Author Interviews, CMAJ, Thyroid Disease / 18.11.2019

MedicalResearch.com Interview with: Dr. Richard Birtwhistle, Professor Departments of Family Medicine and Community Health and Epidemiology Director of the Centre for Studies, Primary Care, Department of Family Medicine Queen’s University MedicalResearch.com: What is the background for this study? Response: Testing for thyroid dysfunction is a commonly done by primary care practitioners. While the Thyroid stimulating hormone (TSH) test is an easy blood test to perform results outside the normal range are often found and will revert to normal over time without treatment in patients without symptoms. We wanted to see if there was any clinical benefit to patients by screening for thyroid dysfunction.  (more…)
Author Interviews, Lipids, NEJM, Neurological Disorders, Stroke / 18.11.2019

MedicalResearch.com Interview with: Pierre Amarenco, MD Professor and Chairman Paris University, Paris, France INSERM Department of Neurology and Stroke Centre Bichat Hospital Paris, France MedicalResearch.com: What is the background for this study? Response: The rationale of the Treat Stroke to target trial was that after we published the SPARCL trial in 2006 (atorvastatin 80 mg/day vs placebo in patients with stroke) which showed a 16% relative risk reduction of recurrent stroke, we performed several pre specified and post hoc analyses, showing that in SPARCL patients randomized with "atherosclerotic disease" the risk reduction for the primary endpoint was much higher (33%), and in in patients achieving a LDL cholesterol of less than 70 mg/dL as compared to those achieving a LDL cholesterol 100 mg/dL or higher, the risk reduction was 28%. Therefore to confirm this findings, we designed the TST trial, which was an investigator initiated trial funded by the french ministry of health,  and enrolled patients with an ischemic stroke due to atherosclerotic stenosis and randomized them to either a target LDL cholesterol of less than 70 mg/dL or a target LDL cholesterol of 90 to 110 mg/dL. To achieve these goals, the investigators could use any statin available on the market, and titrate the dosage of the statin to get to the assigned target. They could also use ezetimibe on top of statin therapy if a high dosage of statin was not sufficient to get to the target level assigned by randomization. (more…)
Author Interviews, Dermatology, Gender Differences, Pediatrics / 17.11.2019

MedicalResearch.com Interview with: Markus Boos, MD, PhD Member of the Society for Pediatric Dermatology. Attending pediatric dermatologist Seattle Children's Hospital Assistant Professor in the Department of Pediatrics University of Washington School of Medicine  MedicalResearch.com: What is the background for this study? Response: Our understanding of the cutaneous health of sexual and gender minority (SGM) individuals (lesbian, gay, bisexual, transgender, queer, asexual, intersex, nonbinary, etc.) remains nascent. This dearth of understanding of the unique needs of SGM children is even more pronounced. This 2-part review article provides practical advice on how to best engage with young SGM patients and serve the distinct needs of this minority population, with a specific emphasis on dermatologic conditions. (more…)
Author Interviews, Cannabis, Heart Disease, Stroke / 17.11.2019

MedicalResearch.com Interview with: Rupak Desai, MBBS Research Fellow, Division of Cardiology Atlanta VA Medical Center MedicalResearch.com: What is the background for this study? Response: Amidst legalization of therapeutic and recreational use of marijuana/cannabis in the United States, cerebrovascular effects of marijuana use remain largely unknown, especially among young adults. We examined the association between cannabis use (18–44 years) among young adults and stroke events. The study analyzed pooled data from the Behavioral Risk Factor Surveillance System (2016–2017)—a nationally representative cross-sectional survey collected by the Centers for Disease Control and Prevention. Overall, 13.6% of total 43,860 young adults (18-44 years) reported using cannabis recently (in the last month), with 63.3% of them being men. Compared with nonusers, marijuana users were often younger, non-Hispanic white or black, and with some college education. (more…)
Author Interviews, Dermatology, JAMA, Melanoma / 17.11.2019

MedicalResearch.com Interview with: Jennifer M. Gardner, MD Clinical Assistant Professor of Dermatology University of Washington School of Medicine  MedicalResearch.com: What is the background for this study? Response: This study looked at age-specific differences of melanoma incidence in the United States. It was an observational study looking at population-based registry data extracted from the combined National Program of Cancer Registries-Surveillance Epidemiology and End Results United States Cancer Statistics (NPCR-SEER) database. The overall take home message from this study is that though melanoma incidence has continued to climb in the past decade for both men and women, most of the increase is seen in adults greater than age 40 years of age.  In contrast, melanoma incidence decreased in adolescents (ages 10-19 years of age) and young adults (ages 20-29) after peaking around 2004-2005. Melanoma is more common in males in older individuals (older than 50 years of age) but in younger individuals (<50 years of age), melanoma is more common in females.  According to a recently published JAMA-Otolaryngology paper by Bray and colleagues, there may be a subset of younger individuals where males are at a higher risk than females in regard to head and neck melanoma, and after that study was published we noted this to be true in our numbers, as well (we didn’t publish this in our study), further identifying a possibly “at risk” demographic within the younger age groups in addition to young women. (more…)
Abuse and Neglect, Electronic Records, Yale / 15.11.2019

MedicalResearch.com Interview with: Edward R. Melnick, MD, MHS Assistant Professor of Emergency Medicine Program Director, Yale-VA Clinical Informatics Fellowship Program Principal Investigator, EMBED Trial Network Yale School of Medicine New Haven, CT 06519  MedicalResearch.com: What is the background for this study? Response: We know that physicians are frustrated with their EHRs and that EHRs are a driver of burnout. This is the first study to measure these issues nationally. We included a standardized metric of technology from other industries (System Usability Scale, SUS; range 0-100) on the AMA’s 2017 physician burnout survey. This metric has been used in >1300 other studies so we can compare where the EHR’s usability is to other everyday technologies. We are also able to measure the relationship between physicians’ perception of their EHR’s usability and the likelihood they are burned out. (more…)
Author Interviews, Breast Cancer, JAMA, Mammograms / 15.11.2019

MedicalResearch.com Interview with: Dr. Elham Kharazmi, MD, PhD Co-Leader, Risk Adapted Prevention (RAD) Group Division of Preventive Oncology National Center for Tumor Diseases (NCT) German Cancer Research Center (DKFZ) Germany MedicalResearch.com: What is the background for this study? Response: Breast cancer is the most common cancer in women worldwide and the second leading cause of cancer death in American women, exceeded only by lung cancer. Available evidence suggests that implementation of a screening program can decrease breast cancer mortality. Reductions in breast cancer mortality in Europe over the past two decades have been associated at least in part with the implementation of screening programs. Screening enables the detection of tumors at an early stage, when more treatment options are feasible and most effective. However, screening is associated with substantial risks, such as over-diagnosis, false-positive results, and physical and psychological harms, particularly when large numbers of women with low risk are frequently screened. (more…)
Allergies, Author Interviews / 15.11.2019

MedicalResearch.com Interview with: Christopher M. Bland, Pharm.D., FCCP, FIDSA, BCPS Clinical Associate Professor Clinical and Administrative Pharmacy University of Georgia College of Pharmacy Clinical Pharmacy Specialist St. Joseph’s/Candler Health System Savannah, GA MedicalResearch.com: What is the background for this study? Response: Nearly 10% of the United States population self-report a penicillin allergy. However 90% of these allergies are found to be false upon reconciliation which includes patient interview, graded challenge, direct challenge, or penicillin skin testing. This is crucial as patients labeled with a penicillin allergy often receive more expensive antibiotics that additionally cause more adverse effects. While reconciling penicillin allergies is an important antimicrobial stewardship goal, resources are often limited in various healthcare settings to accomplish several of these endeavors. Our study evaluated the use of pharmacy students to serve as patient interviewers to aid in reconciling penicillin allergies. (more…)
Author Interviews, Biomarkers, Melanoma, Ophthalmology / 15.11.2019

MedicalResearch.com Interview with: Dr. Mitchell Stark, B.App.Sc (Hons), PhD NHMRC Research Fellow The University of Queensland Diamantina Institute Woolloongabba, QLD MedicalResearch.com: What is the background for this study? Response: Uveal nevi (moles) mimic the appearance of uveal melanoma and their transformation potential cannot be definitively determined without a biopsy. Moles or naevi in the eye are common but can be difficult to monitor because changes to their shape or colouring can’t always be seen as easily as on the skin. As naevi are difficult to biopsy, they are usually “monitored” at regular intervals. If there is a melanoma in the eye, then outcomes are poor for people if their cancer spreads to the liver. This study aimed to identify a “biomarker” that could be measured in patients’ blood that could be used as an early indicator of melanoma formation (from a mole) or progression to other body sites.  (more…)
Author Interviews, Technology, Vaccine Studies / 15.11.2019

MedicalResearch.com Interview with: Sandra Crouse Quinn, PhD Professor and Chair, Department of Family Science Senior Associate Director, Maryland Center for Health Equity School of Public Health University of Maryland College Park, MDSandra Crouse Quinn, PhD Professor and Chair, Department of Family Science Senior Associate Director, Maryland Center for Health Equity School of Public Health University of Maryland College Park, MD  MedicalResearch.com: What is the background for this study? Response: Millions of Americans use Facebook (FB) for a variety of purposes, including seeking health information. However, it is difficult for FB users to discern what is credible and scientifically sound information on the platform.  Facebook ads also focus on health issues including vaccination, which is labelled by FB as an issue of national importance.  We were the first team to conduct a research study examining the FB Ad Archive and analyzed ads that contained vaccine content. (more…)
Author Interviews, Rheumatology / 14.11.2019

MedicalResearch.com Interview with: Benjamin Nowell, Ph.D. Director of Patient-Centered Research CreakyJoints, Principal Investigator of ArthritisPower  MedicalResearch.com: What is the background for this study? Response: Patient-reported outcomes (PROs) are important indicators of treatment effectiveness, but little is known about which PRO measures that patients find the most important to track for their disease management and to evaluate treatment effectiveness and health outcomes. In this study, we used the ArthritisPower Research Registry to evaluate which PROs patients with rheumatological conditions voluntarily selected to understand their experience of disease.  (more…)
Allergies, Author Interviews, Cancer Research, Pediatrics / 13.11.2019

MedicalResearch.com Interview with: Sairaman Nagarajan, MD Clinical Fellow at State University New York (SUNY) Downstate Medical Center College of Medicine MedicalResearch.com: What is the background for this study? Response: The impetus for this study came from our previous research linking asthma, hay-fever and overall cancer diagnoses using the CDC’s National Health Interview Survey database. The division of Allergy and Immunology at SUNY Downstate has also conducted two pilot studies on the relationship between parental cancer and childhood asthma in Brooklyn’s population; one from Lutheran Medical Center focusing on Hispanics and Asian patients, and the other on African-American and Afro-Caribbean patients. (more…)
Author Interviews, Education, Gender Differences, JAMA / 13.11.2019

MedicalResearch.com Interview with: Shannon Ruzycki, MD, MPH, FRCPC, (she/hers) General Internist & Clinical Lecturer Department of Medicine Department of Community Health Sciences Cumming School of Medicine University of Calgary MedicalResearch.com: What is the background for this study? Response: After hearing about the National Academies of Science, Engineering, and Medicine 2018 report to congress on sexual harassment of women in academia, our Department Head asked myself and Dr. Aleem Bharwani to study experiences of gender inequity or equity in our Department. We conducted an in-depth, 18-month mixed methods study of women and men in our Department, including semi-structured interviews and survey. (more…)
Author Interviews / 13.11.2019

MedicalResearch.com Interview with: Magdalena Cerdá DrPH Associate Professor and Director Center for Opioid Epidemiology and Policy Department of Population Health NYU Langone School of Medicine  MedicalResearch.com: What is the background for this study? Response: Legalization of recreational marijuana use is increasingly enacted across US states and across the world. In the US, 11 states and D.C. have legalized recreational use of marijuana, while 33 states and D.C. have legalized medical use of marijuana. In light of these changes, we need to know the impact that recreational marijuana legalization has on marijuana use. To our knowledge, our is the first study to look at the impact that recreational marijuana legalization has had on both use and cannabis use disorder among different age groups.  (more…)
Allergies, Author Interviews, Electronic Records / 13.11.2019

MedicalResearch.com Interview with: Sonam Sani MD Allergy & Immunology Fellow NYU Winthrop Hospital MedicalResearch.com: What is the background for this study? Response: Penicillin allergy label removal is becoming more common. Studies have shown that while 10% of the general population report an allergy to penicillin, after testing only 1% truly have an allergy. Allergists have the ability to evaluate patient’s for penicillin allergy by performing skin tests and oral challenges. However, even when people test negative for penicillin allergy, they still face barriers to having the label removed. We are noting more and more that despite having negative testing, upon further encounters, our patients still have their penicillin allergy label. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Rheumatology / 13.11.2019

MedicalResearch.com Interview with: Natalie McCormick, Ph.D. Post-Doctoral Research Fellow Clinical Epidemiology Program Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital Department of Medicine, Harvard Medical School Arthritis Research Canada  MedicalResearch.com: What is the background for this study? Response: Biologic disease-modifying anti-rheumatic drugs (bDMARDs) have improved the health and productivity of many people living with moderate-to-severe inflammatory rheumatic diseases. They are also among the highest-spend drugs in the USA, with substantial out-of-pocket costs that pose barriers to treatment initiation and adherence. To understand the drivers of ongoing bDMARD spending growth, and effective ways of containing costs, we analysed drug spending data for all bDMARD claims in Medicare Part D, Part B fee-for-service, and Medicaid over 2012 to 2016, isolating the impact of changes in drug prices from changes in utilisation.  (more…)
Author Interviews, Opiods, Rheumatology / 12.11.2019

MedicalResearch.com Interview with: Raveendhara R. Bannuru MD, PhD, FAGE Director, Center for Treatment Comparison and Integrative Analysis (CTCIA) Deputy Director, Center for Complementary and Integrative Medicine (CCIM) Asst Professor of Medicine, Tufts University School of Medicine Asst Professor of Clinical & Translational Science, Sackler School of Graduate Biomedical Sciences Division of Rheumatology, Tufts Medical Center Boston, MA MedicalResearch.com: What is the background for this study? Response: Given the current controversy regarding the use of opioids in chronic pain, we wanted to delve deeper into the efficacy and safety profiles of oral opioid drugs in osteoarthritis patients. Temporal assessments like ours can reveal peak periods of efficacy, and can provide clinicians with a blueprint for optimal durations of treatment regimens. With respect to subgroup analyses based on strength of opioid binding affinity, we sought to explore currently held paradigms that strong opioids may be useful for the treatment of severe pain, and to specifically assess their relevance in OA populations. Knowledge of the relative efficacy and safety profiles of strong versus weak opioids can give clinicians the information they need to weigh benefits and harms of specific subgroups of opioids. (more…)
Author Interviews, Rheumatology / 11.11.2019

MedicalResearch.com Interview with: Kelly Gavigan, MPH Manager, Research and Data Science CreakyJoints  MedicalResearch.com: What is the background for this study? Response: Over the past fifteen years, there have been significant improvements in quality of life among people living with rheumatic and musculoskeletal disease with the introduction of biologics and targeted therapies. However, despite a variety of treatments to try, patients often seek non-pharmacological alternative and complementary treatments, such as marijuana for medical use (MMU), to help manage their condition and symptoms. MMU is becoming increasingly available in the United States as different states legalize it under specific circumstances. Legal or not, according to a survey conducted by CreakyJoints using the ArthritisPower Research Registry (n=1,059 participants), people with arthritis are trying marijuana for medical use.  (more…)
Author Interviews, Pain Research, Rheumatology / 11.11.2019

MedicalResearch.com Interview with: Féline PB Kroon MD Department of Rheumatology Leiden University Medical Centre LUMC · MedicalResearch.com: What is the background for this study? Response: Hand osteoarthritis (OA) is a prevalent joint condition that causes pain, functional disability, and decreased quality of life, for which patients frequently consult health-care providers. Symptoms usually fluctuate over time, with episodes of joint swelling and erythema. Evidence from previous studies has shown that inflammation plays an important role in the disease, being an important predictor for pain and radiographic damage progression. Therefore, we hypothesized that inflammation could be a treatment target in OA, and we investigated this using prednisolone, a potent anti-inflammatory drug. The aim of the HOPE study was to investigate the clinical efficacy and safety of a six-week course of prednisolone 10 mg daily in patients with painful hand OA who had evidence of synovial inflammation. (more…)
Author Interviews, Gout, Kidney Disease, Rheumatology, Transplantation / 10.11.2019

MedicalResearch.com Interview with: Megan Francis-Sedlak, PhD Director of Medical Affairs Horizon Therapeutics Lake Forest, Illinois MedicalResearch.com: What is the background for this study? Response: The prevalence of gout is more than ten-fold greater among patients who have undergone a kidney transplant than the general population as post-transplant medications to prevent organ rejection can contribute to increased uric acid levels. Overall studies have shown this can lead to higher rates of uncontrolled gout among this vulnerable population with organ transplants. While we have seen higher mortality rates for patients who have received a kidney transplant with uncontrolled gout compared to kidney transplant patients without uncontrolled gout, we wanted to evaluate the impact of gout on transplant-related complications to better inform patient care and treatment approaches.  (more…)
Author Interviews, Genetic Research, Kidney Disease, Mineral Metabolism, Pediatrics / 10.11.2019

MedicalResearch.com Interview with: Tracy McGregor, MD MSCI Alnylam Pharmaceuticals Cambridge, Massachusetts  MedicalResearch.com: What is the background for this study?
  • Lumasiran is an investigational RNA interference (RNAi) therapeutic in development for the treatment of primary hyperoxaluria type 1 (PH1). PH1 is a rare life-threatening disease in which a enzymatic deficiency in the liver results in pathologic overproduction of oxalate, often leading to recurrent kidney stones and a progressive decline in kidney function, which typically culminates in end-stage renal disease (ESRD).Patients with ESRD are at a risk of systemic oxalosis, with oxalate depositing throughout the body, including the eyes, skin, bones, and the heart. Complications associated with ESRD and/or systemic oxalosis can be fatal. For patients with ESRD treatment options are limited and include intensive dialysis as a bridge to a dual liver/kidney transplant, highlighting the unmet need for new treatment options. 
(more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Dermatology, JAMA, Rheumatology / 09.11.2019

MedicalResearch.com Interview with: Emily S. Ruiz, MD, MPH Director, High-Risk Skin Cancer Clinic, Dana Farber/Brigham and Women’s Cancer Center Assistant Professor, Harvard Medical School, Dermatology Brigham And Women's Faulkner Hospital  MedicalResearch.com: What is the background for this study? Response: Innovation in oncology has led to increased development and market entry of anticancer drugs. For example, from 2009 to 2013, the US FDA approved 51 oral and systemic anticancer drugs for 63 indications. Prices for anticancer drugs have risen faster than inflation over time, especially for older drugs, and prices in the US have largely been set by market forces rather than novelty or efficacy. Understanding the evolving cancer economic landscape requires consideration of annual and cumulative rates of change for key metrics, such as total spending, drug cost per beneficiary, out-of-pocket cost, and utilization. This study sought to weigh the proportional impacts of rising drug costs and utilization on increased Medicare Part D spending for a cohort of oral anticancer drug utilized from 2013-2017.  (more…)
Author Interviews, JAMA, Sexual Health, STD, Technology, UCSD / 09.11.2019

MedicalResearch.com Interview with: Alicia Nobles, PhD, MS Research Fellow Department of Medicine UC San Diego  MedicalResearch.com: What is the background for this study? Response: Sexually transmitted diseases (STDs) are at record-high rates according to the Centers for Disease Control. Between STDs being highly stigmatized infections and people lacking access to health care, people may elect to turn to social media to connect with others. This is precisely why social media sites are so popular - because they do allow for people to talk with others rapidly. Reddit, a social media site that rivals Twitter with 330 million active users and is the 6th most visited website in the United States, is organized into online communities, many of which discuss health topics. We monitored all r/STD (www.reddit.com/r/STD/) posts, where users can find “anything and everything STD related,” from its inception in November 2010 through February 2019.   (more…)
Author Interviews, Pediatrics, Weight Research / 09.11.2019

MedicalResearch.com Interview with: Jennifer Panganiban, MD Division of Gastroenterology, Hepatology and Nutrition Director, Non Alcoholic Fatty Liver Disease Clinic Children's Hospital of Philadelphia MedicalResearch.com: What is the background for this study? Response: Obesity now affects 1 in 5 children and adolescents in the United States with an estimated prevalence of 13.7 million. We know that this is not only an issue in the US but a worldwide epidemic. Lifestyle modification is the primary treatment of obesity, which can be successful but is limited. Off-label use of medications for weight loss in youth is increasing secondary to the limited availability of FDA approved medications for weight-loss.  (more…)
Author Interviews, Pediatrics, Weight Research / 07.11.2019

MedicalResearch.com Interview with: Kai Ling Kong, PhD, MS Assistant Professor Division of Behavioral Medicine Department of Pediatrics School of Medicine and Biomedical Sciences State University of New York at Buffalo MedicalResearch.com: What is the background for this study? Response: The deleterious effects that obesity has on an individual’s health and the difficulty of reversing it in adults are well-known, ranging from diabetes and heart disease to cancer. For these reasons, obesity prevention in babies and children in populations at high risk is increasingly seen as a critical way to address the obesity epidemic. However, most studies on factors that contribute to obesity in very young children haven’t focused on the populations most at risk. Now an ongoing longitudinal University at Buffalo study being presented Nov. 5 in Las Vegas at ObesityWeek is among the first to explore how mother-infant behaviors during feeding and active play (non-feeding situations) affect infants and children in families with low socioeconomic status. Infants of mothers exhibiting less warmth during free play interactions when infants were 7 months old were associated with steeper body mass index trajectories while the infants of mothers exhibiting more warmth during these interactions were not. (more…)
Author Interviews, Cancer Research, HPV, JAMA, OBGYNE / 07.11.2019

MedicalResearch.com Interview with: Rachel L. Winer, PhD Professor Department of Epidemiology School of Public Health HPV Research Group University of Washington Seattle, WARachel L. Winer, PhD Professor Department of Epidemiology School of Public Health HPV Research Group University of Washington Seattle, WA  MedicalResearch.com: What is the background for this study? Response: In the U.S., 25% of women do not receive recommended cervical cancer screening. Increasing screening participation is a high priority, because over half of the 12,000 cervical cancers diagnosed each year in the U.S. are in women who are underscreened. Currently available options for cervical cancer screening in the U.S. include Pap testing or HPV testing, either alone or in combination. HPV self-sampling is an emerging option for screening because HPV tests – unlike Pap tests – can be performed on either clinician- or self-collected samples, with similar accuracy. Internationally, several countries (including Australia and the Netherlands) include HPV self-sampling as a cervical cancer screening option for underscreened women.  (more…)
Author Interviews, Endocrinology, Stem Cells, Thyroid Disease / 05.11.2019

MedicalResearch.com Interview with: Terry Davies, MD Co-Director, The Thyroid Center at Mount Sinai Union Square Professor, Medicine, Endocrinology, Diabetes and Bone Disease Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many tissues contain stem cells that are responsible for regeneration and repair after injury. The mechanism of thyroid regeneration and the role of thyroid stem cells in this process is poorly understood. This an exploration of how the thyroid gland repairs itself. Using a mouse model we found that a damaged gland can correct itself within 4 weeks and this involves a rapid increase in stem cells driving the repair.  (more…)
Author Interviews, Beth Israel Deaconess, Emergency Care, Health Care Systems, JAMA / 05.11.2019

MedicalResearch.com Interview with: Laura Burke, MD, MPH Department of Emergency Medicine Beth Israel Deaconess Medical Center Boston, MA 02215Laura Burke, MD, MPH Department of Emergency Medicine Beth Israel Deaconess Medical Center Boston, MA 02215  MedicalResearch.com: What is the background for this study? Response: There has been a lot of attention to the growing intensity and costs of emergency care, but relatively little study of how outcomes have changed in recent years for patients using the ED. We examined 30-day mortality rates for traditional Medicare beneficiaries age 65 and older using the emergency department (ED) from 2009-2016 and also examined how their rates of hospitalization have changed over time.   (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Heart Disease / 05.11.2019

MedicalResearch.com Interview with: Rachel E. Climie PhD INSERM U970, Paris Cardiovascular Research Center (PARCC) Integrative Epidemiology of Cardiovascular Disease Team, University de Paris, Paris, France.  MedicalResearch.com: What is the background for this study? Response: It is well known that physical activity (PA) is beneficial for cardiovascular health. However, little consideration is given as to whether different domains of PA have differing associations with health outcomes. Indeed, recent work has shown that high amounts of PA at work are associated with increased risk of early death, however the underlying mechanisms are unknown. In this study, we explored the relationship between physical activity at work, during leisure time and as structured sport with baroreflex sensitivity. We distinguished between the mechanical (dependent on the stiffness of the arterial wall) and neural (nerve impulses sent by the receptors on the walls of the artery) components of the baroreflex. Importantly, baroreflex sensitivity is crucial for short- term blood pressure control and reduced baroreflex function is related to higher risk of cardiac mortality and sudden death.  (more…)