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A prospective longitudinal study of Reactive Attachment Disorder following early institutional care: considering variable- and person-centered approaches.
Guyon-Harris KL, Humphreys KL, Degnan K, Fox NA, Nelson CA, Zeanah CH
(2019) Attach Hum Dev 21: 95-110
MeSH Terms: Child, Child, Institutionalized, Disease Progression, Humans, Interviews as Topic, Longitudinal Studies, Prospective Studies, Qualitative Research, Reactive Attachment Disorder
Show Abstract · Added March 3, 2020
Although the study of reactive attachment disorder (RAD) in early childhood has received considerable attention, there is emerging interest in RAD that presents in school age children and adolescents. We examined the course of RAD signs from early childhood to early adolescence using both variable-centered (linear mixed modeling) and person-centered (growth mixture modeling) approaches. One-hundred twenty-four children with a history of institutional care from the Bucharest Early Intervention Project, a randomized controlled trial of foster care as an alternative to institutional care, as well as 69 community comparison children were included in the study. While foster care was associated with steep reductions in RAD signs across development, person-centered approaches indicated that later age of placement into families and greater percent time in institutional care were each associated with prolonged elevated RAD signs. Findings suggest the course of RAD is variable but substantially influenced by early experiences.
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9 MeSH Terms
Balancing dual demands on the physician-scientist workforce.
Martin DM, Rathmell WK, Tavazoie SF
(2018) J Clin Invest 128: 3204-3205
MeSH Terms: Biomedical Research, Education, Medical, Undergraduate, Humans, Physicians, Research Personnel, Workforce
Added October 30, 2019
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MeSH Terms
Limited achievement of NIH research independence by pediatric K award recipients.
Good M, McElroy SJ, Berger JN, Moore DJ, Wynn JL
(2018) Pediatr Res 84: 479-480
MeSH Terms: Achievement, Awards and Prizes, Career Mobility, Child, Female, Humans, Male, Mentors, National Institutes of Health (U.S.), Pediatrics, Physicians, Research Personnel, Research Support as Topic, Translational Medical Research, United States
Added June 17, 2018
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15 MeSH Terms
Minimal clinically important differences for measures of treatment efficacy in Stevens-Johnson syndrome and toxic epidermal necrolysis.
Kim WB, Worley B, Holmes J, Phillips EJ, Beecker J
(2018) J Am Acad Dermatol 79: 1150-1152
MeSH Terms: Clinical Trials as Topic, Dermatologists, Disease Progression, Humans, Length of Stay, Minimal Clinically Important Difference, Professional Practice, Re-Epithelialization, Research Design, Stevens-Johnson Syndrome, Surgeons, Surveys and Questionnaires, Survival Rate, Treatment Outcome
Added March 30, 2020
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Interdisciplinary Models for Research and Clinical Endeavors in Genomic Medicine: A Scientific Statement From the American Heart Association.
Musunuru K, Arora P, Cooke JP, Ferguson JF, Hershberger RE, Hickey KT, Lee JM, Lima JAC, Loscalzo J, Pereira NL, Russell MW, Shah SH, Sheikh F, Wang TJ, MacRae CA, American Heart Association Council on Genomic and Precision Medicine; Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Radiology and Intervention; Council on Peripheral Vascular Disease; Council on Quality of Care and Outcomes Research; and Stroke Council
(2018) Circ Genom Precis Med 11: e000046
MeSH Terms: American Heart Association, Biomedical Research, Cardiovascular Diseases, Electronic Health Records, Genomics, Humans, Interdisciplinary Studies, Precision Medicine, United States
Show Abstract · Added April 2, 2019
The completion of the Human Genome Project has unleashed a wealth of human genomics information, but it remains unclear how best to implement this information for the benefit of patients. The standard approach of biomedical research, with researchers pursuing advances in knowledge in the laboratory and, separately, clinicians translating research findings into the clinic as much as decades later, will need to give way to new interdisciplinary models for research in genomic medicine. These models should include scientists and clinicians actively working as teams to study patients and populations recruited in clinical settings and communities to make genomics discoveries-through the combined efforts of data scientists, clinical researchers, epidemiologists, and basic scientists-and to rapidly apply these discoveries in the clinic for the prediction, prevention, diagnosis, prognosis, and treatment of cardiovascular diseases and stroke. The highly publicized US Precision Medicine Initiative, also known as All of Us, is a large-scale program funded by the US National Institutes of Health that will energize these efforts, but several ongoing studies such as the UK Biobank Initiative; the Million Veteran Program; the Electronic Medical Records and Genomics Network; the Kaiser Permanente Research Program on Genes, Environment and Health; and the DiscovEHR collaboration are already providing exemplary models of this kind of interdisciplinary work. In this statement, we outline the opportunities and challenges in broadly implementing new interdisciplinary models in academic medical centers and community settings and bringing the promise of genomics to fruition.
© 2018 American Heart Association, Inc.
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9 MeSH Terms
Treatment options in idiopathic subglottic stenosis: protocol for a prospective international multicentre pragmatic trial.
Gelbard A, Shyr Y, Berry L, Hillel AT, Ekbom DC, Edell ES, Kasperbauer JL, Lott DG, Donovan DT, Garrett CG, Sandhu G, Daniero JJ, Netterville JL, Schindler JS, Smith ME, Bryson PC, Lorenz RR, Francis DO
(2018) BMJ Open 8: e022243
MeSH Terms: Adolescent, Adult, Constriction, Pathologic, Female, Humans, Laryngostenosis, Larynx, Multicenter Studies as Topic, Pragmatic Clinical Trials as Topic, Prospective Studies, Quality of Life, Research Design, Treatment Outcome
Show Abstract · Added July 30, 2020
INTRODUCTION - Idiopathic subglottic stenosis (iSGS) is an unexplained progressive obstruction of the upper airway that occurs almost exclusively in adult, Caucasian women. The disease is characterised by mucosal inflammation and localised fibrosis resulting in life-threatening blockage of the upper airway. Because of high recurrence rates, patients with iSGS will frequently require multiple procedures following their initial diagnosis. Both the disease and its therapies profoundly affect patients' ability to breathe, communicate and swallow. A variety of treatments have been advanced to manage this condition. However, comparative data on effectiveness and side effects of the unique approaches have never been systematically evaluated. This study will create an international, multi-institutional prospective cohort of patients with iSGS. It will compare three surgical approaches to determine how well the most commonly used treatments in iSGS 'work' and what quality of life (QOL) trade-offs are associated with each approach.
METHODS AND ANALYSIS - A prospective pragmatic trial comparing the 'Standard of Care' for iSGS at multiple international institutions. Patients with a diagnosis of iSGS without clinical or laboratory evidence of vasculitis or a history of endotracheal intubation 2 years prior to symptom onset will be included in the study. Prospective evaluation of disease recurrence requiring operative intervention, validated patient-reported outcome (PRO) measures as well as patient-generated health data (mobile peak flow recordings and daily steps taken) will be longitudinally tracked for 36 months. The primary endpoint is treatment effectiveness defined as time to recurrent operative procedure. Secondary endpoints relate to treatment side effects and include PRO measures in voice, swallowing, breathing and global QOL as well as patient-generated health data.
ETHICS AND DISSEMINATION - This protocol was approved by the local IRB Committee of the Vanderbilt University Medical Center in July 2015. The findings of the trial will be disseminated through peer-reviewed journals, national and international conference presentations and directly to patient with iSGS via social media-based support groups.
TRIAL REGISTRATION NUMBER - NCT02481817.
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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The Scope of Extraprofessional Caregiving Challenges Among Early Career Faculty: Findings From a University Medical Center.
Hartmann KE, Sundermann AC, Helton R, Bird H, Wood A
(2018) Acad Med 93: 1707-1712
MeSH Terms: Academic Medical Centers, Adult, Biomedical Research, Career Mobility, Faculty, Medical, Female, Humans, Male, Middle Aged, Occupational Stress, Surveys and Questionnaires, United States
Show Abstract · Added February 21, 2019
PURPOSE - Academic scientists work in competitive environments, and many institutions invest in career development supports. These investments may be imperiled when extraprofessional demands challenge a faculty member's reserve capacity. This research assessed prevalence of caregiving challenges and estimated incidence of stressful life events.
METHOD - In 2015-2016, the authors surveyed recipients of career development awards supporting ≥ 75% effort and individuals within the funding period of their first National Institutes of Health R01 or equivalent at Vanderbilt University Medical Center. Domains included family structure, hospitalizations of family members, responsibility for coordination of caregiving, and an inventory of stressful life events.
RESULTS - Seventy-two percent (152 of 210) of early career researchers responded. Over half endorsed experiencing one or more substantial caregiving challenges in the prior year. This included 35 (23%) having a child or adult in the household hospitalized in the prior year and 36 (24%) being responsible for health care needs for a child or adult in the household, or for coordinating elder care, assisted living, or hospice care. The majority experienced one or more caregiving challenges. Stressful life events increased relative risk of "thinking about leaving academics" by 70% (risk ratio: 1.7; 95% confidence interval: 1.2, 2.4). Prevalence and incidence of caregiving demands did not differ by gender.
CONCLUSIONS - Leaders, administrators, mentors, and faculty should anticipate that most women and men early career researchers will experience substantial caregiving challenges and life events in any given year. Sufficient need exists to warrant investigation of institutional programs to address caregiving challenges.
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12 MeSH Terms
An Innovative Program to Support Gender Equity and Success in Academic Medicine: Early Experiences From the Doris Duke Charitable Foundation's Fund to Retain Clinical Scientists.
Jagsi R, Jones RD, Griffith KA, Brady KT, Brown AJ, Davis RD, Drake AF, Ford D, Fraser VJ, Hartmann KE, Hochman JS, Girdler S, Libby AM, Mangurian C, Regensteiner JG, Yonkers K, Escobar-Alvarez S, Myers ER
(2018) Ann Intern Med 169: 128-130
MeSH Terms: Biomedical Research, Female, Foundations, Humans, Male, Research Personnel, Research Support as Topic, Sexism, United States
Added February 21, 2019
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9 MeSH Terms
Attitudes of Radiology Program Directors Toward MD-PhD Trainees, Resident Research Productivity, and Dedicated Research Time.
Cogswell PM, Deitte LA, Donnelly EF, Morgan VL, Omary RA
(2018) Acad Radiol 25: 733-738
MeSH Terms: Attitude of Health Personnel, Biomedical Research, Clinical Competence, Efficiency, Humans, Internship and Residency, Physician Executives, Radiology, Surveys and Questionnaires, Time Factors
Show Abstract · Added March 16, 2018
RATIONALE AND OBJECTIVES - The percentage of clinical scientists in radiology has historically been low. Increasing the pipeline of trainees interested in research could occur by recruiting MD-PhD trainees and providing protected research time during residency. The purpose of this work is to assess the attitudes of radiology program directors toward MD-PhD trainees, resident research productivity, and dedicated research time.
METHODS - An online survey was sent to residency program directors of all diagnostic radiology departments that received National Institutes of Health (NIH) awards in 2014 (n = 63). Survey questions included program size; perception of overall performance, clinical performance, and research productivity of MD-PhD residents compared to non-PhD residents; and presence of dedicated research time. Responses comparing MD-PhD residents to non-PhD residents were reported as a five-point Likert scale. Student t test was used to assess for significance (alpha = 0.05).
RESULTS - Response rate was 37%. Clinical performance of MD-PhD residents was judged inferior (P < .05) to non-PhD residents, although that of all residents engaged in research trended toward superiority compared to those not involved in research. Dedicated research time is offered by 61% of programs in years R1-R3 and all programs in year R4. Research productivity during residency was judged to be similar (P = .5) between MD-PhD and non-PhD residents.
CONCLUSIONS - Survey results suggest that clinical performance during residency and research involvement is often individually based and difficult to generalize based on prior PhD training. All programs offered dedicated research time, and the vast majority of residents were reported to engage in research during residency, which may increase the pipeline of trainees interested in an academic career.
Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
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10 MeSH Terms
Overcoming Translational Barriers in Acute Kidney Injury: A Report from an NIDDK Workshop.
Zuk A, Palevsky PM, Fried L, Harrell FE, Khan S, McKay DB, Devey L, Chawla L, de Caestecker M, Kaufman JS, Thompson BT, Agarwal A, Greene T, Okusa MD, Bonventre JV, Dember LM, Liu KD, Humphreys BD, Gossett D, Xie Y, Norton JM, Kimmel PL, Star RA
(2018) Clin J Am Soc Nephrol 13: 1113-1123
MeSH Terms: Acute Kidney Injury, Animals, Congresses as Topic, Disease Models, Animal, Humans, National Institute of Diabetes and Digestive and Kidney Diseases (U.S.), Translational Medical Research, United States
Show Abstract · Added October 23, 2018
AKI is a complex clinical condition associated with high mortality, morbidity, and health care costs. Despite improvements in methodology and design of clinical trials, and advances in understanding the underlying pathophysiology of rodent AKI, no pharmacologic agent exists for the prevention or treatment of AKI in humans. To address the barriers that affect successful clinical translation of drug targets identified and validated in preclinical animal models of AKI in this patient population, the National Institute of Diabetes and Digestive and Kidney Diseases convened the "AKI Outcomes: Overcoming Barriers in AKI" workshop on February 10-12, 2015. The workshop used a reverse translational medicine approach to identify steps necessary to achieve clinical success. During the workshop, breakout groups were charged first to design feasible, phase 2, proof-of-concept clinical trials for delayed transplant graft function, prevention of AKI (primary prevention), and treatment of AKI (secondary prevention and recovery). Breakout groups then were responsible for identification of preclinical animal models that would replicate the pathophysiology of the phase 2 proof-of-concept patient population, including primary and secondary end points. Breakout groups identified considerable gaps in knowledge regarding human AKI, our understanding of the pathophysiology of AKI in preclinical animal models, and the fidelity of cellular and molecular targets that have been evaluated preclinically to provide information regarding human AKI of various etiologies. The workshop concluded with attendees defining a new path forward to a better understanding of the etiology, pathology, and pathophysiology of human AKI.
Copyright © 2018 by the American Society of Nephrology.
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8 MeSH Terms