Publications by authors named "Thomas Chun"

Background: The γ-aminobutyric acid-B (GABA) receptor is a promising target for the development of new medications to treat alcohol use disorder (AUD). The GABA agonist baclofen has been reported to reduce alcohol consumption but is associated with some undesirable side effects, including sedation. ASP8062 is a novel compound that acts as a positive allosteric modulator at the GABA receptor and may be more tolerable than baclofen.

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  • In 2020, firearm injuries became the leading cause of death for children in the US, surpassing car accidents, prompting a need for effective public health interventions.
  • A study analyzed firearm injury data from 2003 to 2018 for patients under 19, focusing on demographics, injury intent, and outcomes across four pediatric hospitals in different regions.
  • Results showed a significant rise in firearm injuries, particularly in the South, emphasizing variations in injury causes and implications for developing targeted prevention strategies based on regional data.
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Introduction: Lyme disease is the most common vectorborne disease in the Northern hemisphere with more than 400 000 new cases in the USA annually. Lyme meningitis is an uncommon but potentially serious clinical manifestation of Lyme disease. Intravenous ceftriaxone had been the first-line treatment for Lyme meningitis, but is associated with a high rate of complications.

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Background And Objective: The reported impacts of the COVID-19 pandemic on child maltreatment in the United States have been mixed. Encounter trends for child physical abuse within pediatric emergency departments may provide insights. Thus, this study sought to determine the change in the rate of emergency department encounters related to child physical abuse.

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Introduction: Behavioral crises are increasingly prevalent in health care settings. Existing programs, however, include procedures that lack adaptability, omit critical components, and deviate from clinical best-practice recommendations. Health care employees also continue to report lacking confidence for safely managing behavioral crises.

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Importance: Bacterial and viral causes of acute respiratory illness (ARI) are difficult to clinically distinguish, resulting in the inappropriate use of antibacterial therapy. The use of a host gene expression-based test that is able to discriminate bacterial from viral infection in less than 1 hour may improve care and antimicrobial stewardship.

Objective: To validate the host response bacterial/viral (HR-B/V) test and assess its ability to accurately differentiate bacterial from viral infection among patients with ARI.

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  • * Higher screen time (over 3 hours a day) is correlated with increased risks for conduct disorders, depression, and drug use.
  • * The study accounted for demographic factors and academic achievement, revealing that older age and lower academic performance are also tied to risky behaviors and mental health issues.
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  • The study aimed to investigate the relationship between low household income and the severity of acute gastroenteritis (AGE) in children after they were discharged from the emergency department (ED).
  • Data was collected from pediatric EDs across the US, focusing on children aged 3 to 48 months, and explored various income measures and health outcomes.
  • Results showed that lower income households did not experience more severe AGE or increased healthcare utilization compared to higher income groups, suggesting that economic disparities do not significantly affect the disease course of children with AGE.
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Alcohol and cannabis use frequently co-occur, which can result in problems from social and academic impairment to dependence (i.e., alcohol use disorder [AUD] and/or cannabis use disorder [CUD]).

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Introduction: It is unclear whether the alleged efficacy of probiotics in childhood acute gastroenteritis depends on the duration and severity of symptoms before treatment.

Methods: Preplanned secondary analysis of 2 randomized placebo-controlled trials in children 3-48 months of age was conducted in 16 emergency departments in North America evaluating the efficacy of 2 probiotic products (Lactobacillus rhamnosus GG and a combination probiotic: L. rhamnosus and L.

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The National Institutes of Health's Environmental Influences on Child Health Outcomes (ECHO) program aims to study high-priority and high-impact pediatric conditions. This broad-based health initiative is unique in the National Institutes of Health research portfolio and involves 2 research components: (1) a large group of established centers with pediatric cohorts combining data to support longitudinal studies (ECHO cohorts) and (2) pediatric trials program for institutions within Institutional Development Awards states, known as the ECHO Institutional Development Awards States Pediatric Clinical Trials Network (ISPCTN). In the current presentation, we provide a broad overview of the ISPCTN and, particularly, its importance in enhancing clinical trials capabilities of pediatrician scientists through the support of research infrastructure, while at the same time implementing clinical trials that inform future health care for children.

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Nonadherence in clinical trials affects safety and efficacy determinations. Predictors of nonadherence in pediatric acute illness trials are unknown. We sought to examine predictors of nonadherence in a multicenter randomized trial of 971 children with acute gastroenteritis receiving a 5-day oral course of Lactobacillus rhamnosus GG or placebo.

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Background: The alcohol cue reactivity paradigm is increasingly used to screen medications for the treatment of alcohol use disorder (AUD) and other substance use disorders. Yet, its prospective association with craving and naturalistic drinking outcomes in clinical trials remains unknown. This study embedded repeated human laboratory assessments of alcohol cue reactivity within the context of a randomized controlled trial to examine the effects of varenicline tartrate (Chantix ), a partial agonist of α4β2 nicotinic acetylcholine receptors, on alcohol craving among treatment-seeking heavy drinkers with AUD.

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Objectives: In the United States, rates of teenage pregnancy and sexually transmitted infections (STIs) remain exceptionally high, and racial and ethnic disparities persist. Emergency departments (EDs) care for over 19 million adolescents each year, the majority being minority and low socioeconomic status. Single-center studies demonstrate infrequent use of contraceptives among adolescent ED patients and an association between risky sex and behaviors such as alcohol and drug use; however, no multicenter ED data exist.

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Introduction: The Substance Abuse and Mental Health Services Agency (SAMHSA) recognizes Screening, Brief Intervention, and Referral to Treatment (SBIRT) as a comprehensive approach to identify individuals with or at risk of developing substance use disorders. Few studies have explored tools for assessing medical student SBIRT competencies.

Methods: First-year medical students trained in SBIRT and Motivational Interviewing completed an Objective Structured Clinical Encounter (OSCE) with a standardized patient who presented with substance use.

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Background: The utility of CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) in identifying current and future problematic substance use and substance use disorders (SUDs) in pediatric emergency department (PED) patients is unknown. We conducted a secondary analysis of a study in 16 PEDs to determine the concurrent and predictive validity of CRAFFT with respect to SUD.

Methods: At baseline, 4753 participants aged 12 to 17 years completed an assessment battery (CRAFFT and other measures of alcohol, drug use, and risk behaviors).

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Objectives: To determine the test-retest reliability, concurrent, convergent, and discriminant validity of a recently devised screen (the Newton screen) for alcohol and cannabis use/misuse, and its predictive validity at follow-up.

Study Design: Adolescents, 12-17 years old (n = 4898), treated in 1 of 16 participating pediatric emergency departments across the US were enrolled in a study as part of a larger study within the Pediatric Emergency Care Applied Research Network. Concurrent and predictive validity (at 1, 2, and 3 years of follow-up) were assessed in a random subsample with a structured Diagnostic and Statistical Manual of Mental Disorders-based interview.

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Objectives: The aim of this study was to understand the prevalence of alcohol and other substance use among teenagers in generalized samples.

Methods: This study compared the alcohol and other substance use of adolescents enrolled in a screening study across 16 Pediatric Emergency Care Applied Research Network emergency departments (EDs) (ASSESS) with those sampled in 2 nationally representative surveys, the Youth Risk Behavior Surveillance System (YRBSS) and the National Survey of Drug Use and Health (NSDUH). The analysis includes 3362 ASSESS participants and 11,142 YRBSS and 12,086 NSDUH respondents.

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Introduction: Emergency medicine (EM) providers are in an opportunistic position to identify and intervene with patients at risk for alcohol misuse and related problems. However, alcohol screening, brief intervention, and referral to treatment (SBIRT) services are underutilized within the emergency department. Providing SBIRT training to trainees may help to increase utilization of these valuable services in the future.

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Background: The National Institute on Alcohol Abuse and Alcoholism (NIAAA) 2-question screen is a valid adolescent alcohol screening tool. No studies have examined if this tool predicts future alcohol problems. We conducted a study at 16 pediatric emergency departments to determine the tool's predictive validity for alcohol misuse and alcohol use disorders (AUDs).

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