Category Archives: Immunology

The ‘Jekyll and Hyde’ of immune cells – Health Europa

These cells play a key protective role in immunity to infection however, if unregulated, they can also cause tissue damage in autoimmune disorders.

The research, published in theJournal of Experimental Medicine, should help us design more effective vaccines to prevent infections such as MRSA and may also assist help us develop of new therapies for autoimmune diseases, such as multiple sclerosis or rheumatoid arthritis.

The immune system functions to control infection, utilising various immune cells, such as T cells to respond to and control invading microbes. However, if these immune cells are not highly regulated, they can attack and damage body tissues, leading to the development of autoimmune diseases.

Molecules called T cell receptors (TCRs) allow T cells to recognise components of infectious agents with exquisite specificity. The TCRs enable T cells to respond to and eventually eliminate the infectious agent.

Professor Kingston Mills, Professor of Experimental Immunology, School of Biochemistry and Immunology in the Trinity Biomedical Sciences Institute, Dublin explained that: Until now scientists thought that there were two discrete populations of T cells, expressing either or TCRs. The s are the most common T cells in the body.

They play a key role in remembering prior infection or immunisation and thereby help protect us against re-infection and mediate vaccine-induced protective immunity. The s are more prevalent at mucosal surfaces, such as the lung or gut, and provide an immediate first line of defence against pathogens that invade through these routes.

We have discovered a new cell type that expresses both and TCRs. This rare population of chimeric or hybrid - T cells has properties of both and T cells. Importantly, they are normally highly activated and poised to act as first responders to control bacterial infection.

However, given this high level of activation, they are effectively Jekyll and Hyde cells because in certain contexts they can also precipitate autoimmune responses.

Using a model of Staphylococcus aureus infection, Mills and his team found that these cells are rapidly mobilised during infection and play a key role in quickly eliminating the microbes from the body.

By introducing these hybrid - T cells, it may represent a novel approach in the design of more effective vaccines against Staph aureus and other infectious diseases, while advancing our ability to control their response may yield additional therapeutic options.

Mills added: In a model of autoimmune disease, we found that the hybrid T cells can also trigger the inflammatory cascade that mediates tissue damage in autoimmunity. Therefore, approaches for inhibiting these highly activated immune cells in susceptible individuals may open up new approaches for the treatment of autoimmune diseases such as psoriasis and multiple sclerosis.

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The 'Jekyll and Hyde' of immune cells - Health Europa

Italian Government to close all school and universities – Buzz.ie

Italian News Agency, ASNA, has reported today that following a meeting between the Prime Minister Guiseppe Conta and ministers at Palazzo Chigi today, the Italian government is set to close all schools and universities for two weeks.

Northern Italian schools, businesses and universities have been closed for a week now following the coronavirus outbreak resulting in towns in the North of the country going into quarantine.

There have been 2,500 confirmed cases of the virus in Northern Italy, with 79 confirmed deaths, making it the most affected area outside of China.

Professor Kingston Mills, an expert in immunology and the head of the centre for the study of immunology at Trinity College, Dublin, has also come out today to ask the questions of should flights still be running in and out of Italy given the severity of the outbreak. He said; "We need to look more seriously at means of curtailing travel to that region."

Mills, who spoke with RTE's Sean O'Rourke this morning on The Sean O'Rourke Show said he queried the information put out by the HSE saying that the virus could be contracted within 15 minutes of being in the company of someone who has the virus saying, "fifteen minutes is an arbitrary figure".

There has been no evidence so far in Ireland that shows local transmission of the virus, which is slowing the spread of Covid-19 in the country.

Ryanair have also confirmed there has been a notable drop in the number of flight bookings from the middle of March right into next month.

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Italian Government to close all school and universities - Buzz.ie

How a Pennsylvania doctor stopped a virus outbreak in 1934 with blood – The Philadelphia Inquirer

Gallagher was not the first to try this approach against viruses, but his effort was unusually successful, providing important clues about the proper dosage and timing of such infusions, said Arturo Casadevall, chairman of microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health.

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How a Pennsylvania doctor stopped a virus outbreak in 1934 with blood - The Philadelphia Inquirer

SWC hosts Health for Heritage Week with collaboration from campus clubs – Daily Bruin

When Mihika Sridhar ran for Student Wellness Commissioner last year, she wanted to encourage marginalized communities to engage with their health and wellness.

Sridhar finally realized her idea with the inaugural Health for Heritage Week from Feb. 22 to Feb. 28, which was an 11-event collaboration of the Student Wellness Commission and various clubs.

The week included discussions and presentations about the intersection of culture and health, a hygiene drive, an interactive art gallery, a beach cleanup and a CPR class.

Sridhar, a fourth-year microbiology, immunology, and molecular genetics student, planned the event with Sophia McMurry, a fourth-year philosophy student and SWC platforms director, and reached out to almost 100 student organizations. Once they narrowed down their list, they pushed for the SWC subcommittees to reach out to the organizations that sparked their interest.

Sridhar said her goal for the week was to push for collaborations between organizations that might not have come in contact otherwise.

A lot of times people can get sort of pigeonholed, Sridhar said. I think collaboration is a really great way to impact a greater number of people who may not have originally ever been privy to even knowing that an event was happening or that a topic is of interest to them.

Health for Heritage Week kicked off Feb. 22 with a beach cleanup co-hosted by SWC Environmental Awareness, Recycling and Terrestrial Health and the Indian Student Union. Around 200 pieces of trash were collected over a span of two hours from Venice Beach to Santa Monica Beach.

Kiera Dixon, the co-director of SWC EARTH, said that students were handed trash bags and forms to record the types of trash collected. The cleanup allowed students from different backgrounds to bond through environmental beautification efforts, she said.

I feel like its very important to be exposed to different types of cultures and establish friendships with people of different heritages, said Dixon, a fourth-year molecular, cell, and developmental biology student.

Another event that hoped to expose students to new cultural knowledge was organized by SWCs Student Education And Research of Contemporary Health along with Movimiento Estudiantil Chicana/o de Aztln de UCLA. These two organizations collaborated to create conversations about Latinx culture, relationships and intimacy through answering anonymous questions from a box. Other activities included making love potions and meditation.

Tara Shooshani, co-chair of SEARCH, said the event was inspired by Latinx cultural traditions. The two clubs wanted the event to be a celebration of these traditions to share with the UCLA community.

I think the main takeaway is for people to have a renewed respect and interest in other cultures to be interested in learning about other peoples traditions and customs, said Shooshani, a fourth-year human biology and society student.

SEARCH also partnered with the Afrikan Student Union to hold Unpacking Medical Racism, a three-speaker panel regarding the topic of medical racism. Speakers talked about the history of racism in the medical field and why it continues to this day.

Kylie Paramore, a panelist at the event, does research within the UCLA Fielding School of Public Health to uncover the subconscious racial bias on the health outcomes of black patients. She said the more discussion and research on the topic, the more inclined the health care system is to change this problem.

A lot of times, were fed this false narrative that our society is so progressive and colorblind but unfortunately, thats just not true, said Paramore, a fourth-year African American studies student. We have to have these conversations because these conversations are about real life.

To address the intersection of mental wellness and Pilipino culture, Active Minds and Pilipinos for Community Health co-hosted an event called Utakatawan: Physical x Mental Health in the Pilipino Community. The event incorporated Pilipino food, dance and a cappella performances, a panel and a presentation.

Three undergraduates and two graduate students participated in the panel to share how they have overcome struggles that pervade Pilipino culture.

With our culture theres this word called hiya, which translates to shame, as well as to be shy, said Robi Bucayu, who spoke on the panel. Were not good at seeking help or talking about our feelings, so I think this forum really helps to dispel that culture of silence.

Vernadette Laderas, a second-year psychology student, said that it was refreshing to hear raw conversations about taboo topics within Pilipino culture.

Theres definitely trends within the culture, like constantly giving and giving, and waiting until its too late to start to take care of yourself, (which) is something that I have struggled with, specifically with my mom, Laderas said. It surprised me to hear anecdotes that sound almost exactly like mine.

In another effort to promote mental wellness, Total Wellness and Southeast Asian Campus Learning Education and Retention hosted an event that consisted of five stations to prompt reflection on the negative effects of social media.

The first of five stations asked participants to rate their happiness and provided tips on how to foster a healthier relationship with social media. Other stations asked students what makes them happy outside of social media and which part of their body is their favorite.

Its important to recognize how (social media) might be affecting you, even though you dont realize it because you think its a necessity, and then take the steps to use it and in a healthier way, said Rebeca Gasper, a second-year political science and communication student.

Sridhar and McMurry said they hoped different cultural communities would gain insight into each others various health needs.

I really hope that committees and the other students who do attend these events just make meaningful and thoughtful connections with other groups on campus and hopefully (that) continues throughout the year, McMurry said.

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SWC hosts Health for Heritage Week with collaboration from campus clubs - Daily Bruin

Two Wake Forest Baptist scientists receive $1.5 million for cancer research – The Medical News

Two scientists from Wake Forest School of Medicine, part of Wake Forest Baptist Health, have received a total of $1.5 million in research funding from the American Cancer Society (ACS) to study new chemotherapy and immunotherapy treatments for cancer.

One of the grants, for $792,000 over four years, was awarded to Yong Lu, Ph.D., assistant professor of microbiology and immunology, to study a new approach to immunotherapy for metastatic and treatment-resistant cancers.

Using specialized white blood cells or T cells that he discovered, Lu and his research team will determine if the administration of these blood cells can eradicate advanced tumors and prevent recurrence of resistant tumors in an animal model.

Cancer recurrence may cause cancer treatment failure and death in more than 90% of patients with advanced tumors, especially with metastatic disease, which often develops resistance to the initial treatments, Lu said.

We hope our work will shed light on the mechanisms underlying how T cells, the major type of white blood cells, prevent resistance and hopefully establish a foundation for translating that into more effective immunotherapies in human cancers."

Yong Lu, Ph.D., assistant professor of microbiology and immunology

The second grant, for $782,000 over four years, was awarded to David Soto-Pantoja, Ph.D., assistant professor of surgery and cancer biology.

The grant will support his team's efforts to create preclinical models to study cardiotoxicity - damage to the heart muscle - that results from some chemotherapy and immunotherapy drugs.

"In the next 10 to 15 years, there will be 20 million cancer survivors in the U.S. thanks to newer cancer drugs that are very effective," Soto-Pantoja said. "Unfortunately, many of these drugs have other side effects such as heart disease that can occur many years after treatment."

Soto-Pantoja's goal is to better understand how chemotherapy drugs can affect the heart and develop strategies to prevent future development of cardiac diseases, as well as to find new treatments for those patients who have already developed heart disease.

For example, when he was a fellow at the National Institutes of Health prior to coming to Wake Forest Baptist, his team identified a molecule present on cells that when blocked prevents some of the damage caused by chemotherapy drugs.

"The molecule enhanced the immune system to attack the tumor but protected normal tissue from the negative effects of chemotherapy," Soto-Pantoja said.

This grant will support his continued efforts to understand how this molecule works and hopefully lead to a new approach to cancer therapy.

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Two Wake Forest Baptist scientists receive $1.5 million for cancer research - The Medical News

Livestock research ‘going to do some of the very best science’ – Rocky Mountain Collegian

In case you forgot, Colorado State University is a land-grant institution, originally formed as an agricultural college.

To further the Universitys initial mission, the College of Agricultural Sciences and the College of Veterinary Medicine and Biomedical Sciences are teaming up to start the Sustainable Livestock Systems Collaborative.

I think the impetus really is that, you know, CSU is a land-grant university, said Mark Zabel, CVMBS associate dean for research. We still have a commitment to agriculture and to educating Coloradans centered around those issues.

Zabel said that while there will be no physical building or presence, the Sustainable Livestock Systems Collaborative will be a collection of stakeholders researchers, policy makers and producers in the livestock, agriculture and dairy industries coming together around the idea of sustainable farming practices.

The overall goal (is) to specifically engage with livestock production and to help producers at the grassroots (level) address firstly profitability, secondly their environmental footprint, thirdly animal health and lastly human health, particularly via food safety, said Keith Belk, head of the department of animal sciences and co-chair of the steering committee.

Applications for director of the initiative recently closed, Belk said, and research is anticipated to begin by the fall semester of this year. Belk said they will be opening a couple more faculty positions in the coming months as well.

Its actually across our entire campus. Where we have students interested in sustainability, weve got scientists that are interested in it, and were going to be able to do great things by working together. -James Pritchett, College of Agricultural Sciences interim dean

James Pritchett, interim dean of CAS, said professionals in the agriculture industry have been coming to CSU asking for answers to questions grounded in sustainability. The driving force behind much of the research conducted by the collaborative will be issues posed to CSU by those professionals.

For example, as the climate changes and we have disrupted weather patterns and we have periods of drought or flood, how does that affect how we can grow crops? Zabel asked. We can do things like try to develop heartier strains of grain that can survive droughts or that can survive floods. We can develop better feeding and watering practices for our livestock.

Belk added that research could be anything related to the environmental impact of farming, ranching and livestock production. Water use, water contamination, soil erosion, land management and production of greenhouse gases are all topics the collaborative wants to explore and find solutions to.

The collaborative will not only provide faculty with more opportunities to conduct research, but will allow for undergraduate and graduate students to participate as well.

I am very committed to having all of our students at every education level coming together as research teams to solve these problems, Zabel said. In (the department of microbiology, immunology and pathology), we really emphasize undergraduate research. Its our goal to be able to train each of our undergraduates in long-term substantive research experience.

Pritchett said funding for the collaborative comes from repurposing a base budget that funded faculty members who have since retired or moved on, and the Office of the Provost will then match that with funding from student allocations from the general fund.

Were going to do some of the very best science to help create sustainable food systems, Pritchett said. Its reaching across not just the college of agriculture or vet med, its actually across our entire campus. Where we have students interested in sustainability, weve got scientists that are interested in it, and were going to be able to do great things by working together.

Serena Bettis can be reached atnews@collegian.comor on Twitter@serenaroseb.

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Livestock research 'going to do some of the very best science' - Rocky Mountain Collegian

Russia’s Ministry of Health refutes misleading online claim that it stated COVID-19 is man-made – AFP Factcheck

Multiple articles and social media posts viewed tens of thousands of timesclaimthe Russian Ministry of Health confirmed in a document that the novel coronavirus, COVID-19,is man-made.The claim is misleading; the RussianMinistry of Health said it did not make such astatement; the documentcited in the misleading postsstates COVID-19is a recombinant virus which can form naturally.

The claim was made in this report by Taiwanese news site CredereMedia. The article has been viewed almost 150,000 times on Facebook after it was published on February 21, 2020, according to statistics from social media monitoring tool CrowdTangle.

The article's traditional Chinese-language headline translates to English as: The first official confirmation in the world: Russian Ministry of Health says Wuhan pneumonia is caused by a man-made virus.

The photo in the article is captioned: Russian health minister Mikhail Murashko (pictured left) signs a document confirming the source of the Wuhan pneumonia is a man-made recombinant virus."

The article reports onRussia's measures to combat the novel coronavirus, as well ason China'sdenials that the virus was created as a biological weapon.

Below is a screenshot of the misleading post alongside CrowdTangle statistics:

The claim was also shared in Facebook groups with hundreds of thousands of followers, such as here, here, here and here. It has also circulated on Twitter here, here, here and here as well as on Instagram here and here.

The claim is misleading.

The Russian Ministry of Health has never indicated that the virus was of artificial origin in its recommendations on the prevention, diagnosis and treatment of the new coronavirus, a Ministry of Health spokesperson told AFP by email on February 27, 2020.

Regarding the alleged document, the misleading posts refer to a report published late January by the Russian Ministry of Health.

A search forcoronavirus on the ministrys website found the Temporary guidelines for the prevention, diagnosis, and treatment of the new 2019-nCoV coronavirus infection, which was published on January 30, 2020.

Coronavirus 20190nCov is presumably a recombinant virus, between a bat coronavirus and a coronavirus whose origin is unknown, part of the Russian report reads in English.

Professor William Robert Fleischmann Jr., an expert on viruses and immunology, noted in his co-authored academic book Medical Microbiology that recombinant viruses can form naturally.

Viruses are continuously changing as a result of genetic selection. They undergo subtle genetic changes through mutation and major genetic changes through recombination, the book stated. Mutation occurs when an error is incorporated in the viral genome. Recombination occurs when coinfecting viruses exchange genetic information, creating a novel virus.

A research paper published here in January 2020 in the Journal of Medical Virology also explains how recombination can be a natural process.

The report, which is titled Crossspecies transmission of the newly identified coronavirus 2019nCoV, states that the coronavirus may appear to be a recombinant virus between the bat coronavirus and an originunknown coronavirus.

A claimthat the deadly virus was created in a laboratory, and specifically by the US Centers for Disease Control and Prevention, was previously debunked by AFP here.

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Russia's Ministry of Health refutes misleading online claim that it stated COVID-19 is man-made - AFP Factcheck

Coronavirus circulated ‘unnoticed for weeks’ in Italy, expert says – Daily Sabah

The new coronavirus had been "circulating unnoticed for weeks" in Italy, experts said Friday after studying its progression in the country.

"The virus circulated unnoticed for several weeks before the first ascertained cases ... perhaps since mid-January," Massimo Galli, the director of the Biomedical Research Institute, told Agence France-Presse (AFP). Studying the virus in Italy "will help understand the epidemic better, and contain it," he said.

The virus mutates from person to person, he said, so researchers will be looking at why Italy has the largest number of cases in Europe and "the differences between this and the coronavirus in China." That will help in terms of treatment and the potential development of a vaccine, he added.

Some 650 people have tested positive for the virus in Italy, though only 303 are considered serious clinical cases.

Galli's team at the Sacco hospital in Milan, led by immunology professor Claudia Balotta, worked on samples taken from three patients in the "red zone" around Codogno in Lombardy, home to Italy's first known case of COVID-19. They isolated the Italian strain in just four days.

The small town of Codogno in northern Italy is home to a 38-year-old man dubbed "patient one." "Patient zero," who passed the virus to the 38-year-old, has yet to be found, but "patient one" is considered the source of both the Codogno outbreak and another in the Veneto region.

The 38-year-old hospitalized a week ago passed the virus to his heavily pregnant wife, a friend and men who were regulars at a bar in Codogno, before going on to infect doctors, nurses and other hospital patients as well.

The virus has killed 17 people in Italy over the past week, all of whom were either elderly or had pre-existing health issues.

The number of cases of infection reported has risen steadily each day, though Galli said that did not mean the virus was spreading. Most were people who had caught it previously but had not been tested until now.

Bilotta said it would "take weeks" to determine the exact date of arrival of this strain in Italy, saying results would likely only come "once the epidemic is over."

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Coronavirus circulated 'unnoticed for weeks' in Italy, expert says - Daily Sabah

Northwell creates institute for gun violence prevention – The Island Now

Northwell Health System announced the creation of an institute to study gun violence prevention on Wednesday.

The Center for Gun Violence Prevention was established by its President and CEO Michael Dowling to help curtail the nearly 40,000 firearms-related deaths that occur every year in the U.S.

I firmly believe that health care leaders have a social responsibility to try to stop the mindless bloodshed caused by firearms-related violence in this country, just as we respond aggressively to health crises like vaping, the flu or the new coronavirus that is causing worldwide panic, said Dowling, who has called gun violence a major health problem and called on other hospital groups to support legislation to address the problem.

The center will be headed by Dr. Chethan Sathya, a pediatric surgeon and associate trauma medical director at Cohen Childrens Medical Center, whose trauma surgery training at Northwestern Medicines Childrens Hospital in Chicago, Ill. involved treating infants with gunshot wounds.

Our goal is to build a blueprint for how health systems across the nation can reduce gun violence and promote gun safety, Sathya said. If we can develop a successful gun violence prevention strategy internally, it will serve as an example for other health systems and industries to follow suit. We want to lead the charge on this and show others that meaningful change is possible and that lives can be saved.

Northwells Deputy Physician-in-Chief Thomas McGinn will assist, as will Dr. Jose Prince, vice chair of surgery at Northwell and director of the Laboratory of Pediatric Injury and Inflammation at the Feinstein Institutes Center for Immunology and Inflammation.

Multiple prominent voices on gun violence prevention have agreed to serve on an advisory committee that will guide the new interdisciplinary center, including Dr. Peter Masiakos, founder of Massachusetts General Hospitals Center for Gun Violence Prevention and assistant professor at Harvard Medical School; Dr. Robert McLean, president of the American College of Physicians and associate clinical professor at Yale Medical School; Dr. Megan Ranney, chief research officer of the American Foundation for Firearm Injury Reduction in Medicine Research; Dr. Mark Rosenberg, former head for the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention and former CEO of the Task Force for Global Health; and Daniel Webster, director of Johns Hopkins Center for Gun Policy and Research and a leader at the Johns Hopkins-Baltimore Collaborative for Violence Reduction.

Dowling, who served as state director of Health, Education and Human Services, has been outspoken on gun violence as a public health crisis. He ran advertisements in The New York Times last summer calling for efforts to combat the problem, held Northwells Gun Violence Prevention Forum last fall and wrote an editorial in the August issue of Beckers Hospital Review on the subject.

True leadership means having the personal courage to speak out and take the heat, particularly on issues that are affecting the health and wellness of our communities, Dowling wrote. If there was a disease that was killing as many people as guns in this country, we would be mobilizing a national response effort. Its inexcusable for us to remain silent.

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Northwell creates institute for gun violence prevention - The Island Now

Allergists offer advice to parents of kids with food allergies – Reuters

(Reuters Health) - Parents of children with food allergies should acknowledge their kids anxiety, as well as their own, a group of allergy experts advises.

Food allergies affect children of different ages in different ways and can influence relationships with classmates, family and the general public, according to the study in the Annals of Allergy, Asthma & Immunology.

Quality of life issues related to food allergies are ubiquitous, said co-author Dr. Ruchi Gupta, director of the Center for Food Allergy and Asthma Research at the Northwestern Feinberg School of Medicine in Chicago.

Coping with food allergies impacts relationship skills with peers and classmates, emerging independence and sense of self-efficacy, social skills and confidence, willingness to participate in sports teams, dating and more, she told Reuters Health by email. Coping is an individual internal experience, too: Feelings of worry and anxiety can color all thinking and generate anxiety about many life experiences.

About 8% of children in the U.S. have been diagnosed with a food allergy, according to the American Academy of Pediatrics. Allergic reactions to foods tend to be among the most severe, and potentially life-threatening, the study authors note.

Anaphylaxis, the most severe allergic reaction, can be reversed with a shot of epinephrine from an auto-injector like the EpiPen.

To examine the challenges children with life-threatening food allergies and their families encounter, which ones cause the most anxiety and what positive coping patterns work best, Gupta and colleagues interviewed six board-certified allergists who treat a large number of children with food allergies.

Overall, the allergists said, diagnosis, management and treatment occur along a spectrum, and its not a one size fits all practice. Younger children, for instance, may not be especially anxious about food, but their parents often are. Although older children may have better understanding and control of their food allergy, they participate in more independent activities, which can create heightened parental anxiety.

Kids with food allergies experience anxiety as a result of their parents stress, as well as fear of the auto-injector needle, anaphylaxis, food allergy tests and oral immunotherapy. The fallout that follows an allergic reaction can also be complex and interfere with everyday functioning. Successfully using epinephrine, however, can build confidence and bring a sense of relief after facing the unknown.

The allergists also talked about creating thoughtful and balanced communication, having credible health information to share with children, and supporting a positive feedback loop between parents and children rather than one that builds anxiety. Parents should be encouraged to transfer their knowledge to children, not all of their worries, one expert remarked.

Psychosocial coping with food allergies can be understood and managed when clear communication is present between parents and children and between healthcare providers and patients, Gupta said. It is a balance between lots of sound medical information and a good understanding of a childs risks and coping resources.

Coping is often impeded by misinformation about food allergies, the experts said, so its important for parents to receive consistent messaging and counseling for the family, if necessary.

You are taking care of the kids, but you are (also) managing the family unit, as you should be, one allergist said.

Brochures, apps, virtual groups and other educational materials can offer scientifically informed resources for parents and kids to manage food allergies. Gupta and colleagues are now collecting information in an online survey about the coping strategies and integrative medicine that parents and children have used.

Its important for families to know that its normal to be stressed about food allergy and feel overwhelmed, worried, sad or frustrated at times, said Linda Herbert, director of the Psychosocial Services Program for the Division of Allergy and Immunology at Childrens National Hospital in Washington, D.C.

But its equally important to know that they can get help from a professional, Herbert, who wasnt involved in the study, told Reuters Health by email. The mental health and allergy communities are paying more and more attention to the needs of food allergy families, and we are working hard to increase the number of mental health professionals who are equipped to do so.

SOURCE: bit.ly/2utQCOm Annals of Allergy, Asthma & Immunology, online February 25, 2020.

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