MedicalResearch.com Interview with:
Mark DeBoer, MD
Children's Hospital's Department of Pediatrics
University of VirginiaMedical Research: What is the background for this study? What are the main findings?
Dr. DeBoer: We have been interested in how the severity of the metabolic syndrome relates to long term risks, both for children and adults. We formulated a score that takes the different components of the metabolic syndrome (body mass index, blood pressure, fasting blood sugar, triglycerides and high density cholesterol) for an individual and forms a score estimating how severe the metabolic syndrome is in that individual. When we looked at long-term data from individuals followed for 40 years, we found that children and adults with higher scores were more much likely to develop cardiovascular disease.
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MedicalResearch.com Interview with:
Susan Gray MD
Division of Adolescent Medicine
Boston Children's Hospital
Boston, MA
Medical Research: What is the background for this study? What are the main findings?
Dr. Gray: This is a study of the health care costs of 13,000 privately insured adolescents (13 to 21 years old) cared for in an association of pediatric primary care practices. We found that a tiny fraction (1%) of adolescents accounted almost a quarter of the expenses of the whole cohort. Mental health disorders were the most common diagnosis among these high cost adolescents. The characteristics most strongly associated with high cost were complex chronic medical conditions, behavioral health disorders, and obesity, but many high cost adolescents had no chronic conditions. Pharmacy costs, especially orphan drug costs, were a surprisingly large contributor to high costs for these privately insured adolescents. Primary care costs were very small in high cost patients.
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MedicalResearch.com Interview with:Corinna Koebnick, PhD
Research scientist with Research & Evaluation
Kaiser Permanente Southern California
MedicalResearch: Please describe your study, what you were looking for, and why.Dr. Koebnick: This study is based on the Kaiser Permanente Southern California Children’s Health Study, which includes all children and adolescents 2–19 years of age in Southern California who are actively enrolled in a large, integrated, managed health care system. We examined the body weight from electronic health records of more than 1.3 million children and adolescents 2-19 years of age from 2008 to 2013.
The objective of this study was to investigate recent trends in pediatric obesity in Southern California between 2008 and 2013. Several recent studies have investigated national trends in childhood obesity in the United States and indicated that childhood obesity rates may have reached a plateau, but are not declining. Ours is one of the few studies that is large enough to be able to detect small changes in the prevalence of obesity in time periods of less than 10 years.
MedicalResearch: What are the findings of this study? Dr. Koebnick: Our study provides strong indication that the prevalence of overweight and obesity between 2008 and 2013 has not only plateaued, but also is slowly declining. While the decline in overweight and obesity was less pronounced in girls, adolescents, some minority groups and youth living in low income and low education areas, the decline was remarkably stable across all groups and significant even in minority youth and youth of lower socioeconomic status.
We found the prevalence of overweight and obesity decreased overall by 2.2 percent and 1.6 percent, respectively. This change corresponds to a relative decline of 6.1 percent in overweight youth and 8.4 percent in obese youth. Although a decline was seen across all groups, the decrease was not as strong in adolescents aged 12-19 years, in girls compared to boys, and Hispanic and black children compared to non-Hispanic whites.
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MedicalResearch.com Interview with:
Ichiro Morioka, M.D.
Professor of Pediatrics, Kobe University Graduate School of Medicine
Chuo-ku, Kobe, JapanMedical Research: What is the background for this study? What are the main findings?
Dr. Morioka: Japan has the highest survival rate for preterm infants due to recent advanced medical treatment and the availability of Neonatal Intensive Care Units (NICU). Despite this, cases of cerebral palsy and hearing loss caused by neonatal jaundice continue (kernicterus) to occur, with cases reported for at least 2 in every 1000 infants born before the 30th week of gestation. It has also been established that cases of jaundice can worsen even two weeks after birth and thereafter, meaning that there is a need for continuous long-term jaundice monitoring of infants in the NICU. However, jaundice in preterm infants is difficult to detect through physical observations, and monitoring through a daily blood test is not a realistic option.
We focused on transcutaneous jaundice monitoring used in daily health tests for full term infants. The bilirubin levels of 85 infants with a birth weight of under 1500 grams were monitored in NICUs at Kobe University, Kakogawa City Hospital, Hyogo Prefectural Kobe Children’s Hospital, Japanese Red Cross Society Himeji Hospital, and Takatsuki General Hospital, and were taken a total of 383 transcutaneous and blood bilirubin measurements at the same time. Through our results we were able to ascertain that the chest and back areas of preterm infants have the highest levels of sensitivity, and transcutaneous bilirubin levels in those areas were close to bilirubin levels in the blood. In addition to expanding the possibilities for transcutaneous monitoring of jaundice in preterm infants, we discovered the optimum area of skin to monitor it.
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MedicalResearch.com Interview with:
Marte Handal PhDDivision of Epidemiology
Norwegian Institute of Public Health
Oslo, NorwayMedical Research: What is the background for this study?
Dr. Handal: The prevalence of depression during pregnancy is estimated to be as high as between 7 and 15%. It is well understood that untreated maternal depression may be harmful to both the mother and the child. When medical treatment of pregnant women is necessary, selective serotonin reuptake inhibitors (SSRIs) is the most common treatment. However, limited information is available on the potential effect of prenatal exposure to SSRIs on the child’s motor development.
Medical Research: What are the main findings?
Dr. Handal: We did find a week association between prolonged maternal use of SSRIs during pregnancy and delayed motor development in the child even after we had taken the mothers history of depression and her symptoms of anxiety and depression during and after pregnancy into account. However, only a few children were in the least developed category, corresponding to clinical motor delay, indicating that clinical importance is limited.
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MedicalResearch.com Interview with:
Michael P. Sherman, MD, FAAP
Professor, Department of Child Health
University of Missouri - Columbia
Women's and Children's Hospital
Columbia, Missouri 65201
Medical Research: What is the background for this study?
Dr. Sherman: We understand eosinophils are inflammatory cells in the lung during asthma attacks. Publications in a Nature journal described how eosinophils come to the lung after airway injury. Since the lung and intestine have the same embryonic source, we theorized that eosinophils would rise in the blood after the onset of necrotizing enterocolitis in preterm human infants. We correctly predicted that a rise in blood eosinophils would predict later complications from this disease.
Medical Research: What are the main findings?
Dr. Sherman: We found that within two days of disease onset infants could have a rise in eosinophils greater than 5% of the total white blood cell count. If this increase persisted for five or more days, the infant was at risk for later medical or surgical complications including feeding problems, bowel blockage, or intestinal rupture Area under the curve = 0.97, CI: .92-1.0). The babies having this finding were smaller and more premature.
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MedicalResearch.com Interview with:
Dr. Germaine Louis Buck PhD
Senior Investigator and Director of the Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
National Institutes of Health Medical Research: What is the background for this study? What are the main findings?
Dr. Germaine Buck: We wanted to develop intrauterine standards for ultrasound measured fetal growth, given that none currently exist for contemporary U.S. pregnant women. Moreover, we wanted to determine if a single standard would be possible for monitoring all pregnant women, or if the standard needed to be tailored to pregnant women’s race/ethnicity. This added step attempted to address the equivocal data about whether or not race/ethnicity is an important determinant of optimal fetal growth.
Analyzing data from 1,737 low risk pregnant women with uncomplicated pregnancies who had 5 ultrasounds done at targeted times during pregnancy, we found significant differences in estimated fetal weight across the 4 maternal race/ethnic groups. These differences were apparent beginning about 16 weeks gestation and continuing throughout pregnancy. The differences in these curves were apparent when assessing infant’s birthweight, as well. Overall, estimated fetal weights while women were pregnant were highest for White mothers followed by Hispanic, Asian, and Black mothers. A 245 gram difference in estimated fetal weight was observed at 39 weeks gestation between pregnant White and Black women. This pattern was then observed for measured birth weight, with highest birthweights for White then Hispanic, Asian, and Black infants.
Other differences emerged by maternal race/ethnicity for individual fetal measurements: longest bone (femur & humerus) lengths were observed for Black fetuses emerging at 10 weeks gestation, larger abdominal circumference for White fetuses emerging at 16 weeks gestation, larger head circumference for White fetuses emerging at 21 weeks gestation, and larger biparietal diameter for White fetuses emerging at 27 weeks gestation in comparison to other groups.
The race/ethnic differences in fetal size were highly significant and across gestation. If a single White standard was used for estimating fetal weight for non-White fetuses in pregnant women, between 5% and 15% of their fetuses would have been misclassified as being in the <5th percentile of estimated fetal weight.
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MedicalResearch.com Interview with: Nadine Parker M.Sc
Injury Prevention Research Office
Li Ka Shing Knowledge Institute
Keenan Research Centre
St. Michael’s Hospital
Toronto, Ontario, Canada
Medical Research: What is the background for this study? What are the main findings?
Response: TV toppling injuries in children have become increasingly more common in recent years. Including in countries with developing economies where televisions are becoming more affordable. Unfortunately, most people don’t recognize televisions as a hidden home hazard. These easily preventable injuries can be severe or even fatal. Of the deaths due to TV toppling 96% were caused by a head injury. Most of these injuries occur at home with 75% of them unwitnessed by a parent or caregiver. Often furniture such as dressers are used as TV stands but they are not designed to support the weight of TV sets making them unstable. Unfortunately, curious and resourceful young children like to climb these unstable support furniture leading to a toppling event. Play or pushing and pulling the TV set are also common causes of tip-overs.
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MedicalResearch.com Interview with:
Shannon M. Monnat, PhD
Assistant Professor of Rural Sociology, Demography, and Sociology
Department of Agricultural Economics, Sociology, and Education
The Pennsylvania State University
University Park, PA 16802Medical Research: What is the background for this study? What are the main findings?
Dr. Monnat: Given concurrent rapid increases in opioid prescribing and adolescent prescription opioid misuse since the 1990s and historical problems with opioid abuse in rural areas, we were interested in whether adolescents in rural areas were more likely to abuse prescription opioids than their peers in urban areas. Adolescence is a really crucial time to study substance abuse disorders because most abuse begins during adolescence, and individuals who begin use before age 18 are more likely to develop a long-term disorder as an adult compared to those who first try a substance later in life. The active ingredient in prescription opioids and heroin is the same. Prescription opioids are highly addictive and can be dangerous if utilized incorrectly. Prescription opioid abuse is currently responsible for over 16,000 deaths in the US annually and has an estimated annual cost of nearly $56 billion dollars. Therefore, it is correctly viewed as a major public health problem.
We found that teens living in rural areas are more likely to abuse prescription opioids compared to teens living in large urban areas. Several important factors increased rural teens’ risk of abusing prescription opioids, including that they are more likely to rely on emergency department treatment than their urban peers, they have less risky attitudes and perceptions about substance abuse than their urban peers, and they are less likely to be exposed to drug/alcohol prevention messages outside of the school environment than their urban peers. Rural teens are also buffered by several factors that help to reduce opioid abuse, including stronger religious beliefs, less depression, less peer substance abuse, and less access to illicit drugs. If not for these protective factors, the current epidemic we see in rural areas could be even worse.
We also found that both rural and urban adolescents were most likely to report obtaining the prescriptions they abused from friends or family. However, rural adolescents were less likely than urban adolescents to obtain the pills this way. Rural adolescents were more likely than urban adolescents to report getting the pills they abuse directly from physicians.(more…)
MedicalResearch.com Interview with:
Sophie von Stumm BSc MSc PhD
Department of Psychology
Goldsmiths University of London
London, United Kingdom
Medical Research: What is the background for this study?
Dr. von Stumm: At the Hungry Mind Lab (www.hungrymindlab.com), which I direct, we study individual differences in lifespan cognitive development. In particular, I am interested in factors that influence change in cognitive ability and knowledge. One such factor is breastfeeding, which some previous studies suggested to be associated children's intelligence and IQ gains while others failed to find a relationship.
Medical Research: What are the main findings?
Dr. von Stumm: For this study, which was published last week in PloS One (link:http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0138676), data were analyzed from more than 11,000 children born in the UK between 1994 and 1996. The children had been repeatedly assessed on IQ: the first time they were tested on intelligence at age 2, and then again repeatedly throughout childhood, overall 9 times, until the age of 16 years. We found that having been breastfed versus not having been breastfed was not meaningfully associated with children's IQ differences at age 2 and also not with differences in children's IQ gains until age 16. That is not to say that breastfeeding may not have other benefits for children's development but our study strongly suggests that breastfeeding is not important for children's IQ. (more…)
MedicalResearch.com Interview with:
Gayatri Mirani MD and
Tulane University School of Medicine
New Orleans, Louisiana
Paige L. Williams, PhD
Department of Biostatistics
Harvard T. H. Chan School of Public Health
Boston, MA 02115
Medical Research: What is the background for this study
Response: Combination antiretroviral therapy (cART) has resulted in a dramatic decrease in HIV-related opportunistic infections and deaths in US youth, but both continue to occur. IMPAACT P1074, a long-term US-based prospective multicenter cohort study funded through NIH was conducted from April 2008 to June 2014. We reviewed complications and mortality rates in HIV-infected US youth enrolled in this study. Comparisons were made with a previous observational cohort study, P219C. While P219C was conducted from 2000 to 2007, we restricted our analysis to 2004-2007 in order to evaluate changes over the past decade.
A total of 1201 HIV-infected youth were enrolled in the IMPAACT P1074 study, with most (1040, or 90%) infected with HIV at birth. The overall study population was 52% female, 58% black non-Hispanic and 28% Hispanic. Their mean age at the first chart abstraction was 17.4 (±5.4 Std. Dev.) years. The majority were on cART, had a stable CD4 count (baseline mean > 500 cells/mm3) and a suppressed viral load over a median follow-up of 3.7 years. The P219C group was younger, with a mean age of 11.9 (±5.0 Std. Dev.) years at the start of the 2004-2007 follow-up period.
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MedicalResearch.com Interview with:
Avni Y Joshi, MD, MSc
Assistant Professor of Pediatrics and Medicine
Pediatric and Adult Allergy / Immunology
Cellular and Molecular Immunology Laboratory
Mayo Clinic
Medical Research: What is the background for this study? What are the main findings?
Dr. Joshi: We sought to quantify the risk of asthma outcomes in children with asthma who are exposed to second hand tobacco smoke (SHS).
This was a pooled analysis of 25 studies that were included for looking at asthma outcomes in children.
Children with asthma who were exposed to second hand tobacco smoke (SHS) were nearly twice as likely to be hospitalized as compared to children with asthma who were not exposed to second hand tobacco smoke exposure.
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MedicalResearch.com Interview with:
Avik Chatterjee, MD, MPH
Physician, Boston Health Care for the Homeless Program
Instructor, Harvard Medical School
Associate Epidemiologist, Division of Global Health Equity, Brigham and Women's Hospital
Boston, MA
Medical Research: What is the background for this study? What are the main findings?
Dr. Chatterjee: Substance use, sexual activity and violent behaviors are common during adolescence. Understanding risk factors for these behaviors will improve our ability to prevent them and their sequelae. The Chaos, Hubbub and Order Scale (CHAOS) is a measure of household physical and social disorder, and higher CHAOS score, as reported by parents, has been shown to be correlated with less self-regulatory behavior in children. Thus, CHAOS could be a risk factor for the above behaviors in adolescents. We used data from the RISE study, in which 929 adolescents completed face-to-face and computer-assisted (for sensitive questions) interviews about their health behaviors to analyze the relationship between CHAOS score and risky health behaviors. We found that students with highest CHAOS score, compared to those with zero CHAOS score, had elevated odds for tobacco use (3x), alcohol use (2.5x), any substance use at school (6x) and fighting in the past 12 months (2x).
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MedicalResearch.com Interview with:
Dr. Ziming Xuan ScD, SM, MA
Assistant Professor, Community Health Sciences
School of Public Health
Boston UniversityMedical Research: What is the background for this study?
Dr. Xuan: With respect to background, among the 15000 some teenagers died annually in the US, the 3 leading causes of death were unintentional injuries, homicide, and suicide. Among these fatal youth injuries, 83% homicides were gun-related, and about half of suicides involved a gun (45%).
So, The purpose of the study was to investigate the association between state gun law environment and youth gun carrying in the United States, and whether this association is mediated by adult gun ownership.
Medical Research: What are the main findings?Dr. Xuan:
Among 38 states in our study, 5.7%of high school students living in the 19 states with stricter gun laws carried a gun in past 30 days while 7.3% of students living in states with the weaker gun laws carried a gun.
A 10-point increase in the strictness of the state gun law score was associated with a 9% decrease in the odds of youth gun carrying.
Across states, restrictive gun laws may reduce youth gun carrying by limiting adult gun ownership.
MedicalResearch.com Interview with:
Juliana F. W. Cohen, ScD, ScM
Harvard T. H Chan School of Public Health
Assistant Professor Department of Health Sciences
School of Science and Engineering
Department of Health Sciences, Merrimack College
North Andover, MAMedical Research: What is the background for this study? What are the main findings?
Dr. Cohen: There is a substantial amount of variation in the amount of time students have to eat lunch because there are no national standards for lunch period lengths. This study found that when students had less than 20 minutes of seated time in the cafeteria, they were less likely to select a fruit and consumed significantly less of their entrees, milk and vegetables compared with students who had at least 25 minutes to eat their lunch.
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MedicalResearch.com Interview with:Renee M. Johnson, PhD, MPH
Assistant Professor
Johns Hopkins Bloomberg School of Public Health, Dept. of Mental Health
Deputy Director, Drug Dependence Epidemiology Training Program (DDET)
Baltimore MD
Medical Research: What is the background for this study? What are the main findings?
Dr. Johnson: There has been a lot of policy change with regard to marijuana. Several states have enacted laws regarding medical marijuana and decriminalization, and now four states and the District of Columbia have legalized use for adults. Along with these policy changes, there’s been concern that adolescent marijuana use would skyrocket. This prompted me to think about what’s happened over the past 15 years, and so I decided to examine past 15-year trends in adolescent marijuana use among US high school students.
Our research team analyzed data from the Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance Study, or YRBS. It is a nationally-representative survey of high school students. A lot of the information we have about adolescents’ risk behavior comes from the YRBS.
What we found is that marijuana use among US high school students has gone down over the time period. In 1999, 47% of high school students reported lifetime use of marijuana. By 2013, 41% reported lifetime use. Use was lowest in 2009, with 37% of high school students reporting lifetime use. The increase in use from 2009 to 2013 was not statistically significant, so we aren’t sure whether it represents random fluctuation or whether it indicates a reversal in trend.
We also found that gender differences have gotten smaller over the time period, reflecting a real change. Boys have historically had higher rates of use, but that’s changing. In 1999, 51% of boys and 43% of girls reported lifetime marijuana use. By 2013, 42% of boys and 39% of girls reported lifetime use.
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MedicalResearch.com Interview with:
Yang Bai
Graduate research assistant
Department of Kinesiology
College of Human Science
Iowa State University, Ames, IA
Medical Research: What is the background for this study? What are the main findings?Yang Bai: The last national youth physical fitness survey that covered the full developmental age range was conducted more than 25 years ago. A new study conducted by The Cooper Institute known as the NFL PLAY 60 FITNESSGRAM Partnership Project offers potential to study youth fitness on a national level. The NFL PLAY 60 FITNESSGRAM Partnership Project is a participatory research network that tracks health and fitness data from over 1000 schools across the country.
The present study describes the distribution of health-related fitness in 1st-12th grade youth from this large nationwide sample of schools. The main finding included that the fitness levels varied greatly based on gender and age and the percentage of youth had adequate aerobic fitness and healthy BMI were low. For example, there were 62.1％ to 37.6％ (different from grade 4th to 12th) boys meeting the requirements for healthy aerobic capacity, and the range for girls were 50.8％to 26.1％. Aerobic capacity among boys started to decline in the sixth grade, while girls experienced a continual decline with age. There was less variation among boys and girls with a healthy BMI, which ranged 52.7% to 65.0%.
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MedicalResearch.com Interview with: Annemarie Schalkwijk, MSc/MD
PhD candidate, GP in training
Diabetes Research Group
EMGO Institute for Health and Care Research
VU University Medical Center
Amsterdam The Netherlands
Medical Research: What is the background for this study?
Dr. Schalkwijk: Overweight and obese children are at increased risk of becoming overweight and obese adults and therefore are an important risk factor for developing type 2 diabetes. It is known from the literature that being overweight or obese is associated with environmental, parental and socioeconomic status (SES) characteristics. However, the interdependence of these variables has not been studied before.Therefore, the aim of our study is to assess the influence of the amount of green space, accessibility to a garden and the safety of the surroundings during ages 3-5 on being overweight or obese at age 7. Furthermore, we want to assess if parental choices and SES moderate or mediate this influence.
Medical Research: What are the main findings?Dr. Schalkwijk: Statistically significant associations (p≤0.05) were found between low levels green space, not having access to a garden, shabbiness of the neighborhood and childhood obesity (OR (95% CI) respectively: 1,14 (1,02-1,27), 1,35 (1,16-1,58), 1,22 (1,05-1,42)). Parental determinants were related to the environmental determinants and childhood overweight/obese but did not moderate or mediate the association between the latter two. Therefore no parental variables were left in the model. As for SES, the highest level of education in the household did diminish the magnitude of the associations found between the environmental determinants and being overweight/obese. In the final model the remaining significant associations with childhood overweight/obese were no garden access for lower educated households and shabbiness of the neighborhood for higher educated households (OR (95% CI) respectively: 1,38 (1,16-1,58), 1,38 (1,12-1,70). We can conclude from our study, that environmental factors do have an association with children being overweight or obese. However, these associations are complex and might not be as distinct as previously assumed.
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MedicalResearch.com Interview with:
Prof. Dr. Holger Lode
Clinical Immunology, Pediatrics
University of Greifswald, Greifswald
Medical Research: What is the background for this study?
Response: Neuroblastoma is a cancer in childhood with one of the highest death rates. Standard treatment is already very intensive. It includes chemotherapy, surgery, radiation, high dose chemotherapy followed by autologous stem cell transplantation. However, the progress made in improving survival rates is still poor.
The use of an immune-modulatory treatment with a neuroblastoma specific monoclonal antibody ch14.18 (100 mg/m2 /cycle) in combination with cytokines and 13cis retinoic acid (13 cis RA) has shown benefit for patients with this disease [1]. This antibody targets ganglioside GD2 abundantly expressed on neuroblastoma with limited to no expression on healthy tissue. Low expression of GD2 on pain fibers is associated with an on-target side effect of the treatment, which is the induction of neuropathic pain. Approval of ch14.18 (dinutuximab) for the treatment of children with neuroblastoma has been provided by FDA.
In Europe, ch14.18 was not available for a long time. There were several reasons why the antibody in the US could not be given to children in Europe. Therefore a new development of this side of the Atlantic was initiated following the remanufacturing of the antibody in CHO cells [2] (dinutuximab beta) and was made available within clinical trials of the SIOPEN group. The SIOPEN group is a network of leading European pediatric oncology centers to improve outcome for children with neuroblastoma (http://www.siopen.org), similar to the COG (children`s oncology group in the USA; https://www.childrensoncologygroup.org).
Following the recloning procedure, ch14.18/CHO was first evaluated for safety in a Phase I study [3], which confirmed the tolerability and showed activity at a dosing regimen of 20 mg/m2 given by 8 hour infusions on 5 consecutive days. Dinutuximab beta is further developed by Apeiron Biologics.
The current way to apply 100 mg /m2 / cycle is by 4 short term infusions of 25 mg/m2/day each over 8 hrs on 4 consecutive days. The entire treatment consists of 5 cycles. The drawback is that STI is associated with a high amount of intravenous morphine required to make this treatment tolerable for patients. Also the rate of inflammatory side effects observed is substantial.
Clinical observation indicates that if patients treated by STI suffer from pain despite analgesic treatments, a decrease in speed of antibody infusion improves this on target toxicity. Therefore, we hypothesized that significant prolongation of the time of antibody infusion will improve tolerability of that treatment, but at the same time maintains clinical activity and efficacy in high risk neuroblastoma patients.
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MedicalResearch.com Interview with:
Jessica M. Robbins, PhD
Adjunct Assistant Professor
Public Health Epidemiologist
Philadelphia Department of Public HealthMedical Research: What is the background for this study?
Response: The rapid increase in child obesity rates across the US in recent decades has affected Philadelphia as it has other cities. The Philadelphia Department of Public Health has worked with the School District of Philadelphia to analyze data on students' heights and weights to determine trends in obesity since the 2006-2007 school year. Data we had examined through the 2009-2010 school year indicated that the prevalence of obesity and severe obesity were declining in this population, and notably were declining in African-American and Hispanic students as well. We updated the analyses with data through the 2012-2013 school year to see if that trend had continued.
Medical Research: What are the main findings?
Response: Overall, the prevalence of obesity and particularly of severe obesity continued to decline, although more slowly than in the earlier period. However, there were some disturbing disparities, with improvement largely limited to boys. Girls in grades kindergarten through 5 and Hispanic girls actually saw increased obesity since 2009-2010.
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MedicalResearch.com Interview with:
Ana C. Krieger, MD, MPH, FCCP, FAASM
Medical Director, Center for Sleep Medicine
Associate Clinical Professor
Departments of Medicine, Neurology and Genetic Medicine
Weill Cornell Medical College - Cornell University
Associate Attending
NewYork-Presbyterian Hospital
Rockefeller University Hospital
Medical Research: What is the background for this study? What are the main findings?Dr. Krieger: For many years, sleep researchers have been concerned about sleep deprivation in adolescents. Our study shows that high school students have shorter sleep duration on the nights following the spring Daylight Saving Time adjustment. This sleep loss was associated with a decline in daytime vigilance and cognitive performance on the week following DST.
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MedicalResearch.com Interview with:
Monika Goyal, MD
Pediatric emergency medicine
Children’s National Hospital
Washington, DC
Medical Research: What is the background for this study? What are the main findings?
Dr. Goyal: Appendicitis is a painful surgical condition and adequate analgesia, particularly with opioids, are considered one of the mainstays of management. We found that almost half of all children diagnosed with appendicitis did not receive any analgesia. Furthermore, among the patients that did receive analgesia, there were marked racial differences with black children having lower rates of opioid medication receipt than white children, even after we took pain scores or acuity level into account.
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MedicalResearch.com Interview with:
Merja Nermes, MD
Dept. of Pediatrics
Turku University Hospital
Turku, Finland
Medical Research: What is the background for this study? What are the main findings?
Response: Earlier it was thought that exposure to pets early in childhood was a risk factor for developing allergic disease. Later epidemiologic studies have given contradictory results and even suggested that early exposure to pets may be protective against allergies, though the mechanisms of this protective effect have remained elusive. Our results are the first to show that specific bifidobacteria present in pets can be transferred to the infant gastrointestinal tract during a close contact. Bifidobacteria in general are a part of the microbiota in healthy breast fed infants, and many studies have shown that human-specific bifidobacteria have beneficial effects to health, e.g. lower the risk of allergic disease. The same might hold true for bifidobacteria of animal origin which may enhance and strengthen the development of the infants´ immune system to be protective against allergies.
Our results showed that animal-derived bifidobacteria were found in a higher proportion in infants of pet-keeping families than in those without such exposure. We also found that B. thermophilum (pet-derived Bifidobacterium) was associated with a lower risk for atopic sensitization at 6 months of age.
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MedicalResearch.com Interview with:
Brian A. Primack, MD, PhD
Associate Professor of Medicine, Pediatrics, and Clinical and Translational Science
Director, Center for Research on Media, Technology, and Health
Assistant Vice Chancellor for Research on Health and Society
University of Pittsburgh School of Medicine
Pittsburgh, PA 15213
Medical Research: What is the background for this study?
Dr. Primack: Adolescents and young adults who have never smoked traditional cigarettes are now using e-cigarettes. It is unclear whether these people are at risk for progression to traditional cigarette smoking. Therefore, we followed 694 non-smokers ages 16-26 who did not intend on taking up smoking for 1 year.
Medical Research: What are the main findings?
Dr. Primack: At baseline, only 16 of the 694 participants had used e-cigarettes. However, those individuals were significantly more likely to start smoking traditional cigarettes by the 1-year follow-up. In fully adjusted models, baseline e-cigarette use was independently associated with both progression to smoking (AOR = 8.3, 95% CI = 1.2-58.6) and to susceptibility (AOR = 8.5, 95% CI = 1.3-57.2).
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MedicalResearch.com Interview with:
Henrik Ullman, MD, PhD Candidate
Department of Neuroscience
Karolinska Institutet
Stockholm, Sweden
Megan Spencer-Smith, PhD
School of Psychological Sciences
Monash University
Melbourne, Australia
Medical Research: What is the background for this study? What are the main findings?
Response: Infants born preterm are at risk for school-age cognitive and academic impairments. While some will suffer severe impairments, many more will experience mild impairments, and it is these children who might not raise sufficient concern for referral and intervention. Identifying early markers and methods for classifying preterm infants at risk for school-age impairments, many years before difficulties emerge, would provide important information for clinicians in advising families regarding intervention and ongoing monitoring.
Brain alterations are common in preterm populations. Any brain alterations associated with school-age impairments are likely already present in the neonatal period but are not detected with the current standard clinical and radiological evaluations.
In this study we wanted to see how well we could use advanced analysis of volumetric and diffusion MRI collected in the neonatal period from 224 very preterm children to predict cognitive functions at five and seven years of age. We used statistical models to look for localised regions as well as machine learning methods to correlate patterns in the neonatal MRI data that could predict school-age outcomes.
We found that localised volumes in the insula and basal ganglia as well as a distributed patterns of diffusion MRI could predict working memory and early mathematical skills even after co-varying for important perinatal clinical factors.
It has previously been shown that quantitative and pattern analysis can catch subtle patterns in MRI data not easily detected by eye and may predict cognitive development. The current study builds further on these results showing clinically relevant predictions in preterm children.
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MedicalResearch.com Interview with:Brian D. Elbel, PhD, MPH
Associate professor, Departments of Population Health, Division of Health and Behavior and Medicine, Division of General Internal Medicine
Marie Bragg, PhD
Assistant professorDepartment of Population Health
Jonathan Cantor, MS
Department of Population Health, Section on Health Choice, Policy and Evaluation
NYU Langone Medical CenterMedicalResearch: What is the background for this study? Response: On July 17th, 2014 the New York City Council proposed the “Healthy Happy Meals” bill in an effort to improve the nutritional value of fast food restaurant meals marketed to children. The bill states a restaurant cannot offer an incentive item (i.e. a toy) in combination with the purchase of a meal unless the meal met several nutritional standards.
The meals with toys would be required to:
Be less than 500 hundred calories total
Be less than 600 milligrams of sodium total
Have less than 35% of total calories come from fat
Have less than 10% of total calories come from saturated fat
Have less than 10% of total calories come from added sugar
Contain one half cup of fruit or vegetable or one serving of whole-grain products
This study examined potential reductions in purchased calories, sodium and percentage of calories from fat that could occur among children if the policy were to go into effect.
MedicalResearch: What are the main findings?Response: Researchers collected receipts for fast food purchases for 422 children who were accompanied by 358 adults. On average, adults purchased 600 calories for each child, with 36 percent of those calories coming from fat. One third of the children in the sample had a children’s meal, with 98% of the purchased children’s combination meals would be restricted from handing out a toy with the meal if the bill passed.
If the bill passed, there would be a 9% reduction in calories purchased for kid’s meals, the equivalent of 54 calories. Similarly, researchers found that there would be a 10% (83 mg) reduction in sodium purchased and a 10% reduction in the percentage of calories from fat purchased for children. This all assumes that children ordered what they did previously but the meals meet the nutrition criteria.
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MedicalResearch.com Interview with:
Beate W. Hygen PhD Student
Department of Psychology
Norwegian University of Science and Technology Social Science
Medical Research: What is the background for this study?
Response: The study is part of the Trondheim Early Secure Study (TESS) conducted at the Department of Psychology, Norwegian University of Science and Technology (NTNU) and NTNU Social Science. The main aim of TESS is to detect risk and protective factors with regards to children’s mental health and well-being. TESS examines multiple factors which may play a role in children`s development.
There is substantial research, based on diathesis-stress theorizing, indicating that some individuals, including children, are more susceptible to the negative effects of contextual adversity than are others. However, according to differential susceptibility theory, such "vulnerable" individuals may also be the ones that benefit the most from positive environmental conditions. Thus, some individuals are more malleable for "better and for worse" to environmental exposures. The articleChild exposure to serious life events, COMT, and aggression: Testing differential susceptibility theory was designed to examine if the COMT polymorphism moderated the effect of early-life adversity on aggressive behavior. Thus, we sought to competitively evaluate which model of person X environment interaction best accounted for the anticipated differential effects of life event stress on children's aggressive behavior.
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MedicalResearch.com Interview with:
Daryl R. Cheng, MBBS
Monash Children's Hospital
Victoria, Australia
Medical Research: What is the background for this study? What are the main findings?Response: Inanimate objects worn and used by health care workers (HCW), such as neckties and stethoscopes, have been shown to be reservoirs for potential pathogens. Of particular concern in the pediatric setting are identity (ID) badges and lanyards.
Many pediatric health care workers use them not only for
identification but also as a distraction tool during examination or procedures. Children have an increased tendency to place these items in their mouth as health care workers lean over to examine or care for them, therefore completing the chain of transmission for a potential nosocomial infection.
Whilst previous studies have demonstrated that ID badges and lanyards worn by health care workers may harbor pathogenic bacteria , there is paucity of comparative data suggesting that ID badges may be similarly contaminated with viral pathogens.
However, given the higher incidence of viral infections in pediatrics up to 50% of preterm infants screened during their hospital stay y had viruses detected in their nasopharynx, further evaluation of the viral burden and potential for nosocomial transmission of prevalent viruses are of both clinical and economic significance.
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MedicalResearch.com Interview with:
Stephanie J. Crowley, Ph.D.
Assistant Professor
Biological Rhythms Research Laboratory
Department of Behavioral Sciences
Rush University Medical Center
Chicago, IL 60612
Medical Research: What is the background for this study? Dr. Crowley: Your readers may have seen recent reports by the American Academy of Pediatrics and the CDC about problems with early morning school bells for teens and the need to push school start times later. These recent calls for later school start times come from data showing that biological processes make it challenging for a teen to get enough sleep and be rested for school when they have to wake up very early for school. One of these biological processes is the circadian timing system, which is the approximate 24-hour brain clock that regulates the timing of sleep and wake. During the teen years, the brain clock is shifted later making it more difficult for many teens to fall asleep early enough to get sufficient sleep on school nights.
Medical Research: What are the main findings?
Dr. Crowley: Melatonin suppression, as tested in this new study, is a good indication of how light affects the circadian system. Our findings show that even a very small amount of light (similar to “romantic mood lighting”) in the evening suppressed melatonin levels in the middle-school-aged adolescents. Because evening light “seen” by the brain clock shifts the clock later in time, the message is that biologically-driven later sleep times starts at this early age and needs to be considered when managing school and sleep schedules.
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MedicalResearch.com Interview with:
Jeffrey R. Kaiser, MD, MA
Professor of Pediatrics and Obstetrics and Gynecology
Section of Neonatology
Baylor College of Medicine
Texas Children's Hospital
Houston, TX 77030
Medical Research: What is the background for this study? What are the main findings?
Dr. Kaiser: The continuous utero-placental-umbilical infusion of glucose ends at birth, and levels decrease during the first 1–2 hours stimulating counterregulatory hormones and promoting successful glucose homeostasis in healthy newborns. This is important because the newborn brain principally uses glucose for energy, and prolonged and severe hypoglycemia has been linked with poor long-term neurodevelopment. Most previous newborn hypoglycemia-outcome studies, however, are problematic because they did not control for maternal educational level and socioeconomic status, factors that are highly associated with childhood neurodevelopment and academic success. Further, little is known about whether newborn transient hypoglycemia (1 low value followed by a second normal value), frequently considered to be a normal physiological phenomena with no serious sequelae, is associated with poor academic achievement. To address this knowledge gap, we compared initial newborn glucose values from the universal glucose-screening database, available only at the University of Arkansas for Medical Sciences (UAMS), to their matched student achievement-test scores in 4th grade (10 years later).
After controlling for gestational-age group, race, gender, multifetal gestation, insurance, maternal education, and gravidity, we observed transient hypoglycemia in a heterogeneous cohort of newborns born at a university hospital was associated with lower fourth-grade achievement-test scores—real-world assessments that predict high school graduation, college attendance, and long-term adult economic success.
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MedicalResearch.com Interview with:
Mark DeBoer, MD
Children's Hospital's Department of Pediatrics
University of Virginia
Medical Research: What is the background for this study? What are the main findings?
Dr. DeBoer: We have been interested in how the severity of the metabolic syndrome relates to long term risks, both for children and adults. We formulated a score that takes the different components of the metabolic syndrome (body mass index, blood pressure, fasting blood sugar, triglycerides and high density cholesterol) for an individual and forms a score estimating how severe the metabolic syndrome is in that individual. When we looked at long-term data from individuals followed for 40 years, we found that children and adults with higher scores were more much likely to develop cardiovascular disease.
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