Author Interviews, Fertility, JAMA, Menopause / 10.04.2021
Factors Associated with Later Menopause and Longer Reproductive Lifespan
MedicalResearch.com Interview with:
Duke Appiah, Ph.D., MPH
Assistant Professor,Public Health
Texas Tech University
MedicalResearch.com: What is the background for this study?
Response: Reports from several countries point towards increasing trends in age at natural menopause. However, epidemiological report from the United States on the long-term trends in age at natural menopause or reproductive life span among a nationally representative sample of women is lacking. Understanding changes in the timing of age at natural menopause and length of the reproductive life span and their associated factors are important. For instance, earlier age at natural menopause is reported to be associated with cardiovascular diseases, neurological diseases and osteoporosis while later onset of menopause has been associated with the occurrence of breast, endometrial, and ovarian cancers. Similarly, longer durations of reproductive life span are associated with reduced morbidity and mortality.
Sarah Windle[/caption]
Sarah Windle, MPH
PhD Student in Epidemiology
Department of Epidemiology, Biostatistics, and Occupational Health
McGill University (Montréal, Québec, Canada)
MedicalResearch.com: What is the background for this study?
Response: Concerns have been raised about the potential for increases in impaired driving following the legalization of recreational cannabis use in Canada in October 2018. Data from Statistics Canada suggest that cannabis use in the previous three months increased among adults (15 and older) from 14% before legalization in 2018 to 17% in 2019. Among those users with a driver’s license, 13% reported driving within two hours of cannabis use. While this proportion remained the same before and after legalization, this indicates that the absolute number of individuals who reported driving within two hours of use has increased following legalization (due to an increase in the number of users).
Dr. Chien-Wen Tseng[/caption]
Chien-Wen Tseng, M.D., M.P.H., M.S.E.E.
The Hawaii Medical Service Association Endowed Chair
Health Services and Quality Research
Professor, and Associate Research Director
Department of Family Medicine and Community Health
University of Hawaii John A. Burns School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Age-related hearing loss cannot be reversed and can be a significant problem for older adults. Four out of 10 adults who are age 70 and older report hearing loss and it can worsen isolation, cognitive decline, and quality of life, as well as interfere with someone’s ability to live independently. There are simple screening tests to detect hearing loss, so the Task Force did an extensive review of whether there are health benefits to screening for hearing loss in people who do not have symptoms before they notice any hearing problems.
The Task Force determined that there is not enough evidence to recommend for or against screening for hearing loss in adults who are age 50 and older and do not have signs or symptoms of hearing loss. This is an I statement.
Prof. D'Aiuto[/caption]
Francesco D’Aiuto
Professor/Hon Consultant
Head of Periodontology Unit
UCL Eastman Dental Institute
MedicalResearch.com: What is the background for this study?
Response: This study was set out to further our understanding of the link between gum disease and high blood pressure. Recent evidence suggested that individuals with gum disease had a 20-70% increased risk of hypertension and systemic inflammation seemed to be a driver in mediating this association. Further research on the matter was needed. We recruited two relatively large groups of otherwise healthy participants (without a confirmed diagnosis of hypertension) who had gum disease one and healthy gums the other.
We found that diagnosis of periodontitis (gum disease) was consistently linked to higher systolic blood pressure independent of other cardiovascular risk factors.
Dr. Rettew[/caption]
David C. Rettew, MD
Child & Adolescent Psychiatrist
Associate Professor of Psychiatry and Pediatrics
University of Vermont Larner College of Medicine
MedicalResearch.com: What is the background for this study?
Response: Our group, the Wellness Environment Scientific Team at the University of Vermont, hadn’t planned to look at COVID at the outset of this study and instead were going to look at mental health and engagement in wellness activities in college students across a semester. The pandemic disrupted that plan when students were abruptly sent home but fortunately, they continued to do their daily app-based ratings of their mood, stress levels, and engagement in healthy activities. We then realized we had some interesting pre-COVID to COVID data that was worth exploring. 
Prof.Auger[/caption]
Nathalie Auger
Professeure agrégée de clinique
École de santé publique - Département de médecine sociale et preventive
University of Montreal
MedicalResearch.com: What is the background for this study?
Response: COVID-19, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been a major public health concern. The number of infected pregnant women continues to increase. Pregnant women and infants are particularly susceptible to COVID-19 because the physiologic changes of pregnancy involve cardiovascular, respiratory, and immune changes that may alter the response to SARS-CoV-2 infection. Fetuses may be exposed to SARS-CoV-2 during critical periods of development. The nature of the association between COVID-19 and pregnancy outcomes remains unclear and meta-analyses of pregnant women with COVID-19 are lacking.
Matt Spick[/caption]
Matt Spick, Post-Graduate Researcher
University of Surrey
Faculty of Engineering and Physical Sciences
Guildford, UK
MedicalResearch.com: What is the background for this study? Are you measuring lipids or the virus?
Response: In this study, we aimed to detect what the virus does to us, rather than the virus itself. The gold standard for detecting COVID-19 is the RT-PCR test, but by their nature, PCR tests only provide diagnostic information, and at times during the pandemic the availability of PCR tests has been a bottleneck for the identification of the disease. Our goal was to investigate a novel method for the diagnosis of COVID-19, at the same time as learning more about what the disease does to us through lipidomics.
Anne Cust[/caption]
Anne Cust | PhD, Professor of Cancer Epidemiology
The University of Sydney
Faculty of Medicine and Health
Sydney School of Public Health
MedicalResearch.com: What is the background for this study? Are the screeners specially trained, use full body photographs, dermoscopy etc?
Response: The Melanoma High-risk Clinic Study was developed to optimise the early detection of new melanomas in people at high risk of developing melanoma. A previous single-centre study observed fewer excisions and healthcare costs, thinner melanomas and better quality of life when surveillance of high risk patients was conducted in a melanoma dermatology clinic with a structured surveillance protocol involving 6-monthly full body examinations aided by total body photography (TBP) and sequential digital dermoscopy imaging (SDDI). The initial pilot study was performed in a single tertiary referral specialist centre using trained dermatologists who routinely used the diagnostic interventions.
Our objective was to examine longer-term sustainability and expansion of the program to multiple practices including a primary care skin cancer clinic setting. The hypothesis was that the outcomes would be similar if using the same protocol and diagnostic tools. The participating doctors were trained to follow the protocol, which included instruction on how to respond and interpret changing lesions, but not in use of dermoscopy or skin examinations, which were routinely and consistently used in all clinics prior to the study commencing. There were 593 participants assessed as very high risk of melanoma who participated in the Melanoma High-risk Clinic Study from 2012-2018. Nearly all of the participants had had a previous melanoma and had additional melanoma risk factors. 57% were male and the median age at study entry was 58 years.
Dr. Fornwalt[/caption]
Brandon K Fornwalt, MD, PhD
Associate Professor, Director Department of Imaging Science and Innovation
Geisinger
MedicalResearch.com: What is the background for this study?
Response: Atrial fibrillation (AF) is an abnormal heart rhythm that is associated with outcomes such as stroke, heart failure and death. If we know a patient has atrial fibrillation, we can treat them to reduce the risk of stroke by nearly two-thirds. Unfortunately, patients often don’t know they have AF. They present initially with a stroke, and we have no chance to treat them before this happens. If we could predict who is at high risk of either currently having AF or developing it in the near future, we could intervene earlier and hopefully reduce bad outcomes like stroke. Artificial intelligence approaches may be able to help with this task.
Dr. Jacob[/caption]
Jesse T. Jacob, MD
School of Medicine
Director, Antibiotic Stewardship Program
Emory University, Atlanta, Georgia
MedicalResearch.com: What is the background for this study?
Response: Since coronavirus disease 2019 (COVID-19) was recognized in the United States in January 2020, the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) attributed to exposures in the health care workplace has been studied with conflicting results, and the role of job functions (such as nurse) or specific workplace activities, including care for individuals with known and unknown SARS-CoV-2 positivity, increase the risk of SARS-CoV-2 infection.
We assessed more than 24,000 healthcare providers between April and August 2020 across four large academic medical systems (Emory, Johns Hopkins, Rush University Medical Center, and University of Maryland) which collaborate in the CDC’s Prevention Epicenter Program and conduct innovative infection prevention research. Each site conducted voluntary COVID-19 antibody testing on its health care workers, as well as offered a questionnaire/survey on the employees’ occupational activities and possible exposures to individuals with COVID-19 infection both inside and outside the workplace. We also looked at three-digit residential zip-code prefixes to determine COVID-19 prevalence in communities. 
Dr. Lee[/caption]
Brian P. Lee, MD, MAS
Assistant Professor Clinical Medicine
University of Southern Californi
Keck School of Medicine
Los Angeles, California
MedicalResearch.com: What is the background for this study?
Response: The COVID-19 pandemic has been associated with mental health stressors, including anxiety, loneliness, and social instability. We hypothesized the pandemic may have led to increased alcohol and tobacco use as a coping mechanism for these stressors. National retrospective questionnaires had suggested higher reports of substance use, but these are limited by selection and recall biases, in addition to subjective report – we sought to address this knowledge gap by using a nationally-representative longitudinal cohort (Nielsen National Consumer Panel) tracking real-time purchases of households across the US. 
Dr. Bunik[/caption]
Maya Bunik, MD, MPH | Professor, Pediatrics
Medical Director, Child Health Clinic, Primary Care | Breastfeeding Management Clinic
Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS)
School of Medicine| University of Colorado Anschutz Medical Campus
Children's Hospital Colorado
MedicalResearch.com: What is the background for this study?
Response: Marijuana legalization has been increasing in the United States, with increasing consumption of marijuana products. Currently, the American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG) and Academy of Breastfeeding Medicine (ABM) do not recommend marijuana use during pregnancy or lactation due to concerning though limited data on the effects of perinatal marijuana exposure.
As there has been increasing prevalence of women using marijuana during pregnancy due to legalization and perceptions of safety, we sought to determine the duration of THC excretion in breast milk among women who had evidence of marijuana use at delivery and abstained post-partum. 
