Author Interviews, Education, Pediatrics, Sleep Disorders, University of Michigan / 22.08.2017

MedicalResearch.com Interview with: Galit Dunietz, Ph.D., MPH Epidemiologist, Sleep Disorders Center Department of Neurology University of Michigan Ann Arbor MI MedicalResearch.com: What is the background for this study? What are the main findings? Response: Insufficient sleep has a negative impact on health, cognition and mood and is linked to motor vehicle accidents. However, sleep loss in adolescents has become an epidemic and arises in part from biological processes that delay sleep and wake timing at the onset of puberty. This biology does not fit well with early school start times (before 8:30 a.m.). Despite recommendations from the American Academy of Pediatrics and the American Academy of Sleep Medicine to delay school start times, most schools in the U.S. have current start times before 8:30 a.m. In this nationally representative study of US parents of teens, we examined whether parents supported or opposed later school start times (after 8:30 a.m.). We also examined what may have influenced their opinions. We found that only about half of surveyed parents of teens with early school start times supported later school start times. Opinions appeared to depend in part on what challenges and benefits were expected to result from the change. For example, parents who expected an improvement in their teen’s academic performance or sleep quantity tended to support the change, whereas parents that expected negative impact on afterschool activities or transportation opposed delays in school start times.  We also found that parents had misconception about sleep needs of their adolescents, as the majority perceived 7-7.5 hours of sleep as sufficient, or possibly sufficient even at this young age when 8-10 hours are typically recommended. (more…)
Author Interviews, Education, Heart Disease, JAMA, Lifestyle & Health, Primary Care, UCLA / 28.07.2017

MedicalResearch.com Interview with: Carol M. Mangione, MD, MSPH, FACP Barbara A. Levey, MD, and Gerald S. Levey, MD Endowed chair in medicine David Geffen School of Medicine University of California, Los Angeles Professor of public health at the UCLA Fielding School of Public Health MedicalResearch.com: What is the background for this study? Response: Americans can experience several health benefits from consuming healthy foods and engaging in physical activity. The Task Force recommends that primary care professionals work together with their patients when making the decision to offer or refer adults who are not obese and do not have hypertension, high cholesterol, high blood sugar, or diabetes to behavior counseling to promote healthful diet and physical activity. Our focus was on the impact of a healthful diet and physical activity on cardiovascular risk because this condition is the leading cause of premature morbidity and mortality. The Task Force evaluates what the science tells us surrounding the potential benefits and harms of a particular preventive service. In this case, the Task Force found high quality evidence focusing on the impact a healthful diet and physical activity can have on a patient’s risk of cardiovascular disease. Relying on this evidence, the Task Force was able to conclude that there is a positive but small benefit of behavioral counseling to prevent cardiovascular disease. (more…)
Author Interviews, Education, Heart Disease, JAMA, Social Issues / 14.06.2017

MedicalResearch.com Interview with: Yasuhiko Kubota, MD, MPH Visiting Scholar Division of Epidemiology and Community Health School of Public Health University of Minnesota, Minneapolis, MN MedicalResearch.com: What is the background for this study? Response: Educational inequality is one of the most important socioeconomic factors contributing to cardiovascular disease. Since education is usually completed by young adulthood, educational inequality may affect risk of cardiovascular disease early in the life course. We thought it would be useful to calculate the lifetime risk of cardiovascular disease according to educational levels in order to increase public awareness of the importance of education. Thus, our aim was to evaluate the association of educational attainment with cardiovascular disease risk by estimating the lifetime risks of cardiovascular disease using a US. biracial cohort. Furthermore, we also assessed how other important socioeconomic factors were related to the association of educational attainment with lifetime risk of cardiovascular disease. (more…)
Author Interviews, Education, Pediatrics / 27.05.2017

MedicalResearch.com Interview with: Professor Hermundur Sigmundsson Department of Psychology Norwegian University of Science and Technology MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are around 23 baby-swimming instructors in Iceland who are offering baby swimming-courses. However, Snorris way to do this is unice after my knowledge. He has been doing baby swimming from 1990 - and has had around 7.000.- babies He heard about this from Norway and discovered that very young babies can stand in this way. He discovered this through practical experience. It works like this:  When holding children in the water - He put his hand under the feet of the children - and lift little bit under i.e gives some pressure (tactile stimuli) the children are gradually able to stand in the feet - so stimuli and experience is important. When they are able to stand once they are able to stand again. How long time it takes for each baby to be able to stand varies a lot - as in our study - the youngest was 3.6 months old. One of the participants was standing in 15 sec in the hands of Snorri in the first week of baby swimming course. I did see babies stand first soon after Snorri started baby swimming instruction around 1990-1991. I was very surprised - and was thinking how is it possible? This is not supported by the literature. My colleagues an I thought about this as a window to study development of balance and coordination in infants. The issue about reflexes versus voluntary movement through experience was central. (more…)
Author Interviews, Education / 24.05.2017

MedicalResearch.com Interview with: Pallavi Amitava Banerjee, PhD, FRS Lecturer, Graduate School of Education St Luke's Campus University of Exeter  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several educational programs are being run to increase an awareness and understanding of STEM generally and more specifically to encourage young people to take up STEM learning trajectories. A longitudinal study was conducted where nearly 60,000 year 7 students were followed up through secondary school. Every year these students took part in several hands on activities, ambassador led events, school STEM trips throughout each academic year from the beginning of year 7 till they took GCSEs. Two main educational outcomes were considered – a) GCSE attainment in science and math and b) continued post-16 STEM participation (AS- and A-levels). (more…)
ADHD, Author Interviews, Education, Gender Differences, JAMA, Pediatrics / 01.05.2017

MedicalResearch.com Interview with: Professor Jill Pell MD Director of Institute (Institute of Health and Wellbeing) Associate (School of Medicine, Dentistry and Nursing) University of Glasgow MedicalResearch.com: What is the background for this study? Response: The novelty of our study lies in its scale and scope. In terms of scope, it reported on six educational outcomes and three health outcomes in the same group of children. In terms of scale, it is the first study of a whole country to compare educational outcomes of children with treated ADHD with their unaffected peers and is more than 20 times larger than previous studies on similar educational outcomes. The only previous countrywide study on health outcomes, included only children with very severe ADHD who were in psychiatric hospitals. (more…)
Author Interviews, Education, Technology / 01.05.2017

MedicalResearch.com Interview with: Frederick W. Kron, MD President and Founder of Medical Cyberworlds, Inc Department of Family Medicine,Ann Arbor, MI and Michael D. Fetters, M.D., M.P.H., M.A. Professor of Family Medicine University of Michigan MedicalResearch.com: What is the background for this technology and study? Dr. Kron: Communication is the most important component of the doctor-patient relationship. I know that through research, but also through personal experience. As a cancer survivor, I’ve seen first-hand the difference that outstanding communication skill can make to a vulnerable patient. At the beginning of the project, we asked medical educators about the challenges they had in assessing and training communication competency. They told us that technical skills are easy to teach and assess, but communication skills are mainly behavioral skills that involve verbal and nonverbal behaviors, facial expressions, and many other cues that pass between patient and provider. That’s hard to teach and assess. Activities like role play with standardized patients (SPs) have been widely used, but it’s impossible for SPs to accurately portray these behaviors, or for faculty to fully assess the nuanced behaviors of both learner and patient. Supporting this idea is a lack of evidence proving that SP encounters translate in behavioral changes or transfer into clinical settings. Developments in virtual reality provided us with a great opportunity for assessing and teaching of communication behaviors. Working with a national group of experts, we created computer-based Virtual Humans that interact with learners using the full range of behaviors you’d expect from two people talking together. They are so behaviorally realistic and compelling, that they trigger emotional responses in learners, and make learners want to learn so they can do their best. Dr. Fetters: Our team has particular interest in doctor-patient communication in the context of cancer. There are many critical aspects of cancer communication: breaking the bad news to the patient, negotiating sometimes conflicting family opinions about treatment, and communication among team members about the patient's care, just to name a few. We’ve begun building out those scenarios in the technological platform we developed, Mpathic-VR. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Education, Nursing, Pediatrics / 25.04.2017

MedicalResearch.com Interview with: Deborah A. Raines PhD, EdS, RN, ANEF School of Nursing University at Buffalo MedicalResearch.com: What is the background for this study? What are the main findings? Response: This research grew from my experience as a neonatal nurse. I have worked with many families preparing to take their baby home and have seen the anxiety they experience wondering if they will be able to take care of their baby’s medical needs at home. Parents are usually most anxious about emergency situations that may occur. Majority of these parents are able to state what they should do, but have never experienced the actual situation with their baby. This study was designed to see if a simulation experience would fill this gap in parents’ preparation for the discharge of their baby from the NICU. This study had parents participated in a customized simulation to have them experience the care needed by their baby at home following discharge from the NICU. The findings revealed that parents reported a nearly 30 percent increase in confidence in their abilities to care for their baby after participating in the simulation. (more…)
Author Interviews, Education, JAMA, Race/Ethnic Diversity, Yale / 06.03.2017

MedicalResearch.com Interview with: Dowin Boatright, MD, MBA Department of Emergency Medicine Yale School of Medicine New Haven, Connecticut Fellow, Robert Wood Johnson Clinical Scholars Program Veterans Affairs Scholar MedicalResearch.com: What is the background for this study? What are the main findings? Response: Studies have demonstrated racial and ethnic inequities in medicine, including disparities in the receipt of awards, research funding, and promotions. Yet few studies have examined the link between race and ethnicity and opportunities for medical school students. Our results show that black and Asian medical school students are less likely to be selected for membership in a prestigious medical honor society, Alpha Omega Alpha (AΩA), than white medical school students. (more…)
Author Interviews, Education, PNAS / 20.01.2017

MedicalResearch.com Interview with: Janet Shibley Hyde Evjue-Bascom Professor Helen Thompson Woolley Professor of Psychology and Gender & Women’s Studies Director, Center for Research on Gender & Women University of Wisconsin Madison, WI MedicalResearch.com: What is the background for this study? Response: The background is that, in the U.S. and many other Western nations, we don’t have enough people going into STEM fields (Science, Technology, Engineering, and Mathematics). Innovations in STEM fields are enormously important in 21st century economies. So, we need to encourage more people to go into STEM fields. To do that, they have to major in a STEM field in college, and to do that, they need to prepare in high school. (more…)
Author Interviews, Education, Nature / 12.01.2017

MedicalResearch.com Interview with: Prof. Shulamit (Shu) Kahn Department of Markets, Public Policy and Law Questrom School of Business Boston University MedicalResearch.com: What is the background for this study? What are the main findings? Response: We started this research because Donna Ginther (Kansas) and I had an NIH R01 to study gender differences in biomedical careers. We quickly discovered that a major problem for women was the fact that between many years of graduate study and long postdocs, their biological clocks had almost expired before they would have a decent amount of time in their lives to think about having children. (more…)
Author Interviews, Education / 17.12.2016

MedicalResearch.com Interview with: Pallavi Amitava Banerjee, PhD Lecturer, Graduate School of Education University of Exeter, UK MedicalResearch.com: What is the background for this study? Response: Science technology engineering mathematics skills are highly valued in the UK as in most other developed countries of the world. Concerns were raised in the past by the Royal Society, Science Council and other learned societies and the UK Parliament about the insufficient number of young people wanting to take up these subjects beyond school. What then followed were a range of STEM enrichment and enhancement activities delivered at the local and national level. These activities were run to help young people appreciate science and math better to break the myth that these are only for the brainy. Students from secondary schools did hands-on practical activities, had STEM ambassador visits and several other events organized. (more…)
Author Interviews, Education, JAMA, Mental Health Research, Pediatrics / 06.10.2016

MedicalResearch.com Interview with: Laurie Miller Brotman, PhD Bezos Family Foundation Professor of Early Childhood Development Director, Center for Early Childhood Health and Development Department of Population Health NYU Langone Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Children attending high-poverty schools are often exposed to an accumulation of stressors and adverse childhood experiences that can interfere with optimal mental health and learning. This study examines mental health and academic outcomes through second grade in nearly 800 Black and Latino children who participated in a randomized controlled trial of ParentCorps--a family-centered, school-based intervention in pre-kindergarten. In the original trial, elementary schools with pre-k programs serving primarily Black and Latino children from low-income families were randomized to receive ParentCorps or standard pre-k programming. ParentCorps includes professional development for pre-k and kindergarten teachers on family engagement, social-emotional learning, and behavioral regulation, and a program for families and pre-k students provided over four months at the school by specially trained pre-k teachers and mental health professionals. ParentCorps creates a space for families to come together, reflect on their cultural values and beliefs, and set goals for their children. Parents learn a set of evidence-based strategies and choose which ones fit for their families—such as helping children solve problems and manage strong feelings, reinforcing positive behavior, setting clear rules and expectations, and providing effective consequences for misbehavior. Teachers and parents help children learn social, emotional and behavioral regulation skills such as identifying feeling sad, mad, or scared, calming bodies during stressful situations, paying attention, and solving problems together. This three year follow-up study finds that ParentCorps as an enhancement to pre-k programming in high-poverty schools results in fewer mental health problems (behavioral and emotional problems) and better academic performance through second grade. (more…)
Author Interviews, Cancer Research, Cognitive Issues, Education, Lancet, Leukemia, Mental Health Research, Pediatrics / 04.10.2016

MedicalResearch.com Interview with: Yin Ting Cheung, PhD Department of Epidemiology and Cancer Control and Noah D Sabin, MD Department of Diagnostic Imaging St Jude Children's Research Hospital Memphis, TN MedicalResearch.com: What is the background for this study? What are the main findings? Response: Long-term survivors of childhood acute lymphoblastic leukemia (ALL) who are treated with high-dose intravenous methotrexate or intrathecal chemotherapy are at risk for neurocognitive impairment, particularly in cognitive processes such as processing speed, attention and executive function. However, many children who receive these therapies do not experience significant impairments, suggesting the need for biomarkers to identify patients at greatest risk. Prior research from our team demonstrated that, during chemotherapy, patients were at risk for white matter changes in the brain, also known as leukoencephalopathy. No studies documented the persistence or impact of brain leukoencephalopathy in long-term survivors of childhood ALL treated on contemporary chemotherapy-only protocols. In this study, we included prospective neuroimaging from active therapy to long-term follow-up, and comprehensive assessment of brain structural and functional outcomes in long-term survivors of ALL treated with contemporary risk-adapted chemotherapy. We demonstrated that survivors who developed leukoencephalopathy during therapy displayed more neurobehavioral problems at more than 5 years post-diagnosis. Moreover, these survivors also had reduced white matter integrity at long-term follow-up, and these structural abnormalities were concurrently associated with the neurobehavioral problems. (more…)
Author Interviews, Education, JAMA / 30.08.2016

MedicalResearch.com Interview with: Daniel J. Morgan M.D., M.S Associate Professor Epidemiology & Public Health University of Maryland School of Medicine MedicalResearch.com: What is the background for this study? Response: Physicians are generally taught if a treatment is indicated, not how well the treatment works. Although this has been part of evidence based medical training, doctors still perform poorly with ability to understand risk and how treatment limits risk (Bayesian reasoning). Many publications focus on relative risk reduction which inflates the perception of an effect over the more accurate absolute risk reduction. (more…)
Author Interviews, Education, Pediatrics / 06.08.2016

MedicalResearch.com Interview with: David C. Geary, Ph.D. Curators’ Distinguished Professor Thomas Jefferson Fellow Department of Psychological Sciences Interdisciplinary Neuroscience Program University of Missouri Columbia, MO MedicalResearch.com: What is the background for this study? What are the main findings? Response: In an earlier study, we found that children’s understanding of numbers and the relations among them (e.g., that 6 = 5 + 1 & 4 + 2 & 3 + 3…) at the beginning of 1st grade predicted their performance on math measures in adolescence, controlling IQ, working memory, family background and other factors. These are measures that predict employability and wages in young adults and thus is practically important. We were interested in understanding the very early quantitative knowledge that predicts children’s later number knowledge. We tested children on a variety of quantitative measures 2 years before they entered kindergarten and in kindergarten gave them the same type of number test that we used in the first study. We found that 3 year olds' cardinal knowledge was critical to their later understanding of number relations, controlling IQ and many other factors. Cardinal knowledge is their understanding of the quantities associated with number words. So, if you ask a child to give you 3 toys, and they give you a handful, they do not understand what ‘three’ means. Young children with poor knowledge of number words, we at risk for poor math outcomes in kindergarten, controlling other factors. (more…)
Author Interviews, Education, Pediatrics, Technology / 18.07.2016

MedicalResearch.com Interview with: Lauren J. Myers, Ph.D. Assistant Professor Psychology Department Lafayette College Easton, Pennsylvania MedicalResearch.com: What is the background for this study? Response: Many families with young children use video chat to connect with family and friends--but what do children understand about the on-screen people and content of these interactions? The American Academy of Pediatrics discourages screen time for kids under 2 years because children who watch a lot of media often have poor language skills, and they miss out on other activities that would be more developmentally appropriate. However, in this study we wondered whether there is a difference between putting a baby in front of a television and having an interactive exchange via video chat. (more…)
Author Interviews, Education, NEJM / 09.07.2016

MedicalResearch.com Interview with: Marsha Regenstein, Ph.D, Professor From the Department of Health Policy and Management Milken Institute School of Public Health George Washington University Washington, DC MedicalResearch.com: What is the background for this study? Response: Despite the billions of dollars in public spending on graduate medical education (GME) in the United States, little is known about the true cost of training a resident, with the few studies that exist showing wide variation in their methods and results. At the same time, the U.S. appears to be producing too few primary care physicians to meet the health care needs of the population, and especially those who live in underserved areas with high health care needs and shortages of health professionals. The Teaching Health Center (THC) Graduate Medical Education funding program was established under the Affordable Care Act to increase the number of medical and dental residents training in six primary care specialties in underserved areas. The Teaching Health Center funding supports community-based residency training in settings such as Federally-qualified health centers, rural clinics, mental health clinics and other non-profit community-based organizations. Hospitals commonly serve as training partners, but THC funding goes directly to the community-based partner, bringing funding and training closer to the communities where underserved patients live. The Health Resources and Services Administration (HRSA), which manages and funds the program, set an interim payment of $150,000 per resident; currently, 59 THCs are training 690 residents in 27 states and the District of Columbia. The interim payment rate was based on the best available information at the time and was meant to cover the full cost of training a resident. (more…)
Author Interviews, Education, Exercise - Fitness / 28.06.2016

MedicalResearch.com Interview with: Peter Krustrup PhD Professor of Team Sport and Health Department of Nutrition, Exercise and Sports Copenhagen Centre for Team Sport and Health University of Copenhagen, Denmark Dr. Krustrup discusses ideas formulated in the Copenhagen Consensus Conference 2016: children, youth, and physical activity in schools and during leisure time. MedicalResearch.com: What is the background for this study? What are the main findings? Response: A desire to improve children’s and youth’s health, well-being and social inclusion motivated researchers at University of Copenhagen, Department of Nutrition, Exercise and Sports to gather 24 international top level researchers from a variety of academic disciplines at a consensus conference in Denmark on 4-7 April 2016. The aim of the Copenhagen Consensus Conference in 2016 was to reach an evidence-based consensus within the four themes: 1) Physical activity in children and youth: Fitness and health. 2) Physical activity in children and youth: Cognitive functioning 3) Physical activity in children and youth: Engagement, motivation and psychological well-being 4) Physical activity in children and youth: Social inclusion and physical activity implementation strategies. (more…)
Author Interviews, Education, JAMA, Pharmacology, UCSF / 21.06.2016

MedicalResearch.com Interview with: Colette DeJong Medical student at UCSF and Research Fellow at the UCSF Center for Healthcare Value. MedicalResearch.com: What is the background for this study? Response: Data released under the U.S. Sunshine Act reveals that in the last five months of 2013, over half of American physicians received free meals, gifts, or payments from the pharmaceutical industry. Recent studies have shown that doctors who receive large payments from drug companies—such as speaking fees and royalties—are more likely to prescribe expensive brand-name drugs, even when generics are available. Our findings, however, suggest that physicians’ prescribing decisions may be associated with much smaller industry payments than previously thought. We found that doctors who receive a single industry-sponsored meal—with an average value under $20—are up to twice as likely to prescribe the brand-name drug being promoted. (more…)
Author Interviews, Education, Gender Differences / 07.06.2016

MedicalResearch.com Interview with: Sara E. Brownell PhD School of Life Sciences Arizona State University Tempe, AZ MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Brownell: Our group has been broadly interested in gender biases in introductory biology since we published a study that showed that women underperform on course exams and under participate in whole class discussions compared to men (http://www.lifescied.org/content/13/3/478.full). We were curious why women might be under performing on these course exams so in this new study, we examined characteristics of the exams to see if that had an impact. What we found was that women and men perform equally on questions that test basic memorization. However, when questions tested more higher-level critical thinking skills, women were not scoring as high as men. This happened even when we took into account the academic ability of the students - women and men who had the same ability coming into the class. We also found that students from lower socioeconomic statuses also underperformed on these higher-level critical thinking questions compared to students from higher socioeconomic statuses, again even when we took into account academic ability. (more…)
Author Interviews, Education, Genetic Research, Nature / 13.05.2016

MedicalResearch.com Interview with: Dr. Daniel J. Benjamin PhD Associate Professor (Research), USC, 2015-present Associate Professor (with tenure), Cornell, 2013-2015 Assistant Professor, Cornell University, 2007-2013 Research Associate, NBER, 2013-present Faculty Research Fellow, NBER, 2009-2013  MedicalResearch.com: What is the background for this study? Dr. Benjamin: Educational attainment is primarily determined by environmental factors, but decades of twin and family studies have found that genetic factors also play a role, accounting for at least 20% of variation in educational attainment across individuals. This finding implies that there are genetic variants associated statistically with more educational attainment (people who carry these variants will tend on average to complete more formal education) and genetic variants associated statistically with less educational attainment (people who carry these variants will tend on average to complete less formal education). But none of these genetic variants had been identified until our 2013 paper on educational attainment. That paper, which studied a sample of roughly 100,000 individuals, identified 3 genetic variants associated with educational attainment, each of which has a very small effect. In the current paper, we expanded our sample to roughly 300,000 individuals, with the goal of learning much more about the genetic factors correlated with educational attainment. (more…)
Author Interviews, Education, Pediatrics, Pediatrics / 29.04.2016

MedicalResearch.com Interview with: Jorijn Hornman, BSc (MD PhD student) Departments of Health Sciences University Medical Center Groningen University of Groningen, Netherlands MedicalResearch.com: What is the background for this study? Response: Preterm children are at increased risk of emotional and behavioral problems compared to full-term children. Prevalences vary with degree of prematurity and assessment age. Unknown was whether stability of these problems upon school entry differs between preterm and full-term children. MedicalResearch.com: What are the main findings? Response: We found that preterm children had higher rates than full-term children of persistent (7.2% versus 3.6%), emerging (4.3% versus 2.3%), and resolving (7.5% versus 3.6%) emotional and behavioral problems. Early preterm children –born at <32 weeks gestation- had the highest rates of persistent (8.2%) and emerging (5.2%) problems, and moderately preterm children –born at 32-35 weeks gestation- the highest rates of resolving problems (8.7%). (more…)
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…)
AHA Journals, Author Interviews, Education, Heart Disease, Stroke / 23.12.2015

MedicalResearch.com Interview with: Carole Decker, RN, PhD, CPHQ, FAHA Director, Cardiovascular Outcomes Research Saint Luke's Mid America Heart Institute Kansas City, MO 64111 Medical Research: What is the background for this study? What are the main findings? Dr. Decker: Stroke is the leading cause of disability and the fifth leading cause of death. The utilization of thrombolytic therapy is the national standard of care for acute ischemic stroke (AIS) treatment resulting in improved outcomes at 90 days and yet only 7% of patients with AIS receive a thrombolytic. The American College of Emergency Physicians emphasizes the importance of using a shared medical decision-making model with AIS patients and their caregivers to discuss benefits and risks of treatment. The recommended door-to-needle (emergency door to thrombolytic administration) is 60 minutes to achieve the optimal patient outcomes which can be problematic in that conversation on benefits and risks occurs in a hurried emergency setting. Multiple risk models to identify individualized benefits and risks of thrombolytic therapy have been developed but few are used prospectively and are not used at the point of care. Our team created ePRISM (Personalized Risk Information Services Manager), a Web-based tool, to generate personalized documents with patient-specific outcomes based on validated risks models. To support knowledge transfer and creation of a shared decision-making tool, our multidisciplinary team conducted qualitative interviews to define the information needs and preferred presentation format for stroke survivors, caregivers, and clinicians considering thrombolytic treatment. (more…)
Author Interviews, Cost of Health Care, Education, JAMA / 16.12.2015

MedicalResearch.com Interview with: Lorette A. Stammen, MD Department of Educational Development and Research Faculty of Health, Medicine, and Life Sciences Maastricht University, Maastricht The Netherlands Medical Research: What is the background for this study? What are the main findings? Dr. Stammen: Research indicated that we can improve the quality of care and reduce the health care costs by eliminating health care waste. Health care waste are health care services that are not beneficial to patients. There are many ways to reduce health care waste, like through insurance and government policies modification,  but we were especially interested in how the medical expertise of physicians could improve high-value, cost-conscious care. We conducted a systematic review with the aim of understanding how training programs cause learning among physicians, residents and medical students. We analyzed 79 articles using realist review method and found three important factors that facilitate the learning of physicians (in training).
  • First, educational programs should focus on knowledge transmission. Knowledge that is essential entails knowledge regarding prices and general health economics, scientific evidence, and patient preferences.
  • Besides knowledge, the second factor of training for high-value, cost-conscious care is reflective practice. Reflective practice for example using feedback and asking reflective questions, by peers, colleagues and supervisors to reflect on decisions made in daily practice.
  • The third element of training programs should address an supportive environment in which physicians, residents and medical students learn. A supportive environment is important to cultivate the importance of high-value, cost-conscious care on multiple levels in the health care system. Since physicians are a part of a health care team their training programs should incorporate the training of health care professionals.
  • Furthermore, it is important that role models demonstrate high-value cost-conscious care.
(more…)
AHA Journals, Author Interviews, Duke, Education, Gender Differences, Heart Disease / 10.11.2015

MedicalResearch.com Interview with: Pamela S. Douglas, MD, MACC, FASE, FAHA Ursula Geller Professor of Research in Cardiovascular Disease Duke University School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Douglas: The impetus for our study was the concern that cardiology as a profession might be enhanced by greater diversity. By not attracting women in larger numbers (9% of FACCs are female), our fellowships have incomplete access to the talent pool of outstanding residents, and we do not have a diverse group of clinicians to care for our increasingly diverse patient population, or of researchers to explore potentially important health care disparities. Our findings were twofold: first, job descriptions for men and women cardiologists are dramatically different. Men are much more likely to do invasive procedures while women are more likely to see patients and perform imaging/noninvasive tests.  While there were slightly more women working part time than men this was still rare, and the difference in number of days worked was just 6, across an entire year. The second finding was that there was a significant difference in compensation. Unadjusted, this was over $110, 000 per year; after very robust adjustment using over 100  personal, practice, job description and productivity measures, the difference was $37, 000 per year, or over a million dollars across a career. A separate independent economic analysis of wage differentials yield a similar difference of $32,000 per year. (more…)