Dr. Christian Pulcini[/caption]
Christian D. Pulcini, MD, MEd, MPH
Pediatric Resident
Children's Hospital of Pittsburgh of UPMC
Chair, Section on Pediatric Trainees (SOPT)
American Academy of Pediatrics
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Poverty influences the well-being of children and adolescents in a negative way. Poor children are often exposed to toxic health stressors, including violence, environmental toxins, and inadequate nutrition. Children in poverty with chronic health conditions also are more likely to have higher rates of secondary disorders and worse outcomes. We studied children with asthma, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD), to describe the how much disease and if the children had multiple (comorbid) conditons and how these vary by poverty status.
Parents reported through the National Survey of Children's Health that asthma and ADHD rose 18% and 44% from 2003-2011/2012, respectively, whereas the lifetime prevalence of ASD rose 32% from 2007-2011/2012 in all income levels. For asthma, the rise was most among the poor at 25.8%. For ADHD, the percent change among the poor was similar, however the rise in autism spectrum disorder was associated with being non-poor. Publicly insured children with asthma, ADHD, and ASD also had a significant higher chance (1.9×, 1.6×, 3.0×, respectively) of having higher more than one chronic condition. In addition, kids who were poor with asthma and ADHD.
Dr. James Rilling[/caption]
James K. Rilling, PhD
Professor, Anthropology, Psychiatry and Behavioral Science
Emory University School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It has been known for a long time that female mammals experience hormonal changes during pregnancy that prepare them to care for their offspring. More recently, it has been shown that some mammalian males, including humans, can also experience hormonal changes that prepare them to care for their offspring. For example, oxytocin levels can increase in human fathers and studies have shown that oxytocin facilitates paternal physical stimulation, play and emotional synchrony with their children. We examined the effects of intranasal oxytocin on brain function in human fathers. We found that intranasal oxytocin increased activation in brain areas involved with reward and empathy when human fathers viewed pictures of their children, but not unknown children.
Dr. Chris Malley[/caption]
Chris Malley PhD
The Stockholm Environment Institute
University of York
MedicalResearch.com: What is the background for this study?
Response: When a baby is born preterm (at less than 37 weeks of gestation, an indicator of premature birth), there is an increased risk of infant death, or long-term physical and neurological disabilities. For example, 965,000 infant deaths in 2013 (35% of all neonatal deaths) have been estimated to be due to preterm birth complications. In 2010, an estimated 14.9 million births were preterm – about 4–5% of the total in some European countries, but up to 15–18% in some African and South Asian countries. The human and economic costs are enormous.
There are many risk factors for preterm birth – from the mother’s age, to illness, to poverty and other social factors. Recent research has suggested that exposure to air pollution could also be a risk factor. Our study quantifies for the first time the global impact of pregnant women's exposure to outdoor fine particulate matter (PM2.5) by combining data about air pollution in different countries with knowledge about how exposure to different levels of air pollution is associated with preterm birth rates.
Dr. Carla Bann[/caption]
Carla M. Bann, Ph.D.
Division of Statistical and Data Sciences
RTI International
Research Triangle Park, NC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Several medical advances have been made over the past two decades to improve the care and survival of infants born pre-term. However, approaches to care differ greatly among providers for infants born at the limits of viability (22 to 24 weeks gestation), far earlier than the 40 weeks generally expected for a pregnancy to reach full-term. Little is known about the outcomes of these infants, particularly whether those who survive experience significant neurodevelopmental impairments.
RTI served as the data coordinating center for this research that examined the survival and neurodevelopmental impairment at 18-22 months corrected age of over 4,000 infants born at 22 to 24 weeks gestation during 2000 to 2011 at medical centers participating in a national research network funded by the NIH. In this group of babies, infant survival improved over time from survival rates of 30 percent in 2000-2003 to 36 percent in 2008-2011. The proportion of infants who survived without a neurodevelopmental impairment also increased from 16 percent in 2000-2003 to 20 percent in 2008-2011.
Dr. Scott Hadland[/caption]
Scott E. Hadland, MD, MPH, MS
Assistant Professor of Pediatrics
Boston University School of Medicine
Urban Health & Advocacy Track Director | Boston Combined Residency Program
Boston, MA 02118
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Studies to date have shown that states’ alcohol laws can help prevent young people from dying in car crashes. However, studies to date have usually only looked at a single policy at once. We wanted to build on these previous studies by looking at the overall effect of multiple alcohol laws acting at once. We also wanted to look at laws not necessarily only targeting drinking and driving among young people, but also policies aimed primarily at adults over 21.
We studied deaths of young people under 21 who were killed in motor vehicle crashes across the United States between 2000 and 2013. We found that one-quarter of all young people died in a crash involving a driver who alcohol level was over the legal limit. One-half died in a crash in which the driver had any level of alcohol in their bloodstream above zero.
We also found that most young people died on evenings and weekends, which is when people are most likely to have been drinking. Importantly, almost half of all young people died in a crash in which they were the passenger, not the driver. In 80% of cases in which they were the passenger, it was actually an adult >21, not a young person, who was driving the vehicle.
We then looked at states’ alcohol laws, and found that the stronger the set of alcohol policies in a state, the lower the likelihood of young people dying in a crash that was alcohol-related. Policies included laws relating to alcohol taxes, alcohol availability and hours of sales, and graduated driver’s licensing for young people, among many others.
Dr. David Greenberg[/caption]
Dr. David Greenberg MD
Vice President, Scientific & Medical Affairs
and Chief Medical Officer
Sanofi Pasteur U.S.
MedicalResearch.com: What is the importance of improved vaccination rates in light of recent outbreaks of vaccine-preventable diseases?
Response: It’s imperative. Too many children remain under-vaccinated against serious infectious diseases, and as the CDC reminds us – in addition to our country’s most credible medical associations – immunization is key in helping prevent both sporadic and outbreak-related cases of these diseases.1 In 2015, the CDC reported 6,448 new cases of pertussis in kids younger than 7 years of age, some of which could have potentially been avoided if vaccination completion was better. 2
Dr. Esther van Zuuren[/caption]
Esther van Zuuren MD
on behalf of the authors
Department of Dermatology
Leiden University Medical Center
Leiden, Netherlands
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In view of the high prevalence of eczema and the exponential increase in number of clinical trials over recent years, the NIHR designated this clinical topic, emollients and moisturisers for eczema, as a high priority. Widely prescribed as the basis of eczema management the treatment strategy is often supported by a mixed array of reviews and guidelines. Evidence for the effectiveness of emollients and moisturisers is also of variable quality.
Eczema is a chronic skin disorder, the main symptoms being dry skin and intense itching with a significant impact on quality of life. As dry skin is an important feature, moisturisers are a cornerstone of eczema treatment, but there was uncertainty about their efficacy and whether one moisturiser is preferable to another. The main finding of our review is that indeed moisturisers are effective.
Dr. Bobbi Pineda[/caption]
Bobbi Pineda, PhD
Assistant professor of occupational therapy and of pediatrics
Washington University School of Medicine
St. Louis
MedicalResearch.com: What is the background for this study?
Response: We published findings in 2014 from a study in which we investigated differences in outcome among preterm infants hospitalized in an open ward NICU compared to those hospitalized in a NICU private room. In this study, we found that infants who were in the open ward had differences in brain structure by the time they were discharged from the hospital, and by age 2 years they had significantly better language outcomes than those in private rooms. The study NICU is located in an urban area and cares for families who have a high risk of social challenges, resulting in rates of parent engagement that were not optimal. However, such findings made us question if the sensory exposure, specifically auditory stimulation, may be significantly reduced in the private room and could explain our findings.
Dr. Christopher Ferguson[/caption]
Dr. Christopher J. Ferguson PhD
Professor of Psychology
Stetson University
MedicalResearch.com: What is the background for this study?
Response: The degree to which screen time influences youth across a variety of behavioral outcomes has been a source of debate and contention for decades. For many years the American Academy of Pediatrics recommended to parents that they allow older children no more than 2 hours of screen time per day. However, this number was never clearly based on good data. And in 2014 one study (Przybylski, 2014 in Pediatrics) suggested that ties between screen time and behavioral outcomes were very weak, and only seen for the most extreme screen users. So I was curious to see if these results would replicate for a large sample of US youth.
Kristi Roberts[/caption]
Kristi Roberts, M.S., M.P.H.
Research Project Coordinator
Center for Injury Research and Policy
Nationwide Children’s Hospital
Columbus, Ohio
MedicalResearch.com: What is the background for this study? What are the main findings?
Prof. Richard Miech[/caption]
Professor Richard Miech
Institute for Social Research
University of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The main finding of this study is that teen vaping predicts future smoking. We surveyed a nationally-representative sample of 12th graders in 2014 and then re-surveyed them a year later. We found:
Dr. Lara Dugas[/caption]
Lara Dugas, PhD, MPH, FTOS
Public Health Sciences
Loyola University Chicago
MedicalResearch.com: What is the background for this study?
Response: Our NIH-funded study is led by Dr. Amy Luke, Public Health Sciences, Loyola University Chicago, and is titled “Modeling the Epidemiologic Transition study” or METS. It was initiated in 2010, and 2,500 young African-origin adults were recruited from 5 countries, spanning the Human Development Index (HDI), a WHO index used to rank countries according to 4 tiers of development. The 5 countries include the US, Seychelles, Jamaica, South Africa, and Ghana. Within each country 500 young adults, 25-45 yrs., and 50% male, were recruited and followed prospectively for 3 years. Each year, contactable participants completed a health screening, body composition, wore an activity monitor for 7 days, and told researchers everything they had eaten in the preceding 24hrs. Our main research questions we were trying to answer were to understand the impact of diet and physical activity on the development of obesity, and cardiovascular disease in young adults. It was important to have countries spanning the HDI, with differences in both country-level dietary intake and physical activity levels.
Dr. Melissa N. Poulsen[/caption]
Melissa N. Poulsen, PhD, MPH
Postdoctoral Fellow
Johns Hopkins Bloomberg School of Public Health
Geisinger Center for Health Research
MedicalResearch.com: What is the background for this study?
Response: Several past studies report positive associations between early childhood antibiotic use (particularly in the first year of life) and body mass index (BMI) later in childhood. Studies have also observed positive associations with prenatal antibiotic use and BMI, but without information on childhood antibiotics, such studies cannot rule out an underlying causal relationship between prenatal antibiotic exposure and early childhood antibiotic use.
No study to date has concurrently evaluated prenatal and early childhood antibiotic exposure. We used mother-child linked electronic health record data to determine whether prenatal and childhood antibiotic use are independently associated with BMI at age 3 years.
Victoria Pemberton[/caption]
Victoria Pemberton, RNC, MS, CCRC
Program Officer
Division of Cardiovascular Sciences
National Heart, Lung, and Blood Institute, NIH
Bethesda, Maryland
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Adda Grimberg[/caption]
Adda Grimberg, MD
Associate Professor of Pediatrics,
Perelman School of Medicine, University of Pennsylvania
Scientific Director, Diagnostic and Research Growth Center
The Children's Hospital of Philadelphia
Philadelphia, PA 19104
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study sought to update the last guidelines for the use of growth hormone (GH) by the Drug and Therapeutics Committee of the Pediatric Endocrine Society (PES), published in 2003, and was the first to be endorsed also by the Ethics Committee of the PES. To facilitate evidence-based decision making, it was the first such GH guidelines to follow the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) group. Because idiopathic short stature (ISS) remains a controversial indication, and diagnostic challenges often blur the distinction between ISS, growth hormone deficiency (GHD), and primary insulin-like growth factor-I deficiency (PIGFD), this guidelines statement focused on these three diagnoses and added recombinant IGF-I therapy to the GH guidelines for the first time.
Children's National Research Team[/caption]
Paul D. Morton, Ph.D.
Research PostDoc and lead study author of “Abnormal Neurogenesis and Cortical Growth in Congenital Heart Disease.”
Children’s National Health System Washington, DC
Nobuyuki Ishibashi, M.D.
Director of the Cardiac Surgery Research Laboratory at Children’s National Health System and co-senior study author.
Vittorio Gallo, Ph.D.
Director of the Center for Neuroscience Research at Children’s National Health System and co-senior study author.
Richard A. Jonas, M.D.
Chief of the Division of Cardiac Surgery at Children’s National Health System and co-senior study author.
MedicalResearch.com: What is the background for this study?
Response: Congenital heart disease (CHD) is the leading birth defect in the United States and often results in an array of long-term neurological deficits including motor, cognitive and behavioral abnormalities. It has become increasingly clear that children with CHD often have underdeveloped brains. In many cases of complex CHD, blood flow to the brain is both reduced and less oxygenated, which has been associated with developmental abnormalities and delay. The cellular mechanisms underlying the impact of CHD on brain development remain largely unknown. We developed a preclinical chronic hypoxia model to define these mechanisms.
Dr Rebecca Richmond[/caption]
Dr Rebecca Richmond PhD
Senior Research Associate in the CRUK Integrative Cancer Epidemiology Programme
MRC Integrative Epidemiology Unit
School of Social and Community Medicine
University of Bristol
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We have been involved in earlier work which applied the same methods used here (using genetic variants to provide causal evidence) and showed that higher maternal pregnancy body mass index (BMI) causes greater infant birth weight. The paper here aimed to build on that earlier research and asked whether maternal BMI in pregnancy has a lasting effect, so that offspring of women who were more overweight in pregnancy are themselves likely to be fatter in childhood and adolescence. Our aim was to address this because an effect of an exposure in pregnancy on later life outcomes in the offspring could have detrimental health consequences for themselves and future generations. However, we did not find strong evidence for this in the context of the impact of maternal BMI in pregnancy on offspring fatness.
Robin Gelburd, JD[/caption]
Robin Gelburd, JD
President
FAIR Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: For more than 20 years, an epidemic of obesity has been contributing to increasing rates of type 2 diabetes in the United States. During at least part of that period, both conditions have been found to be rising in young people as well as adults. Using our FAIR Health database of billions of privately billed healthcare claims, we sought to ascertain recent trends in obesity and obesity-related conditions (including type 2 diabetes) in the national, privately insured, pediatric population, which we defined as spanning the ages from 0 to 22 years. Our study period was the years 2011 to 2015.
We found that claim lines with a diagnosis of obesity increased across the pediatric population during the study period. The largest increase among pediatric patients was 154 percent, in the age group 19 to 22 years. Claim lines with a type 2 diabetes diagnosis more than doubled in the pediatric population, increasing 109 percent.
In most pediatric age groups, claim lines with an obesity diagnosis occurred more often in females than in males; by contrast, claim lines with a type 2 diabetes diagnosis were more common for males than females in most pediatric age groups.
Other conditions associated with obesity also increased in claim lines among young people. The conditions included obstructive sleep apnea and hypertension, both of which were more common in claim lines for males than females.
We also compared the percent of claim lines for pediatric type 2 diabetes diagnoses to the percent of claim lines for all pediatric medical claims by state. Using that standard, pediatric type 2 diabetes was most prevalent in Ohio, Pennsylvania, North Dakota, Utah and South Dakota. It was least prevalent in New Hampshire, Vermont, Delaware, Hawaii and Rhode Island.
MedicalResearch.com Interview with: Anick Bérard PhD FISPE Research chair FRQ-S on Medications and Pregnancy and Director, Réseau Québécois de recherche sur le médicament (RQRM) and Professor, Research Chair on Medications, Pregnancy and Lactation Faculty of Pharmacy University of Montreal and Director, Research Unit on Medications and Pregnancy Research Center CHU Ste-Justine MedicalResearch.com: What is the background for this...
Prof. Adrian Liston[/caption]
Prof. Adrian Liston
(VIB-KU Leuven)
MedicalResearch.com: What is the background for this study?
Response: With vaccinations, sanitation, antibiotics and general improvements in living standards, infectious disease is no longer a major killer of children. Death or hospitalisation of children from infection is rare in countries with modern health care systems. Those rare events were once thought to be chance outcomes on the roulette of bad luck, but increasingly we are recognising that genetic mutations underlie severe pediatric infections.
In our study we are seeking to identify the mutations and immunological changes that occur in children, causing them to have severe reactions to infectious disease.
Dr Kajsa Landgren
Faculty of Medicine, Department of Health Sciences
Lund University, Sweden
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Infantile colic is common, affecting 10-20% of newborns. These infants have intense crying and fussing, more than 3 hours/day more than 3 days/week. There is no medical treatment, causing desperate parents to seek complementary medicine. The evidence for acupuncture is sparse.
In this trial including 147 infants with colic, we tested two types of acupuncture. Both types of acupuncture were minimal, i.e needles were inserted for only a few seconds without further stimulation.
Group A received only one single needle for 2-5 seconds. Group B received up to five needle insertions for maximum 30 seconds. A third group, C, received no acupuncture. All families came to four extra visits to their Child Health Center where they met a nurse who gave advice and support. During these visits the infants were separated from their parents for five minutes, being alone with an acupuncturist who gave acupuncture to the infants in group A and B, but not to infants in group C. Parents and the nurse were blinded to which group the infant was randomized to.
Dr. Alex Kemper[/caption]
Dr. Alex Kemper, MD, MPH, MS
Member,US Preventive Services Task Force
Professor of Pediatrics and Professor in Community Medicine
Department of Pediatrics
Duke University School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Neural tube defects, where the brain or spinal cord do not develop properly in a baby, can occur early in pregnancy, even before a woman knows she is pregnant. Taking folic acid before and during pregnancy can help protect against neural tube defects. Most women do not get enough folic acid in their diets, so most clinicians recommend that any woman who could become pregnant take a daily folic acid supplement.
Dr. Daniel Romer[/caption]
Daniel Romer, PhD
Annenberg Public Policy Center
University of Pennsylvania
Philadelphia, Pennsylvania
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We have been studying trends in health compromising behaviors in popular films that were released since 1950, and in 2013 we reported that films rated PG-13 had just passed the rate of portrayed gun violence shown in popular R-rated films in 2012. In this report, we updated the trends in gun violence through 2015 and found that the trend has continued. In addition, we noted the strong contribution to this trend of films with comic book heroes whose heavy use of guns omits the harmful and otherwise realistic consequences of blood and suffering.