Search

Your search keyword '"Sandel, Megan"' showing total 591 results
Start Over Author "Sandel, Megan"
591 results on '"Sandel, Megan"'

4. Home and school pollutant exposure, respiratory outcomes, and influence of historical redlining

Author

Jung, Kyung Hwa, Argenio, Kira L., Jackson, Daniel J., Miller, Rachel L., Perzanowski, Matthew S., Rundle, Andrew G., Bacharier, Leonard B., Busse, William W., Cohen, Robyn T., Visness, Cynthia M., Gill, Michelle A., Gruchalla, Rebecca S., Hershey, Gurjit K., Kado, Rachel K., Sherenian, Michael G., Liu, Andrew H., Makhija, Melanie M., Pillai, Dinesh K., Rivera-Spoljaric, Katherine, Gergen, Peter J., Altman, Matthew C., Sandel, Megan T., Sorkness, Christine A., Kattan, Meyer, and Lovinsky-Desir, Stephanie

Published
2024
Full Text
View/download PDF

7. Clinical and molecular analysis of longitudinal rhinitis phenotypes in an urban birth cohort

Author

Ramratnam, Sima K., Johnson, Molly, Visness, Cynthia M., Calatroni, Agustin, Altman, Mathew C., Janczyk, Tomasz, McCauley, Kathryn E., Schachtschneider, Claire, Fujimura, Kei E., Fadrosh, Douglas W., Lynch, Susan V., Bacharier, Leonard B., O'Connor, George T., Sandel, Megan T., Kattan, Meyer, Wood, Robert A., Gergen, Peter J., Jackson, Daniel J., Togias, Alkis, and Gern, James E.

Published
2024
Full Text
View/download PDF

12. Part II: A Qualitative Study of Social Risk Screening Acceptability in Patients and Caregivers

Author

Byhoff, Elena, De Marchis, Emilia H, Hessler, Danielle, Fichtenberg, Caroline, Adler, Nancy, Cohen, Alicia J, Doran, Kelly M, de Cuba, Stephanie Ettinger, Fleegler, Eric W, Gavin, Nicholas, Huebschmann, Amy G, Lindau, Stacy Tessler, Tung, Elizabeth L, Raven, Maria, Jepson, Susan, Johnson, Wendy, Olson, Ardis L, Sandel, Megan, Sheward, Richard S, and Gottlieb, Laura M

Subjects
Health Services and Systems, Health Sciences, Behavioral and Social Science, Prevention, Patient Safety, Clinical Research, Health Services, Health and social care services research, 8.1 Organisation and delivery of services, Generic health relevance, Good Health and Well Being, Adult, Caregivers, Child, Cross-Sectional Studies, Delivery of Health Care, Emergency Service, Hospital, Female, Humans, Interviews as Topic, Male, Mass Screening, Medicaid, Medicare, Middle Aged, Patients, Primary Health Care, Social Determinants of Health, Social Welfare, Surveys and Questionnaires, United States, Medical and Health Sciences, Education, Public Health, Biomedical and clinical sciences, Health sciences
Abstract

IntroductionThis study aimed to better understand patient and caregiver perspectives on social risk screening across different healthcare settings.MethodsAs part of a mixed-methods multisite study, the authors conducted semistructured interviews with a subset of adult patients and adult caregivers of pediatric patients who had completed the Center for Medicare and Medicaid Innovation Accountable Health Communities social risk screening tool between July 2018 and February 2019. Interviews, conducted in English or Spanish, asked about reactions to screening, screening acceptability, preferences for administration, prior screening experiences that informed perspectives, and expectations for social assistance. Basic thematic analysis and constant comparative methods were used to code and develop themes.ResultsFifty interviews were conducted across 10 study sites in 9 states, including 6 primary care clinics and 4 emergency departments. There was broad consensus among interviewees across all sites that social risk screening was acceptable. The following 4 main themes emerged: (1) participants believed screening for social risks is important; (2) participants expressed insight into the connections between social risks and overall health; (3) participants emphasized the importance of patient-centered implementation of social risk screening; and (4) participants recognized limits to the healthcare sector's capacity to address or resolve social risks.ConclusionsDespite gaps in the availability of social risk-related interventions in healthcare settings, patient-centered social risk screening, including empathy and attention to privacy, may strengthen relationships between patients and healthcare teams.Supplement informationThis article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation.

Published
2019

13. Part I: A Quantitative Study of Social Risk Screening Acceptability in Patients and Caregivers.

Author

De Marchis, Emilia H, Hessler, Danielle, Fichtenberg, Caroline, Adler, Nancy, Byhoff, Elena, Cohen, Alicia J, Doran, Kelly M, Ettinger de Cuba, Stephanie, Fleegler, Eric W, Lewis, Cara C, Lindau, Stacy Tessler, Tung, Elizabeth L, Huebschmann, Amy G, Prather, Aric A, Raven, Maria, Gavin, Nicholas, Jepson, Susan, Johnson, Wendy, Ochoa, Eduardo, Olson, Ardis L, Sandel, Megan, Sheward, Richard S, and Gottlieb, Laura M

Subjects
Public Health, Medical and Health Sciences, Education
Abstract

INTRODUCTION:Despite recent growth in healthcare delivery-based social risk screening, little is known about patient perspectives on these activities. This study evaluates patient and caregiver acceptability of social risk screening. METHODS:This was a cross-sectional survey of 969 adult patients and adult caregivers of pediatric patients recruited from 6 primary care clinics and 4 emergency departments across 9 states. Survey items included the Center for Medicare and Medicaid Innovation Accountable Health Communities' social risk screening tool and questions about appropriateness of screening and comfort with including social risk data in electronic health records. Logistic regressions evaluated covariate associations with acceptability measures. Data collection occurred from July 2018 to February 2019; data analyses were conducted in February‒March 2019. RESULTS:Screening was reported as appropriate by 79% of participants; 65% reported comfort including social risks in electronic health records. In adjusted models, higher perceived screening appropriateness was associated with previous exposure to healthcare-based social risk screening (AOR=1.82, 95% CI=1.16, 2.88), trust in clinicians (AOR=1.55, 95% CI=1.00, 2.40), and recruitment from a primary care setting (AOR=1.70, 95% CI=1.23, 2.38). Lower appropriateness was associated with previous experience of healthcare discrimination (AOR=0.66, 95% CI=0.45, 0.95). Higher comfort with electronic health record documentation was associated with previously receiving assistance with social risks in a healthcare setting (AOR=1.47, 95% CI=1.04, 2.07). CONCLUSIONS:A strong majority of adult patients and caregivers of pediatric patients reported that social risk screening was appropriate. Most also felt comfortable including social risk data in electronic health records. Although multiple factors influenced acceptability, the effects were moderate to small. These findings suggest that lack of patient acceptability is unlikely to be a major implementation barrier. SUPPLEMENT INFORMATION:This article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation.

Published
2019

18. Longitudinal relationships between early-life homelessness and school- aged asthma and wheezing.

Author

Keen, Ryan, Hayoung Kim, Hannah, Chen, Jarvis T., Tiemeier, Henning, Sandel, Megan T., Denckla, Christy, and Slopen, Natalie

Subjects
ASTHMA risk factors, RESPIRATORY organ sounds, RISK assessment, RESEARCH funding, MULTIPLE regression analysis, MULTIVARIATE analysis, DESCRIPTIVE statistics, LONGITUDINAL method, ODDS ratio, HOMELESS persons, MATHEMATICAL models, STATISTICS, HOMELESSNESS, THEORY, CONFIDENCE intervals, DATA analysis software, PSYCHOSOCIAL factors, CHILDREN
Published
2024
Full Text
View/download PDF

19. Characteristics Associated with Homeless Pregnant Women in Columbus, Ohio

Author

Ervin, Emma, Poppe, Barbara, Onwuka, Amanda, Keedy, Hannah, Metraux, Stephen, Jones, Leslie, Sandel, Megan, and Kelleher, Kelly

Subjects
Columbus, Ohio -- Surveys -- Health aspects, Homeless women -- Surveys -- Health aspects, Pregnant women -- Surveys -- Health aspects, Health care industry
Abstract

Introduction The effects of homelessness on pregnant women are substantial. We aim to identify key characteristics of a group of women identified as homeless and pregnant in order to understand their history of housing, family composition, health, and demographics as a first step for future intervention. Methods We present cross-sectional survey data on a sample of 100 women reporting homelessness and pregnancy in the prior year in Columbus, Ohio, identified through social service and housing not for profit agencies. Our analysis uses data collected from a survey of health behaviors, housing, employment status, and demographics. Continuous measures are described with means and standard deviations, and categorical variables are described with percentages. Results The majority (81%) of the women identified as African American. Over 95% of the women were single, and 74 women reported a prior pregnancy. Almost half of the women reported being behind on rent at least one time in the last 6 months, and 43% indicated that they had lived in more than three places in the last year. Approximately 34% of the sample reported cigarette use during pregnancy, while 12% and 30% reported alcohol and illicit drug use, respectively. Discussion Women who were pregnant and experiencing homelessness in our study reported a multitude of complex and severe problems ranging from high rates of substance use, longstanding housing insecurity and financial stress. Programs hoping to successfully support women will need to address a variety of service needs while recognizing the resilience of many women., Author(s): Emma Ervin [sup.1] , Barbara Poppe [sup.2] , Amanda Onwuka [sup.1] , Hannah Keedy [sup.1] , Stephen Metraux [sup.3] , Leslie Jones [sup.1] , Megan Sandel [sup.4] , Kelly [...]

Published
2022
Full Text
View/download PDF

21. Development of Asthma in Inner-City Children: Possible Roles of MAIT Cells and Variation in the Home Environment

Author

Chandra, Shilpi, Wingender, Gerhard, Greenbaum, Jason A, Khurana, Archana, Gholami, Amin M, Ganesan, Anusha-Preethi, Rosenbach, Michael, Jaffee, Katy, Gern, James E, Wood, Robert, O'Connor, George, Sandel, Megan, Kattan, Meyer, Bacharier, Leonard, Togias, Alkis, Horner, Anthony A, and Kronenberg, Mitchell

Subjects
Biochemistry and Cell Biology, Biomedical and Clinical Sciences, Biological Sciences, Immunology, Lung, Clinical Research, Asthma, Pediatric, Prevention, Respiratory, CD4-Positive T-Lymphocytes, Child, Child, Preschool, Cities, Cohort Studies, Dust, Environment, Female, Humans, Infant, Interferon-gamma, Lymphocyte Activation, Lymphocyte Count, Male, Mucosal-Associated Invariant T Cells, Natural Killer T-Cells, Risk, Biochemistry and cell biology
Abstract

Humans have populations of innate-like T lymphocytes with an invariant TCR α-chain that recognize nonpeptide Ags, including invariant NKT (iNKT) cells and mucosal-associated invariant T (MAIT) cells. iNKT cell involvement in human asthma is controversial, whereas there has been little analysis of MAIT cells. Using peripheral blood cells from 110 participants from the Urban Environment and Childhood Asthma (URECA) birth cohort study, these cells were analyzed for number and function. We determined whether iNKT cell or MAIT cell frequency at 1 y is correlated with the cytokine polarization of mainstream CD4+ T cells and/or the development of asthma by age 7 y. Dust samples from 300 houses were tested for iNKT cell antigenic activity. Our results show that a higher MAIT cell frequency at 1 y of age was associated with a decreased risk of asthma by age 7 y. The frequency of MAIT cells was associated with increased production of IFN-γ by activated CD4+ T cells from the URECA cohort. iNKT cell antigenic activity in bedroom dust samples was associated with higher endotoxin concentration and also with reduced risk of asthma. In conclusion, MAIT cell frequency at 1 y may reflect the tendency of the immune system toward Th1 responses and is associated with protection from asthma. Additionally, iNKT cell antigenic activity may be a marker of houses with increased microbial exposures and therefore also with protection from asthma.

Published
2018

22. Trends in Household and Child Food Insecurity among Families with Young Children from 2007 to 2013

Author

Bovell, Allison R., de Cuba, Stephanie Ettinger, Casey, Patrick H., Coleman, Sharon, Cook, John T., Cutts, Diana, Heeren, Timothy C., Meyers, Alan, Sandel, Megan, Black, Maureen M., Chilton, Mariana, and Frank, Deborah A.

Abstract

Background: 2007-2013 spanned an economic downturn with rising food costs. While Supplemental Nutrition Assistance Program (SNAP) benefits increased during those years by 13.6% from the 2009 American Recovery Reinvestment Act (ARRA), the impact of these competing conditions on household food insecurity (HFI, household food insecure but child food secure) and child food insecurity (CFI, household and child food insecure) in households with infants and toddlers has not been investigated. Objective: To describe HFI and CFI in households participating in SNAP vs. households likely eligible but not participating (No SNAP). Design: Repeat cross-sectional. Participants/Setting: 19,999 caregivers of children. Children's HealthWatch survey in emergency and primary care departments in 5 US cities. Main Outcome Measures: The 18-item U.S. Household Food Security Survey (HFSS) measured HFI (=3 affirmative responses on non-child-specific questions) and CFI (=2 affirmative responses to eight child-specific questions). Statistical analyses performed: The sample was stratified by SNAP/No SNAP. Multinomial logistic regression analyses examined the association between SNAP receipt and HFI and CFI. Results: Across the study period, controlling for confounders including year, households with SNAP were 17% less likely to experience HFI (AOR 0.83; 95% CI, 0.75, 0.91) and children in households participating in SNAP were 33% less likely to experience CFI (AOR 0.67; 95% CI, 0.60-0.74) than children in the No SNAP group. Conclusions: Receipt of SNAP vs. No SNAP was associated with decreased prevalence of HFI and CFI during much of the economic downturn; this impact waned as the buying power of the boost in benefit amounts during the ARRA period eroded.

Published
2015

27. Co-Enrollment for Child Health: How Receipt and Loss of Food and Housing Subsidies Relate to Housing Security and Statutes for Streamlined, Multi-Subsidy Application

Author

Sandel, Megan, Cutts, Diana, Meyers, Alan, Ettinger de Cuba, Stephanie, Coleman, Sharon, Black, Maureen M., Casey, Patrick H., Chilton, Mariana, Cook, John T., Shortell, Amanda, Heeren, Timothy, and Frank, Deborah

Abstract

In light of recent policy debates around funding food and housing subsidies, the combined influence of these programs on housing security (HS), defined as housing without crowding or frequent moves, remains unstudied. In a multi-city study of young children, federal nutrition and housing subsidies together increased the odds of HS, whereas loss of nutrition subsidies lowered the odds of HS even after controlling for housing subsidy receipt. Ensuring eligible families' access to both nutrition and housing subsidies may sustain HS. The results of this study inform and support current efforts by states to streamline online applications for social services and remove statutory legal barriers to accessing these subsidies simultaneously.

Published
2014

28. Promoting Caregiver and Child Health through Housing Stability Screening in Clinical Settings

Author

Sheward, Richard, Bovell-Ammon, Allison, Ahmad, Nayab, Preer, Genevieve, Ettinger de Cuba, Stephanie, and Sandel, Megan

Abstract

Within the health care sector, researchers, clinicians, and payers increasingly recognize the importance of the social determinants of health for improving maternal and child health. This article focuses on existing and emerging approaches to screening families for unstable housing circumstances. The authors describe how housing stability screening helps health care providers to better understand risks for caregiver and child health and wellness. They urge clinicians to screen more actively for housing stability, not just homelessness, hospitals to pursue incentive payments and alternative financial models to address housing instability, and policymakers to expand investments in housing as a health-promoting policy opportunity.

Published
2019

31. Expression quantitative trait locus fine mapping of the 17q12–21 asthma locus in African American children: a genetic association and gene expression study

Author

Achten, Niek, Ainsworth, John, Akkerman, Nonna, Anderson, Elizabeth, Anderson, Larry J., Andrews, Howard, Armagost, Elizabeth, Aubuchon, Mary Ann, Bach, Julia, Bacharier, Leonard, Barnes, Kathrine L., Barone, Charles, Bauer, Irma, Beamer, Paloma, Becker, Patrice, Bednarek, Alyssa, Bellemore, Stacey, Bendixsen, Casper G., Biagini Myers, Jocelyn M., Billheimer, Dean, Billstrand, Christine, Birg, Geraldine, Blocki, Shirley, Bloomberg, Gordon, Bobbitt, Kevin, Bochkov, Yury, Bourgeois, Karen, Boushey, Homer, Brockman-Schneider, Rebecca, Brunwasser, Steven M., Budrevich, Richard, Burkle, Jeffrey W., Busse, William, Calatroni, Agustin, Campbell, Janice, Carlson-Dakes, Kirsten, Cassidy-Bushrow, Andrea, Chappell, James D., Chasman, Deborah, Chipps, Teresa M., Chirkova, Tatiana, Cole, Deanna, Connolly, Alexandra, Cootauco, Michelle, Costello, Kaitlin, Couch, Philip, Coull, Brent, Craven, Mark, Crisafi, Gina, Cruikshank, William, Curtsinger, Kristi, Custovic, Adnan, Das, Suman R., DaSilva, Douglas, Datta, Soma, Davidson, Brent, De La Ossa, Lydia, DeVries, Mark, Di, Qian, Dixon, Samara, Donnerbauer, Erin, Dorst, Marian, Doyle, Susan, Dresen, Amy, Dupont, William D., Durrange, Janet, Erickson, Heidi, Evans, Michael D., Ezell, Jerel, Farnham, Leanna, Filardo-Collins, Roxanne, Finazzo, Salvatore, Flege, Zachary, Fleurat, Conner, Floerke, Heather, Floerke, Dorothy, Foss, Terry, Freie, Angela, Frome, Wayne, Fye, Samantha, Gagalis, Lisa, Gammell, Rebecca, Gangnon, Ronald E., Ge, James E., Gebretsadik, Tebeb, Gergen, Peter, Gern, James E., Gibson, Heike, Gjerasi, Edlira, Gold, Diane R., Gonzalez, Nicole, Goodman, Kayla, Gress, Lisa, Grindle, Kristine, Groeschen, Taylor, Hallmark, Brian, Halonen, Marilyn, Hart, Jaime, Hartert, Tina V., Havstad, Suzanne, Heinritz, Patrick, Hensley Alford, Sharon, Herbstman, Julie, Hernandez, Kellie, Hoepner, Lori, Jackson, Daniel J., Jadhao, Samadhan J., Jaffee, Katy, James, Peter, Jezioro, Jacqueline, Jimenez Pescador, Marcia, Johnson, Christine C., Johnson, Tara, Johnson, Camille, Jones, Amelia, Jones, Kyra, Jones, Paul, Jordan, Carolina, Joseph, Christine LM, Kattan, Meyer, Keidel, Kristina, Keifer, Matthew C., Kelley, Rick, Khurana Hershey, Gurgit K., Kim, Haejin, Kloog, Itai, Koepel, Tammy Kronenwetter, Koerkenmeier, Clint, Ladick, Laura, Lamm, Carin, Larkin, Emma, Lederman, Howard, Lee-Parritz, Aviva, Leimenstoll, Stephanie, Lemanske, Jr., Robert F., LeMasters, Grace K., Levin, Albert M., Levine, Jessica, Liu, Xinhua, Liu, Zhouwen, Lopez, Silvia, Lothrop, Nathan, Lovinsky-Desir, Stephanie, Lukacs, Nicholas, Lynch, Susan, Lynch, Christian, Mann, Erik, Martin, Jennifer, Martin, Lisa, Martinez, Fernando D., Matsui, Elizabeth, McCauley, Katherine, Mccollum, Megan, McCullough, Judith, McKennon, Chris G., Meece, Jennifer, Mendonca, Eneida, Mikus, Lance, Miller, Rachel L., Minton, Patricia, Mitchell, Herman, Moon, Vicki, Moore, Paul E., Morgan, Wayne, Morgan, Valerie, Morgan, David, Murrison, Liza, Nicholas, Charlotte, Nicolae, Daniel, Nunez, Adam, O'Connor, George, O'Toole, Sharon, Ober, Carole, Olson, Brent F., Ong, Irene, Osmundson, Sarah, Ownby, Dennis, Pappas, Tressa, Perera, Frederica, Perzanowski, Matthew, Peterson, Edward, Pierce, Marcela, Price-Johnson, Penny, Rajamanickam, Victoria, Ramirez, Judyth, Ray, Kimberly, Renneberg, Megan, Requia, Weeberb, Riley, Kylie, Rivera, Janelle, Rivers, Neisha, Roberg, Kathy, Rogers, Theresa, Rosas-Salazar, Christian, Russell, Pat, Ryan, Patrick H., Sadovsky, Yoel, Salazar, Lisa, Sampson, Hugh, Sandel, Megan, Schoettler, Nathan, Schwartz, Joel, Scott, Dena, Seroogy, Christine M., Sharp, Renee, Shilts, Meghan H., Sigelman, Steve, Singh, Anne Marie, Sitarik, Alexandra, Smartt, Ernestine, Sorkness, Ronald, Sorkness, Christine, Spangenberg, Amber, Sperling, Rhoda, Spies, David, Stern, Debra A., Stoffel, Brandy, Peebles, R. Stokes, Stouffer, Gina, Strauchman Boyer, Cathey, Suddeuth, Caitlin, Tachinardi, Umberto, Tang, Deliang, Tang, Zhengzheng, Tate, Jena, Taylor, William, Tensing, Krista, Tesson, Elizabeth, Thompson, Kathy, Thompson, Emma, Tisler, Christopher, Togias, Alkis, Turi, Kedir, Turner, Victoria, Tuzova, Marina, VanWormer, Jeffrey J., Visness, Cynthia M., Vrtis, Rose, Wahlman, Anthony, Wang, Lena, Wegienka, Ganesa, Wells, Karen, Wentworth-Sheilds, William, Wheatley, Lisa, Whitney, Nitsa, Williams, L. Keoki, Witter, Frank, Wolfe, Christopher, Wood, Robert A., Woodcroft, Kimberley, Woodward, Kim B., Wright, Anne L., Wright, Rosalind, Wu, Pingsheng, Yaeger, Melissa, Yaniv, Perri, Zanobetti, Antonella, Zhang, Shirley, Zook, Patricia, Zoratti, Edward M., McKennan, Chris G, Magnaye, Kevin M, Altman, Matthew C, Washington, Charles, 3rd, Stanhope, Catherine, Naughton, Katherine A, Rosasco, Mario G, Bacharier, Leonard B, Gold, Diane R, Hartert, Tina, Khurana Hershey, Gurjit K, Hogarth, D Kyle, Jackson, Daniel J, Johnson, Christine C, Lemanske, Robert F, Lynch, Susan V, Mendonca, Eneida A, Miller, Rachel L, Naureckas, Edward T, O'Connor, George T, Seroogy, Christine M, White, Steven R, Wood, Robert A, Wright, Anne L, Zoratti, Edward M, Martinez, Fernando D, Nicolae, Dan L, Levin, Albert M, and Gern, James E

Published
2020
Full Text
View/download PDF

35. Effects of early-life exposure to allergens and bacteria on recurrent wheeze and atopy in urban children

Author

Lynch, Susan V, Wood, Robert A, Boushey, Homer, Bacharier, Leonard B, Bloomberg, Gordon R, Kattan, Meyer, O’Connor, George T, Sandel, Megan T, Calatroni, Agustin, Matsui, Elizabeth, Johnson, Christine C, Lynn, Henry, Visness, Cynthia M, Jaffee, Katy F, Gergen, Peter J, Gold, Diane R, Wright, Rosalind J, Fujimura, Kei, Rauch, Marcus, Busse, William W, and Gern, James E

Subjects
Asthma, Clinical Research, Perinatal Period - Conditions Originating in Perinatal Period, Prevention, Pediatric, Lung, Aetiology, 2.2 Factors relating to the physical environment, Inflammatory and immune system, Respiratory, Sustainable Cities and Communities, Allergens, Antigens, Bacterial, Bacteria, Case-Control Studies, Child, Preschool, Cohort Studies, Dust, Environmental Exposure, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Male, Recurrence, Respiratory Sounds, Risk, United States, Urban Population, atopy, allergen exposure, microbial exposure, inner city, Immunology, Allergy
Abstract

BackgroundWheezing illnesses cause major morbidity in infants and are frequent precursors to asthma.ObjectiveWe sought to examine environmental factors associated with recurrent wheezing in inner-city environments.MethodsThe Urban Environment and Childhood Asthma study examined a birth cohort at high risk for asthma (n = 560) in Baltimore, Boston, New York, and St Louis. Environmental assessments included allergen exposure and, in a nested case-control study of 104 children, the bacterial content of house dust collected in the first year of life. Associations were determined among environmental factors, aeroallergen sensitization, and recurrent wheezing at age 3 years.ResultsCumulative allergen exposure over the first 3 years was associated with allergic sensitization, and sensitization at age 3 years was related to recurrent wheeze. In contrast, first-year exposure to cockroach, mouse, and cat allergens was negatively associated with recurrent wheeze (odds ratio, 0.60, 0.65, and 0.75, respectively; P ≤ .01). Differences in house dust bacterial content in the first year, especially reduced exposure to specific Firmicutes and Bacteriodetes, was associated with atopy and atopic wheeze. Exposure to high levels of both allergens and this subset of bacteria in the first year of life was most common among children without atopy or wheeze.ConclusionsIn inner-city environments children with the highest exposure to specific allergens and bacteria during their first year were least likely to have recurrent wheeze and allergic sensitization. These findings suggest that concomitant exposure to high levels of certain allergens and bacteria in early life might be beneficial and suggest new preventive strategies for wheezing and allergic diseases.

Published
2014

38. There's No Place Like Home: How America's Housing Crisis Threatens Our Children.

Author

Boston Medical Center, MA. Doc4Kids Project., Housing America, San Francisco, CA., Sandel, Megan, Sharfstein, Joshua, and Shaw, Randy

Abstract

This report pulls together recent research from the Centers for Disease Control, leading medical and public health journals, and firsthand observations by pediatricians across the country on the link between affordable housing and children's health and outcomes. Also included are the most recent data from the America Housing Survey, the U.S. Department of Housing and Urban Development (HUD), the National Housing Trust, the U.S. Conference of Mayors, and city and county consolidated plans on the many children growing up in housing that is substandard, unaffordable, or dangerous. Following an executive summary, the report discusses five consequences to children's health of poor housing: asthma and respiratory disease, chronic illness, injuries, lead poisoning, and homelessness. The report also describes how poor housing increases malnutrition among children and undermines their education. The report concludes with these recommendations: (1) increase Section 8 vouchers; (2) protect the existing affordable housing stock; (3) increase the low-income housing tax credit; (4) ensure affordable housing for kids with severe asthma or chronic diseases; and (5) eliminate the shelter deduction cap. (EV)

Published
1999

39. Not Safe at Home: How America's Housing Crisis Threatens the Health of Its Children. A Research Report.

Author

Children's Hospital Medical Center, Boston, MA., Sharfstein, Joshua, and Sandel, Megan

Abstract

Through an Internet campaign, the Doc4Kids Project gathered stories from pediatric caregivers about children whose health has been compromised by poor housing and whose health has been improved by housing assistance. The medical literature was also reviewed to estimate the total impact of inadequate housing on child health in the United States. The goal of this compilation was to redefine America's housing crisis as a catastrophe for child health. The report contains these sections: (1) "Background. U.S. Housing Crisis: The Facts"; (2) "The Consequences of Inadequate Housing" (asthma and respiratory disease, injuries, lead poisoning, homelessness, malnutrition); (3) "Double Trouble: Chronic Disease and Inadequate Housing"; (4) "Statistics: The Impact of Inadequate Housing on Child Health"; and (5) "Recommendations for Action." General recommendations include changes to housing voucher programs and collaboration between health care institutions and housing authorities. Recommendations are also provided in the areas of asthma, lead poisoning, injuries and violence, malnutrition, and homelessness. Includes notes and an appendix containing stories submitted to the Doc4Kids Project. (EV)

Published
1998

40. Factors influencing the infant gut microbiome at age 3-6 months: Findings from the ethnically diverse Vitamin D Antenatal Asthma Reduction Trial (VDAART)

Author

Sordillo, Joanne E., Zhou, Yanjiao, McGeachie, Michael J., Ziniti, John, Lange, Nancy, Laranjo, Nancy, Savage, Jessica R., Carey, Vincent, O'Connor, George, Sandel, Megan, Strunk, Robert, Bacharier, Leonard, Zeiger, Robert, Weiss, Scott T., Weinstock, George, Gold, Diane R., and Litonjua, Augusto A.

Published
2017
Full Text
View/download PDF

43. The maternal prenatal and offspring early-life gut microbiome of childhood asthma phenotypes

Author

Lee-Sarwar, Kathleen A., Chen, Yih Chieh, Chen, Yuan Yao, Kozyrskyj, Anita L, Mandhane, Piush J., Turvey, Stuart E., Subbarao, Padmaja, Bisgaard, Hans, Stokholm, Jakob, Chawes, Bo, Sørensen, Søren J., Kelly, Rachel S, Lasky-Su, Jessica, Zeiger, Robert S., O'Connor, George T., Sandel, Megan T., Bacharier, Leonard B., Beigelman, Avraham, Carey, Vincent J, Harshfield, Benjamin J., Laranjo, Nancy, Gold, Diane R., Weiss, Scott T, Litonjua, Augusto A., Lee-Sarwar, Kathleen A., Chen, Yih Chieh, Chen, Yuan Yao, Kozyrskyj, Anita L, Mandhane, Piush J., Turvey, Stuart E., Subbarao, Padmaja, Bisgaard, Hans, Stokholm, Jakob, Chawes, Bo, Sørensen, Søren J., Kelly, Rachel S, Lasky-Su, Jessica, Zeiger, Robert S., O'Connor, George T., Sandel, Megan T., Bacharier, Leonard B., Beigelman, Avraham, Carey, Vincent J, Harshfield, Benjamin J., Laranjo, Nancy, Gold, Diane R., Weiss, Scott T, and Litonjua, Augusto A.

Abstract

Background: The infant fecal microbiome is known to impact subsequent asthma risk, but the environmental exposures impacting this association, the role of the maternal microbiome, and how the microbiome impacts different childhood asthma phenotypes are unknown. Methods: Our objective was to identify associations between features of the prenatal and early-life fecal microbiomes and child asthma phenotypes. We analyzed fecal 16 s rRNA microbiome profiling and fecal metabolomic profiling from stool samples collected from mothers during the third trimester of pregnancy (n = 120) and offspring at ages 3–6 months (n = 265), 1 (n = 436) and 3 years (n = 506) in a total of 657 mother–child pairs participating in the Vitamin D Antenatal Asthma Reduction Trial. We used clinical data from birth to age 6 years to characterize subjects with asthma as having early, transient or active asthma phenotypes. In addition to identifying specific genera that were robustly associated with asthma phenotypes in multiple covariate-adjusted models, we clustered subjects by their longitudinal microbiome composition and sought associations between fecal metabolites and relevant microbiome and clinical features. Results: Seven maternal and two infant fecal microbial taxa were robustly associated with at least one asthma phenotype, and a longitudinal gut microenvironment profile was associated with early asthma (Fisher exact test p =.03). Though mode of delivery was not directly associated with asthma, we found substantial evidence for a pathway whereby cesarean section reduces fecal Bacteroides and microbial sphingolipids, increasing susceptibility to early asthma. Conclusion: Overall, our results suggest that the early-life, including prenatal, fecal microbiome modifies risk of asthma, especially asthma with onset by age 3 years.

Published
2023

47. Comparison of Rhinitis Phenotypes with the Development of Asthma by Age 10 in an Urban Birth Cohort

Author

Tanis, Ross, primary, Calatroni, Agustin, additional, Bacharier, Leonard, additional, Little, Frederic, additional, Sandel, Megan, additional, Rivera-Spoljaric, Katherine, additional, Visness, Cynthia, additional, Togias, Alkis, additional, Gergen, Peter, additional, Gern, James, additional, Ramratnam, Sima, additional, Lamm, Carin, additional, Wood, Robert, additional, and Johnson, Molly, additional

Published
2023
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results