Author Interviews, Education, NYU, Pediatrics, Pediatrics, Social Issues / 05.02.2016

MedicalResearch.com Interview with: Alan Mendelsohn, MD Associate professor, Departments of Pediatrics and Population Health Adriana Weisleder, PhD Research scientist, Department of Pediatrics NYU Langone Medical Center Medical Research: What is the background for this study? What are the main findings? Response: In the last decade, scientists have begun to understand the mechanisms by which poverty can cause changes in brain development that can lead to higher rates of behavior problems and lower educational achievement for disadvantaged children. This study shows that pediatric-based programs that promote reading aloud and play can help prevent these problems before they arise. The Video Interaction Project (VIP) – the main program studied in the research – takes place at regular pediatric check-ups starting at birth. A trained parenting coach meets with the family at each visit and records the parent and child playing and reading together with materials provided by the program. The coach then reviews the video with the parent to identify and reinforce positive interactions and encourage strong parent-child relationships. The second intervention program, Building Blocks, is a lower-intensity option in which families receive parenting pamphlets and learning materials monthly by mail to facilitate reaching specific developmental goals. The results of the three-year randomized-controlled trial showed notable benefits for children’s social and emotional development. Children of families who participated in the Video Interaction Project had better attention and play skills as toddlers and reduced hyperactivity and aggression at three years, compared to children in a control group. For the highest risk families, hyperactivity was reduced by more than half.  These findings are important because a child’s ability to control or regulate his or her behavior is a critical factor in their learning and success at school. (more…)
Author Interviews, Emergency Care, Social Issues / 29.01.2016

MedicalResearch.com Interview with: Jessica Moe MD, MA, PGY4 FRCPC Emergency Medicine MSc (Candidate) Clinical Epidemiology RCPS Emergency Medicine Residency Program University of Alberta Edmonton, Alberta Medical Research: What is the background for this study? What are the main findings? Dr. Moe: Patients who leave the emergency department (ED) prior to completing their care account for a substantial number of annual visits; some of these patients are at high medical risk. We used the National Hospital Ambulatory Medical Care Survey from 2009-2011 to examine a nationally representative sample of patients who left the ED prior to completing care. Our work suggests that, among patients who leave the ED prematurely, the degree of medical risk may be related to whether or not these patients saw a medical professional prior to leaving the ED. Patients who leave prior to medical evaluation are generally younger and present with lower acuity visits, whereas patients who leave after medical evaluation tend to be older, are more likely to arrive by ambulance and have higher acuity visits. (more…)
Author Interviews, Cancer Research, Colon Cancer, Cost of Health Care, JAMA, Social Issues, University of Michigan / 23.12.2015

MedicalResearch.com Interview with: Christine Veenstra MD Clinical Lecturer, Internal Medicine Medical Oncology University of Michigan Ann Arbor, MI  48109-5343 MedicalResearch: What is the background for this study? What are the main findings? Dr. Veenstra: Patients with cancer face many costs and incur financial burden as they go through diagnosis and treatment. For working patients, cancer diagnosis and treatment may come with the additional burden of time away from work, lost income, and even long-term job loss. Although 40% of US workers do not have access to paid sick leave, we hypothesized that availability of paid sick leave could reduce the need to take unpaid time away from work during cancer treatment and might therefore be associated with job retention and reduced personal financial burden. In a survey of over 1300 patients with Stage III colorectal cancer, we found that only 55% of those who were employed at the time of their cancer diagnosis retained their jobs. Working patients with paid sick leave were nearly twice as likely to retain their jobs compared with working patients who did not have paid sick leave. This held true even when controlling for income, education and health insurance. Furthermore, working patients without paid sick reported significantly higher personal financial burden than those who had paid sick leave available. (more…)
Author Interviews, Emory, Race/Ethnic Diversity, Social Issues / 22.12.2015

MedicalResearch.com Interview with: Abigail Sewell PhD Assistant Professor of Sociology Emory University Medical Research: What is the background for this study? Dr. Sewell: Ethnoracial minorities report poorer quality of care than do whites. However, one key dimension of health care quality - trust in one's personal physician - indicates mixed associations with race. This study examines five dimensions of the patient-physician relationship independently of each other to identify the aspects of health care where minorities feel most alienated from their doctors. Medical Research: What are the main findings? Dr. Sewell: The results of the study show that Blacks and Latinos are less likely to believe that their doctors really care about them as a person than are Whites. (more…)
AHA Journals, Author Interviews, Duke, Exercise - Fitness, Heart Disease, Social Issues / 18.11.2015

MedicalResearch.com Interview with: Lauren Cooper, MD Fellow in Cardiovascular Diseases Duke University Medical Center Duke Clinical Research Institute Medical Research: What is the background for this study? Dr. Cooper: The HF-ACTION study, published in 2009, showed that exercise training is associated with reduced risk of death or hospitalization, and is a safe and effective therapy for patients with heart failure and reduced ejection fraction. Subsequently, Medicare began to cover cardiac rehabilitation for patients with heart failure. However, many patients referred to an exercise training program are not fully adherent to the program. Our study looked at psychosocial reasons that may impact participation in an exercise program. Medical Research: What are the main findings? Dr. Cooper: We found that patients with higher levels of social support and fewer barriers to exercise exercised more than patients with lower levels of social support and more barriers to exercise. And patients who exercised less had a higher risk of cardiovascular death or heart failure hospitalization compared to patients who exercised more. (more…)
Author Interviews, Kidney Disease, Social Issues / 10.11.2015

MedicalResearch.com Interview with: Dr. Rachael Morton, PhD Associate Professor Director of Health Economics, NHMRC Clinical Trials Centre The University of Sydney, Sydney Australia Medical Research: What is the background for this study? Dr. Morton: Household income was measured at baseline and study end among participants with moderate to severe chronic kidney disease (CKD), randomized into the Study of Heart and Renal Protection (SHARP).Household poverty was defined as <50% of the median household income for the participating country. (more…)
Author Interviews, Nutrition, Social Issues / 03.11.2015

MedicalResearch.com Interview with: Meg Bruening, PhD, MPH, RD Assistant Professor Arizona State University School of Nutrition and Health Promotion College of Health Solutions Phoenix, AZ 85004 Medical Research: What is the background for this study? What are the main findings? Dr. Bruening: Food insecurity is understudied in college populations, particularly college freshmen. We saw that over 1/3 of our population of freshmen living in dorms reported inconsistent access to healthy foods. Students who were food insecure reported higher odds of anxiety and depression (by almost 3-fold), and were less likely to eat breakfast and eat home cooked meals. (more…)
Author Interviews, OBGYNE, Social Issues / 03.11.2015

MedicalResearch.com Interview with: Susan Cha, PhD Division of Epidemiology Department of Family Medicine and Population Health School of Medicine Virginia Commonwealth University Richmond, VA  Medical Research: What is the background for this study? What are the main findings? Dr. Cha: We used data from the 2006-2010 National Survey of Family Growth to evaluate the association between couple pregnancy intentions and rapid repeat pregnancy (RRP) in women. Results indicated that the odds of RRP was primarily influenced by paternal rather than maternal desire for pregnancy. For instance, couples where the father intended the pregnancy but not the mother were 2.5 times as likely to have rapid repeat pregnancy than couples who both intended their pregnancy. Furthermore, more than 85% of women in the study reported no contraceptive use between pregnancies. (more…)
Author Interviews, JAMA, Social Issues / 16.10.2015

Joseph M. Unger, PhD MS Assistant Member Fred Hutchinson Cancer Research Center Seattle, WAMedicalResearch.com Interview with: Joseph M. Unger, PhD MS Assistant Member Fred Hutchinson Cancer Research Center Seattle, WA Medical Research: What is the background for this study? What are the main findings? Response: In a prior study, we identified patient-level income as an important predictor of clinical trial participation. Because this was one of many demographic and socioeconomic factors that we examined, we sought to confirm the finding in this new study using prospective data. Again, we found that patient-level income predicted clinical trial participation. Patients with household income <$50,000/year had a 32% lower odds of participating in clinical trials than patients with household income >$50,000/year. This confirmed our previous observation and provided strong evidence that the observation of income disparities in clinical trial enrollment is valid. (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…)
Author Interviews, Social Issues / 27.08.2015

Juliana Schroeder PhD, Assistant Professor Berkeley Haas Management of Organizations Group University of California at BerkeleyMedicalResearch.com Interview with: Juliana Schroeder PhD, Assistant Professor Berkeley Haas Management of Organizations Group University of California at Berkeley Medical Research: What is the background for this study? What are the main findings? Dr. Schroeder: Whereas much research examines how physicians perceive their patients,in this paper we instead study how patients perceive physicians. We propose that patients consider their physicians like personally emotionless “empty vessels:” The higher is individuals’ need for care, the less they value physicians’ traits related to physicians' personal lives (e.g., self-focused emotions) but the more they value physicians’ traits relevant to patient care (e.g., patient-focused emotions). ​In a series of experiments,we show that participants in higher need for care believe their physicians have less personal emotions. That is, they perceive physicians as emotionally "empty" the more they need them. This was true both when we manipulated need for care - for example, by having participants focus on potential medical problems or reminding them they needed to get a medical check-up - and also when we measured it, for example by comparing patients at a medical clinic (high need) to people not at a clinic (low need). (more…)
Author Interviews, Social Issues / 27.08.2015

Asmir Gračanin, PhD Tilburg University Department of Medical and Clinical Psychology & Department of Communication and Information Sciences Tilburg The NetherlandsMedicalResearch.com Interview with: Asmir Gračanin, PhD Tilburg University Department of Medical and Clinical Psychology & Department of Communication and Information Sciences Tilburg The Netherlands Medical Research: What is the background for this study? What are the main findings? Dr. Gračanin: Background for this study are primarily the results from previous paper and pencil studies in which people (retrospectively) claimed that crying made them feel better, which also corresponds to popular cultural beliefs. The remaining background were the results from lab studies that showed mood decreases immediately following crying episodes that were typically induced by emotional films. So, as you can see in both cases background is quite devoid of any theory, but it represented enough motivation to try to see what is really happening here. In addition, human tears are surprisingly understudied and we do not know exactly what is their function, so any research that looks for their intra-individual as well as inter-individual functions is badly needed. In this laboratory study we found that those individuals that cried felt much worse immediately after crying (which corresponds to previous lab studies), but their mood recovered surprisingly quickly (new finding), and finally it went even above the initial levels, that is, they felt even a bit better than before the emotional film that made them cry (corresponds to previous retrospective but not lab studies). No mood changes were observed in those that did not cry. Therefore, it seems that there is something to the popular belief that crying makes one feel better. However, we suspect that people could misinterpret that large mood improvement, which appears just necessarily after the initial mood deterioration, as a general mood improvement. So it is a strong return to initial mood levels that people could experience as a relief. In addition, we did observe a general mood improvement as well, although this effect was quite small. Thus, if there is general positive effect of crying on one's mood, it seems to take more time. This is the first such laboratory finding. (more…)
Author Interviews, JAMA, Social Issues / 26.08.2015

Adi V. Gundlapalli, MD, PhD Associate Professor of Internal Medicine University of Utah School of Medicine and University of Utah Hospitals and ClinicsInformatics, Decision Enhancement, and Analytic Sciences Center VA Salt Lake City Health Care System, Salt Lake City, Utah MedicalResearch.com Interview with: Adi V. Gundlapalli, MD, PhD Associate Professor of Internal Medicine University of Utah School of Medicine and University of Utah Hospitals and ClinicsInformatics, Decision Enhancement, and Analytic Sciences Center VA Salt Lake City Health Care System, Salt Lake City, Utah   Medical Research: What is the background for this study? What are the main findings? Dr. Gundlapalli: We wanted to explore the hypothesis that those separated for misconduct-related reasons would have more difficulty reintegrating into their communities post-deployment, with homelessness as an extreme example of such difficulties. Misconduct-related separations from the military are associated with subsequent adverse civilian outcomes that are of substantial public health concern. This study analyzed the association between misconduct-related separations and homelessness among recently returned active-duty military service members. Using US Department of Veterans Affairs (VA) data, investigators identified 448,290 Veterans who were separated from the military (end date of last deployment) between October 1, 2001 and December 31, 2011; had been deployed to Iraq and/or Afghanistan; and had subsequently used VA healthcare. Homelessness was determined by an assignment of “lack of housing” during a VA healthcare visit, by participation in a VA homelessness program, or both. Veterans’ housing status was followed through April 30, 2012. We assessed risk for homelessness as a function of separation category (e.g., normal, misconduct, early release), controlling for patient demographics and military service covariates, including service-related disability, branch, rank, and combat exposure. In our opinion, the most significant finding was that 26% of Veterans who were separated for misconduct related reasons were homeless at their first VA encounter; and this number climbed to 28% within one year after their first VA encounter. Additionally, the likelihood of being homeless at the first VA encounter was nearly 5 times greater for those separated for misconduct-related reasons as compared to normal separations; this climbed to nearly 7 times greater at one year after the first VA encounter. Collectively, these results represent the strongest risk factor for homelessness among US Veterans observed to date, and helps to explain the higher risk of homelessness observed among Veterans, despite access to VA benefits and services. (more…)
Author Interviews, Education, Genetic Research, Social Issues / 21.08.2015

Ben Domingue Assistant Professor (starting 9/2015) Stanford Graduate School of Education   MedicalResearch.com Interview with: Ben Domingue Assistant Professor (starting 9/2015) Stanford Graduate School of Education     Medical Research: What is the background for this study? What are the main findings? Response: Earlier research has started to illuminate which genetic variants are associated with educational attainment. Subsequent work has taken these variants, combined them into a "polygenic score", and studied how that polygenic score predicts educational attainment. Our research continues this line of inquiry by examining the predictive performance of that polygenic score in a representative sample of US adults who are now in their 30s. A few notable findings include that: (A) the polygenic score predicts educational attainment in the African Americans in our sample and (B) that the polygenic score is associated with neighborhood characteristics. As with earlier research, we are able to show that the higher score sibling from within a family will complete more years of schooling (on average) than their lower score co-sib. (more…)
Author Interviews, Social Issues / 19.08.2015

Carlota Batres PhD Candidate at the Perception Lab School of Psychology and Neuroscience University of St Andrews MedicalResearch.com Interview with: Carlota Batres PhD Candidate at the Perception Lab School of Psychology and Neuroscience University of St Andrews   Medical Research: What is the background for this study? What are the main findings? Response:  Dominance in men is associated with a variety of social outcomes, ranging from high rank attainment of cadets in the military to high levels of sexual activity in teenage boys. Dominant men are also favored as leaders during times of intergroup conflict and are more successful leaders in the business world. Therefore, we wanted to investigate what exactly it is that makes a face look dominant. Our main finding was that maximum dominance was achieved by increasing perceived height and masculinity while maintaining a man's age at around 35 years. (more…)
Author Interviews, Cost of Health Care, Social Issues / 27.07.2015

Laura Rosella, PhD MHSc Assistant Professor, Dalla Lana School of Public Health, University of Toronto Scientist, Public Health Ontario Adjunct Scientist, Institute for Clinical Evaluative Sciences Toronto, OntarioMedicalResearch.com Interview with: Laura Rosella, PhD MHSc Assistant Professor, Dalla Lana School of Public Health, University of Toronto Scientist, Public Health Ontario Adjunct Scientist, Institute for Clinical Evaluative Sciences Toronto, Ontario Medical Research: What is the background for this study? What are the main findings? Response: High-cost users of health care generally refer to the top five per cent of health care users. They are a small portion of the population who consume a disproportionately high share of health care resources. We undertook a study to explore the social and economic determinants that were associated with future, high cost users. That is, the characteristics of these individuals before they proceed on a trajectory of high health care utilization. By understanding these associations we can better understand the role that socio-economic factors play in future health care utilizations and costs. (more…)
Author Interviews, Social Issues, Weight Research / 24.06.2015

MedicalResearch.com Interview with: Ruopeng An, PhD Assistant Professor, Department of Kinesiology and Community Health College of Applied Health Sciences University of Illinois at Urbana-Champaign Champaign, IL 61820 Medical Research: What is the background for this study? What are the main findings? Response: Health disparity is a particular type of health difference that is closely linked with social, economic and environmental disadvantage. One fundamental goal in the Healthy People 2020 is to “achieve health equity, eliminate disparities, and improve the health of all groups”. Obesity is a leading risk factor for many adverse health outcomes such as type 2 diabetes, hypertension, dyslipidemia, coronary heart disease, and certain types of cancer. Sweeping across the nation during the past 3 decades, the prevalence of obesity increased from 15% in 1980 to 35% in 2012 among U.S. adults. The obesity epidemic is marked by salient demographic and socioeconomic disparities pertaining to gender, race/ethnicity, education, income and geographic location. In this study, we examined the annual trends in educational disparity in obesity among U.S. adults 18 years and older from 1984 to 2013 using data from a nationally-representative health survey. We found that the obesity prevalence among people with primary school or lower education increased from 17.46% or 3.41 times the prevalence among college graduates (5.12%) in 1984 to 36.16% or 1.73 times the prevalence among college graduates (20.94%) in 2013. In any given year, the obesity prevalence increased monotonically with lower education level. The obesity prevalence across education subgroups without a college degree gradually converged since early 2000s, whereas that between those subgroups and college graduates diverged since late 1980s. Absolute educational disparity in obesity widened by 60.84% to 61.14% during 1984-2013 based on the Absolute Concentration Index and the Slope Index of Inequality, respectively; meanwhile, relative educational disparity narrowed by 52.06% to 52.15% based on the Relative Index of Inequality and the Relative Concentration Index, respectively. The trends in educational disparity in obesity differed substantially by gender, race/ethnicity, age group, and obesity severity. (more…)
AHA Journals, Author Interviews, Heart Disease, Social Issues / 21.06.2015

Jaana Halonen Ph.D Finnish Institute of Occupational Health Kuopio, FinlandMedicalResearch.com Interview with: Jaana Halonen Ph.D Finnish Institute of Occupational Health Kuopio, Finland MedicalResearch: What is the background for this study? What are the main findings? Dr. Halonen: Research on predictors of cardiovascular disease has increasingly focused on exposures to risk factors other than the conventional behavioral and biological ones, such as smoking, hypertension, dyslipidaemia, or diabetes. One of the potential predictors beyond the conventional risks is exposure to childhood psychosocial adversities. Previous studies have found that people who had experienced financial difficulties, serious conflicts and long-term disease in the family in childhood have a higher level of cardiovascular risk factors and increased cardiovascular morbidity in adulthood, but the underlying mechanisms linking childhood exposure to adult disease remain unclear. It is possible that childhood adversity sets an individual on a risk pathway leading to adverse future exposures. An important source of adversity experienced in adulthood is residence in a socioeconomically disadvantaged neighborhood. However, no previous study had examined the combined effect of childhood psychosocial adversity and adult neighborhood disadvantage on cardiovascular disease risk. We found that exposure to childhood psychosocial adversity and adult neighborhood disadvantage in combination was associated with a doubling of the risk of incident cardiovascular disease in adulthood when compared to the absence of such exposures. This association was not explained by conventional cardiovascular risk factors. Neither childhood psychosocial adversity nor adult neighborhood disadvantage alone were significantly associated with incident CVD, although they were associated with CVD risk factors. (more…)
Author Interviews, Kidney Disease, Social Issues / 18.06.2015

Holly Kramer, MD, MPH Department of Public Health Sciences Loyola University Chicago Health Sciences Campus Maywood, ILMedicalResearch.com Interview with: Holly Kramer, MD, MPH Department of Public Health Sciences Loyola University Chicago Health Sciences Campus Maywood, IL MedicalResearch: What is the background for this study? What are the main findings? Dr. Kramer: The U.S. dialysis dependent population continues to grow with  636,905 prevalent cases of end-stage renal disease (ESRD) in the U.S. as of December 31, 2012, , an increase of 3.7% since 2011.  Poverty is a well described risk factor for ESRD because poverty impacts access to care and nutritious foods.  The definitions for poverty in the U.S. have not changed over the past several decades despite marked changes in social structure.  For example, social integration in the U.S. society currently requires a cell phone, computer and internet access and access to transportation.  Healthy foods also cost more now relative to unhealthy foods compared to past decades.  Thus, the link between poverty and any chronic disease or health outcome is likely dynamic due to the evolving financial burden for living in a rapidly changing industrialized society.  Our study defined poverty as living in a zip code defined area with > 20% of the residents living below the federal poverty line.  We show that the prevalence of adults receiving dialysis who are living in poverty has increased over time.  We also show that the association between poverty and ESRD may be getting stronger over time.   (more…)
Author Interviews, Endocrinology, Nature, NYU, Social Issues / 16.04.2015

Bianca Jones Marlin, PhD Froemke Laboratory New York University Langone School of MedicineMedicalResearch.com Interview with: Bianca Jones Marlin, PhD Froemke Laboratory New York University Langone School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Marlin: Oxytocin is a hormone that plays an important role in the expression of social and parental behaviors, but little is know about how it works in the brain to produce these behaviors. Virgin mice will usually ignore, and sometimes cannibalize newborn mouse pups. Our study has shown that oxytocin works in the auditory cortex of virgin mice to change both their neural responses, and eventually their behaviors, to mirror the maternal response. (more…)
Author Interviews, Diabetes, Diabetologia, Pediatrics, Social Issues / 10.04.2015

MedicalResearch.com Interview with: Maria Nygren Division of Pediatrics Linköping University, Sweden MedicalResearch: What is the background for this study? What are the main findings? Response: What factors that cause type 1 diabetes is still unknown, but we know that environmental factors are involved besides the genetics. Since the incidence of type 1 diabetes among children have increased worldwide in recent decades, it is important to find out the reasons behind the disease to hopefully be able to prevent new cases. We have in a prospective study of over 10000 children and their parents in Sweden investigated if psychological stress can be a risk-factor, and found that childhood experience of serious life events (such as death/illness in family, divorce, new adult/child in the family) was associated with increased risk for diagnosis of type 1 diabetes up to 14 years of age. (more…)
Author Interviews, Blood Pressure - Hypertension, Social Issues, University of Michigan / 08.04.2015

Kira S. Birditt, Ph.D. Research Associate Professor Life Course Development Program The Institute for Social Research University of Michigan Ann Arbor, MI MedicalResearch.com Interview with: Kira S. Birditt, Ph.D. Research Associate Professor Life Course Development Program The Institute for Social Research University of Michigan Ann Arbor, MI Medical Research: What is the background for this study? What are the main findings? Dr. Birditt: We know that negative marital quality (e.g., conflict, irritation) has important implications for physical health but the mechanisms that account for these links are still unclear. This study explored links between negative marital quality (e.g., criticism, demands), stress (long term chronic stresses) and blood pressure among older married couples in  a large longitudinal nationally representative sample of couples in the U.S..  We found that husbands had higher blood pressure when wives reported greater stress and that this link was even greater when husbands felt more negative about the relationship.  In addition, negative marital quality experienced by only one member of the couple was not associated with blood pressure but when both members of the couple reported higher negative marital quality they had higher blood pressure.  (more…)
Author Interviews, Heart Disease, Social Issues / 16.03.2015

Colleen K. McIlvennan, DNP, ANP Assistant Professor of Medicine University of Colorado, Division of Cardiology Section of Advanced Heart Failure and TransplantationMedicalResearch.com Interview with: Colleen K. McIlvennan, DNP, ANP Assistant Professor of Medicine University of Colorado, Division of Cardiology Section of Advanced Heart Failure and Transplantation Medical Research: What is the background for this study? Response: Destination therapy left ventricular assist device (DT LVAD) patients are often older with significant comorbidities that preclude heart transplantation. As such, the decision to get a DT LVAD is arguably more complicated than the decision to receive a temporary LVAD in anticipation of a transplant. Centers offering LVADs often require the identification of a caregiver prior to proceeding with the implant. Caregivers are commonly female spouses of DT LVAD patients, who are also older with co-morbidities. Understanding their perspective in DT LVAD decision making is extremely important as they are at particular risk for experiencing stress and caregiver burden due to the increased demands on caregiving with DT LVAD. Medical Research: What are the main findings? Response: We performed semi-structured qualitative interviews with 17 caregivers: 10 caregivers of patients living with DT LVAD, 6 caregivers of patients who had died with DT LVAD, and 1 caregiver of a patient who had declined DT LVAD. Throughout the interviews, the overarching theme was that considering a DT LVAD is a complex decision-making process. Additionally, three dialectical tensions emerged: 1) the stark decision context, with tension between hope and reality; 2) the challenging decision process, with tension between wanting loved ones to live and wanting to respect loved ones’ wishes; and 3) the downstream decision outcome, with tension between gratitude and burden. (more…)
Author Interviews, CDC, Emory, OBGYNE, Social Issues / 13.03.2015

MedicalResearch.com Interview with: Elizabeth Burns, MPH Rollins School of Public Health Emory University MedicalResearch: What is the background for this study? What are the main findings? Response: Epidemiologic studies suggest that prenatal stress is associated with preterm birth, low birth weight and peripartum anxiety and depressive symptoms. The most recent population-based study on the prevalence of stress among pregnant women, which used data from 1990-1995, reported that 64% of women experience stressful life events (SLEs) in the year before their infant’s birth. More recent estimates of prevalence and trends of prenatal stressful life events are useful for clinicians in order to understand the risk profile of their patients. The Pregnancy Risk Assessment Monitoring System (PRAMS) collects self-reported information on maternal experiences and behaviors before, during, and after pregnancy among women who delivered a live infant. PRAMS includes 13 questions about maternal SLEs experienced in the year preceding the birth of the child. Based on previous research, SLEs were grouped into four dichotomous constructs: 1) emotional stressors (family member was ill and hospitalized or someone very close died); 2) financial stressors (moved to a new address, lost job, partner lost job, or unable to pay bills); 3) partner-associated stressors (separated/divorced, argued more than usual with partner/husband, or husband/partner said he did not want pregnancy); and 4) traumatic stressors (homeless, involved in a physical fight, partner or self-went to jail, or someone very close had a problem with drinking or drugs). The prevalence of self-reported stressful life events decreased modestly but significantly during 2000–2010. Despite this, 70.2% of women reported ≥1 SLEs in 2010. Prevalence of stressful life events vary by state and maternal demographic characteristics and are especially prevalent among younger women, women with ≤12 years of education (75.6%), unmarried women (79.6%), and women that were covered by Medicaid for prenatal care or delivery of their child (78.7%). (more…)
AHA Journals, Author Interviews, Heart Disease, Social Issues / 06.03.2015

Randy Cohen, MD, MS, FACC Division of Cardiology Mt. Sinai St. Luke's Hospital New York, NYMedicalResearch.com Interview with: Randy Cohen, MD, MS, FACC Division of Cardiology Mt. Sinai St. Luke's Hospital New York, NY MedicalResearch: What is the background for this study? Dr. Cohen: Psychosocial conditions such as depression, anxiety, chronic stress and social isolation have strong associations with heart disease and mortality. Recently, however, attention has focused on positive emotions, psychological health and their collective impact on overall health and well-being.   Purpose in life is considered a basic psychological need, and has been defined as a sense of meaning and direction in one’s life which gives the feeling that life is worth living. We performed a meta-analysis of prospective studies evaluating the relationship between having a sense of purpose in life, mortality and cardiovascular disease. MedicalResearch: What are the main findings? Dr. Cohen: We identified 10 prospective studies involving over 137,000 subjects and found that possessing a sense of purpose in life was associated with a 23% reduced risk for all-cause mortality and a 19% reduced risk for cardiovascular disease events. (more…)
Aging, Author Interviews, Geriatrics, Social Issues / 01.03.2015

Angela L. Curl PhD MSW School of Social Work University of Missouri Columbia, MOMedicalResearch.com Interview with: Angela L. Curl PhD MSW School of Social Work University of Missouri Columbia, MO MedicalResearch: What is the background for this study? What are the main findings? Dr. Curl: Often people think of stopping driving as just effecting one person: the person who stops driving. In reality, for married couples driving cessation affects both spouses. Using longitudinal data (1998-2010) from 1,457 married couples participating in the Health and Retirement Study, we found that husbands and wives who are no longer able to drive are less likely to work, and less likely to engage in formal volunteering (for charitable organizations) and informal volunteering (helping friends and neighbors not-for-pay). Having a spouse in the household who is still able to drive does reduce these negative consequences a little, but not entirely. Furthermore, the spouse who continues to drive is also less likely to continue working or volunteering following the driving cessation of their partner, presumably because he/she is providing transportation or social support to the non-driver. (more…)
Author Interviews, BMJ, Social Issues / 13.02.2015

MedicalResearch.com Interview with: Professor Khalid Khan Women's Health Research Unit Multi-disciplinary Evidence Synthesis Hub The Blizard Institute Medical Research: What is the background for this study? What are the main findings? Prof. Khan: My co-author talked me into helping him with his online dating and so we embarked on this project. We were fascinated to see if there was any scientific evidence which could help people in their online pursuit of love - and to our surprise there was lots of attraction and persuasion research. There were 86 published studies on attraction and persuasion which met our criteria, and these covered literature in psychology, sociology, and computer behavioural and neurocognitive sciences. Their design features included randomisation in 28 studies, cohort follow-up in 13 studies, cross-sectional evaluation in 37 studies, qualitative analysis in 5 studies and systematic review in 3 studies​. We found that Success in converting initial online contact to a first date is not a complex formula. It relates to simple factors such as a fluent headline, truthfulness of profile, and reciprocity in communication.  Just like when you meet someone in real life, simple actions such as showing interest in the other person (commenting on something in their profile rather than just talking about yourself) goes a long way. (more…)
Author Interviews, Social Issues / 07.02.2015

Hailey Winetrobe, MPH, CHES Project Manager NIDA Transitions to Housing Study School of Social Work University of Southern CaliforniaMedicalResearch.com Hailey Winetrobe, MPH, CHES Project Manager NIDA Transitions to Housing Study School of Social Work University of Southern California MedicalResearch: What is the background for this study? What are the main findings? Response: Homeless young adults are a very vulnerable population with high healthcare needs. However, because of their housing instability and very low income, many homeless young adults may not have health insurance and/or access to healthcare services. Prior research regarding this population’s health insurance coverage was mostly outdated. Additionally, with the implementation of the Affordable Care Act (ACA), homeless young adults may now qualify for health insurance coverage (i.e., if there is a relationship, by being a dependent on their parent’s health insurance until 26 years old; and via Medicaid expansion in states choosing to expand). As such, this study aimed to update homeless young adults’ rates of health insurance coverage prior to the full implementation of the ACA (i.e., before Medicaid expansion) and to determine if there was an association between insurance and use of healthcare services. We found that 70% of homeless young adults did not have health insurance in the prior year. Of those with health insurance, 46% reported coverage through their parents, and 34% through Medicaid (not mutually exclusive). Over half (52%) of the sample received healthcare in the prior year. Furthermore, in a multivariable logistic regression model controlling for demographic characteristics, homeless young adults with health insurance, compared to their peers who did not have health insurance, had 11 times the odds of receiving healthcare in the prior year. (more…)