Team Sports Benefits Teens With a Troubled Childhood

MedicalResearch.com Interview with:
Molly C. Easterlin, MD

Fellow, UCLA National Clinician Scholars Program
Clinical Instructor, Pediatrics, Cedars-Sinai Medical Center 

MedicalResearch.com: What is the background for this study?

Response: Adverse childhood experiences or ACEs (including physical or emotional neglect or abuse, sexual abuse, domestic abuse, exposure to household substance misuse or mental illness, parental separation or divorce, and parental incarceration) are common with about half of children experiencing 1 and one-quarter of children experiencing 2 or more.

Children exposed to adverse childhood experiences have worse mental health throughout life, including higher rates of depression and anxiety. However, little is known about what factors improve long-term mental health in those exposed to ACEs. Additionally, as far as we are aware, no studies have looked at team sports participation as a potential factor that may be associated with improved mental health among those with adverse childhood experiences.

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Dialysis Unit Profit Primarily From Small Percentage of Privately Insured Patients

MedicalResearch.com Interview with:

Chris Childers, MD, PhDDivision of General SurgeryDavid Geffen School of Medicine at UCLA10833 Le Conte Ave., CHS 72-247Los Angeles, CA 90095

Dr. Childers

Chris Childers, MD, PhD
Division of General Surgery
David Geffen School of Medicine at UCLA
Los Angeles, CA 90095

MedicalResearch.com: What is the background for this study?

Response: Patients with end-stage renal disease – poorly functioning kidneys – often have to receive dialysis. This typically requires a patient to visit an outpatient clinic several times a week to have their blood filtered by a machine. Over the past few years, two for-profit companies have increased their control over the outpatient dialysis market – DaVita and Fresenius. Combined they control approximately ¾ of the market.  A number of concerns have been raised against these for-profit companies suggesting that the quality of care they deliver may be worse than the care delivered at not-for-profit companies. But, because they control so much of the market and because patients have to receive dialysis so frequently, patients may not have much choice in the clinic they visit.

Medicare covers patients who are 65 years or older and also patients on dialysis regardless of age.  Medicare pays a fixed rate for dialysis which they believe is adequate to cover the clinics’ costs. However, if a patient also has private insurance, the insurer is required to pay for dialysis instead of Medicare. Whereas Medicare rates are fixed by the federal government, private insurers have to negotiate the price they pay, and may pay much more as a result.

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Health Status Declines in Disabled Adults Prior to Receipt of SSI Benefits

MedicalResearch.com Interview with:

Rajan Sonik, PhD JD MPHResearch ScientistTucker-Seeley Research LabLeonard Davis School of GerontologyPostdoctoral Research FellowLeonard D. Schaeffer Center for Health Policy and EconomicsLeonard Davis School of GerontologyUniversity of Southern CaliforniaLos Angeles, CA 90089-3333

Dr. Sonik

Rajan Sonik, PhD JD MPH
Research Scientist
Tucker-Seeley Research Lab
Leonard Davis School of Gerontology
Postdoctoral Research Fellow
Leonard D. Schaeffer Center for Health Policy and Economics
Leonard Davis School of Gerontology
University of Southern California
Los Angeles, CA 90089-3333

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Not everyone who is eligible for public benefits like Supplemental Security Income (SSI) tries to receive them. One distinguishing factor is that those who apply for benefits disproportionately experience shocks (e.g., divorce, job loss, health problems) and sharp increases in material hardships (e.g., food insecurity, housing insecurity) shortly before applying. Typically, these increases in hardships are then partially—but not fully—alleviated by receipt of the public benefits.

Given strong associations between these hardships and poor health outcomes, we wanted to examine whether health status might fluctuate before and after the receipt of public benefits as well. We examined SSI in particular given its focus on individuals with disabilities, keeping in mind the particular health vulnerabilities experienced by this population. In line with patterns previously observed for material hardships, we found in a nationally representative sample that the health status of eventual SSI recipients worsened significantly in the period prior to program entry. After enrollment began, the decline in health status stopped but was not fully reversed.

In the paper, we discuss why these findings were more likely to be driven by changes in material hardship levels rather than changes in disability status.

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Exercise: A Non-Pharmaceutical “Drug” To Reduce Heart Disease in Breast Cancer Patients

MedicalResearch.com Interview with:

Christina M. Dieli-Conwright, PhD, MPH, FACSM, CSCSAssistant Professor of ResearchDirector, Integrative Center for Oncology Research in ExerciseDivision of Biokinesiology & Physical Therapy, Ostrow School of DentistryDepartment of Medicine, Keck School of MedicineUniversity of Southern CaliforniaLos Angeles, CA 90033

Dr. Dieli-Conwright

Christina M. Dieli-Conwright, PhD, MPH, FACSM, CSCS
Assistant Professor of Research
Director, Integrative Center for Oncology Research in Exercise
Division of Biokinesiology & Physical Therapy, Ostrow School of Dentistry
Department of Medicine, Keck School of Medicine
University of Southern California
Los Angeles, CA 90033 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: This study was designed to assess the effects of an aerobic and resistance exercise on metabolic dysregulation in sedentary, obese breast cancer survivors, however we further examined the effects on cardiovascular disease risk measured by the Framingham Risk Score, reported here.

Our findings indicated that exercise, indeed, reduces the risk of cardiovascular disease in this population.  Continue reading

Cataract Surgery: QI Initiative Markedly Reduced Low-Value Preoperative Care

MedicalResearch.com Interview with:

John N. Mafi MPH Assistant Professor of Medicine David Geffen School of Medicine University of California, Los Angeles Natural scientist in Health Policy RAND Corporation Santa Monica, California

Dr. Mafi

John N. Mafi, MD, MPH
Division of General Internal Medicine and Health Services Research
Department of Medicine
David Geffen School of Medicine at UCLA
RAND Health, RAND Corporation

MedicalResearch.com: What is the background for this study? What types of services are low-value in this setting? 

Response: For decades we have known that offering routine preoperative testing for patients undergoing cataract surgery provides limited value, yet low-value preoperative testing persists at very high rates, even at Los Angeles County Department of Health Services, one of the largest safety net health systems in the United States.

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Stereotactic Radiation Can Condense Treatment Times For Prostate Cancer

MedicalResearch.com Interview with:

Amar U. Kishan, MD Assistant Professor Department of Radiation Oncology University of California, Los Angeles

Dr. Kishan

Amar U. Kishan, MD
Assistant Professor
Department of Radiation Oncology
University of California, Los Angeles

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Typical external beam radiation courses range up to 8-9 weeks in length (39-45 treatments). There are data that shorter courses, delivering a higher dose per day, may be just as effective.

Stereotactic body radiotherapy (SBRT) really pushes this concept by condensing the treatment to just four to five treatments, with a high dose per day.

Here, we present the pooled results of the outcomes of 2142 men with low and intermediate risk prostate cancer and a median of 6.9 years of followup.

We demonstrate a very favorable efficacy and safety profile. Specifically, the rates of recurrences were 4.5% and 10.2% for low and intermediate risk disease at 7 years, and rates of late severe toxicity were 2.4% for urinary toxicity and 0.4% for gastrointestinal toxicity.

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Zika: Simple General Movement Assessment Tool Can Predict Babies at Risk of Developmental Problems

MedicalResearch.com Interview with:

Karin Nielsen-Saines, MD, MPH Professor of Clinical Pediatrics Division of Pediatric Infectious Diseases  David Geffen School of Medicine at UCLA

Dr. Nielsen

Karin Nielsen-Saines, MD, MPH
Professor of Clinical Pediatrics
Division of Pediatric Infectious Diseases
David Geffen School of Medicine at UCLA

MedicalResearch.com: What is the background for this study?

Response: Our study used a very simple evaluation called GMA (General Movement Assessment tool) which checks baby movements at approximately 3 to 5 months of age.

We examined 111 babies exposed to maternal illness during the Zika epidemic in Brazil and 333 control babies without this exposure by GMA at 3 months  and then tested them through standard neurodevelopmental tests at the age of 12 months.

We found that this simple evaluation, which consists of filming a baby lying down on their back for one minute and studying their movements worked extremely well in predicting which babies would or would not have future problems in their neurodevelopment. The study advances knowledge in the area because a simple one minute video of a baby can predict neurodevelopment, something that is extremely hard to determine in young babies.  This is true even in places where sophisticated brain scans are available. By identifying which babies are at risk of developmental problems early on, professionals can rapidly refer these babies to  stimulation programs when they are very young, which increases their chances of having better outcomes. Because the brains of young children respond much better  to stimulation, the timing of interventions to improve their development is very important, that is why they need to be identified early.

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