Kristina Gaietto1,2, Yueh-Ying Han1,2, Erick Forno1, Leonard B Bacharier3, Wanda Phipatanakul4, Theresa W Guilbert5, Michael D Cabana6, Kristie Ross7, Joshua Blatter8, Edna Acosta-Pérez9, Gregory E Miller10, Rafael E de la Hoz11, Franziska J Rosser1, Sandy Durrani5, Glorisa Canino9, Stephen R Wisniewski12, Juan C Celedón13. 1. Division of Pulmonary Medicine, Dept of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA. 2. K. Gaietto and Y-Y. Han are shared first authors. 3. Division of Allergy, Immunology, and Pulmonary Medicine, Dept of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, TN, USA. 4. Division of Allergy and Immunology, Dept of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. 5. Division of Pulmonary Medicine, Dept of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 6. Dept of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA. 7. Division of Pediatric Pulmonology, UH Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA. 8. Division of Allergy, Immunology, and Pulmonary Medicine, Dept of Pediatrics, St Louis Children's Hospital, Washington University at St Louis, St Louis, MO, USA. 9. Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico. 10. Dept of Psychology, Northwestern University, Evanston, IL, USA. 11. Dept of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 12. Dept of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA. 13. Division of Pulmonary Medicine, Dept of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA juan.celedon@chp.edu.
Abstract
BACKGROUND: Exposure to violence has been associated with lower lung function in cross-sectional studies. METHODS: 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 randomised clinical trial in 98 youth with asthma (aged 9-16 years) treated with low-dose inhaled corticosteroids (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 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 (PAQLQ)). RESULTS: In a multivariable analysis in VDKA, each 1-point increment in CCDS score was associated with decrements of 3.27% in forced expiratory volume in 1 s (FEV1) % pred (95% CI -6.44- -0.22%; p=0.04), 2.65% in forced vital capacity (FVC) % pred (95% CI -4.86- -0.45%; p=0.02) and 0.30 points in the overall PAQLQ score (95% CI -0.50- -0.10 points; p<0.01). Similar findings for FEV1 and FVC were obtained in the prospective study of Puerto Rican youth. CONCLUSIONS: 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 USA and Puerto Rico.
BACKGROUND: Exposure to violence has been associated with lower lung function in cross-sectional studies. METHODS: 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 randomised clinical trial in 98 youth with asthma (aged 9-16 years) treated with low-dose inhaled corticosteroids (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 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 (PAQLQ)). RESULTS: In a multivariable analysis in VDKA, each 1-point increment in CCDS score was associated with decrements of 3.27% in forced expiratory volume in 1 s (FEV1) % pred (95% CI -6.44- -0.22%; p=0.04), 2.65% in forced vital capacity (FVC) % pred (95% CI -4.86- -0.45%; p=0.02) and 0.30 points in the overall PAQLQ score (95% CI -0.50- -0.10 points; p<0.01). Similar findings for FEV1 and FVC were obtained in the prospective study of Puerto Rican youth. CONCLUSIONS: 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 USA and Puerto Rico.
Authors: Edith Chen; Madeleine U Shalowitz; Rachel E Story; Katherine B Ehrlich; Erika M Manczak; Paula J Ham; Van Le; Gregory E Miller Journal: J Allergy Clin Immunol Date: 2017-01-13 Impact factor: 10.793
Authors: Alison G Lee; Yueh-Hsiu M Chiu; Maria J Rosa; Sheldon Cohen; Brent A Coull; Robert O Wright; Wayne J Morgan; Rosalind J Wright Journal: Ann Allergy Asthma Immunol Date: 2017-06-28 Impact factor: 6.347
Authors: Erick Forno; Leonard B Bacharier; Wanda Phipatanakul; Theresa W Guilbert; Michael D Cabana; Kristie Ross; Ronina Covar; James E Gern; Franziska J Rosser; Joshua Blatter; Sandy Durrani; Yueh-Ying Han; Stephen R Wisniewski; Juan C Celedón Journal: JAMA Date: 2020-08-25 Impact factor: 56.272
Authors: Jeremy Landeo-Gutierrez; Erick Forno; Gregory E Miller; Juan C Celedón Journal: Am J Respir Crit Care Med Date: 2020-04-15 Impact factor: 30.528