Stress and Negative Affect as Mediators in the Association between Parental Social Support and Lung Function in Adolescents with Asthma

Asthma is the leading chronic condition amongst children in the United States as 7.5% of children are diagnosed with asthma. Studies have shown that positive social support is associated with positive asthma management. A strong social support system predicts good management of asthma symptoms; however, current literature has not yet examined how social support impacts lung function as opposed to merely symptom management. Stress and negative affect have been revealed to be associated with worse asthma control, as well as exacerbation of symptoms. Stressful situations, such as the death of a family member, unemployment, and familial tensions lead to worsening asthma symptoms, caused by the release of hormones. Similarly, negative affect has been analyzed as a causal factor for worsening asthmatic symptoms. Therefore, this pilot study sought to assess parental social support, adolescent stress and negative affect, and adolescent biological lung function to determine whether these affective processes (negative affect and stress) might serve as mediators in the association between social support and lung function. Adolescents suffering from asthma ages 12-17 (mean age = 13.9) (n = 21) were recruited from the pediatric asthma clinic at CHOC Children’s Hospital of Orange County for this pilot study. Participants were asked to complete a baseline survey upon recruitment assessing parental social support and stress. Seven consecutive days thereafter, for 4 times a day, participants were given a spirometer and asked to record lung function values including Peak Expiratory Flow (PEF) and Forced Expiratory Volume in 1 second (FEV1) as well as negative affect emotionality. Regression analysis revealed that higher levels of parental social support were associated with lower negative affect, b = -0.44, p \u3c 0.05, and stress, b = -0.40, p \u3c 0.05. However, there was no association between parental social support and lung function, for both PEF and FEV1 values. Implications for this study suggest that children with asthma who have more social support from parents have less stress and less negative affect. Next steps in this work are to analyze these mediators again, by recruiting more participants to the present study. Research should continue to consider psychological factors on children’s asthma in hopes of improving quality of their life

Pediatric Asthma and Psychological Resilience: Examining Whether Family Functioning and Social Support Relate to Asthma Symptoms and Lung Function

Upwards of 6 million children in the United States are afflicted with pediatric asthma. While previous research has linked asthma to multiple contributing biological and environmental factors, recent research suggests that psychological and social factors may have an impact on physiological outcomes of asthma like lung function and lung inflammation. Therefore, we suggest the need to study the impact of positive psychological factors such as a well-functioning family environment and beneficial social support on symptoms and lung function of children diagnosed with asthma. In the present pilot study, we recruited a total of 15 children with a confirmed asthma diagnosis and their parents from the Division of Pulmonology at the Children’s Hospital of Orange County. Participants were asked to complete an initial baseline assessment as well as ecological momentary assessments four times a day for seven days followed by a final follow up survey. Asthma symptoms and pulmonary function were measured using a 7-item Asthma Control Diary, and peak expiratory flow (PEF) values were gathered using data from self-administered spirometer recordings during the ecological momentary assessment portion of the study. This pilot study demonstrates the feasibility in collecting ecological momentary assessments surrounding positive psychological factors. Further, in testing the associations between family functioning and social support on children’s asthma symptoms and lung function, children who received more support from teachers (b = 0.03, t = 2.34, p = 0.048) and close friends (b = 0.04, t = 3.88, p = 0.006) had worse symptoms and lung function. Family functioning was not significantly associated with asthma symptoms and lung function (b = -0.00, t = -0.03, p = 0.975). Based on the results obtained, significant associations were only found in some aspects of social support. Interestingly, it seems as though children with more social support had worse asthma symptoms and lung function. This negative association might be an issue of reverse causality in which children who need more assistance receive more support. Next steps in this work include testing these associations in a larger-scale study. In sum, as pediatric asthma’s prevalence continues to rise, future studies should further examine the relationship between positive psychological factors and children’s asthma resilience

Muscle size and cardiorespiratory response to exercise in cystic fibrosis.

The mechanism responsible for diminished exercise performance in cystic fibrosis (CF) is not clear. We hypothesized that reduced muscle size, rather than an intrinsic muscle defect, was the primary factor in such diminished exercise performance. Twenty-two subjects with CF (14 females and eight males, aged 6.5 to 17.7 yr, with FEV(1) of 46% to 111% predicted) participated in a study of this hypothesis, and were compared with healthy children tested in the same laboratory. Muscle size was estimated from midthigh muscle cross-sectional area (CSA) obtained by magnetic resonance imaging, and fitness was determined by progressive cycle ergometer exercise testing with breath-by-breath measurements of gas exchange. Peak oxygen consumption (V O(2)) was reduced in CF subjects (956 +/- 81 [mean +/- SEM] ml/min, as compared with 1,473 +/- 54 ml/min in controls; p < 0.00001). Surprisingly, CF subjects had a lower peak V O(2) per CSA (mean for CF subjects 70 +/- 3% predicted, p < 0.0001) than did controls, whereas muscle CSA in CF subjects was not significantly smaller than in controls. The scaling parameters of peak V O(2) and muscle CSA did not differ significantly between healthy controls (0.80 +/- 0.16) and CF subjects (1.03 +/- 0.12). Indexes of aerobic function that are less effort-dependent than peak V O(2) were also lower in the CF subjects (e.g., the slope of V O(2) versus work rate [WR] (DeltaV O(2)/DeltaWR) was 68 +/- 2% predicted; p < 0.005). The study data did not support the initial hypothesis, and suggest a muscle-related abnormality in oxygen metabolism in patients with CF

Muscle size and cardiorespiratory response to exercise in cystic fibrosis.

The mechanism responsible for diminished exercise performance in cystic fibrosis (CF) is not clear. We hypothesized that reduced muscle size, rather than an intrinsic muscle defect, was the primary factor in such diminished exercise performance. Twenty-two subjects with CF (14 females and eight males, aged 6.5 to 17.7 yr, with FEV(1) of 46% to 111% predicted) participated in a study of this hypothesis, and were compared with healthy children tested in the same laboratory. Muscle size was estimated from midthigh muscle cross-sectional area (CSA) obtained by magnetic resonance imaging, and fitness was determined by progressive cycle ergometer exercise testing with breath-by-breath measurements of gas exchange. Peak oxygen consumption (V O(2)) was reduced in CF subjects (956 +/- 81 [mean +/- SEM] ml/min, as compared with 1,473 +/- 54 ml/min in controls; p < 0.00001). Surprisingly, CF subjects had a lower peak V O(2) per CSA (mean for CF subjects 70 +/- 3% predicted, p < 0.0001) than did controls, whereas muscle CSA in CF subjects was not significantly smaller than in controls. The scaling parameters of peak V O(2) and muscle CSA did not differ significantly between healthy controls (0.80 +/- 0.16) and CF subjects (1.03 +/- 0.12). Indexes of aerobic function that are less effort-dependent than peak V O(2) were also lower in the CF subjects (e.g., the slope of V O(2) versus work rate [WR] (DeltaV O(2)/DeltaWR) was 68 +/- 2% predicted; p < 0.005). The study data did not support the initial hypothesis, and suggest a muscle-related abnormality in oxygen metabolism in patients with CF

Fitness, acute exercise, and anabolic and catabolic mediators in cystic fibrosis.

Exercise can stimulate catabolic inflammatory cytokines even in healthy children. For patients with cystic fibrosis (CF), this may be problematic because CF is characterized by increased inflammation and suppressed growth. We examined fitness and the response to brief exercise of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), insulinlike growth factor-I (IGF-I), and IGF binding protein-1 (IGFBP-1) in 14 subjects with CF (10.5 +/- 0.8 yr of age), 9 of whom were treated with ibuprofen, and 14 healthy control subjects (11.6 +/- 0.5 yr of age, NS). Subjects performed brief intermittent, constant work rate protocol (scaled to each individual's exercise capacity) with blood and urine sampling. Peak V O(2) was correlated with IGF-I (r = 0.68, p < 0.01) in control subjects but not in subjects with CF. In subjects with CF, baseline IL-6 was 79% greater (p < 0.05) and IGF-I was 47% lower than in control subjects (p < 0.05). Post hoc analysis revealed a progressive increase in the IL-6 response to exercise, with the lowest increase observed in control subjects (11.8 +/- 4.6 pg/L/kJ), higher increases in patients with CF treated with ibuprofen (23.4 +/- 7.7 pg/L/kJ), and highest in subjects with CF not receiving ibuprofen (29.2 +/- 7.5 pg/L/kJ). Qualitatively similar results were observed for TNF-alpha. Exercise also significantly increased IGFBP-1 in both control subjects and subjects with CF. Brief exercise can increase even chronically elevated inflammatory mediators in CF, and this response may be attenuated by ibuprofen

Het Nationaal Historisch Museum en de emotional turn

<p><strong><em>The Dutch National History Museum and the ‘Emotional Turn’</em></strong><br />Recent discussions about the Dutch National History Museum (NHM) should not be restricted to issues put forward by professional historians, be it the importance of a historical canon or nuanced historical debates. Two major, strongly intertwined developments will have to be considered. Firstly, the emotional turn in recent heritage discussions and, secondly, the increasing multi-medialisation of our daily lives. These 21st century developments call for a redefinition of the tasks of a museum for cultural history and a new paradigm in history museums. Traditional collection-driven museums will not be able to satisfy the challenges of the emotional and digital requirements. The NHM should aim to be at the cutting edge of new museum practises.</p><p> </p><p>This article is part of the <a href="/419/volume/124/issue/3/">forum</a> 'The Dutch National History Museum'.</p