ECHO

Carlos Camargo: Heterogeneity of Severe Bronchiolitis: Implications for Acute Management and for Developing Asthma
2020-10-13 13:00 - 14:00 (America/New_York) | WebEx
Heterogeneity of Severe Bronchiolitis: Implications for Acute Management and for Developing Asthma

Speaker:

Carlos Camargo, MD
Harvard University and Massachusetts General Hospital

Speaker Bio: Dr. Carlos Camargo is a Professor of Emergency Medicine, Medicine, and Epidemiology at Harvard University, and the Conn Chair in Emergency Medicine at Massachusetts General Hospital. He founded and leads the Emergency Medicine Network (or EMNet), an international research collaboration with 247 hospitals. Two EMNet cohorts are part of ECHO: the MARC-35 severe bronchiolitis cohort and MARC-43 healthy infant cohort. He also works on the role of nutrition in respiratory/allergy disorders, both in large cohort studies and in randomized controlled trials; the health effects of vitamin D are a major focus.
Dr Camargo is past president of the American College of Epidemiology, and has worked on several U.S. guidelines, including those on diet, asthma, and food allergy. He has >1,000 publications, with an H-index of 134.
Date: Tuesday, October 13, 1 to 2pm
Slides

Heather Volk: Moving ECHO Science Toward Gene-Environment Interaction for Neurodevelopmental Outcomes
2020-09-09 13:00 - 14:00 | WebEx
Moving ECHO Science Toward Gene-Environment Interaction for Neurodevelopmental Outcomes

Speaker:

Heather Volk. PhD, MPH
Johns Hopkins Bloomberg School of Public Health

Speaker Bio: Heather E. Volk is an Associate Professor in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health. She is also Co-Director of the NICHD-funded Intellectual and Developmental Disabilities Research Center (IDDRC) at the Kennedy Krieger Institute, and Associate Director for Environmental Epidemiology in the Wendy Klag Center for Autism and Developmental Disabilities Research. Dr. Volk additionally is co-Director of the Psychiatric Epidemiology Traning program, supported by a Institutional Training grant (T32) from the National Institute of Mental Health. She also holds a joint appointment in the School’s Department of Environmental Health and Engineering. Dr. Volk earned a MPH in Epidemiology and Biostatistics at Boston University and a PhD in Public Health Studies (Epidemiology) at Saint Louis University, prior to post-doctoral training in Enviornmental Genomics through the Department of Preventive Medicine at the University of Southern California (USC). She, along with her team, studies how environmental and genetic factors work together to confer risk for neurodevelopmental outcomes, including autism spectrum disorder (ASD). She is the PI of several NIH-funded research grants which examine how environmental exposures (air pollution, metals) effect brain development, epidemiologic studies of comorbidity with ASD, and leads investigations into joint genetic, epigenetic, and environmental risks for ASD. Dr. Volk additionally serves as co-PI for the Autism Spectrum Disorder Enriched Risk ECHO Cohort, a collaboration of nine cohorts of infants at high-familial risk for ASD.
Date: Wednesday, September 9, 1 to 2pm
Slides

Forrest/Ganiban: More than the Absence of Disease: Studying Positive Health in ECHO
2020-08-12 13:00 - 14:00 | WebEx
More than the Absence of Disease: Studying Positive Health in ECHO

Speaker:

Chris Forrest, MD, PhD
Children’s Hospital of Philadelphia

Jody Ganiban, PhD
George Washington University

Speaker Bios: Chris Forrest is a Pediatrician at Children’s Hospital of Philadelphia, and the Director of the Applied Clinical Research Center. Dr. Forrest’s research focuses on developing novel ways of conducting multi-center pediatric applied clinical research and life course health science. He co-chairs the Positive Health Work Group within ECHO and is a member of the ECHO PRO core.
Dr. Ganiban’s early research focused on parent-child attachment relationships and child temperament, and development within groups of children that differed in their genetic, temperamental, or environmental risks for emotional and behavioral problems. Dr. Ganiban’s research has incorporated behavioral genetic research techniques to examine further the interplay between environmental factors and personal characteristics in determining children’s and parents’ emotional and physical health. Her recent projects include assessments of personality, temperament, and genetic makeup.
Topic:
Positive health is one of the five outcome priority areas for ECHO. It refers to having a state of physical, mental, and social well-being, and broadens our view of health as more than the absence of disease. In this presentation, we will present the science of positive health and ways to study it within ECHO.
Date: Wednesday, August 12, 1 to 2pm
Slides

Rob McConnell: Vaping: Risks to Children and Youth
2020-07-08 13:00 - 14:00
Vaping: Risks to Children and Youth

Speaker:

Rob McConnell, MD
Keck School of Medicine
University of Southern California

Speaker Bio: Rob McConnell is a physician and environmental epidemiologist, and Professor of Preventive Medicine. He directs the NIH/Environmental Protection Agency-supported Southern California Children’s Environmental Health Center. He has studied the effects of air pollution on children’s health, including the development of asthma and lung function deficits, and early markers for cardiovascular disease. Dr. McConnell has investigated susceptibility to the effects of environmental exposures conferred by psychosocial stress and social factors, exercise, genetics and co-exposures associated with housing conditions.
Topic: Vaping
Date: Wednesday, July 8, 1 to 2pm
Slides

Jessie Buckley: Estimating Effects of Exposure Mixtures on Child Health: Novel Methods for Solution-oriented ECHO Research
2020-06-17 13:00 - 14:00 | WebEx
Estimating Effects of Exposure Mixtures on Child Health: Novel Methods for Solution-oriented ECHO Research

Speaker:

Jessie Buckley, PhD, MPH
Johns Hopkins Bloomberg School of Public Health
ECHO Data Analysis Center (DAC)

Speaker Bio: Jessie Buckley is an environmental and pediatric/perinatal epidemiologist, working on research to inform environmental policies targeted at improving children’s health. Her work looks at developmental origins of health and disease framework and focuses on determining effects of early life exposure to endocrine disrupting chemicals on child physical growth and development. Using molecular epidemiology and advanced statistical approaches, she has conducted several studies evaluating the role of environmental chemical exposures in the development of childhood obesity. She has also researched the utility of biomarkers of exposure to several classes of environmental chemicals that have widespread human exposure, including phthalates.
Topic: Interest in understanding the combined effects of multiple exposures (i.e., mixtures) on children’s health is rapidly increasing, with a related proliferation of methods for estimating these effects. In this talk, Jessie will demonstrate two useful approaches for estimating mixtures effects – Bayesian kernel machine regression and quantile g-computation – with an application to endocrine disrupting chemical mixtures and childhood bone health. In addition, Jessie will introduce a novel statistical framework to advance solution-oriented mixtures research in ECHO by more directly informing practices, programs, and policies to improve children’s health.
Date: Wednesday, June 10, 1 to 2pm
Slides

Emily Oken: Using Cohort Studies to Understand Joint Effects of the Environment and Lifestyle on Health
2020-05-13 13:00 - 14:00 | WebEx
Using Cohort Studies to Understand Joint Effects of the Environment and Lifestyle on Health

Speaker:
Emily Oken
Department of Population Medicine at Harvard Pilgrim Health Care Inc

Speaker Bio: Dr. Oken was trained in internal medicine and pediatrics and is currently a Professor in the Department of Population Medicine at Harvard Medical School and the Harvard Pilgrim Health Care Institute, and in the Department of Nutrition at the Harvard School of Public Health. Dr. Oken Directs the Division of Chronic Disease Research Across the Lifecourse within the Department of Population Medicine. Her research focuses on the influences of nutrition and other environmental factors during pregnancy and early childhood on pregnancy outcomes as well as long-term maternal and child health, especially cardiometabolic health, cognitive development, asthma, and atopy. Since 2016 she has led Project Viva, a pre-birth cohort study that has followed pregnant women and their children since 1999. Project Viva is currently conducting in follow-up visits with teens aged 17-19 and their moms. The team is doing a fantastic job weathering the challenges of transition to remote data collection.

Date: Wednesday, May 13, 1 to 2pm
Slides

Jim Gern: An Integrated Approach to Identifying Early Life Causes of Childhood Asthma
2020-04-20 13:00 - 14:00 | WebEx
An Integrated Approach to Identifying Early Life Causes of Childhood Asthma
Speaker:
James Gern
University of Wisconsin School of Medicine and Public Health in Madison

Speaker Bio: Dr. James (Jim) Gern’s research group is conducting several NIH-funded translational research studies to define the role of viral infections and other environmental factors in the initiation and disease activity of asthma, and to identify interactions between host, viral and environmental factors (e.g. bacteria) that determine the severity of respiratory illnesses.
Outcome Areas: Airways
Date: Monday, April 20, 1 to 2pm
Slides

Bill Fifer: Sleep: Perchance to Find the Earliest Markers and Mediators of Childhood Disease and Positive Health
2020-03-11 13:00 - 14:00 | WebEx
Sleep: Perchance to Find the Earliest Markers and Mediators of Childhood Disease and Positive Health

Speaker:
Bill Fifer, PhD
Columbia University Medical Center

About the Speaker:
Dr. Fifer’s early work focused on the effects of prenatal experience on infant behavior and perception with a specific interest in the role of fetal and newborn learning. His current research interests focus on fetal and neonatal behavioral, physiological and central nervous system development. Current investigations in his laboratory include studies of fetal, newborn and premature infant neurobehavioral responses to environmental stimulation during sleep and the effects of prenatal exposures on later neurodevelopment. With local, national and international colleagues, his laboratory studies the effects of maternally mediated exposures on the developing fetus, early learning and memory, behavioral and cortical activity during environmental challenges, development of autonomic control during sleep, and assessment of risk adverse outcomes including placental dysfunction, sudden infant death, autism and other neurodevelopmental disorders. With local, national and international colleagues he is currently involved in several maternal/fetal/infant longitudinal cohort studies investigating early markers, mediators and mechanisms underlying the origins of health and disease.
Outcome Areas: Positive Health
Date: Wednesday, February 11, 1 to 2pm
Presentation Overview:
Dr. Fifer will discuss sleep and early markers, mediators and mechanisms underlying the origins of health and disease.
Slides

Paneth/Hirko: Identifying Opportunities for Implementation Science Approaches in the ECHO Program
2020-02-12 13:00 - 14:00 | WebEx
Identifying Opportunities for Implementation Science Approaches in the ECHO Program

Speaker:
Nigel Paneth, MD, MPH
Michigan State University

Kelly Hirko, PhD, MPH
Michigan State University

About the Speakers:
Nigel Paneth is a pediatrician and perinatal and child health epidemiologist with a particular interest in the causes and prevention of childhood neurodevelopmental handicap, especially cerebral palsy. After training in pediatrics and epidemiology, Dr. Paneth began his academic career at Columbia University in 1978 in the newly established Sergievsky Center, a research unit created to examine the etiology of epilepsy and other brain disorders. There he conducted studies of the relationship of perinatal medical care to patterns of fetal and infant mortality, particularly in premature infants. Dr. Paneth’s NIH-supported case-control study of cerebral palsy (CP) from 2009-2012 showed that considerable amounts of mRNA are reliably preserved on newborn blood spots, and hat gene expression in the newborn period differs in children who will later develop CP. His continued interest in CP is reflected in serving on the international task force on the definition and classification of CP.
Kelly Hirko is an epidemiologist and community-based researcher focusing on the role of lifestyle and behavioral factors on health disparities. Kelly recently completed the NCI’s Training Institute for Dissemination & Implementation Research in Cancer facilitated course and is interested in investigating the implementation of evidence-based interventions in tobacco cessation and interested in physical activity to address rural cancer disparities. Kelly earned her Master of Public Health degree in Epidemiology from the Boston University School of Public Health, and her PhD in Epidemiology from the University of Michigan School of Public Health. She completed a post-doctoral fellowship in Nutritional Epidemiology from the Harvard T.H. Chan School of Public Health and is an assistant professor in the Department of Epidemiology & Biostatistics at Michigan State University.
Outcome Areas: Airways
Date: Wednesday, February 12, 1 to 2pm
Presentation Overview:
Drs. Paneth and Hirko will use their cumulative epidemiology expertise to discuss opportunities with ECHO for implementation of methods to promote the systematic uptake of research findings and other evidence-based practives into routine practice, and to improve the quality and effectiveness of healthcare.

Slides

Richard Gershon: Advances in Pediatric Measurement Science: Implications in ECHO
2020-01-08 13:00 - 14:00 | WebEx
Advances in Pediatric Measurement Science: Implications in ECHO

Speaker:
Richard Gershon
Northwestern University

*If you would like CME credits for attending this presentation, please email Katherine.Simos@duke.edu*
About the Speaker:
Dr. Gershon is the Vice Chair for Research in Medical Social Sciences at Northwestern University’s Feinberg School of Medicine. Dr. Gershon has had a robust career in Patient Report Outcomes (PRO) and Performance Outcomes as he has acted as the principal investigator for the NIH Toolbox for the Assessment of Neurological Function and Behavior and the NIH Roadmap Patient – Reporting Outcomes Measurement Information System (PROMIS) Technical Center. He has served as PI, MPI or co-investigator for over 70 NIH, DoD, and Foundation awards.
Topic Areas: PRO Core, Person-reported outcomes, Patient-reported outcomes
Date: Wednesday, January 8 11, 1 to 2pm
Slides

Juliette Madan: The Microbiome Across Life Stages: Potential Health Implications and Opportunities for ECHO
2019-12-11 13:00 - 14:00 | WebEx
The Microbiome Across Life Stages: Potential Health Implications and Opportunities for ECHO

Speaker:
Juliette Madan
Dartmouth Geisel School of Medicine

About the Speaker:
Dr. Madan is an Associate Professor of Pediatrics and Epidemiology. Dr. Madan’s research interests the developing microbiome in health and in disease in premature infants with Cystic Fibrosis.
Topic Areas: Microbiome
Date: Wednesday, December 11, 1 to 2pm
Slides

Lisa Gatzke-Kopp: A Developmental Framework for Studying Social Environmental and Experiential Influences on Children's Behavioral Health
2019-11-13 13:00 - 14:00 | WebEx
A Developmental Framework for Studying Social Environmental and Experiential Influences on Children’s Behavioral Health

Speaker:
Lisa Gatzke-Kopp
Penn State University

About the Speaker:
Dr. Gatzke-Kopp is a Professor in the department of Human Development and Family Studies at Penn State. Her work focuses on the development of socioemotional and behavior problem in children, from a neuroscience perspective. Her research includes the examination of genetic, biological, and physiological processes as indices of individual vulnerability that moderate the effects of environmental risk factors on children’s developmental trajectories, as well as how experiential influences shape children’s biological systems over time.
Outcome Areas: Neurodevelopment
Date: Wednesday, November 13, 1 to 2pm
Presentation Overview:
Dr. Gatzke-Kopp discussed the importance of considering a child’s social and contextual environment. Social environment has been demonstrated to exert a direct effect on the development of children’s physical and mental health, as well as moderate the impact of biological exposures, and identifying social mechanisms of risk and resilience also identifies key points of intervention and preventative approaches to optimizing healthy development.
Slides

Leo Trasande: Endocrine Disrupting Chemicals: A Costly Public Health Threat with Opportunities for Policy Prevention
2019-10-15 13:00 - 14:00 | WebEx
Endocrine Disrupting Chemicals: A Costly Public Health Threat with Opportunities for Policy Prevention

Speaker:
Leo Trasande, MD, MPP
NYU School of Medicine, Professor of Pediatrics

About the Speaker:
Leonardo Trasande, MD, MPP is a professor in the departments of Pediatrics, Environmental Medicine, and Public Health at New York University, and is a leader in children’s environmental health researcher. His research focuses on the roles of environmental exposures in childhood obesity, and on the economic costs of failing to address these environmental factors to prevent diseases in children proactively.
Dr. Trasande received his bachelors, medical, and public policy degrees from Harvard University. He also completed the Boston Combined Residency in Pediatrics and a legislative fellowship in the Office of Senator Hillary Rodham Clinton.
Outcome Areas: Obesity; Neurodevelopment
Date: Tuesday, October 15, 1 to 2pm
Slides

Singleton/Semmens: Working with Rural Communities to Improve Household Air Quality and Health: Strategies to Guide Environmental Interventions in the ECHO IDeA States Pediatric Clinical Trials Network
2019-06-12 13:00 - 14:00 | WebEx
Working with Rural Communities to Improve Household Air Quality and Health: Strategies to Guide Environmental Interventions in the ECHO IDeA States Pediatric Clinical Trials Network

Speakers:
Ros Singleton, MD, MPH; Alaska Native Tribal Health Consortium, Anchorage
Speaker Bio: Rosalyn Singleton graduated from Northwestern University Medical School, Chicago and completed a Pediatric residency and MPH. She initially worked as a pediatrician in a Navajo hospital. Since 1988 she has worked as a pediatrician, immunization consultant and researcher for Alaska Native Tribal Health Consortium, and guest researcher at Arctic Investigations Program – CDC. Ros has worked with Alaska Native people on clinical studies related to vaccine preventable infections, respiratory infections, vitamin D deficiency, indoor air quality and bronchiectasis.

Erin Semmens, PhD, MPH; University of Montana
Speaker Bio: Erin Semmens graduated with a degree in Biology and Political Science from Duke University and received an MPH in Environmental and Occupational Health and a PhD in Epidemiology from the University of Washington. She is an Assistant Professor of Epidemiology in the School of Public and Community Health Sciences at the University of Montana. Erin’s research investigates the effects of environmental and occupational factors– and more recently their interaction with social influences– on long-term health. Specifically, she focuses on the health impacts of air pollution from multiple sources including wildfires, wood smoke, and traffic.
Outcome Areas: Airways
Date: Wednesday, June 12 from 1 to 2pm
Slides

Discussion:
Q: I would like to know the hypotheses that link those special populations, including Alaskan Natives, to a prevalence of bronchiectasis?
Ros Singleton: It is clear in collaborations with Australia and New Zealand and Canada and other researchers on bronchiectasis that this orphan disease is prevalent in these populations because of environmental and social factors. We did a three country analysis and discovered that household crowding was one of the most prevalent common factors. In Alaska lack of running water, and in Australia access to basic household features like a working refrigerator and a working sink, are the factors that are associated with both pneumonia and childhood pneumonia, which is the driver of bronchiectasis. Bronchiectasis was common in many other populations around the world until vaccines and improvements in running water and basic public health measures have really reduced that risk around the world. But it is still prevalent in much of the developing world and low income countries, although rarely identified because CT scans are not available. We have identified very high rates in many different indigenous populations.
Q: Indoor PM2.5 did not decrease after intervention, was it possible that PM2.5 from outdoors and neighboring houses played a role and that is why you do not see the decreased PM2.5?
Ros Singleton: I don’t think that is a major factor based on the feedback that we received from the environmental health specialist. It is possible that in a time when there is a lot of wood burning that you could have ambient 2.5 that comes in and so that could be a factor. Many of these homes are on a very windy tundra so that ambient 2.5 level is not very high in general, but we don’t have the data to prove that so that is one possibility. I think one other major thing that we identified was just the challenges for accessing dry wood. You have to find dry wood and in many areas there is no wood available and so people use driftwood and sometimes unfortunately trash. My colleagues have done a lot of education around the best practices in wood burning, and that’s why I’m excited about this new potential project in incorporating indigenous knowledge and really coming together to determine what are the best things to burn and how to burn so that it is most efficient and has the lowest PM2.5.
Q: How prevalent is secondary cigarette exposures in the studies described today? Has smoking cessation education been combined with indoor air quality interventions discussed today?
Erin Semmens: In the ARTIS study we excluded homes where there was an active smoker in the home, and in our ongoing study we did not make that exclusion because we thought that would exclude too many families. We don’t include smoking cessation as part of the education. We do nicotine wipes in the home as an indicator of whether there is smoking inside the home. I can say from looking at Montana birth certificate data that about 15% of women report smoking during pregnancy which is likely an underestimate, but still fairly high.
Ros Singleton: In Alaska, smoking rates are very high among Alaskan native people. Over 40% of adults smoke, as compared to about 20% in other populations. In Navajo smoking is actually very rare. In our study we did do tobacco cessation education and there are major tobacco cessation projects underway in Alaskan Native communities in collaboration with Mayo Clinic, and specifically with pregnant women because the rate of tobacco use including both smoking and also chew is extremely prevalent and smoking cessation is challenging. However, the homes in this study, as well as homes of families that have children hospitalized, have told us for many years that they do not smoke in the home. I believe that household education has really hit on fertile ground and people do understand the message about not smoking indoors. But smoking itself is very prevalent.
Q: In our region (South Dakota), many of our families are pretty mobile between seasons. Is this a common occurrence in your region? If so, how did you handle this in the analysis?
Ros Singleton: In our smaller study, we did have one family withdraw because of moving, but in general we were able to work with families that were there for the year. Moving is very common and that was a challenge. One family was actually living in a Conex (shipping container) at the initial part of the study and then had other housing.
Erin Semmens: Moving has been a challenge in our study, so when we provide potential participants with information about the study, we ask if they plan to be in the same home over the next two years. So to be in the study they have to plan to be stable with respect to their residence, but that isn’t always the case. That is the primary reason participants drop out of the study is because they move and when we are utilizing interventions that are aimed at improving indoor air quality it is very difficult when a person moves to a different home, even if it is another home with a wood stove to compare that. Unfortunately that has resulted in lost to follow-up or participants withdrawing from the study due to moving. A somewhat related point is when children spend part of their time during the week with one parent and part of the time with another parent. In those cases the child can be in the study, but we just do all of our sampling at the one residence.
Q: Did the stove change-out help decrease particulate matter?
Ros Singleton: In our first study, even with education we did not show a decrease in PM2.5. We did show a decrease in volatile organic compounds and we actually added volatile organic compounds late, but we found that it is a significant contributor to some aspects of indoor air pollution. In our region houses are small and villages often do not have a workshop available, and so the home is often used as a workshop and it is not unusual to have a father that is working on a snow machine or snow mobile inside the house. Also because of the cold temperatures, fuel is often stored in the house and people try to store it in the artic entry way but that is another potential source of volatile organic compounds. So we have some unusual sources of volatile organic compounds and we did some education around that.
Erin Semmens: In the Libby change-out there was a decrease in ambient PM2.5, which is a huge achievement, and it was such a large scale change-out. 1200 wood stoves and the population of Libby is under 3000 people, so that was a very large scale change-out in that community. But within the homes, indoor air quality reductions varied from home to home and the reason we hypothesized that there weren’t universal reductions is just having the new cleaner burning wood stove is not sufficient and that there are all these other best burning practices and education around how to use the wood stove that are needed as well. Another consideration is that people with new wood stoves might end up using their new stoves more.
Ros Singleton: In a pre-study home visit, the healthy home specialist said that the house was so smoky you could hardly see across the room. Obviously if you have a wood stove that is that bad and you have an alternative like a Toyo stove you are going to use the Toyo stove, but then if you get a great new wood stove that is much more efficient than you will probably revert to using the wood stove. That is one of our hypotheses, that no matter what you do to a wood stove it still has more PM2.5 than not using a wood stove. So if the use of the wood stove increase, then your PM2.5 may increase just because of that.
Q: I’m curious about your comments about best burn practices. What are people burning, what were they burning and talk more about best burn practices?
Ros Singleton: What you burn is so critical and like I mentioned a lot of the houses in Alaska are in non-treed areas. People burn driftwood and you have to leave driftwood for a long time for it to become dried, and by default people often use wet wood and burn wood that is wet. The wetter it is then the more inefficiently it burns and you have higher PM2.5 gas and other things. What you burn is critical. If you burn trash you can imagine what is in newspaper print and other things. There are all kinds of volatile compounds that are in trash and in other paper products that may have plastic also. Sometimes families revert to burning trash because that is what they have available. There has been many efforts to try to improve this. One effort is education on stacking and drying wood, and the emphasis on using only wood. There are also some very innovative projects that provide very efficient pellets. We’ve received feedback from some of those, but unfortunately it is pretty expensive to have them shipped up to Alaska so we haven’t done that intervention yet.
Erin Semmens: Having dry wood is not always available even if you live in a place like Montana that has a lot of trees and a lot of wood available, you may not have dry wood available. One of the main factors we saw in our pre-intervention year in the ARTIS study was that letting your wood dry out for a year or more was associated with lower PM2.5 concentrations, so it is a really important feature of best burning practices. In one community in a different study taking place in Idaho that tries to address that by having a community-level intervention with a community wood yard where the wood is stored properly and in season for the recommended length of time and then distributed to elders living in the community to provide them with access to dry wood. That is one way to try and address that challenge.
Q: I wanted to know more details about the air filtration device used in their study. Erin says it was a 3M electrostatic precipitator but I was interested in knowing more details about this device such as model and how they were maintained in the study. The info would help me understand why they did not observe reductions in PM2.5.
Erin Semmens: We used a large 3M filtrate with an electrostatic filter. We recommended that homes run the filter continuously on the highest setting, and we saw substantial reductions (nearly 70% greater than those observed in the placebo arm) from the pre- to post-intervention winter. We replaced the filter approximately once per month. It was the wood stove change-out arm, in which we did not see significant reductions in PM2.5 from the pre- to post-intervention winter.
Q: Have insulation in the homes had been investigated?
Ros Singleton: For Alaska studies – In general, the houses are insulated and tend to be tight homes for heating efficiency which can exacerbate indoor air pollution. For the most part, homes for our study had already had insulation evaluated through weatherization programs.
Erin Semmens: That is a great question and reminds me that we did blower door tests in the ARTIS study to evaluate airtightness. I recall we had a wide range of values but I am not sure if or to what degree home tightness varied between treatment arms. Theoretically, it should have balanced out, but I would need to look back to see if it actually did.

Catherine Monk: Pregnant Women’s Mental Health and Its Influence on the Next Generation: Implications for ECHO Science
2019-05-08 13:00 - 14:00 | WebEx
Pregnant Women’s Mental Health and Its Influence on the Next Generation: Implications for ECHO Science

Speaker:
Catherine Monk, PhD
Columbia University Medical Center

Speaker Bio: Dr. Catherine Monk holds dual appointments as a Professor of Medical Psychology in the Departments of Obstetrics & Gynecology, and Psychiatry, and is Director of Research at the Women’s Program at Columbia University Irving Medical Center, and Research Scientist VI at the New York State Psychiatric Institute. Originally trained as a clinical psychologist treating children and adults in a program that emphasized the developmental origins of psychopathology, Dr. Monk’s research brings together the fields of perinatal psychiatry, developmental psychobiology, and neuroscience to focus on the earliest influences on children’s developmental trajectories — those that happen in utero and how to intervene early to help pregnant women and prevent risk for mental health disorders in the future children.
Outcome Areas: Pre-, peri, and postnatal
Date: Wednesday, May 8, 1 to 2pm
Slides

Discussion:
Q: How do conceptualize stress? What are the challenges in measuring stress?
A: Stress is so used that it can lose precise meaning, but it is about the person-context experience and about perception. Stress can be measured by physical manifestations (allostatic load) or mental (subjective experience). The challenge in measuring is the difficulty in reliably linking high stress to high cortisol.

Q: One of the implications of the work was social support and its impact on outcomes. What would it look like to do a study of this as part of ECHO?
A: Social support has often been a co-variant or a moderator in past studies, but it actually accounts for large differences between groups, so it’s important to focus on in the future. ECHO could mine the data to create a hypothesis about the role of social support in creating positive outcomes. Loneliness is a factor that has been studied minimally, but would be fascinating to look at more closely, especially as it is differentiated from stress (women can be depressed or stress, but have social support).

Q: A type of research that you could look at that controls just for social support is the studies done on women having a doula at their birth. Has this been researched?
A: There is some data out there about the positive effect of doulas, but it’s not rigorous, so we could certainly bring in that perspective. Also, depending on where a woman gives birth, doulas may or may not be as welcomed and included in the process.

Q: In what ways would you study contributions of fathers in social support that might impact child outcomes?
A: “Belonging” is fairly general at this point, and not really distinguished as belonging with family, friends, or baby’s father, but we want to learn more about fathers/partners, and their roles in social support.

Q: Is there any data on pre-pregnancy stress and pregnancy and neurodevelopmental outcomes?
A: This is a main question of local cohort’s ECHO research.

Q: I’m wondering about the populations being investigated: low income, moderate income, and/or special populations, i.e., mothers and children in homeless shelters.
A: The part of New York (Washington Heights) where this cohort is includes a diverse group of women, with a large representation from Latina and low-income women. This includes women in homeless shelters.

Q: Is there any data comparing maternal non-treated depression vs. treated depression (use of medication) on health outcomes for the child?
A: Treating women’s psychiatric issues during pregnancy was not enough; parenting issues and risk factors that contributed to these issues were not impacted by the direct treatment of depression, and had to be addressed separately.

Q: In addition to fathers, teams should consider asking pregnant women about specific support from mother or other family/family-like individual. Particularly in minority communities and those of low-income, if biological fathers are not maintaining partnership with mothers, these individuals can play a critical role (our Memphis focus groups pointed this out to us too late for us to assess this). Our questionnaires don’t typically ask about this, and instead ask about partners.
A: That’s a great point, and I agree this needs to be broadened.

Roz Wright: Advancing Discovery in ECHO: Creating a Transdisciplinary Learning Culture Through Use of Life Course Models
2019-04-10 13:00 - 14:00 | WebEx
Advancing Discovery in ECHO: Creating a Transdisciplinary Learning Culture Through Use of Life Course Models

Speaker:
Rosalind (Roz) Wright, MD, MPH
Icahn School of Medicine at Mount Sinai, Department of Pediatrics

About the Speaker: Rosalind J Wright MD, MPH, is the Horace W. Goldsmith Professor of Life Course Health Research in the Departments of Pediatrics and Environmental Medicine & Public Health at the Icahn School of Medicine at Mount Sinai (ISMMS) in New York. She is also Dean of Translational Biomedical Sciences for the Mount Sinai Health System (MSHS), a clinician scientist and Program Director and Principal Investigator of Conduits, the Institute for Translational Sciences for the Mount Sinai Health System (the NCATs-funded CTSA).
She is an internationally recognized clinician scientist and life course epidemiologist with transdisciplinary training in molecular biology, environmental health, social determinants, and stress mechanisms. Her background includes transdisciplinary training and expertise in environmental exposure assessment as well as genetics, epigenetics, and psychosocial stress measurement applied to environmental health studies across the life course.
Outcome Areas: Neurodevelopment; Pre-, peri, and postnatal; Airways
Date: Wednesday, April 10, 1 to 2pm
Presentation Overview:
Lessons learned from developing a transdisciplinary team science and making discoveries at the intersections of various research disciplines outside of any one individual field.
Slides
