Author Interviews, Cannabis, CDC, Pediatrics, Tobacco Research / 16.10.2015

MedicalResearch.com Interview with: Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC Medical Research: What is the background for this study? What are the main findings? Response: Since 2010, the proportion of U.S. 12th grade students who used marijuana during the preceding 30 days (21.4%) has surpassed the proportion who used cigarettes (19.2%). Negative outcomes associated with cigarette and marijuana use include addiction to one or both substances and diminished cognitive function, which can lead to lower academic achievement. CDC analyzed data from the 1997–2013 national Youth Risk Behavior Surveys (YRBS) among U.S. non-Hispanic white (white), non-Hispanic black (black), and Hispanic students in grades 9–12 to examine trends in the prevalence of current 1) exclusive cigarette or cigar use, 2) exclusive marijuana use, and 3) any use of the three products. CDC further examined the prevalence of current marijuana use among current users of cigarettes or cigars. During 1997–2013, exclusive cigarette or cigar use declined overall by 64%, from 20.5% to 7.4% (p<0.01). However, exclusive marijuana use more than doubled overall from 4.2% to 10.2% (p<0.01). Any cigarette, cigar, or marijuana use decreased overall from 46.1% to 29.9% (p<0.01), whereas marijuana use among cigarette or cigar users increased from 51.2% to 62.4%. Considerable increases were identified among black and Hispanic students toward the end of the study period for exclusive marijuana use and marijuana use among cigarette or cigar users. Increased exclusive marijuana use and use of marijuana among cigarette or cigar users could undermine success in reducing tobacco use among youths. (more…)
Author Interviews, Education, Pediatrics / 16.10.2015

Arielle Borovsky, PhD Assistant Professor Department of Psychology Florida State University Tallahassee, FL 32306 MedicalResearch.com Interview with: Arielle Borovsky, PhD Assistant Professor Department of Psychology Florida State University Tallahassee, FL 32306 Medical Research: What motivated this research? Dr. Borovsky: Early vocabulary learning sets the stage for many other language and academic skills. It is important to understand how this process proceeds normally so that we can identify children who may be in need of other clinical language interventions as early as possible. One of the emerging observations in early vocabulary acquisition research is that while the number of words that infants know is important, the structure of this knowledge also matters. That is, children do not learn words randomly, nor is their vocabulary a representative subset of adult vocabulary. Young children learn words that matter for communication in their daily activities, and these words tend to be related in meaning. It is highly possible that children are learning new language even when watching an Official Video on Youtube. Young children's early semantic structure in vocabulary knowledge suggests is that it may be easier for them to learn new words that have greater connections to their existing knowledge. However, although there had been some promising observational research on this topic, this idea had not yet been experimentally tested. So that is what we decided to do. Medical Research: What did you find? Dr. Borovsky: We found that children were be able to understand new words more effectively when those words had more connections to their exisiting vocabularies. We found this by asking parents of 32 two-year-old children to complete a detailed survey of the words their child says. We then taught these children the same six words and identified for each individual child the three words came from categories that they knew the most about, and the three that came from the child's least well-known categories. In this way, we could control for the child's overall vocabulary size, while selecting words that had relatively more or fewer connections to their own vocabulary. Afterwards, we used an eye-tracking task to test how children understood these high and low connection words. This allowed us to probe the child's knowledge without requiring them to talk or point, they simply had to do what they like to do naturally - watch a simple video on a computer screen with pictures that corresponded to the words they learned. We found that when the new items were named in this computer game, children looked more towards the words that had more connections rather than fewer connections. This suggested that they understood these high density words more easily than the more sparsely connected words. (more…)
Author Interviews, NEJM, Pediatrics / 15.10.2015

Prof. Dr. Dirk Bassler, MSc Department of Neonatology Zurich SwitzerlandMedicalResearch.com Interview with: Prof. Dr. Dirk Bassler, MSc Department of Neonatology Zurich Switzerland  Medical Research: What is the background for this study? What are the main findings? Response: The lungs of preterm infants are very vulnerable and these infants frequently develop chronic lung disease, also called bronchopulmonary dysplasia (BPD). BPD is not only a problem of the lungs, it is also a major cause of early death in these infants and if they survive, their risks of respiratory problems in later life and neurodevelopmental impairment are increased when compared to infants without bronchopulmonary dysplasia. Few drugs are available to prevent or to treat BPD and up to this date, no licensed drug for this indication is on the market, neither in Europe nor the USA. Hence additional preventive strategies are needed to reduce the risk of BPD and inhaled glucocorticoids seemed to have a favorable benefit-risk ratio. Medical Research: What are the main findings? Response: A total of 863 preterm infants with a gestational age of less than 28 weeks from 40 study centers in 9 countries (8 European countries and Israel) participated in the Neonatal European Study of Inhaled Steroids (NEUROSIS). The study investigated whether inhaled budesonide, an anti-inflammatory glucocorticoid, would decrease the incidence of bronchopulmonary dysplasia and death in preterm infants. The results show for the first time that inhaled budesonide reduces the incidence of BPD in preterm infants, a finding that is statistically significant. However, in absolute numbers, more infants died during the study period in the budesonide group compared to the placebo group. This difference is not statistically significant and could be caused by chance. Budesonide had a statistically significant positive effect on two more prespecified secondary outcomes: it reduced the rate of infants requiring intubation after completion of study treatment and the frequency of surgery required to close a patent ductus arteriosus, a blood vessel connecting the pulmonary artery to the aorta. The rate of side effects was similar in the budesonide and in the placebo group. (more…)
Author Interviews, JAMA, Mental Health Research, Pediatrics / 15.10.2015

MedicalResearch.com Interview with: Christine Walrath, PhD Public Health Division ICF International New York, New York Medical Research: What is the background for this study? What are the main findings? Dr. Walrath: The study is part of a legislatively mandated evaluation of programs funded by the Garrett Lee Smith Memorial Act, signed into law in 2004 in recognition of the major public health problem of suicide and suicidal behavior in the US. The legislation set aside funding for campuses, states, tribes and US territories to develop, evaluate, and improve early intervention and suicide prevention programs. This is the most widely implemented group of suicide prevention programs in the United States, and allowed a unique opportunity, as reflected in the findings of this study and the study in the American Journal of Public Health in the spring (Walrath, C., Godoy Garraza, L., Reid, H., Goldston, D. B., & McKeon, R. (2015) to demonstrate that comprehensive community based suicide prevention programs appear to be effective in reducing suicide and suicide attempts. As mentioned, this is the second article on the impact of GLS suicide prevention program on youth suicide behavior. The previous one, published in APHA earlier this year, focused on suicide deaths, while this one focuses on suicide attempts. They use different sources for the outcome measures: vital records in one case and a large national survey in the other. In both cases, the county is the unit of analysis. They both take advantage of the availability of a large amount of information for relatively small areas to select counties that are essentially comparable. Making sure that the counties being compared are similar except for the GLS implementation is very important when randomized trials to assess impact of the prevention program are not feasible. The study found a reduction in the rate of suicide attempts among youth 16 to 23 following the implementation of the GLS program in counties exposed to these prevention activities when compared with similar counties that were not exposed to such intervention. The difference is significant and substantial: 4.9 less attempts per thousand youths. There is no evidence of a simultaneous change in the suicide attempt rate among adults, a group that was not targeted by GLS. The findings are consistent with those from the previous study, which found a substantial reduction in suicide mortality among youths 10-24 following GLS implementation: 1.3 fewer deaths per one hundred thousand youths. (more…)
Author Interviews, Heart Disease, JACC, Metabolic Syndrome, Pediatrics / 07.10.2015

Mark DeBoerMedicalResearch.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. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, Pediatrics / 06.10.2015

Susan Gray MD Division of Adolescent Medicine Boston Children's Hospital Boston, MAMedicalResearch.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. (more…)
Author Interviews, Kaiser Permanente, Pediatrics, Weight Research / 05.10.2015

MedicalResearch.com Interview with: Dr-Corinna-Koebnick 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. (more…)
Author Interviews, Pediatrics, Technology / 05.10.2015

Ichiro Morioka, M.D. Professor of Pediatrics, Kobe University Graduate School of Medicine Chuo-ku, Kobe, JapanMedicalResearch.com Interview with: Ichiro Morioka, M.D. Professor of Pediatrics, Kobe University Graduate School of Medicine Chuo-ku, Kobe, Japan  Medical 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. (more…)
Author Interviews, Depression, OBGYNE, Pediatrics / 02.10.2015

Marte Handal PhD Division of Epidemiology Norwegian Institute of Public Health Oslo, Norway MedicalResearch.com Interview with: Marte Handal PhD Division of Epidemiology Norwegian Institute of Public Health Oslo, Norway  Medical 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. (more…)
Author Interviews, Biomarkers, Gastrointestinal Disease, Pediatrics / 01.10.2015

Michael P. Sherman, MD, FAAP Professor, Department of Child Health University of Missouri - Columbia Women's and Children's Hospital Columbia, Missouri 65201MedicalResearch.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. (more…)
Author Interviews, NIH, OBGYNE, Pediatrics / 01.10.2015

Dr. Louis Germaine Buck 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 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. (more…)
Accidents & Violence, Author Interviews, Pediatrics / 30.09.2015

Nadine Parker M.Sc Injury Prevention Research Office Li Ka Shing Knowledge Institute Keenan Research Centre St. Michael’s Hospital Toronto, Ontario, CanadaMedicalResearch.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. (more…)
Author Interviews, Opiods, Pediatrics, Pharmacology / 29.09.2015

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 16802MedicalResearch.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 16802  Medical 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…)
Author Interviews, Cognitive Issues, Pediatrics, PLoS / 27.09.2015

Sophie von Stumm BSc MSc PhD Department of Psychology Goldsmiths University of London London, United KingdomMedicalResearch.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…)
Author Interviews, HIV, Pediatrics / 24.09.2015

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. (more…)
Asthma, Author Interviews, Pediatrics, Tobacco Research / 24.09.2015

Avni Y Joshi, MD, MSc Assistant Professor of Pediatrics and Medicine Pediatric and Adult Allergy / Immunology Cellular and Molecular Immunology Laboratory Mayo ClinicMedicalResearch.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. (more…)
Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, Pediatrics, Social Issues / 22.09.2015

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, MAMedicalResearch.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). (more…)
Accidents & Violence, Author Interviews, JAMA, Pediatrics / 21.09.2015

Dr. Ziming Xuan ScD, SM, MA Assistant Professor, Community Health Sciences School of Public Health Boston University MedicalResearch.com Interview with: Dr. Ziming Xuan ScD, SM, MA Assistant Professor, Community Health Sciences School of Public Health Boston University  Medical 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.
(more…)
Author Interviews, Nutrition, Pediatrics / 18.09.2015

Juliana F. W. Cohen, ScD, ScM Harvard T. H Chan School of Public Health Department of Health Sciences, Merrimack College North Andover, MAMedicalResearch.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, MA  Medical 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. (more…)
Author Interviews, Cannabis, Gender Differences, Pediatrics / 16.09.2015

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 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. (more…)
Author Interviews, Exercise - Fitness, Gender Differences, Pediatrics / 16.09.2015

Yang Bai Graduate research assistant Department of Kinesiology College of Human Science Iowa State University, Ames, IAMedicalResearch.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%. (more…)
Author Interviews, Pediatrics, Weight Research / 16.09.2015

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. (more…)
Author Interviews, Cancer Research, Pain Research, Pediatrics / 16.09.2015

Prof. Dr. Holger Lode Clinical Immunology, Pediatrics University of Greifswald, GreifswaldMedicalResearch.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. (more…)
Author Interviews, CDC, Pediatrics, Weight Research / 15.09.2015

MedicalResearch.com Interview with: Jessica M. Robbins, PhD Adjunct Assistant Professor Public Health Epidemiologist Philadelphia Department of Public Health  Medical 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. (more…)
Author Interviews, Pediatrics, Sleep Disorders / 15.09.2015

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 HospitalMedicalResearch.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. (more…)
Author Interviews, JAMA, Pain Research, Pediatrics, Race/Ethnic Diversity, Surgical Research / 14.09.2015

Monika Goyal, MD Pediatric emergency medicine Children’s National Hospital Washington, DC 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. (more…)
Allergies, Author Interviews, Pediatrics / 12.09.2015

Merja Nermes, MD Dept. of Pediatrics Turku University Hospital Turku, FinlandMedicalResearch.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. (more…)
Author Interviews, JAMA, Pediatrics, Tobacco Research, University of Pittsburgh / 12.09.2015

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 15213MedicalResearch.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). (more…)
Author Interviews, Education, MRI, Pediatrics / 10.09.2015

Henrik Ullman, MD, PhD Candidate Department of Neuroscience Karolinska Institutet Stockholm, Sweden 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, AustraliaMegan 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. (more…)