Accidents & Violence, Author Interviews, JAMA / 30.07.2018

MedicalResearch.com Interview with: “GUNS” by Jessica Spengler is licensed under CC BY 2.0Kendrin R. Sonneville, ScD, RD Assistant Professor Department of Nutritional Sciences University of Michigan School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: The results from this come out of MyVoice, a text message cohort of youth ages 14-24 representing every state in the country (http://hearmyvoicenow.org/). Each week we ask the youth in our cohort a series of open-ended to questions, with the goal of gathering the real-time opinions and experiences of youth across the U.S. This study reports the results of questions we asked MyVoice paritpatns between 07/2017 and 01/2018 about guns and gun control.  (1) What are your thoughts about having guns in your home? (2) Do you think gun control laws would affect mass shootings? Why? (3) Who, if anyone, should NOT be allowed to own guns? We found that about one-third of youth in our diverse sample were “against” guns in the home, and the remaining two-thirds were either “pro” or “conditionally pro” guns in the home, stating that gun ownership is acceptable under certain conditions, such as proper storage, or kept away from children. Youth in our sample largely believed that gun control laws could decrease mass shootings, but one-third felt that gun control laws would not be enough to impact mass shootings. (more…)
Author Interviews, Biomarkers, NYU, Pediatrics, Pulmonary Disease / 29.07.2018

MedicalResearch.com Interview with: Dr. Mikhail Kazachkov MD Director of Pediatric Pulmonology Hassenfeld Children’s Hospital NYU Langone Medical Center  MedicalResearch.com: What is the background for this study? How common is the problem of chronic cough in children?  Is it more common in children with allergies, asthma or reflux? Response: Chronic cough is one of the leading causes of pediatric referrals to subspecialty physicians.  Its prevalence in the general pediatric population may approach 3% (Galassi et al, Epidemiol. Prev. 2005;29,Suppl.:9–13). It is important to recognize that the main causes of chronic cough in children are completely different for those in adults.  Specifically, gastroesophageal reflux and postnasal drip are not considered to be important causes of cough in children.  Cough variant asthma, although is a common cause of cough in adults, does not seem to be frequently diagnosed and a cause of chronic cough in children. The main cause of chronic wet cough in children is protracted bacterial bronchitis (Chang et al, Chest. 2017 Apr;151:884-890).  It is important to recognize that neurologically impaired children have completely different pathogenesis of chronic cough, which is mostly related to aspiration into the lower airway and development of aspiration-related lung disease. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, JAMA, Pediatrics, University of Pittsburgh / 25.07.2018

MedicalResearch.com Interview with: Idris V.R. Evans, M.D.,MA Assistant Professor Department of Critical Care Medicine University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings? Response: New York State issued a state-wide mandate in 2013 for all hospitals to develop protocols for sepsis recognition and treatment. This mandate was called “Rory’s Regulations” in honor of Rory Staunton, a boy who died from sepsis in 2012. Pediatric protocols involved a bundle of care that included blood cultures, antibiotics, and an intravenous fluid bolus within 1–hour. We analyzed data collected by the NYS Department of Health on 1,179 patients from 54 hospitals and found that the completion of the pediatric bundle within 1 hour was associated with a 40% decrease in the odds of mortality.  (more…)
Author Interviews, HIV, OBGYNE, Pediatrics, Pediatrics, STD / 24.07.2018

MedicalResearch.com Interview with: Monika K. Goyal, M.D., M.S.C.E., senior study author Assistant professor of Pediatrics and Emergency Medicine Children’s National Health System Washington, DC  MedicalResearch.com: What is the background for this study? Response: Patients with pelvic inflammatory disease (PID) are at an increased risk for syphilis and HIV. We know that adolescents account for 20 percent of the 1 million cases of PID that are diagnosed each year. We also know that an estimated one in four sexually active adolescent females has a sexually transmitted infection (STI). While screening for syphilis and HIV is recommended when diagnosing PID, actual screening rates among adolescents have been understudied. This multi-center study aimed to quantify rates of HIV and syphilis screening in young women diagnosed with . pelvic inflammatory disease in pediatric emergency departments and to explore patient- and hospital-specific characteristics associated with screening for these two sexually transmitted infections. (more…)
Author Interviews, Education, Gender Differences, JAMA, Pediatrics / 22.07.2018

MedicalResearch.com Interview with: Julie Silver, MD Associate Professor and Associate Chair Department of Physical Medicine and Rehabilitation at Harvard Medical School and Staff physician at Massachusetts General Brigham and Women’s and Spaulding Rehabilitation Hospitals  MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are many documented disparities for women in medicine that include promotion and compensation. For physicians in academic medicine, both promotion and compensation may be directly or indirectly linked to publishing. Similarly, opportunities that stem from publishing such as speaking engagements, may be affected by a physician’s ability to publish. For more than twenty years, there have been reports of women being underrepresented on journal editorial boards and gaps in their publishing rates. For example, a report titled “Is There a Sex Bias in Choosing Editors?” by Dickersin et al was published in JAMA in 1998 and made a compelling case for bias. Moreover, the authors noted that “a selection process favoring men would have profound ramifications for the professional advancements and influence of women”. Despite a steady stream of reports over the years, gaps have not been sufficiently addressed, and in 2014 Roberts published an editorial in Academic Psychiatry titled “Where Are the Women Editors?”. The 2017 review by Hengel titled “Publishing While Female” highlights many of the gaps, disparities and barriers for women in medicine. Conventional reasons for disparities, such as there are not enough women in the pipeline or women do not want to conduct research or pursue leadership positions, are simply not valid. Therefore, it is important to look at other barriers, such as unconscious (implicit) bias that may affect the editorial process. In this study, we analyzed perspective type articles from four high impact pediatric journals. We selected pediatrics, because most pediatricians are women, and therefore there are plenty of highly accomplished women physicians. We found that women were underrepresented among physician first authors in all of the journals (140 of 336 [41.7%]). We also found that underrepresentation was more pronounced in article categories that were described as more scholarly (range, 15.4%-44.1%) versus narrative (52.9%-65.6%).  (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Pediatrics, Social Issues / 11.07.2018

MedicalResearch.com Interview with: Dr. Tessie W. October. MD, MPH Critical Care Specialist Children’s National Health System  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This is a qualitative study that examines the impact of empathetic statements made by doctors on the ensuing conversation with families of critically ill children. We know families are more satisfied when doctors show empathy, but until this study, we did not know how these empathetic statements are received by families. In this study we found that doctors frequently respond to a family’s emotions by responding with empathy, but how the doctor presented that empathetic statement mattered. When doctors made an empathetic statement, then paused to allow time for a family’s response, the family was 18 times more likely to share additional information about their fears, hopes or values. Conversely, when doctors buried the empathetic statement within medical talk or if a second doctor interrupted, the empathetic statement frequently went unheard by the family. (more…)
Author Interviews, Pediatrics / 11.07.2018

MedicalResearch.com Interview with: Andrew N. Meltzoff Ph.D. Job and Gertrud Tamaki Endowed Chair Co-Director, Institute for Learning & Brain Sciences (I-LABS) Professor of Psychology Elected member of the American Academy of Arts & Sciences. University of Washington, Box 357920 Seattle, WA 98195 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We are applying safe, noninvasive neuroscience techniques to examine the development of young children. We are especially interested in social-emotional learning and cognitive development. The way the body is represented in the brain is well-studied topic in cognitive neuroscience using adults, for example, the classical studies by W. Penfield on the ‘sensorimotor homunculus’ in the adult brain. The development of neural body map in human infants is, however, deeply understudied. We think that the way the body is represented in the brain will provide important information about infant learning prior to language. For example, one of the chief avenues of learning in human infants is through observation and imitation. Infants watch what adults do and imitate those behaviors, rapidly learning about people, things, and causal relations. The mechanisms of imitation themselves are interesting. In order to imitate, infants need to know what part of their body to move and how to move it. We wanted to explore the representations of the human body in the infant brain prior to language. (more…)
Author Interviews, Cancer Research, Endocrinology, JAMA, Pediatrics / 02.07.2018

MedicalResearch.com Interview with: “Cancer awareness” by Susan Roberts is licensed under CC BY 2.0Mette Vestergaard Jensen, MD Danish Cancer Society Research Center MedicalResearch.com: What is the background for this study? Response: Cancer survival rates have improved and it is necessary to explore the long-term consequences of cancer treatment. Adolescents and young adults with cancer are at risk for several therapy-related late effects; however, these have not been studied extensively. We investigatet the lifetime risks of endocrine late effects of cancer and cancer treatment in adolescent and young adult cancer s (more…)
Accidents & Violence, Author Interviews, Emergency Care, Pediatrics / 27.06.2018

MedicalResearch.com Interview with: “Bikes” by Britta Frahm is licensed under CC BY 2.0Lara McKenzie, PhD Principal investigator in the Center for Injury Research and Polic Nationwide Children’s Hospital. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Bicycling is a great way for families to get outside and be active together, but certain precautions need to be taken to keep everyone safer. This study looked at bicycle-related injuries among children age 5-17 years treated in hospital emergency departments in the United States from 2006 through 2015 and found that, despite a decrease in the rate of injuries over the 10-year study period, there were still more than 2.2 million injuries. This averages 608 cases per day or 25 every hour. The majority of injuries involved children 10 to 14 years of age (46%) and boys (72%). The most commonly injured body region was the upper extremities (36%), followed by the lower extremities (25%), face (15%), and head and neck (15%). The most common types of injury were bruises and scrapes (29%) and cuts (23%). Overall, traumatic brain injuries (TBIs) represented 11% of total injuries and were most common among patients 10-14 years of age (44%). About 4% of patients were hospitalized. Injuries most frequently occurred in the street (48%) or at home (37%). Helmet use at the time of injury was associated with a lower likelihood of head and neck injuries and hospitalizations, but there was no significant change in the rate of injury among helmet users over the study period. Motor vehicle involvement increased the odds of bicycle-related TBIs and injury-related hospitalizations.  (more…)
Author Interviews, Opiods, Pediatrics, Pediatrics / 27.06.2018

MedicalResearch.com Interview with: Gary A. Smith, MD, DrPH Director, Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH MedicalResearch.com: What is the background for this study? Response: Buprenorphine is a prescription opioid medication commonly used to treat opioid use disorder. From 2005 to 2010, the annual number of individual patients who received a buprenorphine prescription increased from 100,000 to more than 800,000. Although buprenorphine is important for the treatment of opioid use disorder, pediatric exposure to this medication can result in serious adverse outcomes. (more…)
Author Interviews, OBGYNE, Pediatrics / 23.06.2018

MedicalResearch.com Interview with: Melissa Lorenzo MD Pediatric medical resident Dr. Lorenzo is currently training at the University of Toronto, however the research was conducted while a medical student at Queens University MedicalResearch.com: What is the background for this study? Response: Preterm infants are born before 37 weeks gestation, with late preterm neonates defined as infants born between 34 weeks to 37 weeks gestation. Of all preterm births, over 70% of babies are born in the late preterm period. Late preterm births are common, affecting 12.5% of all births in the United States. Compared to infants born at term, late preterm neonates are at increased risk for many common complications following birth such as jaundice, low blood sugar, and respiratory distress, prolong hospital stay, admission to the neonatal intensive care unit, and increase readmission rate after hospital discharge. There are many causes for preterm delivery- two important ones are early onset of labour either spontaneous or after premature rupture of membranes, and medically indicated delivery prior to full term gestation due to chronic diseases in mother affecting her health in pregnancy, fetal medical reasons, or placental insufficiency. There is a debate that the risk of neonatal complications is affected by the causes of preterm delivery with immaturity acting as a contributing factor. The relative contribution of immaturity versus the reason for delivery and the resulting neonatal complications is unclear. (more…)
Author Interviews, Environmental Risks, Pediatrics, PLoS, Toxin Research / 19.06.2018

MedicalResearch.com Interview with: Cheryl Rosenfeld PhD DVS Professor of biomedical sciences in the College of Veterinary Medicine investigator in the Bond Life Sciences Center, and research faculty member for the Thompson Center for Autism and Neurobehavioral Disorders University of Missouri MedicalResearch.com: What is the background for this study? What are the main findings? Response: My laboratory has been examining the effects of developmental exposure to the endocrine disrupting chemical (EDC), bisphenol A (BPA) on later neurobehavioral responses in a variety of rodent models, including California mice. This species is unique in that both parents rear the pups and they have monogamous social structure, similar to most human societies. We had previously found that developmental exposure to BPA or another EDC, ethinyl estradiol (EE), disrupted later maternal and paternal care by F1 offspringto their F2 pups. Rodent pups use vocalizations both in the range of human hearing (20,000 hertz or below) and outside of the range of human hearing (20,000 hertz) to communicate with each other and their parents, and for the latter, such communications serve as a trigger to provide additional parental care in the form of nutrition or warmth to the pups. Thus, in the current studies we sought to determine if exposure of the grandparents to BPA or EE could lead to disruptions in their grandoffspring (F2 generation) pup communications that might then at least partially account for the parental neglect of their F1 parents. We found that early on female BPA pups took longer to call to their parents but later during the neonatal period they vocalized more than pups whose grandparents were not exposed to either chemical. Such vocalization changes could be due to multigenerational exposure to BPA and/or indicate that the pups are perceiving and responding to the reduced parental care and attempting but failing to signal to their F1 parents that they need more attention. (more…)
Author Interviews, Environmental Risks, Gastrointestinal Disease, Pediatrics / 18.06.2018

MedicalResearch.com Interview with: Kris R. Jatana, MD, FAAP, FACS Associate Professor Director, Pediatric Otolaryngology Quality Improvement Department of Otolaryngology-Head & Neck Surgery Nationwide Children's Hospital & Wexner Medical Center at Ohio State University MedicalResearch.com: What is the background for this study?   Response: More than 2,500 pediatric button battery ingestions occur annually in the United States. When lodged in the esophagus, rapid injury can occur from the tissue and saliva connecting the circuit of the battery. Serious injury can occur in a matter of hours. This results in a highly alkaline caustic injury that dissolves tissue, a process called liquefactive necrosis. There was a need for novel mitigation strategies to slow the progression of esophageal injury caused by presence of a button battery. This study aimed at identifying a palatable liquid that can be given at home or hospital setting to reduce esophageal injury until the battery can be removed. (more…)
Author Interviews, Ophthalmology, Pediatrics / 14.06.2018

MedicalResearch.com Interview with: multiple choice test takingKrista Kelly, PhD Postdoctoral Fellow Crystal Charity Ball Pediatric Vision Evaluation Center Retina Foundation of the Southwest Dallas, TX 75231 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We were interested in seeing whether the fine motor deficits typically seen in amblyopia (lazy eye) and strabismus (crossed eyes) translate to an academic setting. Namely, transferring answers to a multiple choice answer form widely used in standardized testing in schools. Children with amblyopia and strabismus took about 28% longer than their peers transferring answers to a multiple choice answer form, even though they have good vision in one or both eyes.  (more…)
Allergies, Author Interviews, Autism, JAMA, Pediatrics / 10.06.2018

MedicalResearch.com Interview with: Wei Bao, MD, PhD Assistant Professor, Epidemiology College of Public Health University of Iowa MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies indicated a possible link between immunologic dysfunction and autism. The current study, based on nationally representative large-scale surveys, showed that food allergy, respiratory allergy, and skin allergy, all relevant to immunological dysfunction, were associated with autism spectrum disorder among US children. (more…)
Author Interviews, Genetic Research, Pediatrics, Weight Research / 22.05.2018

MedicalResearch.com Interview with: “Great Grandmother” by David Amsler is licensed under CC BY 2.0Rebecca Somerville MB BCh BAO, BMedSci, MRCPI, MPH, PhD School of Public Health, Physiotherapy and Sports Science University College Dublin Dublin, Ireland  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Rates of obesity in the Western world have increased dramatically over recent decades. The negative health consequences of obesity are well known and significant amounts of research have been conducted into the causes and possible solutions. While it is clear that there have been massive changes in diet and physical activity at a societal level that are primarily responsible for this 'obesity epidemic', it is less clear the extent to which obesity, once established, or risk factors for same, can be perpetuated down generations. Family studies lend opportunity to explore these questions, however there are few world wide which incorporate 3 generations. We therefore sought to examine patterns of central adiposity, as measured by waist circumference, between grandparents and their grandchildren, separately in maternal and paternal lines. We were able to utilize prospectively collected data from the Lifeways Cross-Generation Cohort Study. This is a longitudinal birth cohort, established in Ireland in 2001, involving up to 7 members of the same family (mother, father, child and 4 grandparents). In the 589 families where a child had a waist circumference measurement we found that, at the age of both 5 and 9, there was a direct relationship between the waist circumference of the maternal grandmother and her grandchild (both male and female). This remained after adjustment for a wide range of confounding variables including mother's waist circumference. There was no relationship seen with any of the other grandparents. (more…)
Author Interviews, Nutrition, Pediatrics / 18.05.2018

MedicalResearch.com Interview with: Katherine Ottolini MD, lead study author Children’s National Health System and Catherine Limperopoulos, Ph.D., senior study author and Director of Developing Brain Research Laboratory Children’s National Health System MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nutrition is an important modifiable factor for brain development in premature infants, however few studies have evaluated the impact of nutritional interventions in the neonatal intensive care unit (NICU) on structural brain development in very premature infants using advanced, quantitative MRI techniques. The goal of this study was to utilize quantitative MRI to evaluate the impact of macronutrient (carbohydrate, protein, fat) and energy intake throughout the duration of the NICU stay on brain volumes and white matter development in very premature infants at term-equivalent age (TEA). We prospectively enrolled 68 very low birthweight infants (< 1500g) admitted to Children’s NICU within the first 7 days of life. We found significant negative associations between cumulative macronutrient and energy intake on both the brain’s white matter microstructural development (in the superior cerebellar peduncle, corpus callosum) and regional brain volumetric growth (cortical gray matter and cerebellum). In contrast, when evaluating average nutritional intake, we found significant associations between lipid and energy intake and regional brain volumes in the cortical gray matter, brainstem and cerebellum.  (more…)
Author Interviews, CDC, JAMA, Pediatrics / 15.05.2018

MedicalResearch.com Interview with: Craig M. Hales, MD, MPH, MS CDR, U.S. Public Health Service Division of Health and Nutrition Examination Surveys National Center for Health Statistics Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? Response: Monitoring trends in prescription medication use among children and adolescents is an important part of understanding the health of youth in the U.S. and the healthcare they receive. For this study we used data from the National Health and Nutrition Examination Survey or NHANES, which is a nationally representative survey of the US population and as part of this face-to-face survey in the home, we ask participants about their prescription medication use in the last 30 days and collect information about the prescription directly from the medication package. (more…)
Accidents & Violence, Author Interviews, Pediatrics, Pediatrics / 14.05.2018

MedicalResearch.com Interview with: “Crime Scene _MG_4847” by thierry ehrmann is licensed under CC BY 2.0Daniel Romer, PhD Research Director Annenberg Public Policy Center and Director of its Adolescent Communication Institute (ACI) University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have been studying the steady increase in gun violence that has been occurring in popular PG-13 movies since the new rating was adopted in 1984.  It has recently even surpassed the amount of gun violence in R-rated movies.  Since these movies are open to the public at any age, we are concerned that they promote the use of guns and potentially socialize youth to believe that using guns to defend oneself is an appropriate way to handle threats and other conflicts. We knew that the rating requires the omission of graphic consequences, such as blood and suffering, that can make the violence more acceptable.  But we also wondered whether the motivation for the violence might make a difference as well.  Many of the characters in PG-13 movies are seen as heroic (e.g., Bruce Willis and Liam Neeson).  Could that also be a factor that makes such films more acceptable to parents despite their concerns about their children seeing so much violence in the movies.  So, we conducted this experiment to see if parents are less upset by justified violence in PG-13 style movies.  (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Depression, Pediatrics / 11.05.2018

MedicalResearch.com Interview with: Karen Fratantoni, M.D., M.P.H. Pediatrician and lead study author Children’s National Health System MedicalResearch.com: What is the background for this study? Response: We looked at the prevalence of depressive symptoms at NICU discharge and at six months after discharge among 125 parents randomized to the control group of a larger PCORI-funded trial of peer-to-peer support after NICU discharge. Determining factors associated with parental depressive symptoms at NICU discharge may help to identify at-risk parents who could benefit from mental health support. (more…)
Author Interviews, BMJ, Genetic Research, Pediatrics / 10.05.2018

MedicalResearch.com Interview with: “Newborn” by Brad Carroll is licensed under CC BY 2.0Dr Sian Taylor-Phillips MPhys, PhD Associate Professor Screening and Test Evaluation / NIHR Career Development Fellow Division of Health Sciences Warwick Medical School University of Warwick Coventry MedicalResearch.com: What is the background for this study? What are the main findings? Response: In newborn blood spot screening a small amount of blood is taken from newborn babies heels, and this is tested for a range of rare diseases. The idea is to detect each disease earlier when it is more treatable. However, it would be better not to test for some diseases, for example if the test is inaccurate so worries parents that their baby may have a serious illness when they do not. Some countries test for as few as 5 diseases and others as many as 50. In this study we investigated how different countries choose which diseases to test for. We found that many national recommendations on whether to screen newborn babies for rare diseases do not assess the evidence on the key benefits and harms of screening. Evidence about the accuracy of the test was not considered in 42% of recommendations, evidence about whether early detection at screening has health benefits was not consulted in 30% of recommendations, and evidence around the potential harm of overdiagnosis where babies have variants of the disease that would never have caused any symptoms or ill effects was not considered in 76% of recommendations. We also found through meta-analysis that when a systematic review was used to bring together the evidence then countries were less likely to recommend screening for the disease. (more…)
Accidents & Violence, Author Interviews, Pediatrics / 07.05.2018

MedicalResearch.com Interview with: Dr. Julie Leonard MD MPH Nationwide Children’s Hospital Columbus, OH MedicalResearch.com: What is the background for this study? What are the main findings? Response: We looked at children with unintentional injuries who were hospitalized to see if there was an increase in their mental health needs. We saw an average 63% increase in mental health diagnoses and a 155% increase in medications prescribed to treat a mental illness. (more…)
Author Interviews, CDC, Depression, Pediatrics / 04.05.2018

MedicalResearch.com Interview with: Rebecca H. Bitsko, PhD National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention  MedicalResearch.com: What is the background for this study? What are the main findings? Response: CDC’s National Center on Birth Defects and Developmental Disabilities(https://www.cdc.gov/ncbddd/index.html) (NCBDDD) is committed to helping children who have mental, emotional, and behavioral disorders. Anxiety and depression are both internalizing mental disorders that often start during childhood, and that frequently occur together. In this study, we show that more than 1 in 20, or 2.6 million, US children aged 6-17 had a current diagnosis of anxiety or depression, by parent report, in 2011-12. We also found an increase of diagnosed anxiety in these children from 1 in 28 in 2007 to 1 in 24 in 2011-12. Further, in 2011-12, approximately 1 in 5 children with current anxiety or depression did not receive mental health treatment in the past year. Children with current anxiety or depression were more likely than those without to have:
  • Another mental, behavioral, or developmental disorder such as ADHD, learning disability, or speech or language problems
  • School problems
  • Parents who report high levels of stress and frustration with parenting
  • Unmet medical and mental health service needs
(more…)
Author Interviews, BMJ, Global Health, Pediatrics, Vitamin D, Weight Research / 04.05.2018

MedicalResearch.com Interview with: Dr Javeria Saleem PhD Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry Queen Mary University of London London, United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Response: Severe acute malnutrition is the most extreme and visible form of undernutrition. Affected children have very low weight for their height and severe muscle wasting; they may also have swollen feet, face and limbs. Around 20 million children suffer from severe acute malnutrition worldwide of whom an estimated 1.4 million live in Pakistan. The condition is a major cause of death in children under 5 in Asia and Africa. The standard treatment is to give a high-energy, micronutrient enhanced paste called ready-to-use therapeutic food (RUTF). Vitamin D deficiency has been reported to be a risk factor for severe wasting in children with severe acute malnutrition Ready-to-use therapeutic food contains relatively modest amounts of vitamin D. However, the effects of adding high-dose vitamin D to this standard treatment have not previously been evaluated. We therefore did a clinical trial to assess whether high-dose vitamin D hastened recovery in 185 children aged 6-58 months who were receiving standard treatment for severe acute malnutrition in Southern Punjab, Pakistan. The 93 children in the active arm of the study received two doses of 5 mg vitamin D by mouth, while the 92 children in the control arm received placebo (a dummy medicine containing no vitamin D). Our findings were very striking: after 2 months of treatment, the children who received high-dose vitamin D in addition to standard therapy had significantly better weight gain, and significantly better motor and language development, than those who received standard treatment alone. (more…)
Author Interviews, Education, JAMA, Pediatrics / 20.04.2018

MedicalResearch.com Interview with: “Children Playing at Swyalana Lagoon” by Doug Hay is licensed under CC BY 2.0Dr Anuja Pandey Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health London UK  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Evidence from longitudinal studies suggests that self-regulation skills can be a powerful predictor of positive health, educational, financial and social outcomes. Hence, self-regulation has received interest as an intervention target and a number of interventions have been evaluated in children and adolescents. Our study summarised the evidence from 50 rigorously evaluated self-regulation interventions in children and adolescents including 23098 participants. We found that while most interventions were successful in improving self-regulation (66%), some of them did not produce a noticeable change (34%).Curriculum based approach was most commonly used to deliver interventions, and this involved training teachers, who implemented these interventions.  (more…)
Author Interviews, Environmental Risks, Infections, Pediatrics, Respiratory / 18.04.2018

MedicalResearch.com Interview with: Benjamin D. Horne, PhD Director of Cardiovascular and Genetic Epidemiology Intermountain Heart Institute Intermountain Medical Center Salt Lake City, Utah  MedicalResearch.com: What is the background for this study? Response: Evidence suggests that short-term elevations (even for just a few days) of fine particulate matter air pollution (PM2.5, which is particulate matter less than 2.5 um or about one-thirtieth the diameter of a human hair) is associated with various poor health outcomes among adults, including myocardial infarction, heart failure exacerbation, and worsening of chronic obstructive pulmonary disease symptoms. Studies of long-term exposure to moderately elevated levels of PM2.5 indicate that chronic daily air pollution exposure may contribute to death due to pneumonia and influenza. Research regarding the association of short-term elevations in PM2.5 has provided some limited evidence of a possible association between short-term PM2.5 increases and infection with respiratory syncytial virus (RSV) or bronchiolitis in children, but scientifically these reports have been weak and unreliable, probably because they have only looked at a period of a few days to a week after short-term PM2.5 elevations. An evaluation of a very large population in a geographic location that provides a wide variation in PM2.5 levels from lowest to highest levels and that examines longer periods of time after the PM2.5 elevations is needed to determine whether a PM2.5 association with lower respiratory infection exists. (more…)
Author Interviews, Mental Health Research, Pediatrics, Primary Care / 15.04.2018

MedicalResearch.com Interview with: Anna Scandinaro Medical student Penn State College of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Dr. Usman Hameed, a child and adolescent psychiatrist, and Dr. Dellasega wrote a previous paper called "What is irritability?" which examined the idea and concept of what irritability in school aged children can encompass. After considering possible definitions of irritability, we wanted to see how the concept manifested in clinical practice, especially with the controversy around the new diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) in the DSM 5. The main findings of this study are that primary care providers (PCP)​identified a need for more training and education in how to assess irritability in pediatric and adolescent populations. In contrast, the child and adolescent psychiatrists we interviewed thought more triage from PCPs who care for school aged children with irritability would be helpful.  (more…)
Author Interviews, Depression, Eating Disorders, JAMA, Mental Health Research, Pediatrics / 13.04.2018

MedicalResearch.com Interview with: Tracy Vaillancourt, Ph.D. Full Professor and Canada Research Chair Children’s Mental Health and Violence Prevention Counselling Psychology, Faculty of Education School of Psychology, Faculty of Social Sciences University of Ottawa MedicalResearch.com: What is the background for this study? Response: Although there have been a few studies that have looked at the relation between being bullied and disordered eating, most studies have looked at it from the perspective of does being bullied lead to disordered eating and does depressive symptoms mediate (i.e., explain) the link. We wanted to look more closely at how bullying, disordered eating, and depression were related over time among teenagers by examining all possible pathways. Another novel aspect of our study was the focus on disordered eating behaviour only (e.g., vomiting, using diet pills, binge eating). Most previous work has examined behaviour and thoughts together, but because disordered eating thoughts are so common (termed normative discontent; e.g., fear of fat, dissatisfaction with body shape or size), particularly among girls and women, we wanted to focus on behaviour, which is more problematic in terms of physical and psychiatric health. (more…)
Author Interviews, JAMA, Mental Health Research, OBGYNE, Pediatrics / 11.04.2018

MedicalResearch.com Interview with: Jiook Cha, PhD Assistant Professor Division of Child and Adolescent Psychiatry Columbia University Medical Center New York, NY 10032 MedicalResearch.com: What did we already know about the connection between maternal SSRI use during pregnancy and infant brain development, and how do the current study findings add to our understanding? What’s new/surprising here and why does it matter for mothers and babies? Response: Prior studies have shown mixed results in terms of the associations between maternal SRI use during pregnancy and offspring’s brain and cognitive development. Neurobiological studies with animal models suggest that SSRI use perturbs serotonin signaling and that this has important effects on cognitive development (a study conducted an author of this paper, Jay Gingrich, MD, PhD: Ansorge et al., 2004, Science). The human literature has been more mixed in terms of the associations of prenatal exposure to SSRI with brain and cognitive development. In our study, we used neonatal brain imaging because this is a direct, non-invasive method to test associations between SSRI use and brain development at an early developmental stage, limiting the effects of the post-natal environment. In our study, we had two different control groups, that is, a non-depressed SSRI-free group (healthy controls), and depressed but SSRI-free (SSRI controls) group. Also, in our study we used rigorous imaging analytics that significantly improve the quantitative nature of MR-derived signals from the brain structure using two of the nation’s fastest supercomputers (Argonne National Laboratory and Texas Advanced Computing Center) and allows robust reconstruction of brain’s grey and white matter structure in the infants’ brains. We report a significant association of prenatal exposure to SSRI with a volume increases within many brain areas, including the amygdala and insula cortex, and an increase in white matter connection strength between the amygdala and insular cortex. We were surprised by the magnitude of the effects (or the statistical effect size), compared with other brain imaging studies in psychiatry with children or adults’ brains. Importantly, it should be noted that our estimates of brain structure are still experimental and for research-purpose only. This means that our data need to be replicated and rigorously tested against confounders in order to make a firm conclusion. While our study suggests a “potential” association between prenatal exposure to SSRI and a change in fetal or infant brain development, we still need more research.  tracts_in_the_brain (more…)