SEEKING ANSWERS THAT IMPROVE LIVES OF CANCER PATIENTS

RESEARCH LEADING TO IMPROVED OUTCOMES FOR PEDIATRIC CANCER PATIENTS IS THE FOCUS OF SEVERAL PROJECTS BY A FACULTY MEMBER AND CLINICAL PHARMACIST AT CHAPMAN’S SCHOOL OF PHARMACY (CUSP) IN COLLABORATION WITH THE CHOC CANCER INSTITUTE.

Sun Yang, an assistant professor at CUSP, is working to unlock insights that could improve pain management, stem-cell transplants and infection risk in pediatric oncology patients. Among them are:

ƒ Investigations into outpatient opioid prescribing for pediatric and young adult patients in California – Yang found a high degree of variability of prescription rates. Findings were published in the Journal of Contemporary Pharmacy Practice. The Kay Family Foundation-Data Analytic Grant supported the work.

ƒ A newly initiated clinical study planned to investigate the impact of mental distress on patients’ response to opioid prescriptions – The research could help identify which patients could benefit from interventions to help manage pain without extensive use of the powerful pain medications, says Yang.

ƒ A predictive risk model to determine patient likelihood for a severe infection caused by the infection C. difficile – Collaborating with CHOC oncologist and infectious disease physicians, Yang and CUSP colleague, Jason Yamaki, are working to develop a predictive risk model to determine patient likelihood for this infection. This translational research project is supported by the 2021 Faculty Opportunity Grant from Chapman University Office of Research.

ƒ Research aimed at identifying risk factors for a complication that often afflicts bone marrow transplant recipients – Called acute graft-versus-host disease, the syndrome occurs when donor cells attack the cells of the transplant recipient. The data analysis found a correlation with donor age as a risk factor, suggesting that siblings rather than parents might be preferred donors.

Opportunities to conduct translational research so close to patient impact inspires Yang daily, she says.

“Every morning you just want to go to work because you know what you’re doing is helping patients. Working with CHOC helps me see the patients we’re working to help,” she says. “It’s very rewarding.”

Charting The Dangers Of Household Chaos And Toxic Stress

CHILD DEVELOPMENT EXPERTS KNOW THAT ADVERSITY AND TOXIC STRESS SUFFERED EARLY IN LIFE CAST A LONG SHADOW. CALLED ADVERSE CHILDHOOD EXPERIENCES (ACES), THE RISK FACTORS ARE LINKED WITH A VARIETY OF CONDITIONS ACROSS THE LIFESPAN, FROM HIGH BLOOD PRESSURE TO DEPRESSION.

Chapman University professor of psychology Laura Glynn is part of a collaborative team that includes researchers from Chapman, Children’s Health of Orange County (CHOC) and UC Irvine. The researchers want to better understand which children are most vulnerable to these events so that targeted interventions and preventive therapies can be deployed in early childhood.

The team was awarded a $2.8 million grant for the research project by the California Governor’s Office of Planning & Research, in partnership with the Office of the California Surgeon General. The three-year project connects with an initiative set by then-California Surgeon General Nadine Burke Harris to cut ACEs and toxic stress in half in one generation through targeted public health strategies.

“California is leading the way in addressing the impacts of early life adversity because of our surgeon general, and what’s really exciting is that Chapman, CHOC and UCI are part of that agenda,” said Glynn, director of Chapman’s Early Human and Lifespan Development Lab. “It’s profound and it’s important.”

WHAT’S THE TIPPING POINT OF CHAOTIC ENVIRONMENTS?

A unique portion of the three-year project led by Glynn will also measure how persistent chaos and unpredictability in the household affects child neurodevelopment and cognitive function. Unlike many sources of toxic stress –including poverty, substance abuse, parental incarceration and systemic racism – household chaos can be more immediately addressed, Glynn explains.

“One could argue that things such as encouraging parents to have regular mealtimes, a bedtime routine and consistent family time are easier intervention targets,” she says.

A paper co-authored by Glynn, “A predictable home environment may protect child mental health during the COVID-19 pandemic”, was cited in the U.S. Surgeon General’s 2021 advisory document, “Protecting Youth Mental Health.” Glynn and her colleagues concluded that

“maintaining a structured, predicable home environment by adherence to family routines appears to mitigate (the) adverse effects” of the COVID-19 pandemic.

Most households with young children hit hectic patches occasionally, Glynn notes. But with the scale of the state-funded project, which will include data gathered from 100,000 children visiting CHOC clinics throughout Orange County, she hopes they can identify a tipping point at which such environments become chronic and unhealthy.

Much of the work also involves the predictive tools behind big data, which brings another Chapman connection to the collaborative effort, CHOC senior data scientist Louis Ehwerhemuepha, (M.S. ’13, Ph.D. ’15).

‘UNPREDICTABILITY CUTS ACROSS ALL SOCIO-ECONOMIC LEVELS’

Additionally, project participants aim to gain insights into the role socioeconomic status plays. Such data will be the focus of Chapman postdoctoral researcher Sabrina Liu, an expert in toxic stress and health disparities.

Nearly 70% of children in Orange County visit CHOC clinics and practitioners for everyday health care needs, Glynn says.

“The CHOC landscape is very diverse. Unpredictability cuts across all socio-economic levels,” she says.

In the second component of the study, Glynn and fellow researchers at the Early Human and Lifespan Development Lab will collect DNA samples from children at birth and 12 months of age. The goal is to discover if there is an epigenetic biomarker that can predict their level of resilience to ACEs, again so targeted interventions can be provided.

“It’s exciting to get a little closer to how we can incorporate research into practice,” Glynn says. “With this multiinstitution collaboration, we are in a position to affect health and pediatric practice in a meaningful way.”