Brains, Fatigue, and Saving Earth

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Preterm Birth Rates – Mexico

Rank: 149 –Rate: 7.3% Estimated # of preterm births per 100 live births (USA – 12%)

Source: https://www.marchofdimes.org/mission/global-preterm.aspx#tabs-3

Mexico, officially the United Mexican States  is a country in the southern portion of North America. It is bordered to the north by the United States; to the south and west by the Pacific Ocean; to the southeast by Guatemala, Belize, and the Caribbean Sea; and to the east by the Gulf of Mexico. Covering almost 2,000,000 square kilometers (770,000 sq mi), the nation is the fifth largest country in the Americas by total area and the 13th largest independent state in the world. With an estimated population of over 129 million people, Mexico is the tenth most populous country and the most populous Spanish-speaking country in the world, while being the second most populous nation in Latin America after Brazil.  Mexico is a federation comprising 31 states plus Mexico City (CDMX), which is the capital city and its most populous city. Other metropolises in the country include Guadalajara, Monterrey, Puebla, Toluca, Tijuana, and León.

Since the early 1990s, Mexico entered a transitional stage in the health of its population and some indicators such as mortality patterns are identical to those found in highly developed countries like Germany or Japan. Mexico’s medical infrastructure is highly rated for the most part and is usually excellent in major cities, but rural communities still lack equipment for advanced medical procedures, forcing patients in those locations to travel to the closest urban areas to get specialized medical care. Social determinants of health can be used to evaluate the state of health in Mexico.

State-funded institutions such as Mexican Social Security Institute (IMSS) and the Institute for Social Security and Services for State Workers (ISSSTE) play a major role in health and social security. Private health services are also very important and account for 13% of all medical units in the country.

Medical training is done mostly at public universities with much specializations done in vocational or internship settings. Some public universities in Mexico, such as the University of Guadalajara, have signed agreements with the U.S. to receive and train American students in Medicine. Health care costs in private institutions and prescription drugs in Mexico are on average lower than that of its North American economic partners.photos.mex.5.jpg

COMMUNITY

 2016 US election linked to increase in preterm births among US Latinas

Analysis suggests 3.5 percent more preterm births among Latinas than projected for nine months following election

Source: Johns Hopkins University Bloomberg School of Public Health – July 19, 2019

Summary: A significant jump in preterm births to Latina mothers living in the U.S. occurred in the nine months following the November 8, 2016 election of President Donald Trump, according to a new study.

The study, published July 19 in JAMA Network Open, was prompted by smaller studies that had suggested adverse, stress-related health effects among Latin Americans in the U.S. after the Trump election. The new analysis, based on U.S. government data on more than 33 million live births in the country, found an excess of 2,337 preterm births to U.S. Latinas compared to what would have been expected given trends in preterm birth in the years prior to the election. This is roughly 3.5 percent more preterm births than expected given projections from pre-election data.

Preterm birth, defined as birth before 37 weeks of gestation, is associated with a wide range of negative health consequences, from a greater risk of death in infancy to developmental problems later in life.

“The 2016 election, following campaign promises of mass deportation and the rollback of policies such as DACA, the Deferred Action for Childhood Arrivals program, may have adversely affected the health of Latinas and their newborns,” says study first author Alison Gemmill, PhD, MPH, assistant professor in the Department of Population, Family and Reproductive Health at the Bloomberg School.

Researchers know that stress in pregnant women can bring an elevated risk of preterm birth. Prior studies also suggest that anti-immigrant policies or actions can stress immigrant women and/or make them less likely to seek prenatal care. Moreover, although most Latinas living in the U.S. are citizens or otherwise documented immigrants and would not be directly threatened by tighter policies for undocumented immigrants, they are very likely to have close friends or family members who would be threatened by such policies.

The new study was prompted by a smaller study in 2018 by other researchers, who found a moderately elevated rate of preterm births to foreign-born Latina women in New York City from September 1, 2015 to July 31, 2016 compared to January 1, 2017 to August 31, 2017. Gemmill and her colleagues decided to investigate this issue on a national level, using more rigorous methodology that would account, for example, for the slow rise in the national preterm rate that has been observed since 2014.

In their analysis, Gemmill and colleagues used a database from the Centers for Disease Control and Prevention that covers essentially all live births in the U.S. First, the researchers tracked preterm births to self-identified Latina women over the previous administration, January 2009 to October 2016. They then used those data to generate an estimate of expected preterm births during the following nine months, from November 2016 to July 2017. Next, the authors compared those expected numbers to the actual numbers of preterm births to Latina women during the nine months after the election. The researchers found there were 1,342 preterm births of male infants above the expected number of 36,828, and 995 preterm births of female infants above the expected 30,687.

The analysis also revealed peaks in excess preterm births in February and July of 2017 for both male and female infants, which hints that infants conceived or in the second trimester of gestation at the time of the election may have been particularly vulnerable to maternal stress.

“We’ve known that government policies, even when they’re not health policies per se, can affect people’s health, but it’s remarkable that an election and the associated shift in presidential tone appears to have done so,” says Gemmill.

Gemmill and her colleagues suggest that future research should be done to determine more precisely the mechanisms by which policies and government messages can negatively affect population health outcomes.

This work was supported in part by the Transdisciplinary Postdoctoral Fellowship of the Preterm Birth Initiative at the University of California San Francisco and a Population Health & Health Equity Scholars award from the UCSF School of Medicine.

Source: Materials provided by Johns Hopkins University Bloomberg School of Public Health. https://www.sciencedaily.com/releases/2019/07/190719135535.htm

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Touch shapes preterm babies’ brains

16th March 2017

A baby’s earliest experiences of touch have lasting effects on the way it responds to touch at home.

Babies born prematurely are less likely to have the usual brain response to gentle touch. However, when given supportive touch while still in the hospital, their brain responses become more like those of full-term babies by the time they go home. Nathalie Maitre and colleagues measured the brain responses of 125 preterm and full-term babies using a soft, high-density EEG net.

We spoke with Maitre about the Current Biology study, which has care implications for the 15 million preterm babies born each year.

ResearchGate: What motivated this study?

Nathalie Maitre: Preterm infants have high rates of delays and neurodevelopmental impairments. We know from research that this can be linked to early problems reacting to sensations in daily life. Infants who have difficulties responding to touch, sound, position changes, and sights also have problems with movement, learning language, and higher cognitive skills. We wanted to study the importance of responses to touch because it is one of the earliest senses to functionally develop in human infants.

However, we did not want to assume that we could tell what babies feel, because most of our guesses would have been based on what older children showed outwardly. Our team wanted to look “inside” the infant brains to see what they actually felt in response to gentle touch. We did not want to assume that other signs, such as facial expressions or vital signs, could tell us how babies’ brains process touch.

RG: Can you tell us what you found?

Maitre: The earlier a baby is born, the more likely it is to have a smaller brain response to gentle touch when going home from the hospital. The more supportive touch preterm babies experience while still in the hospital, the more their brain responses to touch will be like term-born babies by the time they go home. Conversely, the more preterm babies experience painful procedures, the less their brain responses will be like those of term born babies, even when they receive pain medications and sucrose to try and mitigate pain. ​We were very surprised to find that if babies experience painful procedures early in life, their sense of gentle touch can be affected. Thanks to the groundbreaking work of other scientists who study the responses to pain in the baby brain, we can make sense of our findings as a kind of cross-over in the wiring of the brain between two different kinds of touch sensation. ​

RG: How did you conduct the study?

Maitre: We used a soft, high-density EEG net and repeatedly measured the baby brain’s response to a soft puff of air, comparing it to the brain’s response to a sham puff. Our analysis utilized the latest topographic analysis tools, developed by the team in Switzerland. We did this with term-born babies in the nursery and in preterm babies who were in the neonatal intensive care unit, right before they were going home. ​​

RG: Why do babies, particularly preterm babies, need touch?

Maitre: All babies need supportive touch to build essential connections in their brains. For preterm infants, providing this touch is especially important because they miss months of typical development inside the uterus of the mother, where they receive constant, non-noxious tactile feedback. This tactile feedback is essential, as it happens during a critical period of brain development. In some other sensory systems, when input does not happen during critical windows, the entire sensory system can be permanently affected. We do not know if this is the case for touch, but we certainly can see the impact of deprivation in preterm infants.

Touch is a critical building block of infant learning. It helps infants learn how to move, discover the world around them, and how to communicate. Touch allows them to learn these skills even before their vision is fully developed, and certainly before they learn verbal skills.  ​

RG: How can hospitals best integrate the results of your study into caring for preterm babies?

Maitre: Making sure that preterm babies receive positive, supportive touch, such as skin-to-skin care by parents, is essential to help their brains respond gentle touch in ways similar to those of babies who experienced an entire pregnancy inside their mother’s womb. When parents cannot do this, hospitals may want to consider occupational and physical therapists to provide a carefully planned touch experience, which is sometimes missing from a hospital setting. ​

RG: Does it matter who touches the baby?

Maitre: Our study included touch by therapists and parents, and we only counted touches when skin-to skin contact was involved. This is based on studies of skin-to-skin (kangaroo care), breastfeeding, and massage that have shown promising results in helping the maturation of the nervous system. While we know that certain types of touch appear supportive, we did not have the tools before this to study which forms may prove more beneficial than others. In general, infants benefit more from their parents’ touch for other reasons such as emotional bonding, increased opportunities for parents to practice responsivity, and in the case of breast feeding and skin-to-skin care, increased health benefits for both mom and baby.
Source: https://www.researchgate.net/blog/post/touch-shapes-preterm-babies-brains

               Michigan State University’s Sleep and Learning Lab                                           has conducted one of the largest sleep studies to date, revealing that sleep deprivation affects us much more than prior theories have suggested.

Published in the Journal of Experimental Psychology: General, the research is not only one of the largest studies, but also the first to assess how sleep deprivation impacts placekeeping — or, the ability to complete a series of steps without losing one’s place, despite potential interruptions. This study builds on prior research from MSU’s sleep scientists to quantify the effect lack of sleep has on a person’s ability to follow a procedure and maintain attention.

“Our research showed that sleep deprivation doubles the odds of making placekeeping errors and triples the number of lapses in attention, which is startling,” Fenn said. “Sleep-deprived individuals need to exercise caution in absolutely everything that they do, and simply can’t trust that they won’t make costly errors. Oftentimes — like when behind the wheel of a car — these errors can have tragic consequences.”

By sharing their findings on the separate effects sleep deprivation has on cognitive function, Fenn — and co-authors Michelle Stepan, MSU doctoral candidate and Erik Altmann, professor of psychology — hope that people will acknowledge how significantly their abilities are hindered because of a lack of sleep.

“Our findings debunk a common theory that suggests that attention is the only cognitive function affected by sleep deprivation,” Stepan said. “Some sleep-deprived people might be able to hold it together under routine tasks, like a doctor taking a patient’s vitals. But our results suggest that completing an activity that requires following multiple steps, such as a doctor completing a medical procedure, is much riskier under conditions of sleep deprivation.”

The researchers recruited 138 people to participate in the overnight sleep assessment; 77 stayed awake all night and 61 went home to sleep. All participants took two separate cognitive tasks in the evening: one that measured reaction time to a stimulus; the other measured a participant’s ability to maintain their place in a series of steps without omitting or repeating a step — even after sporadic interruptions. The participants then repeated both tasks in the morning to see how sleep-deprivation affected their performance.

“After being interrupted there was a 15% error rate in the evening and we saw that the error rate spiked to about 30% for the sleep-deprived group the following morning,” Stepan said. “The rested participants’ morning scores were similar to the night before.

“There are some tasks people can do on auto-pilot that may not be affected by a lack of sleep,” Fenn said. “However, sleep deprivation causes widespread deficits across all facets of life.”

Journal Reference: Michelle E. Stepan, Erik M. Altmann, Kimberly M. Fenn. Effects of total sleep deprivation on procedural placekeeping: More than just lapses of attention.. Journal of Experimental Psychology: General, 2019; DOI: 10.1037/xge0000717

Source: https://www.sciencedaily.com/releases/2019/11/191121183923.htm

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HEALTH CARE PARTNERS

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Predicting Long-Term Survival Without Major Disability for Infants Born Preterm

December 2019 – Volume 215, Pages 90–97.e1

Objective

To describe the long-term neurodevelopmental and cognitive outcomes for children born preterm.

Study design

In this retrospective cohort study, information on children born in Western Australia between 1983 and 2010 was obtained through linkage to population databases on births, deaths, and disabilities. For the purpose of this study, disability was defined as a diagnosis of intellectual disability, autism, or cerebral palsy. The Kaplan–Meier method was used to estimate the probability of disability-free survival up to age 25 years by gestational age. The effect of covariates and predicted survival was examined using parametric survival models.

Results

Of the 720 901 recorded live births, 12 083 children were diagnosed with disability, and 5662 died without any disability diagnosis. The estimated probability of disability-free survival to 25 years was 4.1% for those born at gestational age 22 weeks, 19.7% for those born at 23 weeks, 42.4% for those born at 24 weeks, 53.0% for those born at 25 weeks, 78.3% for those born at 28 weeks, and 97.2% for those born full term (39-41 weeks). There was substantial disparity in the predicted probability of disability-free survival for children born at all gestational ages by birth profile, with 5-year estimates of 4.9% and 10.4% among Aboriginal and Caucasian populations, respectively, born at 24-27 weeks and considered at high risk (based on low Apgar score, male sex, low sociodemographic status, and remote region of residence) and 91.2% and 93.3%, respectively, for those at low risk (ie, high Apgar score, female sex, high sociodemographic status, residence in a major city).

Conclusions

Apgar score, birth weight, sex, socioeconomic status, and maternal ethnicity, in addition to gestational age, have pronounced impacts on disability-free survival.

Source: https://www.jpeds.com/article/S0022-3476(19)30964-3/fulltext

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Compassion Fatigue

Compassion fatigue, also known as secondary traumatic stress (STS), is a condition characterized by a gradual lessening of compassion over time. Scholars who study compassion fatigue note that the condition is common among workers who work directly with victims of disasters, trauma, or illness, especially in the health care industry. Professionals in other occupations are also at risk for experiencing compassion fatigue, e.g. attorneys, child protection workers and veterinarians. Other occupations include: therapists, child welfare workers, nurses, radiology technologists, teachers, journalists, psychologists, police officers, paramedics, emergency medical technicians (EMTs), firefighters, animal welfare workers, public librarians, and health unit coordinators. Non-workers, such as family members and other informal caregivers of people who are suffering from a chronic illness, may also experience compassion fatigue. It was first diagnosed in nurses in the 1950s.

People who experience compassion fatigue can exhibit several symptoms including hopelessness, a decrease in experiences of pleasure, constant stress and anxiety, sleeplessness or nightmares, and a pervasive negative attitude. This can have detrimental effects on individuals, both professionally and personally, including a decrease in productivity, the inability to focus, and the development of new feelings of incompetency and self-doubt.

Journalism analysts argue that news media have caused widespread compassion fatigue in society by saturating newspapers and news shows with decontextualized images and stories of tragedy and suffering. This has caused the public to become desensitized or resistant to helping people who are suffering.

Source: https://en.wikipedia.org/wiki/Compassion_fatigue

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Compassion Fatigue: What is it and do you have it?

Juliette Watt   Published on Nov 26, 2018

In this compelling talk, Juliette introduces us to “Compassion Fatigue.” A hugely pervasive syndrome that not only affects people like professional caregivers but also most of us one way or another. Juliette herself has suffered from Compassion Fatigue first hand and she is very passionate about sharing the insidious nature of this syndrome and the devastating effects it can have on your life. Compassion Fatigue can potentially happen to any age group. From people in their twenties right up to their senior years. It is an important, critical topic that Juliette has pulled out of the shadows so that we can recognize the symptoms and develop a renewed resilience to teach ourselves how to continue to give compassion without sacrificing ourselves and our lives. Born and raised in London, England, Juliette was a stunt horse rider for MGM pictures then later a London Playboy Bunny. From 18 she spent the next 20 years performing a one woman show in cabarets world-wide. In 1971 she moved to Beirut, Lebanon where she lived for 4 years during their vicious civil war. Moving to NYC in her forties, she thrived as a soap opera scriptwriter, winning two Writers Guild Awards and a nomination for a Daytime Emmy. She then become an ATP pilot and Master Flight Instructor which led her to working for 10 years at Best Friends Animal Sanctuary in Utah, eventually flying rescue missions in New Orleans saving abused and abandoned dogs in the aftermath of Hurricane Katrina. Over 6000 animals were saved. Currently she is on a passionate mission to help and guide people who have lost themselves in who they’ve been for everyone else.

 

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Pain‐related increase in serotonin transporter gene methylation associates with emotional regulation in 4.5‐year‐old preterm‐born children

First published: 31 October 2019

Aim

The main goal of this study was to assess the association between pain‐related increase in serotonin transporter gene (SLC6A4) methylation and emotional dysregulation in 4.5‐year‐old preterm children compared with full‐term matched counterparts.

Methods

Preterm (n = 29) and full‐term (n = 26) children recruited from two Italian hospitals were followed‐up from October 2011 to December 2017. SLC6A4 methylation was assessed from cord blood at birth from both groups and peripheral blood at discharge for preterm ones. At 4.5 years, emotional regulation (ie, anger, fear and sadness) was assessed through an observational standardised procedure.

Results

Preterm children (18 females; mean age = 4.5, range = 4.3‐4.8) showed greater anger display compared with full‐term controls (14 females; mean age = 4.5, range = 4.4‐4.9) in response to emotional stress. Controlling for adverse life events occurrence from discharge to 4.5 years and SLC6A4 methylation at birth, CpG‐specific SLC6A4 methylation in the neonatal period was predictive of greater anger display in preterm children but not in full‐term ones.

Conclusion

These findings contribute to highlight how epigenetic regulation of serotonin transporter gene in response to NICU pain exposure contributes to long‐lasting programming of anger regulation in preterm children.

Source: https://onlinelibrary.wiley.com/doi/10.1111/apa.15077

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PREEMIE FAMILY PARTNERS

How Parents Help Preemies Fight to Survive

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There are a number of factors that can cause premature labor, but parents should remember that they plan an essential role in helping their preemies  become healthier during the first weeks of their lives.

Development follow up for NICU babies

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med.press.pngPreterm birth linked to increased rates of diabetes in children and young adults

by Diabetologia

New research shows that preterm birth is linked to increased rates of type 1 and type 2 diabetes in children and young adults, with certain effects stronger in females. People who have been born preterm may need more intensive monitoring and prevention efforts to lower their risk of diabetes, concludes the study, published in Diabetologia.

Preterm birth (before 37 weeks of pregnancy) has been associated with early life insulin resistance, which can develop into diabetes. However, no large population-based studies have examined risks of type 1 diabetes (T1D) and type 2 diabetes (T2D) in people born preterm and potential differences between boys and girls from childhood into adulthood. “This is important because doctors will increasingly encounter adults who were born prematurely due to higher survival rates, and will need to understand their long-term risks,” say the authors who include Professor Casey Crump, Icahn School of Medicine at Mount Sinai, New York, NY, USA, and colleagues.

The authors did a national cohort study of all 4,193,069 single babies (not twins or other multiple births) born in Sweden during 1973-2014, who were followed up for T1D and T2D identified from nationwide diagnoses and pharmacy data to the end of 2015 (and thus having a maximum age 43 years; the median age of the study population was 22 years). Computer modelling was used to adjust for potential confounders that could affect the results, including maternal age at delivery, maternal education, country of maternal birth, maternal BMI, maternal smoking and presence of pre-eclampsia.

In addition, the authors performed a co-sibling analysis—an assessment of the siblings of the people in the study (83% had at least one sibling). This analysis was to provide more evidence as to whether the risk of diabetes was associated specifically with preterm birth, or associated with genetic or environmental factors shared by all siblings in a family.

Throughout the study, 27,512 (0.7%) and 5,525 (0.1%) people were identified with T1D and T2D, respectively (the lower number for T2D was because of the young age of this population; T2D is much more common in older adults). Analysis showed being born preterm (earlier than 37 weeks) was associated with a 21% increased risk of T1D and a 26% increased risk of T2D in those aged less than 18 years. In young adults aged 18-43 years, being born preterm was associated with a 24% increased risk of T1D and a 49% increased risk of T2D.

In most cases, being born extremely preterm (22-28 weeks) was associated with higher risks of diabetes than those born at term, except for T1D in those aged less than 18 years. The authors say this finding for T1D in those under 18 years was against their expectations and needs further research.

Being born male and preterm was associated with an approximately 20% increased risk of T1D at both the under 18 years group and the age 18-43 years group, while for females the increased risk was around 30% for both age groups. For T2D, being born female and preterm was associated with a 60% increased risk in those aged under 18 years, while for males aged under 18 years there was no increased risk. In those aged 18-43 years, the authors found the increased risk associated with being born preterm was much higher among women (75%) than men (28%). This is despite the fact that across all normal term births in this study, T2D incidence was slightly higher among males (5.84 per 100,000 person-years) than females (5.27).

Across all the results, shared genetic and environmental factors between siblings were not wholly responsible for differences in diabetes risk in individuals born preterm. The authors highlight specifically that the association between preterm birth and T2D in those aged 18-43 years appeared independent of shared familial factors.

The authors say a host of mechanisms could account for these observed associations, including preterm birth interrupting and limiting the production of beta cells in the pancreas which produce insulin; effects on the immune system; the impact of medications and procedures in intensive care during the birth period; and then differences in other risk factors such as diet, exercise and obesity.

The authors say: “Because of major advances in treatment, most preterm infants now survive into adulthood. As a result, clinicians will increasingly encounter adult patients who were born prematurely.Preterm birth should now be recognized as a chronic condition that predisposes to the development of diabetes across the life course.”

They add: “Doctors currently seldom seek birth histories from adult patients, and thus preterm birth may remain a ‘hidden’ risk factor. Medical records and history-taking in patients of all ages should routinely include birth history, including gestational age, birthweight and any complications during or after the birth. Such information can help identify those born prematurely and facilitate screening and early preventive actions, including patient counselling to promote lifestyle prevention of diabetes.”

They conclude: “We found that preterm and early term birth were associated with increased risk of type 1 and type 2 diabetes from childhood into early to mid-adulthood in a large population-based cohort. Children and adults who were born prematurely may need early preventive evaluation and long-term follow-up for timely detection and treatment of diabetes.”

Source: https://medicalxpress.com/news/2019-12-preterm-birth-linked-diabetes-children.html

More information: Casey Crump et al. Preterm birth and risk of type 1 and type 2 diabetes: a national cohort study, Diabetologia (2019). DOI: 10.1007/s00125-019-05044-z

Preterm Labor & Premature Birth

Even if you do everything right during pregnancy, you can still have preterm labor and premature birth. Preterm labor is labor that starts too early, before 37 weeks of pregnancy.

Premature babies may have more health problems or need to stay in the hospital longer than babies born on time. Some of these babies also face long-term health effects, like problems that affect the brain, lungs, hearing or vision.

Learn the signs and symptoms of preterm labor and what to do if they happen to you. If you do begin labor early, there are treatments that may help stop your labor.

In This Topic

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INNOVATIONS

INSIGHTS INTO LINKS BETWEEN MICROBIOLOGY AND PRETERM BIRTH

One of the most promising areas of inquiry in our search for the causes of and preventions for premature birth is the interaction between the mom and her microbiome, which is the community of microorganisms in her body. We know that inflammation as a result of infection is responsible for at least 50 percent of all cases of premature birth. And typically, that infection triggers a complex series of actions and reactions. These include the activation of cells of the immune system, such as neutrophils, which can precipitate the physical transformations of collagen breakdown, cervical shortening, fetal membrane stretch, contractions and ultimately, premature labor and birth. Although we know some details about how that process works, up until now, we haven’t known why. For this reason, we’ve turned to some brilliant minds in microbiology and cell-to-cell communications for help.

That help will arrive in the form of the newly formed sixth March of Dimes Prematurity Research Center at Imperial College London. There are many reasons why Imperial College London is an ideal fit. They’ve been collaborating and sharing information with March of Dimes Prematurity Research Centers (PRCs) for a number of years. And like the other centers, they specialize in researching the causes of and preventions for premature birth. Ultimately, Imperial College was motivated to apply, and was selected, because of their global leadership, unique expertise and pioneering work in the field of glycobiology, including its links to the immune system and premature birth.

Glycobiology is the study of sugar molecules that coat all cells, both human and bacterial. In the birth canal, these molecules perform a kind of “handshake” that either activates or deactivates immune responses that can in turn, either trigger or prevent premature birth. But like everything else in the study of premature birth, this process is even more complicated than it seems. In some women, for example, certain types of bacteria like Lactobacillus in the birth canal protect against other groups of bacteria, such as Streptococcus, Staphylococcus and E. coli, entering the birth canal and infecting the mom, baby or both. But in other women, some types of Lactobacillus may perform the opposite function, triggering premature birth and putting both mom and baby at risk.

The expertise of Imperial College London in this area is unmatched by any other institution and not covered by the work of any other PRC in the March of Dimes network. It is however complementary to the research themes of other PRCs, including the microbiome (Stanford), physical changes in the structure of the birth canal and organs (University of Pennsylvania), and the genetics of premature birth (The Ohio Collaborative). Together these were the most important factors in their selection as the sixth center in our network.

Professor Phillip Bennett, M.D., Ph.D., is the center’s principal investigator and has specialized in helping to prevent premature birth his entire career. Joining him to put the center together are Dr. David MacIntyre and Dr. Lynne Sykes from the Institute of Reproductive and Developmental Biology at Imperial College. Their team includes three world renowned specialists in the glycosciences: Professor Anne Dell, Professor Ten Feizi and Dr. Stuart Haslam. Also on the team are Professor Marina Botto and Dr. Pascale Kropf, experts in inflammation and immunology, as well as some of the finest microbiologists, chemists, mathematicians, obstetricians, gynecologists and researchers anywhere in the field of reproduction. Also contributing to the work will be three hospitals affiliated with Imperial College London—Queen Charlotte’s Hospital, St. Mary’s Hospital and Chelsea and Westminster Hospital.

One of the motivating factors for Professor Bennett’s team to join March of Dimes’ PRC network was the transdisciplinary approach. “What normally happens in academia is that isolated university groups work in competition with each other. But what we found exciting was the concept of a research family,” Dr. Bennett said. “March of Dimes’ model has some of the best universities in the world using their own individual expertise and skills to work together for a common cause—we find that to be a particularly attractive way of doing research.” March of Dimes believes the transdisciplinary approach to research will be profoundly important to understanding how premature birth happens and how to prevent it. As always, we’re limited only by resources, not ideas. More funding is vital for the research to continue.

Source: https://www.marchofdimes.org/materials/ICL_theme1.pdf

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Intrahealth International  VITAL – November 15, 2019

The survival rate of preterm babies improved  from 73% to 100% in 2019.

The demands from the children’s ward are overwhelming. We receive so many mothers in distress.

Katakwi district, in the eastern corner of Uganda, grapples with high disease burden. The most vulnerable are young mothers like Margret because there aren’t enough health workers to meet the high demand for services, including life-threatening childbirth emergencies. The district hospital serves 38,000 people from across eight sub-counties and is a referral point for many coming through the Karamoja region.

“The demands from the children’s ward are overwhelming,” says Dr. Opus Benjamin, acting medical superintendent at the Katakwi Hospital. “We receive so many mothers in distress and must provide quality care every day.”

The hospital needed more trained staff to provide basic quality care when and where it was needed, so that babies born too soon would have a chance to live. So, they brought in Catherine Alinga, a trained midwife. Senior Catherine, as she is fondly called by many at the maternity ward, works with the IntraHealth International-led Regional Health Integration to Enhance Services in Eastern Uganda (RHITES-E) project to improve the quality of care for mothers and preterm babies.

In March 2019, Catherine began training staff at the Katakwi Hospital on helping babies breathe techniques and neonatal care. She also mentored the entire maternity staff at Katakwi and lower-level facilities on kangaroo mother care and newborn care.

Margret’s baby is alive today thanks to Catherine and the midwives she trained. Catherine’s skills and efforts showcase how hospitals in rural areas have found workable solutions to prevent newborn deaths.

Before Catherine’s training, the survival rate for preterm births was less than 10%, as many babies referred from lower facilities were at risk of dying on their way to Katakwi General Hospital. Since Catherine’s trainings, though, the unit has saved 15 premature babies, including Orisa. In the month of October alone, seven premature babies were admitted. All have been discharged alive.

To achieve this feat, the hospital developed a standard operating procedure for referrals and displayed it at facilities that were sending in most cases. Now, staff at local hospitals know when to refer mothers who are in need for care to the general hospital and staff at the general hospital are prepared to care for referred mothers when they arrive at the maternity ward.

The survival rate of preterm babies improved at Katakwi hospital from 73% in June 2019 to 80% in September 2019— and then to 100% in October 2019.

“The team here has been trained in handling premature babies, in terms of infection control, prevention of hypothermia, drug administration, dosages, frequency, and dilution,” Catherine says. “These are crucial and lifesaving steps that make a difference in the death or survival of a preterm baby.”

The maternity unit also encourages mothers to practice kangaroo mother care as one of the prevention measures to keep the baby warm and suggests that male partners participate in this care as well. The father’s participation in the baby’s post-birth care has ensured the survival of babies long after they have been discharged back into the community.

“Right now, the unit is on top of its game and the hospital administration is doing its very best to make sure equipment, drugs, and systems are in place to ensure all preterm babies survive,” says Geoffrey Orijabo, senior technical officer for maternal newborn and child health / family planning for RHITES-E .

The Regional Health Integration to Enhance Services in Eastern Uganda (RHITES-East) program is led by IntraHealth International and funded by the US Agency for International Development.

Source: https://www.intrahealth.org/vital/right-training-has-led-100-survival-preterm-babies-ugandan-hospital

WARRIORS:

Interesting… and I am looking forward to knowing over time what the research below means for our Warrior family. My Mom and I try very hard to find new research and resources to share. We explored preemie developmental care and follow-up guidelines, have found little to share to date, but are confident the information will develop and become available over time. Our community of preterm birth survivors has grown, especially our micro-preemie brothers and sisters.  Some of our potential health care concerns are recently discovered and research is growing and vibrant. Resources are sparse in terms of medical follow-up for preemies, although some medical centers have organizational programs noted on their websites. In addition NICE has created a comprehensive site for provider reference (Developmental follow-up of children and young people born preterm: https://pathways.nice.org.uk/pathways/developmental-follow-up-of-children-and-young-people-born-preterm.

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Preterm adults have ‘older’ brains, finds study

Written by Honor Whiteman on September 27, 2017

Adolescents and adults who were born very prematurely may have “older” brains than those who were born full term, a new study reveals.

Researchers identified changes in the brain structure of adults born between 28 and 32 weeks gestation that corresponded with accelerated brain aging, meaning that their brains appeared older than those of their non-preterm counterparts.

Lead study author Dr. Chiara Nosarti, of the Institute of Psychiatry, Psychology and Neuroscience at King’s College London in the United Kingdom, and colleagues recently reported their findings in the journal Neuroimage.

According to the Centers for Disease Control and Prevention (CDC), around 1 in 10 infants born in the United States in 2015 were preterm, meaning that they were born before 37 weeks of pregnancy.

A baby’s brain fully develops in the final few weeks of gestation, so being born early disrupts this process. As such, babies born preterm are at greater risk of developmental disabilities including impairments in learning, language, and behavior.

But how does preterm birth affect the brain in adulthood? This is what Dr. Nosarti and colleagues sought to find out with their new study.

According to Dr. Nosarti and team, their study is the first to investigate how preterm birth might affect this adult brain maturation process.

Using MRI, the researchers analyzed the brain structure of 328 adults who had been born before 33 weeks gestation. Subjects were assessed at two time points: adolescence (mean age 19.8 years) and adulthood (mean age 30.6 years).

The brain scans of these participants were then compared with those of 232 adults who were born full term (the controls), alongside 1,210 brain scans gathered from open-access MRI archives.

Specifically, the researchers looked at volume of gray matter in the participants’ brains, which they say can be a marker of “brain age.”

Accelerated brain maturation identified:

Compared with the controls, the team found that subjects born very preterm had a lower volume of gray matter in both adolescence and adulthood, particularly in brain regions associated with memory and emotional processing.

They also pinpointed a number of structural brain alterations that demonstrated resilience to the effects of preterm birth. For example, they identified increases in gray matter volume in regions associated with behavioral control.

The team hypothesizes that such alterations may arise to compensate for other brain functions negatively impacted by preterm birth.

“Even though one can only speculate on the functional significance of these alterations, prior studies suggested that compensatory mechanisms may support cognitive and language processing in very preterm samples,” write the authors.

Upon further investigation, the team found that the reduced gray matter volume identified in very preterm participants was associated with accelerated brain maturation. As a result, the brains of the preterm subjects appeared older than those of the controls.

First study author Dr. Vjaceslavs Karolis, also of the Institute of Psychiatry, Psychology and Neuroscience at King’s College London, says that the team was surprised by the results.

“The finding of structural signatures of accelerated brain maturation in those born very prematurely was unexpected,” he notes, “because previous research suggested delayed brain maturation at earlier stages of development.”

Dr. Nosarti adds that they are unable to confirm how the structural brain changes identified in very preterm adolescents and adults translate to day-to-day functioning, but they believe that this is something that should be investigated in future research.

Source: https://www.medicalnewstoday.com/articles/319564.php#1

We have posted numerous articles exposing the detrimental effects of pollution and climate change on our global Neonatal Womb Warrior/preterm birth community. As Warriors, we are viscerally empowered to  understand and appreciate the healing power of  our community. Although research relating to the unique medical challenges we Warriors may face as we age is in it’s early stages, we can choose to be aware of and take actions to impact issues that seriously threaten our planet and all of our people. Our survival demands our attention, evaluation, innovative efforts, and responsive involvement in the creation and facilitation of proactive and retrospective efforts to support a healthy planet.   This is our chance to provide life support to our community. Even small steps are significant.  Let’s find our ways to make a difference.

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FACT SHEET: ‘The climate crisis is a child rights crisis’

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A young boy crosses a bridge near where houses were swept after Cyclone Idai hit Rusitu Valley, Chimanimani District, eastern Zimbabwe.

MADRID, 6 December 2019 – The climate crisis is threatening to roll back progress on child rights without sufficient urgent investment in solutions that benefit the most vulnerable children, UNICEF said today as the UN Climate Change Conference COP25 enters its second week.

“From hurricanes to droughts to floods to wildfires, the consequences of the climate crisis are all around us, affecting children the most and threatening their health, education, protection and very survival,” said Gautam Narasimhan, UNICEF Senior Adviser on Climate Change, Energy and Environment. “Children are essential actors in responding to the climate crisis. We owe it to them to put all our efforts behind solutions we know can make a difference, such as reducing vulnerability to disasters, improving the management of water resources, and ensuring that economic development does not happen at the expense of environmental sustainability.”

Some ways the climate crisis is affecting children, and how they can be addressed, include:

  • Around 503 million children now live in areas at extremely high risk of floods due to extreme weather events such as cyclones, hurricanes and storms, as well as rising sea levels. Investments in disaster-risk reduction, such as early warning systems can help prepare communities to protect children during extreme weather events.
  • The number of children displaced by extreme weather events in the Caribbean has increased six-fold in the past five years. From 2014 to 2018, 761,000 children were internally displaced, up from 175,000 children displaced between 2009 and 2013. Strategies that limit forced displacement and shorten rehabilitation time so that families can return home are critical.
  • Around 160 million children live in areas experiencing high levels of drought – and by 2040, 1 in 4 children will live in areas of extreme water stress. Technologies to effectively manage water exist, but greater investment to scale up techniques can help better locate, extract and sustainably manage water.
  • Weather-related disasters increase the risk for girls to drop out of school and be forced into marriages, trafficking, sexual exploitation and abuse. Educating girls increases their awareness of the climate crisis and builds their resilience and capacity to cope with these impacts.
  • Nearly 90 per cent of the burden of disease attributable to climate change is borne by children under the age of five. Changes in temperature, precipitation and humidity have a direct effect on the reproduction and survival of the mosquitoes that transmit deadly diseases. However, improved prediction capabilities complimented with support to health workers and systems on the ground, is enabling us to map disease prevalence with greater accuracy and predict – and disrupt – transition mechanisms and pathways.
  • Approximately 300 million children are breathing toxic air – 17 million of them are under 1-year-old. These children live in areas where PM2.5 levels exceed six times the international limits set by the World Health Organisation, which has an immediate and long-term detrimental effect on their health, and brain function and development. Cleaner, renewable sources of energy, affordable access to public transport, more green spaces in urban areas, and better waste management that prevents the open burning of harmful chemicals can help improve the health of millions.
  • Toxic air – caused largely by carbon emissions and other greenhouse gases – has grave consequences for young children, contributing to the deaths of around 600,000 children under-five every year due to pneumonia and other respiratory problems. Despite knowing its dangers many places with high-levels of pollution do not have ground-level monitoring systems to measure the problem regularly. Only 6 per cent of children in Africa, for example, live within 50km of a ground-level monitoring station.

Source: https://www.unicef.org/press-releases/fact-sheet-climate-crisis-child-rights-crisis

Taking Action through Unicef: https://www.unicef.org/take-action

 

Sayulita, Mexico Surfing * Lola Mignot * LA BAILARINA

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