Asthma is one of the most common chronic diseases of childhood with nearly 7 million children affected in the United States. Nonadherence to controller medication is a substantial issue that results in higher pediatric asthma disease morbidity. The common sense model of self-regulation is a useful theoretical framework to understand chronic disease self-management in adults, but has not been used in the context of pediatric chronic disease. Using Fawcett's framework, the authors analyze and evaluate the common sense model. To conclude, the authors propose a reformulation of the model that incorporates parent-child shared regulation of pediatric asthma.
Background:
Limited data suggest air pollution exposures may contribute to pediatric high blood pressure (HBP), a known predictor of adult cardiovascular diseases.
Methods:
We investigated this association in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study, a sociodemographically diverse pregnancy cohort in the southern United States with participants enrolled from 2006 to 2011. We included 822 mother–child dyads with available address histories and a valid child blood pressure measurement at 4–6 y. Systolic (SBP) and diastolic blood pressures (DBP) were converted to age-, sex-, and height-specific percentiles for normal-weight U.S. children. HBP was classified based on SBP or DBP
percentile. Nitrogen dioxide (
) and particulate matter
in aerodynamic diameter (
) estimates in both pre- and postnatal windows were obtained from annual national models and spatiotemporal models, respectively. We fit multivariate Linear and Poisson regressions and explored multiplicative joint effects with maternal nutrition, child sex, and maternal race using interaction terms.
Results:
Mean
and
in the prenatal period were 10.8 [standard deviation (SD): 0.9]
and 10.0 (SD: 2.4) ppb, respectively, and 9.9 (SD: 0.6)
and 8.8 (SD: 1.9) ppb from birth to the 4-y-old birthday. On average, SBP percentile increased by 14.6 (95% CI: 4.6, 24.6), and DBP percentile increased by 8.7 (95% CI: 1.4, 15.9) with each
increase in second-trimester
.
averaged over the prenatal period was only significantly associated with higher DBP percentiles [
11.6 (95% CI: 2.9, 20.2)]. Positive associations of second-trimester
with SBP and DBP percentiles were stronger in children with maternal folate concentrations in the lowest quartile (
0.05 and 0.07, respectively) and associations with DBP percentiles were stronger in female children (
0.05). We did not detect significant association of
, road proximity, and postnatal
with any outcomes.
Conclusions:
The findings suggest that higher prenatal
exposure, particularly in the second trimester, is associated with elevated early childhood blood pressure. This adverse association could be modified by pregnancy folate concentrations.
https://doi.org/10.1289/EHP7486
The study compared sleep disturbances and behavior problems in school-age children with and without juvenile idiopathic arthritis (JIA).
Children 6-to-11 years of age, with (n = 70) and without (n = 46) JIA, and their parent participated. Parents completed questionnaires on sleep habits and behavior problems. Compared to control children, JIA children had significantly higher total sleep disturbances and higher scores on six of eight subscales. Sleep disturbances predicted externalizing behavior problems, controlling for age, medications, study group, and pain. Sleep disturbances such as, sleep disordered breathing are often overlooked or unrecognized in JIA and may contribute to behavioral problems.
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