National Jewish Health

About: National Jewish Health is a healthcare organization based out in Denver, Colorado, United States. It is known for research contribution in the topics: Asthma & T cell. The organization has 883 authors who have published 833 publications receiving 79201 citations. The organization is also known as: National Jewish Medical and Research Center.

Material asthma status alters relation of infant feeding to asthma childhood

Abstract: The relation of infant feeding to childhood asthma is controversial. This study tested the hypothesis that maternal asthma alters the relation of breastfeeding to childhood asthma. Questionnaires were completed at age 6, 9 or 11 years by parents of 1043 children enrolled at birth. Active MD asthma was defined as a physician diagnosis of asthma plus asthma symptoms reported on one of the questionnaires. Duration of exclusive breastfeeding, categorized as never, <4 months, or≥_4 months, was based on prospective physician reports or questionnaires completed at 18 months. The relationship between breastfeeding and asthma differed by maternal asthma status. For children with maternal asthma, the percent developing active MD asthma increased significantly with longer duration of exclusive breastfeeding. Odds of developing asthma among these children were significantly elevated (OR: 5.7,CI; 2.8–11.5), after adjusting for confounders. This association of longer exclusive breastfeeding with increased risk of reported asthma among children with asthmatic mothers may be biologically based, or may reflect reporting biases.

Boundary Ambiguity in Parents With Chronically Ill Children: Integrating Theory and Research

Abstract: This article integrates theory and research related to boundary ambiguity in parents of children with a chronic health condition. We propose that boundary ambiguity is a risk factor for psychological distress in these parents. Clinical applications and a case example highlight how boundary ambiguity can be assessed and managed in clinical settings by professionals working with parents with chronically ill children. Questions are provided for assessing boundary ambiguity in clinical and research settings, and implications for research are discussed. Key Words: boundary ambiguity, child chronic health conditions, childhood illness, contextual model of family stress. Chronic illness is a strikingly common feature of childhood. Estimates indicate that between 10% and 30% of American children have a chronic health condition or disability (Davidoff, 2004; Newacheck et al., 1998; Van Dyck, Kogan, McPherson, Weissman, & Newacheck, 2004). Because of advances in medicine and technology, children with previously fatal health conditions often survive and have chronic, incurable conditions (Palmer & Boisen, 2002). Parents are left in an ambiguous situation with little certainty about how the child's illness will progress and, in some cases, how long their child will live. In addition, parents may be unsure of how to relate to their child with a chronic health condition. For example, parents may be uncertain how to discipline a child with a serious health condition (Cohen, 1999; Eddy et al., 1998; Phillips, Bohannon, Gayton, & Friedman, 1985). In more extreme situations, parents may question whether they should let themselves get attached to a child with a limited life expectancy or may be stymied in their attempts to form a connection with a child who is continuously undergoing treatments in the hospital (Clark & Miles, 1999). As a result, it can be difficult for parents to decide how a child with a chronic condition fits into their family, a situation referred to as "boundary ambiguity." Boundary ambiguity has been defined as "a state in which family members are uncertain in their perception about who is in or out of the family and who is performing what roles and tasks within the family system" (Boss & Greenberg, 1984, p. 536). Research has indicated that parents of children with chronic health conditions are at increased risk for symptoms of psychological distress such as depression and anxiety (Mastroyannopoulou, Stallard, Lewis, & Lenton, 1997; Nagy & Ungerer, 1990; Quittner, DiGirolamo, Michel, & Eigen, 1992). It is important to identify correlates of parental distress, so additional services can be offered to parents at highest risk. In this article, we propose that boundary ambiguity is a risk factor for psychological distress in parents of children with chronic health conditions. The purpose of this article is to integrate theory and research related to boundary ambiguity and parents with chronically ill children in order to clarify implications for clinical work and research. First, the contextual model of family stress (CMFS) is described to provide a theoretical foundation. second, this article reviews research that supports the proposition that boundary ambiguity is a risk factor for psychological distress among parents with chronically ill children. Third, this article identifies applications for using boundary ambiguity in clinical work. The article concludes with key questions that can be used to elicit information about boundary ambiguity in these parents and provides suggestions for future research. Theoretical Foundation: The CMFS One of Boss's contributions to family stress theory is the introduction of two new constructs: ambiguous loss and boundary ambiguity. These constructs are key components of die CMFS (Boss, 2002) and are founded on the premise that meaning and perception are of vital importance in determining how families respond to stressful events or situations. …

The Placebo Effect in Asthma

Abstract: The placebo effect is a complex phenomenon occurring across a variety of clinical conditions. While much placebo research has been conducted in diseases defined by self-report such as depression, chronic pain, and irritable bowel syndrome (IBS), asthma has been proposed as a useful model because of its easily measured objective outcomes. Studies examining the placebo response in asthma have not only contributed to an understanding of the mechanisms behind the placebo response but also shed an interesting light on the current treatment and diagnosis of asthma. This paper will review current literature on placebos in general and specifically on the placebo response in asthma. It focuses on what we know about the mechanisms behind the placebo effect, whether there is a specific portion of the population who responds to placebos, which patient outcomes are influenced by the placebo effect, and whether the effect can be augmented.

The Lambda variant of SARS-CoV-2 has a better chance than the Delta variant to escape vaccines

Abstract: The newly emerging variants of SARS-CoV-2 from India (Delta variant) and South America (Lambda variant) have led to a higher infection rate of either vaccinated or unvaccinated people. We found that sera from Pfizer-BioNTech vaccine remain high reactivity toward the receptor binding domain (RBD) of Delta variant while it drops dramatically toward that of Lambda variant. Interestingly, the overall titer of antibodies of Pfizer-BioNTech vaccinated individuals drops 3-fold after 6 months, which could be one of major reasons for breakthrough infections, emphasizing the importance of potential third boost shot. While a therapeutic antibody, Bamlanivimab, decreases binding affinity to Delta variant by ~20 fold, it fully lost binding to Lambda variant. Structural modeling of complexes of RBD with human receptor, Angiotensin Converting Enzyme 2 (ACE2), and Bamlanivimab suggest the potential basis of the change of binding. The data suggest possible danger and a potential surge of Lambda variant in near future.

Smoking-related idiopathic interstitial pneumonia

Abstract: Cigarette smoking is a key factor in the development of numerous pulmonary diseases. An international group of clinicians, radiologists and pathologists evaluated patients with previously identified idiopathic interstitial pneumonia (IIP) to determine unique features of cigarette smoking. Phase 1 (derivation group) identified smoking-related features in patients with a history of smoking (n=41). Phase 2 (validation group) determined if these features correctly predicted the smoking status of IIP patients (n=100) to participants blinded to smoking history. Finally, the investigators sought to determine if a new smoking-related interstitial lung disease phenotype could be defined. Phase 1 suggested that preserved forced vital capacity with disproportionately reduced diffusing capacity of the lung for carbon monoxide, and various radiographic and histopathological findings were smoking-related features. In phase 2, the kappa coefficient among clinicians was 0.16 (95% CI 0.11-0.21), among the pathologists 0.36 (95% CI 0.32-0.40) and among the radiologists 0.43 (95% CI 0.35-0.52) for smoking-related features. Eight of the 100 cases were felt to represent a potential smoking-related interstitial lung disease. Smoking-related features of interstitial lung disease were identified in a minority of smokers and were not specific for smoking. This study is limited by its retrospective design, the potential for recall bias in smoking history and lack of information on second-hand smoke exposure. Further research is needed to understand the relationship between smoking and interstitial lung disease.