Author Interviews, Pediatrics, Race/Ethnic Diversity / 19.08.2020
California Infant Mortality Rate Declining But Wide Disparities Persist
MedicalResearch.com Interview with:
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Dr. Ratnasiri[/caption]
Anura Ratnasiri PhD
Senior Research Scientist
(Epidemiology and Biostatistics) Benefits Division
Department of Health Care Services
Sacramento, CA 95899-7417
MedicalResearch.com: What is the background for this study?
Response: Infant mortality rate (IMR) is a widely-reported indicator of population health and is used as a standardized measurement of deaths in the first year of life per thousand live births. While IMR has been steadily declining in the United States, it remains relatively high compared with other developed countries.
Even though significant improvements have been made in the quality and access to neonatal and infant care during the past decade, large educational, socioeconomic, racial, ethnic, geographic and behavioral disparities persist, and appear to be responsible for significant differences in IMR among different subgroups. Certain maternal and infant characteristics have important associations with IMR, and this study attempted to quantify major maternal and infant predictors, and trace associated mortality trends during the study period.
There were no recent studies on infant mortality using a large data set such as California State. Moreover, gestational age based on obstetric estimates from fetal ultrasound, prepregnancy obesity, and smoking during pregnancy were not available in prior population-based studies in California.
Dr. Ratnasiri[/caption]
Anura Ratnasiri PhD
Senior Research Scientist
(Epidemiology and Biostatistics) Benefits Division
Department of Health Care Services
Sacramento, CA 95899-7417
MedicalResearch.com: What is the background for this study?
Response: Infant mortality rate (IMR) is a widely-reported indicator of population health and is used as a standardized measurement of deaths in the first year of life per thousand live births. While IMR has been steadily declining in the United States, it remains relatively high compared with other developed countries.
Even though significant improvements have been made in the quality and access to neonatal and infant care during the past decade, large educational, socioeconomic, racial, ethnic, geographic and behavioral disparities persist, and appear to be responsible for significant differences in IMR among different subgroups. Certain maternal and infant characteristics have important associations with IMR, and this study attempted to quantify major maternal and infant predictors, and trace associated mortality trends during the study period.
There were no recent studies on infant mortality using a large data set such as California State. Moreover, gestational age based on obstetric estimates from fetal ultrasound, prepregnancy obesity, and smoking during pregnancy were not available in prior population-based studies in California.
Dr. Walline[/caption]
Jeffrey J. Walline, OD PhD
Associate Dean for Research
The Ohio State University
Columbus, OH 43210-1240
MedicalResearch.com: What is the background for this study?
Response: Greater amounts of nearsightedness are related to higher risks of sight-threatening complications in adulthood, so anything we can do to slow the progression of nearsightedness in childhood can have meaningful benefits in the future.
As the prevalence of nearsightedness increases worldwide and affects approximately 1/3 of the people in the United States, a treatment that provides clear vision AND slows the progression of nearsightedness can have a profound effect.
Dr. Heald-Sargent[/caption]
Taylor Heald-Sargent, M.D., Ph.D.
Ann & Robert H. Lurie Children’s Hospital
Chicago
MedicalResearch.com: What is the background for this study?
Response: Given the ongoing debate around the ability of children to transmit SARS-CoV-2, we noticed that our clinical data could address one of the prevalent assumptions. Some people postulated that the reason children have less severe infections with SARS-CoV-2 is because they are not able to replicate virus as much as adults and therefore may not transmit as readily. 
Alyssa M. Thompson[/caption]
Alyssa M. Thompson is currently a 2nd year medical student at the UA-COM Tucson. She graduated from the University of Arizona, Summa Cum Laude in 2018 as the athletic department's Valedictorian with a degree in Physiology and an Entrepreneurship certificate. Her passion for research and dermatology stems from her innovative and integrative mindset with specific interest in inflammatory skin disease.
MedicalResearch.com: What is the background for this study?
Response: Eczema is very common in children. Prescription medications are important for managing eczema flares, but a lot of the work in treating eczema is preventative, done by consistently moisturizing the skin at home with drug store products. Allergic contact dermatitis occurs more commonly in people with eczema. A previous study was done in characterizing the allergenic potential of drug-store moisturizers and found that 88% of moisturizers contain at least one common allergen. Many moisturizers are marketed specifically to eczema, but the allergen content of these products are unknown.
Dr. Schoch[/caption]
Jennifer Schoch, MD
Dr. Schoch is a pediatric dermatologist and
Associate Professor of Dermatology at the University of Florida.
Her research focuses on the infantile skin microbiome and its role in pediatric skin disease.
She is a member of the Society for Pediatric Dermatology.
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Dr. Perrett[/caption]
Kirsten P Perrett MD PhD
Group Leader/Clinician Scientist Fellow
Population Allergy Research Group and
Melbourne Children's Trial Centre
Murdoch Children's Research Institute
Rachel L Peters PhD
Murdoch Children’s Research Institute
Department of Paediatrics
The University of Melbourne
Parkville, Australia
MedicalResearch.com: What is the background for this study?
Dr. Dixon[/caption]
Cinnamon A. Dixon, DO, MPH
Associate Professor of Pediatrics
University of Colorado School of Medicine
Children’s Hospital Colorado
Senior Investigator | Center for Global Health
Colorado School of Public Health
Aurora, CO
MedicalResearch.com: What is the background for this commentary?
Response: Dog bites are a long-standing public health problem. Each year there are approximately 4.5 million dog bites across the Unites States (US),1 and global estimates suggest tens of millions of these injuries worldwide.2 Children are the most vulnerable population with nearly 1 million annual dog bites in the US and more severe injury outcomes.1
National organizations espouse consistent strategies on how to prevent dog bites to children, however studies reveal that most children have never received dog bite prevention education.3,4 Furthermore, children lack critical knowledge of how to prevent dog bites in high-risk “resource guarding” situations (such as when a dog is eating or chewing on toys).4
During the COVID-19 pandemic, millions of US households are experiencing restrictions in activities. Children now spend more time in the home environment and presumably have increased exposure to their pet dogs. Parents and caregivers likely experience greater stress with more potential for competing interests and resultant decreased supervision of their children and dogs. Finally, pet dogs may be affected by the increased tension of their environment and be more likely to mirror the emotions of their human caregivers.
We hypothesized that these combined elements compound the risk of dog bites to children during the COVID-19 pandemic.
Dr. Kempe[/caption]
Allison Kempe, MD, MPH
Ergen Family Endowed Chair in Pediatric Outcomes Research
Professor of Pediatrics, University of Colorado School of Medicine
Director of ACCORDS (Adult and Child Consortium for Health Outcomes Research and Delivery Science)
University of Colorado School of Medicine | Children’s Hospital Colorado
MedicalResearch.com: What is the background for this study?
Response: In 2019 the WHO designated vaccine hesitancy as one of the ten leading threats to global health. Although studies have assessed parental vaccine hesitancy in different localities and estimated vaccine refusals nationally, there is little recent US national data on the prevalence of hesitancy about routine childhood vaccines and national hesitancy rates for influenza vaccine have never been assessed. We used a hesitancy scale developed by the WHO to estimate levels of parental hesitancy for both routine childhood and childhood influenza vaccination 
Dr. Paller[/caption]
Amy S Paller, MD
Chair, Department of Dermatology
Director, Skin Biology and Diseases Resource-Based Center
Walter J. Hamlin Professor of Dermatology
Professor of Dermatology and Pediatrics (Dermatology)
Feinberg School of Medicine
Northwestern University
Dr. Paller discusses the FDA approval of Dupixent® (dupilumab) for children aged 6 to 11 years with moderate-to-severe atopic dermatitis (eczema), whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable.
MedicalResearch.com: What is the background for this announcement? Would you briefly discuss what is meant by atopic dermatitis and how it affects children?
Response: “Atopic dermatitis, the most common form of eczema, is a chronic inflammatory disease that often appears as a rash on the skin. Moderate-to-severe atopic dermatitis is characterized by rashes that can potentially cover much of the body and can include intense, persistent itching, skin lesions and skin dryness, cracking, redness or darkness, crusting and oozing. Itch is one of the most burdensome symptoms for patients and can be debilitating.
This recent FDA approval expands the use of Dupilumab in the U.S. to include children aged 6 to 11 years with uncontrolled moderate-to-severe atopic dermatitis, making it the only biologic medicine approved for this use in this population. Dupilumab is also approved in the U.S. to treat patients aged 12 years and older with moderate-to-severe atopic dermatitis.
Moderate-to-severe atopic dermatitis can place a particularly substantial burden on young children aged 6 to 11 years and their families. Limited treatment options leave many of these children to cope with intense, unrelenting itch and skin lesions. Families of these children can spend countless hours helping them to manage their disease.”
Dr. Garstang[/caption]
Dr Joanna Garstang
Consultant Community Paediatrician / Designated Doctor for Child Death
Allenscroft Children's Centre
Kings Heath, Birmingham UK
MedicalResearch.com: What is the background for this study?
Response: Each year in England and Wales there around 3-400 babies die unexpectedly, in many cases the cause of death remains unexplained and these deaths are called Sudden Infant Death Syndrome (SIDS). Parents are understandably anxious about the risks for future children, the Care of Next Infant (CONI) programme was set up to offer support for families. In this study, we looked at records of families registered with CONI between 2000-2015 to determine the frequency and causes for repeat unexpected infant deaths.
Dr. Travers[/caption]
Colm Travers, M.D., MSPH
Assistant Professor
Department of Pediatrics
University of Alabama at Birmingham
MedicalResearch.com: What is the background for this study?
Response: It is known that black mothers are much more likely to deliver preterm and low birth weight infants. The purpose of this study was to determine whether racial/ethnic disparities in care practices and outcomes were decreasing or increasing among extremely preterm infants.
These are infants born from 22 to 27 weeks of gestation who have a high risk of death and major illnesses. 
Dr. Kao-Ping Chua[/caption]
Kao-Ping Chua, M.D., Ph.D.
Assistant Professor, Pediatrics, Medical School
Susan B. Meister Child Health Evaluation and Research Center
University of Michigan
MedicalResearch.com: What is the background for this study?
Response: Due to high and rising prices, insulin has become increasingly unaffordable for patients with type 1 diabetes who must pay out-of-pocket for this life-saving medication. Over the past 5 months, many states and insurers have taken steps to cap insulin out-of-pocket spending. For example, Cigna imposed a $25 monthly cap earlier this year. This week, the Centers for Medicare and Medicare Services announced a $35 monthly cap for many Medicare Part D beneficiaries.
Dr. Tandon[/caption]
Pooja S. Tandon, MD, MPH
Center for Child Health, Behavior and Development
Seattle Children's Research Institute
MedicalResearch.com: What is the background for this study?
Response: Cell phone use is common among middle and high school students, yet we do not have an understanding of school cell phone policies and practices in the U.S. We conducted a survey of public schools serving grades 6-12. The survey sent to over 1,100 school principals, representing a national sample of schools across the U.S., asked questions about the presence of a cell phone policy for students and staff and restrictions on phone use. Additional questions addressed consequences of policy violation, the use of cell phones for curricular activities and principals’ attitudes toward cell phone policies.
Barbara Chaiyachati, MD PhD
SafePlace: The Center for Child Protection and Health
Division of General Pediatrics
The Children’s Hospital of Philadelphia,
Center for Pediatric Clinical Effectiveness
University of Pennsylvania
Philadelphia, Pennsylvania
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Children in foster care have high rates of medical problems including chronic diseases. There is less known about the differences in mortality for children in foster care.
Looking at national data from 2003 to 2016, this study finds that children (ages 1 to 18) in foster care have higher mortality compared to children in the general population and that the difference in mortality has increased over time. 
