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AHA Journals, Author Interviews, Cost of Health Care, Gender Differences, Heart Disease, Social Issues / 19.10.2016

Both Men and Women Can Face Financial Barriers After Heart Attack

MedicalResearch.com Interview with: Adam L. Beckman Yale College, New Haven, CT (at the time this work was completed) Erica S Spatz MD MHS Assistant Professor, Section of Cardiovascular Medicine Center for Outcomes Research and Evaluation Yale-New Haven Hospital Yale University School of Medicine MedicalResearch.com: What is the background for this study? Beckman: Despite the expansion of insurance coverage, young adults face major challenges to obtaining affordable healthcare. We suspected women may experience greater challenges than men — they often have lower income and less complete medical coverage than men, and care for multiple generations of family, and that this may in part explain why young women have worse outcomes following a heart attack as compared with similarly-aged men. (more…)

Author Interviews, Pediatrics, Social Issues / 14.10.2016

Impact of Two Adolescent Pregnancy Prevention Interventions on Risky Sexual Behavior

MedicalResearch.com Interview with: Anita P. Barbee, MSSW, Ph.D. Professor and Distinguished University Scholar President-Elect, International Association for Relationship Research Kent School of Social Work University of Louisville Louisville, KY 40292 MedicalResearch.com: What is the background for this study? Response: In 2010, our team at the University of Louisville with colleagues from Spalding University, were awarded a Tier 2 grant from the Office of Adolescent Health to study innovative teen pregnancy prevention interventions. We assembled a fantastic team of staff, students, community members and twenty three community based organizations to work together collaboratively to recruit and retain close to 1450 youth from the most distressed areas of our metropolitan area in order to conduct a randomized controlled trial. We tested the efficacy of two interventions compared to a control condition. Our reason for this was to see how a new type of teen pregnancy intervention would perform compared to a more typical comprehensive sex education program, Reducing the Risk, which was already on the OAH list of evidence based interventions as well as to a control condition, which focused on community building but had no content on personal self esteem building, healthy relationships, dating violence or sexuality. The new program that was tested was Love Notes. Love Notes is a healthy relationship curriculum that addresses the context of sexual exploration as well as key points in preventing problematic outcomes of sexual activity such as the spread of disease, pregnancy and emotional heartache. The groups of youth that continue to have high rates of pregnancy tend to be disconnected from society through poverty and discrimination (minority and poor youth) or from family as a result of leaving home countries (refugees and immigrants), being removed from their homes due to child abuse or neglect (foster youth) or being rejected from families due to their LGBTQ orientations. (more…)

Author Interviews, JAMA, Nutrition, Social Issues / 21.09.2016

Combination of Restrictions and Incentives May Lead To Better Food Choices By SNAP Beneficiaries

MedicalResearch.com Interview with: Lisa Harnack, DrPH, RD | Professor and Director Nutrition Coordinating Center Division of Epidemiology and Community Health School of Public Health, University of Minnesota Minneapolis, MN 55454-1087 MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is interest in considering ways to reshape SNAP so that it better meets meet its objective to help families buy the food they need for good health. Prohibiting the purchase of foods such as soft drinks with SNAP benefits is one of the proposed program changes. Offering an incentive for the purchase of fruits and vegetables is another program change that is being discussed. Little is known about the effects of prohibitions and restrictions on food purchasing and consumption. Consequently, we carried out an experimental trial to evaluate effects. In our study we found that a food benefit program that includes both prohibitions on the purchase of less nutritious foods and incentives for purchasing nutritious foods may lead to a number of favorable changes in diet. To elaborate, we found those enrolled in a food benefit program that prohibited the purchase of sugar sweetened beverages, sweet bakes goods, and candies with food program benefits and provided a 30% financial incentive for fruit and vegetable purchases had a number of favorable dietary changes that were significantly different from changes among those enrolled in a food benefit program that had neither prohibitions or incentives. These favorable changes included reduced consumption of calories, sugar sweetened beverages, sweet baked goods, and candies; and increased consumption of fruit. The overall nutritional quality of the diet also improved. Fewer nutritional improvements were observed among those enrolled in food benefit programs that included prohibitions or incentives only. (more…)

Author Interviews, Diabetes, Social Issues, Weight Research / 16.09.2016

Socio-Economic Factors Influence Genetic Tendency Toward Obesity

MedicalResearch.com Interview with: Professor Timothy Frayling PhD Professor of Human Genetics University of Exeter Medical School Exeter, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that genes and environmental factors influence our Body mass index. We know less about if and how they interact. We wanted to answer the question of whether or not aspects of the environment and our lifestyles accentuate any genetic predisposition to obesity. The question is important as it may highlight aspects of the environment that cause some people to be particularly susceptible to gaining weight. Previous, separate, studies have suggested that specific aspects of the environment are to blame. These included sugary drinks, fried food and TV watching. (more…)

Author Interviews, Duke, Medical Imaging, MRI, PLoS, Psychological Science, Social Issues / 15.09.2016

Brain Scans Can Predict Specific Spontaneous Emotions

MedicalResearch.com Interview with: Kevin S. LaBar, Ph.D. Professor and Head, Cognition & Cognitive Neuroscience Program Co-Director of Undergraduate Studies in Neuroscience Center for Cognitive Neuroscience Duke University Durham, NC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Emotion research is limited by a lack of objective markers of emotional states. Most human research relies on self-report, but individuals may not have good insight into their own emotions. We have developed a new way to identify emotional states using brain imaging and machine learning tools. First, we induced emotional states using film and music clips while individuals were in an MRI scanner. We trained a computer algorithm to identify the brain areas that distinguished 7 emotions from each other (fear, anger, surprise, sadness, amusement, contentment, and a neutral state). This procedure created a brain map for each of the 7 emotions. Then, a new group of participants self-reported their emotional state every 30 seconds in an MRI scanner while no stimuli were presented. We could predict which emotion was spontaneously reported by the subjects by comparing their brain scans to each of the 7 emotion maps. Finally, in a large group of 499 subjects, we found that the presence of the fear map during rest predicted state and trait anxiety while the presence of the sadness map predicted state and trait depression. (more…)

Author Interviews, JAMA, Pediatrics, Social Issues, UCSF / 12.09.2016

Low-Intensity Interventions Addressing Social Needs In Pediatric Settings Can Improve Child Health

MedicalResearch.com Interview with: Laura M. Gottlieb, MD, MPH Department of Family and Community Medicine, 2Center for Health and Community University of California, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: Numerous studies have demonstrated that childhood exposures to social adversities, like family financial insecurity, food insecurity, and housing instability, lead to poorer health outcomes across the life course. These social adversities disproportionately affect low-income and racial minority populations. In response to this evidence there have been calls to address social needs in pediatric clinical care settings. For example, recently the American Academy of Pediatrics’ Task Force on Childhood Poverty endorsed the promotion of evidenced-based strategies to reduce the negative health effects of poverty on low-income children, including by increasing the availability of clinic-based interventions addressing social risks. In response to these calls to action, a growing number of pediatric health care organizations are screening for and address families’ social needs. There is a critical need for more evidence on the effectiveness of these types of interventions. Many of the studies conducted so far have focused primarily on assessing program process outcomes or impacts on families’ social needs, but have not evaluated actual health outcomes resulting from program participation. To our knowledge, this study was the first randomized clinical trial evaluating the impacts of a pediatric social needs navigation program on child health. The reported number of social needs identified at baseline ranged from 0 to 11 out of 14 possible items, with a mean [SD] of 2.7[2.2] needs identified by participating families. Family participation in the navigation program intervention significantly decreased families’ reports of social needs by a mean (SE) of .39(0.13) vs. an increase of a mean (SE) of .22(0.13) in the active control arm. Participation in the navigation program also significantly improved parent-reported overall child health, with a mean (SE) change of -.036(0.05), compared to the active control arm with a mean (SE) change of -0.12(0.05). At 4 months post enrollment, the number of social needs reported by those that participated in the navigation program decreased by a mean (SE) of .39(0.13). (more…)

Author Interviews, Social Issues / 19.08.2016

Can Bartenders Have ‘Normal’ Home and Family Lives?

MedicalResearch.com Interview with: Emily H. Starr, M.A. Doctoral Candidate City, Culture, & Community Tulane University, New Orleans MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study examines the relationship between work, partnering, and parenthood through the perspectives of bartenders working in the New Orleans metro area. Bartenders frame work, intimate relationships, and family as interlocking matrices and view their lack of legitimate work (or their lack of a normative 9-5 job with security, benefits, and a salary) as a prohibitive or complicating factor in their ability to assume the roles of partner and parent. Some of the fastest growing segments of the U.S. labor market are low-wage and low-skill jobs meaning that young people will increasingly grapple with hegemonic "white picket fence" ideologies that prescribe certain family forms and occupational/labor relationships as ideal. Moreover, the matrices of performative adulthood are gendered with women and men framing their work as incompatible with family life for different reasons. Women more often experience sexual harassment/objectification, feel their skills and abilities are called into question, and perceive that women bartenders are marginalized as "certain types of women." These perceptions lend themselves towards women bartenders framing barwork as incompatible or undesirable with mothering. Men express anxiety about their long-term earning potential and combating the stigma of low-status work through the professionalization of the craft cocktail and spirits industry. Thus, men are more concerned about their role as breadwinner rather than viewing bartending and fatherhood roles as mutually-exclusive. These findings suggest that bartenders draw upon dominant ideologies of normative adulthood and invoke traditional gender roles to frame their perspectives about bartending and family life. Importantly, the contours and realities of their working lives are the prohibitive factor in bartenders' perspectives about the possibility for participating in long-term intimate relationships and parenthood. (more…)

Author Interviews, Dermatology, JAMA, OBGYNE, Sexual Health, Social Issues, UCSF / 29.06.2016

Genital Grooming a Cultural Phenomenon Among Younger, White and Educated Women

MedicalResearch.com Interview with: Tami Rowen MD MS Obstetrics, Gynecology and Reproductive Sciences UCSF MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study sought to answer the question of which women are engaging in genital grooming and understand their motivations. Prior studies have been limited by geography and age thus our goal was to provide a nationally representative sample of women. (more…)

Author Interviews, OBGYNE, Pediatrics, Social Issues / 17.06.2016

Higher Minimum Wage Associated With Fewer Small Babies and Neonatal Deaths

MedicalResearch.com Interview with: Kelli A. Komro, MPH, PhD, Professor Director of Graduate Studies Behavioral Sciences and Health Education Jointly Appointed, Epidemiology Rollins School of Public Health Emory University Atlanta, GA 30322 MedicalResearch.com: What is the background for this study? Dr. Komro: Epidemiologists have done a thorough job describing the income-health gradient, which shows a clear association between income and health. That is, as income increases, exposure to health risks and premature mortality decreases. Each step down on the income ladder decreases one’s health for many reasons related to material resources, physical environment exposures and social circumstances. The income to health association begins at birth, and more than one in four women giving birth in the U.S. are below the poverty level, putting nearly 1 million babies at risk each year. Low-income mothers are more likely to give birth prematurely, to have low birth weight babies, and to suffer the death of their infant during the post-neonatal period (28 to 364 days old). Given the importance of the income-health gradient, we set out to test the health effects of policies that are designed to increase economic security among low-income families. Our main question is: Do policies designed to reduce poverty and improve family economic security also improve health? One relevant policy is minimum wage laws. A federal minimum wage was first enacted in 1938. The real value (in 2015 dollars) of the federal minimum wage reached a high of $10.85 in 1968. The current federal rate is $7.25. Many cities and states have passed minimum wage laws that are higher than the federal rate, and currently there is a range of minimum wage increases under active public and policymaker discussion. Given that some states pass minimum wage standards and others do not, and that laws within states change over time, we took advantage of all the changes that have occurred to design a natural experiment. Our natural experiment examined the effects of state minimum wage laws on infant health. (more…)

Author Interviews, Mental Health Research, Pediatrics, Social Issues / 27.05.2016

Father’s Lengthy Work Commute Linked to Emotional Distress in Children

MedicalResearch.com Interview with: Dr. Jianghong Li, Senior Scientist (PhD) From the President’s Project Group, WZB Berlin Social Science Center (Wissenschaftszentrum Berlin für Sozialforschung GmbH: www.wzb.eu) Reichpietschufer 50, 10785 Berlin, Germany MedicalResearch.com: What is the background for this study? Dr. Jianghong Li: Commuting to work is a common phenomenon in developed countries. In the US full-time wage workers residing in urban counties on average commuted about 55 minutes to work. In the UK, workers commuted 42 minutes (round trip) for work in 2008. German workers commute 13 kilometers and 44 minutes both ways to work on average. The average daily commuting time for work in other European countries ranges from 29 minutes in Portugal to 51 minutes in Hungary. To make your commute a little easier, why not try the Moovit app with its handy tracking tools such as the metro map. Men commute longer than women to work and working fathers commute further to work than working mothers. Men who are employed full-time and with children commute longer than their counterparts without children, regardless of the age of the youngest child. Previous research has shown that long commuting to workplace is associated with reduced civic participation and social interactions, lower life satisfaction, elevated stress hormone and reduced task performance, and increased risk for marriage breakdown. Daily experiences of unreliable transport, conflicting time schedules, congested roads and crowded trains contribute to commuters’ physical and psychological stress. These health and psychosocial consequences of commuting raise a concern about its plausible negative impact on children’s well-being. Yet, there was no inquiry about the effect of commuting on children’s well-being, except one small-scale study in the US of mothers leaving welfare for employment. (more…)

Aging, Author Interviews, End of Life Care, NEJM, Social Issues / 24.05.2016

Many Caregivers Report High Levels of Depression and Loss of Control Over Their Lives

MedicalResearch.com Interview with: Jill Cameron, PhD Canadian Institutes of Health Research New Investigator Associate Professor, Department of Occupational Science and Occupational Therapy Rehabilitation Sciences Institute Faculty of Medicine, University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Cameron: In the world of critical illness, a lot of research has focused on helping people to survive – and now that more people are surviving, we need to ask ourselves, what does quality of life and wellbeing look like afterwards for both patients and caregivers? The aim of our research was to identify factors associated with family caregiver health and wellbeing during the first year after patients were discharged from the Intensive Care Unit. We examined factors related to the patient and their functional wellbeing, the caregiving situation including the impact it has on caregivers everyday lives, and caregiver including their sense of control over their lives and available social support. We used Pearlin’s Caregiving Stress Process model to guide this research. From 2007-2014, caregivers of patients who received seven or more days of mechanical ventilation in an ICU across 10 Canadian university-affiliated hospitals were given self-administered questionnaires to assess caregiver and patient characteristics, caregiver depression symptoms, psychological wellbeing, and health-related quality of life. Assessments occurred seven days and three, six and 12-months after ICU discharge. The study found that most caregivers reported high levels of depression symptoms, which commonly persisted up to one year and did not improve in some. Caregiver sense of control, impact on caregivers’ everyday lives, and social support had the largest relationships with the outcomes. Caregivers’ experienced better health outcomes when they were older, caring for a spouse, had higher income, better social support, sense of control, and caregiving had less of a negative impact on their everyday lives. No patient characteristics or indicators of illness severity were associated with caregiver outcomes. Poor caregiver outcomes may compromise patients’ rehabilitation potential and sustainability of home care. Identifying risk factors for caregiver distress is an important first step to prevent more suffering and allow ICU survivors and caregivers to regain active and fulfilling lives. (more…)

Author Interviews, Sexual Health, Social Issues / 26.04.2016

When It Comes To Sexual Satisfaction Between Partners, Gut-Level Responses May Be Most Accurate

MedicalResearch.com Interview with: Lindsey Hicks Doctoral Student Social Psychology Florida State University MedicalResearch.com: What is the background for this study? What are the main findings? Response: My colleagues and I are very interested in the factors that differentially predict peoples’ self-reported relationship satisfaction and their gut-level feelings about their partners—the spontaneous feelings they have and may not articulate. Because explicit self-reports require conscious deliberation they are subject to the influence of biases and beliefs about relationships; gut-level, automatic attitudes do not require conscious deliberation and thus appear to better track actual experience. With that in mind, we examined whether sexual frequency influences automatic but not explicit evaluations of the partner. Previous research has yielded inconsistent results regarding the influence of sexual frequency on relationship satisfaction, and we thought such inconsistencies may stem from the influence of deliberate reasoning and biased beliefs regarding the sometimes taboo topic of sex. Thus, we tested the association between partners’ sexual frequency and their gut-level feelings about each other. Basically we found that the frequency with which couples have sex has no influence on whether or not they report being happy with their relationship, but their sexual frequency does influence their more spontaneous, automatic, gut-level feelings about their partners. This is particularly important in light of previous research done by my colleagues demonstrating that it these automatic attitudes ultimately predict whether or not they’ll end up becoming dissatisfied with their relationship. (more…)

Author Interviews, JAMA, Pediatrics, Social Issues / 05.04.2016

Street Children Report Poverty, Family Conflict, and Abuse as Reasons For Their Homelessness

MedicalResearch.com Interview with: Paula Braitstein, PhD Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Department of Medicine, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis Regenstrief Institute Inc, Indianapolis, Indiana MedicalResearch.com: What is the background for this study? Dr. Braitstein: There are vast numbers of children and youth in the world who find themselves in street circumstances. Yet, there is an absence of consensus among academics, policymakers, stakeholders, and international organizations regarding the causes of child and youth street-involvement around the world. Without data concerning these reasons, policies are developed or implemented to mitigate street-involvement without taking these causes into account. Often, the prevailing paradigm assumes that children and youth on the street are juvenile delinquents and the government response is often characterized by social exclusion, criminalization, and oppression by police and civic authorities. Therefore we wanted to find out what reasons do children and youth self-report for their street-involvement globally. MedicalResearch.com: What are the main findings? Dr. Braitstein: We systematically reviewed the literature and compiled data from 49 studies representing 24 countries globally. Street-connected children and youth most frequently reported poverty, family conflict, and abuse as their reasons for street-involvement. They infrequently identified delinquent behaviours for their circumstances. There were no significant differences between males and females reported reasons, with the exception of females in developed regions who were more likely to report abuse. (more…)

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