Author Interviews, Lancet, Mental Health Research, Pediatrics / 26.05.2017

MedicalResearch.com Interview with: [caption id="attachment_34863" align="alignleft" width="200"]Dr Annie Herbert, PhD Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare University College London London UK Dr. Herbert[/caption] Dr Annie Herbert, PhD Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare University College London London  UK  MedicalResearch.com: What is the background for this study? Response: 1 in 25 adolescents (i.e. one in every classroom) will be admitted to hospital as an emergency with injuries related self-harm, drug or alcohol misuse, or violence. Currently, the guidelines for how these adolescents are managed differ greatly depending on the type of injury they come in with (whether through self-harm, drug or alcohol misuse, or violence). MedicalResearch.com: What are the main findings? Response: In our study, we found that adolescents admitted with any of these injuries were at an increased risk of suicide and of drug or alcohol related death in the ten years after leaving hospital, compared to other admitted adolescents.While the overall risk is relatively low—for example, 2–3 girls out of 1000 and 7 boys out of 1000 who are admitted as an emergency to hospital with drug or alcohol related injuries die from suicide within 10 years—the rates are 5–6 times higher than among adolescents admitted to hospital following an accident.
Abuse and Neglect, Blood Pressure - Hypertension, UT Southwestern / 21.05.2017

MedicalResearch.com Interview with: [caption id="attachment_34742" align="alignleft" width="132"]Wanpen Vongpatanasin, M.D.</strong> Professor of Medicine Norman & Audrey Kaplan Chair in Hypertension Fredric L. Coe Professorship in Nephrolithiasis and Mineral Metabolism Research Director, Hypertension Section, Cardiology Division, UT Southwestern Medical Center Dallas, TX 75390-8586 Dr. Vongpatanasin[/caption] Wanpen Vongpatanasin, M.D. Professor of Medicine Norman & Audrey Kaplan Chair in Hypertension Fredric L. Coe Professorship in Nephrolithiasis and Mineral Metabolism Research Director, Hypertension Section, Cardiology Division, UT Southwestern Medical Center Dallas, TX 75390-8586 MedicalResearch.com: What is the background for this study? Response: It is well know that treatment of isolated systolic hypertension (ISH), a subtype of hypertension with elevated systolic BP 140 or above but normal diastolic BP of < 90 mmHg, improves cardiovascular outcomes in older adults after the sixth decade of life. However, it is controversial if ISH in young adults requires treatment because it was suggested that elevated systolic BP in these individuals are related to high stroke volume, rather than increased aortic stiffness. In earlier case series, ISH in young adults were particularly common in athletes with long arms and legs, suggesting that pulse wave amplification coupled with high stroke volume were responsible for elevated brachial systolic blood pressure but the true central BP was normal. Thus,  isolated systolic hypertension was proposed to be a spurious condition in young adults that can be ignored. However, previous studies used only indirect technique in assessing aortic structure and function. Furthermore, none of these studies were conducted in the U.S. Population.
Author Interviews, Brigham & Women's - Harvard, HIV, Pediatrics / 28.03.2017

MedicalResearch.com Interview with: [caption id="attachment_33465" align="alignleft" width="135"]Anne M Neilan, MD,MPH Assistant In Medicine, Massachusetts General Hospital Research Fellow, Harvard Medical School Department: Medicine Service Division: Infectious Disease Department: Pediatric Service Massachusetts General Hospital Boston, MA 02114 Dr. Neilan[/caption] Anne M Neilan, MD,MPH Assistant in Medicine and Pediatrics Massachusetts General Hospital Instructor at Harvard Medical School Department: Medicine Service Division: Infectious Disease Department: Pediatric Service Massachusetts General Hospital Boston, MA 02114 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Adolescents infected with HIV – either at birth or later in life – experience poorer health outcomes compared to adults with HIV in nearly every respect. This study found that U.S. youth infected with HIV around the time of their birth are at higher risk throughout their adolescence and young adulthood for experiencing serious health problems, poor control of the HIV virus (having high levels of HIV virus in their bodies and fewer CD4 immune cells which protect the body from infection), or death. The study also found that among those with good HIV control, serious health problems are rare. By combining data from two large, long-term U.S. studies – the Pediatric HIV/AIDS Cohort Study (PHACS, www.phacsstudy.org) and the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT, www.impaactnetwork.org) Network – we were able to study the health of more than 1,400 perinatally HIV-infected children, adolescents and young adults ages 7 to 30 years between 2007 and 2015. The study found that youth ages 13 to 30 were most likely to have poor HIV control AIDS-related illnesses, and death compared to younger participants. Among 18 – 30 year-olds, the study found that poor control of the HIV virus – meaning higher levels of HIV virus and lower levels of CD4 immune cells which protect the body from infection –35 percent of the time, increasing the risk that these youth would stop responding to certain HIV medications and could transmit HIV to others. These findings are consistent with other U.S. and European reports. Despite being engaged in health care, the number of deaths among youth born with HIV in the U.S. is 6 to12 times higher than for youth without HIV of the same age, sex and race. Along with HIV-related health problems, the most commonly reported health conditions concerned mental health and brain and nervous system development. Many women in the study also had sexually transmitted infections, which was found to be associated with lower CD4 immune cell counts. This may suggest a biological mechanism or may reflect that patients who have difficulty with their medications are also engaging in more frequent risky sexual behaviors.
Author Interviews, Johns Hopkins, OBGYNE, Pediatrics / 16.03.2017

MedicalResearch.com Interview with: [caption id="attachment_33016" align="alignleft" width="80"]Krishna K. Upadhya, M.D., M.P.H. Division of General Pediatrics & Adolescent Medicine Department of Pediatrics Johns Hopkins University School of Medicine Baltimore, MD 21287 Dr. Upadhya[/caption] Krishna K. Upadhya, M.D., M.P.H. Division of General Pediatrics & Adolescent Medicine Department of Pediatrics Johns Hopkins University School of Medicine Baltimore, MD 21287 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study reviewed medical literature to examine the question of whether minor teens should be treated differently from older women with regard to a future over the counter oral contraceptive product.  Our analysis found that oral contraceptive pills are safe and effective for teens and there is no scientific rationale to restrict access to a future oral contraceptive pill based on age.
Addiction, Alcohol, Author Interviews, Cannabis, Education, Pediatrics, Smoking / 23.02.2017

MedicalResearch.com Interview with: Dr. James Williams UCL Medical School UCL, London, UK MedicalResearch.com: What is the background for this study? Response: Despite a downward trend over the last decade in the usage of particular substances amongst adolescents in the UK, smoking cigarettes, drinking alcohol and smoking cannabis remain prevalent behaviours in this demographic. These risky health behaviours present a large problem in terms of public health due to the immediate and long-term health problems they cause, as well as negative non-health outcomes such as poor educational attainment and reduced employment. The role of academic ability in determining patterns of substance use is not clear and no study has evaluated academic ability at age 11 in relation to the onset and persistence of all three substances from early to late adolescence and into young adulthood. Our study sought to determine the association between academic ability and the onset and persistence of substance use in adolescence in a representative sample of English school pupils. This would answer for the first time whether ability was associated with ‘experimentation’ in early adolescence or if the association persists into late adolescence.
Accidents & Violence, Alcohol, Author Interviews, Pediatrics / 14.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32000" align="alignleft" width="154"]Scott E. Hadland, MD, MPH, MS Assistant Professor of Pediatrics | Boston University School of Medicine Urban Health & Advocacy Track Director | Boston Combined Residency Program Boston, MA 02118 Dr. Scott Hadland[/caption] Scott E. Hadland, MD, MPH, MS Assistant Professor of Pediatrics Boston University School of Medicine Urban Health & Advocacy Track Director | Boston Combined Residency Program Boston, MA 02118 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Studies to date have shown that states’ alcohol laws can help prevent young people from dying in car crashes. However, studies to date have usually only looked at a single policy at once. We wanted to build on these previous studies by looking at the overall effect of multiple alcohol laws acting at once. We also wanted to look at laws not necessarily only targeting drinking and driving among young people, but also policies aimed primarily at adults over 21. We studied deaths of young people under 21 who were killed in motor vehicle crashes across the United States between 2000 and 2013. We found that one-quarter of all young people died in a crash involving a driver who alcohol level was over the legal limit. One-half died in a crash in which the driver had any level of alcohol in their bloodstream above zero. We also found that most young people died on evenings and weekends, which is when people are most likely to have been drinking. Importantly, almost half of all young people died in a crash in which they were the passenger, not the driver. In 80% of cases in which they were the passenger, it was actually an adult >21, not a young person, who was driving the vehicle. We then looked at states’ alcohol laws, and found that the stronger the set of alcohol policies in a state, the lower the likelihood of young people dying in a crash that was alcohol-related. Policies included laws relating to alcohol taxes, alcohol availability and hours of sales, and graduated driver’s licensing for young people, among many others.
Author Interviews, Cost of Health Care, Depression, JAMA, Pediatrics / 21.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28010" align="alignleft" width="173"]Laura P. Richardson, MD, MPH Interim Chief | Division of Adolescent Medicine Director | UW Leadership Education in Adolescent Health (LEAH) Program Professor | UW Department of Pediatrics Seattle Children's | University of Washington Dr. Laura Richardson[/caption] Laura P. Richardson, MD, MPH Interim Chief | Division of Adolescent Medicine Director | UW Leadership Education in Adolescent Health (LEAH) Program Professor | UW Department of Pediatrics Seattle Children's | University of Washington MedicalResearch.com: What is the background for this study? Response: Adolescent depression is one of the most common mental health conditions during adolescence. Up to one in five adolescents experience an episode of major depression by age 18. Depressed youth are at greater risk of suicide, dropping out of school and poor long-term health. Treatments, including medications and psychotherapy, have been proven to be effective but most depressed teens don’t receive any treatment. Two years ago, we showed that the Reaching Out to Adolescents in Distress (ROAD) collaborative care model (a.k.a. Reach Out 4 Teens) designed to increase support and the delivery of evidence-based treatments in primary care was effective in treating depression in teens, significantly improving outcomes. We ran a randomized clinical trial at nine of Group Health’s primary care clinics and reported effectiveness results in JAMA. The current paper represents the next step in this work, examining the cost-effectiveness of collaborative care for adolescent depression in our intervention sample of 101 adolescents with depression, ages 13-17 years.
Author Interviews, Mayo Clinic, Nutrition, Pediatrics, Weight Research / 17.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28058" align="alignleft" width="133"]David R. Jacobs, Jr., PhD Mayo Professor of Public Health Division of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN 55454-1075 Dr. David R. Jacobs, Jr.[/caption] David R. Jacobs, Jr., PhD Mayo Professor of Public Health Division of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN 55454-1075 MedicalResearch.com: What is the background for this study? Response: Project EAT (Eating and Activity in Teens and Young Adults) is on ongoing longitudinal study which began by screening middle and secondary school students in the Minneapolis and St Paul Metropolitan are. Students were the 11-18 years old (average age 15), then followed up at average ages 20 and 25. We had devised an eating pattern in about 2006, which a) predicts a lot of things in several different studies (including total mortality in the Iowa Women's Health Study) and b) looks a great deal like the recently released 2015 Dietary Guidelines for Americans (DGA). We call our diet pattern A Priori Diet Quality Score (APDQS) and think of it as close to or in the style of a Mediterranean/prudent/healthy diet. We hypothesized that this pattern would be associated with lower weight (in general with better long term health, but the focus in Project EAT was weight and BMI), probably least so at age 15. The minimal hypothesized effect in adolescence relates to the very large energy expenditure in adolescent growth years; we thought that diet composition would be less important for body weight at that time than energy intake (and APDQS is about diet composition).
Author Interviews, Cancer, Cancer Research, OBGYNE, Pediatrics / 14.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27794" align="alignleft" width="144"]Pooja Rao, MD, MSCE Assistant Professor Division of Pediatric Hematology/Oncology Milton S. Hershey Medical Center Penn State College of Medicine Dr. Pooja Rao[/caption] Pooja Rao, MD, MSCE Assistant Professor Division of Pediatric Hematology/Oncology Milton S. Hershey Medical Center Penn State College of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although many chemotherapy drugs can cause birth defects, no standardized guidelines exist for pregnancy screening in adolescent female patients with cancer. Additionally, little is known about how often they are screened prior to receiving treatment. Our study found that adolescent girls are not adequately screened for pregnancy prior to receiving chemotherapy or CT scans that could potentially harm a developing fetus. Adolescents with acute lymphoblastic leukemia, the most common childhood cancer, had the lowest pregnancy screening rates of the patients studied.
Accidents & Violence, Author Interviews, BMJ, Mental Health Research, Pediatrics / 17.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24425" align="alignleft" width="120"]Dr Edward Tyrrell NIHR In-Practice Research Fellow Division of Primary Care University Park Nottingham Dr. Edward Tyrrell[/caption] Dr Edward Tyrrell NIHR In-Practice Research Fellow Division of Primary Care University Park Nottingham  MedicalResearch.com: What is the background for this study? Dr. Tyrrell: Poisonings are among the most common causes of death amongst adolescents across the world, many of them related to self-harm. Poisonings leading to death are just the tip of the iceberg with many more resulting in invasive treatment, time off school and long term health effects. Many adolescent self-harm episodes are linked to mental health problems, which are often predictive of mental health problems in adulthood, making adolescence a key window for preventative intervention. However, up to date rates and time trends for adolescent poisonings are lacking, hindering the development of evidence-informed policy and planning of services. To quantify this problem at a national level and provide recent time trends of poisonings, we used routinely collected primary care data from 1.3 million 10-17 year olds. We assessed how intentional, unintentional and alcohol-related poisonings for adolescent males and females vary by age, how these have changed between 1992 and 2012 and whether socioeconomic inequalities exist.
Author Interviews, HPV, Infections, Pediatrics, Sexual Health / 23.12.2015

MedicalResearch.com Interview with: Seo Yoon Lee, RN Department of Health Policy and Management Graduate School of Public Health Eun-Cheol Park MD, PhD Institute of Health Services Research Department of Preventive Medicine Yonsei University, Seoul, South Korea  Medical Research: What is the background for this study? What are the main findings? Response: Sexually Transmitted Infections (STIs) are a major public health issue which causes acute illness, infertility, long-term disability or other serious medical and psychological consequences, around the world. Adolescence is a key developmental period with rapid cognitive growth. In recent decades, substantial change in the sexual behaviors and attitudes of adolescents has occurred and this would lead them greater risk of STIs than other. Our study looked at the relationship between adolescents’ first sexual intercourse age and their STI experience, as well as to identify vulnerable time table of their sexual activity by considering the time gap between their secondary sex characteristic occurrence age and first sexual intercourse age. The findings from our study show that earlier initiation of sexual intercourse increases the odds of experiencing STIs. Also as the age gap gets shorter, the odds of experiencing STIs increase. Approximately 7.4% of boys and 7.5% of girls reported had STI. For both boys and girls, the chance of experiencing STIs increased as the age of first sexual intercourse decreased [boys: before elementary school (age 7 or under) OR=10.81, first grade (age 7or 8) OR=4.44, second grade (age 8 or 9) OR=8.90, fourth grade (age 10 or 11) OR=7.20, ninth grade (age 15 or 16) OR=2.31; girls: before elementary school OR=18.09, first grade OR=7.26, second grade OR=7.12, fourth grade OR=8.93, ninth grade OR=2.74]. The association between the absolute age gap (AAG: defined as absolute value of “Age gap” = [Age at first sexual intercourse] - [age of secondary sexual manifest]) and STI experience was examined additionally which the result showed, students who had sexual intercourse after their secondary sexual manifestation, as the AAG increases, the odds of STI experience were decreased (boys OR=0.93, girls OR=0.87).
Author Interviews, Pediatrics, Smoking, Tobacco / 23.11.2015

[caption id="attachment_19571" align="alignleft" width="120"]Dr. Andrea C. Villanti PhD, MPH Director, Regulatory Science and Policy Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative Washington, DC 20001 Dr. Villanti[/caption] MedicalResearch.com Interview with: Dr. Andrea C. Villanti PhD, MPH Director, Regulatory Science and Policy Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative Washington, DC 20001 Medical Research: What is the background for this study? What are the main findings? Dr. Villanti: Awareness, interest, and use of electronic cigarettes (e-cigarettes) have increased since the products were introduced in the U.S. in 2006. Between 2012 and 2013, 8.3% of young adults reported current e-cigarette use compared to 4.2% of adults overall. One factor likely driving e-cigarette use as well as the use of other tobacco products is advertising, which has been demonstrated to promote the initiation and continued use of cigarettes. Advertising is critical for raising awareness about newly introduced products, and has been shown to influence initiation, experimentation, and progression to regular combustible cigarette smoking in youth. This study used a randomized control trial to assess the impact of brief exposure to four e-cigarette print advertisements (ads) on perceptions, intention, and subsequent use of e-cigarettes and cigarettes among young adults (age 18-34). It found that exposure to e-cigarette ads may enhance curiosity and limited trial of e-cigarettes in never users. Other findings include:
  • Compared to the control group, ad exposure was associated with greater curiosity to try an e-cigarette among never e-cigarette users (18.3% exposed vs. 11.3% unexposed), and greater likelihood of e-cigarette trial at follow-up among never users of cigarettes and e-cigarettes (3.6% exposed vs. 1.2% unexposed).
  • Exploratory analyses did not find an association between ad exposure and cigarette trial or past 30-day use among never users at follow-up, nor cigarette use among smokers over time.
  • Curiosity to try an e-cigarette mediated the relationship between ad exposure and e-cigarette trial among e-cigarette never users.
Author Interviews, Cannabis, CDC, Pediatrics, Tobacco Research / 16.10.2015

[caption id="attachment_18486" align="alignleft" width="300"]Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC Marijuana plant (Cannabis sativa)[/caption] MedicalResearch.com Interview with: Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC Medical Research: What is the background for this study? What are the main findings? Response: Since 2010, the proportion of U.S. 12th grade students who used marijuana during the preceding 30 days (21.4%) has surpassed the proportion who used cigarettes (19.2%). Negative outcomes associated with cigarette and marijuana use include addiction to one or both substances and diminished cognitive function, which can lead to lower academic achievement. CDC analyzed data from the 1997–2013 national Youth Risk Behavior Surveys (YRBS) among U.S. non-Hispanic white (white), non-Hispanic black (black), and Hispanic students in grades 9–12 to examine trends in the prevalence of current 1) exclusive cigarette or cigar use, 2) exclusive marijuana use, and 3) any use of the three products. CDC further examined the prevalence of current marijuana use among current users of cigarettes or cigars. During 1997–2013, exclusive cigarette or cigar use declined overall by 64%, from 20.5% to 7.4% (p<0.01). However, exclusive marijuana use more than doubled overall from 4.2% to 10.2% (p<0.01). Any cigarette, cigar, or marijuana use decreased overall from 46.1% to 29.9% (p<0.01), whereas marijuana use among cigarette or cigar users increased from 51.2% to 62.4%. Considerable increases were identified among black and Hispanic students toward the end of the study period for exclusive marijuana use and marijuana use among cigarette or cigar users. Increased exclusive marijuana use and use of marijuana among cigarette or cigar users could undermine success in reducing tobacco use among youths.
Author Interviews, JAMA, Mental Health Research, Pediatrics / 15.10.2015

[caption id="attachment_18394" align="alignleft" width="214"]Christine Walrath, PhD Public Health Division, ICF International New York, New York Dr. Christine Walrath[/caption] MedicalResearch.com Interview with: Christine Walrath, PhD Public Health Division ICF International New York, New York Medical Research: What is the background for this study? What are the main findings? Dr. Walrath: The study is part of a legislatively mandated evaluation of programs funded by the Garrett Lee Smith Memorial Act, signed into law in 2004 in recognition of the major public health problem of suicide and suicidal behavior in the US. The legislation set aside funding for campuses, states, tribes and US territories to develop, evaluate, and improve early intervention and suicide prevention programs. This is the most widely implemented group of suicide prevention programs in the United States, and allowed a unique opportunity, as reflected in the findings of this study and the study in the American Journal of Public Health in the spring (Walrath, C., Godoy Garraza, L., Reid, H., Goldston, D. B., & McKeon, R. (2015) to demonstrate that comprehensive community based suicide prevention programs appear to be effective in reducing suicide and suicide attempts. As mentioned, this is the second article on the impact of GLS suicide prevention program on youth suicide behavior. The previous one, published in APHA earlier this year, focused on suicide deaths, while this one focuses on suicide attempts. They use different sources for the outcome measures: vital records in one case and a large national survey in the other. In both cases, the county is the unit of analysis. They both take advantage of the availability of a large amount of information for relatively small areas to select counties that are essentially comparable. Making sure that the counties being compared are similar except for the GLS implementation is very important when randomized trials to assess impact of the prevention program are not feasible. The study found a reduction in the rate of suicide attempts among youth 16 to 23 following the implementation of the GLS program in counties exposed to these prevention activities when compared with similar counties that were not exposed to such intervention. The difference is significant and substantial: 4.9 less attempts per thousand youths. There is no evidence of a simultaneous change in the suicide attempt rate among adults, a group that was not targeted by GLS. The findings are consistent with those from the previous study, which found a substantial reduction in suicide mortality among youths 10-24 following GLS implementation: 1.3 fewer deaths per one hundred thousand youths.
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, Pediatrics / 06.10.2015

Susan Gray MD Division of Adolescent Medicine Boston Children's Hospital Boston, MAMedicalResearch.com Interview with: Susan Gray MD Division of Adolescent Medicine Boston Children's Hospital Boston, MA Medical Research: What is the background for this study? What are the main findings? Dr. Gray: This is a study of the health care costs of 13,000 privately insured adolescents (13 to 21 years old) cared for in an association of pediatric primary care practices. We found that a tiny fraction (1%) of adolescents accounted almost a quarter of the expenses of the whole cohort. Mental health disorders were the most common diagnosis among these high cost adolescents. The characteristics most strongly associated with high cost were complex chronic medical conditions, behavioral health disorders, and obesity, but many high cost adolescents had no chronic conditions. Pharmacy costs, especially orphan drug costs, were a surprisingly large contributor to high costs for these privately insured adolescents. Primary care costs were very small in high cost patients.
Accidents & Violence, Author Interviews, JAMA, Pediatrics / 21.09.2015

Dr. Ziming Xuan ScD, SM, MA Assistant Professor, Community Health Sciences School of Public Health Boston University MedicalResearch.com Interview with: Dr. Ziming Xuan ScD, SM, MA Assistant Professor, Community Health Sciences School of Public Health Boston University  Medical Research: What is the background for this study? Dr. Xuan: With respect to background, among the 15000 some teenagers died annually in the US, the 3 leading causes of death were unintentional injuries, homicide, and suicide. Among these fatal youth injuries, 83% homicides were gun-related, and about half of suicides involved a gun (45%). So, The purpose of the study was to investigate the association between state gun law environment and youth gun carrying in the United States, and whether this association is mediated by adult gun ownership. Medical Research: What are the main findings? Dr. Xuan:
  • Among 38 states in our study, 5.7%of high school students living in the 19 states with stricter gun laws carried a gun in past 30 days while 7.3% of students living in states with the weaker gun laws carried a gun.
  • A 10-point increase in the strictness of the state gun law score was associated with a 9% decrease in the odds of youth gun carrying.
  • Across states, restrictive gun laws may reduce youth gun carrying by limiting adult gun ownership.
Author Interviews, Cannabis, Gender Differences, Pediatrics / 16.09.2015

MedicalResearch.com Interview with:Renee M. Johnson, PhD, MPH Assistant Professor Johns Hopkins Bloomberg School of Public Health, Dept. of Mental Health Deputy Director, Drug Dependence Epidemiology Training Program (DDET) Baltimore MD Renee M. Johnson, PhD, MPH Assistant Professor Johns Hopkins Bloomberg School of Public Health, Dept. of Mental Health Deputy Director, Drug Dependence Epidemiology Training Program (DDET) Baltimore MD Medical Research: What is the background for this study? What are the main findings? Dr. Johnson: There has been a lot of policy change with regard to marijuana. Several states have enacted laws regarding medical marijuana and decriminalization, and now four states and the District of Columbia have legalized use for adults. Along with these policy changes, there’s been concern that adolescent marijuana use would skyrocket. This prompted me to think about what’s happened over the past 15 years, and so I decided to examine past 15-year trends in adolescent marijuana use among US high school students. Our research team analyzed data from the Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance Study, or YRBS. It is a nationally-representative survey of high school students. A lot of the information we have about adolescents’ risk behavior comes from the YRBS. What we found is that marijuana use among US high school students has gone down over the time period. In 1999, 47% of high school students reported lifetime use of marijuana. By 2013, 41% reported lifetime use. Use was lowest in 2009, with 37% of high school students reporting lifetime use. The increase in use from 2009 to 2013 was not statistically significant, so we aren’t sure whether it represents random fluctuation or whether it indicates a reversal in trend. We also found that gender differences have gotten smaller over the time period, reflecting a real change. Boys have historically had higher rates of use, but that’s changing. In 1999, 51% of boys and 43% of girls reported lifetime marijuana use. By 2013, 42% of boys and 39% of girls reported lifetime use.
Author Interviews, Cannabis, Columbia, Lancet / 18.06.2015

Deborah S. Hasin, Ph.D. Professor of Epidemiology Columbia University New York, New York 10032MedicalResearch.com Interview with: Deborah S. Hasin, Ph.D. Professor of Epidemiology Columbia University New York, New York 10032 MedicalResearch: What is the background for this study? What are the main findings? Dr. Hasin: The background for the study was the need to identify the causes of the marked increase in marijuana use among U.S. adolescents over the last several years, given that early adolescent marijuana use leads to a number of adverse health and psychosocial consequences, including cognitive decline, into adulthood. We had two main findings from the study:
  1. A comparison of the rates of adolescent marijuana use between states that ever passed a medical marijuana law and those that did not revealed that states with such laws had higher rates of teen marijuana use, regardless of when they passed the law; and
  2. When we compared the rates of teen marijuana use in these states before and after passage of the laws, we did not find a post-passage increase in the rates of teen marijuana use. This suggests that some common factor may be causing both the laws to be passed and the teens to be more likely to smoke marijuana in the states that passed these laws.
Addiction, Author Interviews, Case Western, Psychological Science / 29.04.2015

Maria Pagano, PhD Case Western Reserve University School of Medicine Department of Psychiatry, Division of Child Psychiatry Cleveland, OHMedicalResearch.com Interview with: Maria Pagano, PhD Case Western Reserve University School of Medicine Department of Psychiatry, Division of Child Psychiatry Cleveland, OH MedicalResearch: What is the background for this study? Dr. Pagano: Socially anxious adolescents quickly figure out that alcohol and drugs can provide ease and comfort in social situations that are anxiety provoking.  Reaching for a substance to change how you feel can quickly become a knee-jerk reaction, can develop into an addiction, and robs youths of learning how to tolerate interpersonal differences and uncomfortable feelings, developing emotional maturity, and cultivating self acceptance. Adolescents who fear being criticized by their peers are likely to not speak up in group therapies during treatment, which can limit their benefit from treatment.  There is a lot of healing that comes sharing your insides with others. Socially anxious patients may not get this healing nor let others really get to know who they are and give input to their lives Higher peer helping in AA during treatment means getting active in low intensity tasks like putting away chairs, or making coffee at a 12-step meeting.  It is less about needing peer assistance or expecting praise or recognition from giving service.  It is more about adopting the attitude of "how can I be helpful?"
Author Interviews, HIV, JAMA, Pediatrics, University of Pennsylvania / 02.04.2015

Elizabeth Lowenthal, MD MSCE Assistant Professor of Pediatrics Children's Hospital of PhiladelphiaMedicalResearch.com Interview with: Elizabeth Lowenthal, MD MSCE Assistant Professor of Pediatrics Children's Hospital of Philadelphia Medical Research: What is the background for this study? What are the main findings? Dr. Lowenthal: Between 2005 and 2012, HIV related deaths declined by 30% worldwide. However, during the same time period, HIV related deaths increased 50% among adolescents. Over 90% of HIV-infected children and adolescents live in sub-Saharan Africa and HIV is the leading cause of death among adolescents in Africa. Treatment is available that can allow babies born with HIV to live to be healthy adults. However, strict adherence to these medicines is necessary and often becomes a great challenge during adolescence. In our study of 300 adolescents (ages 10-19) in Botswana, my team found that adolescents who come to clinic without a parent or guardian have a 4.5X greater odds of failing their HIV treatment.
Accidents & Violence, Author Interviews, JAMA, Mental Health Research, Pediatrics / 01.01.2015

MedicalResearch.com Interview with: Joseph A Simonetti, MD MPH Research Fellow Harborview Injury Prevention & Research Center University of Washington Seattle, WA, USA Medical Research: What is the background for this study? What are the main findings? Dr. Simonetti: Studies have consistently shown that children living in households where firearms are stored safely have a lower risk of suffering firearm injuries, including lethal firearm injuries, compared to those living in households where firearms are stored unlocked and/or loaded. Safe firearm storage is widely recommended by public health experts, professional medical societies, and gun rights organizations, especially for households where children might be suffering from mental heath and substance abuse issues that put them at increased risk for suicide or unintentional injury. Our goal was to find out if those recommendations were being effectively implemented in the community. To do this, we used survey data that assessed mental health conditions and firearm access among a nationally representative sample of US adolescents. Medical Research: What are the main findings? Dr. Simonetti: First, we confirmed previous findings that a large proportion of US adolescents have access to a firearm in the home. Of those who reported living in a home with a firearm, 40% said they could immediately access and shoot the firearm. Second, the prevalence of most mental health diagnoses was similar between adolescents who did and did not report firearm access. However, a greater proportion of adolescents with firearm access had drug and alcohol disorders compared to adolescents who reported living in a home with a firearm but did not have access to the firearm. The main finding was that children with mental health risk factors for suicide were just as likely to report in-home firearm access as those without identified risk factors. This finding held true even when comparing firearm access between children with no identified risk factors and those who reported a recent suicide attempt, who arguably have the highest suicide risk in this sample.
Author Interviews, Weight Research / 10.09.2014

Dr. Sonja Yokum Ph.D. Oregon Research Institute Eugene Oregon, 97403MedicalResearch.com Interview with: Dr. Sonja Yokum Ph.D. Oregon Research Institute Eugene Oregon, 97403 Medical Research: What are the main findings of the study? Dr. Yokum: We found that adolescents showing elevated responses in reward regions to food commercials gained more weight over 1-year follow-up compared to those with less activation in these brain regions. This suggests that there are individual differences in neural vulnerability to food commercials that appear to identify youth at risk for excess weight gain.
Author Interviews, Genetic Research, JAMA, Schizophrenia / 31.07.2014

Dr Angelica Ronald Genes Environment Lifespan (GEL) laboratory Centre for Brain and Cognitive Development Department of Psychological Sciences Birkbeck, University of London London WC1E 7HXMedicalResearch.com Interview with: Dr Angelica Ronald Genes Environment Lifespan (GEL) laboratory Centre for Brain and Cognitive Development Department of Psychological Sciences Birkbeck, University of London London WC1E 7HX Medical Research: What are the main findings of the study? Dr. Ronald: Psychotic experiences, such as paranoia, hallucinations and disorganised thinking, are commonly reported by adolescents. Until now it has not been understood whether mild variations in psychotic experiences in the community are part of the same construct as more severe psychotic experiences in adolescence. Our findings suggest that they are. In our study, over 10,000 16-year-old adolescents in England and Wales were assessed on measures of psychotic experiences. The study identified a close link between normal, less frequent psychotic experiences and more severe and frequent experiences in the general population. A classic twin design was employed, which enabled us to conduct analyses investigating the role of genetic and environmental influences on psychotic experiences. The same genetic influences appeared to play a role across the spectrum of severity of psychotic experiences. The study found that psychotic experiences are moderately heritable in adolescence in the general population. This suggests it would be worth directing molecular genetic endeavours towards this area, which has so far received very little attention in terms of causal explanations. We also show that psychotic experiences have considerable environmental influence; in fact, environmental influence appears to play a larger role in causing psychotic experiences in adolescence than for diagnosed psychotic disorders in adults, such as schizophrenia. This result suggests a fruitful avenue will be to tackle what environmental risk factors influence adolescents to have psychotic experiences.
Author Interviews, Insomnia, Mental Health Research / 31.07.2014

MedicalResearch.com Interview with: Pasquale K Alvaro School of Psychology University of Adelaide South Australia, Australia Medical Research: What are the main findings of the study? Answer: In adolescents, insomnia is related to depression beyond chronotype (a classification system for circadian rhythms or body clock), anxiety and age. Insomnia is also related to Generalised Anxiety Disorder (GAD) beyond chronotype, depression and age. Depression accounts for the relationship between insomnia and Obsessive Compulsive Disorder (OCD), Separation Anxiety Disorder (SAD) and Social Phobia (SP). Furthermore, an evening chronotype  (delayed sleep phase, that is, preferring to go to bed in the early morning) predicts insomnia beyond depression, anxiety and age. Moreover, an evening chronotype predicts depression beyond insomnia, anxiety and age. Finally, insomnia and depression account for the relationships between an evening chronotype and panic disorder, OCD, SAD and SP.
Author Interviews, Lancet, Mental Health Research / 20.04.2014

Dr. George Patton Department of Paediatrics, University of Melbourne Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, AustraliaMedicalResearch.com Interview with: Dr. George Patton Department of Paediatrics, University of Melbourne Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia MedicalResearch.com: What are the main findings of the study? Dr. Patton: Although there has been wide acceptance that the teens are a time when emotional problems are common, views have been polarized about their significance. Some have viewed these problems are usual for this phase of life with little significance for later life mental health; others have argued that early psychiatric intervention was essential given the risks of ongoing disorders. In this sample almost two thirds of girls and a third of boys had an episode of emotional troubles (anxiety and depression) at a level that would concern a family physician. For those where the episode were brief lasting weeks to months, recovery without further later life episodes was common. In contrast those with persistent (longer than 6 months) or recurrent emotional problems during the teens had a high likelihood of similar problems with depression and anxiety in their twenties. In general these emotional problems persisted more in females than in males.
Author Interviews, Duke, JAMA, Pediatrics, Sexual Health / 31.12.2013

Stewart C. Alexander, PhD Department of Medicine Duke University Medical Center Durham, North CarolinaMedicalResearch.com Interview with: Stewart C. Alexander, PhD Department of Medicine Duke University Medical Center Durham, North Carolina MedicalResearch.com: What are the main findings of the study? Dr. Alexander: Adolescents are reluctant to talk about sex with their doctors and won't raise the topic with their doctors. For physicians, there are common and valid barriers to talking about sexuality with adolescents, including time pressures and discomfort with the topic. Two-thirds of adolescents in our study had some sexuality talk during their annual visit, lasting 36 seconds long. Girls, African Americans, and older teens were more likely to receive sexuality talk. Additionally, longer visits and visits where the physician talked confidentially with their adolescent patient were more likely to have sexuality talk. Our study suggest that sexuality conversations in annual visits can be improved.