Author Interviews, CDC, Environmental Risks, Infections / 02.07.2019

MedicalResearch.com Interview with: Radhika Gharpure MPH DVM Epidemic Intelligence Service Officer CDC MedicalResearch.com: What is the background for this report? Would you tell us about cryptosporidiosis infections?  Where is is found? How is it transmitted? Response: The data from our most recent report looked at outbreaks caused by Cryptosporidium (Crypto) in the United States during 2009 – 2017. Outbreaks have increased an average of 13% each year. Crypto, a parasite, is spread through the poop of infected humans or animals. People can get sick after they swallow the parasite in contaminated water or food or after contact with infected people or animals. Crypto is the leading cause of disease outbreaks in the United States linked to water, specifically outbreaks linked to pools or water playgrounds. (more…)
Author Interviews, Global Health / 02.07.2019

MedicalResearch.com Interview with: Leah Zallman, MD, MPH Assistant Professor of Medicine Harvard Medical School Physician at Cambridge Health Alliance. Director of Research Institute for Community Health MedicalResearch.com: What is the background for this study? Response: In October 2018, the U.S Department of Homeland Security published a proposed change to a longstanding immigration rule. The proposed change would increase the chance of an immigrant being deemed a “public charge”, and increase the chance of being denied legal permanent residency or entry to the United States. Up to now, enrollment in public food, housing and health insurance programs were not counted against immigrants applying for “green cards"; the proposed rule change drastically changes the intent of the rule and newly includes food, housing and health insurance programs as benefits that can be considered counted against immigrants. These proposed changes are expected to cause many immigrant parents to disenroll their families from safety-net programs, largely because of fear and confusion about the rule - even among families to whom the rule does not technically apply. (more…)
Author Interviews, Biomarkers, Geriatrics, Heart Disease, JACC / 02.07.2019

MedicalResearch.com Interview with: Martin Bødtker Mortensen, læge PhD Afdelingen for Hjertesygdomme Aarhus Universitetshospital Danmark  MedicalResearch.com: What is the background for this study?   Response: The background for the study is a combination of two things: First, the proportion and number of elderly people 65 years of age or older are increasing fast worldwide. Second, given the dominant impact of age on estimated risk for cardiovascular disease, nearly all elderly individuals eventually become statin eligible under current guidelines – just because of aging alone. Thus, to limit overtreatment of elderly individuals, we wanted to find “negative” risk markers that can be used to identify elderly individuals at truly low cardiovascular risk who are less likely to benefit from statin therapy despite advancing age. (more…)
Author Interviews, CDC, Emory, Infections, JAMA, Pediatrics, Vaccine Studies / 02.07.2019

MedicalResearch.com Interview with: Ms. Cassandra Pingali Ms. Pingali worked on this paper while a a graduate student at Emory University, and completed it post-graduation. She is currently an ORISE fellow at Centers for Disease Control and Prevention Immunization Services Division MedicalResearch.com: What is the background for this study? Response: Despite high overall immunization coverage in the United States, we are currently experiencing the largest measles outbreak since measles was declared eliminated in 2000. In 2014, California grappled with a very large measles outbreak known as the “Disneyland” outbreak. Later investigation revealed that most of the affected children were unvaccinated against measles despite the availability of a safe and effective vaccine. In order to prevent future outbreaks, California officials wanted to improve their declining childhood vaccination coverage. California passed two laws and implemented an educational program for school staff to increase vaccination rates in the state. We felt it was important to take a systematic look at these interventions and examine if public health initiatives such as these are working to improve vaccination rates. (more…)
Author Interviews, Electronic Records / 02.07.2019

MedicalResearch.com Interview with: Ming Tai-Seale, PhD, MPH Professor Department of Family Medicine and Public Health University of California San Diego School of Medicine  MedicalResearch.com: What is the background for this study? Response: The electronic health record (EHR) potentially creates a 24/7 work environment for physicians. Its impact on physicians’ wellness has become a challenge for most health care delivery organizations. Understanding the relationships between physicians’ well-being and “desktop medicine”1 work in the EHR and work environment is critical if burnout is to be addressed more effectively. (more…)
Alcohol, Author Interviews, Environmental Risks / 02.07.2019

MedicalResearch.com Interview with: alcohol, bottles, Dr Andrew Turner, PhD Associate Professor (Reader) in Environmental Sciences School of Geography, Earth and Environmental Sciences MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This study was part of a wider study to look at potentially toxic metals in everyday household and consumer products. The main findings here are that many enameled bottles, mainly used to store alcoholic beverages, contain very high levels of cadmium and lead in the décor.   (more…)
Author Interviews, Cost of Health Care, Genetic Research, Personalized Medicine / 02.07.2019

Dr. Winegarden
Dr. Winegarden

MedicalResearch.com Interview with:

Wayne Winegarden, Ph.D.
Director, Center for Medical Economics and Innovation
Pacific Research Institute

MedicalResearch.com:  What is the background for this poll? Would you tell us a little about the Center for Medical Economics and Innovation? 

Response: Recent press reports have focused on how extensive innovative gene therapies can be.  PRI was interested in learning where Americans stand on these cures of the future, and commission a new national opinion survey to find out.

The Center for Medical Economics and Innovation is a new center launched by PRI this spring to research and advance policies showing how a thriving biomedical and pharmaceutical sector benefits both patients and economic growth. Medical innovation is an important driver of economic growth, responsible for over $1.3 trillion in economic activity each year. As the Milken Institute has found, every job in the biomedical sphere supports another 3.3 jobs elsewhere in the economy.

Among the activities of the Center – which can be accessed at www.medecon.org – are providing free-market analysis to evaluate current policy proposals, producing easy-to-understand data and analysis on current trends in medical science, breaking down complex issues like pharmaceutical and biomedical pricing structures, and demonstrating the benefits that market-based reforms can offer patients and the U.S. health care system.  (more…)

Author Interviews, Cancer Research, Pediatrics, Technology / 02.07.2019

MedicalResearch.com Interview with: atomwiseAbraham Heifets, PhD Department of Computer Science University of Toronto  MedicalResearch.com: What is the background for this announcement? How many children and adolescents are affected by pediatric cancer? Response: Cancer is diagnosed in more than 15,000 children and adolescents each year. Many cancers, including pediatric cancer, do not have effective treatments and for those that do, it is estimated that 80% have serious adverse effects that impact long-term health.  (more…)
Addiction, Author Interviews, JAMA, Opiods, University of Michigan / 30.06.2019

MedicalResearch.com Interview with: Rebecca L. Haffajee, J.D., Ph.D., M.P.H. Assistant Professor Department of Health Management & Policy umichsphumichsph MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Evidence suggests that the availability of medications to treat opioid use disorder (OUD) has been slow to expand, particularly in rural areas, despite the efficacy and effectiveness of these medications in reducing overdose deaths and other adverse life outcomes. We were interested in understanding the characteristics of counties both with high need (as measured by above-national rates in opioid overdose deaths) AND low provider capacity to deliver medications to treat OUD in 2017. We found that such "opioid high-risk" counties were likely to be in the East North Central (e.g., Michigan, Ohio, Illinois, Indiana), South Atlantic (e.g., North Carolina, South Carolina, Virginia, West Virginia), and Mountain (e.g., New Mexico, Arizona, Nevada) regions. We also found that these opioid high-risk counties were more likely to have higher rates of unemployment and less likely to have fewer primary care clinicians or be micropolitan (more…)
Accidents & Violence, Author Interviews, Pediatrics / 28.06.2019

MedicalResearch.com Interview with:

Amanda Fingarson, DO Attending Physician, Child Abuse Pediatrics Ann and Robert H. Lurie Children’s Hospital of Chicago Assistant Professor of Pediatrics Feinberg Northwestern School of Medicine 

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response: Child physical abuse is a substantial pediatric public health issue, with significant morbidity and mortality. Studies have found that men, particularly children’s fathers and mothers’ boyfriends are common perpetrators of physical abuse. There is still a lack of knowledge, however, about the specific caregiver features that increase a child’s risk for physical abuse.

Our study design was unique, in that it was a multi-center study that compared young children with abusive and accidental injuries. Our primary finding was that abuse was much more likely when a male caregiver was present, and the resulting injuries were more likely to be severe or fatal. The presence of the mother’s boyfriend was the riskiest scenario, with the highest likelihood of abuse. Similarly, we found that caregiver relationships of less than 1 year increased the odds of abuse. Overall, the likelihood of abuse with female caregivers was much lower, with the exception of female babysitters.  A final important finding of our study was that caregiving arrangements that were different than usual at the time of injury were at increased risk of abuse, suggesting that a stable and consistent caregiver is also important.  (more…)

Author Interviews, Columbia, JAMA, Pulmonary Disease / 28.06.2019

MedicalResearch.com Interview with: Elizabeth C. Oelsner, MD, MPH Irving Assistant Professor of Medicine Division of General Medicine New York Presbyterian Columbia University MedicalResearch.com: What is the background for this study? Response: Uncertainty regarding how to diagnose chronic obstructive pulmonary disease (COPD) has posed significant problems for early detection and treatment of this common disease. Simplifying and standardizing the diagnosis of COPD has the potential to improve diagnosis, clinical care, and clinical research for this common and under-diagnosed chronic lung disease. We therefore aimed to provide robust evidence for the best threshold to diagnose COPD by comparing how well various thresholds predict hospitalizations and deaths from COPD. (more…)
AACR, Author Interviews, CT Scanning, Lung Cancer / 28.06.2019

MedicalResearch.com Interview with: Barbara Nemesure, PhD Professor, Department of Family, Population and Preventive Medicine Division Head, Epidemiology and Biostatistics Director, Cancer Prevention and Control Program Director, Lung Cancer Program, Stony Brook Cancer Center Renaissance School of Medicine Stony Brook University    MedicalResearch.com: What is the background for this study? What are the main findings? Response: Lung cancer is the most common cause of cancer death, claiming the lives of more than 150,000 people in the United States each year. While lung nodules are not uncommon, it has remained a challenge to differentiate those that will progress to cancer and those that will remain benign. Although numerous risk prediction models for lung cancer have been developed over the past 2 decades, the majority have been based on retrospective analyses or high risk groups with a strong history of tobacco use. To date, there have been a limited number of large-scale, prospective studies evaluating risk that a nodule will convert to cancer in the general population. This investigation aimed to construct a population-based risk prediction model of incident lung cancer for patients found to have a lung nodule on initial CT scan. The derived model was determined to have high accuracy for predicting nodule progression to cancer and identified a combination of clinical and radiologic predictors including age, smoking history (pack-years), a personal history of cancer, the presence of chronic obstructive pulmonary disease (COPD), and nodule features such as size, presence of spiculation and ground glass opacity type. When compared to patients in the low risk category, those defined as high risk had more than 14 times the risk of developing lung cancer. Quantification of reliable risk scores has high clinical utility, enabling physicians to better stratify treatment plans for their patients.      (more…)
Author Interviews, JAMA, Pediatrics, Sexual Health, Technology / 28.06.2019

MedicalResearch.com Interview with: texting, sextingCamille Mori, B.A. (hons) M.Sc. candidate Clinical Psychology Program Determinants of Child Development Lab University of Calgary  MedicalResearch.com: What is the background for this study? Response: Sexting, which is the sharing of sexual messages, images, or videos over technological devices, has recently become a cause for concern among parents, teachers, and policy makers. However, the research on sexting among youth is still in early stages, and evidence of the risks associated with sexting is inconsistent. One way to resolve discrepancies in the field is to conduct a meta-analysis, which statistically summarizes existing research. We conducted a meta-analysis in order to examine the association between sexting and sexual activity (having sex, multiple sexual partners, and lack of contraception use). The associations between sexting and mental health related variables, including delinquent behaviour, substance use, and depression/anxiety were also examined. (more…)
ALS, Alzheimer's - Dementia, Author Interviews, Biomarkers, JAMA, Multiple Sclerosis / 27.06.2019

MedicalResearch.com Interview with: Charlotte E. Teunissen, PhD Neurochemistry Laboratory, Department of Clinical Chemistry VU University Medical Centre, Neuroscience Campus Amsterdam Amsterdam, the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several reports have shown increased in NfL in various neurological disorders, separately. We wanted to know how the levels are in these disorders relative to each other. Moreover, some reports showed absence of age effects in Multiple Sclerosis (MS) patients, which is normally present in controls. So, we thought that it would be good to study age effects in a large group of controls, and if these effects are absent in other diseases, similarly as in MS. (more…)
Author Interviews, Brain Injury, Columbia, Critical Care - Intensive Care - ICUs, NEJM, Neurology / 27.06.2019

MedicalResearch.com Interview with: Jan Claassen, MD, PhD, FNCS Associate Professor of Neurology Division of Division of Critical Care and Hospitalist Neurology Columbia University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Unconsciousness is common and predicting recovery is challenging – often inaccurate. Many patients do not show movements on commands and typically this is interpreted as unconsciousness. Some of these patients may be able to have brain response to these commands raising the possibility of some preservation of consciousness. This has previously been shown months or years after the injury mostly using MRI. We were able to detect this activation at the bedside in the ICU shortly after brain injury. For this we applied machine learning to the EEG to distinguish the brain’s responses to commands. Patients that showed this activation were more likely to follow commands prior to discharge and had better outcomes one year later.  (more…)
Author Interviews, Opiods / 26.06.2019

MedicalResearch.com Interview with: John Holaday, PhD Chairman and CEO of DisposeRx Dr. Holaday discusses the recentannouncement that Walgreen's has added DisposeRx to its safe medication drop off kiosks.  MedicalResearch.com: What is the background for this study? How big is the problem of unused risky medications leftover after the need or indication period has passed? Response: Keeping leftover medications in the home significantly increases the risk of accidental poisonings as well as diversion, which can lead to addiction, overdoses and death. According to the Centers for Disease Control & Prevention (CDC), accidental medicine poisonings send nearly 60,000 children under 5 years old to emergency rooms annually. And, a study by the National Institute on Drug Abuse found that the first opioid used by 70% of individuals with heroin-use disorder was a prescription pain medication, often remaining in their medicine cabinet well after the pain subsided and then a remaining temptation for abuse. This is a pervasive problem across the country. In an independent survey DisposeRx sponsored, it was found that 4 out of 10 Americans are keeping leftover prescriptions—including opioids – in their medicine cabinets. Other results of the survey include: 62% of respondents who said they stored medications in case a condition returns; and 37% said they save prescription drugs in case a friend or family member needs them. Walgreens sees value in adding DisposeRx at-home solution to its comprehensive medication management and opioid stewardship programs These consumers need to be educated about all the potential harm resulting from saving leftover medications. Leading pharmacy chains such as Walgreens are committed, as responsible corporate citizens, to making DisposeRx available upon request for their customers and to educate them about its use in getting rid of leftover drugs before they cause harm. Walgreens sees value in adding DisposeRx at-home solution to its comprehensive medication management and opioid stewardship programs as an additional method to reduce risks and exposure. (more…)
Author Interviews, Bristol Myers Squibb, Rheumatology / 26.06.2019

MedicalResearch.com Interview with: Sean Connolly, Ph.D. Director of Non-Registrational Data Generation Study Director for ASCORE Bristol-Myers Squibb MedicalResearch.com: What is the background for this study? Response: ASCORE is a two-year, prospective multicenter study to observe retention and response rates of moderate-to-severe rheumatoid arthritis (RA) patients receiving ORENCIA® (abatacept), administered subcutaneously via a pre-filled syringe, in routine clinical practice. Findings shared at the Annual European Congress of Rheumatology (EULAR 2019) are the results from the first 12 months. An important objective of our development program is to understand how well we can replicate findings from our clinical trials among a real-world patient population. In the case of ASCORE, which looked at approximately 3,000 patients, both bio-naïve and patients receiving later-line therapies, these data add to the body of research that may help inform physicians treating patients with RA. Patients participating in ASCORE were divided into two distinct cohorts at the outset of the study: bio-naïve and patients previously administered one or more biologic agents. The primary endpoint is to estimate the rentention rate of patients in each cohort over a 24-month period. Furthermore, ASCORE examines the patient populations across ten countries to understand factors including: how ORENCIA is prescribed, characteristics of patients from each country (socio-demographic data, medical history, co-morbidities, etc.), and population health statistics within each country. This sub-analysis is factored into patient response to treatment across both cohorts, which may help physicians better understand how and why certain populations demonstrate a specific retention rate. (more…)
Author Interviews, Opiods, Pediatrics / 25.06.2019

MedicalResearch.com Interview with: Jennifer N. Cooper, PhD Principal Investigator Center for Innovation in Pediatric Practice The Research Institute at Nationwide Children's Hospital, Research Assistant Professor of Pediatrics The Ohio State University College of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although postoperative opioid prescribing has decreased in recent years due to an increased awareness of the risks of excess opioid prescribing, many patients are still prescribed more opioids than they need after surgery. In the pediatric population, most opioids are prescribed after surgical and dental procedures. Although patients are often prescribed more opioids than they need after surgery, previous studies have found that excess opioids left unused after surgery are rarely properly disposed. These leftover opioids can be misused or accidentally ingested by young children. Previous studies have targeted the problem of non-disposal of opioids leftover after surgery by providing patients and families with educational materials describing proper methods of postoperative opioid disposal. However, these studies have had mixed results with some finding an increase in opioid disposal after education and others finding no effect of such education. In addition to education, another means of facilitating postoperative opioid disposal is the provision of drug disposal products. These products contain compounds that irreversible adsorb or oxidize medications, enabling them to be safely disposed of in the home garbage. (more…)
Author Interviews, JAMA, Prostate, Prostate Cancer, Urology / 25.06.2019

MedicalResearch.com Interview with: Kari Tikkinen, MD, PhD, Adjunct Professor Departments of Urology and Public Health University of Helsinki and Helsinki University Hospital Helsinki, Finland MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Men’s choice of whether to undergo screening is value and preference sensitive: fully informed men will make different choices depending on their experience and perspective. For such decisions, shared decision-making represents an ideal approach to decision making. In shared decision-making both the patient and health care provider contribute to the medical decision-making process. The health care provider explains alternatives to patients, informs them of the best evidence regarding the anticipated consequences of a decision for or against the intervention, and helps them choose the option that best aligns with their preferences. All major guidelines of prostate cancer screening acknowledge the importance of informing men about risks and benefits of PSA screening. Shared decision-making is challenging because it requires time, knowledge, and specific skills. Prostate cancer screening decisions aids may, by summarizing the current best evidence and by supporting conversations that address what matters most to men, address these challenges. The impact of decision aids on the decision-making process is, however, uncertain. We therefore undertook a systematic review and meta-analysis of the randomized trials that have addressed the impact of decision aids in the context of prostate cancer screening.  (more…)
ASCO, Author Interviews, Biomarkers, Colon Cancer / 24.06.2019

MedicalResearch.com Interview with: Lawrence LaPointe, Ph.D. Chief Innovation Officer Clinical Genomics Bridgewater, New Jersey  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Colorectal cancer is a cancer of the colon and the rectum. The American Cancer Society estimates that about 1 in 21 men and 1 in 23 women in the United States will develop colorectal cancer during their lifetime. This disease is the second leading cause of cancer death in women, and the third for men. Colorectal cancer has a high 5-year recurrence rate and most likely is spread to the liver and lungs. Clinical Genomics has two decades of experience striving to save lives and reduce costs by developing easy-to-use tests for the detection of colorectal cancer. With breakthrough diagnostic tools, the company aims to offer affordable and accurate tests, supporting physicians and patients with potential life-saving knowledge about colorectal cancer. On June 3, 2019, Clinical Genomics presented research detailing breakthrough methods of colorectal cancer recurrence monitoring at the American Society of Clinical Oncology (ASCO) annual meeting in the McCormick Place Convention Center, Chicago.  (more…)
AstraZeneca, Author Interviews, Diabetes, Kidney Disease / 24.06.2019

MedicalResearch.com Interview with: Naeem Khan MD Vice President at AstraZeneca  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A pre-specified exploratory analysis of renal data from the DECLARE-TIMI 58 trial, the largest SGLT-2 inhibitor (SGLT-2i) cardiovascular outcomes trial (CVOT) conducted to date, showed that FARXIGA (dapagliflozin) reduced the composite of kidney function decline, end-stage renal disease (ESRD) or renal death by 47% in patients with type 2 diabetes (T2D). Additionally, FARXIGA reduced the relative risk of a cardio-renal composite of kidney function decline, ESRD, or renal or cardiovascular (CV) death by 24% compared to placebo. The analysis evaluated 17,160 patients with type 2 diabetes and predominantly preserved renal function, irrespective of underlying atherosclerotic CV disease (ASCVD). (more…)
Author Interviews, HPV, OBGYNE, Vaccine Studies / 24.06.2019

MedicalResearch.com Interview with: “Syringe and Vaccine” by NIAID is licensed under CC BY 2.0Ali Moghtaderi PhD MBA Assistant Research Professor and Avi Dor PhD Professor of Health Policy and Economics Milken Institute School of Public Health George Washington University MedicalResearch.com: What is the background for this study? Response: In this study, we investigate the effect of Human Papillomavirus (HPV) vaccination on participation in Pap test, which is one of the most effective cancer screening interventions. Cervical cancers are causally linked to HPV infections. The Pap test is a diagnostic procedure for early detection of cervical cancer. HPV vaccination provides partial protection against cervical cancer, and the Pap test is strongly recommended for women 21 to 65 years of age even after vaccination. If vaccination leads to a reduction in testing participation, it could contribute to greater incidence and severity of cervical cancer. Note that we focus on relatively older women (age 22 or older) who were not vaccinated at younger ages.  (more…)
Author Interviews, CDC, Cognitive Issues, Infections, Vaccine Studies / 24.06.2019

MedicalResearch.com Interview with: Arindam Nandi  PhD Center for Disease Dynamics, Economics & Policy  MedicalResearch.com: What is the background for this study?   Response: The motivation for this study comes from a small but growing body of evidence on the potential long-term benefits of vaccines. The recent resurgence of measles outbreaks in several countries which had previously eliminated the virus makes our study additionally relevant. There have been over 1,000 measles cases reported across 28 states in the US so far in 2019, which is the largest number of cases the country has seen in almost 3 decades. Similarly high number of cases have been reported in several European countries in recent years. This study reiterates the importance of vaccination and proves the long-term benefits of the measles vaccine in low- and middle-income countries, which account for a large proportion of global measles cases. (more…)
Author Interviews, Infections / 24.06.2019

MedicalResearch.com Interview with: David Houston PhD Senior Scientist and wound project Neem Biotech MedicalResearch.com: What is the background for this study?   Response: Biofilms are complex bacterial communities formed during the natural infection process as a protection mechanism and controlled by bacterial quorum sensing. These biofilm communities allow infections to spread by producing toxins that inhibit the body’s immune system, generating exopolysaccharide and changes in metabolic state that reduce the efficacy of antibiotics and activating virulence factors, which ultimately drive the spread of infection. Stopping the spread of infection by inhibition of quorum sensing has potential to manage a wide range of infections, including in wounds. In chronically-infected wounds, the prevention of biofilm formation, disruption of mature biofilms, reduction of virulence factors and thereby the spread of infection remains clinically elusive. Quorum sensing (QS) pathways regulate microbial motility, virulence factor production and the formation and maturation of biofilms. Inhibiting QS therefore presents a potential mode of therapeutic intervention for infections. (more…)
Author Interviews, Brain Injury, University Texas / 24.06.2019

MedicalResearch.com Interview with: Kevin F. Bieniek, Ph.D. Assistant Professor, Department of Pathology & Laboratory Medicine Joe R. & Teresa Lozano Long School of Medicine Director, Biggs Institute Brain Bank Core Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases University of Texas Health Science Center San Antonio San Antonio, Texas 78229 MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by CTE?   Response: CTE, or chronic traumatic encephalopathy, is a progressive neurodegenerative disorder that is linked to prior exposure to repetitive traumatic brain injuries.  CTE pathology, characterized by a distinct deposition pattern of the protein ‘tau’, is most often observed in the brains former contact sport athletes and military veterans.  The public health impacts of this disorder are largely unknown, as this disease is often studied in individuals which advanced levels of exposure, particularly professional American football player. This study aimed to understand what the presence of this disorder might be in the general population by studying athletes and non-athletes, a number of different sports, different levels of participation, and both males and females. (more…)