User login
Dual-task walking test may be effective dementia predictor
Poor performance in dual-task gait testing was significantly associated with dementia progression in patients with mild cognitive impairment (MCI), according to a small prospective study.
The dementia prediction model could provide clinicians with a minimally invasive, low-cost analysis tool for patients with MCI and a compass to help guide decisions for further testing, according to Manuel Montero-Odasso, MD, PhD, an associate professor at the University of Western Ontario, London, and his colleagues.
In a study of 112 patients with MCI who were part of the Gait and Brain Study, investigators measured patients’ walking speed while only focusing on walking and then again while walking and counting backward from 100 by ones, counting backward from 100 by 7, or naming animals. The percentage difference between patients’ single-test walking speed and the dual-task speed was the dual-task gait cost. Patients received a biannual follow-up over a 6-year period.
Investigators found that higher gait costs in the dual gait test involving either counting backward by ones or naming animals were associated with a significantly increased risk of progression to dementia (JAMA Neurol. 2017 May 15. doi: 10.1001/jamaneurol.2017.0643).
“Our sensitivity analysis showed that dual-task gait was comparable with cognitive testing to predict incident dementia,” said Dr. Montero-Odasso. “Clinicians may use dual-task gait testing in screening patients with MCI who could benefit the most from additional testing, optimizing recommendations for imaging, spinal fluid examinations, and genetic testing.”
Patients were an average of 75 years old, with an even distribution of men and women. Patients had an average of five comorbidities, most common among them hypertension (60.4%) and history of smoking (56.1%). Of the 112 participants, 24% progressed to dementia, an incidence rate of 121 per 1,000 person-years. A total of 39% of the study participants carried an APOE e4 allele.
Investigators confirmed the presence of MCI by evaluating patients’ levels of cognitive challenges, impairment in memory, executive function, attention, language, certain living activities, and an absence of dementia using criteria from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition.
When comparing the three dual-task gait tests, researchers found that higher gait cost when asking patients to count backward by ones or name animals presented a 3.8 times (P = .003) and 2.4 times (P = .04), respectively, increased risk of dementia progression. Gait cost when counting from 100 by sevens wasn’t significantly associated with dementia risk.
The researchers said that they still do not understand completely the relationship between walking velocity and cognitive function, although they hypothesized the connection may have to do with shared networks in the brain.
“What does seem clear is that executive demands used for gait and for the selected cognitive tasks may share a similar pathogenic mechanism at the brain level,” according to Dr. Montero-Odasso and his fellow investigators. “Episodic memory, a cognitive domain that was affected in all of our participants who progressed to dementia, relies on frontal-hippocampal circuits that are also central for gait control.”
The study was limited by the small population size, causing investigators to conclude that their findings are only generalizable at a clinic-based level. The investigators also noted the need for cross-validation in other MCI cohorts.
The model would be accessible for clinicians and researchers alike when identifying high-risk patients, designing further testing strategies, or planning primary prevention or intervention studies by more easily selecting patients with a greater risk of dementia progression, Dr. Montero-Odasso and his peers asserted.
The Canadian Institutes of Health Research funded the study. One of the authors reported having been a part-time employee of Pfizer and owning employee stock options. The investigators reported no other relevant financial disclosures.
[email protected]
On Twitter @eaztweets
Poor performance in dual-task gait testing was significantly associated with dementia progression in patients with mild cognitive impairment (MCI), according to a small prospective study.
The dementia prediction model could provide clinicians with a minimally invasive, low-cost analysis tool for patients with MCI and a compass to help guide decisions for further testing, according to Manuel Montero-Odasso, MD, PhD, an associate professor at the University of Western Ontario, London, and his colleagues.
In a study of 112 patients with MCI who were part of the Gait and Brain Study, investigators measured patients’ walking speed while only focusing on walking and then again while walking and counting backward from 100 by ones, counting backward from 100 by 7, or naming animals. The percentage difference between patients’ single-test walking speed and the dual-task speed was the dual-task gait cost. Patients received a biannual follow-up over a 6-year period.
Investigators found that higher gait costs in the dual gait test involving either counting backward by ones or naming animals were associated with a significantly increased risk of progression to dementia (JAMA Neurol. 2017 May 15. doi: 10.1001/jamaneurol.2017.0643).
“Our sensitivity analysis showed that dual-task gait was comparable with cognitive testing to predict incident dementia,” said Dr. Montero-Odasso. “Clinicians may use dual-task gait testing in screening patients with MCI who could benefit the most from additional testing, optimizing recommendations for imaging, spinal fluid examinations, and genetic testing.”
Patients were an average of 75 years old, with an even distribution of men and women. Patients had an average of five comorbidities, most common among them hypertension (60.4%) and history of smoking (56.1%). Of the 112 participants, 24% progressed to dementia, an incidence rate of 121 per 1,000 person-years. A total of 39% of the study participants carried an APOE e4 allele.
Investigators confirmed the presence of MCI by evaluating patients’ levels of cognitive challenges, impairment in memory, executive function, attention, language, certain living activities, and an absence of dementia using criteria from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition.
When comparing the three dual-task gait tests, researchers found that higher gait cost when asking patients to count backward by ones or name animals presented a 3.8 times (P = .003) and 2.4 times (P = .04), respectively, increased risk of dementia progression. Gait cost when counting from 100 by sevens wasn’t significantly associated with dementia risk.
The researchers said that they still do not understand completely the relationship between walking velocity and cognitive function, although they hypothesized the connection may have to do with shared networks in the brain.
“What does seem clear is that executive demands used for gait and for the selected cognitive tasks may share a similar pathogenic mechanism at the brain level,” according to Dr. Montero-Odasso and his fellow investigators. “Episodic memory, a cognitive domain that was affected in all of our participants who progressed to dementia, relies on frontal-hippocampal circuits that are also central for gait control.”
The study was limited by the small population size, causing investigators to conclude that their findings are only generalizable at a clinic-based level. The investigators also noted the need for cross-validation in other MCI cohorts.
The model would be accessible for clinicians and researchers alike when identifying high-risk patients, designing further testing strategies, or planning primary prevention or intervention studies by more easily selecting patients with a greater risk of dementia progression, Dr. Montero-Odasso and his peers asserted.
The Canadian Institutes of Health Research funded the study. One of the authors reported having been a part-time employee of Pfizer and owning employee stock options. The investigators reported no other relevant financial disclosures.
[email protected]
On Twitter @eaztweets
Poor performance in dual-task gait testing was significantly associated with dementia progression in patients with mild cognitive impairment (MCI), according to a small prospective study.
The dementia prediction model could provide clinicians with a minimally invasive, low-cost analysis tool for patients with MCI and a compass to help guide decisions for further testing, according to Manuel Montero-Odasso, MD, PhD, an associate professor at the University of Western Ontario, London, and his colleagues.
In a study of 112 patients with MCI who were part of the Gait and Brain Study, investigators measured patients’ walking speed while only focusing on walking and then again while walking and counting backward from 100 by ones, counting backward from 100 by 7, or naming animals. The percentage difference between patients’ single-test walking speed and the dual-task speed was the dual-task gait cost. Patients received a biannual follow-up over a 6-year period.
Investigators found that higher gait costs in the dual gait test involving either counting backward by ones or naming animals were associated with a significantly increased risk of progression to dementia (JAMA Neurol. 2017 May 15. doi: 10.1001/jamaneurol.2017.0643).
“Our sensitivity analysis showed that dual-task gait was comparable with cognitive testing to predict incident dementia,” said Dr. Montero-Odasso. “Clinicians may use dual-task gait testing in screening patients with MCI who could benefit the most from additional testing, optimizing recommendations for imaging, spinal fluid examinations, and genetic testing.”
Patients were an average of 75 years old, with an even distribution of men and women. Patients had an average of five comorbidities, most common among them hypertension (60.4%) and history of smoking (56.1%). Of the 112 participants, 24% progressed to dementia, an incidence rate of 121 per 1,000 person-years. A total of 39% of the study participants carried an APOE e4 allele.
Investigators confirmed the presence of MCI by evaluating patients’ levels of cognitive challenges, impairment in memory, executive function, attention, language, certain living activities, and an absence of dementia using criteria from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition.
When comparing the three dual-task gait tests, researchers found that higher gait cost when asking patients to count backward by ones or name animals presented a 3.8 times (P = .003) and 2.4 times (P = .04), respectively, increased risk of dementia progression. Gait cost when counting from 100 by sevens wasn’t significantly associated with dementia risk.
The researchers said that they still do not understand completely the relationship between walking velocity and cognitive function, although they hypothesized the connection may have to do with shared networks in the brain.
“What does seem clear is that executive demands used for gait and for the selected cognitive tasks may share a similar pathogenic mechanism at the brain level,” according to Dr. Montero-Odasso and his fellow investigators. “Episodic memory, a cognitive domain that was affected in all of our participants who progressed to dementia, relies on frontal-hippocampal circuits that are also central for gait control.”
The study was limited by the small population size, causing investigators to conclude that their findings are only generalizable at a clinic-based level. The investigators also noted the need for cross-validation in other MCI cohorts.
The model would be accessible for clinicians and researchers alike when identifying high-risk patients, designing further testing strategies, or planning primary prevention or intervention studies by more easily selecting patients with a greater risk of dementia progression, Dr. Montero-Odasso and his peers asserted.
The Canadian Institutes of Health Research funded the study. One of the authors reported having been a part-time employee of Pfizer and owning employee stock options. The investigators reported no other relevant financial disclosures.
[email protected]
On Twitter @eaztweets
FROM JAMA NEUROLOGY
Key clinical point:
Major finding: Greater changes in the walking speeds of patients as they counted backward (hazard ratio, 3.79; P = .003) or named animals (HR, 2.41; P = .04) were associated with increased risk of progression to dementia.
Data source: A prospective cohort study of 122 MCI patients enrolled in the Gait and Brain Study, with follow-up reports gathered between July 2007 and March 2016.
Disclosures: The Canadian Institutes of Health Research funded the study. One of the authors reported having been a part-time employee of Pfizer and owning employee stock options. The investigators reported no other relevant financial disclosures.
Women less likely to be diagnosed with sleep disorders
Women are less likely to be diagnosed with and treated for sleep-disordered breathing, despite having symptoms similar to those of men, a Swedish study showed.
In a survey of 10,854 subjects, 14% of women reported being diagnosed with obstructive sleep apnea (OSA), compared with 25% of men (P less than .001), and 9% of women reported having any OSA treatment, compared with 16% of men (Sleep Med. 2017. doi: 10.1016/j.sleep.2017.02.032).
Underdiagnosis of sleep-disordered breathing (SDB) in women may have dire consequences, as symptoms, specifically snoring and excessive daytime sleepiness (EDS), correlate with increased risk for hypertension and diabetes, regardless of gender, according to Eva Lindberg, PhD, professor in the department of medical sciences, respiratory, allergy, and sleep research at Uppsala (Sweden) University, and her colleagues.
The mean age of the patients at baseline was 41 years. Mean body mass index was 25.4 kg/m2 for men and 24 kg/m2 for women.
On initial testing, approximately three times the percentage of men reported having issues with snoring and no EDS, compared with women (19% vs. 6% respectively), while more women reported the opposite, EDS but no snoring (19% vs. 11%). A slightly larger percentage of men reported having both symptoms (7.3% vs. 4.5%).
Investigators hypothesized the disparity between women and men reporting problems with snoring may be caused by gender expectations.
“It is more probable that SDB is still assumed to be a condition associated predominantly with men, and women feel ashamed of reporting these symptoms and seeking medical advice,” said Dr. Lindberg and her coinvestigators. These gender expectations may “contribute to females being less inclined to seek medical advice due to SDB symptoms.”
In a follow-up survey conducted 11 years after the initial one, doctors found 1,716 and 319 patients had received a new diagnosis for hypertension and diabetes, respectively.
While incidence was greater in men than in women for both (hypertension: 18.6% vs. 15.8% [P less than .001] and 3.6 vs. 2.4% [P less than .001], respectively), the investigators found “after adjusting for BMI and snoring at baseline, none of these gender differences remained significant.”
Physicians’ perception of SDB is partially responsible for the number of women who go undiagnosed, according to the researchers. Because SDB is considered to occur predominantly in males, doctors may overlook symptoms in female patients that would otherwise be a cause for further testing, they noted.
“[Even] among health professionals, SDB is still usually attributed to a male population, and female patients are therefore less frequently asked about the cardinal symptoms of snoring and sleepiness and do not therefore undergo sleep recordings. ... Also, among patients with obesity hypoventilation syndrome, females are generally diagnosed when the disease is more advanced and significantly more frequently develop acute disease before achieving treatment,” the investigators wrote.
“[Even] among health professionals, SDB is still usually attributed to a male population and female patients are therefore less frequently asked about the cardinal symptoms of snoring and sleepiness and do not therefore undergo sleep recordings ... Also, among patients with obesity hypoventilation syndrome, females are generally diagnosed when the disease is more advanced and significantly more frequently develop acute disease before achieving treatment,” the investigators claimed.
Dr. Lindberg and her team suggested engaging female patients more frequently about SDB symptoms, as well as referring patients with positive symptoms to participate in a sleep study.
The current study was limited by the nature of the data, which were self-reported. Patients were not surveyed via the Epworth Sleepiness Scale.
The study was funded by grants from the Norwegian Research Council, the Icelandic Research Council, Aarhus University, the Swedish Heart-Lung Foundation, and the Estonian Science Foundation.
The investigators reported no relevant financial disclosures.
On Twitter @eaztweets
Women are less likely to be diagnosed with and treated for sleep-disordered breathing, despite having symptoms similar to those of men, a Swedish study showed.
In a survey of 10,854 subjects, 14% of women reported being diagnosed with obstructive sleep apnea (OSA), compared with 25% of men (P less than .001), and 9% of women reported having any OSA treatment, compared with 16% of men (Sleep Med. 2017. doi: 10.1016/j.sleep.2017.02.032).
Underdiagnosis of sleep-disordered breathing (SDB) in women may have dire consequences, as symptoms, specifically snoring and excessive daytime sleepiness (EDS), correlate with increased risk for hypertension and diabetes, regardless of gender, according to Eva Lindberg, PhD, professor in the department of medical sciences, respiratory, allergy, and sleep research at Uppsala (Sweden) University, and her colleagues.
The mean age of the patients at baseline was 41 years. Mean body mass index was 25.4 kg/m2 for men and 24 kg/m2 for women.
On initial testing, approximately three times the percentage of men reported having issues with snoring and no EDS, compared with women (19% vs. 6% respectively), while more women reported the opposite, EDS but no snoring (19% vs. 11%). A slightly larger percentage of men reported having both symptoms (7.3% vs. 4.5%).
Investigators hypothesized the disparity between women and men reporting problems with snoring may be caused by gender expectations.
“It is more probable that SDB is still assumed to be a condition associated predominantly with men, and women feel ashamed of reporting these symptoms and seeking medical advice,” said Dr. Lindberg and her coinvestigators. These gender expectations may “contribute to females being less inclined to seek medical advice due to SDB symptoms.”
In a follow-up survey conducted 11 years after the initial one, doctors found 1,716 and 319 patients had received a new diagnosis for hypertension and diabetes, respectively.
While incidence was greater in men than in women for both (hypertension: 18.6% vs. 15.8% [P less than .001] and 3.6 vs. 2.4% [P less than .001], respectively), the investigators found “after adjusting for BMI and snoring at baseline, none of these gender differences remained significant.”
Physicians’ perception of SDB is partially responsible for the number of women who go undiagnosed, according to the researchers. Because SDB is considered to occur predominantly in males, doctors may overlook symptoms in female patients that would otherwise be a cause for further testing, they noted.
“[Even] among health professionals, SDB is still usually attributed to a male population, and female patients are therefore less frequently asked about the cardinal symptoms of snoring and sleepiness and do not therefore undergo sleep recordings. ... Also, among patients with obesity hypoventilation syndrome, females are generally diagnosed when the disease is more advanced and significantly more frequently develop acute disease before achieving treatment,” the investigators wrote.
“[Even] among health professionals, SDB is still usually attributed to a male population and female patients are therefore less frequently asked about the cardinal symptoms of snoring and sleepiness and do not therefore undergo sleep recordings ... Also, among patients with obesity hypoventilation syndrome, females are generally diagnosed when the disease is more advanced and significantly more frequently develop acute disease before achieving treatment,” the investigators claimed.
Dr. Lindberg and her team suggested engaging female patients more frequently about SDB symptoms, as well as referring patients with positive symptoms to participate in a sleep study.
The current study was limited by the nature of the data, which were self-reported. Patients were not surveyed via the Epworth Sleepiness Scale.
The study was funded by grants from the Norwegian Research Council, the Icelandic Research Council, Aarhus University, the Swedish Heart-Lung Foundation, and the Estonian Science Foundation.
The investigators reported no relevant financial disclosures.
On Twitter @eaztweets
Women are less likely to be diagnosed with and treated for sleep-disordered breathing, despite having symptoms similar to those of men, a Swedish study showed.
In a survey of 10,854 subjects, 14% of women reported being diagnosed with obstructive sleep apnea (OSA), compared with 25% of men (P less than .001), and 9% of women reported having any OSA treatment, compared with 16% of men (Sleep Med. 2017. doi: 10.1016/j.sleep.2017.02.032).
Underdiagnosis of sleep-disordered breathing (SDB) in women may have dire consequences, as symptoms, specifically snoring and excessive daytime sleepiness (EDS), correlate with increased risk for hypertension and diabetes, regardless of gender, according to Eva Lindberg, PhD, professor in the department of medical sciences, respiratory, allergy, and sleep research at Uppsala (Sweden) University, and her colleagues.
The mean age of the patients at baseline was 41 years. Mean body mass index was 25.4 kg/m2 for men and 24 kg/m2 for women.
On initial testing, approximately three times the percentage of men reported having issues with snoring and no EDS, compared with women (19% vs. 6% respectively), while more women reported the opposite, EDS but no snoring (19% vs. 11%). A slightly larger percentage of men reported having both symptoms (7.3% vs. 4.5%).
Investigators hypothesized the disparity between women and men reporting problems with snoring may be caused by gender expectations.
“It is more probable that SDB is still assumed to be a condition associated predominantly with men, and women feel ashamed of reporting these symptoms and seeking medical advice,” said Dr. Lindberg and her coinvestigators. These gender expectations may “contribute to females being less inclined to seek medical advice due to SDB symptoms.”
In a follow-up survey conducted 11 years after the initial one, doctors found 1,716 and 319 patients had received a new diagnosis for hypertension and diabetes, respectively.
While incidence was greater in men than in women for both (hypertension: 18.6% vs. 15.8% [P less than .001] and 3.6 vs. 2.4% [P less than .001], respectively), the investigators found “after adjusting for BMI and snoring at baseline, none of these gender differences remained significant.”
Physicians’ perception of SDB is partially responsible for the number of women who go undiagnosed, according to the researchers. Because SDB is considered to occur predominantly in males, doctors may overlook symptoms in female patients that would otherwise be a cause for further testing, they noted.
“[Even] among health professionals, SDB is still usually attributed to a male population, and female patients are therefore less frequently asked about the cardinal symptoms of snoring and sleepiness and do not therefore undergo sleep recordings. ... Also, among patients with obesity hypoventilation syndrome, females are generally diagnosed when the disease is more advanced and significantly more frequently develop acute disease before achieving treatment,” the investigators wrote.
“[Even] among health professionals, SDB is still usually attributed to a male population and female patients are therefore less frequently asked about the cardinal symptoms of snoring and sleepiness and do not therefore undergo sleep recordings ... Also, among patients with obesity hypoventilation syndrome, females are generally diagnosed when the disease is more advanced and significantly more frequently develop acute disease before achieving treatment,” the investigators claimed.
Dr. Lindberg and her team suggested engaging female patients more frequently about SDB symptoms, as well as referring patients with positive symptoms to participate in a sleep study.
The current study was limited by the nature of the data, which were self-reported. Patients were not surveyed via the Epworth Sleepiness Scale.
The study was funded by grants from the Norwegian Research Council, the Icelandic Research Council, Aarhus University, the Swedish Heart-Lung Foundation, and the Estonian Science Foundation.
The investigators reported no relevant financial disclosures.
On Twitter @eaztweets
Key clinical point:
Major finding: Women were less likely than were men to be diagnosed with sleep apnea (14% vs. 25%, P = .001) or given treatment for any kind of sleep disordered breathing (9% vs. 16%, P = .01).
Data source: Survey of 10,854 subjects: 4,962 men and 5,892 women, gathered from the European Community Respiratory Health Survey with subsequent follow-up.
Disclosures: The study was funded by grants from the Norwegian Research Council, the Icelandic Research Council, Aarhus University, the Swedish Heart-Lung Foundation, and the Estonian Science Foundation. The investigators report no relevant financial disclosures.
Tools measuring oxygen desaturation produced disparate data
WASHINGTON – Oxygen desaturation index (ODI) scores showed significant variation across two software systems, a study showed.
The researchers assessed the ODI scores of 106 patients using the ResMed ApneaLink Plus system (AL) and the Compumedics Grael Profusion PSG3 system (Comp). “AL ODI values tended to be higher than Comp ODI values, but with significant variability,” they said.
AL showed a bias of an additional 4.4 events per hour (95% limits of agreement, –5.8 to 14.6 events per hour) for ODI scores at 4% desaturation and a bias of an additional 7.1 events per hour (95% limits of agreement, –6.4 to 20.6 events per hour) at 3% desaturation (J Clin Sleep Med. 2017;13[4]:599-605).
This may be problematic for physicians evaluating patients during sleep studies who rely on ODI scores at 3% and 4% desaturations to create accurate apnea severity assessments, the investigators said.
“[The] wide limits of agreement in our study highlight that clinicians cannot be confident that an ODI4% recorded in the AL is the same as that recorded in the Comp,” wrote Yvonne Ng, MBBS, of the department of lung and sleep medicine at Monash Health, Victoria, Australia, and her colleagues. “The differences are large enough to significantly affect diagnostic thresholds for OSA [obstructive sleep apnea] and, in particular, moderate-severe OSA.”
The researchers gathered data from patients undergoing sleep analysis at the Monash Medical Centre, who were, on average, 47 years of age, had a body mass index score of 32 kg/m2, and had an apnea hypopnea index (AHI) of 23.2.
ODI3% scores analyzed through Comp diagnosed 66 patients with OSA (ODI3% greater than or equal to 5 events per hour), while desaturation events analyzed through the AL system diagnosed 90 patients, a 36% increase over Comp (P = .0002).
When researchers tested for moderate to severe OSA (ODI3% greater than or equal to 15 events per hour), 32 patients were diagnosed using the Comp system, compared with 59 patients using the AL system.
Disparities in these measurements create uncertainty among clinicians, who rely on ODI measurements for scores that are accurate and can be easily replicated using an algorithm, the researchers said.
“The current work demonstrates that significantly more patients would receive a diagnosis of OSA, or more particularly, moderate-severe OSA, with the AL ODI, compared to the Comp ODI,” Dr. Ng and her colleagues wrote.
When sensitivity scores for Comp and AL were compared, AL ODI3% scores were significantly more sensitive than Comp, with sensitivity scores of 96% vs. 58%.
Using different fingers for measuring desaturation during the test or differences in algorithms used to assess ODI scores were possible sources of the disparities, the researchers noted.
Differences in internal processing between the two systems were the most likely causes of the discrepancies between the data collected using each system, they added.
Because there is no universal standard for ODI measurements, the researchers were unable to determine which system was more accurate.
Several of the researchers reported receiving financial support, research equipment, or consultancy fees from various entities.
[email protected]
On Twitter @eaztweets
WASHINGTON – Oxygen desaturation index (ODI) scores showed significant variation across two software systems, a study showed.
The researchers assessed the ODI scores of 106 patients using the ResMed ApneaLink Plus system (AL) and the Compumedics Grael Profusion PSG3 system (Comp). “AL ODI values tended to be higher than Comp ODI values, but with significant variability,” they said.
AL showed a bias of an additional 4.4 events per hour (95% limits of agreement, –5.8 to 14.6 events per hour) for ODI scores at 4% desaturation and a bias of an additional 7.1 events per hour (95% limits of agreement, –6.4 to 20.6 events per hour) at 3% desaturation (J Clin Sleep Med. 2017;13[4]:599-605).
This may be problematic for physicians evaluating patients during sleep studies who rely on ODI scores at 3% and 4% desaturations to create accurate apnea severity assessments, the investigators said.
“[The] wide limits of agreement in our study highlight that clinicians cannot be confident that an ODI4% recorded in the AL is the same as that recorded in the Comp,” wrote Yvonne Ng, MBBS, of the department of lung and sleep medicine at Monash Health, Victoria, Australia, and her colleagues. “The differences are large enough to significantly affect diagnostic thresholds for OSA [obstructive sleep apnea] and, in particular, moderate-severe OSA.”
The researchers gathered data from patients undergoing sleep analysis at the Monash Medical Centre, who were, on average, 47 years of age, had a body mass index score of 32 kg/m2, and had an apnea hypopnea index (AHI) of 23.2.
ODI3% scores analyzed through Comp diagnosed 66 patients with OSA (ODI3% greater than or equal to 5 events per hour), while desaturation events analyzed through the AL system diagnosed 90 patients, a 36% increase over Comp (P = .0002).
When researchers tested for moderate to severe OSA (ODI3% greater than or equal to 15 events per hour), 32 patients were diagnosed using the Comp system, compared with 59 patients using the AL system.
Disparities in these measurements create uncertainty among clinicians, who rely on ODI measurements for scores that are accurate and can be easily replicated using an algorithm, the researchers said.
“The current work demonstrates that significantly more patients would receive a diagnosis of OSA, or more particularly, moderate-severe OSA, with the AL ODI, compared to the Comp ODI,” Dr. Ng and her colleagues wrote.
When sensitivity scores for Comp and AL were compared, AL ODI3% scores were significantly more sensitive than Comp, with sensitivity scores of 96% vs. 58%.
Using different fingers for measuring desaturation during the test or differences in algorithms used to assess ODI scores were possible sources of the disparities, the researchers noted.
Differences in internal processing between the two systems were the most likely causes of the discrepancies between the data collected using each system, they added.
Because there is no universal standard for ODI measurements, the researchers were unable to determine which system was more accurate.
Several of the researchers reported receiving financial support, research equipment, or consultancy fees from various entities.
[email protected]
On Twitter @eaztweets
WASHINGTON – Oxygen desaturation index (ODI) scores showed significant variation across two software systems, a study showed.
The researchers assessed the ODI scores of 106 patients using the ResMed ApneaLink Plus system (AL) and the Compumedics Grael Profusion PSG3 system (Comp). “AL ODI values tended to be higher than Comp ODI values, but with significant variability,” they said.
AL showed a bias of an additional 4.4 events per hour (95% limits of agreement, –5.8 to 14.6 events per hour) for ODI scores at 4% desaturation and a bias of an additional 7.1 events per hour (95% limits of agreement, –6.4 to 20.6 events per hour) at 3% desaturation (J Clin Sleep Med. 2017;13[4]:599-605).
This may be problematic for physicians evaluating patients during sleep studies who rely on ODI scores at 3% and 4% desaturations to create accurate apnea severity assessments, the investigators said.
“[The] wide limits of agreement in our study highlight that clinicians cannot be confident that an ODI4% recorded in the AL is the same as that recorded in the Comp,” wrote Yvonne Ng, MBBS, of the department of lung and sleep medicine at Monash Health, Victoria, Australia, and her colleagues. “The differences are large enough to significantly affect diagnostic thresholds for OSA [obstructive sleep apnea] and, in particular, moderate-severe OSA.”
The researchers gathered data from patients undergoing sleep analysis at the Monash Medical Centre, who were, on average, 47 years of age, had a body mass index score of 32 kg/m2, and had an apnea hypopnea index (AHI) of 23.2.
ODI3% scores analyzed through Comp diagnosed 66 patients with OSA (ODI3% greater than or equal to 5 events per hour), while desaturation events analyzed through the AL system diagnosed 90 patients, a 36% increase over Comp (P = .0002).
When researchers tested for moderate to severe OSA (ODI3% greater than or equal to 15 events per hour), 32 patients were diagnosed using the Comp system, compared with 59 patients using the AL system.
Disparities in these measurements create uncertainty among clinicians, who rely on ODI measurements for scores that are accurate and can be easily replicated using an algorithm, the researchers said.
“The current work demonstrates that significantly more patients would receive a diagnosis of OSA, or more particularly, moderate-severe OSA, with the AL ODI, compared to the Comp ODI,” Dr. Ng and her colleagues wrote.
When sensitivity scores for Comp and AL were compared, AL ODI3% scores were significantly more sensitive than Comp, with sensitivity scores of 96% vs. 58%.
Using different fingers for measuring desaturation during the test or differences in algorithms used to assess ODI scores were possible sources of the disparities, the researchers noted.
Differences in internal processing between the two systems were the most likely causes of the discrepancies between the data collected using each system, they added.
Because there is no universal standard for ODI measurements, the researchers were unable to determine which system was more accurate.
Several of the researchers reported receiving financial support, research equipment, or consultancy fees from various entities.
[email protected]
On Twitter @eaztweets
Key clinical point:
Major finding: ODI tests analyzed using the ResMed APneaLink Plus system vs. Compumedics Grael Profusion PSG3 system reported ODI4% bias = 4.4 events per hour (95% limits of agreement, –5.8 to 14.6 events per hour) and ODI3% bias = 7.1 events per hour (95% limits of agreement, –6.4 to 20.6 events per hour).
Data source: ODI test results for 106 participants in a sleep study at Monash Medical Centre.
Disclosures: Several of the researchers reported receiving financial support, research equipment, or consultancy fees from various entities.
Tattoo artist survey finds almost half agree to tattoo skin with lesions
The importance of educating tattoo artists on identifying and being careful around skin with melanocytic nevi and other lesions was highlighted by the results of a survey of tattoo artists, according to a study from the University of Pittsburgh.
“While most of those surveyed reported deliberately avoiding nevi, a similar proportion reported either tattooing over them or simply deferring to the client’s preference,” wrote Westley S. Mori and his associates in the department of dermatology at the University of Pittsburgh, Pennsylvania. “This is concerning because few clients specifically ask tattoo artists to avoid skin lesions,” they added.
They surveyed 42 tattoo artists in July and August 2016 regarding their encounters with clients with skin lesions and their personal knowledge or experiences they may have had with skin cancer. Of those surveyed, 23 (55%) said they had declined to tattoo skin with a rash or lesion (JAMA Dermatology. 2017;153[4]:328-30).When asked about their reasoning for declining a client’s request, 21 (50%) of respondents said they did so because of a poor cosmetic outcome, while the next highest answer, a concern of potential skin cancer, was only cited by 12 (29%).
Most (74%) said there was no official store policy about tattooing over moles or other skin lesions. When asked about their approaches to tattooing skin with moles or other lesions, many said they choose to tattoo around the lesion (41%), tattoo over the lesion (19%), or defer to the client’s preferences (24%). However, with regards to deferring to a client, 29 artists (69%) reported never being asked to avoid a lesion.
Investigators noted that 12 respondents reported that they had identified a possible cancerous lesion on a client, followed by the same number of respondents reporting having recommended that a client see a dermatologist.
Tattoo artists who had seen a dermatologist for a skin examination were significantly more likely to refuse to tattoo a client with a lesion (P = .01) and recommend that the client see a dermatologist (P less than .001) when they had a lesion. Based on this response, the authors said that they believed that educating both clients and tattoo artists may be the best way to get tattoo artists to engage clients. “Our study highlights an opportunity for dermatologists to educate tattoo artists about skin cancer, particularly melanoma, to help reduce the incidence of skin cancers hidden in tattoos and to encourage appropriate referral to dermatologists for suspicious lesions on clients,” they concluded.
“When you perform a total body skin examination, it’s a little difficult to kind of tease out if a lesion looks suspicious or not if it’s surrounded by ink,” Mr. Mori, a medical student at the university, said in an interview. “Tattoos are becoming more and more common, especially among younger people, and incidence of melanoma has increased in younger populations as well. ... It is very concerning that skin cancers could be hidden in tattoos.”
In fact, Mr. Mori pointed out, there are opportunities for dermatologists to reach out to the tattoo artist community and start the communication process. “Tattoo artists have national conferences where they get together and discuss the state of the industry, and that represents one opportunity where dermatologists could talk about the effects of skin cancer,” he said.
The study was funded by the University of Pittsburgh. The authors reported no relevant financial disclosures.
[email protected]
On Twitter @eaztweets
The importance of educating tattoo artists on identifying and being careful around skin with melanocytic nevi and other lesions was highlighted by the results of a survey of tattoo artists, according to a study from the University of Pittsburgh.
“While most of those surveyed reported deliberately avoiding nevi, a similar proportion reported either tattooing over them or simply deferring to the client’s preference,” wrote Westley S. Mori and his associates in the department of dermatology at the University of Pittsburgh, Pennsylvania. “This is concerning because few clients specifically ask tattoo artists to avoid skin lesions,” they added.
They surveyed 42 tattoo artists in July and August 2016 regarding their encounters with clients with skin lesions and their personal knowledge or experiences they may have had with skin cancer. Of those surveyed, 23 (55%) said they had declined to tattoo skin with a rash or lesion (JAMA Dermatology. 2017;153[4]:328-30).When asked about their reasoning for declining a client’s request, 21 (50%) of respondents said they did so because of a poor cosmetic outcome, while the next highest answer, a concern of potential skin cancer, was only cited by 12 (29%).
Most (74%) said there was no official store policy about tattooing over moles or other skin lesions. When asked about their approaches to tattooing skin with moles or other lesions, many said they choose to tattoo around the lesion (41%), tattoo over the lesion (19%), or defer to the client’s preferences (24%). However, with regards to deferring to a client, 29 artists (69%) reported never being asked to avoid a lesion.
Investigators noted that 12 respondents reported that they had identified a possible cancerous lesion on a client, followed by the same number of respondents reporting having recommended that a client see a dermatologist.
Tattoo artists who had seen a dermatologist for a skin examination were significantly more likely to refuse to tattoo a client with a lesion (P = .01) and recommend that the client see a dermatologist (P less than .001) when they had a lesion. Based on this response, the authors said that they believed that educating both clients and tattoo artists may be the best way to get tattoo artists to engage clients. “Our study highlights an opportunity for dermatologists to educate tattoo artists about skin cancer, particularly melanoma, to help reduce the incidence of skin cancers hidden in tattoos and to encourage appropriate referral to dermatologists for suspicious lesions on clients,” they concluded.
“When you perform a total body skin examination, it’s a little difficult to kind of tease out if a lesion looks suspicious or not if it’s surrounded by ink,” Mr. Mori, a medical student at the university, said in an interview. “Tattoos are becoming more and more common, especially among younger people, and incidence of melanoma has increased in younger populations as well. ... It is very concerning that skin cancers could be hidden in tattoos.”
In fact, Mr. Mori pointed out, there are opportunities for dermatologists to reach out to the tattoo artist community and start the communication process. “Tattoo artists have national conferences where they get together and discuss the state of the industry, and that represents one opportunity where dermatologists could talk about the effects of skin cancer,” he said.
The study was funded by the University of Pittsburgh. The authors reported no relevant financial disclosures.
[email protected]
On Twitter @eaztweets
The importance of educating tattoo artists on identifying and being careful around skin with melanocytic nevi and other lesions was highlighted by the results of a survey of tattoo artists, according to a study from the University of Pittsburgh.
“While most of those surveyed reported deliberately avoiding nevi, a similar proportion reported either tattooing over them or simply deferring to the client’s preference,” wrote Westley S. Mori and his associates in the department of dermatology at the University of Pittsburgh, Pennsylvania. “This is concerning because few clients specifically ask tattoo artists to avoid skin lesions,” they added.
They surveyed 42 tattoo artists in July and August 2016 regarding their encounters with clients with skin lesions and their personal knowledge or experiences they may have had with skin cancer. Of those surveyed, 23 (55%) said they had declined to tattoo skin with a rash or lesion (JAMA Dermatology. 2017;153[4]:328-30).When asked about their reasoning for declining a client’s request, 21 (50%) of respondents said they did so because of a poor cosmetic outcome, while the next highest answer, a concern of potential skin cancer, was only cited by 12 (29%).
Most (74%) said there was no official store policy about tattooing over moles or other skin lesions. When asked about their approaches to tattooing skin with moles or other lesions, many said they choose to tattoo around the lesion (41%), tattoo over the lesion (19%), or defer to the client’s preferences (24%). However, with regards to deferring to a client, 29 artists (69%) reported never being asked to avoid a lesion.
Investigators noted that 12 respondents reported that they had identified a possible cancerous lesion on a client, followed by the same number of respondents reporting having recommended that a client see a dermatologist.
Tattoo artists who had seen a dermatologist for a skin examination were significantly more likely to refuse to tattoo a client with a lesion (P = .01) and recommend that the client see a dermatologist (P less than .001) when they had a lesion. Based on this response, the authors said that they believed that educating both clients and tattoo artists may be the best way to get tattoo artists to engage clients. “Our study highlights an opportunity for dermatologists to educate tattoo artists about skin cancer, particularly melanoma, to help reduce the incidence of skin cancers hidden in tattoos and to encourage appropriate referral to dermatologists for suspicious lesions on clients,” they concluded.
“When you perform a total body skin examination, it’s a little difficult to kind of tease out if a lesion looks suspicious or not if it’s surrounded by ink,” Mr. Mori, a medical student at the university, said in an interview. “Tattoos are becoming more and more common, especially among younger people, and incidence of melanoma has increased in younger populations as well. ... It is very concerning that skin cancers could be hidden in tattoos.”
In fact, Mr. Mori pointed out, there are opportunities for dermatologists to reach out to the tattoo artist community and start the communication process. “Tattoo artists have national conferences where they get together and discuss the state of the industry, and that represents one opportunity where dermatologists could talk about the effects of skin cancer,” he said.
The study was funded by the University of Pittsburgh. The authors reported no relevant financial disclosures.
[email protected]
On Twitter @eaztweets
Key clinical point: Dermatologists can educate tattoo artists about avoiding tattoos around moles and other skin lesions.
Major finding: Of 42 tattoo artists who were surveyed, 19 (45%) reported never declining a client’s request to tattoo skin with a lesion, and 31 (74%) reporting having no official store policy on tattooing over lesions.
Data source: An anonymous survey of 42 tattoo artists conducted in July and August 2016.
Disclosures: This study was funded by the University of Pittsburgh. Investigators reported no relevant disclosures.
Central centrifugal cicatricial alopecia can affect adolescents
Central centrifugal cicatricial alopecia (CCCA) can affect adolescents, and a study of six biopsy-proven cases indicates CCCA has a genetic component, Ariana N. Eginli and her colleagues report in Pediatric Dermatology.
CCCA, a scarring alopecia that disproportionately affects middle-aged women of African descent, has been attributed to hair care and styling practices. In this series, however, five of the six patients had a maternal history of CCCA, and only one had used chemical products or styling tools. “Specifically, the early onset of CCCA in these patients with natural virgin hair raises the possibility of genetic anticipation,” wrote Ms. Eginli of Wake Forest Baptist Health, Winston-Salem, N.C., and her coauthors. “Therefore, recognizing that CCCA can present in children, particularly in those with a positive family history, is of utmost importance in controlling further disease progression and improving their quality of life.”
Two patients had previously undergone scalp surgery, specifically ventriculoperitoneal shunt placement, years before their hair loss began. The authors speculated that the scalp surgery may have contributed to the early development of CCCA.
“We recommend that clinicians check for early signs of CCCA when there are complaints of hair loss on the scalp of offspring of affected women of African descent,” they wrote. “If there is any clinical suspicion of CCCA or any scarring alopecia, a scalp biopsy should be performed.”
Ms. Eginli had no disclosures. One of her colleagues is a consultant for and has received grant support from various drug companies.
[email protected]
On Twitter @eaztweets
Central centrifugal cicatricial alopecia (CCCA) can affect adolescents, and a study of six biopsy-proven cases indicates CCCA has a genetic component, Ariana N. Eginli and her colleagues report in Pediatric Dermatology.
CCCA, a scarring alopecia that disproportionately affects middle-aged women of African descent, has been attributed to hair care and styling practices. In this series, however, five of the six patients had a maternal history of CCCA, and only one had used chemical products or styling tools. “Specifically, the early onset of CCCA in these patients with natural virgin hair raises the possibility of genetic anticipation,” wrote Ms. Eginli of Wake Forest Baptist Health, Winston-Salem, N.C., and her coauthors. “Therefore, recognizing that CCCA can present in children, particularly in those with a positive family history, is of utmost importance in controlling further disease progression and improving their quality of life.”
Two patients had previously undergone scalp surgery, specifically ventriculoperitoneal shunt placement, years before their hair loss began. The authors speculated that the scalp surgery may have contributed to the early development of CCCA.
“We recommend that clinicians check for early signs of CCCA when there are complaints of hair loss on the scalp of offspring of affected women of African descent,” they wrote. “If there is any clinical suspicion of CCCA or any scarring alopecia, a scalp biopsy should be performed.”
Ms. Eginli had no disclosures. One of her colleagues is a consultant for and has received grant support from various drug companies.
[email protected]
On Twitter @eaztweets
Central centrifugal cicatricial alopecia (CCCA) can affect adolescents, and a study of six biopsy-proven cases indicates CCCA has a genetic component, Ariana N. Eginli and her colleagues report in Pediatric Dermatology.
CCCA, a scarring alopecia that disproportionately affects middle-aged women of African descent, has been attributed to hair care and styling practices. In this series, however, five of the six patients had a maternal history of CCCA, and only one had used chemical products or styling tools. “Specifically, the early onset of CCCA in these patients with natural virgin hair raises the possibility of genetic anticipation,” wrote Ms. Eginli of Wake Forest Baptist Health, Winston-Salem, N.C., and her coauthors. “Therefore, recognizing that CCCA can present in children, particularly in those with a positive family history, is of utmost importance in controlling further disease progression and improving their quality of life.”
Two patients had previously undergone scalp surgery, specifically ventriculoperitoneal shunt placement, years before their hair loss began. The authors speculated that the scalp surgery may have contributed to the early development of CCCA.
“We recommend that clinicians check for early signs of CCCA when there are complaints of hair loss on the scalp of offspring of affected women of African descent,” they wrote. “If there is any clinical suspicion of CCCA or any scarring alopecia, a scalp biopsy should be performed.”
Ms. Eginli had no disclosures. One of her colleagues is a consultant for and has received grant support from various drug companies.
[email protected]
On Twitter @eaztweets
FROM PEDIATRIC DERMATOLOGY
Key clinical point:
Major finding: Of six pediatric patients with biopsy-proven CCCA, five had a family history of CCCA and only one had used chemical products or styling tools.
Data source: A case series of six pediatric patients with biopsy-confirmed CCCA.
Disclosures: Ms. Eginli had no disclosures. One of her colleagues is a consultant for and has received grant support from various drug companies.
Declining bullying rates in Maryland study contradict common misconception
Rates of bullying among students in grades 4-12 decreased over the past 10 years in a state study, contradicting a common perception of a rising trend in schools, according to a study.
The rate of self-reported, frequent bullying victimization fell from 28% in 2005 to 13% in 2014, reported Tracy Evian Waasdorp, PhD, at the Children’s Hospital of Philadelphia and the Center for the Prevention of Youth Violence at the Johns Hopkins Bloomberg School of Public Health, Baltimore, and her associates. “These findings do contradict the public’s [mis]perception that bullying is increasing.”
Data collected through a survey of 246,306 students in grades 4-12 from 109 schools in Maryland in 2005-2014 found significant decreases in 10 of 13 bullying indicators (Pediatrics. 2017. doi: 10.1542/peds.2016-2615).
In the survey, students anonymously reported if they had been a frequent victim of bullying – two or more times within the past month – as defined by the World Health Organization and Center for Disease Control and Prevention’s definition: “A person is bullied when he or she is exposed, repeatedly and over time, to negative actions on the part of one or more other persons. Bullying often occurs in situations where there is a power or status difference. Bullying includes actions like threatening, teasing, name-calling, ignoring, rumor spreading, sending hurtful emails and text messages, and leaving someone out on purpose.”
The investigators found victimization decreased across indicators including pushing (beta = –0.03), hitting (beta = –0.03), threats (beta = –0.02), cyberbullying (beta = –0.01), and rumors (beta = –0.02), according to the researchers. All values were determined with a P value less than .001.
“It was hypothesized that cyberbullying might increase, but consistent with the other forms of bullying, cyberbullying also decreased,” the researchers wrote. “However, given the rapid change of technology and new social media platforms used by youth and increasingly at younger ages, the nature and quality of cyberbullying may change.”
Dr. Waasdorp and her colleagues also had children report if and how often they had participated in bullying or had witnessed bullying, both of which also declined, from 21% to 7% of students and 66% to 43% of students, respectively.
Along with bullying, students were asked how safe they felt in school and if adults in their school were doing enough to prevent bullying, both of which sentiments increased over the course of the study. While 80% of students reported feeling safe in the school, the number of those who felt as though they belonged remained relatively unchanged.
While decreases in each category were relatively small from year to year, “some of these changes were fairly substantial across 10 years, as indicated by the effect size estimates comparing the first and last years (average difference = 0.325),” according to the researchers.
In fact, Dr. Waasdorp and her peers found the final year of the study to have the greatest improvement, which they estimate may come from more comprehensive bullying laws and school practices.
Looking across grade levels, Dr. Waasdorp and her colleagues found greater declines in witnessing bullying and school safety in high schoolers than middle schoolers, which they say may indicate more support in middle school systems, where bullying peaks.
Because of the large number of outcomes, significant associations between school levels and bullying indicators were limited. The anonymous nature of the survey limited the ability of the researchers to link student data across years. The investigators also did not collect data on why changes to the bullying indicators occurred.
During the study, the researchers were supported in part by grants from the U.S. Department of Education, the William T. Grant Foundation, and the National Institute of Justice. The authors reported no relevant financial disclosures.
[email protected]
On Twitter @eaztweets
The Waasdorp et al. study is a comprehensive one using a sophisticated longitudinal design and a number of covariates to give a better comprehension of current bullying trends.
While it is encouraging to hear of the declining trends across many forms of bullying, it is important to remember 48% of children still reported bullying as an issue in their lives, with nearly as many reporting witnessing bullying against others.
We must be watchful for instances of bullying and active in getting rid of it both in and out of the classroom.
This means calling on educators to implement programs that not only sound like they will work, but have been tested and proven to be the best choice for the entire community. Programs that build empathy and encourage students to figure out productive conflict-management solutions often are good choices.
The responsibility to end bullying is not just with educators, but with pediatricians as well. Bullying can have serious mental and physical ramifications for patients, and clinicians must be vigilant for signs of victimization, such as anxiety, depression, or social withdrawal. If it seems as though a patient has been the victim or is the perpetrator of bullying, clinicians may want to talk with the child and their parents about finding a counselor at school where bullying might occur most often, encourage the child to talk with his or her parents about any problems at school, build a stronger communication between parents and the school, and help to support at least one peer friendship, which has been found to be a strong buffer against peer victimization.
This study is a good example of the progress made so far, but there is still plenty of work to be done.
Stephen S. Leff, PhD, is a psychologist in the department of child and adolescent psychiatry and behavioral sciences and codirector of the Violence Prevention Initiative at the Children’s Hospital of Philadelphia and Chris Feudtner, MD, PhD, is director of the department of medical ethics at the hospital. This a summary of their comments from an editorial accompanying the report by Waasdorp et al. (Pediatrics. 2017. doi: 10.1542/peds.2017-0504 ) Neither Dr. Leff nor Dr. Feudtner reported any relevant disclosures.
The Waasdorp et al. study is a comprehensive one using a sophisticated longitudinal design and a number of covariates to give a better comprehension of current bullying trends.
While it is encouraging to hear of the declining trends across many forms of bullying, it is important to remember 48% of children still reported bullying as an issue in their lives, with nearly as many reporting witnessing bullying against others.
We must be watchful for instances of bullying and active in getting rid of it both in and out of the classroom.
This means calling on educators to implement programs that not only sound like they will work, but have been tested and proven to be the best choice for the entire community. Programs that build empathy and encourage students to figure out productive conflict-management solutions often are good choices.
The responsibility to end bullying is not just with educators, but with pediatricians as well. Bullying can have serious mental and physical ramifications for patients, and clinicians must be vigilant for signs of victimization, such as anxiety, depression, or social withdrawal. If it seems as though a patient has been the victim or is the perpetrator of bullying, clinicians may want to talk with the child and their parents about finding a counselor at school where bullying might occur most often, encourage the child to talk with his or her parents about any problems at school, build a stronger communication between parents and the school, and help to support at least one peer friendship, which has been found to be a strong buffer against peer victimization.
This study is a good example of the progress made so far, but there is still plenty of work to be done.
Stephen S. Leff, PhD, is a psychologist in the department of child and adolescent psychiatry and behavioral sciences and codirector of the Violence Prevention Initiative at the Children’s Hospital of Philadelphia and Chris Feudtner, MD, PhD, is director of the department of medical ethics at the hospital. This a summary of their comments from an editorial accompanying the report by Waasdorp et al. (Pediatrics. 2017. doi: 10.1542/peds.2017-0504 ) Neither Dr. Leff nor Dr. Feudtner reported any relevant disclosures.
The Waasdorp et al. study is a comprehensive one using a sophisticated longitudinal design and a number of covariates to give a better comprehension of current bullying trends.
While it is encouraging to hear of the declining trends across many forms of bullying, it is important to remember 48% of children still reported bullying as an issue in their lives, with nearly as many reporting witnessing bullying against others.
We must be watchful for instances of bullying and active in getting rid of it both in and out of the classroom.
This means calling on educators to implement programs that not only sound like they will work, but have been tested and proven to be the best choice for the entire community. Programs that build empathy and encourage students to figure out productive conflict-management solutions often are good choices.
The responsibility to end bullying is not just with educators, but with pediatricians as well. Bullying can have serious mental and physical ramifications for patients, and clinicians must be vigilant for signs of victimization, such as anxiety, depression, or social withdrawal. If it seems as though a patient has been the victim or is the perpetrator of bullying, clinicians may want to talk with the child and their parents about finding a counselor at school where bullying might occur most often, encourage the child to talk with his or her parents about any problems at school, build a stronger communication between parents and the school, and help to support at least one peer friendship, which has been found to be a strong buffer against peer victimization.
This study is a good example of the progress made so far, but there is still plenty of work to be done.
Stephen S. Leff, PhD, is a psychologist in the department of child and adolescent psychiatry and behavioral sciences and codirector of the Violence Prevention Initiative at the Children’s Hospital of Philadelphia and Chris Feudtner, MD, PhD, is director of the department of medical ethics at the hospital. This a summary of their comments from an editorial accompanying the report by Waasdorp et al. (Pediatrics. 2017. doi: 10.1542/peds.2017-0504 ) Neither Dr. Leff nor Dr. Feudtner reported any relevant disclosures.
Rates of bullying among students in grades 4-12 decreased over the past 10 years in a state study, contradicting a common perception of a rising trend in schools, according to a study.
The rate of self-reported, frequent bullying victimization fell from 28% in 2005 to 13% in 2014, reported Tracy Evian Waasdorp, PhD, at the Children’s Hospital of Philadelphia and the Center for the Prevention of Youth Violence at the Johns Hopkins Bloomberg School of Public Health, Baltimore, and her associates. “These findings do contradict the public’s [mis]perception that bullying is increasing.”
Data collected through a survey of 246,306 students in grades 4-12 from 109 schools in Maryland in 2005-2014 found significant decreases in 10 of 13 bullying indicators (Pediatrics. 2017. doi: 10.1542/peds.2016-2615).
In the survey, students anonymously reported if they had been a frequent victim of bullying – two or more times within the past month – as defined by the World Health Organization and Center for Disease Control and Prevention’s definition: “A person is bullied when he or she is exposed, repeatedly and over time, to negative actions on the part of one or more other persons. Bullying often occurs in situations where there is a power or status difference. Bullying includes actions like threatening, teasing, name-calling, ignoring, rumor spreading, sending hurtful emails and text messages, and leaving someone out on purpose.”
The investigators found victimization decreased across indicators including pushing (beta = –0.03), hitting (beta = –0.03), threats (beta = –0.02), cyberbullying (beta = –0.01), and rumors (beta = –0.02), according to the researchers. All values were determined with a P value less than .001.
“It was hypothesized that cyberbullying might increase, but consistent with the other forms of bullying, cyberbullying also decreased,” the researchers wrote. “However, given the rapid change of technology and new social media platforms used by youth and increasingly at younger ages, the nature and quality of cyberbullying may change.”
Dr. Waasdorp and her colleagues also had children report if and how often they had participated in bullying or had witnessed bullying, both of which also declined, from 21% to 7% of students and 66% to 43% of students, respectively.
Along with bullying, students were asked how safe they felt in school and if adults in their school were doing enough to prevent bullying, both of which sentiments increased over the course of the study. While 80% of students reported feeling safe in the school, the number of those who felt as though they belonged remained relatively unchanged.
While decreases in each category were relatively small from year to year, “some of these changes were fairly substantial across 10 years, as indicated by the effect size estimates comparing the first and last years (average difference = 0.325),” according to the researchers.
In fact, Dr. Waasdorp and her peers found the final year of the study to have the greatest improvement, which they estimate may come from more comprehensive bullying laws and school practices.
Looking across grade levels, Dr. Waasdorp and her colleagues found greater declines in witnessing bullying and school safety in high schoolers than middle schoolers, which they say may indicate more support in middle school systems, where bullying peaks.
Because of the large number of outcomes, significant associations between school levels and bullying indicators were limited. The anonymous nature of the survey limited the ability of the researchers to link student data across years. The investigators also did not collect data on why changes to the bullying indicators occurred.
During the study, the researchers were supported in part by grants from the U.S. Department of Education, the William T. Grant Foundation, and the National Institute of Justice. The authors reported no relevant financial disclosures.
[email protected]
On Twitter @eaztweets
Rates of bullying among students in grades 4-12 decreased over the past 10 years in a state study, contradicting a common perception of a rising trend in schools, according to a study.
The rate of self-reported, frequent bullying victimization fell from 28% in 2005 to 13% in 2014, reported Tracy Evian Waasdorp, PhD, at the Children’s Hospital of Philadelphia and the Center for the Prevention of Youth Violence at the Johns Hopkins Bloomberg School of Public Health, Baltimore, and her associates. “These findings do contradict the public’s [mis]perception that bullying is increasing.”
Data collected through a survey of 246,306 students in grades 4-12 from 109 schools in Maryland in 2005-2014 found significant decreases in 10 of 13 bullying indicators (Pediatrics. 2017. doi: 10.1542/peds.2016-2615).
In the survey, students anonymously reported if they had been a frequent victim of bullying – two or more times within the past month – as defined by the World Health Organization and Center for Disease Control and Prevention’s definition: “A person is bullied when he or she is exposed, repeatedly and over time, to negative actions on the part of one or more other persons. Bullying often occurs in situations where there is a power or status difference. Bullying includes actions like threatening, teasing, name-calling, ignoring, rumor spreading, sending hurtful emails and text messages, and leaving someone out on purpose.”
The investigators found victimization decreased across indicators including pushing (beta = –0.03), hitting (beta = –0.03), threats (beta = –0.02), cyberbullying (beta = –0.01), and rumors (beta = –0.02), according to the researchers. All values were determined with a P value less than .001.
“It was hypothesized that cyberbullying might increase, but consistent with the other forms of bullying, cyberbullying also decreased,” the researchers wrote. “However, given the rapid change of technology and new social media platforms used by youth and increasingly at younger ages, the nature and quality of cyberbullying may change.”
Dr. Waasdorp and her colleagues also had children report if and how often they had participated in bullying or had witnessed bullying, both of which also declined, from 21% to 7% of students and 66% to 43% of students, respectively.
Along with bullying, students were asked how safe they felt in school and if adults in their school were doing enough to prevent bullying, both of which sentiments increased over the course of the study. While 80% of students reported feeling safe in the school, the number of those who felt as though they belonged remained relatively unchanged.
While decreases in each category were relatively small from year to year, “some of these changes were fairly substantial across 10 years, as indicated by the effect size estimates comparing the first and last years (average difference = 0.325),” according to the researchers.
In fact, Dr. Waasdorp and her peers found the final year of the study to have the greatest improvement, which they estimate may come from more comprehensive bullying laws and school practices.
Looking across grade levels, Dr. Waasdorp and her colleagues found greater declines in witnessing bullying and school safety in high schoolers than middle schoolers, which they say may indicate more support in middle school systems, where bullying peaks.
Because of the large number of outcomes, significant associations between school levels and bullying indicators were limited. The anonymous nature of the survey limited the ability of the researchers to link student data across years. The investigators also did not collect data on why changes to the bullying indicators occurred.
During the study, the researchers were supported in part by grants from the U.S. Department of Education, the William T. Grant Foundation, and the National Institute of Justice. The authors reported no relevant financial disclosures.
[email protected]
On Twitter @eaztweets
FROM PEDIATRICS
Key clinical point:
Major finding: Reports of victimization overall among Maryland students in grades 4-12 decreased from 28% to 13% over a decade, with decreases in 10 of 13 bullying indicators in the study.
Data source: Self-reported survey of 246,306 students in grades 4-12 from 109 Maryland schools in 2005-2014, analyzed using a longitudinal hierarchical linear model.
Disclosures: During the study, researchers were supported in part by grants from the U.S. Department of Education, the William T. Grant Foundation, and the National Institute of Justice. The authors reported no relevant financial disclosures.
U.S. yellow fever vaccine stocks could be depleted within months
Supply of the only U.S.-licensed yellow fever vaccine will be depleted by mid-2017 because of manufacturing issues, according to the Centers for Disease Control and Prevention.
Sanofi Pasteur, the manufacturer of the YF-VAX vaccine, notified the CDC and the Food and Drug Administration in 2016 there could be a shortage this year after the manufacturing complications during a factory switch over led to the loss of a large amount of vaccine supply, according to an article published online in the Morbidity and Mortality Weekly Report.
The CDC, Sanofi Pasteur, and the FDA are working to supplement the shortage. The manufacturer submitted an expanded investigational new drug (eIND) application to the FDA in September 2016 for marketing permission for Stamaril, an alternative vaccine manufactured by Sanofi Pasteur France and used in around 70 countries.
The application included planning for strategic distribution sites, which the CDC is determining using a tiered system based on volume of doses ordered in 2016.
As of April 2017, 250 civilian sites have been invited to participate in the eIND program, significantly less than the 4,000 currently distributing YF-VAX.
The CDC will “monitor for critical gaps in vaccine access and collaborate to address any issues, including considering the possibility of recruiting additional clinics to participate as necessary,” according to a statement.
Updates on the shortage will be available on the CDC travel health website.
[email protected]
On Twitter @eaztweets
Supply of the only U.S.-licensed yellow fever vaccine will be depleted by mid-2017 because of manufacturing issues, according to the Centers for Disease Control and Prevention.
Sanofi Pasteur, the manufacturer of the YF-VAX vaccine, notified the CDC and the Food and Drug Administration in 2016 there could be a shortage this year after the manufacturing complications during a factory switch over led to the loss of a large amount of vaccine supply, according to an article published online in the Morbidity and Mortality Weekly Report.
The CDC, Sanofi Pasteur, and the FDA are working to supplement the shortage. The manufacturer submitted an expanded investigational new drug (eIND) application to the FDA in September 2016 for marketing permission for Stamaril, an alternative vaccine manufactured by Sanofi Pasteur France and used in around 70 countries.
The application included planning for strategic distribution sites, which the CDC is determining using a tiered system based on volume of doses ordered in 2016.
As of April 2017, 250 civilian sites have been invited to participate in the eIND program, significantly less than the 4,000 currently distributing YF-VAX.
The CDC will “monitor for critical gaps in vaccine access and collaborate to address any issues, including considering the possibility of recruiting additional clinics to participate as necessary,” according to a statement.
Updates on the shortage will be available on the CDC travel health website.
[email protected]
On Twitter @eaztweets
Supply of the only U.S.-licensed yellow fever vaccine will be depleted by mid-2017 because of manufacturing issues, according to the Centers for Disease Control and Prevention.
Sanofi Pasteur, the manufacturer of the YF-VAX vaccine, notified the CDC and the Food and Drug Administration in 2016 there could be a shortage this year after the manufacturing complications during a factory switch over led to the loss of a large amount of vaccine supply, according to an article published online in the Morbidity and Mortality Weekly Report.
The CDC, Sanofi Pasteur, and the FDA are working to supplement the shortage. The manufacturer submitted an expanded investigational new drug (eIND) application to the FDA in September 2016 for marketing permission for Stamaril, an alternative vaccine manufactured by Sanofi Pasteur France and used in around 70 countries.
The application included planning for strategic distribution sites, which the CDC is determining using a tiered system based on volume of doses ordered in 2016.
As of April 2017, 250 civilian sites have been invited to participate in the eIND program, significantly less than the 4,000 currently distributing YF-VAX.
The CDC will “monitor for critical gaps in vaccine access and collaborate to address any issues, including considering the possibility of recruiting additional clinics to participate as necessary,” according to a statement.
Updates on the shortage will be available on the CDC travel health website.
[email protected]
On Twitter @eaztweets
FROM MMWR
Risk of recurrence outweighs risk of contralateral breast cancer for DCIS patients
LAS VEGAS – The risk of ipsilateral breast tumor recurrence was greater than the risk of contralateral breast cancer at both 5 and 10 years following diagnosis of ductal carcinoma in situ (DCIS), investigators report at a press conference in advance of the annual meeting of the American Society of Breast Surgeons.
“A rapidly growing number of women are choosing double mastectomies for DCIS, perhaps because they misperceive their risk of future cancer. Our research provides important data for treatment decision-making,” said Megan Miller, MD, of Memorial Sloan Kettering Cancer Center. “It suggests patients and their doctors should focus on risk factors and appropriate therapy for the diseased breast, not the opposite breast, and that ipsilateral DCIS should not prompt a bilateral mastectomy.”
The investigators also found that CBC did not correlate with age, family history, and initial DCIS characteristics, though these factors did correlate with the risk of IBTR.
Dr. Miller and her colleagues found radiation had no impact on risk of CBC (4.9% vs. 6.3%; P = .1), though it significantly reduced the risk for IBTR (10.3% vs. 19.3%; P less than .0001).
More research is needed on risk factors for patients with a preinvasive condition, Dr. Miller said.
“Most studies examining the benefits of bilateral mastectomy focus on invasive cancer,” she said. “This study is unique in providing hard data for women with preinvasive disease. For these patients, examining risk factors for recurrence and the benefits of radiation and endocrine therapy to treat the existing cancer are important.”
[email protected]
On Twitter @eaztweets
LAS VEGAS – The risk of ipsilateral breast tumor recurrence was greater than the risk of contralateral breast cancer at both 5 and 10 years following diagnosis of ductal carcinoma in situ (DCIS), investigators report at a press conference in advance of the annual meeting of the American Society of Breast Surgeons.
“A rapidly growing number of women are choosing double mastectomies for DCIS, perhaps because they misperceive their risk of future cancer. Our research provides important data for treatment decision-making,” said Megan Miller, MD, of Memorial Sloan Kettering Cancer Center. “It suggests patients and their doctors should focus on risk factors and appropriate therapy for the diseased breast, not the opposite breast, and that ipsilateral DCIS should not prompt a bilateral mastectomy.”
The investigators also found that CBC did not correlate with age, family history, and initial DCIS characteristics, though these factors did correlate with the risk of IBTR.
Dr. Miller and her colleagues found radiation had no impact on risk of CBC (4.9% vs. 6.3%; P = .1), though it significantly reduced the risk for IBTR (10.3% vs. 19.3%; P less than .0001).
More research is needed on risk factors for patients with a preinvasive condition, Dr. Miller said.
“Most studies examining the benefits of bilateral mastectomy focus on invasive cancer,” she said. “This study is unique in providing hard data for women with preinvasive disease. For these patients, examining risk factors for recurrence and the benefits of radiation and endocrine therapy to treat the existing cancer are important.”
[email protected]
On Twitter @eaztweets
LAS VEGAS – The risk of ipsilateral breast tumor recurrence was greater than the risk of contralateral breast cancer at both 5 and 10 years following diagnosis of ductal carcinoma in situ (DCIS), investigators report at a press conference in advance of the annual meeting of the American Society of Breast Surgeons.
“A rapidly growing number of women are choosing double mastectomies for DCIS, perhaps because they misperceive their risk of future cancer. Our research provides important data for treatment decision-making,” said Megan Miller, MD, of Memorial Sloan Kettering Cancer Center. “It suggests patients and their doctors should focus on risk factors and appropriate therapy for the diseased breast, not the opposite breast, and that ipsilateral DCIS should not prompt a bilateral mastectomy.”
The investigators also found that CBC did not correlate with age, family history, and initial DCIS characteristics, though these factors did correlate with the risk of IBTR.
Dr. Miller and her colleagues found radiation had no impact on risk of CBC (4.9% vs. 6.3%; P = .1), though it significantly reduced the risk for IBTR (10.3% vs. 19.3%; P less than .0001).
More research is needed on risk factors for patients with a preinvasive condition, Dr. Miller said.
“Most studies examining the benefits of bilateral mastectomy focus on invasive cancer,” she said. “This study is unique in providing hard data for women with preinvasive disease. For these patients, examining risk factors for recurrence and the benefits of radiation and endocrine therapy to treat the existing cancer are important.”
[email protected]
On Twitter @eaztweets
FROM ASBS 2017
Key clinical point:
Major finding: Among 2,759 patients, incidence rate of contralateral breast cancer was 2.8% and 5.6% over 5 and 10 years, respectively, while risk of ipsilateral breast tumor recurrence was 7.8% and 14.3% over 5 and 10 years, respectively.
Data source: Study of 2,759 DCIS patients who underwent breast conserving surgery between 1978-2011, who were followed for a median of 6.8 years.
Disclosures: The investigators reported no relevant disclosures.
Small study: Vitamin D repletion may decrease insulin resistance
WASHINGTON – Normalizing vitamin D levels correlated with lower insulin resistance and decreased adipose fibrosis in obese patients, according to a study presented at the Eastern regional meeting of the American Federation for Medical Research.
Approximately 86 million U.S. patients have prediabetes, according to Diabetes Report Card 2014, the most recent estimates from the Centers for Disease Control and Prevention. Vitamin D therapy may be able to help lower that number and prevent diabetes in some patients, Jee Young You, MD, a research fellow at Albert Einstein College of Medicine, New York, said at the meeting.
“When there’s increased adiposity, there is reduction of the blood flow which will further lead to inflammation, macrophage infiltration, and fibrosis, which all together leads to insulin resistance,” Dr. You said. “It is shown that there are vitamin D receptors present on adipocytes, so we hypothesize repleting vitamin D will help in reducing this inflammation.”
In a double blind study, Dr. You and her colleagues randomized 11 obese patients, with an average body mass index of 34 kg/m2, insulin resistance, and vitamin D deficiency to vitamin D repletion therapy. Eight similar patients served as controls. The average age was 43 years.
Patients in the test group were placed on a step schedule for vitamin D supplementation. For 3 months, they received 40,000 IU of vitamin D3 weekly in an effort to reach a target 25-hydroxyvitamin D level of greater than 30 ng/ml. Patients then received another 3 months of the same supplementation with an aim to reach a target level of greater than 50 ng/ml.
“We wanted to see if there was a dose dependent effect for vitamin D in patients,” Dr. You said.
Endogenous glucose production decreased by 24% (P = .04) after normalization of vitamin D levels. Patients who received placebo saw an increase in endogenous glucose, pointing to lower hepatic insulin sensitivity, Dr. You said.
When the vitamin D receptors are activated, they inhibit the profibrotic pathways like TGFb-1, Dr. You explained, decreasing fibrosis.
The researchers also found a decrease in profibrotic gene expression in TGFb-1, HiF-1, MMP7, and Collagen I, V, and VI.
However, while testing for reduction in profibrotic gene expression in whole fat, the investigators found that there was no additional improvement after the first round of vitamin D therapy, leading them to assert that raising vitamin D levels above the normal range does not give any additional benefit.
[email protected]
On Twitter @eaztweets
WASHINGTON – Normalizing vitamin D levels correlated with lower insulin resistance and decreased adipose fibrosis in obese patients, according to a study presented at the Eastern regional meeting of the American Federation for Medical Research.
Approximately 86 million U.S. patients have prediabetes, according to Diabetes Report Card 2014, the most recent estimates from the Centers for Disease Control and Prevention. Vitamin D therapy may be able to help lower that number and prevent diabetes in some patients, Jee Young You, MD, a research fellow at Albert Einstein College of Medicine, New York, said at the meeting.
“When there’s increased adiposity, there is reduction of the blood flow which will further lead to inflammation, macrophage infiltration, and fibrosis, which all together leads to insulin resistance,” Dr. You said. “It is shown that there are vitamin D receptors present on adipocytes, so we hypothesize repleting vitamin D will help in reducing this inflammation.”
In a double blind study, Dr. You and her colleagues randomized 11 obese patients, with an average body mass index of 34 kg/m2, insulin resistance, and vitamin D deficiency to vitamin D repletion therapy. Eight similar patients served as controls. The average age was 43 years.
Patients in the test group were placed on a step schedule for vitamin D supplementation. For 3 months, they received 40,000 IU of vitamin D3 weekly in an effort to reach a target 25-hydroxyvitamin D level of greater than 30 ng/ml. Patients then received another 3 months of the same supplementation with an aim to reach a target level of greater than 50 ng/ml.
“We wanted to see if there was a dose dependent effect for vitamin D in patients,” Dr. You said.
Endogenous glucose production decreased by 24% (P = .04) after normalization of vitamin D levels. Patients who received placebo saw an increase in endogenous glucose, pointing to lower hepatic insulin sensitivity, Dr. You said.
When the vitamin D receptors are activated, they inhibit the profibrotic pathways like TGFb-1, Dr. You explained, decreasing fibrosis.
The researchers also found a decrease in profibrotic gene expression in TGFb-1, HiF-1, MMP7, and Collagen I, V, and VI.
However, while testing for reduction in profibrotic gene expression in whole fat, the investigators found that there was no additional improvement after the first round of vitamin D therapy, leading them to assert that raising vitamin D levels above the normal range does not give any additional benefit.
[email protected]
On Twitter @eaztweets
WASHINGTON – Normalizing vitamin D levels correlated with lower insulin resistance and decreased adipose fibrosis in obese patients, according to a study presented at the Eastern regional meeting of the American Federation for Medical Research.
Approximately 86 million U.S. patients have prediabetes, according to Diabetes Report Card 2014, the most recent estimates from the Centers for Disease Control and Prevention. Vitamin D therapy may be able to help lower that number and prevent diabetes in some patients, Jee Young You, MD, a research fellow at Albert Einstein College of Medicine, New York, said at the meeting.
“When there’s increased adiposity, there is reduction of the blood flow which will further lead to inflammation, macrophage infiltration, and fibrosis, which all together leads to insulin resistance,” Dr. You said. “It is shown that there are vitamin D receptors present on adipocytes, so we hypothesize repleting vitamin D will help in reducing this inflammation.”
In a double blind study, Dr. You and her colleagues randomized 11 obese patients, with an average body mass index of 34 kg/m2, insulin resistance, and vitamin D deficiency to vitamin D repletion therapy. Eight similar patients served as controls. The average age was 43 years.
Patients in the test group were placed on a step schedule for vitamin D supplementation. For 3 months, they received 40,000 IU of vitamin D3 weekly in an effort to reach a target 25-hydroxyvitamin D level of greater than 30 ng/ml. Patients then received another 3 months of the same supplementation with an aim to reach a target level of greater than 50 ng/ml.
“We wanted to see if there was a dose dependent effect for vitamin D in patients,” Dr. You said.
Endogenous glucose production decreased by 24% (P = .04) after normalization of vitamin D levels. Patients who received placebo saw an increase in endogenous glucose, pointing to lower hepatic insulin sensitivity, Dr. You said.
When the vitamin D receptors are activated, they inhibit the profibrotic pathways like TGFb-1, Dr. You explained, decreasing fibrosis.
The researchers also found a decrease in profibrotic gene expression in TGFb-1, HiF-1, MMP7, and Collagen I, V, and VI.
However, while testing for reduction in profibrotic gene expression in whole fat, the investigators found that there was no additional improvement after the first round of vitamin D therapy, leading them to assert that raising vitamin D levels above the normal range does not give any additional benefit.
[email protected]
On Twitter @eaztweets
AT THE AFMR EASTERN REGIONAL MEETING
Key clinical point:
Major finding: Of the 19 patients studied, expression of profibrotic genes TGFb-1, HiF-1, MMP7, and Collagen I, V, and VI in those given vitamin D therapy decreased 0.81, 0.72, 0.62,. 0.56, 0.56, and 0.43 times, respectively (P less than .05).
Data source: Randomized, double blind, placebo-controlled study of 19 obese, insulin resistant, vitamin D deficient patients.
Disclosures: The investigators reported no relevant conflicts of interest.
Science advocates take to D.C. streets in March for Science
WASHINGTON – Crowds of protesters packed the Washington’s National Mall for the March for Science, joining participants in 600 cities across the world on Saturday, April 22.
Advocates came in droves, braving the rain armed with homemade signs, chants, and a passion for peer review, to champion the scientific method and the importance of its role in society and policy making.
The event, organized by March for Science, Earth Day Network, and a robust list of advocacy groups and think tanks, started with learning sessions hosted in tents located beyond the Washington Monument, where experts in topics from physics to environmental science informed attendees about the importance of their subjects.
To the left of the tents, directly across from the White House, scores gathered around a large stage, where 56 science professionals from different fields came together to promote the importance of scientific research and science-based policy.
The main stage event was emceed by musician Questlove and Tyler DeWitt, PhD, host of the YouTube science education show “Science with Tyler DeWitt.”
“You cannot criticize a public that doesn’t understand science if we can’t explain it,” said Dr. DeWitt.
“A strong commitment to research is absolutely essential to crafting evidence-based policies to protect us from serious health threats,” said Georges C. Benjamin, MD, executive director of the America Public Health Association. “A nation that ignores science, that denies science, that underfunds science, does so at its own peril.”
Speakers like Kellan Baker, senior fellow with the LGBT Research and Communications Project at the Center for American Progress, promoted political action, echoing organizers’ intentions of being bipartisan but not shying away from promoting political action.
“Advocacy is not a dirty word” said Mr. Baker. “Science is objective, but it is not neutral.”
Other speakers included Mona Hanna-Attisha, MD, the pediatrician who helped expose the lead poisoning situation in Flint, Mich., and Bill Nye, CEO of the Planetary Society and host of the Netflix series “Bill Nye Saves the World.”
After speeches, protesters marched from the Washington Monument to the U.S. Capitol, chanting loudly and waving signs.
March for Science and its partners are continuing to promote advocacy through a “week of action” scheduled to run through April 29.
*This article was updated May 2, 2017.
[email protected]
On Twitter @eaztweets
WASHINGTON – Crowds of protesters packed the Washington’s National Mall for the March for Science, joining participants in 600 cities across the world on Saturday, April 22.
Advocates came in droves, braving the rain armed with homemade signs, chants, and a passion for peer review, to champion the scientific method and the importance of its role in society and policy making.
The event, organized by March for Science, Earth Day Network, and a robust list of advocacy groups and think tanks, started with learning sessions hosted in tents located beyond the Washington Monument, where experts in topics from physics to environmental science informed attendees about the importance of their subjects.
To the left of the tents, directly across from the White House, scores gathered around a large stage, where 56 science professionals from different fields came together to promote the importance of scientific research and science-based policy.
The main stage event was emceed by musician Questlove and Tyler DeWitt, PhD, host of the YouTube science education show “Science with Tyler DeWitt.”
“You cannot criticize a public that doesn’t understand science if we can’t explain it,” said Dr. DeWitt.
“A strong commitment to research is absolutely essential to crafting evidence-based policies to protect us from serious health threats,” said Georges C. Benjamin, MD, executive director of the America Public Health Association. “A nation that ignores science, that denies science, that underfunds science, does so at its own peril.”
Speakers like Kellan Baker, senior fellow with the LGBT Research and Communications Project at the Center for American Progress, promoted political action, echoing organizers’ intentions of being bipartisan but not shying away from promoting political action.
“Advocacy is not a dirty word” said Mr. Baker. “Science is objective, but it is not neutral.”
Other speakers included Mona Hanna-Attisha, MD, the pediatrician who helped expose the lead poisoning situation in Flint, Mich., and Bill Nye, CEO of the Planetary Society and host of the Netflix series “Bill Nye Saves the World.”
After speeches, protesters marched from the Washington Monument to the U.S. Capitol, chanting loudly and waving signs.
March for Science and its partners are continuing to promote advocacy through a “week of action” scheduled to run through April 29.
*This article was updated May 2, 2017.
[email protected]
On Twitter @eaztweets
WASHINGTON – Crowds of protesters packed the Washington’s National Mall for the March for Science, joining participants in 600 cities across the world on Saturday, April 22.
Advocates came in droves, braving the rain armed with homemade signs, chants, and a passion for peer review, to champion the scientific method and the importance of its role in society and policy making.
The event, organized by March for Science, Earth Day Network, and a robust list of advocacy groups and think tanks, started with learning sessions hosted in tents located beyond the Washington Monument, where experts in topics from physics to environmental science informed attendees about the importance of their subjects.
To the left of the tents, directly across from the White House, scores gathered around a large stage, where 56 science professionals from different fields came together to promote the importance of scientific research and science-based policy.
The main stage event was emceed by musician Questlove and Tyler DeWitt, PhD, host of the YouTube science education show “Science with Tyler DeWitt.”
“You cannot criticize a public that doesn’t understand science if we can’t explain it,” said Dr. DeWitt.
“A strong commitment to research is absolutely essential to crafting evidence-based policies to protect us from serious health threats,” said Georges C. Benjamin, MD, executive director of the America Public Health Association. “A nation that ignores science, that denies science, that underfunds science, does so at its own peril.”
Speakers like Kellan Baker, senior fellow with the LGBT Research and Communications Project at the Center for American Progress, promoted political action, echoing organizers’ intentions of being bipartisan but not shying away from promoting political action.
“Advocacy is not a dirty word” said Mr. Baker. “Science is objective, but it is not neutral.”
Other speakers included Mona Hanna-Attisha, MD, the pediatrician who helped expose the lead poisoning situation in Flint, Mich., and Bill Nye, CEO of the Planetary Society and host of the Netflix series “Bill Nye Saves the World.”
After speeches, protesters marched from the Washington Monument to the U.S. Capitol, chanting loudly and waving signs.
March for Science and its partners are continuing to promote advocacy through a “week of action” scheduled to run through April 29.
*This article was updated May 2, 2017.
[email protected]
On Twitter @eaztweets