 2007 to the present (10-year search), and Google Scholar was searched for articles published in 2017 and 2018 to identify the most recent publications. STUDY SELECTIONS Studies selected were recent, empirical, or meta-analytic, conducted in humans, and had specific relevance to one or more of the identified pathways. Articles published before 2007 were included if deemed essential because they addressed key pathways, for which there were no more recent articles. RESULTS Review of the literature substantiates that caregiver depression plays a key role in the socioeconomic, familial, psychological, and biological cascade of effects on childhood asthma. Childhood asthma outcomes are affected indirectly by socioeconomic status and family stress mediated by caregiver depression, which affects disease management, and/or stress and depression in the child, which, in turn, affect asthma through alterations in immune modulation and autonomic regulation. CONCLUSION Findings indicate that future research should concentrate on mediators and moderators to further clarify the complex interplay of these factors that affect childhood asthma. The findings also have substantial translational implications. Given that child stress and depression contribute to asthma disease activity and that treating caregiver depression improves child stress and depression, there is strong rationale for treating depressed caregivers of children with asthma as a component means of improving childhood asthma control.
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Affiliation(s)
- Beatrice L Wood
- Department of Psychiatry, Jacobs School of Medicine, University at Buffalo, Buffalo, New York; Department of Pediatrics, Jacobs School of Medicine, University at Buffalo, Buffalo, New York.
| | - E Sherwood Brown
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas
| | - Heather K Lehman
- Department of Pediatrics, Jacobs School of Medicine, University at Buffalo, Buffalo, New York
| | - David A Khan
- Department of Internal Medicine, Division of Allergy & Immunology, UT Southwestern Medical Center, Dallas, Texas
| | - Min Jung Lee
- Department of Internal Medicine, Division of Allergy & Immunology, UT Southwestern Medical Center, Dallas, Texas; Department of Pediatrics, UT Southwestern Medical Center, Dallas, Texas
| | - Bruce D Miller
- Department of Psychiatry, Jacobs School of Medicine, University at Buffalo, Buffalo, New York; Department of Pediatrics, Jacobs School of Medicine, University at Buffalo, Buffalo, New York
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18
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Miller GE, Chen E, Shalowitz MU, Story RE, Leigh AKK, Ham P, Arevalo JMG, Cole SW. Divergent transcriptional profiles in pediatric asthma patients of low and high socioeconomic status. Pediatr Pulmonol 2018. [PMID: 29528197 PMCID: PMC5992048 DOI: 10.1002/ppul.23983] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AIM There are marked socioeconomic disparities in pediatric asthma control, but the molecular origins of these disparities are not well understood. To fill this gap, we performed genome-wide expression profiling of monocytes and T-helper cells from pediatric asthma patients of lower and higher socioeconomic status (SES). METHOD Ninety-nine children with asthma participated in a cross-sectional assessment. Out of which 87% were atopic, and most had disease of mild (54%) or moderate (29%) severity. Children were from lower-SES (n = 49; household income <$50 000) or higher-SES (n = 50; household income >$140 000) families. Peripheral blood monocytes and T-helper cells were isolated for genome-wide expression profiling of mRNA. RESULTS Lower-SES children had worse asthma quality of life relative to higher-SES children, by both their own and their parents' reports. Although the groups had similar disease severity and potential confounds were controlled, their transcriptional profiles differed notably. The monocytes of lower-SES children showed transcriptional indications of up-regulated anti-microbial and pro-inflammatory activity. The T-helper cells of lower-SES children also had comparatively reduced expression of genes encoding γ-interferon and tumor necrosis factor-α, cytokines that orchestrate Type 1 responses. They also showed up-regulated activity of transcription factors that polarize cells towards Type 2 responses and promote Th17 cell maturation. CONCLUSION Collectively, these patterns implicate pro-inflammatory monocytes and Type 2 cytokine activity as mechanisms contributing to worse asthma control among lower-SES children.
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Affiliation(s)
- Gregory E Miller
- Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, Illinois
| | - Edith Chen
- Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, Illinois
| | - Madeleine U Shalowitz
- NorthShore University Health Systems, University of Chicago, Pritzker School of Medicine, Chicago, Illinois
| | - Rachel E Story
- NorthShore University Health Systems, University of Chicago, Pritzker School of Medicine, Chicago, Illinois
| | - Adam K K Leigh
- Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, Illinois
| | - Paula Ham
- Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, Illinois
| | - Jesusa M G Arevalo
- Division of Hematology-Oncology, UCLA AIDS Institute, Molecular Biology Institute, Jonsson Comprehensive Cancer Center, and Norman Cousins Center, UCLA School of Medicine, Los Angeles, California
| | - Steve W Cole
- Division of Hematology-Oncology, UCLA AIDS Institute, Molecular Biology Institute, Jonsson Comprehensive Cancer Center, and Norman Cousins Center, UCLA School of Medicine, Los Angeles, California
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19
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Miller GE, Culhane J, Grobman W, Simhan H, Williamson D, Adam EK, Buss C, Entringer S, Kim KY, Garcia-Espana JF, Keenan-Devlin L, McDade TW, Wadhwa PD, Borders A. Mothers' childhood hardship forecasts adverse pregnancy outcomes: Role of inflammatory, lifestyle, and psychosocial pathways. Brain Behav Immun 2017; 65:11-19. [PMID: 28450221 PMCID: PMC5537016 DOI: 10.1016/j.bbi.2017.04.018] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/28/2017] [Accepted: 04/23/2017] [Indexed: 12/23/2022] Open
Abstract
Research suggests the health consequences of economic hardship can be transmitted across generations. Some of these disparities are thought to be passed to offspring during gestation. But this hypothesis has not been tested in contemporary American samples, and the mechanisms of transmission have not been characterized. Accordingly, this study had two goals: first, to determine if women exposed to economic hardship during childhood showed higher rates of adverse birth outcomes; and second, to evaluate the contribution of inflammation, psychosocial, lifestyle, and obstetric characteristics to this phenomenon. This prospective study enrolled 744 women with singleton pregnancies (59.1% White; 16.3% Black; 18.7% Latina; 5.9% Other). Childhood economic hardship was measured by self-report. Birth outcomes included length of gestation and incidence of preterm birth; birth weight percentile and small for gestational age; length of hospital stay and admission to Special Care Nursery. Analyses revealed that mothers' childhood economic hardship was independently associated with multiple adverse birth outcomes, even following adjustment for demographics, maternal education, and obstetrical confounders. Women raised in economically disadvantaged conditions had shorter gestation length and higher preterm delivery rates. Their babies had lower birth weights, were more likely to be small for gestational age, stayed in the hospital longer, and had more Special Care Nursery admissions. Mediation analyses suggested these associations arose through multiple pathways, and highlighted roles for inflammation, education, adiposity, and obstetric complications. Collectively, these findings suggest that childhood economic hardship predisposes women to adverse birth outcomes, and highlights likely behavioral and biological mechanisms.
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Affiliation(s)
- Gregory E. Miller
- Department of Psychology, Northwestern University,Institute for Policy Research, Northwestern University
| | - Jennifer Culhane
- Children’s Hospital of Philadelphia, Division of Adolescent Medicine,Department of Pediatrics, University of Pennsylvania Perelman School of Medicine
| | - William Grobman
- Center for Healthcare Studies, Northwestern University Feinberg School of Medicine,Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine
| | - Hyagriv Simhan
- Division of Maternal-Fetal Medicine, University of Pittsburgh School of Medicine,Division of Obstetrical Services, Magee Women’s Hospital
| | | | - Emma K. Adam
- Institute for Policy Research, Northwestern University,School of Education and Social Policy, Northwestern University
| | - Claudia Buss
- Development, Health and Disease Research Program, University of California, Irvine,Institute of Medical Psychology, Charite University of Medicine, Berlin, Germany
| | - Sonja Entringer
- Development, Health and Disease Research Program, University of California, Irvine,Institute of Medical Psychology, Charite University of Medicine, Berlin, Germany
| | - Kwang-Youn Kim
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | | | - Lauren Keenan-Devlin
- Department of Obstetrics and Gynecology, NorthShore University Health System, University of Chicago Pritzker School of Medicine
| | - Thomas W. McDade
- Institute for Policy Research, Northwestern University,Department of Anthropology, Northwestern University
| | - Pathik D. Wadhwa
- Development, Health and Disease Research Program, University of California, Irvine
| | - Ann Borders
- Center for Healthcare Studies, Northwestern University Feinberg School of Medicine,Department of Obstetrics and Gynecology, NorthShore University Health System, University of Chicago Pritzker School of Medicine,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
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20
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Bush NR, Lane RD, McLaughlin KA. Mechanisms Underlying the Association Between Early-Life Adversity and Physical Health: Charting a Course for the Future. Psychosom Med 2017; 78:1114-1119. [PMID: 27763991 PMCID: PMC5111624 DOI: 10.1097/psy.0000000000000421] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Early-life adversities (ELA) are associated with subsequent pervasive alterations across a wide range of neurobiological systems and psychosocial factors that contribute to accelerated onset of health problems and diseases. In this article, we provide an integrated perspective on recent developments in research on ELA, based on the articles published in this Special Issue of Psychosomatic Medicine. We focus on the following: 1) the distinction between specific versus general aspects of ELA with regard to the nature of exposure (e.g., physical and sexual abuse, emotional abuse or neglect, relative socioeconomic deprivation), biological and behavioral correlates of ELA, and differences across diseases; 2) the importance of timing in the critical phases of exposure to ELA; and 3) adaptive versus dysfunctional responses to ELA and their consequences for biological and behavioral risk factors for adverse health outcomes. This article concludes with outlining important new targets for research in this area, including the neurobiology of affect as a mechanism linking ELA to adverse health outcomes, and the need for large-scale longitudinal investigations of multisystem processes relevant to ELA in diverse samples, starting prenatally, continuing to late adolescence, and with long-term follow-up assessments that enable evaluation of incident disease outcomes.
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Affiliation(s)
- Nicole R Bush
- From the Departments of Psychiatry and Pediatrics, University of California San Francisco, Division of Developmental Medicine, Center for Health and Community (Bush), San Francisco, California; Departments of Psychiatry, Psychology and Neuroscience (Lane), University of Arizona, Tucson, Arizona; Department of Psychology (McLaughlin), University of Washington, Seattle, Washington
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21
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Hostinar CE, Nusslock R, Miller GE. Future Directions in the Study of Early-Life Stress and Physical and Emotional Health: Implications of the Neuroimmune Network Hypothesis. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2017; 47:142-156. [PMID: 28107039 DOI: 10.1080/15374416.2016.1266647] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Early-life stress is associated with increased vulnerability to physical and emotional health problems across the lifespan. The recently developed neuroimmune network hypothesis proposes that one of the underlying mechanisms for these associations is that early-life stress amplifies bidirectional crosstalk between the brain and the immune system, contributing to several mental and physical health conditions that have inflammatory underpinnings, such as depression and coronary heart disease. Neuroimmune crosstalk is thought to perpetuate inflammation and neural alterations linked to early-life stress exposure, and also foster behaviors that can further compromise health, such as smoking, drug abuse and consumption of high-fat diets. The goal of the present review is to briefly summarize the neuroimmune network hypothesis and use it as a starting point for generating new questions about the role of early-life stress in establishing a dysregulated relationship between neural and immune signaling, with consequences for lifespan physical and emotional health. Specifically, we aim to discuss implications and future directions for theory and empirical research on early-life stress, as well as for interventions that may improve the health and well-being of children and adolescents living in adverse conditions.
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22
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Chen E, Shalowitz MU, Story RE, Ehrlich KB, Manczak EM, Ham PJ, Le V, Miller GE. Parents' childhood socioeconomic circumstances are associated with their children's asthma outcomes. J Allergy Clin Immunol 2017; 140:828-835.e2. [PMID: 28089871 DOI: 10.1016/j.jaci.2016.11.040] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 11/09/2016] [Accepted: 11/24/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Previous literature documents associations between low socioeconomic status (SES) and poor health outcomes, including asthma. However, this literature has largely focused on the effects of current family circumstances. OBJECTIVE We sought to test an intergenerational hypothesis, that the childhood SES that parents experience will be associated with asthma outcomes in their children, independent of effects of current family SES. Second, we aimed to test whether this association is in part due to difficulties in current parent-child relationships. METHODS This was an observational study, whereby 150 parents were interviewed about their childhood SES and their children (physician-diagnosed asthma, ages 9-17 years) were interviewed about current family stress. Asthma control was assessed by parent report and child report (primary outcome), and blood was collected from children to measure cytokine production relevant to asthma (secondary outcomes). RESULTS To the degree that parents had lower childhood SES, their offspring showed worse asthma outcomes across multiple indicators. This included lower asthma control scores (parent and child report, Ps < .05), and greater stimulated production of TH2 and TH1 cytokines by PBMCs (Ps < .05). These associations were independent of current family SES. Mediation analyses were consistent with a scenario wherein parents with low childhood SES had current family relationships that were more stressful, and these difficulties, in turn, related to worse asthma control and greater cytokine production in children. CONCLUSIONS These results suggest the potential "long reach" of low SES across generations, and the importance of expanding theories of how the social environment can affect childhood asthma to include characteristics of earlier generations.
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Affiliation(s)
- Edith Chen
- Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, Ill.
| | | | | | - Katherine B Ehrlich
- Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, Ill
| | - Erika M Manczak
- Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, Ill
| | - Paula J Ham
- Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, Ill
| | - Van Le
- Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, Ill
| | - Gregory E Miller
- Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, Ill
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