Author Interviews, Brigham & Women's - Harvard, Education, JAMA / 06.05.2019

MedicalResearch.com Interview with: Arabella L. Simpkin,  MD, MMSc Associate Director, Center for Educational Innovation and Scholarship, MGH Associate Program Director, Education and Curriculum, Internal Medicine Residency, MGH Instructor in Medicine, Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? Response: The academic health care environment has changed in unprecedented ways over several decades, with mounting evidence that faculty are becoming increasingly more unhappy, dissatisfied, and burnt out in their work. Concern for faculty wellbeing is high, with much speculation about causes of burnout. Comprehending what affects satisfaction at work in academic health care centers is critically important to stem this epidemic of discontent. For physicians, satisfaction has been reported to be associated with quality of care delivered, particularly as measured by patient satisfaction; faculty retention and job satisfaction are intricately linked, with dissatisfied physicians more likely to leave the profession and to discourage others from entering. Other industries that have suffered similar rises in employee discontent have found that demonstration of respect is the most important leadership behavior in improving employees satisfaction. To our knowledge this factor has not been looked at in healthcare professionals. To address this gap, we sought to determine key variables influencing satisfaction at work for faculty in a large academic medical center in the United States. (more…)
Addiction, Author Interviews, Education, Mental Health Research / 16.04.2019

MedicalResearch.com Interview with: Lina Begdache, PhD, RDN, CDN, CNS-S, FAND Assistant Professor Health and Wellness Studies Department GW 15 Decker School of Nursing Binghamton University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: College students engage in activities such as binge drinking, abuse of ADHD medications as "study drugs" or use of illicit drugs during a critical brain developmental window that supports maturation of the brain (the prefrontal cortex) necessary for emotional control, cognitive functions and regulation of impulsive behaviors. These activities not only affect brain function, thus mental health and cognitive functions, but may dampen brain development with potential long-lasting effects. As for findings, we were able to identify neurobehavioral patterns that associate with mental wellbeing and mental distress in young adults. Based on evidence from the literature, we constructed conceptual models that describe how one behavior may lead to another until virtuous or vicious cycles set-in.  (more…)
Author Interviews, Education, JAMA, University of Pennsylvania / 16.04.2019

MedicalResearch.com Interview with: Krisda Chaiyachati, MD, MPH, MSHP Assistant Professor Medicine, Perelman School of Medicine Clinical Innovation Manager Penn's Center for Health Care Innovation Perelman School of Medicine Medical Director, Penn Medicine's FirstCall Virtual Care   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The United States spends more than $12 billion annually on training young doctors who have rates of burnout and depression at an alarmingly high rate. Yet, we have limited evidence as to what they are doing while training in the hospital. We sought to glimpse into how their day is spent. In the largest study to date, we observed 80 first-year internal medicine physicians (“interns”) for nearly 2200 hours across 194 work shifts at 6 different sites. Our research sought to understand what medical residents did by categorizing training activities into themes such as time spent in education or patient care.  (more…)
Author Interviews, Education, Health Care Systems / 14.03.2019

MedicalResearch.com Interview with: Nicholas A. Rattray, Ph.D. Research Scientist/Investigator VA HSR&D Center for Health Information and Communication Implementation Core, Precision Monitoring to Transform Care (PRISM) QUERI Richard L. Roudebush Veterans Affairs Medical Center Indiana University Center for Health Services & Outcomes Research Regenstrief Institute, Inc. Indianapolis, Indiana on behalf of study co-authors re: Rattray NA, Flanagan ME, Militello LG, Barach P, Franks Z, Ebright P, Rehman SU, Gordon HS, Frankel RM MedicalResearch.com: What is the background for this study? What are the main findings?  Response: End-of-shift handoffs pose a substantial patient safety risk. The transition of care from one doctor to another has been associated with delays in diagnosis and treatment, duplication of tests or treatment and patient discomfort, inappropriate care, medication errors and longer hospital stays with more laboratory testing. Handoff education varies widely in medical schools and residency training programs. Although there have been efforts to improve transfers of care, they have not shown meaningful improvement. Led for the last decade by Richard Frankel, Ph.D., a senior health scientist at Regenstrief Institute and Indiana University and professor at Indiana University School of Medicine, our team has studied how health practitioners communicate during end-of-shift handoffs. In this current study, funded by VA Health Services and Research Development, we conducted interviews with 35 internal medicine and surgery residents at three VA medical centers about a recent handoff and analyzed the responses. Our team also video-recorded and analyzed more than 150 handoffs. Published in the Journal of General Internal Medicine, this study explains how the person receiving the handoff can affect the interaction. Medical residents said they changed their delivery based on the doctor or resident who was taking over (i.e., training level, preference for fewer details, day or night shift). We found that handoff communication involves a complex combination of socio-technical information where residents balance relational factors against content and risk. It is not a mechanistic process of merely transferring clinical data but rather is based on learned habits of communication that are context-sensitive and variable, what we refer to as “recipient design”. In another paper led by Laura Militello, we focus on how residents cognitively prepare for handoffs. In the paper published in The Joint Commission Journal of Quality and Patient Safety®, researchers detailed the tasks involved in cognitively preparing for handoffs. A third paper, published in BMC Medical Education, reports on the limited training that physicians receive during their residency. Residents said they were only partially prepared for enacting handoffs as interns, and clinical experience and enacting handoffs actually taught them the most.   (more…)
Author Interviews, Education, Health Care Systems, Outcomes & Safety, University of Pennsylvania / 07.03.2019

MedicalResearch.com Interview with: Jeffrey H. Silber, MD, PhD Director, Center for Outcomes Research Nancy Abramson Wolfson Endowed Chair Health Services Research Children's Hospital of Philadelphia Professor of Pediatrics, Anesthesiology and Critical Care Perelman School of Medicine, University of Pennsylvania Professor of Health Care Management Wharton School, University of Pennsylvania  MedicalResearch.com: What is the background for this study? Response: This was a year-long randomized trial that involved 63 internal medicine residency programs from around the US.  In 2015-2016, about half of the programs were randomized to follow the existing rules about resident duty hours that included restrictions on the lengths of shifts and the rest time required between shifts (the standard arm of the trial) and the other half of the programs didn’t have those shift length or rest period rules (the flexible arm of the trial).  We measured what happened to the patients cared for in those programs (the safety study), and other studies examined how much sleep the residents received, and how alert they were at the end of shifts (the sleep study), and previously we published on the educational outcomes of the interns. To measure the impact on patient outcomes when allowing program directors the ability to use a flexible shift length for their interns, we compared patient outcomes after the flexible regimen went into place to outcomes the year before in the same program. We did the same comparison for the standard arm. Then we compared the difference between these comparisons. Comparing before and after the implementation of the trial within the same program allowed us to be more confident that a particularly strong or weak program, or a program with especially sick or healthy patients, would not throw off the results of the study. The trial was designed to determine, with 95% confidence, if the flexible arm did not do more than 1% worse than the standard arm. If this were true for the flexible arm, we could say the flexible regimen was “non-inferior” to the standard regimen. (more…)
Author Interviews, Cognitive Issues, Education, Social Issues / 04.03.2019

MedicalResearch.com Interview with: Marja Aartsen, PhD Research professor at NOVA Norwegian Social Research / OsloMet Oslo Metropolitan University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study is part of a larger project “Life course influences on health trajectories at older age” conducted at the University of Geneva, of which dr. Stéphane Cullati is the principle investigator (see for more information on the project https://cigev.unige.ch/index.php?cID=887). The aim of that research project is to examine in what way retrospective life course precursors from childhood to late adulthood have long-term impacts on current health trajectories at older age. A number of studies in this project are now published among which our study on childhood conditions and cognitive functioning and cognitive decline in later life. In our research, we were particularly interested in the origins of cognitive decline in later life.  Studies among children show that the childhood is an important phase in the development of the brain. Growing up in environments in which people are cognitively stimulated stimulates the brain to develop more complex neuronal networks and larger brain reserves, which may compensate for the neuronal losses that occur when people get older. This effect is long visible, even at old age as a number of important studies recently provided quite solid evidence for the beneficial effect of advantaged childhood conditions on level of cognitive functioning in later life. However, not many studies investigated the relation between childhood conditions and the speed of cognitive decline in later life. Those that did found inconsistent results. We reasoned that part of the inconsistencies in study findings might stem from differences in the analytical approach (not sensitive enough), too little cognitive change because of a short follow-up, too young people, or too small sample (all causing too little power to find statistically significant effects) or differences in the measurement of the childhood conditions. To overcome these potential limitations, we used a large study sample with long follow-up, used a multidimensional measurement of childhood condition, and applied a powerful analytical technique.  (more…)
Author Interviews, Diabetes, Education, JAMA, Pediatrics / 06.02.2019

MedicalResearch.com Interview with: Niels Skipper PhD Associate Professor, Department of Economics and Business Economics Aarhus University MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is unclear if there is an association between type 1 diabetes and school performance in children. Some studies have found type 1 diabetes to be associated with worse performance, while others have found no differences. However, most of the existing literature are based on smaller, non-random samples of children with diabetes. In this study we used data on all public school children in the country of Denmark, involving more than 600,000 schoolchildren where approximately 2,000 had a confirmed diagnosis of type 1 diabetes. The children were tested in math and reading using a nationally standardized testing procedure, and we found no difference in the obtain test scores between children with diabetes compared to children without diabetes.  (more…)
Author Interviews, Education, JAMA, Pediatrics / 03.02.2019

MedicalResearch.com Interview with: Sheri Madigan, Ph.D, R.Psych Canada Research Chair in Determinants of Child Development Assistant Professor, Department of Psychology Alberta Children's Hospital Research Institute University of Calgary MedicalResearch.com: What is the background for this study? What are the main findings? Response: Parents are reporting that screen time is one of their major concerns, so we wanted to find out more about how large of a role screen time was playing on children’s developmental outcomes. We were especially interested in the long-term impact of screens, which is why we followed children over time, from ages 2 to 5 and repeatedly assessed both screen time use and children’s achievement of developmental milestones. There are three main findings:
  1. Our study revealed that on average children were viewing screens for 2.4, 3.6 and 1.6 hours per day at two, three and five years of age, respectively. This means that the majority of the participants in our sample are exceeding the American Academy of Pediatrics’ guideline.
  2. We found statistically significant, albeit small effects suggesting that greater amounts of screen time at two and three years predict poorer child outcomes at three and five years, respectively. Thus, screen time has a lasting influence on children’s development.
  3. The opposite pattern was not observed. That is, we did not find evidence that children showing poor performance in terms of achieving developmental milestones were more likely to be place in front of screens to help cope with their potentially challenging behaviors.
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Author Interviews, Dermatology, Education / 13.01.2019

MedicalResearch.com Interview with: Yssra-SolimanYssra S. Soliman, BA Division of Dermatology, Department of Internal Medicine Albert Einstein College of Medicine Bronx, New York MedicalResearch.com: What is the background for this study? What are the main findings?  Response: As the population of the United States becomes increasingly diverse, certain fields within medicine have not followed this trend. Dermatology is the least diverse field after orthopedics. We wanted to understand what barriers prevent medical students from applying to dermatology and whether these barriers differed based on students' racial, ethnic or socioeconomic backgrounds. The main findings of this study are that certain groups are more likely to cite specific barriers than non-minority students. These barriers are significant deterrents to applying to dermatology and include the lack of diversity in dermatology, negative perceptions of minority students by residency programs, socioeconomic barriers such as lack of loan forgiveness and poor accessibility to mentors.  (more…)
Author Interviews, Education, JAMA, OBGYNE, Pediatrics, Social Issues / 21.12.2018

MedicalResearch.com Interview with "Pregnancy 1" by operalynn is licensed under CC BY 2.0Josephine Funck Bilsteen, MSc Department of Pediatrics, Hvidovre University Hospital, Hvidovre, Section of Epidemiology, Department of Public Health University of Copenhagen Copenhagen, Denmark MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The background of this study is that there is increasing recognition of the longer-term health and social outcomes associated with preterm birth such as independent living, quality of life, self-perception and socioeconomic achievements. However, much less is known about differences in education and income among adults born at different gestational weeks in the term period. In this study shorter gestational duration, even within the term range, was associated with lower chances of having a high personal income and having completed a secondary or tertiary education at age 28 years. This is the first study to show that adults born at 37 and 38 completed weeks of gestation had slightly lower chances of having a high income and educational level than adults born at 40 completed weeks of gestation.  (more…)
Author Interviews, Education / 11.12.2018

MedicalResearch.com Interview with:

Kirti Magudia, MD, PhD Diagnostic RadiologyResident, Brigham and Women’s Hospital Clinical Fellow, Radiology, Harvard University
Dr. Magudia


Kirti Magudia, MD, PhD
Diagnostic RadiologyResident, Brigham and Women’s Hospital
Clinical Fellow, Radiology, Harvard University




Debra F. Weinstein, M.D.
Vice President, Graduate Medical Education, Partners Health Care
Associate Professor of Medicine, Harvard Medical School

Christina Mangurian, MD,MAS
Professor and Vice Chair at the UCSF Department of Psychiatry
Weill Institute for Neurosciences
Core Faculty, UCSF Center for Vulnerable Populations
Affiliate Faculty, UCSFPhilip R. Lee Institute for Health Policy Studies

Reshma Jagsi, MD, DPhil
Professor and DeputyChair, Department of Radiation Oncology
Director, Center for Bioethics and Social Sciences in Medicine
University of Michigan

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

Response: Training lengths for medical specialties are increasing and many people are starting training later. Hence, many more trainees are having children during training, an especially difficult time due to long and inflexible work hours. Given the match system, trainees may not have complete control over where they end up in training and thus may not have an optimal support system nearby. Many of the top training institutions are also in high cost of living areas. Since trainees are essentially temporary employees, changing policies to their benefit is challenging. For all of these reasons, prospective and current trainee parents are especially vulnerable.

Parental leave is important to both male and female trainees. We found that just over half of the 15 top graduate medical education (GME) sponsoring institutions associated with the top 12 medical schools did not have parental leave policies. Without these policies, trainees are at the mercy of their departments and program directors. Those institutions that do have parental leave policies for trainees offer significantly less leave to trainees than to faculty. Even then, trainees may not be encouraged to take leave afforded by policy as, depending on specialty board regulations, the leave may extend training time.

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Author Interviews, Education, Sleep Disorders / 04.12.2018

MedicalResearch.com Interview with: Michael K. Scullin, Ph.D. Assistant Professor of Psychology and Neuroscience Director, Sleep Neuroscience and Cognition Laboratory Baylor University Waco, TX 76798  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is a gap between what health behaviors individuals know they should adopt, and what those individuals actually end up doing. For example, a growing literature shows that simply educating students on the importance of sleep does not change their sleep behaviors. Thus, we need to think outside of the box for solutions. In three classes, we have now investigated a motivational solution: if students can earn extra credit on their final exam for sleeping better, will they do so even during finals week? (more…)
Author Interviews, Autism, Education, Exercise - Fitness, Pediatrics / 26.09.2018

MedicalResearch.com Interview with: Dr. Marcus Smith PhD Reader in Sport and Exercise Physiology University of Chichester Co-founder, Clem Burke Drumming ProjectDr. Marcus Smith PhD Reader in Sport and Exercise Physiology University of Chichester Co-founder, Clem Burke Drumming Project MedicalResearch.com: What is the background for this study? Response: The research group first started to examine rock drumming from a scientific perspective in 1999 through collaboration with Clem Burke, drummer with the iconic band ‘Blondie’. In 2008 the Clem Burke Drumming Project (CBDP) was formed (visit clemburkedrummingproject.org for further information) where academics from different disciplines came together to not only explore the physiological demands of rock drumming but also the potential use of rock drumming as an intervention in research studies. Rock drumming is attractive to the scientist in that it is a unique activity that requires the coordination of multiple limbs to produce the required drumming pattern. Inherent demands relating to timing, tempo and volume must also be met. Therefore, the ability to manipulate these facets of drumming performance in a research setting is very appealing. In relation to potential research populations drumming has a universal fascination regardless of age, gender, culture, language competency and ethnicity. Anecdotal evidence suggests that drumming is a ‘cool’ activity that has a unique ‘language currency’ in terms of stimulating communication within and between those who can and cannot play the drums. The impetus for our research study came from parents of autistic children contacting us to express their belief that drumming was having a positive effect on their child’s physical and psychological behaviour. A review of the literature showed a range of anecdotal evidence in support of such statements (Freidman 2000) and an increase in empirical drumming based research being undertaken (Bungay 2010). More recent studies have reported psychosocial benefits such as enhanced communication (Maschi et al. 2010; 2012), emotional processing and tension reduction (Flores et al. 2016; Maschi et al. 2010; 2012), group cohesion and connectedness (Blackett et al. 2005), concentration, psychomotor coordination and posture (Chen et al. 2017). The majority of this work was undertaken with adolescents with very little work focused on younger age groups. (more…)
Author Interviews, Education, Exercise - Fitness / 14.09.2018

“Girl Playing Soccer” by Bold Content is licensed under CC BY 2.0MedicalResearch.com Interview with: Craig Pulling. MSc, PGCE, BA (Hons), FHEA Head of Physical Education University of Chichester MedicalResearch.com: What is the background for this study? Response: Successful perceptual-cognitive skill in team-sports such as football requires players to pick up task-relevant information during the control of action in complex and dynamic situations. It has been proposed that players could perform visual exploratory activity (VEA) to be able to recognise important cues in the playing environment. VEA is defined as: “A body and/or head movement in which the player’s face is actively and temporarily directed away from the ball, seemingly with the intention of looking for teammates, opponents or other environmental objects or events, relevant to perform a subsequent action with the ball” (Jordet, 2005, p.143). Research has suggested that VEA is an important facet of skilled performance in youth and adult football. However, it is currently unknown whether such evidence is commensurate with the views of coaches and whether coaching practices are utilised to develop VEA in training. In order to further current understanding on VEA and coaching practices, the present study developed an online survey to examine: (i) when VEA should be introduced in coaching; (ii) how VEA is delivered by coaches and (iii) how coaches evaluate VEA. Further, this study aimed to explore whether distinct groups of football coaches existed who differed in their approach to the delivery of VEA training and, if so, whether there were differences in the demographics of the coaches across these differentiated groups. (more…)
Author Interviews, Dermatology, Education, Gender Differences, JAMA / 03.09.2018

MedicalResearch.com Interview with: Lia E. Gracey, MD, PhD Department of Dermatology Baylor Scott & White Health Austin, Texas  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The co-authors and I were interested in this issue as new parent leave (or the lack thereof) is increasingly being examined in many professions.  As a mother who had children during dermatology residency, I felt the pressure to take a short new parent leave to avoid having to make up time at the end of my training. I came back to work only 3 ½ weeks after having my first baby. Anecdotally, other new parent residents (both men and women) reported similar concerns and we noticed a lack of data about new parent leave policies in dermatology residency training programs. We distributed surveys to dermatology residency program directors and residents and were struck by a basic lack of awareness by residents for whether their institution even offered new parent leave.  Less than 50% of surveyed residents were aware of a written new parent leave policy for their residency program, yet over 80% of program directors stated they had a policy in place. We also found discrepancies between resident and program director perceptions of sufficiency of new parent leave and the availability of pumping facilities for breastfeeding mothers.  (more…)
Author Interviews, Education / 30.08.2018

MedicalResearch.com Interview with: “Lecture Hall” by Sholeh is licensed under CC BY 2.0Dr. David P. Smith, NTF, BSc, PhD, SFHEA Senior Lecturer in Biochemistry / Course Leader MSc Molecular and Cellular Biology and National Teaching Fellow Sheffield Hallam University, in the UK MedicalResearch.com: What is the background for this study? Response: Lectures are not going to go away, when done well they can be an effective method for teaching large groups of students. To make the lecture experience more effective we wanted to find out why students chose to sit in a given location such that we can better interact with them during taught sessions. We also wanted to find out the reasons they made this choice and if this choice of location had an effect on finial attainment (marks).  (more…)
Author Interviews, Education, JAMA, Pediatrics, Weight Research / 09.08.2018

MedicalResearch.com Interview with: Ian M. Paul, M.D., M.Sc. Professor of Pediatrics and Public Health Sciences Chief, Division of Academic General Pediatrics Vice Chair of Faculty Affairs, Department of Pediatrics Penn State College of Medicine Hershey, PA 17033-0850 MedicalResearch.com: What is the background for this study? What are the main findings? Response: 20-25% of 2-5 year old children are overweight or obese in the US, and these children have increased risk of remaining overweight across the lifecourse. To date, research efforts aimed at preventing early life overweight have had very limited success. In our randomized clinical trial that included 279 mother-child dyads, a responsive parenting intervention that began shortly after birth significantly reduced body mass index z-score compared with controls at age 3 years. (more…)
Author Interviews, Brigham & Women's - Harvard, Education, Gender Differences, JAMA, Surgical Research / 09.08.2018

MedicalResearch.com Interview with: Erika L. Rangel, MD,MS Instructor, Harvard Medical School Trauma, Burn and Surgical Critical Care Department of Surgery, Center for Surgery and Public Health Brigham and Women’s Hospital Harvard T. H. Chan School of Public Health Boston, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Although women make up half of medical student graduates in 2018, they only comprise a third of applicants to general surgery. Studies suggest that lifestyle concerns and perceptions of conflict between career and family obligations dissuade students from the field. After entering surgical residencies, women residents have higher rates of attrition (25% vs 15%) and cite uncontrollable lifestyle as a predominant factor in leaving the field. Surgeons face reproductive challenges including stigma against pregnancy during training, higher rates of infertility, need for assisted reproduction, and increased rates of pregnancy complications. However, until recently, studies capturing the viewpoints of women who begin families during training have been limited. Single-institution experiences have described mixed experiences surrounding maternity leave duration, call responsibilities, attitudes of coworkers and faculty, and the presence of postpartum support. Earlier this year, our group presented findings of the first national study of perspectives of surgical residents who had undergone pregnancy during training. A 2017 survey was distributed to women surgical residents and surgeons through the Association of Program Directors in Surgery, the Association of Women Surgeons and through social media via twitter and Facebook. Responses were solicited from those who had at least one pregnancy during their surgical training. 39% of respondents had seriously considered leaving surgical residency, and 30% reported they would discourage a female medical student from a surgical career, specifically because of the difficulties of balancing pregnancy and motherhood with training (JAMA Surg 2018; July 1; 153(7):644-652). These findings suggested the challenges surrounding pregnancy and childrearing during training may have a significant impact on the decision to pursue or maintain a career in surgery. The current study provides an in-depth analysis of cultural and structural factors within residency programs that influence professional dissatisfaction. We found that women who faced stigma related to their pregnancies, who had no formal maternity leave at their programs, and who altered subspecialty training plans due to perceived challenges balancing motherhood with the originally chosen subspecialty were most likely to be unhappy with their career or residency. (more…)
Author Interviews, Education, JAMA / 02.08.2018

MedicalResearch.com Interview with: “Doctors with patient, 1999” by Seattle Municipal Archives is licensed under CC BY 2.0Dr. Laura M. Mazer, MD Goodman Surgical Education Center Department of Surgery Stanford University School of Medicine Stanford, California MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There are numerous articles that clearly document the high prevalence of mistreatment of medical trainees. We have all seen and experienced the results of an “I’ll do unto you like they did unto me” attitude towards medical education. Our motivation for this study was to go beyond just documenting the problem, and start looking at what people are doing to help fix it. Unfortunately, we found that there are comparatively few reports of programs dedicated to preventing or decreasing mistreatment of medical trainees. In those studies we did review, the study quality was generally poor. Most of the programs had no guiding conceptual framework, minimal literature review, and outcomes were almost exclusively learner-reported. (more…)
Author Interviews, Education, Pharmaceutical Companies / 01.08.2018

MedicalResearch.com Interview with: Brian J. Piper, PhD, MS Department of Basic Sciences Geisinger Commonwealth School of Medicine Scranton, PA 18509 MedicalResearch.com: What is the background for this study? Response: The authors of this study are biomedical scientists, health care providers and educators who teach medical and pharmacy students. It is a standard practice in reputable medical journals like the New England Journal of Medicine to disclose conflicts of interest (CoI). Reputable sources like the Cochrane Library also disclose CoIs and analyze for their potential impact on the evidence base. Unfortunately, textbooks, which can be highly influential in the training of medical professionals, usually do not disclose their conflicts of interest. A prior study in this quantitative bioethics area found that more than one-quarter of a team-authored pharmacology textbook, Goodman and Gilman’s Pharmacological Basis of Therapeutics, had an undisclosed patent (PLoS One, 2015; 10: e0133261).  The goal of this investigation was to determine whether there were undisclosed CoIs in textbooks used in the training and as a reference for allopathic physicians, osteopathic physicians, dentists, pharmacists, nurses and other allied healthcare providers.  (more…)
Author Interviews, Education, Gender Differences, JAMA, Pediatrics / 22.07.2018

MedicalResearch.com Interview with: Julie Silver, MD Associate Professor and Associate Chair Department of Physical Medicine and Rehabilitation at Harvard Medical School and Staff physician at Massachusetts General Brigham and Women’s and Spaulding Rehabilitation Hospitals  MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are many documented disparities for women in medicine that include promotion and compensation. For physicians in academic medicine, both promotion and compensation may be directly or indirectly linked to publishing. Similarly, opportunities that stem from publishing such as speaking engagements, may be affected by a physician’s ability to publish. For more than twenty years, there have been reports of women being underrepresented on journal editorial boards and gaps in their publishing rates. For example, a report titled “Is There a Sex Bias in Choosing Editors?” by Dickersin et al was published in JAMA in 1998 and made a compelling case for bias. Moreover, the authors noted that “a selection process favoring men would have profound ramifications for the professional advancements and influence of women”. Despite a steady stream of reports over the years, gaps have not been sufficiently addressed, and in 2014 Roberts published an editorial in Academic Psychiatry titled “Where Are the Women Editors?”. The 2017 review by Hengel titled “Publishing While Female” highlights many of the gaps, disparities and barriers for women in medicine. Conventional reasons for disparities, such as there are not enough women in the pipeline or women do not want to conduct research or pursue leadership positions, are simply not valid. Therefore, it is important to look at other barriers, such as unconscious (implicit) bias that may affect the editorial process. In this study, we analyzed perspective type articles from four high impact pediatric journals. We selected pediatrics, because most pediatricians are women, and therefore there are plenty of highly accomplished women physicians. We found that women were underrepresented among physician first authors in all of the journals (140 of 336 [41.7%]). We also found that underrepresentation was more pronounced in article categories that were described as more scholarly (range, 15.4%-44.1%) versus narrative (52.9%-65.6%).  (more…)
Author Interviews, Education, JAMA, Ophthalmology, Pediatrics / 20.07.2018

MedicalResearch.com Interview with: Aparna Raghuram, OD, PhD Optometrist, Department of Ophthalmology Instructor, Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Developmental dyslexia is a specific learning disability of neurobiological origin whose core cognitive deficit is widely believed to involve language (phonological) processing. Although reading is also a visual task, the potential role of vision has been controversial, and experts have historically dismissed claims that visual processing might contribute meaningfully to the deficits seen in developmental dyslexia. Nevertheless, behavioral optometrists have for decades offered vision therapy on the premise that correcting peripheral visual deficits will facilitate reading. Yet there is a surprising dearth of controlled studies documenting that such deficits are more common in children with developmental dyslexia, much less whether treating them could improve reading. In the present study, we simply assessed the prevalence and nature of visual deficits in 29 school aged children with developmental dyslexia compared to 33 typically developing readers. We found that deficits in accommodation 6 times more frequent in the children with developmental dyslexia and deficits in ocular motor tracking were 4 times more frequent. In all, more than three-quarters of the children with developmental dyslexia had a deficit in one or more domain of visual function domain compared to only one third of the typically reading group. (more…)
Author Interviews, Education, Pediatrics, Smoking, Technology, Tobacco Research / 29.06.2018

MedicalResearch.com Interview with: Jon-Patrick Allem, Ph.D., M.A. Research Scientist Keck School of Medicine of USC MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by JUUL?  Response: The JUUL vaporizer is the latest advancement in electronic cigarette technology, delivering nicotine to the user from a device about the size and shape of a thumb drive. JUUL has taken the electronic cigarette market by storm experiencing a year-over-year growth of about 700 percent. In our most recent study, we wanted to document and describe the public’s initial experiences with JUUL. We collected posts to Twitter containing the term “Juul” from April 1, 2017 to December 14, 2017. We analyzed over 80,000 posts representing tweets from 52,098 unique users during this period and used text classifiers (automated processes that find specified words and phrases) to identify topics in posts. (more…)
Author Interviews, Education, Mental Health Research, Pharmacology / 28.06.2018

MedicalResearch.com Interview with: Kiyohito Iigaya PhD Gatsby Computational Neuroscience Unit and Max Planck UCL Centre for Computational Psychiatry and Ageing Research University College London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Serotonin (5-HT) is believed to play many important roles in cognitive processing, and past experiments have not crisply parsed them. We developed a novel computational model of mice behavior that follows reinforcement learning principles, which are widely used in machine learning and AI research. By applying this model to experimental data, we found that optogenetic 5-HT stimulation speeds up the learning rate in mice, but the effect was only apparent on select subset of choices. (more…)
Author Interviews, Education, Social Issues / 23.06.2018

MedicalResearch.com Interview with: “siblings” by Britt Reints is licensed under CC BY 2.0Xiaoran Sun Department of Human Development and Family Studies The Pennsylvania State University University Park, PA 16802.   MedicalResearch.com: What is the background for this study? Response: College graduation has significant implications for adult life outcomes including for employment, family formation, and health (IOM & NRC, 2015). Investigating how sibling differences in college graduation emerge sheds light on why children growing up in the same family sometimes follow diverging paths in adulthood. Our study also responds to the call by researchers interested in policy and practice to conduct longitudinal research investigating the role of early family socialization processes in educational attainment (Pettit, Davis-Kean, & Magnuson, 2009). Despite siblings’ important role in child and adolescent development, previous research has focused on parenting and on the academic outcomes of individual children in the family. Further, although sibling experiences, including their relationship characteristics and parental differential treatment, have been linked to sibling similarities and differences in domains such as risky behaviors (Slomkowski, Rende, Novak, Lloyd-Richardson, & Raymond, 2005), to date, there has been very little research on the role of sibling experiences in positive development, such as academic achievement.   (more…)
Annals Internal Medicine, Author Interviews, Diabetes, Education, Outcomes & Safety / 12.06.2018

MedicalResearch.com Interview with: Bradley Gray, PhD Senior Health Services Researcher American Board of Internal Medicine MedicalResearch.com: What is the background for this study? Response: This study is part of an ongoing effort to improve and validate ABIM’s MOC process through the use of real data that is ongoing here at ABIM. MedicalResearch.com: What are the main findings?  Response: The paper examines the association between MOC status and a set of HEDIS process quality measures for internists twenty years past the time they initially certified. An example of one HEDIS performance measure we looked at was percentage of patients with diabetes that had twice annual HbA1c testing. The key findings of the paper are that physicians who maintained their certification had better scores on 5 of 6 HEDIS performance measures than similar physicians who did not maintain their certification. (more…)
Author Interviews, Education, JAMA / 04.06.2018

MedicalResearch.com Interview with: Kathleen M. Finn MD, MPhil Christiana Iyasere MD, MBA Division of General Internal Medicine Department of Medicine Massachusetts General Hospital, Boston MedicalResearch.com: What is the background for this study? Response: While the relationship between resident work hours and patient safety has been extensively studied, little research evaluates the role of attending supervision on patient safety. Beginning with the Bell Commission there have been increased calls for enhanced resident supervision due to patient safety concerns. At the same time, with the growth of the hospitalist movement more faculty physicians join daily resident work rounds under the assumption that increased supervision is better for patient safety and resident education. However, we know that supervision is a complex balancing act, so we wanted to study whether these assumptions were true. On the one hand patient safety is important, but on the other adult learning theory argues residents need to be challenged to work beyond their comfort level. Importantly, being pushed beyond your comfort level often requires appropriate space between teacher and learner. To investigate the role of attending supervision on patient safety and resident learning we studied the impact of two levels of physician supervision on an inpatient general medical team. Twenty-two teaching faculty were randomized to either direct supervision of resident teams for patients previously known to the team vs usual care where they did not join rounds but rather discussed the patients later with the team. Faculty participated in both arms of the study, after completing the first arm they then crossed over to the other arm; each faculty member participated in the study for a total of 4 weeks. (more…)