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Ask an expert: Are children mentally rebounding back to a sense of normalcy?

With kids heading back to class and schools facing a new normal, there's a lot to consider about life post-pandemic, especially when it comes to America's children. Recently, we sat down with Augusta University's Dr. Dale Peeples, a child and adolescent psychiatrist who treats young patients and educates parents on psychological disorders such as anxiety, ADHD and depression. Throughout the pandemic, Peeples has also been the go-to psychiatrist for media and parents, providing tips to maintain mental wellbeing. Q: Are children mentally rebounding or adjusting back to a sense of normalcy? I think we are seeing an impact from the pandemic that’s continued even though life is getting much closer to what we consider normal. The impact with kids largely focuses on school, both through education and through those social interactions. I still see kids who are struggling to make up for things after falling behind during the pandemic and struggling to work back to that classroom setting when they developed a little bit of anxiety for such extended periods. You also are seeing kids dealing with a lot of regret having missed out on life, on friendships and connections, and some kids have been really struggling with how to deal with a bunch of people again. Q: Is there a certain age group that you’ve seen that may be struggling more than others? I think the older kids are, because when they were going through this, the more impact it had. A couple of reasons for that: Peer relationships become a lot more important as you become a teenager as compared to when you are little bit younger. Also, school becomes more demanding and sometimes that catch-up on work that was missed is going to be a little more challenging than younger grades. Q: What would your advice be to parents to help their children mentally in these increasingly challenging times, specifically as we begin the new school year? Communication, obviously, is still ideal. Families want to make sure that they are still getting together, having dinner as a family, discussing how the children's day went, so parents are in the loop about what kids are dealing with, trying to maintain that open line of communication. Parents also want to kind of generally be on the lookout for symptoms of depression. Obviously that's the changes in mood, feeling sad, feeling down, but also when kids kind of socially withdrawal and they lock themselves in their rooms and they don't want to go out, be around other people, do things they enjoy. When you see grades begin to decline, those are warning signs that there might be a little bit more going on here. Q: What can children do to help themselves and make sure they feel heard? Any time I'm sitting down with a patient for the first time and we're talking about treatment options, we'll talk about medication sometimes. We generally talk about talk therapy, behavioral and cognitive interventions. They also always talk about lifestyle interventions, healthy lifestyle, and there is a ton there that people can really do to make a big difference. The biggest thing I see kids struggle with, honestly, is sleep. Sleep has a huge impact on mood and anxiety and getting proper sleep is really tough in this day and age, when you've got cell phone notifications going off around the clock. Q: We know kids are resilient. Those who have struggled the most over the last two years, can they turn the corner and get better? Absolutely, I 100% agree that the kids are resilient. I'd say almost always, I share that optimistic attitude that if they have a hard time, they're going to get better. Sometimes it's just putting out the safety guards to support them and make sure that they keep on that right track. Q: Unfortunately, school shootings are again in the news and seem to be on the rise in recent years. Are you seeing more concern and stress for children or maybe even from their parents as it relates to safety in school? I try to remind my patients that part of the reason they get a lot of national attention is because they're infrequent and they're rare. So part of it is parents kind of controlling media for younger kids. Teenagers, obviously, they understand what's going on, and it's going to be a little bit harder for parents to monitor the media, but having those open dinner table discussions can let parents know when their kids are having worries.  This is an important topic, especially as students are heading back to school and beginning a fresh start to a new academic year. If you're a reporter looking to cover this topic, then let us help. Dr. Dale Peeples is available to speak with media. Simply click on his icon now to arrange an interview today.

Need a deeper understanding of retirement living? Let our experts help with your questions.

There's much consider when looking to make the monumental step toward retirement living. There's an entire industry out there devoted to the topic, with a multitude of options to consider. Considering the costs, your budget, future healthcare needs, and contract types, choosing a retirement community can be overwhelming. CARF can help you, or members of your family, navigate the system. Continuing Care Retirement Communities, or Life Plan Communities (CCRCs), present a number of contract offerings to consider as well. CARF's recently updated flagship publication, the Consumer Guide to Life Plan Communities: Quality and Financial Viability, offers tools and resources to guide you through decision-making process for yourself or a loved one.   Take the time to review the options available to find out what is best for your specific situation or lifestyle. Below you can find a link to a list of CARF-accredited CCRCs, as well as our guide to selecting an assisting living program. If you're a reporter or researcher looking to know more, then let our experts help with your questions or coverage. Terrence Carolan is the Managing Director of Medical Rehabilitation and Aging Services at CARF International. To arrange a time to chat with or interview Terrence, simply click on his icon now and book some time today.

What does back to school look like this year? Augusta University expert talks challenges

Students will be back at the bus stop with school starting soon, but what can parents expect as their children return to the classroom after the effects of the pandemic years? Dr. Stacie Pettit, associate professor in the College of Education and Human Development at Augusta University, said not being in the classroom full-time has had an impact. Pettit said it’s documented that reading scores are down and many students were unaccounted for during at-home learning. But students also developed other skills during this period of time. “On one hand, you can’t completely make up for learning loss,” said Pettit. “Teachers just need to assess where students are and both students and teachers do the best you can from this point. On the other hand, students didn’t just stop learning altogether. There are important life and family skills that were gained during quarantine and the months after. I believe we should look at students from 'funds of knowledge' perspective rather than a deficit lens in order to recognize the cultural resources that a student’s household contains.” She added some students did become isolated and will need to relearn social skills, but many found a lively community online through social media during the pandemic. Pettit also pointed out students are resilient, as well as teachers. They didn’t stop teaching, but rather found new skills in instruction to make learning accessible in the new reality. There are some challenges going back to in-person instruction after the last couple of years. “Overcoming fear they’ve picked up through other people and the news,” she added. “”Feeling uncomfortable with their faces exposed after getting used to hiding behind a mask and dealing with germ phobia. Students also have the additional challenge of another recent school shooting in Uvalde, so not only are they getting used to being back in school full-time, but they also have safety concerns.” Pettit added there are still a few groups of students who could struggle being back in the classroom full-time. “Certainly kids who missed kindergarten. Students from foster care. Students in special education who didn’t have the support they needed during at home learning.” If you're a journalist covering education or are looking to line up your back-to-school stories this year, then let us help. Pettit is a respected leader in middle level teacher education and meeting the needs of marginalized young adolescents. She's available to speak with media - simply click on her icon now to arrange an interview today.

Assessing and Treating Heat-Related Illness in Children

Dangerously high global temperatures require an abundance of caution and preparation, especially when it comes to protecting the littlest members of society. Villanova University associate professor of nursing Michelle Kelly, PhD, CRNP, CNE, is an expert in pediatric healthcare, and she recently shared some tips for preventing and treating heat-related illness in children. Q: First, what is heat exhaustion? Dr. Kelly: Heat exhaustion is a slowly progressing condition that begins as one is exposed to increased temperatures for extended periods of time without the proper precautions. Ultimately, heat exhaustion can become heatstroke, which always requires immediate intervention. Q: What are the signs of heat exhaustion? DK: Signs of heat exhaustion include increased thirst, nausea, vomiting, irritability, headache, increased sweating, fainting, weakness, extreme tiredness and muscle cramps. The child will have cool and clammy feeling skin, with an elevated body temperature, but it will be below 105 degrees Fahrenheit (40.5 degrees Celsius). Q: When does heat exhaustion become heatstroke? DK: With heatstroke, the above symptoms progress to severe headache, weakness, dizziness, confusion, fast breathing and increased heart rate. The child will feel flushed—hot, with dry skin, little to no sweating—and may pass out or have a seizure, due to the body temperature exceeding 105 degrees Fahrenheit. This child needs immediate intervention aimed at decreasing the child’s body temperature. Q: What should caregivers do when a child experiences heat-related illness? DK: Interventions that a family can begin while getting the child emergency treatment include getting the child to lie down with feet elevated indoors or in shade. Remove excess clothing. Apply lukewarm water to the skin either with a wet cloth or spray bottle. If the child is awake, give sips of cool clear fluids. If the child is vomiting, keep the child on their side to prevent choking. Emergency treatment will include continuing to decrease the child’s body temperature, giving fluids (by mouth or with intravenous fluids), and monitoring for seizures. Q: Any tips for prevention? DK: Plan ahead if you and your children will be outside during this extreme heat. Wear light colors and plan for some sort of shade if possible. Try to arrange outdoor activities to take place in the early morning or evening, not during the heat of the day. Or better yet, spend time in a pool or indoors in air conditioning. If your child will be participating in sports during a heatwave, start hydrating 24 hours before to prevent the risk of dehydration. This means making sure they have had adequate fluids before competing, during the competition and afterward to recover. Water is the best liquid, but an alternative would be low-sugar-containing electrolyte solutions designed for children (such as Pedialyte). Stay safe!

MEDIA RELEASE: Ten travel tips Ontarians should consider before flying this summer

CAA South Central Ontario (CAA SCO) has compiled a list of ten things that Ontarians should be aware of if they are considering travelling this summer – both inside and outside the country. “Those who are considering booking a trip should make sure they understand the scope of what travel looks like at the moment,” said Nadia Matos, manager external communications, CAA SCO. “The checklist for planning a trip has changed and we want to help people navigate this new environment. “Airports are experiencing delays with varying degrees of impact, and Ontarians should be prepared.” Through consultation with its top travel agents, CAA SCO has identified ten key considerations that potential travelers may not be aware of. Anyone who is considering travel in the current environment should remember that travel requirements and regulations are continually changing. Expect itinerary changes. CAA SCO travel agents say our members are experiencing schedule changes for flights. Subscribe to the airline’s text message service to be immediately notified of any changes, and book connecting flights with more time in between than you normally would if available. A travel agent is also a valuable resource if this happens. Consider packing a carryon instead of checking luggage. Potential baggage delays mean that your luggage may not arrive with you or take extra time to be unloaded off the plane. If you bring a carryon, make sure it fits the size requirements for all the airlines you are flying on, and with any tour operators. When using a carryon to travel, you still need to follow the 3-1-1 rule: three ounces of liquid, gel, aerosol, cream or paste that fit in one quart-sized resealable bag. If you are checking luggage, make sure your carryon has your hygiene essentials, any medications, and a change of clothing. Expect longer wait times at the airport. The old standby of being at the airport one hour before takeoff for domestic flights and two hours before international flights no longer apply. CAA currently recommends arriving at the airport a minimum of two hours before domestic flight departures and at least three hours for international flights. Make sure all your documentation is in order before you book. Your passport should still be valid six months after your travel date, as this is required in several countries. Passports themselves are taking longer than usual to renew, so it should be done several months before you travel. Each destination has varying documentation requirements, so make sure you fully understand what information you need to have ready and in what format. Buy travel insurance and understand what is covered. Make sure you have $5 million in coverage for emergency medical situations and that illness related to COVID-19 is included. Understand your entitlements for situations like denied boarding in the event of a positive test, trip cancellation or delays, what luggage is covered and what isn’t. Car rentals need to be booked months in advance. High demand as well as a shortage of vehicles means a shortage of rental cars. Some rental agencies, particularly on the east and west coasts, are not allowing vehicles to be rented in one city and left in another. A travel agent can help you navigate this. COVID-19 is still a major consideration. Confirm the COVID-19 situation at destination prior to booking. Understand the risk level associated with travel to a particular destination by checking the Government of Canada Travel Advice and Advisories website. Individual travel advisories remain on a country-by-country basis. It is important that Ontarians understand the ongoing uncertainty associated with international travel, whether that be related to the continued community transmission of COVID-19, or state of health care systems in destinations hit hard by the pandemic. Canadians returning home must have all required documentation loaded onto the ArriveCAN App or website. Stay connected. It is important to have access to trusted, up-to-date information while travelling so you can monitor changing conditions and requirements and adapt accordingly. Bookmark the Global Affairs Canada website prior to departure and check it regularly while abroad. It is also a good idea to sign up for Registration of Canadians Abroad and stay in touch with a family or friend that has knowledge of your travel plans. Find these and more information at www.caasco.com/travel Confirm change and cancellation flexibility with your travel service provider. Many airlines and hotels have been providing more flexibility when it comes to refunds and changes to bookings. Make sure you understand any key dates related to cancellation and changes and whether you are entitled to a refund or a future travel voucher or credit at the time of booking. Be patient, be kind. Around the globe, airlines are dealing with staff shortages and luggage handling back-ups. Keep in mind that the staff at the airports are there to help you, and that things may take longer than usual.

'I knew the men murdered in the Amazon—and their alleged killer'

On June 5, 2022, Indigenous expert Bruno Pereira of Brazil and freelance reporter Dom Phillips of Britain went missing while working in a remote part of the Amazon. Since then, a suspect in the case has confessed to their murders. But the story hasn't ended there. As journalists and experts take a closer look, the plot behind the story has thickened with politics, Indigenous rights, and organized crime. Scott Wallace, an associate professor of journalism at the University of Connecticut and author of The Unconquered: In Search of the Amazon’s Last Uncontacted Tribes, has worked extensively in Brazil's Javari Valley. He shared his perspective -- as someone who knew the victims as well as the alleged perpetrator, with National Geographic: The increasingly brazen intruders are no longer small-time players with a net or rifle seeking to put a meal on the family table. Members of the Indigenous patrols say that more and more, poaching crews appear to be highly-capitalized ventures, backed by a shadowy network of outside investors with suspected links to the illicit drug trade. Their fishing boats feature high-horsepower motors, and they carry large quantities of fuel, expensive gill nets, ice, and hundreds of kilos of salt to preserve bushmeat and critically endangered pirarucu, one of the world’s largest freshwater fish. In a rare police action, officers in March intercepted fishermen leaving the reserve with two dozen endangered river turtles, 650 pounds of salted bushmeat, and nearly 900 pounds of salted pirarucu. The evident outlays of cash create both the ability and the imperative for fishermen such as Oliveira to head deeper into the Javari territory, stay there longer, and return with hefty payloads to settle their debts. Unconfirmed reports indicate that Oliveira may have owed a Peruvian financier nicknamed “Colombia” more than $15,000 because a load of his contraband had been intercepted by the Indigenous patrols. As intruders penetrate into the depths of the Javari, Indigenous leaders and their allies fear the growing likelihood of a conflagration involving the uncontacted nomads roaming the forest. “They’re definitely putting the isolados—the isolated ones—at risk,” says Orlando Possuelo, Sydney’s son, who is based in Atalia do Norte and has been working alongside Pereira in advising the Indigenous patrols for the past two years. Poachers are pillaging the animals the isolated groups depend on for survival. And uncontacted groups remain highly vulnerable to contagious diseases, for which they have little to no immunological defense. Finally, and perhaps most immediately, there’s the very real danger of violence. “These fishermen don’t hesitate to shoot,” Orlando says. “If they’re willing to kill outside the reserve, there’s no doubt the lives of the isolated ones are in danger.” An uncontacted Indigenous group would have no way to peacefully communicate with interlopers entering their territory. Their likely first response would be to attack, which could provoke a bloodbath when intruders respond to spears or arrows with far more lethal bullets, says Paulo Marubo. “Anyone knows what the results will be between those carrying firearms and those who do not have them.” The hope of averting that alarming possibility was what led Pereira to risk his life. “The greatest concern that I have is the advance of outsiders—be they for projects authorized by the government or illegal players like loggers, miners, and land-grabbers—into the territories of the isolados,” Pereira told me in a phone call in 2019 after he was ousted from heading the isolated tribes department. “At the same time, you have the crippling of FUNAI and the department to protect the isolated tribes. It’s a very dangerous mix.” Scott Wallace is a bestselling author, photojournalist and educator who covers the environment and vanishing cultures worldwide. Scott is available to speak to media - simply click on his icon now to arrange an interview today.

ChristianaCare Partners with PursueCare and SimpleTherapy to Bring Virtual Health Care to Higher Education Institutions

ChristianaCare is out to revolutionize health care. One of the country’s most dynamic health care systems, ChristianaCare is partnering with two leaders in medical and therapy services to provide comprehensive, integrated virtual health services 24/7 to colleges, universities and other institutions of higher education. Together with PursueCare and SimpleTherapy, ChristianaCare created a bundled health care product that combines general medical services from ChristianaCare’s Center for Virtual Health, mental health and addiction treatment programs from PursueCare and hyper-personalized musculoskeletal care from SimpleTherapy. ‘The future of health care is virtual’ “At ChristianaCare, we know that the future of health care is virtual,” said Sharon Anderson, MS, RN, FACHE, ChristianaCare’s chief virtual health officer and president of ChristianaCare’s Center for Virtual Health. “When college students are able to access medical, behavioral health and musculoskeletal services through their phone or laptop, from their dorm room or a private space on campus, they’ll be more likely to get help when they need it. This is about delivering care to students on their terms, so that they can be healthy and supported with high-quality care throughout their college experience.” Personalized virtual health solutions will be available to students at participating higher education institutions through a customized portal accessible from any computer or mobile device. Students will be able to access assessments, resources and virtual treatment via modules or telemedicine sessions with licensed providers. The offering provides students with unlimited, on-demand care from a multidisciplinary team solving for a multitude of conditions. “For college and university student health services and administrators, this partnership offers a powerful new way to provide comprehensive, affordable health solutions that benefit students,” Anderson said. “In a highly competitive recruiting environment, these solutions are easy to implement and can add tremendous value. We are excited to partner with colleges and universities to strengthen their student health programs by creating a comprehensive virtual care solution to meet their student’s health care needs.” Through a single digital portal, participating students can access internal and family medicine providers from ChristianaCare’s Center for Virtual Health. PursueCare’s Joint Commission-accredited mental health, psychiatric and medication-assisted treatment providers, and SimpleTherapy’s licensed physical therapists specializing in musculoskeletal care, acute or chronic pain management, and strength and mobility training can all be accessed through the portal. Students will also have the option of using PursueCareRx for their pharmacy needs. PursueCareRx is a competitively priced full-service pharmacy that accepts most major insurance and delivers directly to customers. “Young adults face an escalating mental health and substance use crisis,” said Nick Mercadante, founder, and CEO of PursueCare. “Colleges and universities are frequently unable to comprehensively serve the increased need, and research suggests substance use, mental health and suicide carry a significant social stigma. Our goal is to work collaboratively with campus health resources to bring a low-barrier solution students can access privately, any time, on their terms. Additionally, partnering with a world-class health system like ChristianaCare means we can help support whole-person care needs.” “Chronic musculoskeletal disorders have never been more prevalent and traditional care pathways are often ineffective and costly,” said Arpit Khemka, co-founder and CEO of SimpleTherapy. "SimpleTherapy removes barriers for students allowing them to take control of their musculoskeletal health, reducing their need for high-cost, high-risk services, such as surgery and opioids, to manage pain. This results in higher compliance rates and more successful outcomes." Customized and co-branded product The product is designed for colleges, universities and all other higher education institutions. For a flat fee, a school will be able to offer care that is customized and co-branded with school-specific content to be an extension of existing campus health services. It provides curated resources for rapid pre-assessment, on-demand chat and discreet, personalized access to care for students on or off-campus. The innovative patient portal aims to improve and strengthen how schools offer health care solutions to their student population while reducing any potential interruptions of academic and athletic pursuits by making it possible for students to conveniently access care from anywhere. In addition, the offering eliminates social stigma and other access obstacles for students who are at-risk or potentially at-risk, making it more likely that students will avail themselves of treatment options and remain in school. These services are currently licensed to operate in Delaware, New Jersey, Pennsylvania and Maryland. Applications for licenses are underway in other states. ChristianaCare has long been a trailblazer in virtual health. Among its achievements, during the COVID-19 pandemic, ChristianaCare developed a COVID-19 virtual monitoring program that helped 37 companies in 14 states safely reopen with daily symptom monitoring, testing and connections to care for more than 10,000 employees. It’s Center for Virtual Health makes receiving care radically convenient, offering a full continuum of virtual care delivery programs. These programs include virtual primary care, specialty care programs and a Hospital Care at Home Program bringing hospital level of care to a patient’s home. The Center for Virtual Health cares for thousands of patients using state-of-the-art virtual care capabilities supporting patients in receiving care anytime, anyplace, including in the comfort of their own homes. For more information about the program, visit StudentCareSolutions.com.

ChristianaCare Launches Gender Wellness Program for Transgender and Gender Diverse Individuals

Pride Month announcement highlights need for quality health care for LGBTQ+ community ChristianaCare has opened a Gender Wellness Program to provide psychotherapy and support services for individuals age 13 and older who are exploring their gender identity or experiencing gender dysphoria—a sense of incongruence and distress that a person may have because of a mismatch between their gender identity and their sex affirmed at birth. Downloadable: PHOTOS VIDEO The program also provides treatment for any behavioral health condition the individual may be struggling with, such as anxiety and depression. People who identify as transgender have higher rates of suicide attempts than individuals who do not identify as transgender, according to the National Institutes of Health. “ChristianaCare aims to provide the safest, highest quality health care and the best experience possible for our entire community, guided by our values of love and excellence,” said Mustafa A. Mufti, M.D., interim chair of the ChristianaCare Department of Psychiatry. “Caring for our entire community means providing sensitive, compassionate, and state-of-the-art behavioral health and medical care to transgender and gender-diverse individuals. Our Gender Wellness Program will help improve health equity and outcomes for individuals and families who need these services. We know that transgender and gender-diverse individuals face health disparities, and our program will help address that.” The program follows the guidelines of the World Professional Association for Transgender Health (WPATH). WPATH promotes the highest standards of health care for the health of transsexual, transgender and gender-nonconforming people based on the best available science and expert professional consensus. “Our Gender Wellness Program is ready to support anyone age 13 or older who is exploring their gender identity, experiencing gender dysphoria or who needs education and support around social and medical transition,” said Brett E. Herb, DSW, LCSW, program manager of the Gender Wellness Program. Dr. Herb has been in clinical practice for more than 25 years as a psychotherapist and a clinical and administrative manager for numerous behavioral health programs, and has been working with the transgender and gender-diverse populations for the past 17 years. “We provide referrals to compassionate, gender-affirming health care experts,” Dr. Herb said. “Often, families find themselves having to educate their primary care providers, schools, neighbors and family members about how to appropriately care for gender-diverse individuals. Our program provides individuals and families with access to specially trained gender therapists they can trust who can get them the answers they need to help navigate the complexities they may encounter.” The Gender Wellness Program provides referrals to trans-competent primary care providers who prescribe gender-affirming hormone treatment, along with specialists for gynecological and obstetrics care. The program offers individual, couples, family and group therapy sessions. It also provides existing patients with assistance with personal documentation changes and letters of surgical support. “This program has provided me with tremendous support throughout my transition,” said Julie Brown of Wilmington, Delaware. “My therapist empathizes with what I am experiencing in my life, and has guided me through my evolution. The group therapy sessions help me understand that I am not alone. “We form a community, share information and support each other in a safe environment. My child is also a patient of the Gender Wellness Program. Their support has helped him deal with my changes and understand his gender dysphoria.” “Brett Herb and the Gender Wellness Program have helped me grow the confidence I needed,” said Kristopher Snedeker of Newark, Delaware. “Working with the professionals at the program has provided resources to help further my gender transition to become who I truly am.” Gender therapists at the Gender Wellness Program are: Brett E. Herb, DSW, LCSW, Program Manager. Amanda Pope Evans, MSW, LCSW. Katherine Goemaat-Suarez, MSW, LCSW. ChristianaCare is a national leader in LGBTQ+ health care. For the past 11 consecutive years, Christiana and Wilmington hospitals have been recognized by the Healthcare Equality Index as an LGBTQ+ Healthcare Equality Leader. Individuals who would like to learn more can contact the Gender Wellness Program at genderwellnessprogram@christianacare.org or call 302-623-6773. For more on ChristianaCare’s LGBTQ+ health initiatives, visit LGBTQ Health Initiatives.

UCI experts available to discuss Roe v. Wade ruling

With the Supreme Court set to rule on Roe v. Wade, UCI would like to provide experts you can reach out to for comment: • Michele Goodwin, Chancellor of Law at UCI’s School of Law, focuses on constitutional law, torts, health law, and feminist jurisprudence. An internationally renowned pioneer and pathbreaker, She has spoken often to media about reproductive rights issues and the Roe vs. Wade issue. Goodwin has helped to establish the field of health law and subspecialties in law and medicine, including biotechnology and biosciences and the law, as well as race and bioethics. Her scholarship has been cited by courts, congress, civil society organizations, and news media worldwide. If you are interested in speaking with Michele, you can reach her directly at (773) 543- 6160 or mgoodwin@law.uci.edu. • Aziza Ahmed, UCI professor of law, examines the intersection of law, politics, and science in the fields of constitutional law, criminal law, health law, and family law. Her work advances multiple scholarly conversations including those related to law and social movements, race and the law, and feminist legal theory. You can reach Aziza on her mobile at (510) 778-3031 or coordinate with our team for an interview. • Charles Anthony “Tony” Smith, UCI professor of political science and law, received his PhD from the University of California-San Diego and his JD from the University of Florida. His research is grounded in the American judiciary but encompasses work in both comparative and international frameworks using a variety of methodologies. The unifying theme of his research is how institutions, and the strategic interactions of political actors relate to the contestation over rights, law & courts, and democracy. He has published seven books and more than 30 articles on the history and politics of the Supreme Court. You can reach Tony via email casmith@uci.edu. • David Meyer, professor of sociology, political science, and planning, policy & design, can discuss the effect of the decision on political mobilization, especially the anti-abortion and abortion rights movements. He can also talk about those movements and the courts more generally. You can reach David via emaildmeyer@uci.edu.

Worth Longest research on more targeted aerosol drug delivery systems

Michael Hindle, Ph.D., a professor in the VCU Department of Pharmaceutics, and P. Worth Longest, a professor in the VCU Department of Mechanical and Nuclear Engineering, have invested years of time and millions of dollars to address challenges found in the field of medical aerosols. In particular: While smaller particles are more effective in delivering drugs into the lungs and airways, these tiny particles are often exhaled out immediately when taking a dose. Current aerosol delivery systems — think asthma inhalers — effectively deliver just 10 percent of an aerosolized dose. That’s fine for most asthma and COPD sufferers who use standard inhalers with existing medications, as these patients only need a small amount of the potent drugs to reach the lungs and have an effect. “But the medical world wants to use the lungs for delivery of other drugs, whether it’s locally to the airways or systemically to the body, and for that, you need more efficient devices,” Hindle says. To effectively use inhaled drugs for complex medical conditions requires more of the aerosol to reach the airways and to potentially target different regions of the airways — plus the devices to get them there. “Our work is about doing something different — changing that ballgame from having 90% of the drug wasted and 10% make it to the lungs, and flip it so that we get just 10% lost and 90% in the lungs,” Hindle says. “That’s always been our goal.” Taking aerosols from lab to lung Over more than a decade, the duo and their teams have created the three keys to making aerosol drug-delivery work: “developing the strategy, developing the device, and developing the formulation,” says Longest, the College of Engineering’s Louis S. and Ruth S. Harris Exceptional Scholar Professor. “When you see inhalation of aerosols fail, or a new pharmaceutical aerosol product fail, one of these areas has often been neglected. Between my lab and the Hindle lab, we have expertise in each of these different areas.” The fourth component — commercializing their inventions — is underway through a partner in Quench Medical in a deal signed in 2020 thanks to VCU Innovation Gateway. The Minnesota-based company, led by founder and CEO Bryce Beverlin II, Ph.D., has identified lung cancer, severe asthma, and cystic fibrosis as potential initial applications using VCU’s intellectual property, the licensing of which covers both the aerosols and the delivery devices. “It’s very difficult for an academic institution to develop a drug product,” says Hindle, the Peter R. Byron Distinguished Professor in Pharmaceutics. “So Bryce has moved forward with a team of manufacturers, clinical testing plans, and is talking to the Food and Drug Administration.” The VCU researchers had not previously pursued lung cancer as a possible application until Quench came along, Hindle says. “The idea that you could deliver a chemotherapy locally to the lungs is obviously very advantageous, because you don’t get the systemic side effects through the body like with traditional chemotherapy,” he says. “You’re just delivering drugs direct to that site of action for targeting the metastases in the lung.” In May, Quench presented data using the VCU technology to the Respiratory Drug Delivery conference in Florida showing that using a chemotherapeutic dry powder aerosol in rats was highly effective. It significantly reduced tumor burden but used half of the standard IV-delivered chemo dose. “This approach also aims to decrease the total drug delivered with reduced systemic drug levels in the circulation to decrease systemic toxicity,” the report read. It noted the efforts “solve a critical unmet medical need to develop new strategies to improve treatment outcomes in patients with lung cancer.” Heavy interest nationally Hindle and Longest have millions of dollars in funded projects underway, backed by the National Institutes of Health, U.S. Food & Drug Administration, and the Bill & Melinda Gates Foundation. Their work is building on the reputation of VCU’s Aerosol Research Group, founded in 1988 by emeritus professor Dr. Peter Byron (the name on Hindle’s professorship). The group’s work spans a wide variety of research areas in aerosol formulation and delivery. Hindle and Longest have worked together since 2006. While Hindle is focused on drug formulations, Longest is the engineering and computer modeling expert. His background is in biological fluid flow, and prior to joining VCU in 2004 had worked in the area of blood flow in vascular disease. But he wanted to differentiate his work, and found VCU’s reputation in medical aerosols was the place he could, in his words, “make an impact.” Through computer models, Longest and his team can understand how powders or liquids will turn into aerosol particles and the behaviors they will undertake when delivered into the body. “The lung is an area of the body where we have all these complex phenomena occurring with airflow and moving walls,’” he says. “It really takes high performance computers to understand it.” Drs. Longest and Hindle have developed a series of technology platforms that produce particles that are tiny when entering the lungs to minimize deposition losses in the mouth and throat — but grow in size as they travel down the warm, humid airways. One of the devices uses a mixer-heater to produce tiny particles, other technologies use a pharmaceutical powder or liquid containing a simple hygroscopic excipient such as sodium chloride; it is this excipient that attracts water from the lungs and makes the particles grow and deposit in the lungs with high efficiency. Eyes on infants Lately, the pair have been working on a method of aerosol drug delivery to newborns and prematurely born babies. “It’s a different set of challenges when you’re trying to deliver aerosols to infants who are born prematurely, and don’t have the ability to breathe on their own due to the lack of airway surfactant,” Hindle says. “And that’s something that, academically, we thought we were in a position to try and make a contribution to the field.” The group is working with funding from the NIH and the Bill and Melinda Gates Foundation to develop a method of delivering an aerosol surfactant to infants that will hopefully remove the need to intubate these fragile babies. In addition to striking licensing deals with Quench and building relationships with additional partners, Innovation Gateway has backed the pair’s work with an initial $25,000 from VCU’s Commercialization Fund as well as a just-awarded additional $35,000. “We turned that into a series of intellectual property that has resulted in three licensed patents and a whole family of IP in relation to both formulations and devices,” Hindle says. “There’s been lots of interest in delivering drugs to the lungs, it’s just been very difficult to institute any sea change, because the pharmaceutical industry is relatively risk averse.” And so their research continues, as Quench moves forward to bring their inventions to the bedside. “What I’m doing, I don’t really consider it work — it’s an opportunity to interact with great colleagues and contribute to a mission that will be very helpful to a broad range of people,” Longest says. “I also see it as a big responsibility. We want to do this in the right way. Because people’s health and lives are at stake. We want to make sure we approach this with a large sense of responsibility, and do our best.”