Author Interviews, Columbia, Emergency Care, JAMA, Pediatrics, Race/Ethnic Diversity, Yale / 17.09.2021
Black Children Are Physically Restrained in Emergency Room at Disproportionate Rates Compared to White children
MedicalResearch.com Interview with:
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Dr. Tolliver[/caption]
Destiny Tolliver, MD
National Clinician Scholars Program
Yale University School of Medicine
New Haven, CT 06510-8088
Katherine Nash MD, MHS
Assistant Professor of Pediatrics
Columbia University Irving Medical Center
MedicalResearch.com: What is the background for this study?
Response: This study was motivated by work from our colleagues in the adult Emergency Medicine world. Earlier this year Dr. Ambrose Wong and colleagues published work describing racial disparities in the physical restraint of adults in the ED. This prompted our group to consider whether these disparities were also present for children.
Dr. Tolliver[/caption]
Destiny Tolliver, MD
National Clinician Scholars Program
Yale University School of Medicine
New Haven, CT 06510-8088
Katherine Nash MD, MHS
Assistant Professor of Pediatrics
Columbia University Irving Medical Center
MedicalResearch.com: What is the background for this study?
Response: This study was motivated by work from our colleagues in the adult Emergency Medicine world. Earlier this year Dr. Ambrose Wong and colleagues published work describing racial disparities in the physical restraint of adults in the ED. This prompted our group to consider whether these disparities were also present for children.
Dr. Gary Smith[/caption]
Gary A. Smith, MD, DrPH
Director, Center for Injury Research and Policy
Nationwide Children’s Hospital
Columbus, OH
MedicalResearch.com: What is the background for this study?
Response: Furniture and TV tip-overs are an important source of injury, especially for children younger than 6 years old. Our study found that an estimated 560,200 children younger than 18 years old were treated in U.S. emergency departments for furniture or TV tip-over injuries from 1990 through 2019. In 2019, there were 11,521 injured children, which is an average of one child every 46 minutes.
Dr. Forbes[/caption]
Lisa Forbes, Ph.D, LPC, NCC
Clinical Assistant Professor
Counseling Program
University of Colorado Denver
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The most common mode of learning in tertiary education is lecture-based learning despite the knowledge that more active, engaged, and flexible approaches to teaching may better support the learning process. This study aimed to understand graduate students’ experiences with a playful pedagogy as an alternative approach to learning.
Dr. Hoberman[/caption]
Alejandro Hoberman, M.D.
Vice Chair of Clinical Research, Division Director, General Academic Pediatrics, and Professor of Pediatrics and Clinical and Translational Science
Jack L. Paradise, MD Endowed Professor of Pediatric Research, UPMC Children's Hospital of PittsburghPresident, UPMC Children's Community Pediatrics
MedicalResearch.com: What is the background for this study?
Response: Acute otitis media (AOM) is the most frequently diagnosed illness in children in the United States for which antibiotics are prescribed. Recurrent AOM is the principal indication for tympanostomy-tube placement, the most frequently performed operation in children after the newborn period. Supporting the performance of tympanostomy-tube placement for recurrent acute otitis media has been the commonplace observation, after surgery, of acute otitis media–free periods of varying duration. Counterbalancing this view have been the cost of tympanostomy-tube placement; risks and possible late sequelae of anesthesia in young children; the possible occurrence of refractory tube otorrhea, tube blockage, premature extrusion, or dislocation of the tube into the middle-ear cavity; various structural tympanic membrane sequelae; and the possible development of mild conductive hearing loss. Tempering support for surgery is the progressive reduction in the incidence of acute otitis media that usually accompanies a child’s increasing age.
Previous trials of tympanostomy-tube placement for recurrent acute otitis media, all conducted before the introduction of pneumococcal conjugate vaccine, have given mixed results and were limited, variously, by small sample size, uncertain validity of diagnoses of acute otitis media determining trial eligibility, short periods of follow-up, and substantial attrition of participants. Official recommendations regarding tympanostomy-tube placement for children with recurrent acute otitis media differ — an otolaryngologic guideline recommends the procedure for children with recurrent acute otitis media, provided that middle-ear effusion is present in at least one ear; a contemporaneous pediatric guideline discusses tympanostomy-tube placement as an “option [that] clinicians may offer.”
Given these uncertainties, we undertook the present trial involving children 6 to 35 months of age who had a history of recurrent acute otitis media to determine whether tympanostomy-tube placement, as compared with medical management (comprising episodic antimicrobial treatment, with the option of tympanostomy-tube placement in the event of treatment failure), would result in a greater reduction in the children’s rate of recurrence of acute otitis media during the ensuing 2-year period.
Dr. Andersson[/caption]
Niklas Worm Andersson, MD
Department of Epidemiology Research
Statens Serum Institut,
Copenhagen Denmark
MedicalResearch.com: What is the background for this study?
Response: "Findings from some previous fetal safety studies on topical corticosteroid use in pregnancy have raised concerns for an increased risk of newborns being small for gestational age or having low birth weight, in particular among pregnancies where larger amounts of potent to very potent agents have been used."
Prof. Papageorghiou[/caption]
Aris Papageorghiou MBChB, MRCOG
Professor of Fetal Medicine and the Clinical Research Director
Oxford Maternal and Perinatal Health Institute
University of Oxford
MedicalResearch.com: What is the background for this study?
Response: Our study was really guided by a key question: does Covid-19 in pregnancy increase the risk of adverse maternal and neonatal outcomes as compared with pregnant women who do not have the infection?
The question is highly relevant because of the known deleterious effects of other coronavirus infections in pregnancy, e.g. SARS (severe acute respiratory syndrome) and MERS-CoV (Middle East respiratory syndrome coronavirus).
In order to answer this question we undertook this multinational cohort study.
Prof. Monsonego Ornan[/caption]
Efrat Monsonego Ornan, Ph.D
Head of School of Nutritional Sciences
Institute of Biochemistry and Nutrition
The Robert H. Smith Faculty of Agriculture,
Food and Environment
The Hebrew University of Jerusalem
MedicalResearch.com: What is the background for this study?
Response: Food supplies in recent decades have been dominated by heavily processed, ready-to-eat products. Essentially, 75% of all world food sales are of processed foods. Over the past 30 years, children’s ultra-processed food intake has increased markedly, with 50% of the children in the US consuming these foods. Only in the US does UPF comprise 58% of energy intake, of which 90% is derived from added sugars. This reflects children’s excessive consumption of food and drink that are high in fat and refined sugars but do not provide appropriate levels of the proteins, vitamins and minerals required for growth.
The negative health outcomes of excessive consumption of Ultra-processed food are well known, include obesity, metabolic syndrome and diabetes, and considered as the current world epidemic; the fact that children, during their postnatal development period (birth to adolescent), are the target of the Ultra-processed food industry is very disturbing in terms of public health. Bone development and growth are the characteristic phenomena of the childhood period. Yet, in spite of the huge importance of nutrition to bone development, the impact of Ultra-processed food consumption on skeleton development during childhood has never been studied directly, and this was the purpose of our study.
To this end, we used young rats which are an excellent pre-clinical model for growth and fed them with either the recommended diet for their age or a diet comprised of a typical Ultra-processed meal (a roll, hamburger, tomatoes, lettuce, ketchup and French fries) and a caloric soft drink. 
Dr. Bullard[/caption]
Jared Bullard MD FRCPC
Associate Professor, Departments of Pediatrics & Child Health and Medical Microbiology & Infectious Diseases
Max Rady College of Medicine
Rady Faculty of Health Sciences
Cadham Provincial Laboratory
Children’s Hospital Research Institute of Manitoba
MedicalResearch.com: What is the background for this study?
Response: Children are well known to transmit epidemic/endemic respiratory viruses like influenza. Initial public health policy was based on that children were likely to transmit SARS-CoV-2 effectively within a community and subsequently in-person school and extracurricular activities were suspended.
Initial research did not show a clear association with children driving transmission. The purpose of our study was to take respiratory samples from both children and adults with COVID-19 (all had SARS-CoV-2 detected by RT-PCR) and compare those samples by their ability to grow in cell culture and amount of virus in samples.
We took 175 samples from children (97 younger than 10 years of age and 78 between 11-17 years) and compared them to 130 adult samples from the same communities in Manitoba experiencing outbreaks of COVID-19. 
Dr. Bunik[/caption]
Maya Bunik, MD, MPH | Professor, Pediatrics
Medical Director, Child Health Clinic, Primary Care | Breastfeeding Management Clinic
Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS)
School of Medicine| University of Colorado Anschutz Medical Campus
Children's Hospital Colorado
MedicalResearch.com: What is the background for this study?
Response: Marijuana legalization has been increasing in the United States, with increasing consumption of marijuana products. Currently, the American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG) and Academy of Breastfeeding Medicine (ABM) do not recommend marijuana use during pregnancy or lactation due to concerning though limited data on the effects of perinatal marijuana exposure.
As there has been increasing prevalence of women using marijuana during pregnancy due to legalization and perceptions of safety, we sought to determine the duration of THC excretion in breast milk among women who had evidence of marijuana use at delivery and abstained post-partum. 
Jill Sommerville[/caption]
Jill Sommerville M.Sc
Director of Medical at WaterWipes
MedicalResearch.com: What is the background for this study? How prevalent is diaper dermatitis? Is it more severe in some babies?
Response: The Utah study is an independent clinical study conducted by the University of Utah Hospital NICU, Salt Lake City and recently published in Advances in Neonatal Care journal. It was a year-long study conducted between January 2018 – March 2019. The NICU staff were interested in exploring a new Perineal Skin Care Guideline in their unit, encompassing use of WaterWipes, to decrease the incidence of diaper dermatitis. Their stated aim was to reduce diaper dermatitis by 20% within a 1-year period. The study involved 1,070 premature babies, 11% of which were born at less than 30 weeks of gestational age. The inclusion criteria for the study were all babies who stayed for more than 1 day in the NICU.
Diaper dermatitis is known to cause discomfort and emotional distress in all babies and can be a possible source of infection among NICU babies. Diaper dermatitis remains prevalent, especially in preterm babies. The reported incidence varies from 21% to 25% among newborn intensive care babies. 1
Diaper dermatitis in pre term babies can be multifactorial especially as babies born early have a less well developed stratum corneum, the outer most layer of skin. NICU babies are often exposed to antibiotics and fortified milk to help them catch up growth. Other medical complications in addition can lead to altered gut flora and altered stool composition resulting in more frequency of stool.
The presence of urine and frequent stools necessitates regular cleaning which can result in excessive rubbing of the skin or the use of wipes containing harsh ingredients that can damage the skin.
Dr. Master[/caption]
Christina L. Master, MD, FAAP, CAQSM, FACSM
Professor of Clinical Pediatrics
Perelman School of Medicine at the University of Pennsylvania
Co-Director, Minds Matter Concussion Program
Pediatric and Adolescent Sports Medicine, Division of Pediatric Orthopedics
Attending Physician, Care Network - Karabots Center
The Children's Hospital of Philadelphia
Philadelphia, PA 19104
MedicalResearch.com: What is the background for this study?
Response: There have been multiple studies investigating potential sex differences in outcomes from concussion which have sometimes had conflicting results with some studies indicating that females take longer to recover than males and some studies reporting no difference in recovery between females and males, with most of these studies being conducted either retrospectively or prospectively in smaller cohorts. This large-scale multi-center prospective study in collegiate athletes provided an opportunity to compare females and males across comparable sports to examine both potential intrinsic or biologic factors (sex differences) or extrinsic (environmental or gender differences) that contribute to outcomes.
Dongmei Li, Ph.D.[/caption]
Dongmei Li, Ph.D., Associate Professor
Clinical and Translational Science Institute
University of Rochester Medical Center
MedicalResearch.com: What is the background for this study?
Response: Previous animal and human studies have found that nicotine exposure could harm adolescents’ brain development and impact their cognitive functions. Electronic cigarettes, which have become very popular among youth in the US in recent years, usually contain nicotine at equivalent or possibly higher levels than traditional tobacco cigarettes. Thus, it is reasonable to assume that vaping might be associated with self-reported cognitive complaints.
MedicalResearch.com: What are the main findings?
Response: Main findings from our study are:
