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A Significant Percentage of Severely Injured U.S. Children Are Treated at Nontrauma Centers
In the United States, regionalized trauma systems have been developed and promoted to improve patient outcomes and optimize the use of hospital resources. Severely injured children should receive the highest level of trauma care available, found at level I or level II trauma centers. But 1 out of every 5 severely injured American children is treated at level III trauma centers or non-trauma centers without transfer to a higher level trauma center, according to a new study published by Henry Xiang, Director of the Center for Pediatric Trauma Research at Nationwide Children’s Hospital, the senior author of the study, and Jin Peng, PhD candidate at the Ohio State University. Children living in rural areas are particularly likely to be undertriaged. Severely injured patients have a significant higher risk of death or adverse outcomes when treated at level III or nontrauma centers without transfer to level I or level II trauma centers. These findings highlight the importance of developing innovative service delivery models, including telemedicine and a trauma triage mobile app, to reduce undertriage and improve outcomes for severely injured children.
Peng J, Wheeler K, Groner JI, Haley KJ, Xiang H. Undertriage of Pediatric Major Trauma Patients in the United States. Clin Pediatr (Phila). 2017;56(9):845-853. doi: 10.1177/0009922817709553. PubMed PMID: 28516800.
Effects of Propranolol on Conversational Reciprocity in Autism Spectrum Disorder: A Pilot, Double-Blind, Single-Dose Psychopharmacological Challenge Study
University of Missouri researchers have found that a medication commonly used to treat high blood pressure and irregular heartbeats may have the potential to improve some social functions of individuals with autism. Led by David Beversdorf, M.D., associate professor in the departments of radiology, neurology and psychological sciences at MU and the MU Thompson Center for Autism and Neurodevelopmental Disorders, and senior author of the study, and Rachel Zamzow, graduate student with the MU Center for Translational Neuroscience, 20 individuals with autism were recruited from the MU Thompson Center and given either a 40-milligram dose of propranolol or a placebo pill. An hour after administration, the researchers had a structured conversation with the participants, scoring their performance on six social skills necessary to maintain a conversation: staying on topic, sharing information, reciprocity or shared conversation, transitions or interruptions, nonverbal communication and maintaining eye contact. The researchers found the total communication scores were significantly greater when the individual took propranolol compared to the placebo. Subsequent research is needed to study the effects of more than one dose in a clinical trial setting. However, these preliminary results suggest the possibility of an inexpensive, widely available agent for treatment of autism that could also benefit access to treatment for the underserved.
Zamzow RM, Ferguson BJ, Stichter JP, Porges EC, Ragsdale AS, Lewis ML, Beversdorf DQ. Effects of propranolol on conversational reciprocity in autism spectrum disorder: A pilot, double-blind, single-dose psychopharmacological challenge study [published online January 14 2016]. Psychopharmacology. 2016. doi: 10.1007/s00213-015-4199-0