Overweight, race, and psychological distress in children in the Childhood Asthma Management Program.

Objective: The purpose of this work was to determine whether overweight in youth with mild-to-moderate asthma occurs with increased frequency and is accompanied by impaired psychological functioning.

Patients And Methods: The interrelationships among BMI and demographic and psychological characteristics were examined in 1005 children (aged 5-12 years) enrolled in the Childhood Asthma Management Program and seen for repeated visits over 4 1/2 years.

Results: Baseline rates of overweight (BMI for age: > or = 95th percentile) were comparable, but rates of overweight risk (BMI for age: 85th to < 95th percentile) among children in the Childhood Asthma Management Program were elevated in comparison with the general population of children in the United States.

Pediatric asthma morbidity: the importance of symptom perception and family response to symptoms.

Objective: To determine whether family response to asthma symptoms mediates the relationship between child symptom perception and morbidity.

Methods: A total of 122 children with asthma, aged between 7 and 17 years (47% females; 25% ethnic minorities), were recruited from three sites. Participants completed a family asthma management interview and 5-6 weeks of symptom perception assessment.

An interdisciplinary intervention for undertreated pediatric asthma.

Study Objectives: To examine the effectiveness of an interdisciplinary intervention for pediatric asthma.

Design: Randomized, controlled study.

Setting: Urban tertiary-referral pediatric hospital.

Effect of body mass index on response to methacholine bronchial provocation in healthy and asthmatic adolescents.

A linkage between airway hyperreactivity and obesity could partly explain the prevalence of obesity in asthmatics. To test for such a linkage, we analyzed body mass index (BMI), pulmonary function, methacholine bronchial provocation, and asthma severity scores in 216 adolescents (aged 12-18 years), of whom 82 were healthy and 134 were asthmatic. Methacholine provocations in a subgroup of 36 subjects (healthy and asthmatic) enabled us to examine the effects of BMI on dynamic hyperinflation and ventilatory indices during induced bronchospasm.

Pediatric asthma management in the family context: the family asthma management system scale.

Objective: To examine psychometric properties of a revised version of the Family Asthma Management System Scale (FAMSS), a clinical interview to assess asthma management.

Methods: The FAMSS was administered to 115 children with asthma and their primary caregivers, along with a measure of asthma morbidity. A subset of families (n = 53) participated also in objective-adherence monitoring and completed measures of asthma knowledge and self-efficacy.

Patterns of quick-relief and long-term controller medication use in pediatric asthma.

Objectives: To simultaneously examine adherence to long-term controller and quick-relief medications and to contrast patterns of medication use in children with asthma.

Study Design: Cross-sectional, 1-month follow-up study conducted with 75 children ages 8 to 16 years diagnosed with persistent asthma and prescribed quick-relief and long-term controller medications by metered dose inhaler. Participants were a subsample of a larger adherence study.

The Asthma Risk Grid: clinical interpretation of symptom perception.

The ability to perceive accurately the onset and intensity of asthma symptoms is a cornerstone of effective asthma management. Research in pediatric and adult asthma patients has shown the important role of symptom perception in asthma management, morbidity, and mortality. Assessment of symptom perception ability has largely remained an empiric methodology rather than an applied clinical tool.

Predicting attrition in a pediatric asthma intervention study.

Objectives: To operationalize a comprehensive description of attrition, including pre-inclusion, dropout, and attrition due to intermittent missing data, and to test a predictive model of attrition using a data set from a randomized controlled intervention in pediatric asthma.

Methods: Participants included children, ages 4-12, diagnosed with asthma and their caregivers. Demographic variables and outcome measures of asthma morbidity were examined in 327 families to determine their association with attrition.

Barriers to mental health referral from pediatric primary care settings.

Objective: To examine the frequency of barriers to mental health referral according to pediatric primary care physician (PCP) report and to identify factors related to perceptions of referral barriers for patients with managed care coverage.

Design And Methods: Data from a national sample of 319 PCPs were examined. Comparisons were made concerning the frequency of PCP-reported barriers to mental health referrals for patients with fee-for-service versus managed care coverage.

The experience of schizophrenia: what's gender got to do with it? A critical review of the current status of research on schizophrenia.

The role of gender in schizophrenia is explored, and literature on gender and schizophrenia is critically reviewed. The importance of investigating gender differences in schizophrenia is underscored by the lack of sufficient research in this area to date and the comparative neglect of sociocultural issues during the "decade of the brain." The importance of incorporating gender factors into research analysis is demonstrated via an interdisciplinary discussion that involves psychiatric, anthropological, and sociological theory.