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In the near future, the vertical dimension of housing will become increasingly important. But high-rise housing is still being seen as not only inconvenient but also as inappropriate for young family households. This article aims to contribute to the vertical turn in the urbanism debate from a family point of view. The focus is on large western-industrialized cities. This literature-based article consists of two parts. The first part starts with the deconstructing of families’ position in urban high-rises. It is argued that young families have an “uneasy” relationship with urban high-rises due to the neglected presence of children. The dichotomous ways in which we define children and cities ultimately define city children and vertical living families as out-of-place. The second part of the article searches for ways to reconstruct families’ relationships with high-rises. Based on an analysis of the literature, problems of vertical family living are identified, and possible solutions are discussed on both the geographical scale level of the apartment and the building. The summarized conclusion from the literature is that vertical apartment living and happy family life are not necessarily at odds. The building of family-inclusive high-rises is both in the benefit of urban-oriented families and cities.

Background: The physiological and pathophysiological roles of secreted membrane-enclosed vesicles known as extracellular vesicles (EVs) have become increasingly recognized, making the EV field a quickly evolving area of research. EVs and their encapsulated molecular material including microRNAs are key mediators of intercellular communication, making EVs analogous to a message in a bottle. This discovery has fundamentally changed the study of gene regulation, and understanding the central role of EVs and their cargo in health and disease will generate new opportunities for basic biology, diagnostics, and disease treatment. EV release and the packaging of molecular material into EVs can be altered by stressors such as air pollution exposure. Exposure to air pollution is associated with significant morbidity among individuals with asthma, especially children who participate in more frequent outdoor activities and are more susceptible to exposure due to their narrower airways and higher breathing rate. Thus, sensitive biomarkers of air pollution exposure are needed to identify children at risk of worsened symptoms and asthma exacerbations. Given their role in cell-to-cell communication, EVs also represent a plausible molecular mechanism in the etiology of disorders such as aging-related cognitive decline. Individuals with mild cognitive impairment and experiencing increased rates of cognitive decline are more likely to develop Alzheimer’s disease and other dementias, signifying the importance of identifying and treating cognitive impairment early. More precise identification of the neurobiological processes of cognitive decline in aging populations may provide critical insights into the precursors of late-life dementias and identify health interventions that can delay cognitive impairment or therapeutic targets for treatment. This dissertation evaluates the utility of EV-encapsulated microRNAs (EV-miRNAs) as biomarkers of environmental exposure (i.e., air pollution) and assesses their role in disease risk (i.e., cognitive decline) in two separate studies. First, in Chapters 2-3, using a cohort of children with asthma in the greater Boston area, we describe saliva EVs isolated from these children using a high-throughput method and explore the potential of salivary EV-miRNAs as easy-to-measure biomarkers of exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O₃). Then, in Chapter 4, we evaluate the association between EV-miRNAs and cognitive function and rates of cognitive decline in a cohort of elderly men and discuss the utility of circulating EV-miRNAs as biomarkers of risk. Furthermore, we discuss the pathways that these EV-miRNAs target if they play a causal role in cognitive decline which could have implications for development of therapeutics. Methods: Drawing from the School Inner-City Asthma Study (SICAS), we isolated salivary EVs and EV-miRNA from children with asthma for analysis in relation to ambient exposure to PM₂.₅, NO₂, and O₃. In accordance with the recommended minimal experimental requirements for the definition of EVs, in Chapter 2 we employ multiple orthogonal methods to describe the EVs that were isolated from cell-free saliva using a high-throughput polymer-based reagent (ExoQuick-TC). In Chapter 3, we utilize EV-miRNA data generated via RNA sequencing and ambient air pollution data estimated using a validated spatiotemporal high-resolution model. We perform differential expression analyses to examine the effect of high exposure to PM₂.₅, NO₂, and O₃ on saliva EV-miRNA abundance. In Chapter 4, we leverage data from the Normative Aging Study, a longitudinal cohort of elderly men, to investigate whether circulating EV-miRNAs are associated with cognitive function and rates of cognitive decline. We used linear models to assess the relationship between plasma EV-miRNAs and cognitive function and linear mixed models to evaluate the relationship between plasma EV-miRNAs and rates of cognitive decline. We performed gene ontology functional enrichment and pathway enrichment analyses to identify the biological pathways that these EV-miRNAs would target if they play causal roles in cognitive decline. Results:In Chapter 2, we demonstrate that EVs can be isolated from human saliva using ExoQuick-TC. The saliva EVs isolated from ExoQuick (N=180) ranged in size but were mostly ~55 nm in diameter and expressed tetraspanins CD9 and CD63, canonical markers for EVs, but did not highly express the tetraspanin CD81. In Chapter 3, in a subset of the SICAS cohort (N=69), we show that relatively high (>19.37 parts per billion) short-term ambient NO2 exposure and relatively high (>38.38 parts per million) prior-day O3 exposure are associated with down-regulation of several saliva EV-miRNAs. We did not detect differential expression of any EV-miRNAs in relation to PM₂.₅ exposure over multiple time windows of exposure. Finally, in Chapter 4, multivariable linear and linear mixed models demonstrated a relationship between several plasma EV-miRNAs and global cognitive function and rates of global cognitive decline, measured by the Mini-Mental State Examination. Functional enrichment and pathway enrichment analyses revealed that the biological pathways targeted by these miRNAs are relevant in neurodegeneration, including pathways regulating synaptic function and plasticity and neuronal death. We found no association between EV-miRNAs and cognitive function or cognitive decline as assessed by cognitive tests measuring specific domains of cognitive function. Conclusion: This work demonstrates the opportunities that EV-miRNAs can create for advancing environmental health research. EV-miRNAs may serve as sensitive biomarkers of environmental exposures as well as biomarkers of risk and may play mechanistic roles in disease. We also make recommendations for integrating EV research into the field of environmental health. Future studies should continue to evaluate the potential of EV-miRNAs and seek to identify EV-miRNAs that can serve as mechanistic biomarkers between exposures and effect across all stages of life to (1) increase our understanding of the consequences of circulating miRNA changes and the contribution of the environment to heterogeneous disorders, (2) advance development of non-invasive diagnostics to allow for longitudinal monitoring, and (3) pave the way for new opportunities for disease prevention and treatment.

Tez (Yüksek Lisans) -- İstanbul Ticaret Üniversitesi -- Kaynakça var. ÖZET Kent, en genel anlamıyla toplumların ve her yaştan bireyin bulunduğu mekân olarak tanımlanır. Günümüzde kentleşmenin getirdiği sorunlarla birlikte, yoğun yapılaşmadan dolayı açık mekanların azalması, artan trafik yüküyle birlikte sokaklar özellikle çocuklar için tehlikeli alanlar haline gelmektedir. Bu da günümüz çocuklarını konut yakın çevresinde veya yetişkinlerin gözetiminde kısıtlı bir alana mahkûm etmektedir. Her ne kadar çocuklar için tasarlanan oyun parkı benzeri kullanım alanları bulunsa da bu mahkûmiyet, çocukların ihtiyaçlarına, beklenti ve isteklerine cevap verememekle birlikte, sosyal, kültürel ve zihinsel gelişimlerini de olumsuz yönde etkilemektedir. Bu çalışmada; ‘‘Çocuk Dostu Kent’’ (Child Friendly City) kavramı yerel yönetimlerin yetki ve sorumluluklarıyla ilişkilendirilerek irdelenmiş ve bu yaklaşımın kent ortamlarının çocuklar için nasıl daha yaşanılabilir hale getirebileceği konusu tartışılmıştır. Aynı zamanda çocuk haklarının yerel yönetim kararlarına dahil edilmesine önemli bir çerçeve oluşturduğu için “Çocuk Dostu Kent” (ÇDK) kavramı, bu teze konu edilmiştir. ÇDK kavramını irdelemek amacı ile hazırlanan bu çalışmanın ilk bölümünde; çocuk kavramı genel hatlarıyla açıklanmış, çocuğun genel tanımından yola çıkılarak gelişimi ve oyunun çocuğun yaşamındaki önemi değerlendirilmiştir. Çalışmanın ikinci bölümünde çocuk ve mekân başlığı altında; çocukların mekansal gereksinimleri, kentsel yaşanabilirlik kavramı ve ölçütleri üzerinde durularak bu konunun çocuğun gelişimindeki rolü ve önemine dikkat çekilmiştir. Çalışmanın üçüncü aşamasında ÇDK kavramı çocuk hakları çerçevesinde, kentsel mekânda çocuk ve yerel yönetimlerin rolleri üzerinden tartışılarak Dünya’dan ve Türkiye’den örnekleri üzerinden değerlendirilmiştir. Son olarak ÇDK uygulamalarında başta plancılar, tasarımcılar, karar vericiler, uygulayıcılar ve kullanıcılar olmak üzere tüm paydaşlara düşen sorumluluklar tartışılmıştır. Anahtar Kelimeler: Çocuk, çocuk dostu kent, kentsel mekân, oyun-mekân ilişkileri, yerel yönetimler. ABSTRACT The city, in its most general sense, is defined as the place where societies and individuals of all ages reside. Today, with the problems brought by urbanization, the decrease in open spaces due to dense construction, and the increasing traffic load, the streets are becoming dangerous areas, especially for children. This confines today's children to a restricted area in the immediate vicinity of the residence or under the supervision of adults. Although there are playground-like areas designed for children, this conviction does not respond to the needs, expectations, and wishes of children, and affects their social, cultural, and mental development negatively. In this study; The concept of a “Child-Friendly City” has been examined in relation to the authorities and responsibilities of local governments, and how this approach can make urban environments more liveable for children has been discussed. At the same time, the concept of “Child-Friendly City” (CDC) has been the subject of this thesis, as it provides an important framework for the inclusion of children's rights in local government decisions. CFC, which can constitute an important framework for creating more liveable urban spaces for children; the concept of the child was explained in general terms, and the development of the child and the importance of play in the child's life were evaluated based on the general definition of the child. In the second part of the study, under the title of child and space; The spatial needs of children, the concept of urban liveability and its criteria are emphasized and attention is drawn to the role and importance of this subject in the development of the child. In the third stage of the study, the concept of CFC was discussed within the framework of children's rights, the roles of children and local governments in urban space, and evaluated through examples from the world and Turkey,Finally, the responsibilities of all stakeholders, especially planners, designers, decision-makers, implementers, and users were discussed. Key Word: Child, child friendly city, local governments, playing activities-space interactions, urban environments. İÇİNDEKİLER İÇİNDEKİLER. . i ÖZET…………………………………………………………………………………. ii ABSTRACT. iii TEŞEKKÜR…………………………………………………………………………. iv ŞEKİLLER DİZİNİ…………………………………………………………………. v 1. GİRİŞ………………………………………………………………………………. 1 2. LİTERATÜR ÖZETİ . 4 2. 1. Çocuk Kavramı . 4 2. 1. 1 Çocukluk dönemi ve tanımlar . 4 2. 1. 2 Çocuğun toplum nüfusundaki yeri . 5 2. 1. 3 Çocuk ve gelişim . 8 2. 1. 4 Çocuk ve oyun …………………………………………………………. 12 2. 2. Çocuk ve Mekan İlişkisi……………………………………………………. 13 2. 2. 1 Çocukların mekansal gereksinimleri ……………………………. ……. 15 2. 2. 2 Çocuk ve kentsel yaşanabilirlik kavramı………………………. ………18 2. 2. 3 Kentsel mekanın çocuğun gelişimindeki önemi…………………………20 3. ÇOCUK DOSTU ŞEHİR…………. ………………………………………. …. …. 24 3. 1 Çocuk Hakları ve Çocuk Dostu Şehir………………………………………. 25 3. 2 Kentsel Mekanda Çocuk ve Yerel Yönetimlerin Rolü………………………. 27 3. 3 Dünya’da Çocuk Dostu Kent Çalışmaları……………………………………. 32 3. 3. 1 UNICEF desteğiyle gerçekleştirilen dünyadan ÇDK uygulamalarına örnekler……………………………………………………………. ………. 33 3. 4 Türkiye’de Çocuk Dostu Kent Çalışmaları . 35 3. 5 Esenler Çocuk Sokağı Örneği………………………………………………. 38 4. SONUÇ VE ÖNERİLER. ……. …………………………………………………. 41 KAYNAKLAR………………………………………………………………………. 46 ÖZGEÇMİŞ………………………………………………………………………… 51

This paper aims to look at the factors affecting the time spend outside their homes for the preschool children aged 0-6 and their families in Istanbul metropole city center focusing on Besiktas district of Istanbul. Building new cities particularly with open areas and new facilities to encourage secure mobility and social interaction is a growing topic of discussion globally. The effects of environment on children and children’s free movement in the natural environment on their mental and physical development are also another growing topic of discussion among the scholars worldwide. Using the methods of observation made in various spaces in Besiktas District such as market areas, streets and data from the face-to-face indepth interviews conducted with 24 parents of 0-6 aged children in Besiktas; the research aims to present the main factors affecting the children’s interaction with the city, mainly the time spend outside together with their parents and alone. The paper will reveal that the number of people taking care of the child, the occupation of the parents, the age of the child, geography and facilities of the place lived, health problems and spacial closeness to the family relatives are prominent factors affecting the time spent outdoors for children. Related to the factors discussed in the paper the times spend outside with children and interaction with the city are mainly limited and not very qualified. The findings of the research can be of value for the further studies in the areas of sociology, education, architecture, and city planners.

The importance of domestic Alternaria exposure to allergic disease in urban communities is underrecognized relative to cockroach, dust mite, and mouse exposures. Concentrations of Alternaria are higher in outdoor than in indoor air; however, dampness, leaks, and resident behaviors can influence fungal penetrance and secondary growth indoors. Moreover, given the amount of time children spend indoors, domestic exposure may contribute more than outdoor exposure to asthma morbidity. Byproducts from fossil fuel combustion are common in urban air and are the most well-established anthropogenic environmental adjuvants of allergic sensitization. Black carbon and elemental carbon (EC), indicators of combustion exposure, vary across cities such as New York (NYC) because of vehicle and residential heating sources. Among NYC children, we previously demonstrated an interaction between exposure to combustion byproducts and cockroach allergen on cockroach sensitization and an association between black carbon measured inside homes and fractional exhaled nitric oxide (Feno), a marker of airway inflammation. Therefore, combustion byproducts might enhance the effect of fungal exposure on allergic disease outcomes among NYC children. We hypothesized that, among NYC children, (1) sensitization to Alternaria alternata would be associated with increased asthma symptoms, (2) domestic exposure to A alternata would be associated with increased Feno, and (3) the association with Feno would be modified by neighborhood EC concentrations.

Exposure to ambient metals in urban environments has been associated with wheeze, and emergency room visits and hospitalizations due to respiratory illness. However, the effect of ambient metals exposure on airway inflammation, and how these associations may be modified by seroatopy, has not been determined. Fractional exhaled nitric oxide (FENO) is a reliable proxy marker of airway inflammation. We hypothesized that recent ambient concentrations of Ni, V, Zn and Fe would be associated differentially with proximal and distal fractions of exhaled NO, and that these associations would be modified by seroatopy. As part of the Columbia Center for Children’s Environmental Health (CCCEH) birth cohort study, 9-11 year old children (n=192) were evaluated. Ambient measures of Ni, V, Zn and Fe were obtained from a local central monitoring site and averaged over nine days based on three 24 hour measures every third day. Fractional exhaled nitric oxide (FENO) samples were obtained at constant flows of 50 (FENO50), 83 and 100 mL/sec, and used to determine surrogate measures for proximal (JNO) and alveolar (Calv) inflammation. Seroatopy was determined by specific IgE at age 7. Data were analyzed using multivariable linear regression. Ambient V and Fe concentrations were associated positively with FENO50 (p = 0.018, p = 0.027). Ambient Fe was associated positively with JNO (p = 0.017). Ambient Ni and V concentrations were associated positively with Calv (p = 0.004, p = 0.018 respectively). A stronger association of Ni concentrations with Calv was observed among the children with seroatopy. These results suggest that ambient metals are associated differentially with different fractions of FENO production, and this relationship may be modified by seroatopy.

Improving the accessibility and effectiveness of community mental health services for children has been a national concern for more than a decade (National Advisory Mental Health Council, 2001). In a seminal study, secondary data analysis of three nationally representative household surveys indicated that nearly 80% of low-income youth in need of mental health services did not receive services in the preceding 12 months, with rates approaching 90% for uninsured families (Kataoka, Zhang, & Wells, 2002). Lack of access to services is especially problematic in urban, low-income communities with high rates of nonattendance at initial appointments and rates below 10% for attendance at as few as four sessions (see McKay & Bannon, 2004). Infrequent use of mental health services has been attributed to stigma (Dempster, Wildman, & Keating, 2013) and concrete obstacles, such as inaccessible locations, lack of information about services, and social isolation (Harrison, McKay, & Bannon, 2004). Concentrated urban poverty also is associated with high risk of substantial mental health difficulties for youth (Cappella, Frazier, Atkins, Schoenwald, & Glisson, 2008). A longitudinal analysis of a large nationally representative sample of youth indicated a robust relation between neighborhood disadvantage and conduct problems over and above a series of family and individual risk factors (Goodnight, et al., 2012). Relatedly, exposure to community violence, affecting almost 80% of urban children (U.S. Department of Justice, 2003), is associated with poor academic performance (McCoy, Roy, & Sirkman, 2013) mediated by depression and disruptive behavior (Borofsky, Kellerman, Baucom, Oliver, & Margolin, 2013). A public health framework offers promise for organizing the design and delivery of more accessible and appropriately targeted services to children living in urban poverty. Within a public health framework, universal intervention strategies are deployed to attenuate risk factors and related behavior problems, while targeted interventions are simultaneously deployed for high-risk cases (Stiffman, Stelk, Evans, & Atkins, 2010). If delivered in those contexts naturally inhabited by children and families – primarily school and home – and focused on specific aspects of those contexts affecting child learning and behavior, service models encompassing such interventions also could be more effective and sustainable (Atkins & Frazier, 2011). In this study, we examined a service delivery model, Links to Learning (L2L), which involved the integration and delivery of universal and targeted interventions focused on supporting schooling for children with disruptive behavior disorders living in urban low-income communities. School-Based Mental Health Services Schools are the de facto providers of mental health services for children and youth (Farmer, Burns, Phillips, Angold, & Costello 2003; Green et al., 2013), providing an estimated 70% to 80% of psychosocial services (Rones & Hoagwood, 2000). However, the primary modality for school-based services, individual counseling (Foster et al., 2005), is largely ineffective for children with disruptive behavior disorders, which comprise the majority of school referrals (Farmer, Compton, Burns, & Robertson, 2002; Foster et al., 2005). This is especially evident for children attending schools in low-income urban communities. In a recent meta-analysis examining school-based mental health programs for low-income, urban youth (Farahmand, Grant, Polo, Duffy, & DuBois, 2011), null effects were found for most outcomes (mean ES = .08), and negative effects were found for programs focused on externalizing behaviors (ES = −.11). The authors suggested that these findings reflect a lack of attention to the many stressors apparent in low-income urban schools and proposed that effective services would require an integration of the school ecology into program planning and implementation. A second meta-analysis of programs based in community mental health settings serving low income urban youth (Farahmand et al., 2012) found positive effects for programs that supported parents or provided other community supports (mean ES = .38), and null effects for programs focused on direct services to youth (mean ES = .03). These findings suggest that individually focused services are contraindicated for low-income youth with disruptive behavior and that interventions are likely to be more impactful when they can be deployed in, and alter, family and community contexts. In the present study, we implemented and examined a model in which community mental health staff worked directly with parents and teachers in low-income urban schools to enhance children’s school success. Predictors of Children’s Learning: Teachers and Parents Informed by evidence supporting the effectiveness of focusing mental health services on the empirical predictors of youth offending (Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998), we constructed a model focusing mental health services on the empirical predictors of children’s learning to impact children’s school success (see Cappella et al., 2008). An extensive literature documents that children’s academic learning is compromised in urban low-income schools, with profound and growing gaps between poor and nonpoor U.S. children (Reardon, 2011). This has important implications given that academic achievement is a hallmark of children’s sense of competence (Masten & Curtis, 2000), and critical to social and emotional adjustment (Roeser, Eccles, & Freedman-Doan, 1999). Academic achievement can operate as a protective factor for urban children (Freudenberg & Ruglis, 2007), and is associated with positive relationships with peers, teachers, and parents, and improved classroom behavior (Atkins, Hoagwood, Kutash, & Seidman, 2010). In addition, a direct focus on schooling by mental health providers could bridge educational and mental health systems, and provide additional resources to struggling urban schools (Ringeisen, Henderson, & Hoagwood, 2003). Reviews of the educational literature reveal that teachers and parents contribute uniquely to children’s learning. Specifically, three components of teacher practices most significantly impact children’s learning: Effective instruction, classroom management, and teacher outreach to parents (Stringfield, 1994). Similarly, parent communication with teachers, homework support, and reading at home are associated with improved learning (Jeynes, 2005). These classroom and family predictors of learning were the focus of the mental health service model developed for this study (Cappella et al., 2008). Diffusion of Innovation: Teacher Key Opinion Leaders and Parent Advocates Diffusion theory posits that key opinion leaders (KOLs) spread innovations as a function of their influential role within their social network (Rogers, 1995). In the first study applying diffusion theory to urban schools (Atkins et al., 2008), KOL teachers, working with mental health providers (MHPs), promoted higher rates of teachers’ self-reported use of recommended interventions than consultation from MHPs without KOL support. These results supported an expanded role for KOL teachers for the dissemination of school-based mental health interventions. Similarly, involving parents with similar characteristics and experiences as the parents of children referred for services can reduce stigma, enhance participation in services, and influence behavior change due to shared experiences and reduced social distance (Frazier, Abdul-Adil, Atkins, Gathright, & Jackson, 2007; Hoagwood et al., 2010). The Current Study We examined the extent to which a mental health model, Links to Learning (L2L), focused on the key predictors of student learning and delivered by community mental health providers aligned with parent advocates and KOL teachers, would lead to greater reductions in children’s disruptive behavior at home and school as compared to mental health services-as-usual (SAU). Moderators included baseline child and family characteristics. This three-year longitudinal study utilized a multi-method, multi-informant design consisting of classroom observations, teacher report, parent report, and direct assessment of academic performance with random assignment of schools to L2L or assisted referral to community based SAU.

Thesis (PhD)--University of South Australia, 2010. Includes bibliographical references. Children are widely regarded as society's future, although the 'here and now' of their childhood receives dismissive treatment in policy development, especially in the realm of urban policy and planning. This results from a complex interplay between social constructions of childhood; notions of citizenship and approaches to public policy-making, and it is particularly evident in urban planning policy because of the particular significance urban environments hold for children. The thesis addresses three research questions. What are the unifying themes across social constructions of childhood, children's citizenship status and the treatment of children in public policy in modern democratic societies? Does urban planning policy recognise children as consumers of the physical environment and local resources, recipients of services, and as participants in shaping the life of the community? Could the public policy interests of children as citizens of the urban environment be advanced through expanding existing conceptualisations of citizenship and adopting more socially inclusive approaches to public policy-making? These questions are addressed through examining discourses of childhood, citizenship theory and policy-making, via document analysis and case studies of local area planning. Four case studies in the cities of Brisbane and Canberra, Australia, examine the place occupied by the rights, needs and interests of children across social and physical domains, and the opportunities for children to participate in shaping their urban environment. Examination of aspects of urban planning from selected international locations draws attention to the potential impact of socio-political acceptance of the concept of the child citizen, and explores support for children's exercise of social agency. A paradigm where children are viewed as in a 'process of becoming', embedded in constructions of childhood, eclipses an appreciation of the social efficacy of children in the 'here and now'. This subjugated status of children is reinforced by, and supports, constructions of citizenship which are generally silent about the social position of children, and approaches to public policy-making which do not reflect a just relationship between the state and children. The findings from study of local area planning illustrate a lack of prominence to the space, service and land use needs of children, and exclusion of children from opportunities and processes which contribute to policy-making. The strongest evidence of attention to children is found where issues of social order may arise or where there are concerns for safety and health. Policy filtering, competition between groups and the dominance of sectional interests are powerful influences in public policy-making. Children are treated as secondary beneficiaries, by association of their needs and interests with more influential forces. Policy recognition of children as participants in shaping the life of the community is patchy and disjointed. In sum, the study findings suggest that sustained recognition of children in public policy-making requires sufficient conditions, created by acknowledgement of children's independent social agency; a reinvigorated conception of citizenship as a journey which is inclusive of children; recognition of children's rights, in particular participation rights; and the adoption of socially inclusive approaches to policy-making. Accordingly, I point to the need for sufficiently integrated and multi-layered change across conceptions of citizenship, constructions of childhood and approaches to policy-making to sustain an enduring shift in the treatment of children in public policy.

Bisphenol A (BPA) is used widely to manufacture food container linings. Mouse models suggest exposure to BPA might increase allergic inflammation.We hypothesized that BPA exposure, as assessed based on urinary BPA concentrations, would be associated with increased odds of wheeze and asthma and increased fraction of exhaled nitric oxide (Feno) values in children.The Columbia Center for Children's Environmental Health recruited pregnant women for a prospective birth cohort study (n = 568). Mothers during the third trimester and children at ages 3, 5, and 7 years provided spot urine samples. Total urinary BPA concentrations were measured by using online solid-phase extraction, high-performance liquid chromatography, isotope-dilution tandem mass spectrometry. Wheeze in the last 12 months was measured by using questionnaires at ages 5, 6, and 7 years. Asthma was determined by a physician once between ages 5 and 12 years. Feno values were measured at ages 7 to 11 years.Prenatal urinary BPA concentrations were associated inversely with wheeze at age 5 years (odds ratio [OR], 0.7; 95% CI, 0.5-0.9; P = .02). Urinary BPA concentrations at age 3 years were associated positively with wheeze at ages 5 years (OR, 1.4; 95% CI, 1.1-1.8; P = .02) and 6 years (OR, 1.4; 95% CI, 1.0-1.9; P = .03). BPA concentrations at age 7 years were associated with wheeze at age 7 years (OR, 1.4; 95% CI, 1.0-1.9; P = .04) and Feno values (β = 0.1; 95% CI, 0.02-0.2; P = .02). BPA concentrations at ages 3, 5, and 7 years were associated with asthma (OR, 1.5 [95% CI, 1.1-2.0], P = .005; OR, 1.4 [95% CI, 1.0-1.9], P = .03; and OR, 1.5 [95% CI, 1.0-2.1], P = .04, respectively).This is the first report of an association between postnatal urinary BPA concentrations and asthma in children.

Background Sensitization to cockroach is one of the strongest identified risk factors for greater asthma morbidity in low-income urban communities; however, the timing of exposures relevant to the development of sensitization has not been elucidated fully. Furthermore, exposure to combustion byproducts, including polycyclic aromatic hydrocarbons (PAHs), can augment the development of allergic sensitization. Objective We sought to test the hypotheses that domestic cockroach allergen measured prenatally would predict cockroach sensitization in early childhood and that this association would be greater for children exposed to higher PAH concentrations. Methods Dominican and African American pregnant women living in New York City were enrolled. In the third trimester expectant mothers wore personal air samplers for measurement of 8 nonvolatile PAHs and the semivolatile PAH pyrene, and dust was collected from homes for allergen measurement. Glutathione-S-transferase μ 1 (GSTM1) gene polymorphisms were measured in children. Allergen-specific IgE levels were measured from the children at ages 2, 3, 5, and 7 years. Results Bla g 2 in prenatal kitchen dust predicted cockroach sensitization at the ages of 5 to 7 years (adjusted relative risk [RR], 1.15; P = .001; n = 349). The association was observed only among children with greater than (RR, 1.22; P = .001) but not less than (RR, 1.07; P = .24) the median sum of 8 nonvolatile PAH levels. The association was most pronounced among children with higher PAH levels and null for the GSTM1 gene (RR, 1.54; P = .001). Conclusions Prenatal exposure to cockroach allergen was associated with a greater risk of allergic sensitization. This risk was increased by exposure to nonvolatile PAHs, with children null for the GSTM1 mutation particularly vulnerable.

Background: Studies suggest that phthalate exposures may adversely affect child respiratory health. Objectives: We evaluated associations between asthma diagnosed in children between 5 and 11 years of age and prenatal exposures to butylbenzyl phthalate (BBzP), di-n-butyl phthalate (DnBP), di(2-ethylhexyl) phthalate (DEHP), and diethyl phthalate (DEP). Methods: Phthalate metabolites were measured in spot urine collected from 300 pregnant inner-city women. Children were examined by an allergist or pulmonologist based on the first parental report of wheeze, other respiratory symptoms, and/or use of asthma rescue/controller medication in the preceding 12 months on repeat follow-up questionnaires. Standardized diagnostic criteria were used to classify these children as either having or not having current asthma at the time of the physician examination. Children without any report of wheeze or the other asthma-like symptoms were classified as nonasthmatics at the time of the last negative questionnaire. Modified Poisson regression analyses were used to estimate relative risks (RR) controlling for specific gravity and potential confounders. Results: Of 300 children, 154 (51%) were examined by a physician because of reports of wheeze, other asthma-like symptoms, and/or medication use; 94 were diagnosed with current asthma and 60 without current asthma. The remaining 146 children were classified as nonasthmatic. Compared with levels in nonasthmatics, prenatal metabolites of BBzP and DnBP were associated with a history of asthma-like symptoms (p < 0.05) and with the diagnosis of current asthma: RR = 1.17 (95% CI: 1.01, 1.35) and RR = 1.25 (95% CI: 1.04, 1.51) per natural log-unit increase, respectively. Risk of current asthma was > 70% higher among children with maternal prenatal BBzP and DnBP metabolite concentrations in the third versus the first tertile. Conclusion: Prenatal exposure to BBzP and DnBP may increase the risk of asthma among inner-city children. However, because this is the first such finding, results require replication.