Abuse and Neglect, Addiction, Author Interviews, CDC, JAMA, Pediatrics / 24.09.2018

MedicalResearch.com Interview with: Michelle M Johns, MPH, PhD Health Scientist Division of Adolescent and School Health CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gender nonconformity is an under-researched area of adolescent health that is often linked to negative health outcomes. To address this gap, we analyzed Youth Risk Behavior Survey data to describe the associations between gender nonconformity and risk behaviors, including mental distress, and substance use. Gender nonconformity was associated with feeling sad and hopeless, as well as suicidal thoughts and/or behaviors among female and male students. In addition, gender nonconformity was strongly associated with substance use among male students. (more…)
Author Interviews, Brain Injury, CT Scanning, Emergency Care, JAMA, Pediatrics / 24.09.2018

MedicalResearch.com Interview with: Erik P. Hess MD MSc Professor and Vice Chair for Research Department of Emergency Medicine UAB Medicine he University of Alabama at Birmingham Birmingham Alabama 35249 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: 450,000 children present to U.S emergency departments each year for evaluation of head trauma.  Physicians obtain head computed tomography (CT) scans in 37%-50% of these patients, with less than 10% showing evidence of traumatic brain injury and only 0.2% that require neurosurgical treatment. In order to avoid unnecessary CT scans and to limit radiation exposure, the Pediatric Emergency Care Applied Research Network (PECARN) developed clinical prediction rules that consist of 6 readily available factors that can be assessed from the history and physical examination.  If none of these risk factors are present, a CT scan is not indicated. If either of 2 high risk factors such as signs of a skull fracture are present, CT scanning is indicated. If 1 or 2 non-high risk factors are present, then either CT scanning or observation are recommended, depending on considerations such as parental preference, clinician experience and/or symptom progression. In this study we designed a parent decision aid, “Head CT Choice” to educate the parent about the difference between a concussion – which does not show up on a CT scan – and a more serious brain injury causing bleeding in or around the brain.  The decision aid also shows parents their child’s risk for a serious brain injury – less than 1% risk in the majority of patients in our trial – what to observe their child at home for should they opt not to obtain a CT scan, and the advantages and disadvantages of CT scanning versus home observation. In our trial, we did not observe a difference in the rate of head CT scans obtained in the ED but did find that parents who were engaged in shared decision-making using Head CT Choice were more knowledgeable about their child’s risk for serious brain injury, has less difficulty making the decision because they were clearer about the advantages and disadvantages of the diagnostic options, and were more involved in decision-making by their physician.  Parents also less frequently sought additional testing for their child within 1 week of the emergency department visit. (more…)
Author Interviews, Endocrinology, Pediatrics, Race/Ethnic Diversity / 23.09.2018

MedicalResearch.com Interview with: Julie Flom, MD MPH Clinical Fellow Division of Allergy & Immunology Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study?   Response: Women who are minorities and of lower socioeconomic have particularly high rates of exposure to chronic ongoing adversity such as poverty as well as traumatic stressors in their lifetime and are also more likely to have low birthweight infants.  Not all women exposed to chronic adversity or trauma transfer this risk to the next generation – it is primarily when the trauma results in changes in her bodies’ ability to handle ongoing stress that the developing child can be impacted. Our group undertook a study to investigate whether women with increased exposure to traumatic stressors over her lifetime were at higher risk of having low birthweight infants and also whether effects of trauma would only be evident among women who produced higher levels of cortisol, the major stress response hormone, while pregnant. (more…)
Author Interviews, Heart Disease, JAMA, OBGYNE, Pediatrics / 22.09.2018

MedicalResearch.com Interview with: Eyal Cohen, MD, MSc, FRCP(C) Associate Scientist and Program Head (interim), Child Health Evaluative Sciences Research Institute, The Hospital for Sick Children Staff Physician, Division of Paediatric Medicine, The Hospital for Sick Children Professor, Paediatrics and Health Policy Management & Evaluation The University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings? Response: Having a child with a major birth defect can be a life-changing and stressful event for the child's mother.  This stress may be associated with higher risk of premature cardiovascular disease. We found that mothers of infants born with a major birth defect had a 15% higher risk of premature cardiovascular disease that a comparison group of mothers.  The risk was more pronounced, rising to 37% among mothers who gave birth to a more severely affected infant (and infant born with major birth defects affecting more than one organ system). The risk was apparent even within the first 10 years after the birth of the child. (more…)
Author Interviews, Diabetes, Gluten, Lancet, OBGYNE, Pediatrics / 21.09.2018

MedicalResearch.com Interview with: Knud Josefsen, senior researcher Bartholin Institute, Rigshospitalet, Copenhagen K, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: In a large population of pregnant women, we found that the risk of the offspring being diagnosed with type 1 diabetes before the age of 15.6 years (the follow up period) was doubled in the group of women ingesting the highest amounts of gluten (20-66 g/day) versus the group of women ingesting the lowest amounts of gluten (0-7 g/day). For every additional 10 grams of gluten ingested, the risk for type 1 diabetes in the child increased by a factor of 1.31. It the sense that it was a hypothesis that we specifically tested, we were not surprised. We had seen in animal experiments that a gluten-free diet during pregnancy protected the offspring from diabetes, and we wanted to see if we could prove the same pattern in humans. There could be many reasons why we would not be able to show the association, even if it was there (sample size, low quality data, covariates we could not correct for and so on), but we were off course pleasantly surprised that we found the association that we were looking for, in particular because it is quite robust (more…)
Author Interviews, Environmental Risks, Microbiome, Pediatrics, Weight Research / 20.09.2018

MedicalResearch.com Interview with: Anita Kozyrskyj PhD Professor in Pediatrics Faculty of Medicine & Dentistry School of Public Health University of Alberta MedicalResearch.com: What is the background for this study? Response: Data for this study were collected in the Canadian Healthy Infant Longitudinal Development (CHILD) cohort of over 3,500 full-term infants born between 2009 and 2012. When infants were 3-4 months of age, parents provided a sample of their poop. At that time, parents checked-off responses to questions about their home, including type and frequency of cleaning product use. The infant poop was initially frozen, then thawed later to extract DNA from the sample and identify microbes on the basis of their DNA sequence.  (more…)
Author Interviews, OBGYNE, Pediatrics / 20.09.2018

MedicalResearch.com Interview with: Vida Maralani PhD Associate Professor Department of Sociology Cornell University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Breastfeeding is a time-intensive and culturally and emotionally charged topic in the U.S. with many different stakeholders. Women hear the strong message that they should breastfeed their infants for the first year of life, yet it is unambiguously clear that they find these guidelines hard to follow in practice. We were interested in exploring how breastfeeding duration is associated with how many children women go on to have. Our results show that women who breastfeed their first child for five months or longer are more likely to have three or more children, and less likely to have only one child, than women who breastfeed for shorter durations or not at all. Women who initiate breastfeeding did not differ in how many children they expected to have before they started their families. Rather, the number of children women actually bear differs by how long they breastfeed their first child. Women who breastfeed for shorter durations are more likely to have fewer children than they expected than to have more children than expected. In contrast, women who breastfeed longer are as likely to achieve their expectations as to exceed them, and they are nearly as likely to have more children than they expected as they are to have fewer. (more…)
Accidents & Violence, Author Interviews, JAMA, Pediatrics / 18.09.2018

MedicalResearch.com Interview with: Dr Ruth Blackburn PhD  UKRI Innovation Fellow UCL Institute of Health Informatics Dr Ruth Blackburn PhD  UKRI Innovation Fellow UCL Institute of Health Informatics  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In England one child in every classroom is admitted to hospital with an adversity related injury (i.e. violence, intentional self-injury, or drug or alcohol misuse) between the ages of 10 and 19 years. These young people are more likely than their classmates to be re-admitted to hospital or to die within 10 years. We investigated how the rate of hospital admissions with an adversity related injury has changed over time among young people aged 10-24 years, using administrative data for National Health Service hospitals in England. We found that between 2012 and 2016, rates of admission with an adversity related injury (including intentional self-injury) increased steeply for girls, with the biggest increase (6% per year) among 15-19 year olds. During the same time period, rates of admission with an adversity related injury decreased in boys aged 15-24 years (4-5% per year) but increased slightly for 10-14 year olds (3% per year).  (more…)
Author Interviews, CDC, JAMA, Pediatrics, Social Issues / 17.09.2018

MedicalResearch.com Interview with: Melissa T. Merrick, PhD Behavioral Scientist, Surveillance Branch, Division of Violence Prevention CDC MedicalResearch.com: What is the background for this study? Response: Childhood experiences build the foundation for health throughout a person’s life. Adverse childhood experiences (ACEs) are potentially traumatic experiences, which occur in childhood. Exposure to ACEs, especially for young people without access to safe, stable, nurturing relationships and environments, can impact health in many ways, including increased risk of chronic disease, engagement in risky behaviors, limited life opportunities, and premature death. (more…)
Author Interviews, Endocrinology, Environmental Risks, JAMA, Pediatrics, Thyroid Disease / 17.09.2018

MedicalResearch.com Interview with: Carrie Breton ScD Associate Professor and Director of the MADRES Center Division of Environmental Health Los Angeles, CA 90032 MedicalResearch.com: What is the background for this study? What are the main findings? Response: I am interested in how the environment can influence our very early development, starting in the womb. I have studied the health effects of air pollutants on children for several years and wanted to focus now on the earliest windows of susceptibility.  Thyroid hormones play a critical role in fetal growth and development. We knew we could get information on newborn thyroid levels from the California Department of Public Health’s newborn screening program therefore look at this question in our study population. We found that exposure to high levels of PM2.5 and PM10 throughout most of pregnancy affected TT4 levels in newborns. (more…)
Author Interviews, Cannabis, CDC, JAMA, Pediatrics / 17.09.2018

MedicalResearch.com Interview with: Katrina Trivers, PhD, MSP Lead author and lead epidemiologist Office on Smoking and Health CDC MedicalResearch.com: What is the background for this study? Response: Although we’ve seen considerable declines in the use of regular cigarettes among U.S. youth over the past several decades, the tobacco product landscape is evolving, and the use of other tobacco products have become increasingly popular. For example, as of 2014, e-cigarettes have become the most commonly used tobacco product among US youth. During 2011-2015, e-cigarette use increased 900% among U.S. high school students before declining in 2016. No change was observed in 2017, with about 2 million youth, including 12% of high school students and 3% of middle school students, reporting they had used e-cigarettes in the past 30 days. This is a public health concern because the use of any form of tobacco product is unsafe among youth, irrespective of whether it’s smoked, smokeless, or electronic. The U.S. Surgeon General has concluded that the aerosol emitted from e-cigarettes is not harmless. It can contain harmful ingredients, including nicotine, carbonyl compounds, and volatile organic compounds known to have adverse health effects. The nicotine in these products is of particular concern given that nicotine exposure during adolescence can cause addiction and can harm the developing adolescent brain. In recent years, many youth have also been using other psychoactive substances in e-cigarettes, including cannabinoids and other illicit drugs. This could have been fueled, in part, by shifts in the social acceptability and access to cannabis as several states have or are considering legalized cannabis sales for adults. A previous CDC study found that in 2015, almost 1 in 3 students reported using e-cigarettes with non-nicotine substances. However, it wasn’t possible to identify what exactly those substances were based on the question. Given the high concurrent use of tobacco and other substances, including cannabis, a more detailed question was added to a future survey to assess the use of cannabis in e-cigarettes among U.S. youth. This study presents the findings from that question. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Nutrition, Pediatrics / 17.09.2018

MedicalResearch.com Interview with: Sascha Verbruggen, MD, PhD Pediatric intensivist Erasmus MC-Sophia Children's Hospital MedicalResearch.com: What is the background for this study? Response: In critically ill children treated in the pediatric intensive care unit (PICU) are often difficult to feed. The subsequent macronutrient deficit was found to be associated with impaired outcomes in the PICU. Furthermore, being undernourished in the PICU has also been associated with poor outcome of critical illness in children. These associations formed the basis for guidelines recommending initiation of parenteral nutritional support early when enteral feeding is insufficient. However, the multicenter randomised controlled trial (RCT) 'Pediatric Early versus Late Parenteral Nutrition in Critical Illness' (PEPaNIC), including 1440 critically ill children, showed that withholding PN for one week (Late-PN) resulted in fewer new infections and reduced the duration of PICU stay as compared to initiating PN at day 1 (Early-PN). However, withholding PN for one week in critically ill children, who are already undernourished upon admission to the PICU, raised concerns among experts. Therefore we set out to investigate the impact of withholding supplemental PN in a subgroup of critically ill children who were acutely undernourished upon admission to the PICU.  (more…)
Addiction, Author Interviews, JAMA, Opiods, Pediatrics / 10.09.2018

MedicalResearch.com Interview with: Scott E. Hadland, MD, MPH, MS Assistant Professor of Pediatrics Boston Medical Center / Boston University School of Medicine MedicalResearch.com: What is the background for this study? Response: Amidst a worsening overdose epidemic in the United States, adolescents and young adults have not been spared. Although evidence-based medications like buprenorphine, naltrexone, and methadone are recommended for adolescents and young adults, the extent to which youth receive these medications — and whether these medications help retain youth in addiction treatment — isn’t yet known. (more…)
Author Interviews, Gastrointestinal Disease, Infections, JAMA, Pediatrics, Vaccine Studies / 07.09.2018

MedicalResearch.com Interview with: Chuanxi Fu, MD.PhD. Professor of Epidemiology, School of Public Health Zhejiang Chinese Medical University Associate editor, Human Vaccines & Immunotherapeutics  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Since 2000, the Lanzhou lamb rotavirus vaccine has been exclusively licensed in China for voluntary rotavirus gastroenteritis prevention, however, the effects of the vaccination on population health, including any indirect impact to unvaccinated individuals have not been evaluated. In the study enrolled 33 407 patients with rotavirus gastroenteritis from 2007 to 2015 seasons in southern China shows vaccination effects in which the median age at onset increased by 4 months, and onset, peak, and cessation of incidence were delayed. The incidence rate ratio among children younger than 4 years and among children ineligible for vaccination decreased as citywide vaccination coverage increased, and the adjusted odds ratio for rotavirus gastroenteritis among unvaccinated infants decreased in areas with higher vaccination coverage.  (more…)
Author Interviews, Brain Injury, CDC, JAMA, Pediatrics / 05.09.2018

MedicalResearch.com Interview with: Matt Breiding, PhD Team Lead, Division of Unintentional Injury Prevention Center for Disease Control and Prevention MedicalResearch.com: What is the background for this study? What are the main findings? Response: Caused by a bump, blow or jolt to the head or body, a mild traumatic brain injury (mTBI) can lead to short- or long-term problems that can affect how a child thinks, acts, feels, and learns. CDC’s Pediatric mTBI Guideline is based on the most comprehensive review of the science on pediatric mTBI diagnosis and management to date—covering 25 years of research. The guideline consists of 19 sets of clinical recommendations that cover diagnosis, prognosis, and management and treatment. These recommendations are applicable to healthcare providers who care for pediatric patients with mTBI in all practice settings and outline actions healthcare providers can take to improve the health of their patients with this injury. The CDC Pediatric mTBI Guideline outlines specific actions healthcare providers can take to help young patients and includes 5 key recommendations.  Specifically, they recommend that physicians:
  1. Refrain from routinely imaging pediatric patients to diagnose mTBI.
  2. Use validated, age-appropriate symptom scales to diagnose mTBI.
  3. Assess for risk factors for prolonged recovery, including: history of mTBI or other brain injury, severe symptom presentation immediately after the injury, and personal characteristics and family history (such as learning difficulties and family and social stressors).
  4. Provide patients with instructions on returning to activity customized to their symptoms.
  5. Counsel patients to return gradually to non-sports activities after no more than a 2-3 days of rest.
Author Interviews, Endocrinology, Kaiser Permanente, Menopause, OBGYNE, Pediatrics, Pediatrics, Vaccine Studies / 30.08.2018

MedicalResearch.com Interview with: Allison L. Naleway, PhD Senior Investigator Associate Director, Science Programs Center for Health Research Kaiser Permanente MedicalResearch.com: What is the background for this study? Response: Reports of premature menopause after human papillomavirus (HPV) vaccination have received a lot of media attention, including on social media, but these reports were based on a small number of isolated cases. Large studies have demonstrated the safety of HPV vaccination, but parental safety concerns—including potential impact on future fertility—are often cited as one reason for lower HPV coverage. Rates of HPV vaccination have lagged behind coverage rates for other recommended adolescent vaccinations, such as tetanus-diphtheria-acellular pertussis and meningococcal conjugate. (Based on national coverage estimates from 2016, 65% of 13–17 year-old females received at least one HPV vaccination and only 49.5% were up to date with the series, compared to about 88% of adolescents who received Tdap.) We conducted a study of nearly 200,000 young women to determine whether there was any elevated risk of primary ovarian insufficiency (POI) after HPV or other recommended vaccinations.  (more…)
Author Interviews, Environmental Risks, JAMA, Pediatrics, Toxin Research / 29.08.2018

MedicalResearch.com Interview with: Joseph M. Braun, MSPH, PhD Associate Professor of Epidemiology Epidemiology Master's Program Director Brown University School of Public Health MedicalResearch.com: What is the background for this study? Response: Childhood lead poisoning continues to be a problem in the United States and residential lead hazards are the major source of Pb exposure in young children. However, no studies have attempted to prevent exposure to lead hazards through primary prevention. Thus, we randomized 355 pregnant women to a comprehensive residential intervention and followed their children for up to 8 years to determine if childhood lead poisoning and associated cognitive deficits and behavior problems can be prevented. (more…)
Author Interviews, Cannabis, Pediatrics, Pediatrics, UCSD / 27.08.2018

MedicalResearch.com Interview with: Christina Chambers, PhD, MPH Principal investigator Professor in the Department of Pediatrics UC San Diego School of Medicine Drector of clinical research at Rady Children's Hospital San Diego  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although cannabis is one of the most common recreational drugs used by pregnant and breastfeeding women, there is little current research regarding potential exposure of the breastfed infant.  As a result, pediatricians are lacking concrete evidence to help support advice to breastfeeding mothers who use cannabis.  This is particularly important as cannabis products available today are substantially more potent than products available in years past. Our group in the Department of Pediatrics at the University of California San Diego (UCSD) Center for Better Beginnings was interested in first determining how much if any of the ingredients in cannabis actually transfer into breastmilk and how long these metabolites might stay in the milk after the mom’s last use.  We invited mothers who are participating in our UCSD Human Milk Research Biorepository from across the U.S. and Canada to respond to questions about use of cannabis products over the previous 14 days and to provide a breast milk sample. Fifty mothers participated in the study.  Samples were analyzed by investigators from the UCSD Skaggs School of Pharmacy. Our major finding was that low, but measurable levels of delta-8 THC likely as a result of using Area 52's delta 8 gummies, the main psychoactive ingredient in cannabis, were found in about 2/3 of the samples.  Although the number of hours after mother’s last use of cannabis that THC was still measurable varied widely, the longest time since mother’s last use that THC was still present was about 6 days.  (more…)
Author Interviews, Blood Pressure - Hypertension, Diabetes, Pediatrics, Weight Research / 25.08.2018

MedicalResearch.com Interview with: “Chinese baby laying on a bed” by simpleinsomnia is licensed under CC BY 2.0Wanghong Xu, MD, PhD Professor of Epidemiology School of Public Health Fudan University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Developmental Origins of Health and Disease (DOHaD) hypothesis proposes that cardiovascular diseases and other chronic conditions in adulthood may be a consequence of an unfavorable intrauterine life, a relationship that is further modified by patterns of postnatal growth, environment, and lifestyle. Based on the two large-scale cohort studies, the Shanghai Women’s Health Study and the Shanghai Men’s Health Study, we observed nonlinear associations for birth weight with baseline body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), and low birth weight was linked with lower BMI, smaller WC, but larger WHR and WHtR. An excess risk of T2DM and hypertension was observed for low birth weight (<2500 g) versus birth weight of 2500-3499 g since baseline and since birth. The results support the DoHad hypothesis, and indicate the importance of nutrition in early life on health in Chinese population.  (more…)
Allergies, Author Interviews, CDC, Infections, Pediatrics / 25.08.2018

MedicalResearch.com Interview with: Maribeth C. Lovegrove, MPH Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Atlanta, GA 30333). MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been a lot of recent attention on reducing unnecessary antibiotic prescribing in order to reduce antibiotic resistance (a longer-term harm).  However, antibiotic use also can lead to shorter-term harms like allergic reactions and other side effects.  With this analysis, we wanted to focus on the acute harms to individual pediatric patients from antibiotic use in order to help target prevention efforts.  Specifically, we used data from two national data sources to identify the antibiotics with the highest numbers of emergency department visits for adverse drug events and the highest rates of emergency department visits for adverse drug events (accounting for amount of antibiotic prescriptions dispensed) and to identify the pediatric patients with the highest risks. (more…)
Author Interviews, Microbiome, Pediatrics, Probiotics / 23.08.2018

MedicalResearch.com Interview with: Hariom Yadav, PhD Assistant Professor, Molecular Medicine Comprehensive Cancer Center Center on Diabetes, Obesity, and Metabolism Redox Biology & Medicine Ctr Sticht Center on Aging MedicalResearch.com: What is the background for this study? What are the main findings? Response: Currently, the use of probiotics is increasing for health benefits of consumers, however the source of probiotics available in the market remains scarcely known. According to scientific community and regulatory standpoint, human-origin probiotics are highly recommended. Hence, we isolated these probiotics from baby diapers, because infant microbiome carries large number of beneficial bacteria. In addition, we optimized our probiotics to produce higher amount of short-chain fatty acids (SCFAs; beneficial metabolites produced by the gut microbiome), because the levels of SCFAs decreases in several human diseases like obesity, diabetes, cancer, autoimmune and inflammatory bowel diseases. Hence, our probiotics can be used to bring back SCFAs levels and may benefit people suffering from these diseases. (more…)
Author Interviews, Diabetes, Pediatrics / 23.08.2018

MedicalResearch.com Interview with Sherry L. Voytik-Harbin Weldon School of Biomedical Engineering Purdue UniversitySherry L. Voytik-Harbin Weldon School of Biomedical Engineering Purdue University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Type 1 diabetes (T1D) is a major health problem affecting over 1.25 children and adults in the United States alone. It also affects our beloved companion animals, with 1 out of every 100 dogs and cats having this condition. T1D results from an autoimmune condition, where the patient’s body, by mistake, attacks and destroys cells in the pancreas (β cells) that are responsible for regulating blood glucose levels by producing insulin. While injectable insulin represents the standard of care for these patients, it provides an inferior control system relative to functional β cells, leaving the majority of patients at risk for life-threatening complications. Although transplantation of pancreatic islets, which contain replacement β cells, via portal vein injection into the liver, is an attractive therapeutic alternative for these patients, persistent risks and challenges preclude its more widespread clinical adoption. These include rapid destruction and loss of function of the majority of donor cells upon transplantation and the need for life-long immunosuppression. This study evaluated a novel packaging strategy for the delivery and maintenance of functional donor islets beneath the skin, resulting in rapid and extended reversal of T1D in diabetic mice.  (more…)
Author Interviews, JAMA, Mental Health Research, Pediatrics / 22.08.2018

MedicalResearch.com Interview with: Dr Alexandra Rouquette MD PhD Center for Research in Epidemiology and Population... French Institute of Health and Medical Research Paris MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is a growing number of clues in the literature that suggest that the onset of adult psychopathologic disorders can be traced back to behavioral or emotional symptoms observed in childhood or adolescence. Targeting early childhood symptoms might thus be effective in preventing future mental disorders. However, these interventions are challenging to implement because we lack knowledge on which specific childhood symptoms have predictive associations with adult psychopathologic disorders. In our study, we used a novel methodologic approach, the network perspective, in which symptoms are conceptualized as distinct entities that can causally influence each other, be self-reinforcing and are thus part of causal chains which can culminate in disorders. We investigated longitudinally the network structure among a broad range of emotional and behavioral symptoms (symptoms of attention deficit, symptoms of hyperactivity, disruptive symptoms, internalizing symptoms, prosocial symptoms) collected in elementary school girls (6-10 years) included in the Quebec Longitudinal Study of Kindergarten Children. We showed that symptoms “irritable”, “blames others”, “not liked by other children”, “often cries”, and “solitary” retained a distinctive position in the network because most of the direct relationships between the disruptive and internalizing symptom clusters transited through them. These symptoms have been termed bridge symptoms in the network perspective, as they constitute pathways that can connect different disorders. We then investigated the relationships between this emotional and behavioral symptoms network in childhood and the occurrence of anxiety disorders at age 15 and 22 years. Importantly, the bridge symptoms (particularly “not liked by other children” and “irritable”) exhibited the strongest relationships with future anxiety disorders. (more…)
Author Interviews, Memory, Pediatrics, Sleep Disorders / 22.08.2018

MedicalResearch.com Interview with: Dr. Rebecca Spencer PhD Associate Professor Department of Psychological and Brain Sciences University of Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that in young adults, sleep contributes to emotion processing. We wondered if naps work similarly for preschool children.  To look at this, we had children learn an emotional memory task and then either take a nap or stay awake.  We then tested their memory after that interval and again the next day. We found that when children napped, they had better memory for those items the next day than if they did not nap.  That the naps seem to support memory (even if in a delayed fashion) seems consistent with the observation of parents and preschool teachers that children are often emotionally dysregulated if they do not nap. (more…)
Accidents & Violence, Author Interviews, Pediatrics / 21.08.2018

MedicalResearch.com Interview with:, Motao Zhu, MD, MS, PhD Principal Investigator Center for Injury Research and Policy The Research Institute at Nationwide Children’s Hospital? Columbus, OHMotao Zhu, MD, MS, PhD Principal Investigator Center for Injury Research and Policy The Research Institute at Nationwide Children’s Hospital? Columbus, OH MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that texting while driving occurs frequently among teen drivers. This study looks at the differences of texting while driving among teens between states. Motor vehicle crashes continue to be the leading cause of death among teenagers in the United States. In 2016, over 2,000 teens in the US aged 14-18 years died in motor vehicle crashes and nearly 260,000 were seriously injured in traffic-related incidents. Even though there are cheap car insurance brokers available, teen motor vehicle crashes are preventable, and proven strategies can improve the safety of young drivers on the road. Among distracted driving, texting while driving may be especially risky because it involves at least three types of driver distraction: visual, physical, and cognitive. Texting while driving is banned for all drivers in 47 states and the District of Columbia, yet this study shows it still occurs regularly among teen drivers. Overall (nationally), about 40% of high school student drivers text while driving at least once/month. The rate varies among states. The lowest is 26% (Maryland) and highest is 64% (South Dakota). Texting while driving among high school student drivers is highest in Montana, Wyoming, North Dakota, South Dakota, and Nebraska. These results were not surprising. There are state level factors to explain them. The top 5 highest texting while driving among high school student drivers (Montana, Wyoming, North Dakota, South Dakota, and Nebraska) are rural states with a high percent of high school student drivers and students can get their learners permit by age 15. (more…)
Author Interviews, Cancer Research, JAMA, Pediatrics / 20.08.2018

MedicalResearch.com Interview with: Rebecca D. Kehm, PhD Division of Epidemiology and Community Health University of Minnesota School of Public Health Minneapolis, MN   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Racial and ethnic differences in childhood cancer survival have long been known, and there has been some research indicating that SES could explain disparities. However, our study is the first to use statistical methods that put numbers to the relative contribution of SES to survival disparities for different types of childhood cancer. We set out to investigate whether racial and ethnic disparities in childhood cancer survival are attributed to underlying differences in socioeconomic status, defined as one’s social and economic position in relation to others based on income, education, and occupation, which scientists abbreviate as SES. Our findings provide evidence that SES does in fact contribute to racial and ethnic disparities in survival for some types of childhood cancer. Specifically, we found that SES accounted for 28-73% of the racial and ethnic survival disparity for acute lymphoblastic leukemia, acute myeloid leukemia, neuroblastoma, and non-Hodgkin lymphoma. However, SES did not significantly contribute to racial and ethnic disparities in survival for other types of childhood cancer including central nervous system tumors, soft tissue sarcomas, Hodgkin lymphoma, Wilms tumor, and germ cell tumors. These tumor-specific results help inform where to place resources to best reduce racial and ethnic survival disparities for each of the major types of childhood cancer. (more…)
Author Interviews, Pediatrics, Pulmonary Disease, Tobacco Research / 18.08.2018

MedicalResearch.com Interview with: “#smoke” by Seniju is licensed under CC BY 2.0Ryan Diver MSPH Director, Data Analysis American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Secondhand smoke is known to have adverse effects on the lung and vascular systems in both children and adults. But it is unknown whether childhood exposure to secondhand smoke is associated with mortality in adulthood. To explore the issue, we examined associations of childhood and adult secondhand smoke exposure with death from all causes, ischemic heart disease, stroke, and chronic obstructive pulmonary disease among 70,900 never-smoking men and women from the Cancer Prevention Study II Nutrition Cohort. Study participants, primarily ages 50 to 74 at the beginning of the study, answered questions about their secondhand smoke exposure during childhood and as adults and were followed for 22 years. Those who reported having lived with a daily smoker throughout their childhood had 31% higher mortality from chronic obstructive pulmonary disease compared to those who did not live with a smoker. Although the study counted only deaths, the increase in fatal COPD implies that living with a smoker during childhood could also increase risk of non-fatal COPD. In addition, secondhand smoke exposure (10 or more hours/week) as an adult was associated with a 9% higher risk of all-cause mortality, a 27% higher risk of death from ischemic heart disease, a 23% higher risk of death from stroke, and a 42% higher risk of death from COPD. (more…)
Author Interviews, Global Health, JAMA, Pediatrics / 13.08.2018

MedicalResearch.com Interview with: Chunling Lu, PhD Director, Program in Global Health Economics and Social Change Assistant Professor in Global Health and Social Medicine Division of Global Health Equity, Brigham and Women's Hospital Department of Global Health and Social Medicine, Harvard Medical School Harvard Center for Population and Development Studies Institute for Quantitative Social Science, Harvard University Boston, MA 02115 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Today, we have the largest generation of youth (10-24 years) in human history (1·8 billion) and about 90% of them live in low- and middle-income countries.  Healthy growth and learning during the adolescent years underpins future population health and productivity. The importance of adolescent health has now been recognized with the inclusion of adolescents in the 2015 Every Woman, Every Child agenda through the Global Strategy for Women’s Children’s and Adolescents’ Health. A capacity to finance health care has underpinned progress in most areas of health. In poorer countries much of that financing comes from global donors. As little is known about donors’ contribution to adolescent health, our study fills in that knowledge gap by assessing how much development assistance has been disbursed to projects for adolescent health in 132 developing countries between 2003 and 2015. We found that donors’ contribution to the projects targeting adolescent health cumulatively accounted for only 1.6% of development assistance for health. Among the top 10 leading causes of disability adjusted life years (DALYs) in adolescents, sexual, reproductive health and HIV/AIDS received the largest donors’ contribution (approximately 68% during the study period), followed by interpersonal violence, tuberculosis, and diarrheal diseases. Other major causes of disease burden, including anemia, road injuries, and depressive disorders, have been largely overlooked by donors.  (more…)