Author Interviews, BMC, OBGYNE, Pediatrics / 05.09.2017

MedicalResearch.com Interview with: Jan Alexander, MD,PhD Norwegian Institute of Public Health Oslo Norway  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study was the widespread uncertainty and general concern among the public about increasing exposure to weak radio frequency electromagnetic fields (EMF-RF). The concern on whether using your cell phone while pregnant can harm your foetus are mainly due to the extensive use of cell phones, that emit EMF-RF. Even though the RF-EMF exposure that may reach the foetus is very low, evidence from previous epidemiological studies with mothers and children are inconsistent as to whether EMF-RF emission from cell phone might harm the developing brain of the foetus. This includes also animal experiments where the exposure may be very different from that in humans. We therefore studied the association between maternal cell phone use during pregnancy and child’s neurodevelopment at 3 and 5 years. We included around 45,000 mother and their children from all over Norway from the Norwegian Mother and Child Study (MoBa study) and used language development as the outcome because we in previous studies found this parameter to be sensitive to exposure to neurotoxicants. T here was no evidence of a harmful effect of the mother using her cell phone during pregnancy on her child’s neurodevelopment at 3 and 5 years. Surprisingly, we even found that the more the mother was using her cell phone during pregnancy the better language and motor skills her child had at 3 years of age. We observed no associations when the child was 5 years old. (more…)
OBGYNE, Pediatrics, Weight Research / 30.08.2017

MedicalResearch.com Interview with: Leanne M. Redman MS, PhD LPFA Endowed Fellowship Associate Professor Pennington Biomedical Research Center Baton Rouge, Louisiana  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Two well-documented risk factors for aberrant weight gain and obesity is whether your mother was obese when she was pregnant and the amount of weight she gained. Up until now few studies have asked questions about whether the pattern of weight gain in pregnancy affect outcomes in offspring, such as birth weight. In a cohort of over 16,000 pregnant women and infants, we found that regardless of the obesity status (BMI) of the mother at the time of pregnancy, weight gain that occurs up until week 24, had the strongest effect on infant birth weight. Infants born to mothers who had weight gain in excess of the 2009 IOM guidelines from conception until week 24, had a 2.5 times higher likelihood of being born large for gestational age. The weight gain that occurred after 24 weeks until delivery, did not attenuate this risk. (more…)
Author Interviews, Pediatrics, Psychological Science / 24.08.2017

MedicalResearch.com Interview with: Dan Romer PhD Research director, Annenberg Public Policy Center Director of its Adolescent Communication Institute University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: In recent years, findings from research in developmental neuroscience indicate that the myelination of the prefrontal cortex (PFC) extends into the third decade of life, proceeding more slowly than in other brain regions. Because subcortical and sensory brain regions appear to mature earlier, this and other findings have been taken as evidence that adolescents may have less ability to control their behavior than children do. These findings spawned theories of “imbalanced” adolescent brain development that were proposed to explain heightened vulnerability to risky behavior and adverse health outcomes during adolescence. Although there is little doubt that as adolescents enter adulthood, they are at risk for many health outcomes that can accompany the initiation of such behaviors as driving, having sex, using drugs, and playing sports. But most adolescents make it through this period of development without serious health consequences. Thus, the argument that a brain deficit is responsible for such adverse health outcomes seemed to overgeneralize effects that only occur for a minority of adolescents. Furthermore, when my colleagues and I examined the evidence in support of imbalance theories, we found it unconvincing. Indeed, it seemed that findings from neuroscience were interpreted through the lens of stereotypes about adolescents that conflate exploration with impulsivity. That is, many of the risky behaviors that attract adolescents are novel activities that reflect lack of experience rather than lack of control over behavior.  (more…)
Author Interviews, Education, Pediatrics, Sleep Disorders, University of Michigan / 22.08.2017

MedicalResearch.com Interview with: Galit Dunietz, Ph.D., MPH Epidemiologist, Sleep Disorders Center Department of Neurology University of Michigan Ann Arbor MI MedicalResearch.com: What is the background for this study? What are the main findings? Response: Insufficient sleep has a negative impact on health, cognition and mood and is linked to motor vehicle accidents. However, sleep loss in adolescents has become an epidemic and arises in part from biological processes that delay sleep and wake timing at the onset of puberty. This biology does not fit well with early school start times (before 8:30 a.m.). Despite recommendations from the American Academy of Pediatrics and the American Academy of Sleep Medicine to delay school start times, most schools in the U.S. have current start times before 8:30 a.m. In this nationally representative study of US parents of teens, we examined whether parents supported or opposed later school start times (after 8:30 a.m.). We also examined what may have influenced their opinions. We found that only about half of surveyed parents of teens with early school start times supported later school start times. Opinions appeared to depend in part on what challenges and benefits were expected to result from the change. For example, parents who expected an improvement in their teen’s academic performance or sleep quantity tended to support the change, whereas parents that expected negative impact on afterschool activities or transportation opposed delays in school start times.  We also found that parents had misconception about sleep needs of their adolescents, as the majority perceived 7-7.5 hours of sleep as sufficient, or possibly sufficient even at this young age when 8-10 hours are typically recommended. (more…)
Author Interviews, BMJ, Pediatrics / 21.08.2017

MedicalResearch.com Interview with: Dr. Andrei Morgan and Dr.Veronique Pierrat Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Cité Research Center INSERM, Paris France Descartes University, Paris, France Department of Neonatal Medicine, Jeanne de Flandre Hospital, Lille, France.  MedicalResearch.com: What is the background for this study? Response: The risk of neurodevelopmental and behavioural disabilities remains high in children and adults born preterm. In the 2000s, outcomes of neonates born extremely preterm was described in several settings, but the outcome of neonates born very and moderately preterm was rarely reported. However, in absolute numbers, these infants represent a larger proportion of preterm births and account for more children with long-term deficits and learning disabilities. EPIPAGE-2 is a national study which aims to study short and long term outcomes of children born at 22-26 weeks’gestation, 27-31 weeks’gestation and 32-34 weeks’gestation in France in 2011. We also compared results from this study with the first EPIPAGE study, carried out in 1997. At two years of age, neuro motor and sensory impairment, as well as overall development, were investigated by sending questionnaires to the attending physician and the parents. (more…)
Author Interviews, CDC, Infections, Ophthalmology, Pediatrics / 18.08.2017

MedicalResearch.com Interview with: Dr. Jennifer R. Cope MD Medical Officer Division of Foodborne, Waterborne, and Environmental Diseases National Center for Emerging and Zoonotic Infectious Diseases CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Wearing contact lenses can increase your chances of getting a severe eye infection. Eye infections can lead to serious problems, including blindness. All contact lens wearers can help prevent serious eye infections by correctly wearing and caring for their contact lenses. Eighty-one percent of young adults, 85% of adolescents, and 88% of older adults regularly did at least one risky behavior related to their contact lenses. The most frequently reported risk behaviors in adolescents were not visiting an eye doctor as least annually, sleeping or napping in lenses, and swimming in lenses. Among young adults and older adults, the most frequently reported risk behaviors were replacing lenses at intervals longer than those prescribed, replacing lens storage cases at intervals longer than those recommended, swimming in lenses, and sleeping or napping in lenses. (more…)
Author Interviews, Diabetes, Education, JAMA, Pediatrics / 16.08.2017

MedicalResearch.com Interview with: Jane E. Harding, DPhil Liggins Institute The University of Auckland Auckland, New Zealand MedicalResearch.com: What is the background for this study? Response: Neonatal hypoglycaemia – low blood sugars in newborns – affects up to one in six babies born. It involves a sustained dip in blood sugar levels following birth. Blood glucose is the only fuel for babies’ brains (adults have alternative, back-up sources). So, if left untreated, this condition can cause developmental brain damage and lowered education outcomes later in life. In developed economies, as many as a third of babies born are at risk. Risk factors include being born smaller or larger than usual, preterm babies and babies whose mothers have any form of diabetes – this last a growing group, with the rising incidence of gestational (pregnancy-related) diabetes. We wanted to systematically track a cohort of babies to see if hypoglycaemia in babies affects their long-term health and development. So we designed the CHYLD study – Children with Hypoglycaemia and their Later Development. We are following 614 New Zealand babies born at risk of low blood sugar levels (neonatal hypoglycemia) into childhood to see if the condition affects their later growth and development. Our team includes researchers from the Liggins Institute, the University of Auckland, Waikato Hospital, the University of Canterbury and the University of Waterloo. Half of the babies in the study were diagnosed with, and treated for low blood sugars. Seventy percent received extra, continuous monitoring of their blood sugar levels, which detected in some babies low levels that were not diagnosed by the heel-prick tests. (more…)
Author Interviews, JAMA, Ophthalmology, Pediatrics / 16.08.2017

MedicalResearch.com Interview with: Mary Elizabeth Hartnett, MD, FACS, FARVO Professor of Ophthalmology, Vitreoretinal Service and Surgery Principal Investigator Retinal Angiogenesis Laboratory Director of Pediatric Retina, Adjunct Professor of Pediatrics John A. Moran Eye Center Salt Lake City UT 84132 On behalf of the co-authors: Julia Shulman, Cindy Weng, Jacob Wilkes, Tom Greene, M. Elizabeth Hartnett MedicalResearch.com: What is the background for this study? Response: Maternal preeclampsia causes morbidity to mothers and infants worldwide. Retinopathy of prematurity (ROP) is a leading cause of childhood blindness worldwide. This study was done to gain insight into the effects of preeclampsia on ROP in a clinical population. The literature is mixed with some reports that preeclampsia increases risk of Retinopathy of prematurity, whereas others suggest preeclampsia is protective or has no effect. The presence of circulating anti-angiogenic factors in preeclamptic mothers that can enter the fetal circulation lends biologic plausibility to the notion that maternal preeclampsia might interfere with developing vascular beds in the fetus, such as the retina, and potentially lead to severe ROP. However, a report using an experimental model provided evidence that uteroplacental insufficiency, a characteristic of preeclampsia, led to protective mechanisms in the offspring that reduced oxygen-induced retinopathy and promoted overall growth. (more…)
AHA Journals, Author Interviews, Heart Disease, Pediatrics, Social Issues / 10.08.2017

MedicalResearch.com Interview with: Lead author, Dr Richard Liu, MCRI Ph.D. student and Senior author - Professor David Burgner PhD The Child Health CheckPoint Investigator Group Murdoch Children’s Research Institute The Royal Children’s Hospital Parkville, Victoria, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: The socioeconomic gradient in cardiovascular disease is well recognised in adults. The more disadvantaged someone is, the higher their risk of heart attack and stroke. The mechanisms by which this occurs are not well understood, but we know the pathological process underlying this, thickening of the arteries, or atherosclerosis, begins very early in life. Our current understanding of the early development of atherosclerosis has previously been limited mainly to autopsy studies. Non-invasive imaging is increasingly being used to examine the early development of atherosclerosis. We wanted to determine if there was an association between socioeconomic disadvantage and the thickness of the carotid artery wall in mid-childhood, which in adults is a proxy for atherosclerosis and indicates higher risk for heart attack and stroke in later life. We analysed both family and neighbourhood socioeconomic position data from 1477 Australian families, which included data on income, education and occupation of parents, as well as the relative socioeconomic status of the immediate neighbourhood. (more…)
Author Interviews, Pediatrics / 10.08.2017

MedicalResearch.com Interview with: Layla Parast PhD Statistician RAND MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study examined the association between pet ownership, specifically dog or cat ownership, and children’s physical and mental health. There has been a lot of previous work looking at this association and these previous results seemed to show that kids with pets have better health than those without pets. The hypothesis has been that pets can improve children’s health by increasing physical activating and improving young people’s empathy skills. We used data from over 5,000 households in California which was obtained from the California Health Interview Survey and looked at physical and mental health outcomes among children in households with pets vs. without pets. We found that children in households with pets do have better health than those without pets, but that after we account for factors such as family income and housing type, for example, there is no evidence of an association between pet ownership and health. That is, households that have pets are more likely to be higher income, to be in a house as opposed to an apartment, and to have healthier adults in the household, for example - and these factors are also associated with better child health. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Opiods, Pediatrics / 04.08.2017

MedicalResearch.com Interview with: Krista F. Huybrechts, MS PhD Assistant Professor of Medicine Brigham and Women’s Hospital Harvard Medical School Boston, MA 02120 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Neonatal drug withdrawal is common; in the U.S. about 1 infant is born every 25 minutes with signs of drug withdrawal. Neonatal drug withdrawal is a well-recognized complication of intrauterine exposure to illicit or prescription opioids, but other psychotropic medications can also cause signs of withdrawal. Psychotropic medications are frequently co-prescribed with opioids in pregnancy, and the use of both has increased significantly, raising concerns about an increase in the incidence and severity of neonatal drug withdrawal due to potential drug-drug interactions, but these risks are not well understood. In this study, we found a 30-60% increase in the risk of neonatal drug withdrawal associated with co-exposure to antidepressants, benzodiazepines and gabapentin, compared to opioids alone; no significant increase in risk was observed for atypical antipsychotics and Z-drugs. Exposure to psychotropic polypharmacy along with opioids was associated with a two-fold increased risk of withdrawal. (more…)
Author Interviews, Hearing Loss, JAMA, Pediatrics / 30.07.2017

MedicalResearch.com Interview with: Dr. Carlijn M. P. le Clercq, MD Speech and Language Pathology, Pediatrics, Otolaryngology Erasmus MC , Rotterdam MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been increasing interest for acquired hearing loss among children, and concerns about its prevalence possibly rising over time. One of the questions that come up, is whether there is an association with the growing use of portable music players with headphones, including smartphones and tablets. There have been few longitudinal studies to explore this relation. In order to examine this relation, among other factors, we have conducted a formal hearing screening among more than 5000 9- to 11-year-old children from a population-based birth cohort in the Netherlands. Our study showed that nearly one in five children did not have normal hearing. Of the cohort, 7.8% of the children showed signs of permanent hearing loss. (more…)
Author Interviews, JAMA, Pediatrics, Sleep Disorders / 26.07.2017

MedicalResearch.com Interview with: Rachel Y. Moon, M.D. Division Head, General Pediatrics Professor of Pediatrics University of Virginia School of Medicine Charlottesville, VA 22908 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Approximately 3500 babies die suddenly and unexpectedly during sleep in the US every year. Even though there are safe sleep recommendations, many parents do not follow them because of misinformation or misconceptions. Therefore we tested 2 complementary interventions to promote infant safe sleep practices. The first was a nursing quality improvement intervention aimed at ensuring that mothers would hear key messages and that there was appropriate role modeling of safe sleep practices by hospital personnel. The second was a mobile health intervention, in which mothers received videos and text messages or emails with safe sleep information during the baby's first two months of life. We randomized mothers to receive either the safe sleep interventions or breast-feeding interventions (the control interventions). Mothers who received the mobile health intervention reported statistically significantly higher rates of placing their babies on their back, room sharing without bed sharing, no soft bedding use, and pacifier use, compared with mothers who received a control intervention. Although the nursing quality improvement intervention did not influence infant safe sleep practices, there was an interaction such that mothers who received both the safe sleep nursing quality improvement intervention and the safe sleep mobile health intervention had the highest rates of placing their babies on the back. (more…)
Author Interviews, OBGYNE, Pediatrics / 21.07.2017

MedicalResearch.com Interview with: Parvati Singh B. Tech, MBA, MPA PhD student, Department of Public Health, University of California, Irvine and Dr. Tim Bruckner, first author MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study builds upon earlier research by our group which showed that male fetal deaths rose and the number of liveborn males fell after the 9/11 attacks. Here we show that, in California, the number of live born males with birth defects fell after 9/11. This finding appears consistent with the notion that frail male gestations, such as those with defects, may have been lost in utero as a result of the stress induced by the 9/11 attacks. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Pediatrics / 19.07.2017

MedicalResearch.com Interview with: Holly Gooding, MD, MSc Assistant Professor of Medicine and Pediatrics Harvard Medical School Division of Adolescent/Young Adult Medicine Boston Children's Hospital Division of General Internal Medicine Brigham and Women's Hospital Boston, MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Dr Stephanie Chiuve and colleagues at the Harvard TH Chan School of Public Health developed the Healthy Heart Score to predict the risk of heart disease in older adults based on lifestyle factors measured in middle age. We have known for some time that the precursor to heart disease – known as atherosclerosis – actually starts in childhood and adolescence. We calculated the Healthy Heart Score for young adults ages 18-30 years old and found it works in this age group as well. (more…)
Author Interviews, OBGYNE, Pediatrics / 19.07.2017

MedicalResearch.com Interview with: Francesca Volpe Psy.D and Prof. Vincenzo Zanardo Division of Perinatal Medicine, Policlinico Abano Terme Abano Terme, ItalyFrancesca Volpe Psy.D and Prof. Vincenzo Zanardo Division of Perinatal Medicine, Policlinico Abano Terme Abano Terme, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: Newborn infants, placed skin-to-skin on their mother’s chest instinctively have the ability to crawl to their mother’s breast, exploring with their hands and massaging the breast to support the first feed.  Left undisturbed, the infant will make several attempts until it finds and latches onto the nipple and begins to nurse. What leads mammalian infants who are placed on their mothers’ chests to seek out, without any assistance, the nipple and to attach themselves to it to nurse is not fully understood. When we turned our attention to the thermal properties of the female’s nipple-areolar complex (NAC) in lactating mothers soon after birth, we found that it had a higher temperature and pH value and lower elasticity with respect to the surrounding breast skin. We hypothesised that the higher temperature could help the newborn infant to locate the nipple and to latch onto it, leading to the first sucking experience.  In addition, the diffusion of odorous molecules is presumably enhanced by the relatively high surface temperature of the areola in view of the rich supply of blood capillaries that irrigate the region. There is, in fact, some scientific evidence that show that infants respond to the odours released by the breasts of lactating women; breast odours, which are enhanced by the skin’s greater warmth, are another factor that facilitates breastfeeding by helping the infant to recognize its mother participating in the mother-to-infant bonding. (more…)
Author Interviews, Infections, JAMA, Pediatrics, Respiratory, Vitamin D / 18.07.2017

MedicalResearch.com Interview with: Jonathon Maguire MD MSc FRCPC Scientist, Li Ka Shing Knowledge Institute Staff Pediatrician, Department of Pediatrics, St. Michael’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Vitamin D has been hypothesized as being protective of seasonal viral upper respiratory tract infections.  In this randomized clinical trial, high dose wintertime vitamin D supplementation (2000 IU/day) was compared with standard-dose vitamin D supplementation (400 IU/day) among 703 children.  The number of laboratory confirmed viral upper respiratory tract infections was not statistically different between groups. (more…)
Author Interviews, CDC, OBGYNE, Pediatrics, Race/Ethnic Diversity / 17.07.2017

MedicalResearch.com Interview with: Dr. Erica H. Anstey PhD Division of Nutrition, Physical Activity and Obesity National Center for Chronic Disease Prevention and Health Promotion Immunization Services Division National Center for Immunization and Respiratory Diseases CDC MedicalResearch.com: What is the background for this study? Response: The American Academy of Pediatrics (AAP) recommends that infants are breastfed exclusively for about the first 6 months and that breastfeeding continue for at least 12 months, and thereafter for as long as mother and baby desire. Although breastfeeding initiation and duration rates have increased overall in the United States, breastfeeding rates vary by geographic location, socioeconomic, and race/ethnic groups. Breastfeeding initiation and duration have been historically and consistently lower among black infants compared with white and Hispanic infants. There are many factors that influence a woman’s decision to start and continue breastfeeding. These include knowledge about breastfeeding, cultural and social norms, family and social support, and work and childcare environments. Some barriers to breastfeeding are disproportionately experienced by black women, including earlier return to work, inadequate receipt of breastfeeding information from providers, and lack of access to professional breastfeeding support. (more…)
Author Interviews, Pediatrics, Primary Care, Vaccine Studies / 14.07.2017

  MedicalResearch.com Interview with: S. Hughes Melton, MD, MBA, FAAFP AAFP Foundation president MedicalResearch: What is the background for this initiative? What are the main vaccinations that teens should have?  Response: The Centers for Disease Control and Prevention (CDC) recommends adolescents receive four immunizations – two of which are administered as multi-dose series – to help protect against meningococcal meningitis caused by serogroups A, C, W and Y; human papillomavirus (HPV); tetanus, diphtheria and pertussis (Tdap); and influenza (flu).1 Despite these recommendations, millions of teens remain vulnerable to serious infectious disease.2,3 Family physicians are well equipped to immunize their patients against a host of common infectious diseases and improve public health. However, discussing teen vaccinations during annual appointments may present challenges due to other issues teens and their parents/guardians may be focused on at this age. The American Academy of Family Physicians Foundation (AAFP Foundation) launched Highlight on VACCINATIONS 4 TEENS to help remind family physicians and their care teams to make immunization a priority at these key appointments for teens. (more…)
Author Interviews, Depression, Gender Differences, Pediatrics / 12.07.2017

MedicalResearch.com Interview with: Jie-Yu Chuang PhD Department of Psychiatry University of Cambridge Cambridge, United Kingdom  MedicalResearch.com: What is the background for this study? Response: Men and women appear to suffer from depression differently, and this is particularly striking in adolescents. By 15 years of age, girls are twice as likely to suffer from depression as boys. There are various possible reasons for this, including body image issues, hormonal fluctuations and genetic factors, where girls are more at risk of inheriting depression. However, differences between the sexes don't just involve the risk of experiencing depression. Men are more liable to suffer from persistent depression, whereas in women depression tends to be more episodic. Compared with women, depressed men are also more likely to suffer serious consequences from their depression, such as substance abuse and suicide. Despite this, so far, most researchers have focused on depression in women, likely because it is more common. As a result, we'd like to make people more aware of the sex difference issue in depression. (more…)
Author Interviews, JAMA, Nutrition, Pediatrics / 10.07.2017

MedicalResearch.com Interview with: Dr. Anne-Louise M. Heath and Professor Rachael Taylor Co-Principal Investigators for the BLISS study. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Conventional approaches to complementary feeding generally advise parents to spoon-feed their infant pureed foods, gradually progressing to greater variety and texture so that by the time the infant is one year of age, they are eating more or less what the family does. Baby-led weaning (BLW) is an alternative approach where the infants feeds themselves right from the start of complementary feeding. Because children of this age cannot use utensils, this means hand-held foods are necessary. Advocates of BLW suggest that children have a lower risk of obesity because they remain in control of their own food intake, but research examining this issue directly is scarce. Health professionals have also expressed concern that BLW might put the infant at increased risk of iron deficiency (parents might avoid red meat for fear of the infant choking, and iron-fortified cereals are not easy for the infant to feed themselves), growth faltering (if only low energy foods are offered) and choking (from the infant feeding themselves ‘whole’ foods). Our study therefore examined a version of BLW that had been modified to address these issues (called BLISS - a Baby-Led Introduction to SolidS). Two hundred families took part in our 2-year intervention, with half following traditional feeding practices and half receiving guidance and support to follow our BLISS approach. We found that BLISS children were not less likely to be overweight than those following traditional feeding practices, nor was growth faltering an issue. BLISS child ate about the same amount of food as control children, and their ability to eat to appetite was not different either. However, it seems that children following a baby-led approach to complementary feeding are less fussy about food, and have a healthier attitude to food, which might make a difference to their health long term. (more…)
Author Interviews, JAMA, Pediatrics / 06.07.2017

MedicalResearch.com Interview with: Seetha Shankaran, M.D. Professor, Neonatology Wayne State University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study was performed because infants with moderate or severe hypoxic-ischemic encephalopathy (abnormal neurological exam within 6 hours of birth due to lack of blood and oxygen supply to the brain at birth) have rates of death or survival with disability that were still high in spite of current intensive care including hypothermia. Whole-body hypothermia, cooling the infant for 72 hours at a depth of 33.5°C that was performed by the Neonatal Research Network funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development was the first trial of this therapy in the USA. We found that hypothermia therapy did decrease the rate of death or survival with disability from 62 to 44%. Since 44% is still high we wanted to see if longer cooling or deeper cooling or both would reduce this rate. This was a randomized controlled clinical trial to examine whether longer cooling or deeper cooling or both reduced the rate of death or survival with disability among full term neonates with hypoxic-ischemic encephalopathy. The study lasted from October of 2010 to January 2016. 364 infants were enrolled. Neonates were randomly assigned to 4 groups of cooling therapy and the major findings were that neither longer cooling nor deeper cooling nor both were more superior to cooling for 72 hours at 33.5°C. Our results were surprising because at the time we planned this study there were reports from animal model studies that longer/deeper cooling were more protective to the brain. (more…)
Author Interviews, Pediatrics, Weight Research / 24.06.2017

MedicalResearch.com Interview with: Michelle S. Wong PhD Department of Health Policy and Management Johns Hopkins School of Public Health Baltimore, Maryland MedicalResearch.com: What is the background for this study? Response: As background, there haven't been many studies on how fathers might influence overweight or obesity in their children. Unsurprisingly most of the research has focused on the mothers' influence. Existing studies on fathers have focused on the relationship between their parenting practices (e.g., discipline), as well as feeding and physical activity behaviors, with child overweight or obesity. A few studies found that some father feeding practices were related to higher child BMI, but we don’t know whether fathers’ general caregiving matters. (more…)
Author Interviews, Hearing Loss, Pediatrics / 23.06.2017

MedicalResearch.com Interview with: Peter Carew Lead author, MCRI PhD student Clinician The University of Melbourne MedicalResearch.com: What is the background for this study? Response: The age at diagnosis of a congenital hearing loss has dropped over time. This has allowed for earlier fitting of amplification (hearing aids, cochlear implants) and earlier access to education intervention programs, all intended to lessen the impact of hearing loss on development. Much research has focused on the outcomes achieved by children with severe and profound losses, but relatively little attention has been given to milder hearing losses (mild and moderate). Despite this lack of evidence, we are observing children with mild loss being fitted with hearing aids earlier than ever before. From a historical age of fitting not uncommonly at 2 years of age or older, today the largest number of children under 12 months who receive a hearing aid for the first time in Australia have a mild hearing loss in their better hearing ear. To this end, clinical practice may have jumped ahead of the evidence in terms of understanding any benefits children with mild hearing loss receive from having hearing aids earlier. (more…)
Author Interviews, JAMA, Pediatrics, Weight Research / 22.06.2017

MedicalResearch.com Interview with: David C. Grossman, M.D., M.P.H. US Preventive Services Task Force Chair Senior Investigator, Kaiser Permanente Washington Health Research Institute Senior Associate Medical Director, Market Strategy & Public Policy Kaiser Permanente Washington Physician, Washington Permanente Medical Group, Pediatrics MedicalResearch.com: What is the background for this recommendation? Response: Recognizing that obesity is a nation-wide health problem, affecting approximately 17% of 2-to 19-year-old children and adolescents in the U.S., the Task Force finalized its recommendation on screening for obesity in children and adolescents and the benefits and harms of weight management interventions. The Task Force found sufficient evidence to recommend screening for obesity in children and adolescents age 6 years and older and then offering or referring those who are found to be obese comprehensive, intensive behavioral interventions to manage their weight and improve overall health. MedicalResearch.com: What are the potential benefits and harms of early screening and intervention for obesity in children? Response: The Task Force found that intensive behavioral interventions for children and adolescents who have obesity can result in benefits of improvement in weight status for up to 12 months’ post-intervention. Additionally, the evidence indicated very little harm from screening and comprehensive, intensive behavioral interventions. This is due to likely minimal harms of using BMI (body mass index), the absence of reported harms of behavioral interventions, and the noninvasive nature of the programs. (more…)
Author Interviews, Global Health, Infections, Pediatrics / 19.06.2017

MedicalResearch.com Interview with: Aleksandra Jakubowski, MPH PhD candidate Department of Health Policy and Management Gillings School of Global Public Health University of North Carolina at Chapel Hill MedicalResearch.com: What is the background for this study? Response: The US President’s Malaria Initiative (PMI) provides approximately $600 million annually to fund implementation of key evidence-based malaria prevention and treatment interventions, including insecticide treated nets (ITNs), artemisinin-based combination therapy (ACT), and indoor residual spraying (IRS) to populations in 19 recipient countries in sub-Saharan Africa (SSA). Despite this considerable investment, no study to date has evaluated the impact of PMI on population health outcomes. Previous evaluations have noted improved health outcomes in PMI countries, but comparison groups are needed to establish whether these changes were beyond the declining trends in mortality observed in the rest of the region. Our study sought to generate objective evidence for policy makers about the role this US-funded malaria aid program may have played in curbing child mortality in SSA. We used a quasi-experimental design known as difference-in-differences to compare trends in health outcomes in PMI-recipient vs. PMI non-recipient countries. We analyzed publicly-available data from 32 countries in SSA spanning a period that included about ten years before and after the introduction of the program. (more…)
Addiction, Author Interviews, JAMA, Opiods, Pediatrics / 19.06.2017

MedicalResearch.com Interview with: Scott Hadland, MD, MPH, MS Youth Addiction Specialist Assistant Professor of Pediatrics Boston University School of Medicine Director, Urban Health and Advocacy Track, Boston Children’s Hospital and Boston Medical Center Associate Program Director, Boston Combined Residency Program in Pediatrics, Boston Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Almost no data have been available on this topic to date.  A recent study showed that teens in subspecialty treatment for opioid addiction were significantly less likely than adults to receive a medication.  Our study was the first to comprehensively look across the health care system, including looking at adolescents and young adults diagnosed with opioid use disorder in outpatient clinics, emergency departments, and inpatient hospitals. We had three important findings.  First, looking at a large sample of 9.7 million adolescents and young adults between the age of 13 and 25 years, we found that the number of youth diagnosed with opioid use disorder increased six-fold from 2001 to 2014.  This is perhaps not surprising given the national opioid crisis we know to be occurring. Second, we found that only a minority of youth (1 in 4) received buprenorphine or naltrexone, the two medications available for opioid addiction that can be prescribed in usual medical settings.  These two medications are evidence-based and their use is recommended by the American Academy of Pediatrics.  Utilizing them is critical to ensure that we offer effective treatment early in the life course of addiction, which can help prevent the long-term harms of addiction. Third, we found significant differences in who received medications.  Whereas approximately 1 in 3 young adults in our study received a medication, only 1 in 10 of the 16- and 17-year-olds we studied received one, and among adolescents under 15 years of age, 1 in 67 received a medication.  Females were less likely than males to receive medications, as were black youth and Hispanic youth relative to white youth. (more…)
Author Interviews, Nutrition, OBGYNE, Pediatrics, Weight Research / 19.06.2017

MedicalResearch.com Interview with: Cuilin Zhang MD, PhD Senior Investigator, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Bethesda, MD 20817  MedicalResearch.com: What is the background for this study? Response: Refined grains with a high glycemic index and reduced fiber and nutrient content have been linked to increased adiposity and higher risk of metabolic syndrome among adults. Despite these differences and the growing body of literature on the link between maternal diet/nutrition during pregnancy and subsequent offspring health consequences throughout the lifespan, little is known about the intergenerational impact of refined-grain intake during pregnancy on long-term cardio-metabolic outcomes in the offspring. (more…)