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Five Tips to Choose Sustainable Fashion
Getty Images Fast Fashion is the most popular trend in retail fashion today. Fast Fashion isn’t a specific style but rather clothing produced quickly and cheaply to respond instantly to consumer demand. Low prices and popular online retailers allow people to purchase clothing more often but at a devastating cost to the environment. According to EarthDay.org, the fashion industry is one of the largest global polluters, creating 4% of all greenhouse gas emissions, 40 million tons of landfill waste and 35% of microplastics in the ocean. According to fashion expert Jay Yoo, Ph.D., associate professor of apparel merchandising in the Robbins College of Health and Human Sciences at Baylor University, consumers are learning more about the environmental impacts of fashion and searching for better options. Fashion expert Jay Yoo, Ph.D., associate professor of apparel merchandising in the Robbins College of Health and Human Sciences at Baylor University Fashion expert Jay Yoo, Ph.D. Yoo’s research shows that purchasing apparel products that help reduce negative impacts on the environment has emerged as a lifestyle. “Fashion-conscious consumers are ready and willing to forgo fast fashion for more sustainable options produced in an ecologically and socially responsible way,” said Yoo. Yoo recommends five ways you can use your purchasing power to support sustainable fashion. Choose natural fibers - organic cotton, linen or hemp. Avoid clothing that requires dry cleaning. Donate to and shop at resale stores. Purchase from retailers that are committed to sustainability. Encourage your friends to join you in supporting sustainable fashion. Although fashion is often understood to center on apparel choices, fashion impacts nearly every aspect of human lives, Yoo said, including health, social responsibility and environmental issues involving consumptive behaviors. His additional research interests include appearance-related behaviors and their implications for individual and social well-being from consumer perspectives, from body-tanning behaviors, body image and quality of life among cancer patients, retail therapy and mental health, and irrational shopping and extreme body modification.
Comprehensive Sleep Wellness Center Opens on Newark Campus
More than 70 million Americans suffer from sleep-related problems. To address this growing need, ChristianaCare has opened a new comprehensive sleep wellness center in the Medical Arts Pavilion II on the ChristianaCare Newark Campus. The ChristianaCare Sleep Wellness Center, accredited by the American Academy of Sleep Medicine, is an outpatient program that provides expert diagnosis and treatment of sleep disorders. The nearly 5,000 square foot, seven-bed facility builds on the success of ChristianaCare’s previous sleep diagnostic center, now incorporating clinical care and diagnostic testing at the same site. The center is staffed by board-certified sleep medicine specialists who provide in-lab and at-home sleep testing, as well as a behavioral health specialist who offers cognitive behavioral therapy for insomnia. The center offers onsite and virtual appointments. “At the ChristianaCare Sleep Wellness Center, we offer the full range of sleep care services in one place, with the expertise to help people with all kinds of sleep disorders,” said Shilpa Kauta, M.D., medical director of the ChristianaCare Sleep Wellness Center. “Sleep disorders affect members of every race, socioeconomic class and age group, but despite the high prevalence of sleep disorders, many people remain undiagnosed and untreated,” she said. National surveys show that more than 60 percent of adults have never been asked about the quality of their sleep by a physician. “It’s important for people to know that if they have problems related to sleeping, they should talk to their doctor about it, or call us at the Sleep Wellness Center. Sleep disorders can affect overall health—and they are often very treatable.” The Sleep Wellness Center provides expert, multidisciplinary diagnosis and care for every kind of sleep problem, including: Obstructive sleep apnea. Restless leg syndrome. Narcolepsy. Parasomnias, such as sleepwalking. As part of the ChristianaCare team, the expert staff at the Sleep Wellness Center coordinates with disease-based programs at ChristianaCare to integrate sleep services into cardiac care, weight loss surgery and renal transplant care. They also partner with surgeons to manage hypoglossal nerve stimulation therapy, a major advancement in obstructive sleep apnea treatment. Patients at the Sleep Wellness Center undergo a personal sleep history, medical background and physical examination. If appropriate, a polysomnography (sleep study) may be ordered to monitor and record brain waves, heart rate, blood oxygen level, breathing and eye movements. Poor Sleep Health is a National Problem According to the National Institutes of Health, of the 70 million Americans suffering from sleep-related problems, more than 50% are likely to have a chronic disorder, such as insomnia, obstructive sleep apnea, restless leg syndrome and narcolepsy. People who suffer from sleep disorders are also more likely to have chronic diseases like hypertension, diabetes, depression, obesity and even cancer. The impact on American life and economy is enormous as sleep deprivation and untreated sleep disorders are estimated to cost over $100 billion annually in lost productivity, medical expenses, sick leave, property and environmental damage. “With information collected through testing, our sleep experts can determine the source of a sleep problem and begin a treatment plan to help patients improve their quality of life,” Kauta said. The address and phone number of the new center: ChristianaCare Sleep Wellness Center 4735 Ogletown Stanton Rd. Suite 2210 Newark, DE 19713 302-623-0610
Discovery may lead to more precise treatments for advanced colorectal cancer Researchers at ChristianaCare’s Cawley Center for Translational Cancer Research at the Helen F. Graham Cancer Center & Research Institute have demonstrated for the first time that microRNA (miRNA) expression leads to a diversity of cancer stem cells within a colorectal cancer tumor. This diversity of cancer cells may explain why advanced colorectal cancer is difficult to treat. Study results have been in the Journal of Stem Cell Research and Therapy. The findings broaden the understanding of how miRNA expression adds to cancer stem cell diversity and may lead to more precise anti-cancer treatments for patients with advanced colorectal cancer. The research builds on prior discoveries by scientists at the Graham Cancer Center about how cancer stem cell activity contributes to the development and spread of colorectal cancer. “Our research shows — at least in the laboratory — that there are different subpopulations of cancer stem cells in a tumor, and they may be driving the growth of the cancer,” said Principal Investigator Bruce Boman, M.D., Ph.D., MSPH, FACP, medical director of Cancer Genetics and Stem Cell Biology at the Graham Cancer Center. “In one subpopulation of cancer stem cells, its miRNA will shut down the stem cell genes that are expressed in another subpopulation, and vice versa, within the same tumor.” From left: ChristianaCare researchers Lynn Opdenaker, Ph.D., Brian Osmond, Bruce Boman, M.D., Ph.D., Chi Zhang, Victoria Hunsu, Caroline Facey, Ph.D. Not pictured Victoria Stark, MS. The study focused on the composition of cancer stem cells within a colorectal cancer cell line (HT29) in the laboratory setting. Researchers evaluated the different cancer stem cell subpopulations that were identified by examining patterns of miRNA expression in each subpopulation and looking for differences. The researchers found that each of the four diverse subpopulations that were studied (ALDH, LRIG1, CD166 and LGR5) had a different miRNA expression or gene signature. The researchers found that miRNA expression could inhibit the expression of messenger RNA (mRNA), which carries instructions from the DNA to encode specific proteins within cells. Therefore, miRNA, by controlling gene expression, dictate which proteins are contained in the stem cells. The researchers discovered the miRNA that are upregulated in certain cancer stem cell subpopulations are downregulated in other cancer stem cell subpopulations. In this way, differential miRNA expression leads to cancer stem cell heterogeneity within colorectal tumor tissue. “It’s an early research finding and needs to be followed up with other experiments, but it has clear relevance to the clinic,” Boman said. “The question is: Can you target the miRNA to make cancer more sensitive to certain treatments? Because we know what the current anti-cancer treatments are targeting, we may be able to modulate or manipulate the cancer, so it becomes more sensitive to the treatment.” Identification of a network of genes regulated by microRNAs in a cancer stem cell subpopulation. For more than a decade, ChristianaCare’s researchers have contributed to the understanding of the role that cancer stem cells and miRNA expression play in the development and spread of colorectal cancer. This latest finding builds on earlier discoveries that examined a link between two cellular signaling pathways: retinoic acid (RA) signaling and wingless-related integration site (WNT) signaling, which are dysregulated by different gene mutations in colorectal tumors. The RA signaling pathway induces growth arrest and differentiation of cancer stem cells. Notably, retinoic acid is effective against other types of cancer such as leukemia. The role of the WNT signaling pathway has an opposite effect on tumor growth. The WNT signaling pathway is activated by a mutation in the APC (adenomatous polyposis coli) gene in about 90% of cases of colorectal cancer. In APC mutant tissue, dysregulated miRNA expression may underlie an imbalance between the RA and WNT signaling, which then leads to intratumoral cancer stem cell heterogeneity. Still, this mechanism that may enable the cancer to proliferate could also provide clues on how to more effectively treat cancer. “If you’ve got an imbalance between these two signaling pathways, then you’ve likely got a growth driver,” Boman said. “The question is: Can you suppress the WNT signaling and enhance the retinoic acid signaling?” It may be possible to increase the sensitivity of colorectal cancer to retinoic acid-type drugs, and therapeutically shift the balance between different cancer stem cell subpopulations, thereby suppressing cancer growth. More research is needed to determine how targeted cancer therapies containing retinoic acid-type drugs may be made more effective against advanced cancer. This research will be presented at the annual meeting of the American Association for Cancer Research in Orlando, Florida, April 14-19. This research project was supported by a grant from the Lisa Dean Moseley Foundation.
Protein engineer to explore route from DNA blueprint to synthetic antibodies – public lecture
Professor Anna Hine will explore how advances in protein engineering have enabled us to make both synthetic antibodies and their replacements Inaugural lecture will take place at Aston University on Tuesday 28 March 2023 at 6.30pm Members of the public may attend in person or online. Professor Anna Hine, a molecular biologist specialising in protein engineering in the College of Health and Life Sciences at Aston University, is to present her inaugural public lecture on Tuesday 28 March 2023. During her lecture, A route to synthetic antibodies (and their replacements), Professor Hine will take the audience from the basics of molecular biology to explaining her inventions in protein engineering, through to examining the ways in which her research is being applied internationally to develop synthetic antibodies. Professor Hine gained her PhD in molecular biology from The University of Manchester Institute of Science and Technology in 1992 and did her postdoctoral training at Harvard Medical School. She returned to the UK to take up a lectureship in molecular biology at Aston University in 1995. Professor Anna Hine, professor of protein engineering, said: “Antibodies are one of our major lines of defence against infection and we can create them very quickly to help incapacitate a multitude of biological invaders. Humans do this by changing the part of the antibody that recognises the invading pathogen, through a process of rapid, natural mutation. Protein engineers have learned to mimic this process in the laboratory to create synthetic proteins – particularly antibodies - for use in both therapy and fundamental research.” “I am delighted to have the opportunity to present our discoveries in a way that I hope will make just as much sense to non-scientists as to a scientific audience.” Similar to the natural mutation of antibodies, protein engineers can make vast numbers of tiny variations of a protein such as an antibody. Professor Hine added: “We will contemplate the vast numbers involved in protein engineering and present how our Aston University-based inventions have made the creation of DNA (and thus protein) ‘libraries’ as efficient as possible. “We will then examine the ensuing problem of how to find the few proteins that we really want from within a protein library. This includes collaborating with experts who specialise in computer-assisted library design and also working with those who have developed the latest methods to search the libraries that we make.” Professor Hine will also show how her latest collaborative projects are starting to move beyond the antibody itself. The lecture will take place at Aston University at 6.00pm for 6.30pm on Tuesday 28 March 2023. It will be followed by a drinks reception from 7.30 pm to 8.00 pm. The lecture is open to the public and free to attend. Places must be booked in advance via Eventbrite.
Cancer Program Earns Reaccreditation From the Commission on Cancer
Report cited zero deficiencies and highlights leadership, innovative programs and strong research program The Commission on Cancer, a quality program of the American College of Surgeons, has granted three-year reaccreditation to the cancer program at ChristianaCare’s Helen F. Graham Cancer Center & Research Institute, one of the original National Cancer Institute Community Cancer Centers Program sites in the U.S. ChristianaCare has received accreditation since 1951. To earn accreditation, a cancer program must meet 34 quality care standards, be evaluated every three years through a survey process and maintain levels of excellence in the delivery of comprehensive patient-centered care. The Commission cited zero deficiencies during its site visit and in its final report. “Earning this prestigious accreditation with no deficiencies cited is a testament to the unparalleled expertise and quality of care our entire team at the Graham Cancer Center provides to our patients and community across the continuum of cancer care,” said Nicholas Petrelli, M.D., Bank of America Endowed Medical Director of the Helen F. Graham Cancer Center & Research Institute. “Patients in the communities we are privileged to serve can be assured of groundbreaking cancer treatments, innovative technology, state-of-the-art research, prevention, education and the most caring, dedicated team anywhere.” “Innovative programs that address community need” The Graham Cancer Center was recognized in the reaccreditation report for taking a multidisciplinary approach to treating cancer as a complex group of diseases that requires consultation among surgeons, medical and radiation oncologists, diagnostic radiologists, pathologists and other cancer specialists. This multidisciplinary partnership results in exceptional patient care. In its performance report, the Commission on Cancer praised the Graham Cancer Center’s leadership that has built a “culture of continual process improvement across all areas from prevention, screening, treatment and support for the patient.” It highlighted “innovative programs that address community need,” such as its on-site primary care practice and its Oncology Express Unit, which offers urgent care for patients with advanced disease. The report also stated that the “research trial offerings are a strong point.” Clinical trials test new drugs and combinations of treatments, as well as new techniques using surgery, radiation therapy, gene therapy, immunotherapy and biologics. ChristianaCare is among the national leaders in cancer clinical trials; patient enrollment rates into clinical trials at the Graham Cancer Center are at 29% which is seven times the national average. A national standard for accreditation The Commission on Cancer accreditation program provides the framework for the Graham Cancer Center to improve its quality of patient care through various cancer-related programs that focus on the full spectrum of cancer care including prevention, early diagnosis, cancer staging, optimal treatment, rehabilitation, life-long follow-up for recurrent disease and end-of-life care. When patients receive care at a Commission on Cancer-accredited facility, they also have access to information on clinical trials and new treatments, genetic counseling and patient-centered services including psycho-social support, a patient navigation process and a survivorship care plan that documents the care each patient receives and seeks to improve cancer survivors’ quality of life. Like all Commission on Cancer-accredited facilities, the Graham Cancer Center maintains a cancer registry and contributes data to the National Cancer Database, a joint program of the Commission on Cancer and American Cancer Society. This nationwide oncology outcomes database is the largest clinical disease registry in the world. Data on all types of cancer is tracked and analyzed through the database and used to explore trends in cancer care. Cancer centers, in turn, have access to information derived from this type of data analysis, which is used to create national, regional and state benchmark reports. These reports help facilities with their quality improvement efforts. Established in 1922 by the American College of Surgeons, the Commission on Cancer is a consortium of professional organizations dedicated to improving patient outcomes and quality of life for patients with cancer through standard-setting, prevention, research, education and the monitoring of comprehensive, quality care. There are currently more than 1,500 Commission on Cancer-accredited programs in the U.S. and Puerto Rico that diagnose and treat more than 70% of all patients newly diagnosed with cancer.
For the first time in Delaware, and likely the nation, cancer specialists have co-authored a consensus statement and clinical pathway for the management of colon cancer that has spread to the peritoneum or abdominal wall. The statement has been published in the Jan. 10 online issue of Surgical Oncology. The statement aligns the state’s major health care providers on a standardized, evidence-based approach to the treatment of this kind of colon cancer. This will ensure patients throughout the state will receive optimal care and equitable access to the most appropriate treatment options and clinical trials. Medical and surgical oncologists from ChristianaCare’s Helen F. Graham Cancer Center & Research Institute, Tunnell Cancer Center at Beebe Healthcare and TidalHealth Allen Cancer Center prepared the statement entitled, “Consensus Statement and Clinical Pathway for the Management of Colon Cancer With Peritoneal Metastases in the State of Delaware.” The statement was published on behalf of the State of Delaware Peritoneal Surface Malignancies Task Force. “Consensus among cancer specialists on how to treat colon cancer patients with peritoneal malignancy will assure that these patients have access to the specialized treatment they need at an experienced cancer center right here in Delaware,” said co-author Nicholas J. Petrelli, M.D., Bank of America endowed medical director of the Helen F. Graham Cancer Center & Research Institute. “As cancer care providers, we know how important it is for patients to be close to home for their cancer care.” “Getting cancer physicians throughout the state to agree on who is eligible for treatment and the right sequence of therapies was no small task,” said lead author Jesus Esquivel, M.D., co-director of Beebe Healthcare’s Peritoneal Surface Malignancy Program. “Thanks to Dr. Petrelli’s leadership, coupled with the support of a very committed task force, we have been able to make this happen on a statewide level.” In about 10% to 20% of cases, colon cancer is found in the peritoneum, the lining of the abdomen that covers the abdominal organs. Historically, patients with peritoneal metastases have a worse prognosis. However, numerous studies show five-year survival rates for patients whose peritoneal cancer can be surgically removed approach the rates of those with successful surgery for metastatic liver disease. “We are looking at a complicated group of patients with advanced colon cancer and a generally poor prognosis, who historically have been treated in a non-uniform fashion despite medical evidence to suggest which therapies are most effective,” Esquivel said. Combining surgery and heated chemotherapy The Delaware pathway includes a combination treatment of surgery and heated chemotherapy, starting with cytoreductive surgery (CRS) to remove all visible cancer in the peritoneum. Hyperthermic Intraperitoneal Chemotherapy (HIPEC) with Mitomycin C is then delivered on the operating table for 90 minutes. Mounting clinical evidence shows this one-two punch can significantly extend survival in well-selected patients when compared with standard systemic chemotherapy. Currently, due to a steep learning curve, only about 120 hospitals in the U.S. have the necessary capability and expertise to perform these procedures. In Delaware, only ChristianaCare and Beebe Healthcare can offer patients CRS with HIPEC. Some patients who are not immediate candidates for surgery may benefit from systemic therapy (chemotherapy/immunotherapy) as a first-round treatment. Others on the pathway may be recommended for systemic therapy alone and potential participation in an appropriate clinical trial. Four-tier scoring system To help providers determine the best form of treatment for each individual patient, the Delaware pathway introduces the Peritoneal Surface Disease Severity Score (PSDSS). The scoring system uses four tiers of estimated disease severity based on a three-point scale that includes symptoms, extent of peritoneal dissemination and primary tumor histology. “With the Delaware pathway in place, our goal is to ensure that multidisciplinary evaluation begins at the time of diagnosis so that each patient is selected for the right sequence of currently available therapy depending the individual cancer,” Esquivel said. “Not only are we recommending a uniform treatment modality for patients, but our framework facilitates data reporting and evaluation that will add to the body of knowledge about this disease and how best to treat it.” Although there is plenty of medical evidence to suggest which therapies are most effective, until now, efforts by Esquivel and others to achieve consensus worldwide have not translated into a universally accepted clinical pathway for the management of this disease. Delaware is a unique launching pad for such a pathway. “As cancer care providers we know how important it is to work together on behalf of our patients,” said Petrelli. “Delaware is uniquely suited to this effort not only because of its size, but also because of the collaborative relationships we have built through groups like the Delaware Cancer Advisory Council and Consortium and most specifically for this effort, the Delaware Peritoneal Surface Malignancy Task Force.” The Delaware Health Information Network (DHIN) is another important resource to assist physician collaboration. Nearly 100% of the state’s medical providers are linked in. The DHIN launched in 2007 as the first operating statewide health information exchange in the country. “I don’t expect 100% of patients to be included in the pathway, but I see it as the best opportunity for patients to maximize benefits and minimize suffering or unnecessary treatment,” Esquivel said. “As a health care provider who treats patients with advanced cancer, I know that is the best one can hope for short of a cure. “With consensus on evidence-based clinical pathways, we can offer increasing numbers of patients the assurance that whether you live in northern or southern Delaware, you can rely on getting the best treatment available for your cancer.”
Award jointly given to President and CEO Dr. Janice Nevin and Chief Digital and Information Officer Randy Gaboriault ChristianaCare has earned the Transformational Leadership Award for excelling in its development and deployment of transformational information technology that improves the delivery of care and streamlines administrative services. Presented by the College of Healthcare Information Management Executives (CHIME) and the American Hospital Association, the award is jointly bestowed to Janice Nevin, M.D., MPH, ChristianaCare’s president and CEO, and Randy Gaboriault, MS, MBA, ChristianaCare’s chief digital and information officer and senior vice president. “Their trailblazing commitment to rapid transformation has set an example for the entire industry in how to pursue a leadership vision with determination, brilliant planning and courage to overcome all challenges,” said CHIME President and CEO Russell P. Branzell. Under the leadership of Nevin and Gaboriault, ChristianaCare has created and deployed new organizational, digital capabilities for both patient and caregiver. Using voice-enabled technology, ChristianaCare HomeHealth patients can interact with an internally developed Alexa capability to guide them through their personalized daily therapy regimens. Similarly, ChristianaCare recently launched the ability for in-house postpartum patients to use an Amazon Echo device to ask questions, request help or communicate with their care team. Taking voice and digital capabilities further, in February 2022, ChristianaCare deployed an innovative tool called Moxi, a collaborative robot – or “cobot” – that can assist in the hospital by making deliveries and performing other non-clinical tasks so that nurses and other clinical caregivers can spend more time focused on what they do best: caring for patients. “Randy is a phenomenal leader, with a relentless focus on creating a culture of innovation for impact, solving for the most complex problems and delivering significantly improved outcomes,” Nevin said. “His work has made ChristianaCare a model for how transformative technology can help to create health so that every person can flourish.” ChristianaCare continues to be recognized for leading innovation in the health care industry. The organization was recently recognized by CHIME’s Most Wired program with Performance Excellence Awards in its acute and ambulatory categories. That level is reserved only for organizations that are considered leaders in health care technology who “actively push the industry forward” and are “realizing meaningful outcomes, including improved quality of care, improved patient experience, reduced costs and broader patient access to healthcare services.” “Under Dr. Nevin’s extraordinary leadership, we have made an intentional commitment to placing technology at the center of all our initiatives to enable our caregivers to best serve our patients,” Gaboriault said. “That commitment, reinforced by our organization’s core behavior to continuously look for new ways to innovate, means that we are able to introduce and leverage robotic nursing assistants in a way that drives meaningful value for both patients and providers. And because our caregivers embrace change, we are confident that we will be using our cobots to assume more tasks in the future, and enable our nurses to devote even more of their precious time to direct patient care.”
Preterm Birth and Lifelong Health
November is Prematurity Awareness Month—a month that places a spotlight on the current state of maternal and infant health in the United States and globally. According to the nonprofit March of Dimes, one in 10 babies is born preterm each year in the U.S. But what does that mean, and why do we need to consider gestation period post-birth? We sat down with Michelle Kelly, PhD, CRNP, CNE, FAANP, associate professor of nursing at Villanova University's M. Louise Fitzpatrick College of Nursing, to discuss and explain the importance of preterm education for lifelong health. Q: To begin, what qualifies as preterm birth? Dr. Kelly: A full-term pregnancy lasts 40 weeks. Infants born before the completion of 37 weeks of gestation are preterm. And there are levels of prematurity: Extremely preterm: Infants born before the completion of 25 weeks of gestation. Very preterm: Infants born before the completion of 32 weeks of gestation. Moderately preterm: Infants born between 32-34 weeks of gestation. Late preterm: Infants born between 34-36 weeks of gestation. Q: Why do health practitioners need to be aware of gestation history? DK: Understanding the potential long-term physical and mental health implications is essential to mitigating the risks. Clinicians cannot change the reality that someone was born early. However, clinicians can utilize that information in treatment decisions. Instituting treatment or therapies early can help minimize the expression of that risk and improve future health. Q: What are the health risks for children born prematurely? DK: The earlier an infant is born, the greater the risk to their overall health and development. And while it is much better to be born at 35 weeks instead of 25 weeks, it does not mean that those born closer to term escape all risks. During infancy and childhood, a preterm birth can cause difficulty with breathing, feeding, gaining weight appropriately and achieving important developmental milestones. Research suggests that children and adolescents born at any level of prematurity are at risk for challenges in school, conditions that require physical or behavioral therapy as well as conditions typically associated with immature body systems, such as respiratory issues like asthma. Additionally, long-term follow-up studies indicate that risk continues into adolescence and adulthood. Q: What are some long-term issues that stem from being born preterm? DK: Adolescents and adults born preterm continue to be at risk for reduced lung function, wheezing and asthma. Research findings suggest that there are also cardiovascular risks, particularly an increased incidence of hypertension (high blood pressure). Additionally, an increased incidence of mental health conditions, specifically anxiety and depression, are associated with preterm birth. All these increased risks are modifiable with early recognition and treatment. Q: What recent research has been conducted and what strides have been made to improve the lives of those born preterm? Is the prognosis for those born preterm positive? DK: Today's NICU environment is vastly different from the NICU of the past. Premature babies born in the last 20 years have survival rates that exceed 95 percent for all but the earliest of gestational ages. Increased attention to developmentally supportive care, breastfeeding, kangaroo care and the recognized importance of family presence in the NICU is now the standard of care. Research and advocacy aimed at supporting families touched by prematurity and raising awareness of healthcare providers and K-12 educators are gaining international attention. While being born preterm presents lifelong risks, identifying and communicating one's status with health practitioners early and often allows for effective treatment and positive outcomes.
Manuka honey could help to clear deadly drug-resistant lung infection – research
• Scientists develop a potential nebulisation treatment using manuka honey to clear a drug resistant lung infection that can be fatal in cystic fibrosis patients • Aston University researchers combined the antibiotic amikacin with manuka honey as a novel treatment for Mycobacterium abscessus • Using the manuka honey combination resulted in an eight-fold reduction in the dosage of the antibiotic A potential new treatment combining natural manuka honey with a widely used drug has been developed by scientists at Aston University to treat a potentially lethal lung infection and greatly reduce side effects of one of the current drugs used for its treatment. The findings, which are published in the journal Microbiology, show that the scientists in the Mycobacterial Research Group in the College of Health and Life Sciences at Aston University were able to combine manuka honey and the drug amikacin in a lab-based nebulisation formulation to treat the harmful bacterial lung infection Mycobacterium abscessus. Manuka honey is long known to have wide ranging medicinal properties, but more recently has been identified for its broad spectrum antimicrobial activity. Now scientists have found that manuka honey has the potential to kill a number of drug resistant bacterial infections such as Mycobacterium abscessus – which usually affects patients with cystic fibrosis (CF) or bronchiectasis. According to the Cystic Fibrosis Trust, CF is a genetic condition affecting around 10,800 people - one in every 2,500 babies born in the UK -and there are more than 100,000 people with the condition worldwide. The NHS defines bronchiectasis as a long-term condition where the airways of the lungs become widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection.. In the study, the researchers used samples of the bacteria Mycobacterium abscessus taken from 16 infected CF patients. They then tested the antibiotic amikacin, combined with manuka honey, to discover what dosage was required to kill the bacteria. As part of the study the team used a lab-based lung model and nebuliser - a device that produces a fine spray of liquid often used for inhaling a medicinal drug. By nebulising manuka honey and amikacin together, it was found they could improve bacterial clearance, even when using lower doses of amikacin, which would result in less life-changing side-effects to the patient. In the UK, of the 10,800 people living with CF, Mycobacterium abscessus infects 13% of all patients with the condition. This new approach is advantageous not only because it has the potential to kill off a highly drug resistant infection, but because of the reduced side effects, benefitting quality of life and greatly improving survival chances for infected CF patients. Mycobacterium abscessus is a bacterial pathogen from the same family that causes tuberculosis, but this bug differs by causing serious lung infections in people (particularly children) with pre-existing lung conditions, such as CF and bronchiectasis, as well as causing skin and soft tissue infections. The bacteria is also highly drug resistant. Currently, patients are given a cocktail of antibiotics, consisting of 12 months or more of antimicrobial chemotherapy and often doesn’t result in a cure. The dosage of amikacin usually used on a patient to kill the infection is 16 micrograms per millilitre. But the researchers found that the new combination using manuka honey, required a dosage of just 2 micrograms per millitre of amikacin - resulting in a one eighth reduction in the dosage of the drug. Until now Mycobacterium abscessus has been virtually impossible to eradicate in people with cystic fibrosis. It can also be deadly if the patient requires a lung transplant because they are not eligible for surgery if the infection is present. Commenting on their findings, lead author and PhD researcher Victoria Nolan said: "So far treatment of Mycobacterium abscessus pulmonary infections can be problematic due to its drug resistant nature. The variety of antibiotics required to combat infection result in severe side effects. "However, the use of this potential treatment combining amikacin and manuka honey shows great promise as an improved therapy for these terrible pulmonary infections. “There is a need for better treatment outcomes and in the future we hope that this potential treatment can be tested further.” Dr Jonathan Cox, senior lecturer in microbiology, Aston University said: “By combining a totally natural ingredient such as manuka honey with amikacin, one of the most important yet toxic drugs used for treating Mycobacterium abscessus, we have found a way to potentially kill off these bacteria with eight times less drug than before. This has the potential to significantly reduce amikacin-associated hearing loss and greatly improve the quality of life of so many patients – particularly those with cystic fibrosis. “I am delighted with the outcome of this research because it paves the way for future experiments and we hope that with funding we can move towards clinical trials that could result in a change in strategy for the treatment of this debilitating infection.” Dr Peter Cotgreave, chief executive of the Microbiology Society said: "The Microbiology Society is proud to support the scientific community as it explores innovative solutions to overcome the growing global challenge of antimicrobial resistance. This study demonstrates one of many ways in which microbiologists are pioneering new methods to tackle drug-resistant infections, by incorporating natural products, like manuka honey, into existing therapies." For more information about the School of Biosciences, please visit our website.
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.
