I AM CATHERINE LONG DIRECTOR OF
COMMUNICATIONS AT THE NATIONAL
CENTER FOR COMPLIMENTARY AND
INTEGRATIVE HEALTH OR NIH, ON
BEHALF OF OUR DIRECTOR, AND
DEPUTY DIRECTOR, I WANT TO
WELCOME YOU TO THE 2022 STEPHEN
E. STRAUS DISTINGUISHED LECTURE
INLET SCIENCE OF COMPLIMENTARY
THERAPIES.
OUR SPEAKER TODAY WILL BE
DR. LAURA ST ROUD OF THE MEDICAL
SCHOOL OF BROWN UNIVERSITY AND
OF THE MIRIAM HOSPITAL IN
PROVIDENCE RHODE ISLAND.
I WOULD NOW LIKE TO TURN THINGS
OVER TO THE DIRECTOR OF NCCIH TO
INTRODUCE OUR SPEAKER.
HELENE, PLEASE TAKE IT AWAY.
>>THANK YOU SO MUCH CATHERINE AND
GOOD AFTERNOON TO YOU ALL AND
THANK YOU VERY MUCH FOR TAKING
THE TIME TO JOIN US TODAY.
AT NCCIH, WE ALWAYS LOOK FORWARD
TO THIS LECTURE EACH YEAR, IT'S
A VERY, VERY SPECIAL TIME TO
HONOR THE MEMORY OF AND LEGACY
OF DR. STEPHEN STRAUS WHO WAS
THE CENTER'S FOUNDING DIRECTOR
FROM 1999 TO 2006.
HIS TENURE AT NCCIH WAS TRULY
FUNDAMENTAL, IMPLEMENTING
PRACTICES WHILE UPHOLDING
INTEGRATION OF RIGOROUS SCIENCE.
DR. STRAUS ALSO HELD THE
POSITION OF SENIOR INVESTIGATOR
AT THE NATIONAL INSTITUTE OF
ALLERGY AND INFECTIOUS DISEASES
OR NIAID.
WHERE HE WAS A PIONEER IN
CONDUCTING RESEARCH ON THE
RELATIONSHIP BETWEEN VIRUSES IN
THE IMMUNE SYSTEM AND AS WEB
CONNECTED ALL KNOW THIS IS A
TOPIC OF TREMENDOUS IMPORTANCE
AS OUR POPULATION IS ALWAYS
BATTLING NEW CHALLENGES FROM
EMERGING VIRUSES ALL THE TIME.
ALL OF US AT NCCIH REMEMBER THIS
FONDLY AND WE MISS HIM.
WHILE MISS BARBARA STRAUS WAS
NOT ABLE TO JOIN US FOR THE LIVE
STREAM TODAY WE KNOW SHE LOOKS
FORWARD TO WATCHING THIS LECTURE
AT A GREATER TIME.
SHE IS ALWAYS A GREAT SUPPORTER
OF THIS ANNUAL EVENT.
I HAVE ALSO ADDITIONAL THANKS TO
SHARE, VERY SPECIAL THANKS TO
MR. BERNARD AND BARBARA OSHER,
WHO MADE THIS POSSIBLE THROUGH
THEIR FOUNDATION FOR THE NIH.
MISS MARY BITTERMAN WHO IS
PRESIDENT OF THE BERNARD
FOUNDATION AND WATCHING TODAY,
AND TRULY APPRECIATE THE FNIH'S
LONG-TERM PARTNERSHIP WITH
NCCIHOT LECTURE SERIES.
THANK YOU ALL.
AND I WILL NOW WELCOME OUR
LECTURURE, DR. LAURA STROUD WHO
WILL SPEAK ON THE TOPIC OF FROM
THE MOUTHS OF BABES, WHAT CAN
RESEARCH ON BABIES, MOMS,
STRESS, AND SUBSTANCE USE TELL
US ABOUT RESILIENCE.
WE ARE EXTREMELY PLEASED THAT
DR. STROUD COULD SHARE HER
THOUGHTS TODAY ON THIS
COMPELLING TOPIC.
DR. LAURA STROUD IS PART OF
HUMAN BEHAVIOR AT THE MEDICAL
SCHOOL OF BROWN UNIVERSITY.
SHE'S ALSO DIRECTOR AND SENIOR
RESEARCH SCIENTISTS AT THE
CENTER FOR BEHAVIAL AND
PREVENTIVE MEDICINE OF THE
MIRIAM HOSPITAL, DR. STROUD
DIRECTS THE NIH FUNDED CENTER OF
BIOMEDICAL EXCELLENCE OR COBRA
FOR STRESS, TRAUMA AND
RESILIENCE.
WHERE SHE AND HER COLLEAGUES
STUDY CHILDHOOD STRESS, TRAUMA
AND RESILIENCE ACROSS THE LIFE
SPAN, SHE HOLDS A PHASH D FROM
YALE UNIVERSITY, COMPLETED A
POST DOCTORAL FELLOWSHIP AT
BROWN AND JOINING FACULTY AND
HOLDS A SECONDARY OPOINTMENT
THEA THE SCHOOL OF PUBLIC
HEALTH.
DR. STRAUS'S WORK HAS BEEN
FUNDED BY SEVERAL INSTITUTES
SINCE 2001 INCLUDING THE
NATIONAL INSTITUTE OF MEDICAL
SCIENCES AND THE SHRIVER
INSTITUTE OF CHILD HEALTH AND
HUMAN DEVELOPMENT, NATIONAL
INSTITUTE ON DRUG ABUSE,
NATIONAL INSTITUTE ON
ENVIRONMENTAL HEALTH SCIENCES
AND ALSO THE NATIONAL INSTITUTE
OF MENTAL HEALTH AND CANCER
INSTITUTES SO QUITE A
COLLECTION.
OTHERS INCLUDE THE SCIENCE
FOUNDATION, BRAIN AND BEHAVIOR
RESEARCH FOUNDATION, U.S. FOOD
AND DRUG ADMINISTRATION AND THE
ROBERT WOOD JOHNSON FOUNDATION
AND NOW, PLEASE WELCOME
DR. LAURA STROUD.
>>THANK YOU SO MUCH FOR THAT
LOVELY INTRODUCTION.
I AM TRULY HONORED
AND DELIGHTED TO BE HERE.
THANKS SO MUCH FOR THE
INVITATION, DELIGHTED TO BE
PARTNERING WITH NCCIH AND
DELIGHTED TO SEE INTERNS IN THE
KIND OF WORK THAT WE HAVE BEEN
DOING, PARTICULARLY FOCUSING ON
THE EARLIEST ORIGINS OF HOUSING
DISEASE AND SIMILAR FOCUS ON
SORT OF THE WHOLE PERSON, THE
WHOLE BODY.
AGAIN ANOTHER THANK TO YOU THE
NIH AS WELL AS THE BERNARD AND
BARBARA OSHER FOUNDATION, I
APPRECIATE THE GIFT AND JUST SO
HONORED BY THE INVITATION FOR
THE NATIONAL CENTER FOR
COMPLIMENTARY AND INTEGRATIVE
HEALTH, REALLY APPRECIATE THE
WHOLE TEAM OF PEOPLE WHO MADE
THIS LECTURE POSSIBLE AND
GETTING ALL THE TECHNICAL
ASPECTS RIGHT AND BEING SO
HELPFUL TO ME IN PUTTING THIS
TOGETHER.
THANK YOU SO MUCH, WANT TO
ACKNOWLEDGE THE MIRIAM HOSPITAL
WHO HAS FOR OVER 30 YEARS
SUPPORTED OUR CENTER FOR
BEHAVIORIAL AND PREVENTIVE
MEDICINE.
IT'S A RESEARCH CENTER THAT ALSO
DOES SIMILAR RESEARCH AND
THEY'VE BEEN SUPPORTIVE OF THE
RESEARCH WE'VE BEEN DOING.
I HAVE NO CONFLICT BUT SOME OF
THE RESEARCH THAT I'M TALKING
ABOUT TODAY WAS FUNDED BY THE
NATIONAL INSTITUTE ON DRUG
ABUSE, THE CENTER GRAND WE HAVE
IS FUNDED BY THE NATIONAL
INSTITUTE OF GENERAL MEDICAL
SCIENCES AND WE ALSO RUN A T32
POST DOCTORAL TRAINING PROGRAM,
FOCUSED ON STRESS, TRAUMA AND
RESILIENCE.
THAT'S FUNDED BY NICH D.
SO AGAIN, MANY, MANY REASONS TO
BE HONORED BY THIS LECTURE BUT I
WAS STRUCK BY THE NAME STRAUS,
STIPICALLY IT'S SPELLED WITH 2
Ss, AND THE VERSION SPELLED
WITH 1 S IS TYPICALLY A GERMAN
JEWISH VARIATION AND IT HAPPENED
TO BE 2 GENERATIONS BACK, MY
NAME.
SO MY GRAND FARTHER WARNER
STRAUS CHANGED HIS NAME TO
VERNON STROUD IN WORLD WAR II TO
ESCAPE RELIGIOUS PERSECUTION AND
I KIND OF POKED AROUND A BIT ON
THE WEB ABOUT DR. STRAUS AND IT
SOUNDS LIKE HIS FAMILY HAD A
EFTHIMIOS HISTORY OF ESCAPING
RELIGIOUS PERSECUTION AND ENDED
UP HAD THE UNITED STATES.
SO I THINK IT'S PARTICULARLY
INTERESTING THAT THIS FOCUSES ON
TRAUMA AND RESILIENCE GIVEN THE
LEVEL THAT DR. STRAUS AND HIS
FAMILY HAVE SHOWN IN ALL THE
WORK THAT HE DID.
SO I RUN THE BEHAVIOR AND MOOD
OF BABIES ADULENCE ENSEL AND
MOTHERS OR ALABAMA LAB.
OUR LAB IS FOCUSED ON THE BY O
BEHAVIORIAL DETERMINANTS OR SORT
OF MECHANISMS THAT LEAD TO
THINGS LOAMACYIC MOOD DISORDERS,
STRESS, THE INTERGENERATION
TRANSMISSION OF STRESS AND
SUBSTANCE USE.
AND WE BELIEVE THAT EARLY
DEVELOPMENT THAT THERE'S
PARTICULAR SENSITIVE PERIODS OF
DEVELOPMENT THAT ARE REALLY
IMPORTANT TO STUDY SO THAT WE
CAN UNDERSTAND WHAT LEADS TO
THESE LONG-TERM IMPLICATIONS FOR
HEALTH.
SO WE HAVE STARTED OUT WITH
INFANTS AND LOOKING FOR
BIOBEHAVIORIAL MARKERS OF
SUBSTANCE USE.
THIS IS--I'M JUST JOKING HERE,
THIS IS POTENTIALLY 1 BEHAVIOR
THAT MIGHT INDICATE EXPOSURE TO
SMOKING AND/OR RISK FOR SMOKING,
BUT IN ALL SERIOUSNESS, WE ARE
LOOKING FOR BOTH BEHAVIOR AND
BIOLOGICAL MARKERS THAT MIGHT
INDICATE RISK AND A POINT OF
INTERVENTION SO THAT WE CAN
HAPPEN STOP THE
INTERGENERATIONAL CYCLE OF
SUBSTANCE USE, STRESS AND MOOD
DISORDERS.
WE'VE ALSO IN ADDITION TO
BEHAVIOR BEEN VERY FOCUSED ON
THE STRESS RESPONSE.
INDIVIDUAL DIFFERENCES IN THE
STRESS RESPONSE AND HOW OUR
BODIES RESPOND TO STRESS MIGHT
BE A KEY LINK BETWEEN EARLY
STRESS AND LIFE COURSE HEALTH.
FOR A WHILE WE'VE BEEN FOCUSING
ON THE HORMONE CORTISOL WHICH
GOES UP WITH ACUTE STRESS AND
OVER TIME AND CAN KIND OF CHANGE
AS DIFFERENT EVENTS HAPPEN IN
THEIR LIFE AND REPRESENTS A
CUMULATIVE IMPACT OF DIFFERENT
STRESSES OF OUR LIFE AND WE'RE
INTERESTED IN SORTING SIGNALS OF
INDIVIDUAL DIFFERENCES.
WHY SOME PEOPLE HAVE A MUCH
LARGER RESPONSE TO STRESS AND
SOME PEOPLE HAVE A LOWER
RESPONSE TO STREASES AND WHAT
CHANGES OUR STRESS RESPONSE?
SO I WILL TALK TODAY, I WILL
GIVE A LITTLE BACKGROUND ON
EARLY STRESS AND ADVERSITY AND
THE IMPACT OVER THE LIFE COURSE,
TALK ABOUT SOME OF THE RESEARCH
WE'VE DONE WITH MOTHERS, BABIES
AND SUBSTANCE USE.
TALK ABOUT WHAT THAT MIGHT MEAN
FOR RESILIENCE, AND THEN TALK
ABOUT SOME OF OUR BROADER
INITIATIVES, PARTICULARLY
TALKING ABOUT RESEARCH AT THE
CENTER FOR BEHAVIORIAL AND
PREVENTIVE MEDICINE AND OUR NEW
CENTER FOR STRESS, TRAUMA AND
RESILIENCE.
AND THE WAY WE'RE LOOKING AT
STRESS AND TRAUMA IN OUR CENTER
AND THEN CONCLUDE.
SO WHAT DO WE KNOW?
ONE THING THAT'S BEEN SHOWN OVER
LARGE BODIES OF RESEARCH IS HA
OUR ENVIRONMENT AND THE
EXPERIENCE OVER THE FIRST
THOUSAND DAYS FROM CONCEPTION TO
2 YEARS OF AGE HAS AN ENORMOUS
IMPACT ON BOTH BRAIN DEVELOPMENT
AND LIFE LONG HEALTH.
THINGS THAT HAPPEN TO US WHEN
WE'RE VERY YOUNG HAPPEN MUCH
LARGER IMPACT, THIS IS A
SENSITIVE PERIOD OF BRAIN
DEVELOPMENT AND A SENSITIVE
PERIOD FOR LIFE LONG HEALTH.
SO EARLY INDIVIDUAL DIFFERENCES
DURING THIS TIME MAY LEAD TO
LARGE DIFFERENCES OVER A
LIFETIME IN CHRONIC DISEASE.
SO IF WE CAN HAVE AN IMPACT
HERE, EARLY, WE MAY BE ABLE TO
CHANGE THE COURSE OF HEALTH AND
DISEASE OVER THE LIFE SPAN.
ANOTHER THING THAT WE KNOW IS
THAT ADVERSE CHILDHOOD
EXPERIENCES OR ACES ARE RELATED
TO LONG-TERM HEALTH.
ACES INCLUDE THINGS LIKE
EMOTIONAL AND SEXUAL ABUSE,
SUBSTANCE MATERNAL OR PATERNAL
SUBSTANCE USE, EXPOSURE TO
DOMESTIC VIOLENCE, PHYSICAL AND
EMOTIONAL NEGLECT, DIVORCE,
MENTAL ILLNESS, PARENTAL
INCARCERATION AND HOMELESSNESS,
AND OTHER MAJOR STRESSFUL
EXPERIENCES THAT CAN IMPACT THE
LIVES OF CHILDREN.
MORE RECENTLY, THE FIELD HAS
STARTED TO FOCUS A LOT ON
ADVERSE COMMUNITY ENVIRONMENT,
SO BEYOND THE IMMEDIATE
HOUSEHOLD WHAT IS THE IMPACT OF
POVERTY, OF DISCRIMINATION,
ONGOING CHRONIC DISCRIMINATION,
COMMUNITY DISRUPTION, PLAQUE
LACK OF OPPORTUNITY, ECONOMIC
MOBILITY AND SOCIAL CAPITAL,
POOR HOUSING QUALITY,
AFFORDABILITY AS WELL AS
VIOLENCE.
ALL THESE FACTORS WHEN CHILDREN
EXPERIENCE THEM EARLY IN LIFE,
CAN HAVE A LIFE LONG IMPACT ON
HEALTH.
THEY CAN IMPACT SYSTEMS RANGING
FROM IMMUNE SYSTEM AND
INFLAMMATION, PHYSIOLOGY AND
STRESS RESPONSE, HEGHT BEHAVIORS
SUCH AS SUBSTANCE USE, PHYSICAL
AND CARDIOVASCULAR HEALTH AND
MENTAL HEALTH AND CONNITION AND
RELATIONSHIP.
EVEN EARLY EXPOSURE TO ACES CAN
EVEN LEAD TO EARLIER MORTALITY.
IN THE WAKE OF THE PANDEMIC WE
ALSO KNOW THAT EVEN MORE
CHILDREN AND FAMILIES ARE
EXPERIENCING STRESS, TRAUMA AND
SEEING UNPRECEDENT LEVEL OF
MENTAL HEALTH PROBLEMS IN
CHILDREN AND IN PARENTS.
SO EVEN MORE IMPORTANT TO TRY TO
UNDERSTAND HOW WE CAN BUILD
RESILIENCE AND THOSE WHO ARE
EXPOSED TO STRESS AND TRAUMA AND
ALSO HOW WE CAN CHANGE OUR
COMMUNITIES AND SOCIETIES TO
BETTER BEEN FIT FAMILIES AND
CHILDREN.
WE ALSO KNOW ON THE POSITIVE
SIDE THE PROTECTIVE EXPERIENCES
MAY PREVENT OR MITIGATE SOME OF
THESE EFFECTS.
SO A COLLEAGUE OF MINE,
DR. JENNIFER HEATH
[INDISCERNIBLE] WHO IS OUR
ADVISOR FOR OUR HEALTH CENTER
AND STRESS CENTER, TALKS ABOUT
PACES, PROTECTIVE AND
COMPENSATORY EXPERIENCES, WHICH
MAY BE FIRST ANTIDOTE TO ACES.
SO THIS IS THINGS LIKE
RELATIONSHIPS AND RESOURCES THAT
LEAD TO OPTIMAL
NEURODEVELOPMENT, OPTIMAL SOCIAL
AND EMOTIONAL AND COGNITIVE
FUNCTIONING, HEALTHY BEHAVIORS,
HELP KIDS ACHIEVE DEVELOPMENTAL
MILESTONES AND ULTIMATELY
POTENTIALLY LEAD TO HEALTH AND
LONGEVITY.
SO THESE CAN MITIGATE IF
CHILDREN ARE EXPOSED TO ACES,
THE PACES MAY MITIGATE THESE
EFFECTS AND/OR MAY HELP TO
REMEDIATE LATER IN LIFE.
IN PARTICULAR WHAT WE KNOW ARE
PROTECTIVE EXPERIENCES INCLUDING
UNCONDITIONAL LOVE, PARENT BEING
IS AN ENORMOUS PROTECTOR,
SENSITIVE AND POSITIVE
RELATIONSHIP BETWEEN PARENT AND
CHILD IS VERY PROTECTIVE EVEN IN
THE FACE OF ADVERSITY.
HAVING A BEST FRIEND, DOING
THINGS TO HELP OTHERS IS
SOMETHING ELSE THAT WE KNOW IS
BENEFICIAL.
HAVING A MENTOR, BEING PART OF A
GROUP, HAVING HOBBIES AND BEING
INVOLVED IN SPORTS OR PHYSICAL
ACTIVITIES AND THEN SORT OF THE
BROADER CONTEXT, LIVING IN A
HOME THAT'S TYPICALLY CLEAN AND
SAFE ENOUGH TO EAT.
HAVING A SCHOOL THAT PROVIDES
RESOURCES AND THE EXPERIENCES
THAT KIDS NEED TO LEARN AND
HAVING RULES IN THE HOME THAT
ARE CLEAR AND FAIRLY
ADMINISTERED.
WE ALSO KNOW THAT STRESS AND
ADVERSITY AND POTENTIALLY
POSITIVE EFFECTS LIKE RESILIENCE
MAY BE TRANSMITTED FROM 1
GENERATION TO THE NEXT.
SO PARENTS HAVE A HISTORY OF
DEPRESSION OR SUBSTANCE USE, WE
KNOW THEIR KIDS ARE ALSO AT
GREATER RISK FOR HAVING SIMILAR
DISORDERS.
BUT WHAT WE WANT TO DO IS
UNDERSTAND HOW THAT TRANSMISSION
HAPPENS AND PARTICULARLY HOW IT
HAPPENS EARLY IN LIFE, SO THAT
WE MIGHT INTERVENE TO PREVENT
IT.
SO FOR A LONG TIME THERE WAS A
LITERATURE IN ANIMAL MODELS THAT
SHOWED THAT STRESS DURING
PREGNANCY HAD A VERY PROFOUND
IMPACT ON OFFSPRING THROUGHOUT
THEIR LIFE SPAN.
AND A FEW DECADES AGO, INITIAL
RESEARCH IN HUMANS STARTED TO
SHOW THE FIRST 9 MONTHS OF LIFE
MAY IMPACT YOUR HOLE LIFE
TRAJECTORY OF HEALTH.
AND THE WAY THIS IS BELIEVED TO
HAPPEN IS SOMETHING CALLED
PRENATAL PROGRAMMING, SO STRESS
OR NUTRITION, DIFFERENCES IN
STRESS AND NUTRITION MAY ALTER
THE MOTHERS BIOLOGY AS WELL AS
FETAL BIOLOGY, LEADING TO
DIFFERENCES IN BRAIN DEVELOPMENT
AND PHYSIOLOGIC SYSTEM
DEVELOPMENT IN OFFSPRING.
SO THIS EXTERNAL ENVIRONMENT,
DURING PREGNANCY MAY BE
PARTICULARLY IMPORTANT FOR CHILD
AND LONG-TERM HEALTH, NOW OFTEN
STUDIES IN HUMANS EVEN THOUGH
THEY'RE TRYING TO UNDERSTAND
MATERNAL EXPERIENCE DURING
PREGNANCY, HAVE NOT SO MUCH
MEASURED EXPERIENCE IN THE FETUS
DURING THIS PERIOD, SO THAT'S
SOMETHING THAT WE HAVE DONE IN
OUR RESEARCH.
WE'VE ALSO BEEN VERY INTERESTED
IN THE PLACENTA, AN ORGAN THAT
DEVELOPS ONLY DURING PREGNANCY
AND NO LONGER WITH US AFTER
PREGNANCY AND IT'S A MASTER
REGULATOR OF THE FETAL
ENVIRONMENT AND THE WAY THAT THE
MOTHER AND THE FETUS, 1 OF THE
WAYS THAT THE MOTHER AND THE
FETUS COMMUNICATE, NUTRITION IS
SHARED BETWEEN MOTHER AND FETUS,
AND IT'S TISSUE THAT IS READILY
AVAILABLE AT BIRTH.
SO WE LOOKED A LITTLE BIT AT
GENOMIC AND EPIGENOMIC PATHWAYS
TO LOOK AT FOR FOOTPRINTS OF
EXPOSURE AS WELL AS POTENTIAL
MECHANISMS LEADING TO OFFSPRING
BEHAVIORIAL CHANGES.
SO JUST ANOTHER WAY TO THINK
ABOUT IT, THE EARLY STRESS AND
IN OUR LAB WE'VE BEEN LOOKING AT
SUBSTANCE USE, MAY LEAD TO
BIOLOGICAL AND THEY MAY AFFECT
THINGS ACROSS THE LIFE SPAN BUT
PARTICULARLY DURING PERIODS OF
DEVELOPMENT LEADING TO POOR
PHYSICAL ASK MENTAL HEALTH
OUTCOMES.
SO WHAT HAVE WE LEARNED IN OUR
RESEARCH.
WE CAN RESEARCH WHETHER MODELS
OF INTERGENERATIONAL STRESS
MIGHT ALSO APPLY TO SUBSTANCE
USE AND PREGNANCY.
MATERNAL SMOKING IS 1 OF THE
SUBSTANCES THAT WE'VE LOOKED AT.
IT IS THE MOST COMMON ARGUABLY
PRENATAL DRUG EXPOSURE IN THE
WORLD.
IN THE UNITED STATES, RATES OF
SMOKING ARE PARTICULARLY HIGH IN
DISADVANTAGED WOMEN INCLUDING
YOUNG, POOR AND LESS EDUCATED
WOMEN AND ALSO CERTAIN
PARLIAMENTS OF OUR COUNTRY, IN
THE SOUTH AND MIDWEST, RATES OF
SMOKING ARE HIGHER.
SO DEPENDING WHO AND WHEN AND
HOW YOU ASK, 7-25% OF U.S. WOMEN
CONTINUE TO SMOKE IN PREGNANCY.
ALTHOUGH A GOOD NUMBER OF WOMEN
ALSO QUIT DURING PREGNANCY WHICH
IS IMPORTANT WHEN WE START TO
THINK ABOUT RESILIENCE.
WE KNOW THAT SMOKING, SIMILAR TO
PRENATAL STRESS AND SIMILAR TO
EARLY LIFE STRESS IS ASSOCIATED
WITH OUTCOMES ACROSS
DEVELOPMENT.
SO IN NEWBORNS IT IS CAUSEALLY
RELATED TO SUDDEN INFANT DEATH
SYNDROME, LOW BIRTH WAY AND
PREMATURITY.
IN CHILDHOOD OBESITY AND
DISRUPTIVE BEHAVIORS HAVE BEEN
LINKED TO SMOKING DURING
PREGNANCY, IN ADOLESCENCE WE SEE
ADHD AS WELL AS DISRUPTIVE
BEHAVIORS AND THE UPTAKE OF
SMOKING.
SO IN THIS IS THE
INTERGENERATIONAL TRANSMISSION
OF SUBSTANCE USE AND IN ADULTS
NICOTINE DEENSEL.
SOMETIMES AS A HARM REDUCTION
STRATEGY, THEY PERCEIVE
E-CIGARETTES AS SAFER THAN
TRADITIONAL CIGARETTES.
THE LITERATURE SHOWS THAT
THEY'RE ASSOCIATED WITH SIMILAR
BIRTH OUTCOMES TO CIGARETTES
DURING PREGNANCY AND NICOTINE
ITSELF, THE ACTIVE INGREDIENT,
THE ADDICTIVE CHEMICAL IN
SMOKING IS PRESENT IN
E-CIGARETTES SO IT CAN AFFECT
INFAPTS.
HOWEVER THERE'S BEEN MUCH LESS
RESEARCH EVEN THOUGH WE KNOW WE
HAVE SEEN THESE LONG-TERM
OUTCOMES FROM SUBSTANCE USE AND
PREGNANCY RELATED TO TO BACK O
AT THE TIME WE STARTED DOING
THIS RESEARCH.
THERE WAS VERY LITTLE ON THE
EARLY EFFECTS ON DEVELOPMENT AND
AGAIN, WE WANTED TO STUDY, STUDY
KIDS EARLY SO THAT WE MIGHT
INTERVENE TO MAKE CHANGES ACROSS
THE LIFE COURSE.
SO WE USE SOMETHING CALLED THE
Ns, THE NICKUE NETWORK
NEUROBEHAVIORIAL SCALE.
SO THIS IS THE COMBINATION OF A
SCALE THAT A DOCTOR THAT A
MEASURE MIGHT DO LOOKING AT TONE
AND REFLEXES IN YOUR BABY.
ALSO LOOK AT BEHAVIORS, SO
BEHAVIORIAL RESPONSE TO
DIFFERENT STIMULI, LIKE A BALL
OR RATTLE, A SOUND AS WELL AS
SOCIAL STIMULI.
HOW WELL THE BABY WILL LOOK INTO
THE EXAMINERS EYES WHILE THEY'RE
TALKING TO THE BABY.
WE ALSO LOOK FOR SIGNS OF
STRESS, AND SIGNS OF ABSENCE,
SOPHISTICATED SOME OF THESE MAY
EVEN OVERLAP WITH WHAT 1 SEES
AFTER EXPOSE TOWER OPIATES.
SO WE WANTED TO SEE HOW BABIES
OF MOTHERS WHO SMOKED LOOKED IN
THE VERY EARLY NEW BORN PERIOD.
SO THIS EXAM CAN BE ADMINISTERED
IN THE FIRST DAY OF LIFE ALL THE
WAY UP TO 1 MONTH.
SO WHAT WE FOUND IS THERE'S
ACTUALLY DIFFERENTIAL EFFECTS
THAT WHEN BABIES ARE 1-2 DAYS
OLD IN A HOSPITAL VERSUS LATER
ON AT 10-30 DAYS.
NICKEE TEEN ISSUES THE ADDICTIVE
CHEMICAL IN SMOKING HAS A VERY
SHORT HALF LIFE SO BY 10-30 DAYS
TYPICALLY NICKEE TEEN WOULD HAVE
LEFT THE BABY'S SYSTEM FROM
EXPOSURE DURING PREGNANCY SO WE
SEE IN THE IMMEDIATE NEW BORN
PERIOD, WE SEE SIGNS OF STRESS
AND MUSCLE TENSION.
WHEREAS IN THE LATTER 30, IN
AFTER A MONTH WE SEE EFFECTS ON
SELF-SOOTHING, INABILITY TO
SELF-REGULATE.
THE ABILITY TO SELF-REGULATE AT
AS INFANT HAS BEEN TIED TO LATER
CERTAINLY--CERTAINLY MOTION
REGULATION.
SO AND THEN ACROSS BOTH THE NEW
BORN AND LEADER INFANT PERIOD,
WE SEE A NEED FOR HANDLING THE
EXAMINER IN ORDER TO HELP THE
INFANT MAINTAIN A CALM STATE
NEEDED TO IRPT VENE MORE.
SO IF WE THINK OF MOMS WHO ARE
SMOKING WHO ARE ALSO TYPICALLY
MORE DISADVANTAGED, HAVE LESS
SUPPORT, ARE MORE LIKELY TO HAVE
AN UNPLANNED PREGINANCE TOW HAVE
A BABY WHO'S JUST BORN SLIGHTLY
MORE ACEROUSABLE, NEEDING
SLIGHTLY MORE ATTENTION, IT MAY
BE A COMBINATION THAT OVERTIME
CAN LEAD TO LONGER TERM EFFECTS.
WE ALSO SAW WITH ATTENTION HOW
WELL THE BABY ATTENDED TO THE
STIMULI DURING THE EXAM, IT ALSO
CHANGED OVER THE 30 DAYS.
AT THE BEGINNING NOT TOO MUCH
BETWEEN THE GROUP OF MOTHERS WHO
SMOKED AND THOSE WHO WERE
EXPOSED TO MOTHER WHO IS DIDN'T
SMOKE.
BUT THE FIRST 30 DAYS WE SEE
THESE DIFFERENCES WIDEN SO THAT
BY 30 DAYS YOU SEE A PRETTY BIG
DIFFERENCE BETWEEN BABIES AND
MOTHER WHO IS SMOKE VERSUS THOSE
WHO DON'T.
I WILL NOTE THAT WE EXPANDED
THIS SCALE SO THAT CAN YOU SEE
THE EFFECTS MAGNIFIED SO THEIR
MEASURABLE EFFECTS, BUT THEY'RE
STILL SUBTLE AND THAT'S
IMPORTANT FOR THINKING ABOUT
RESILIENCE.
SO WHAT WE'RE SEE SUGGEST A
PROFILE OF A SMOKING EXPOSED
BABY THAT INCLUDES INCREASED
IRRITABILITY, DIFDIFFICULTY IN
SELF-SOOTHING AND ALTERATIONS IN
ATTENTION AS WELL AS SOME SIGNS
OF STRESS AND WITHDRAWAL.
SO PERHAPS THEY WOULD NEED TO BE
ON A PACIFIER PATCH.
WE ALSO WANT TO LOOK AT STRESS
RESPONSE WHICH WE GOT FROM THE
MOUTH OF BABES, LITTLE SALIVA
SAMPLES BEFORE AND AFTER THE
BEHAVIORIAL EXAM.
AND THE BEHAVIORIAL EXAM MIMICS
A DAILY STRESSOR IN THE DAY OF
THE LIFE OF AN INFANT, GETTING
CLOSED PUT ON, HELD BY 1 PERSON,
THEN ANOTHER, BETTING PUT DOWN
SO THIS IS A WAY FOR US TO LOOK
AT HOW THE BABY IS RESPONDING TO
DAILY LIFE STRESSORS.
AND WHAT WE FOUND IS REDUCED
STRESS RESPONSE IN THE BABIES OF
MOTHER WHO IS SMOKED SO THEY
DIDN'T MOUNT THE SAME LEVEL OF
CORTISOL RESPONSE TO STRESSORS
TO INFANTS THAT ARE NOT EXPOSED
TO SMOKING DID.
SO THIS SUGGESTS THEY MAY
NOT--WHILE THEY'RE HAVING A
HEIGHTENED BEHAVIORIAL RESPONSE
TO DAILY STRESSORS, THEY'RE
HAVING SORT OF A LOWER
PHYSIOLOGIC RESPONSE AND THAT
COMBINATION MAY SET THEM UP FOR
A LONGER TERM DIFFICULTIES.
WE'RE ALSO INTERESTED IN HOW
SMOKING AFFECTED THE PLACENTA.
AND WHETHER THESE CHANGES IN THE
PLACENTA MIGHT ALSO IMPACT
INFANT CORTISOL IN
NEUROBEHAVIOR, WORKING WITH MY
WONDERFUL COLLEAGUE CARMEN
MARSET AND TODD EVERSON, WE HAVE
LOOKED AT METHYLATION AS WELL AS
EPIGENETIC CHANGES AND GENE
EXPRESSION CHANGES AND WE FOUND
PATTERNS THAT WERE CONSISTENT
WITH ALTERATIONS IN THE
STRETIONZ RESPONSE, GROWTH
BEHAVIOR AS WELL AS AS NICOTINE
METABOLISM.
MOTHERS WHO SMOKED DURING
PREGNANCY MAY NOT BE MOUNTING AN
ADEQUATE RESPONSE TO DAILY
STRESSORS AND THIS MAY BE
MEDIATED BY THE PLACENTA AND
HELP US UNDERSTAND HOW SUBSTANCE
USE IS TRANSMIT FRIDAY 1
GENERATION TO ANOTHER OR HOW
STRESS IS TRANSMITTED
BIOLOGICALLY.
SO THEN WE WONDERED IF WE CAN
SEE EFFECTS AT DAY 1 OR 2 OF
LIFE, CAN WE SEE THEM EARLIER,
CAN WE USE ULTRASOUND TO
ELECTRIC AT WHAT BABIES ARE
DOING BEFORE THEY'RE BORN?
SO MY COLLEAGUE AMY
[INDISCERNIBLE] DEVELOPED
SOMETHING CALLED THE FENS WHICH
IS A COMPLEMENT TO THE ENDS AND
THE MEASURES SOME OF THE SAME
DOMAINS WE MEASURED IN INFANCY.
WE CAN LOOK AT FETAL HEART RATE
WE CAN LOOK AT MOTOR BEHAVIOR
AND ACTIVITY LEVEL, BEHAVIORIAL
STATE AND RESPONSES TO STIMULI.
SO WE CAN SEE TYPICALLY
ULTRASOUNDS ARE USED TO TASK FOR
LEVEL OF FLUID OR BABY SIZE,
SORT OF MEDICAL ISSUES BUT IT'S
ALSO, WE CAN ACTUALLY RECORD THE
VIDEOS ISSUE THE ULTRASOUND AND
CODE THEM FOR BEHAVIOR AND OTHER
ASPECTS AND ALSO MEASURE HEART
RATE.
SO IN THE FIRST SET OF STUDIES,
WE LOOKED AT RESPONSE TO A
VIBEERAL ACOUSTICS AND IT'S
APPLIED TO THE ABDOMEN AND WE
LOOKED AT HOW FETUSES RESPONDED.
AND WE FOUND THAT FETUSES WHO
SMOKED HAD INCREASED WEB
CONNECTED HAIEVERRIAL ACTIVITY
AT BASE LINE AND AFTER THE VIBE
ROUGH ATOM ACOUSTIC STIMULI.
AND THEN WE LOOKED AT BEFORE 29
WEEKS AND AFTER, WE FOUND
SIMILAR AFFECTS BUT THEY WERE
MORE PROON NOUNSED IN PREGNANCY
WHEN THE BABY HAD MORE ROOM TO
MOVE AROUND.
WE THEN WANTED TO SEE HOW THE
FETUS MIGHT RESPOND TO A SOCIAL
STIMULI SO WE RECORDED MOM
READING, ARE MY MY MOTHER AS
WELL AS I STRANGER READING THE
SAME SORTING SIGNALS EXPE WE CAN
LOOK AT HOW THE FETUS RESPONSES
TO MOTHERS VOICE VERSUS A
STRANGERS VOICE.
AND HERE, PARALLELLING WHAT WE
SAW WITH CORTISOL, WE SAW IN
FETUSES IN MOTHERS WHO SMOKED
SHOWED LOWER HEART RATE RESPONSE
TO HEARING THEIR MOTHER TALK AT
27 WEEKS AND MORE SO AT 33
WEEKS.
SO BABIES OF MOTHERS WHO SMOKED
ARE SHOWING SLIGHT, THESE SORT
OF SUBTLE ALTERATIONS IN BOTH
PHYSIOLOGY AND BEHAVIOR EVEN
BEFORE THEY'RE BORN.
SO YOU CAN SEE SUBTLE VARIATIONS
DURING DEVELOPMENT AND WE CAN
SEE INITIAL DETECTION OF FETAL
ACEROUSED BEHAVIORIAL LOW BUT
NOT AUTONOMICALLY AND SO THIS
MIGHT HELP US UNDERSTAND WHICH
BABIES MIGHT BE MORE AFFECTED BY
SUBSTANCE USE AND PREGNANCY AS
WELL AS GIVE USA I WAY TO SEE IF
INTERVENTIONS WE'RE DOING MIGHT
BE CHANGING FETAL BEHAVIOR AND
FETAL DEVELOPMENT.
SO 1 OTHER THING THAT WE KNOW
ABOUT SMOKING SIMILAR TO A LOT
OF OTHER STRESSES INCLUDING
EARLY CHILDHOOD, ADVERSITY,
SMOKING IS NOT A RANDOM
EXPOSURE.
SO MOTHERS WHO SMOKED DURING
PREGNANCY ARE LESS LIKELY TO
RECEIVE ADEQUATE PRENATAL CARE
AND MORE LIKELY TO USE OTHER
SUBSTANCES, TYPICALLY OF HIGHER
STRESS LEVELS AND MORE
PROBLEMATIC RERELATIONSHIPS AND
ARE MORE LIKELY TO HAVE AN
UNPLANNED PREGNANCY AND MAY OR
MAY NOT HAVE A PARTNER INVOLVED
AND MORE LIKELY TO HAVE MULTIPLE
CHILDREN.
SO WE WONDERED, WHAT MIGHT
LOOKING AT BEING EXPOSED TO MORE
THAN 1 SUBSTANCE USE DO?
WOULD THAT HAVE SIMILAR EFFECTS
OR WOULD THAT SORT OF MAGNIFY
THE EFFECTS OF SUBSTANCE USE IN
PREGNANCY AND THEN, WE CAN WE
CAN BROADEN THIS THOUGHT TO
THINKING ABOUT ALL THE
EXPOSESOME WIDE, THE RANGE OF
EXPOSURE TO MANAGERS THAT USE
SUBSTANCES ARE ALSO EXPLOAZED
POETIC, INCLUDING STRESS,
POVERTY AND INCLUDING NOT HAVING
A SUPPORT SUPPORTIVE PARTNER IN
THE PICTURE.
SO WE FIFORTD IN OUR INITIAL
SETTING WE LOOKED AT MARIJUANA
CO-USE, SO THERE'S BEEN ENORMOUS
INCREASE IN USE OF MARIJUANA
AROUND OUR COUNTRY WITH THE
LEGALIZATION AND MEDICALIZATION
OF MARIJUANA.
INCLUDING DURING PREGNANCY.
SO WOMEN USED MARIJUANA WHEN
THEY USE TOBACCO AND AMONG WOMEN
WHO USE MARIJUANA, 66-75% USE
TOBACCO WITH MARIJUANA WHETHER
CO ADMINISTERED AS A BLUNT OR
SEPARATELY, SO CIGARETTE AND
SMOKING MARIJUANA OR ESIGNATURES
OR OTHER TOBACCO PRODUCTS.
AND WE FOUND THAT TOBACCO PLUS
MARIJUANA EXPOSED INFANTS EXPOSE
TO GREATER CHANGES IN THEIR
BEHAVIOR, THEY ARE LESS ABLE TO
SELF-SOOTHE AND HAD EVEN GREATER
NEED FOR AN EXAMINER TO
INTERVENE TO HELP THEM MAINTAIN
A CALM STATE.
WE ALSO FOUND THAT MARIJUANA
USERS SHOWED EVEN MORE ATTENUATE
OR REDUCED CORTISOL RESPONSE,
COMPARED THOSE WHAT ARE TOBACCO
EXPOSED AND INFANTS THAT ARE NOT
EXPOSED TO INFANTS DURING
PREGNANCY.
SO INFANTS OF WOMEN WHO USE MAR
JUAN IN THIS ADDITION TO TO BACK
O SHOWED MORE CHANGES TO
BEHAVIOR AND STRESS RESPONSE.
THIS HELPS US UNDERSTAND THAT
EXPOSE TOWER SUBSTANCES DON'T
OCCUR IN ISOLATION AND BECAUSE
OF THIS MAY LEAD TO IMPACT OF
THE NEXT GENERATION, THE LARGER
SOCIAL CONTEXT MATTERS.
SO MANY, MANY OTHERS ARE TALKING
ABOUT THE GERONTOLOGYSTS MEMORY
CLONE AND OTHER OMES, OTHER
BIOLOGICAL OMES, WE HAVE STARTED
TO TALK ABOUT THE EXPOSE OHM, SO
CAPTURING THE TOTALITY OF
LIFETIME TO BETTER UNDERSTAND
THE HELT.
ALSO LESS LIKELY TO ANSWER
POTENTIALLY LESS LIKELY TO EAT
HEALTHY AND MAY BE LIVING IN THE
ENVIRONMENT THAT ARE NOT
CONDUCIVE TO HEALTH, FEWER GREEN
SPACES, MORE POLLUTION,
FINANCIAL ISSUES, SOCIAL ISSUES,
AND SOCIAL SUPPORT, BUT HERE, WE
MAY SEE SOME OF THESE PROTECTIVE
EXPERIENCES SO EVEN IF MARKETS
ARE EXPERIENCING SOME ADVERSE
EVENTS DURING PREGNANCY MAY THEY
ALSO HAVE BE HAVING A PROTECTIVE
EXPERIENCE AND THAT'S WHERE
RESILIENCE MAY COME INTO PLAY.
ALSO, THINKING ABOUT PHYSICAL
AND CHEMICAL ENVIRONMENTS.
SO FOR A LONG TIME DURING
PREGNANCY, PEOPLE TYPICALLY
FOCUS ON 1 EXPOSURE OF INTEREST
OF STRESS OR SUBSTANCE USE AND
IT'S NOW--WE'RE NOW AWARE THAT
IT'S REALLY IMPORTANT TO TRY TO
DID OUR BEST TO MEASURE AS MANY
OF THESE FACTORS AS WE CAN.
JUST AN EXAMPLE, WE LOOKED IN
SOME OF OUR SAMPLES AT
NEIGHBORHOOD DEPRIVATION.
SO OUR STUDIES TYPICALLY INCLUDE
OUR--THE FOLKS, THE MOTHER WHO
IS DON'T SMOKE ARE MATCHED IN
TERMS OF SOCIOECONOMIC STATUS AS
BEST WE CAN, AND THEY'RE VERY
DIVERSE SAMPLES, SO BETWEEN 50
AND 70% OF OUR SAMPLES ARE FROM
MINORITIZED GROUPS.
SO HERE WE FOUND THAT
NEIGHBORHOOD DEPRIVATION WAS
ASSOCIATED WITH DIFFERENCES IN
MOTHER CORTISOL WHICH HAS BEEN
LINKED TO INFANT BEHAVIOR.
SO MOTHER WHO IS LIVED IN
NEIGHBORHOODS THAT WERE LESS
WELL RESOURCED SHOWED CHANGES IN
THEIR CORTISOL DIFFERENTLY IN
NEIGHBORS THAT WERE MORE
RESOURCED.
SO WHAT KEY LEARN ABOUT THIS
RESILIENCE.
FIRST WE SO LITERATURE FOR
DEPRESSION, STRESS AND OTHER
KINDS OF EXPOSURES DURING
PREGNANCY, THEY'RE SUBTLE, NOT
MAJOR ORGAN CHANGES OR MAJOR,
MAJOR DEVELOPMENTAL FOR THE MOST
PART NOT MAJOR.
AND WE ALSO KNOW THAT PREGNANCY
IS BOTH A STRESS TEST, BUT WE
KNOW THAT MEDICAL CONDITIONS
DURING PREGNANCY THEY'RE MORE
LIKELY TO GET LATER IN LIFE, SO
IT'S A MINIMEDICAL STRESS TEST
FOR WHAT MOM MIGHT LOOK LIKE AS
SHE GETS OLDER BUT IT'S ALSO A
WINDOW OF OPPORTUNITY.
SO ALL OF THESE SENSITIVE AREAS
ARE BOTH POTENTIALLY STRESS
TESTED SO THINGS IMPACT US MORE
AND IMPACT THE NEXT GENERATION
MORE BUT ALSO A WINDOW OF
OPPORTUNITY FOR RESILIENCE.
SO WE KNOW THAT WOMEN ARE MORE
LIKELY TO QUIT SMOKING DURING
PREGNANCY THAN ANY OTHER TIME.
RATES OF QUITTING OR JUST WOMEN
QUITTING ON THEIR OWN ARE UP TO
50% DEPENDING ON THE STUDY AND
QUITTING REVERSES EFFECTS LIKE
LOW BIRTH WAY AND PREMATURITY
THAT ARE SEEN FROM SMOKING
DURING PREGNANCY.
THEREYA ALSO HUGELY INCREASED
CONTACT WITH THE HEALTHCARE
SYSTEM.
SO MOTHERS ARE GOING IN FOR
ULTRASOUNDS AND OTHER SORT OF
MEDICAL CARE.
THIS ALSO REPRESENTS AN
OPPORTUNITY.
IT'S ALSO AN OPPORTUNITY IN
TERMS OF NCCIH FOR INTEGRATIVE
INTERVENTIONS TO HAVE A LARGE
IMPACT.
BECAUSE YOU'RE IMPACING 2
GENERATIONS, THE MOTHER'S
GENERATION IN LIFE AS WELL AS
HER CHILDREN.
AND IT'S CRITICAL, FOLKS IN THE
FIELD LIKE MY WONDERFUL
COLLEAGUE, DR. LAURA
[INDISCERNIBLE] HAVE STARTED TO
TALKING ABOUT BEING SURE TO
EXAMINE THE IMPACT OF PREGNANCY
INTERVENTIONS FOR MOM ON BOTH
MOM AND BABY, SO DESIGNING
INTERVENTIONS, SO WE MAY MEASURE
IMPACT ON BOTH GENERATIONS.
SO AGAIN, HERE WE SEE SUBTLE
EARLY CHANGES, AND THAT IT'S AN
OPPORTUNITY FOR INTERVENTION, SO
THAT WE CAN INCREASE LIFE SPAN
AND INCREASE HEALTHY LIVES OVER
THE COURSE OF A LIFE SPAN.
WE ALSO KNOW THAT MOMS THAT WERE
ABLE TO QUIT SMOKING DURING
PREGNANCY MAY HAVE DIFFERENT
WAYS OF THINKING ABOUT THINGS.
TYPICALLY MOMS WHO ARE ABLE TO
QUIT DURING PREGNANCY ARE MORE
CONCERNED ABOUT THE EFFECTS OF
SMAIKING ON THEIR BABY, MORE
LIKELY TO BE THEIR FIRST
PREGMANCY, WHICH HAS
IMPLICATIONS FOR INTERVENTIONS,
THEY'RE MORE LIKELY TO QUIT,
PRIOR TO CONCEPTION AND AT
PREGNANCY VERIFICATION, SO EARLY
PREGNANCY IS A KEY WINDOW, THEY
ALSO TEND TO REPORT FEWER
PSYCHOLOGICAL SYMPTOMS AND
LIVING WITH SMOKERS, SO WHELM
ARE ABLE TO QUIT MAY GIVE CLUES
IN HOW WE MIGHT HELP WOMEN WHO
ARE CONTINUING TO SMOKE OR USE
OTHER SUBSTANCES.
THIS IS A STUDY OF MATERNAL
FETAL ATTACHMENT WHICH IS AN
INTERESTING TARGET FOR
INTERVENTION AND RESILIENCE.
SO MATERNAL FETAL ATTACHMENT IS
THE EMOTIONAL CONNECTION A WOMAN
DEVELOPS WITH HER FETUS DURING
PREGNANCY ISSUE EXPRESS,
FEELINGS, COGNITION AND
BEHAVIORS.
WE FOUND THIS IS ALL WOMEN WHO
SMOKED THROUGHOUT PREGNANCY BUT
WE FOUND THAT WOMEN WHO FELT A
HIGHER LEVEL OF ARK TACHMENT TO
THEIR FETUS SMOKED FEWER
CIGARETTES PERDAY OVER THE
ENTIRE COURSE OF THEIR PREGNANCY
WHEREAS THOSE WHO HAVE LOWER
ATTACHMENT TO THEIR FETUS SMOKED
MORE DURING PREGNANCY.
THIS WAS NOT A PROECTOMYOSIN
SPECTIVE STUDY BUT AN
INTERESTING AND SUGGESTED HOW
ATTACHED MOM IS TO A FETUS MAY
IMPACT SUBSTANCE USE.
MY COLLEAGUE AMY [INDISCERNIBLE]
JUST GOT AN R21 THAT'S SO
EXCITING AND WE'RE INTERESTED IN
DOING THIS WORK UP HERE AS WELL,
IT'S CALLED NEUROBEHAVIOR
ENGAGEMENT AND CONNECTION
THROUGH ULTRASOUND, NEXUS.
SO USING ULTRASOUND TO IMPROVE
MATERNAL FETAL CONNECTIONS AND
MOTIVATE SELF-CARE AND BRINGING
ULTRASOUND INTO THE COMMUNITY
AND WORKING WITH FOLKS IN THE
COMMUNITY TO GET THEM MORE
ENGAGED IN SUBSTANCE USE
TREATMENT AND SELF-CARE DURING
PREGNANCY.
AND AS WE THINK ABOUT SUBSTANCES
AND THIS IDEA OF THE EXPOSE OHM,
WE CAN PAUSE TO THINK A LITTLE
BIT ABOUT THEORIES OF
RESILIENCE.
SO PARTICULARLY IN PSYCHOLOGY, A
LOT OF THE THEORIES HAVE FOCUS
ON THIS IDEA OF WHAT MAKES THIS
1 INDIVIDUAL WHO'S GROWN UP IN
THIS, IN A DIFFICULT, UNDER
ADVERSE CIRCUMSTANCES, ABLE TO
BLOSSOM AND BLOOM.
SO, WE HAD THIS 1 FLOWER THAT
WAS ABLE TO GROW UP IN THE
CONCRETE.
LET'S STUDY WHAT HAPPENED WHEN
THAT FLOWER, AND WHY THAT THAT
FLOWER ABLE TO SURVIVE AND MAKE
IT DESPITE ALL THE OBSTACLES?
BUT NOW WE'RE STARTING TO
REALIZE OR BE AWARE THAT WE NEED
TO CHANGE THE SOIL, MAKE
FETTERILE MAKE ALL
SOIL FETTERILE AND BE ACTIVE AND
WORK WITH COMMUNITIES AND MAKE
CHANGES IN OUR SOCIETY, SO THAT
ALL CHILDREN ARE ABLE TO SUCCEED
AND THAT CAN HAVE AN ENORMOUS
IMPACT.
WE KNOW THAT EARLY INTERVENTIONS
HAVE SUCH A LONG-TERM ENORMOUS
IMPACT ON BOTH PARENTS AND
CHILDREN.
MY POST DOCTORAL FELLOW
DR. SHARON LEE IS DEVELOPING A
NEW THEORY OF RESILIENCE, WHERE
WE FOCUS ON STRUCTURES AND
COMMUNITY FACTORS IN BUILDING
RESILIENCE IN ADDITION TO
INDIVIDUAL FACTORS SO WE LOOK AT
BIOLOGY AS WELL AS INDIVIDUAL
FAMILY, COMMUNITY, ACCESS TO
LOCAL GOVERNMENT AND
INSTITUTIONS AND ADVOCACY
TRAINING AND ALSO, A FOCUS ON
MINORITY STRESS, ON
DISCRIMINATION AND OTHER TYPES
OF STRUCTURAL STRESSORS THAT
PEOPLE OF COLOR FACE.
SO THIS IS SOMETHING THAT WE'RE
BUILDING AND WELCOME FEEDBACK
THAT DR. LEE AND MY OTHER
COLLEAGUES IN THE STRESS TRAUMA
AND RESILIENCE CENTER ARE
WORKING ON.
AND THIS FITS SO NICELY WITH
NCCIH'S STRATEGIC PLAN, WHICH IS
SO IMPRESSIVE AND THINKING ABOUT
THE WHOLE PERSON HEALTH
FRAMEWORK, WHERE YOU'RE LOOKING
AT THE INDIVIDUAL AND THE
FAMILY, AND COMMUNITY, AND
POPULATION, AND LOOKING AT ALL
LEVELS OF ANALYSIS, BIOLOGICAL,
BEHAVIORIAL, SOCIAL, AND
ENVIRONMENTAL.
AND SYNTHITIZING FROM BIOLOGY TO
BEHAVIOR TO THE WHOLE PERSON.
SO NOW I WANT TO SWITCH GEARS TO
TELL YOU ABOUT THE BROADER
INITIATIVES WE HAVE THROUGH THE
STRESS TRAUMA AND RISWRELIENCE
CENTER AND SOME OF THE PROJECTS
WE HAVE ONGOING.
SO WE LAST YEAR RECEIVED A
TRAUMA AND STRESS GRANT CALLED A
COBRI, CENTER FOR BEHAVIORIAL
AND BIOLOGICAL INNOVATION.
THE GOALS OF COBRIs ARE TO
SUPPORT EARLY CAREER FACULTY TO,
TO GAIN EDUCATION AND TRAINING
AS WELL AS SKILLS, TO BECOME
INDEPENDENT LEVEL INVESTIGATORS.
OUR COBRE IS FOCUSED ON MODEL OF
STRESS ANDKS POSURES EARLY IN
LIFE, AND MECHANISMS IN NOVEL
INTERVENTIONS TARGETS FOR
OUTCOMES.
WE HAVE A ADMINISTRATIVE CORE AS
WELL AS TECHNOLOGY AND COMMUNE
COLLABORATIVE CORE.
OUR COMMUNITY COLLABORATIVE CORE
IS HEADED UP BY DR. STEPHANIE
[INDISCERNIBLE] AND INVOLVES
STATE AND COMMUNITY AGENCIES AND
THE IDEA IS TO HAVE
BI-DIRECTIONAL COLLABORATION
WITH COMMUNITY AGENCIES SO WE
CAN DEVELOP RESEARCH QUESTIONS
AND PARTNERSHIPS WITH OUR
COMMUNITY PARTNERS AS WELL AS
KEEP THEM IN THE LOOP AS WE'RE
DOING THE STUDIES AND RESULTS.
AND WE'VE ALREADY STARTED
DOING--DR. [INDISCERNIBLE] HAS
BEEN DOING THIS WORK FOR MANY,
MANY YEARS AND AS WE HAVE NEW
INVESTIGATORS JOINING THE COBRE,
WE WILL KNOW CO NECT THEM WITH
HIGHLY COLLABORATIVE AGENCIES
AND DOING RESEARCH.
THE TECHNOLOGY CORE IS TRYING TO
GET AT THE EXPOSE ORDER OF
MICRONS, EACH PROJECT WILL HAVE
IT'S OWN WAY OF LOOKING AT
DIFFERENT TECHNOLOGY MEASURES,
BUT WE WILL HAVE GIO CODING AND
LOOKING AT NEIGHBORHOOD VIOLENCE
AND POVERTY IN TERMS OF
STRUCTURAL FACTORS, ALSO LOOKING
AT CHILD MALSTREENLT RECORDS IN
ADDITION TO SELF-REPORT.
WE--DR. NICOLEED AND WHAT IS
DR. BETH [INDISCERNIBLE] WHO HAD
THE CORE HAS BEEN WORKING A LOT
WITH THE ELECTRONICALLY
ACTIVATED RECORDER WHICH ALLOWS
FOR TESTING NIPITS OF
CONVERSATION IN REAL LIFE THAT
CAN BE ANALYZED TO SEE SORT OF
ON A DAY-TO-DAY LEVEL WHAT'S
HAPPENING IN PEOPLE'S LIVES.
AS WELL AS LOOKING AT SOCIAL
MEDIA AND HARNESSING SOCIAL
MEDIA DATA SO THAT WE CAN SEE
WHAT PEOPLE ARE TALKING ABOUT IN
SOCIAL MEDIA AS WELL AS IN THEIR
TEXT MESSAGING.
SO JUST TO GIVE YOU AN IDEA OF
SOME OF THE STUDIES THAT WE'RE
DOING, THIS IS
DR. [INDISCERNIBLE] LOPEZ WHO IS
DOING A 12--FOLLOWING UP ON A 12
YEAR LONGITUDINAL STUDY STUDIED
BY DR. [INDISCERNIBLE] AND
[INDISCERNIBLE] LOOKING AT THE
IMPACT OF CHILD MALTREATMENT
MEASURED PERSPECTIVELY, FROM AGE
3-5 AND 9 TO 11 AND THEN SHE'S
FOLLOWING THEM IN ADOLESCENTS
UNDER 15 YEARS OLD LOOKING AT
REPETITIVE NEGATIVE THINKING AND
INTENTIONAL BIAS AND HOW THAT
MIGHT LEAD TO MENTAL HEALTH
PROBLEMS.
REPETITIVE NEGATIVE THINKING IS
SOMETHING YOU THINK ABOUT
RUMINATION, SO SORT OF DWELLING
ON NEGATIVE THOUGHTS SHE WANTS
TO UNDERSTAND THOSE IN REALTIME
AND IN THE LAB AND HOW THEY MAY
LEAD TO LONG-TERM MENTAL HEALTH
ISSUES.
[INDISCERNIBLE] IS ALSO DOING A
STUDY THAT'S VERY COMPLIMENTARY
TO THIS, SO LOOKING AT EARLY
LIFE ADVERSITY, PARTICULARLY
SEXUAL ABUSE AND COMMUNITY
VIOLENCE, HOW THAT RELATES TO
EANGZ TO AFFECTIVE STIMULI,
EMOTIONAL STIMULI AND HOW KIDS
RESPOND TO THAT AND HOW THAT
LEADS TO DIFFERENCES IN
ADOLESCENCE SUBSTANCE USE
INCLUDING CANNABIS, SUBSTANCE
USE, ALCOHOL AND NICOTINE.
KAREN MATTHEWS HASSA PILOT STUDY
FOCUSED ON UNDERSTANDING
DISCRIMINATION AT THE
INTERSECTION OF IDENTITIES AND
HOW THAT IMPACTS DISCRIMINATION.
SO LOOKING AT RELATIONSHIPS WITH
RACE, GENDER IDENTITY, SEXUAL
ORIENTATION AND WEIGHT.
DOING QUALITATIVE WORK TO TRY TO
UNDERSTAND HOW BLACK ADOLESCENTS
THINK ABOUT ALL THESE DIFFERENT
IDENTITIES AND HOW THEY DEFINE
DISCRIMINATION IN ORDER TO
DEVELOP MEASURES IN REAL WORLD
DISCROSS EXAMINEINATION AND HOW
THEY RELATE TO HEALTH BEHAVIORS
SUCH AS SUBSTANCE USE AND EATING
BEHAVIORS.
DR. WHITNEY EVANS IS DOING A
COMMUNITY BASED RANDOMIZED TRIAL
WHERE SHE'S LOOKING AT THE
BIOBEHAVIORIAL MECHANISMS OF
FOOD INSECURITY IN CHILDREN FROM
LOW INCOME HOUSEHOLDS.
SO THERE'S A STRONG RELATIONSHIP
BETWEEN FOOD INSECURITY AND
OBESITY, WHICH IS NOT VERY WELL
UNDERSTOOD, PARTICULARLY IN THE
CONTEXT OF POVERTY AND SUMMER IS
A HIGH RISK PERIOD FOR THE ONSET
OF FOOD INSURVEYS KIERITY AND
WEIGHT GAIN.
SO DURING THE SCHOOL YEAR, KIDS
FROM DISADVANTAGED BACKGROUNDS
AND POVERTY WILL RECEIVE FREE
SCHOOL LUNCHES AND BREAKFASTS
BUT DURING THE SUMMER THAT GOES
AWAY AND THEIR SCHEDULE AND
ROUTINE MAY BE CHANGED AS WELL,
SO THE IDEA IS TO PROVIDE, HAVE
A GROUP WHERE WE PROVIDE HEALTHY
MEALS, DELIVERED DAILY AS WELL
AS A GROUP THAT IS ROUGH ATOM
VIEDED IN NEWS LETTER COMMUNITY
FOOD PROGRAMS BUT NOT WITH DAILY
MEALS TO TRY TO REALLY ISOLATE
THE IMPACT OF FOOD INSECURITY
THAT HAPPENS EVERY SUMMER WHEN
KIDS ARE NOT--DON'T HAVE ACCESS
TO SCHOOL BREAKFAST AND LUNCH.
AND THE IDEA THAT THIS COULD BE
RESEARCH THAT WILL HELP CHANGE
POLICY IN THIS AREA.
DR. [INDISCERNIBLE] IS DOING
REALLY FABULOUS WORK WITH THE
COMMUNITY AND THE PREVENTION OF
CHILD MALTREATMENT.
SO SHE'S PARTNERING WITH STATE
AGENCIES AND EMBEDDING HER
RESEARCH IN A HOME VISITING
PROGRAM IN RHODE ISLAND.
AND THE IDEA IS THAT WOMEN WHO
EXPERIENCED MALTREATMENT AND
ADVERSE CHILDHOOD EXPERIENCES
ARE MORE LIKELY TO HAVE KID WHO
IS ALSO ARE MORE LIKELY TO HAVE
VIOLENCE IN THEIR HOUSEHOLD AND
ARE AT GREATER RISK FOR HAVING
FAMILY DISRUPTIONS, SO THE IDEA
IS TO TAG ON TO A PERINATAL HOME
VISITING PROGRAM FOR THESE
MOTHERS AND TO ADD MENTAL HEALTH
CONSULTATION AND OTHER ASPECTS
TO THE REALLY ENRICH THAT
PERINATAL HOME VISITING PROGRAM
AND THE IDEA TO SEE WHETHER THAT
HAS AN IMPACT ON PREVENTION OF
MALTREATMENT AS WELL AS FAMILY
RISK FACTORS AND THE
PARENT-CHILD RELATIONSHIP WHICH
WE KNOW IS SO IMPORTANT.
DR. BETH BALK HAS A STUDY FOR
THE NICCH, AND SHE IS LOOKING AT
ADULTS WITH TYPE 2 DIABETES AND
WHETHER YOGA OR A
STANDARD--VERSUS A STANDARD
EXERCISE PROGRAM MIGHT MAKE
CHANGES IN DISEASE OUTCOMES AND
ADHERENCE TO MEDICATION.
SO SHE'S DOING A FEASIBILITY AND
FIDELITY STUDY THAT WILL THEN
LEAD TO A MULTISITE CLINICAL
TRIAL.
AND DR. KATHRYN IS A FACULTY
MEMBER AT THE--HAS OVERLAP WITH
WORK AT NCCIH AND SHE'S REALLY
LOOKING AT WHETHER A VALUED
AFFIRMATION, REFRAMING
MEDICATION USE IN ELDERLY
CARDIAC PATIENTS MIGHT HELP THEM
TO USE MEDICATION MORE
FREQUENTLY AND TO REMEMBER THEIR
MEDICATION AND ADHERE TO THEIR
MEDICATION REGIME.
SO SHE'S REFRAMING MEDICATION
USE AS A SELF-GUIDED EFFORT TO
ENGAGE IN PERSONALLY MEANINGFUL
LIVING AND THEN LUCKING AT
EFFECTS IN WELL BEING AND
REDUCED DEC BURDEN.
[INDISCERNIBLE] IS ANOTHER 1 OF
OUR PILOT PROJECT RECIPIENTS.
SHE'S LOOKING AT MINDFULNESS,
OPTIMISM AND RESILIENCE IN THE
PERINATAL PERIOD.
AND FOR--WITH A PARTICULAR FOCUS
ON HEALTH EQUITY.
SO DISPOSITIONAL OPTIMISM, HAS
BEEN SHOWN TO BE ASSOCIATED WITH
SOME PERINATAL OUTCOMES AND
MAYBE A TARGET THAT CAN BE
CHANGED DURING PREGNANCY AND
WITH IMPACT ON MOTHER AND CHILD.
SO SHE'S DOING--SHE'S USING THE
EXPECTFUL APP WHICH IS
PARTICULARLY DESIGNED FOR WOMEN
OF COLOR, FOR BLACK WOMEN IN
PARTICULAR, AND SHE'S GOING TO
BE WORKING WITH THEM TO REFINE
IT AND MAKE SURE IT'S LIKED BY
PREGNANT BLACK WOMEN AND THEN
TRYING TO SEE HOW IT MIGHT
IMPACT SOCIAL SUPPORT AND HELP
PROMOTING BEHAVIOR AND COGNITIVE
RESPONSES TO STRESS AS WELL AS
HOW IT MIGHT IMPACT PERINATAL
OUTCOMES AND THE LABOR
EXPERIENCE.
AND L. G. WARD IS,A PLYING AT
TRAUMA INFORMED CARE APPROACH TO
[INDISCERNIBLE] USING
IMPLEMENTATION SCIENCE
FRAMEWORK, SO MANY WOMEN WHO GO
THROUGH PREGNANCY MAY HAVE
HISTORIES OF SEXUAL AND OTHER
TRAUMA BUT MAY NOT DISCLOSE THIS
TO THEIR OBSTETRIC PROVIDERS.
SO TRAUMA INFORMED CARE USES
PRINCIPLES OF SAFETY, TRUST,
GIVING WOMEN CHOICE EMPOWERMENT,
COLLABORATION AND RESPECT.
SO THAT WOMEN WHO HAVE A HISTORY
OF TRAUMA WILL BE MORE
COMFORTABLE THROUGHOUT THE
PERINATAL PERIOD WHEN THERE'S
REPEATED CONTACTS WITH THE
MEDICAL PROFESSION.
AND SO, DR. WARD IS DEVELOPING A
TOOL KIT THAT WILL BE--AND
TESTING IT WITH OBSTETRIC
PROVIDERS THAT WILL HELP THEM
IMPLEMENT TRAUMA INFORMED CARE
WHICH CAN IMPACT PERINATAL
INFANT OUTCOMES AND INFANT
OUTCOMES AS WELL.
SO, CONCLUSION.
SO EXPERIENCES DURING FETAL
TWEPMENT IN IT IS FIRST 2 YEARS
OF LIFE ARE CRITICAL FOR
LONG-TERM HEALTH.
OUR RESEARCH HAS SHOWN THAT
PREGNANCY IS A WINDOW OF
OPPORTUNITY TO FOSTER RESILIENCE
IN 2 GENERATIONS.
JUST BECAUSE WE'RE FOCUSING ON
PREGNANCY, WE WANT TO HEIGHT
LIGHT THAT IT'S MORE CRITICAL TO
MAINTAIN RESILIENCE AND SUPPORT
THIS IN THE POSTPARTUM PERIOD,
AND THERE'S INTEREST TO EXPAND
THE SCOPE OF PEDEIAT CARE TO
INCLUDE PARENTS AND THE GOING
INTO THE POSTPARTUM CARE BECAUSE
WE KNOW THAT EARLY BRAIN
DEVELOPMENT DURING THE FIRST 2
YEARS OF LIFE IS SO CRITICAL FOR
LONG-TERM HEALTH AND YET THERE'S
VERY LITTLE.
SO DURING PREGNANCY, THERE'S
LOTS OF CONTACTS WITH THE
MEDICAL CARE SYSTEM BUT NOT SO
MUCH IN THE 2 YEARS FOLLOWING
PREGNANCY SO THERE'S BEEN A PUSH
TO EXPAND POLICY IN THIS AREA,
EXPAND INSURANCE COVERAGE IN
THIS AREA AND REALLY TRY TO
SUPPORT PARENTS THROUGH THE
POSTPARTUM PERIOD.
WE ALSO NEED TO CENTER
MINORITIZED AND MARGINALIZED
POPULATIONS.
EXPERIENCES OF STRESS AND THE
EXPOSE OME ARE MORE MODEL
CITIZEN NOUNSED IN PEOPLE OF
COLOR AND THEY ALSO EXPERIENCE
BOTH DAILY LEVELS OF
DISCRIMINATION, AND ALSO
DISCRIMINATION FROM HEALTHCARE
SITUATIONS AND MEDICAL PROVIDERS
SO WE NEED TO CENTER
MINORITYIZED POPULATIONS AND
FIND WAYS TO CHANGE STRUCTURES
SO THAT HEALTH OUTCOMES ARE
BETTER AND THERE'S THE NEED TO
DEVELOP INTERVENTIONS IN
PARTNERSHIP WITH THE COMMUNITY
AND PARTNERSHIPS WITH COMMUNITY
AGENCIES.
SO I WOULD LIKE TO THANK ERCH IN
MY LAB.
AS WELL AS THE CENTER FOR ALTERN
5 MEDICINE, I WOULD LIKE TO
THANK EVERYONE FOR HELPING WITH
THE LOVELY SLIDES AND VISUALS
AND MY MANY COLLEAGUES WITH
STRESS TRAUMA AND RESILIENCE
CENTER AS WELL AS OUR
ADMINISTRATIVE FOLKS AND THIS IS
HOW YOU MAY CONTACT ME.
>>WELL, THANK YOU SO MUCH
DR. STROUD, THAT WAS A FANTASTIC
TALK AND YOU COVERED SUCH AN
ARRAY OF WONDERFUL RESEARCH.
I'M GOING TO GO AHEAD AND IF YOU
WANT TO STOP YOUR SHARE NOW,
ALTHOUGH THAT IS A BEAUTIFUL
PICTURE BUT WE'RE GOING TO MOVE
TO OUR QUESTION AND ANSWER
SESSION NOW.
AND I DID INVITE INTEREST OF OUR
VIDEOCAST MEMBERS THAT YOU ARE
WELCOME TO SUBMIT QUESTIONS
USING THE FEEDBACK FORM AND WE
WILL KICKOFF OUR QUESTION
SESSION BY GIVING DR. 'S LANG
EVINE AND SHURTLEFF WITH ANY
QUESTIONS THEY WANT TO KICKOFF.
I'M SURE THERE WAS INTERESTING
TO YOU, THE DEVELOPING MANY GOOD
THINGS IN THAT TALK, SO HELENE
WOULD YOU LIKE TO KICK IT OFF
WITH THE FIRST QUESTION.
>>FIRST OF ALL THANK YOU SO
MUCH.
THIS WAS JUST A LOVELY TALK, I
HAVE SO MANY QUESTIONS.
ONE QUESTION, I HAVE THAT'S, I
WONDER IF THIS HAS COME UP AT
ALL BUT, SO CLEARLY YOU'VE SHOWN
A LOT OF DATA ON SMOKING AND
PREGNANCY VERY CONVINCING.
I'M WONDERING IF YOU OR ANYONE
IS PAYING ATTENTION TO CAFFEINE?
THAT IS SUCH A COMMON STIMULANT
AND I'M JUST WONDERING WHETHER
PEOPLE HAVE LOOKED AT THAT,
EITHER BEFORE BIRTH OR DURING
THAT SENSITIVE PERIOD OF
POSTNATAL?
>>THAT IS SUCH AN EXCELLENT
QUESTION.
IN FACT, I HAVE RUN THESE
STUDIES DURING PERIODS OF MY OWN
2 PREGNANCIES AND I ACTUALLY HAD
AN UNDERGRADUATE POKE AROUND AT
THAT QUESTION FOR PARTLY
SCIENTIFIC CURIOSITY AND
WONDERING AS I DRINK COFFEE
DURING PREGNANCY HOW THAT MIGHT
IMPACT IT.
IN SOME OF OUR FETAL BEHAVIOR
STUDIES WE DID FIND SUBTLE
EFFECTS OF CAFFEINE AS WELL AS
CAFFEINE INTERACTING WITH SOME
OF THE OTHER SUBSTANCES.
THERE'S NOT, AGAIN, THERE'S BEEN
LINKS WITH CAFFEINE AND
MISCARRIAGE BUT IT'S USUALLY
QUITE LARGE EFFECTS OF CAFFEINE.
BUT IT'S NOT BEEN AGAIN BECAUSE
IT'S SORT OF NOT A SUBSTANCE
THAT SORT OF ON THE RADAR AND
SORT OF BROAD PUBLIC HEALTH
TERMS, IT'S NOT BEEN STUDIED
HUGE ENOUGH OR ADEQUATELY.
THE OTHER THING IS MOTHER WHO IS
SMOKE AND MOTHERS WHO USE OTHER
SUBSTANCES ARE MUCH, MUCH MORE
LIKELY TO USE CAFFEINE AND ALSO
TO USE ADDITIONAL--TO USE A LOT
OF CAFFEINE.
SO I THINK THAT'S REALLY
IMPORTANT AND AGAIN, IN SOME OF
OUR NOT PUBLISHED BUT WHEN WE'RE
LOOKING AT IT WITH OUR FETAL
DATA, THERE WERE INCREASED
EFFECTS OF CAFFEINE AND WE DO
TRY WHEN WE DO ULTRASOUND WORK
TO CONTROL IT TO HAVE MOTHERS,
CONTROL THE AMOUNT OF CAFFEINE
THAT THEY HAVE BEFORE COMING
INTO ULTRASOUND.
BUT I THINK THAT'S SUCH AN
IMPORTANT QUESTION AND IMPORTANT
AREA, I THINK THE EFFECTS ARE
LIKELY TO BE SEBTLE AND PROBABLY
MORE EXAGGERATED IN THE CONTEXT
OF OTHER SUBSTANCES AND OTHER
STRESSORS BUT I THINK IT'S
SOMETHING WE REALLY NEED TO LOOK
AT MORE.
>>DIFFICULT TO DO.
YEAH, YEAH.
>>ANY FOLLOW UP TO THAT HELENE
OR DAVID?
>>WONDERFUL LECTURE, I SEE HOW
YOU WORK SO WELL COORDINATES
WITH THE EFFORTS WE'RE TRYING TO
DO HERE AT NICCIH, LOOKING AT
INDIVIDUAL FAMILY, COMMUNITY
POPULATION EFFECTS ON HEALTH
DISEASE INTEGRATING
COMPLIMENTARY APPROACHES IN YOUR
OWN RESEARCH.
I THOUGHT IT WAS JUST A
WOBDERFUL TOUR DEFORCE RESEARCH
PROGRAM YOU HAVE, I'M VERY
IMPRESSED BY ALL OF IT.
I GUESS THE QUESTION I HAVE IS
MAYBE SHOULD GO YOU TOUCHED ON
BUT IF YOU COULD JUST GO IN A
BIT MORE DETAIL, OLD ENOUGH TO
REMEMBER THE WORK OF LINDA MAYS
AND THE CRACK BABIES AND THE
WORK SHE DID AND HOW THE ISSUE
THAT REALLY CAME UP, MORE THAN
WHAT WAS HAPPENING BIOLOGICALLY
SORE WITH COCAINE ITSELF, WHAT'S
THE STIGMA ASSOCIATED WITH NOT
ONLY THE MOTHERS BUT THE
OFFSPRING IN TERMS OF HOW THEY
WERE PERCEIVED AND THE STIGMA
ASSOCIATED WITH THEIR FUTURE
GROWTH DEVELOPMENT AND HOW THAT
IMPACTS THEIR OWN TRAJECTORY,
IT'S BAWND LAWEDDER DALE WAS
HAPPENING EITHER IN THE
ENVIRONMENT OR IN UTERO, HAVE
YOU THOUGHT ABOUT OR ADDRESSED
THE ISSUE OF STIGMA PARTICULARLY
AROUND SUBSTANCE USE DISORDER
AND EXPOSURE TO THOSE INFANT WHO
IS MAY BE FRANKLY TREATED
DIFFERENTLY JUST BECAUSE OF THAT
1 EVENT EARLY IN L LIFE BEYOND
THEIR CONTROL.
ANY THOUGHTS YOU MIGHT HAVE ON
THAT.
, YEAH, SUCH A HUGELY IMPORTANT
QUESTION AND IT REALLY RELATES,
CAN GO SMOKING PROBABLY LE LESS
SO THAN COCAINE AND OPIATES.
BUT THERE'S SO MUCH STIGMA ON
ALL LEVELS AND IT LEADS TO, YOU
KNOW THERE'S REPORTING ISSUES
WHEN YOU ARE TALKING ABOUT EVEN
MARIJUANA IN SOME STATES THAT
THEY DON'T WANT TO TALK TO THEIR
PROVIDER ABOUT IT AND
POTENTIALLY GET THE HELP THAT
THEY NEED BECAUSE THEY'RE AFRAID
IT MAY HAVE IMPACT ON THEM BEING
ABLE TO KEEP THEIR INFANT OR
OTHER FACTORS HAVING CHILD
PROTECTIVE SERVICES INVOLVEMENT
THERE'S SO MUCH THERE AND ALL OF
THIS WORK, I THINK IS REALLY
IMPORTANT NOT TO--THAT EVEN
THOUGH THESE ARE SENSITIVE
PERIODS AND WHAT HAPPENS DURING
PREGNANCY IS IMPORTANT AND IT'S
AN IMPORTANT SENSITIVE PERIOD
FOR INTERVENING AND MAKING LIGHT
WITH PROTECTIVE EXPERIENCES, IT
ALSO ISN'T--EVEN ON A SORT OF
SMALLER LEVEL, SO EVEN, YOU KNOW
MOTHERS WHO DON'T EXERCISE,
MIGHT HAVE SUBTLE DIFFERENCES IN
THEIR INFANTS THAT I THINK IT'S
REALLY IMPORTANT NOT TO HAVE IT
BE A BLAMING SITUATION.
I THINK IT'S HARD ENOUGH TO BE A
PARENT IN OUR COUNTRY AS IT IS,
SO I THINK IT'S MORE--IT NEEDS
TO BE MORE STRENGTH BASED AND
MORE IN THE CONTEXT OF MOMS
PARENT AND BEING MORE OF A
SIMILAR TO HOW WE ARE TRYING TO
TREAT ALL ADDICTION THAT IT'S
SOMETHING THAT WE CAN WORK WITH
AND HELP PEOPLE WITH AS OPPOSE
TO SOMETHING THAT NEEDS TO BE
PUNITIVE.
BUT I THINK COCAINE WAS AN
EXAMPLE OF SOME OF THESE SUBTLE
EFFECTS THAT GOT MAGNIFIED IN
THE NEWS AND SORT OF IN THE END
IT TURNED OUT IT WAS SUBSTANCE
USE IN THE CONTEXT OF PARENTS
AND POVERTY AND ALL THESE
FACTORS THAT SUBSTANCE USE IS
JUST 1 PART OF IT AND EVEN WHEN
WE FIRST START DOING THIS
RESEARCH, WE WANTED TO MATCH, TO
HAVE MATCHED GROUP, THAT DIDN'T
SMOKE AND WHAT YOU REALIZE IS
THAT PEOPLE WHO ARE USING
SUBSTANCES TYPICALLY WHOSE HARD
TO FIND AND WHO'S THE SAME IN
EVERY WAY AS SOMEONE WHO IS
BECAUSE THAT MAY BE WHAT LED
THEM TO USE SUBSTANCES.
SO I THINK STIGMA IS HUGELY
IMPORTANT AND I THINK POLICIES
AROUND SUBSTANCE USE AND
PREGMANCY ARE SUCH AN IMPORTANT
AREA, THERE'S SO MUCH WORK TO DO
IN THAT TO MAKE THIS A SYSTEM
THAT HELPS, RATHER THAN--SO,
GREAT POINT.
>>THANK YOU.
VERY NICE.
THANK YOU.
>>SO DR. STROUD, WE WILL MOVE
TO QUESTIONS WE RECEIVED VIA
E-MAIL AND WE HAVE DROPPED THEM
INTO THE CHAT IF YOU WANT TO
FOLLOW ALONG BUT I WILL SHARE
THEM OUTLOUD.
SO FROM E-MAIL WE HEARD FROM
SOMEONE WHO ASKS A VERY
INTERESTING QUESTION, THEY'RE
CURIOUS TO HEAR IF THERE'S ANY
RESEARCH ON CHILDREN WHO WERE IN
UTERO DURING 9/11 AND WHAT HAS
BEEN POSSIBLY THEIR RESPONSE TO
COVID AND LOCK DOWN LATER IN
LIFE.
THESE WOULD HAVE BEEN CHILDREN
WHO HAVE HAD DISRUCHTED EARLY
YEARS SO I FIND IT AS
INTERESTING QUESTION.
I DON'T KNOW IF YOU HAVE ANY
THOUGHTS OR ANY IS THAT MAYBE
OPENS UP A LINE OF QUESTIONING?
>>YEAH THAT'S FASCINATING.
WHEN I QUICKLY GLANCED I THOUGHT
IT WAS JUST A QUESTION ABOUT
WOMEN EXPOSED IN UTERO TO 9/11
AND THERE THEY HAVE BEEN STUDIED
AND THEIR OFFSPRING HAS BEEN
STUDIED BUT I DON'T KNOW IF
PEOPLE HAVE FOUND THE SAME KIDS
AND BEEN ABLE TO LOOK AT--I
ASSUME THEY'RE TALKING ABOUT
SENIOR YEAR IN HIGH SCHOOL AND I
THINK THAT COVID AND LOCK DOWN
WERE--HAD SUCH A HUGE IMPACT AT
EVERY LEVEL, I THINK FAMILIES
WITH LITTLE KIDS AND FAMILIES
WITH LITTLE KIDS WERE THE
MOST--HAD SO MUCH GOING ONA BUT
I ALSO THINK ADOLESCENCE WHO
WERE NOT ABLE TO HAVE A LOT OF
THESE DEVELOPMENTAL MILESTONES
AND SOCIAL MILESTONES THAT ARE
PART OF HIGH SCHOOL AND MIDDLE
SCHOOL, IT'S GOING TO--IT'LL BE
INTERESTING, WE WILL HAVE TO SEE
SORT OF HO YOU THAT UNFOLDS AND
HOW THAT IMPACTS THEIR
DEVELOPMENT BUT I DON'T OFFHAND
KNOW OF A STUDY OF WOMEN WHO
WERE EXPOSED DURING 9/11 AND
WHAT'S HAPPENING WITH THOSE
CHILDREN.
IN TERMS OF INFANTS WHO WERE
EXPOSED AND WHOSE MOTHERS WERE
EXPOSED--PREGNANT DURING THE
PANDEMIC, SOME OF THE
BEHAVIORIAL OUTCOMES HAVE BEEN
REALLY INTERESTING THAT IT'S
ACTUALLY APPEARS TO BE THE
EFFECTS ON BEHAVIORIAL WERE MUCH
MORE DUE TO LOCK DOWN AND SORT
OF A STRESS THAT NECESSARILY
WHETHER THE MOTHER HAD COVID OR
NOT SO THAT--ONCE AGAIN THE
WHOLE CONTEXT OF IT IS SORT OF
THIS WHOLE ALL THE DIFFERENT
EXPOSURES THAT ALL THE WOMEN
HAVE THAT HAD AN IMPACT ON THEIR
OFFSPRING WHICH AGAIN GIVE HOPE
THAT EVEN IN THE FACE OF THIS,
INFECTIOUS, THING WITH WHICH WE
KNOW CAN IMPACT THE DELIVERY AND
THE MEDICAL ASPECTS OF MEG
FRANCEY BUT IN TERMS OF CHILD
OUTCOMES AND BEHAVIOR, IT SEEMS
TO BE IN ITS CONTEXT THAT THE
CONTEXT OF WHETHER OR NOT THE
MOTHER HAD COVID WAS LESS
CRITICAL THAN SORT OF THE LOCK
DOWN AND ALL THE STRESS
ASSOCIATED WITH THAT.
>>THANK YOU: THAT IS
DEFINITELY AN INTERESTING
QUESTION, MOVING TO OUR NEXT
QUESTION, WE HEARD FROM SOMEBODY
WHO SAID SOME OF THE POSTNATAL
DIFFERENCES BE IT RELATED TO
ONGOING ENVIRONMENT, AND WHAT
ABOUT BABIES ADOPTED AT BIRTH
WHO ARE NO LONGER EXPOSED TO
ENVIRONMENTAL STRESSORS?
WHAT MIGHT YOU HAVE AS THOUGHTS
THERE FOR THAT QUESTION?
>>YEAH, I MEAN, I THINK AGAIN
IT'S A BALANCE THAT PREGNANCY
AND FETAL DEVELOPMENT IS A
SENSITIVE PERIOD, BUT THERE'S
THE REST OF KIDS LIVES FOR
PARENT CHILD RELATIONSHIP,
THERE'S A WHOLE YOU KNOW 18, 20
YEARS LATER OF PARENTING AND
LIFE EXPERIENCES THAT ALSO HAVE
AN IMPACT.
SO, I'VE EVEN HAD COLLEAGUES ASK
ABOUT ADOPTING A BABY WHO MIGHT
HAVE BEEN SUBSTANCE EXPOSED AND
AGAIN PATIENTING MATTERS SO MUCH
SO THERE MAY BE SOME SUBTLE
THINGS BUT THEY'RE SO MUCH MORE
EXAGGERATED IN THE CONTEXT OF A
SENSITIVE PARENTING WHICH AGAIN
IS AN AREA OF RESILIENCE AND
IT'S AN AREA THAT WE CAN
INTERVENE TO HELP IMPROVE
THINGS.
SO IT'S DEFINITELY THE POSTNATAL
ENVIRONMENT HAS A BIG IMPACT IN
ADDITION TO PRENATAL.
>>WE HAVE A QUESTION I THINK
FROM AN NIH COLLEAGUE THAT SAYS
WHEN YOU REFER TO PACES,
PROTECTIVE AND COMPETENCATORY
EXPERIENCES DO YOU ACTIVELY
DISTINGUISH BETWEEN PROTECTIVE
AND COMPENSATORY IN YOUR WORK
AND THEN THEY FOLLOW WITH
COMPENSATORY EXPERIENCES MAY NOT
LEAD TO THE SAME RESILIENCE
OUTCOMES AS PROTECTIVE
EXPERIENCES.
IS THERE DIFFERENTIATION THERE
YOU WOULD LIKE TO EXPLORE?
>>YEAH, I MEAN, I THINK AND
AGAIN, THIS IS--WE HAVE NOT YET
USE THE PACES APPROACH OR THAT
MEASURE, BUT I THINK THE IDEA IS
IERK DEALLY PROTECTIVE
EXPERIENCES MAY BE HAPPENING AT
THE SAME TIME.
WE'RE SORT OF PROTECTING
AGAINST, WELL, THE ADVERSE
CHILDHOOD EXPERIENCES WHILE
THEY'RE HAPPENING BUT
COMPENSATORY MAY BE AFTER, SO IF
WE NOTICE THAT A BABY HAS
CHANGES IN BEHAVIOR THAT WE'RE
TRYING TO DO AN INTERVENTION TO
HELP.
SO PROTECTIVE IT WE CAN PREVENT
THE THINGS THAT'S HAPPENING
THAT'S DEVELOPMENTAL
ENDOCRINOLOGILY IMPORTANT.
OT OTHER HAND COMPENSATORY
EXPOSURES AND EXPERIENCES ARE
REALLY IMPORTANT AND IT'S REALLY
NOT EVEN IN ADULTHOOD, THERE ARE
THINGS THAT PEOPLE CAN DO FOR
RESILIENCE EVEN IF THEY HAD A
HISTORY.
IT'S BETTER AND EASIER IF WE CAN
DO IT EARLIER AND HAVE SUCH A
BIGGER IMPACT IF WE CAN BUT I
THINK THAT'S A REALLY, A REALLY
IMPORTANT POINT.
>>THANK YOU.
AND SO WE HAVE A PERSON WHO ASS
ARE YOU REVIEWING THE BODY OF
RESEARCH ON THE EFFICACY OF
MUSIC THERAPY METHODS IN
DECREASING STRESS RESPONSES?
>>I'M NOT PERSONALLY REVIEWING
IT BUT I HAD A STUDENT WHO'S NOW
A FACULTY MEMBER AT VANDERBILT
WHO DOES A LOT OF THIS WORK AND
STARTED HER WORK IN THE NICU
WHERE THEY WERE PLAYING MUSIC
AND THERE'S PEOPLE ACTIVELY
STUDYING SORT OF THE IMPACT OF
MUSIC ON BABIES WHO ARE BORN
EARLY OR BABIES WHO ARE IN THE
NICU FOR OTHER REASONS, SO I
THINK MUSIC IS HUGELY IMPORTANT
AND THERE'S SOME ASPECTS AS KIDS
GET OLDER OF MUSIC WITH OTHERS
SO YOU GET THE SOCIAL ASPECTS OF
MUSIC, TOO, BUT I THINK THAT'S A
REALLY, REALLY IMPORTANT AREA OF
RESEARCH AND I NOTICED THAT
NCCIH HAS A GRANT OR 2 IN YOUR
PORTFOLIO, I BELIEVE 1 OF THEM
WAS WITH KIDS.
>>I BELIEVE SO.
OUR NEXT QUESTION, ARE YOU
MONITORING NUTRIFILL LYMPHOCYTE
RATIO OR OTHER
INFLAMMATORYOXIDATIVE STRESS
BIOMARKERS IN YOUR RESEARCH
COHORTS?
>>WE'VE COLLECTED, WE HAVE NOT
ANALYZED IT, BUT THAT'S AN
IMPORTANT, IT'S PARTICULARLY
WHEN LOOKING AT PRENATAL
PROGRAMMING, INFLAMMATION
APPEARS TO BE HIGHLY RELATED TO
INFANT OUTCOMES AND MAYBE MORE
OF A MEDIATOR THAN SORT SOL.
CORTISOL SEEMS TO HAVE ALMOST A
SEPARATE EFFECT ON INFANT
OUTCOMES AND STRESS AND IT MAY
NOT BE THE WAY THAT STRESS IS
MEDIATED LEADING TO BEHAVIORIAL
DIFFERENCES.
BUT THAT'S ANOTHER REALLY
IMPORTANT AREA.
>>GREAT.
OUR NEXT QUESTION COMES FROM
SOMEONE WHO WORKS IN EARLY
RELATIONAL HEALTH RESEARCH IN
THE NICU ENVIRONMENT AS A
NEUROPROTECTIVE INTERVENTION FOR
INFANTS AND TRAUMA DISRUPTION
FOR MOTHERS AND INFANTS.
SO MANY FACTORS THAT LEAD TO
INFANT STRESS IN UTERO INCLUDING
SUBSTANCE ABUSE AND
ENVIRONMENTAL STRESSORS, ALSO
LEAD TO NICU STATES AND THEN
THEY ASKED THE PRINCIPAL
QUESTION, DO YOU HAVE ANY PLANS
TO EXPAND RESEARCH INTO THE NICU
ENVIRONMENT?
>>MH-HMM.
>>YOU'RE FINE, WE CAN HEAR YOU.
>>OKAY.
CAN YOU SEE ME?
>>YES.
>>OKAY.
OKAY, MY CAMERA WENT BRACK FOR
SOME REASON.
YEAH, YEAH, THE NICU IS SUCH AN
IMPORTANT AND INTERESTING
ENVIRONMENT AND ANOTHER SORT OF
SENSITIVE HIGH STRESS PERIOD
WHERE SMALL CHANGES CAN HAVE A
REALLY BIG IMPACT AGAIN, THERE'S
MUSIC RESEARCH AND OTHERS SO,
AND THERE'S WAYS TO GET--BECAUSE
BABIES WHO ARE BORN SMALL OR
PREMATURE HAVE MUCH LESS SALIVA,
THERE'S WAYS TO GET SALIVA FROM
BABIES AT THAT AGE, SO IT'S A
REALLY IMPORTANT AREA AND AS WE
KNOW, PARTICULARLY SMOKING AND
PREGNANCY BUT ALSO MARIJUANA
SUBSTANCES LEAD TO BABIES BORN
SMALL OR EARLY, SO AND WE CAN
HAVE A LARGE IMPACT.
OUR HOSPITAL, THE WOMEN AND
INFANTS HOSPITAL IN PROVIDENCE,
A NUMBER OF YEARS BACK, STARTED
TO HAVE A NICU WITH SINGLE ROOMS
FOR MOTHERS AND INSTEAD OF A
LARGE ROOM WITH BELLS RINGING
AND LOUD NOISES AND THERE'S BEEN
RESEARCH THAT THAT ENVIRONMENT,
THAT SOME OF THE EEVENGHTS OF
PREMATURITY MAY BE ACTUALLY SORT
IN THIS LOUD STRESSFUL NICU
ENVIRONMENT.
SO THERE'S SOME WORK THAT WAS
DONE HERE WHEN THEY SWITCHED
FROM A LARGE SINGLE ROOM NICU TO
HAVING INDIVIDUAL PLACES FOR
MOMS AND HAVING SORT OF A MUCH
MORE FAMILY CENTERED NICU.
SO THAT'S ANOTHER GREAT AREA OF
RESEARCH THEY WOULD LOVE TO DO.
>>SO WE HAVE JUST A COUPLE MORE
QUESTIONS HERE AND THEN WE WILL
TRY TO GET TO BOTH OF THESE AND
THEN WE WILL PROBABLY WIND
THINGS DOWN FOR THE Q&A.
SO THE 1 QUESTION WE HAVE HERE
IS HOW DO YOU IDENTIFY LINKS
BETWEEN YOUR CHANGES IN FETAL
BEHAVIOR AND LATER TWEPMENTAL
OUTCOMES, GIVEN THE FINDINGS ON
MARIJUANA USE, DO YOU FEEL
THERE'S URGENT NEED FOR PUBLIC
EDUCATION, CAMPAIGN ON THIS,
GIVEN INCREASING NEWS.
THOUGHTS THERE?
>>YES, YES, DEFINITELY, YES,
THERE HAS--THERE HAS BEEN
STUDIES LIKE IN FETAL BEHAVIOR,
ALL THE WAY TO CHILD
DEVELOPMENT, MANY MORE WITH
FETAL BEHAVIOR, LEADING TO
INFANT BEHAVIOR AND WE KNOW THAT
INFANT BEHAVIOR, LEADS TO CHILD
BEHAVIOR SO IT'S LIKELY THAT
IT'S SORT OF THIS LONG-TERM
PERSPECTIVE LINKS.
THE QUESTION ABOUT MARIJUANA USE
IS REALLY IMPORTANT I THINK AND
IT'S A SIMILAR ISSUE WITH
E-CIGARETTE USE, SO, PEOPLE
PERCEIVE BECAUSE MARIJUANA HAS
BEEN LEGALIZED I THINK THERE'S
THE PERCEPTION THAT LEGALIZATION
MEANINGS SAFETY AND I THINK
THERE'S A PERCEPTION BOTH WITH
ROUGH ATOM VIEDERS AND WITH
WOMEN WHO ARE USING THAT THIS
MAY BE HELPFUL FOR--THAT THIS
MAY NOT BE HARMFUL TO INFANTS
AND I THINK THERE'S BEEN MORE
EDUCATION, ACOG HAS PUT OUT
STATEMENTS AND PEDEIATE RICKS
HAS PUT OUT STATEMENTS, BUT I
THINK THERE DEFINITELY NEEDS TO
BE LARGER EDUCATION CAMPAIGN AND
I THINK THAT THE WAY THAT
MARIJUANA SORT OF CAME ABOUT
HERE IS THROUGH THIS
MEDICALIZATION.
ONE THING WE FOUND IN WORKING
WITH MOMS WHO USE MARIJUANA IN
PREGNANCY IS THAT FOR SMOKING
THEY WILL TALK ABOUT USING IT
BECAUSE THEY'RE STRESSED OR
ADDICTED.
WE OFTEN SEE REASONS FOR USE ARE
FOR ANXIETY, PAIN, CAN'T SLEEP,
SO IT'S USED FOR MEDICAL REASONS
DESPITE WOMEN NOT NECESSARILY
HAVING A MEDICAL CARD TO GET
MARIJUANA.
BUT IT'S SEEN AS SOMETHING THAT
COULD BE USED FOR MEDICAL
REASONS AND LESS THOUGHT ABOUT
SORT OF WHAT HAPPENS WITH INFANT
OUTCOMES.
THE OTHER THING IS, UNLIKE
THINGS LIKE OPIATES AND EVEN
TOBACCO, THERE'S LESS OF AN
INFANT SORT OF WITHDRAWALS
SYNDROME AT BIRTH WITH MARIJUANA
SO I THINK IT DOESN'T GET SORT
OF IN THE NEWS AS MUCH AS SOME
OTHER DRUG WHERE BABIES ARE BORN
LOOKING DIFFERENT.
ALTHOUGH, THERE--IT IS APPARENT
THAT THERE ARE EFFECTS ON LOW
BIRTH WEIGHT AND PREMATURITY AND
SOME OF THE SAME THINGS WE SEE
WITH TOBACCO.
I THINK THE OTHER THING, I CAN
GO ON FOR THIS FOR A WHILE, I
THINK THE OTHER THING RELATED TO
MARIJUANA IS IT IS SO OFTEN CO
USED WITH TOBACCO AND WE ALREADY
KNOW THAT TOBACCO CAUSES SO MANY
MEDICAL ISSUES.
FOR BOTH MOM AND BABY.
>>THERE'S DEFINITELY MORE TO
DIG INTO THERE.
AND OUR FINAL QUESTION AND THEN
WE HAVE I THINK A NICE COMMENT
THAT WE CAN CONCLUDE WITH, BUT
OUR FINAL QUESTION IS WHAT
STUDIES ARE YOU AWARE OF THAT
EXPLORE THE LINK IF ANY BETWEEN
PATERNAL SUBSTANCE USE, OR
MATERNAL NONCARRYING PARENT IN
THE SAME SEX RELATIONSHIP AND
INDIVIDUAL OR GENERATIONAL
EFFECTS ON RESILIENCE.
SO THE PARTNER IN SUBSTANCE USE?
>>THAT'S SUCH AN IMPORTANT
POINT.
WITH SOME OF THE SMOKING STUDIES
OFTEN, IT WILL IN ORDER TO SHOW
THAT IT'S THE EFFECT OF
PREGNANCY SMOKING, THEY WILL
LOOK AT DAD SMOKING DURING THE
SAME PERIOD OF TIME AS SORT OF A
CONTROL AND TYPICALLY DON'T FIND
EFFECTS, IT'S INTERESTING,
THERE'S BEEN ANIMAL STUDIES WITH
THC, THE ACTIVE INGREDIENT IN
CANNABIS WHERE EVEN ADOLESCENT
USE IS THEN TRANSMITTED TO--SO
USE IN ADOLESCENCE PRIOR TO
PREGNANCY OR CONCEPTION, IS
STILL LINKED TO
TRANSGENERATEDDATIONAL
TRANSMISSION, I THINK THERE'S
LESS SEEN OF THAT.
THERE'S NOT EVIDENCE SO MUCH OF
THAT IN HUMANS BUT I THINK
LOOKING AT SUBSTANCE USE IN
PARTNERS, PARTICULARLY AFFECTS
OF SECOND HAND SMOKE AND USE OF
SUBSTANCES PRIOR TO--WE KNOW
THAT SORT OF IT'S THIS LONG-TERM
CUMULATIVE EFFECT THAT SUBSTANCE
IS NOT STRESSED OVER THE
LIFETIME THAT MAY IMPACT THE
NEXT GENERATION, SO FATHER
SUBSTANCE USE IS DEFINITELY
IMPORTANT AND SOMETHING TO BE
LOOKED AT.
BUT, SO FAR, IT DOES NOT SEEM
TO--THERE'S NOT AS MUCH EVIDENCE
FOR TRANSGENERATIONAL, AS WITH
ANIMAL MODELS.
>>WELL, THANK YOU SO MUCH
DR. STROUD.
I WANT TO SHARE THIS FINAL
COMMENT WE HAVE FROM 1 OF OUR
VIEWERS THAT THEY JUST WANT TO
SEND APPRECIATION TO YOU
DR. STROUD FOR YOUR UPLIFTING
MESSAGE REGARDING NO NEED TO
THROW STIGMA INTO THE MIX AND
ALSO YOUR COMMENTS REGARDING THE
IMPORTANCE OF PARENTAL INFLUENCE
OVERCOMING ADVERSITY.
SO, THANK YOU SO MUCH FOR SUCH A
WONDERFUL TALK AND I THINK AT
THIS POINT IN TIME, HELENE, ANY
FINAL THOUGHTSAs WE BRING IT
TO CONCLUSION TODAY?
DAVID?
>>WELL I WANT TO THANK YOU
AGAIN.
IT'S INSPIRATIONAL WORK AND I
REALLY SO MUCH APPRECIATE YOU
GIVING THIS WONDERFUL SNAPSHOT
OF ALL THE PROJECTS THAT ARE
HAPPENING WITH YOUR TRAINEES,
SOUNDS LIKE IT'S JUST AN
INCREDIBLE GROUP OF TRAINEES AND
IT'S LOVELY TO SEE HOW A GRANT
SUCH AS THE CORI GRANT IS ABLE
TO REALLY ACCELERATE THAT.
JUST THE MODEL OF WHAT THIS TYPE
OF PROGRAM, ATTEMPTS TO DO, SO
BRAVO TO YOU TO DO SUCH GOOD
WORK WITH IT.
>>BRAVO TO ALL THE EARLY CAREER
FOLKS THAT ARE DOING THE AMAZING
WORK BUT IT IS THE MOST FUN PART
OF HAVING THE COBRE, IN A SMALL
WAY WE GET TO BE NIH AND GIVE
GRANTS TO EARLY CAREER
INVESTIGATORS AND IT'S JUST SUCH
A PLEASURE TO SEE ALL THE
EXCITING IDEAS THAT I COME UP
WITH AND BEING ABLE TO GIVE THEM
SEED FUNDING THAT WILL HOPEFULLY
LEAD THEM TO APPLY FOR FULL RO-1
FUNDING SO THE COBRE CAN'T SAY
ENOUGH GOOD THINGS ABOUT THAT
MECHANISM FOR EARLY CAREER
FACULTY AND THE T FOR TRAINEES.
>>WELL THAT IS FANTASTIC, THANK
YOU SO MUCH DR. STROUD AND THANK
YOU EVERYONE WHO JOINED US ON
VIDEOCAST OR FACEBOOK LIVE.
DO BE AWARE THAT WE DID HAVE
THIS RECORDED AND IT WILL BE
ARCHIVED FOR FUTURE VIEWING ON
THE NIH VIDEOCAST WEBSITE,
PROBABLY IN A FEW DAYS AND SO,
THANK YOU AND HAVE A WONDERFUL
AFTERNOON WHEREVER YOU MAY BE
AND THANKS FOR JOINING US TODAY
AND THANK YOU AGAIN, DR. STROUD
AND WITH THAT I WILL END OUR
TRANSMISSION.
HAVE A GOOD DAY EVERYONE.
BYE-BYE.