HJAR Jan/Feb 2020

HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2020 25 For weekly eNews updates and to read the journal online, visit HealthcareJournalAR.com recognizing them as a product class in 2011, when they were separated from the regulations governing bassinets and cradles. They are cur- rently defined as “a free standing product with an inclined sleep surface primarily intended and marketed to provide sleeping accommodations for an infant up to five months old or when the infant begins to roll over or pull up on sides, whichever comes first.” The appearance of the products varies, but they can look like hammocks or slings suspended on a frame, often with an incline of 10 to 30 degrees. Mannen’s research became public as the Con- sumer Product Safety Commission considers changes to the regulations for this line of product. The team also conducted a review of several examples from the product class and found a wide variety of products are being marketed in this category. Many different designs and mate- rials are in use. They reviewed 91 incidents on a case-by-case basis, looking at police reports, caregiver inter- views, autopsies and other data. They found that in many cases where an infant had been placed to sleep on their back in the sleeper and then rolled over and suffocated, the caregivers reported that they had not rolled over before and it was likely one of their first times to do so, if not the first time. Additionally, the team monitored oxygen satu- ration levels of the babies over about one to two minutes in the inclined sleepers as opposed to a flat crib-like surface and found that even in such short time periods, there were twice as many inci- dents of a drop in oxygen levels in the inclined sleepers. “We found evidence to suggest that this inclined position on a non-rigid surface may make it easier for babies to roll over, but harder for them to roll back,” Mannen said. Baptist Health Family Clinic- Massard Adds Nurse Practitioner Nata Matthews, DNP, APRN, has joined Baptist Health Family Clinic-Massard. As a nurse practitioner, Matthews can diagnose and treat acute and chronic conditions, as well as provide wellness exams and education on pre- venting illness. Matthews earned a Doctor of Nursing Practice from Creighton University in Omaha, Neb. She earned a Bachelor of Science in Nursing from the University of Arkansas – Fort Smith in 2012. Prior to becoming a nurse practitioner, Mat- thews worked a registered nurse in the Intensive Care Unit at Baptist Health-Fort Smith. She most recently served residents of LeFlore County, Okla- homa, at Baptist Health Family Clinic-Spiro. UAMS Researcher Pinpoints Immune SystemCause for AutismSubtype Researcher Terry Harville, MD, PhD, of the Uni- versity of Arkansas for Medical Sciences (UAMS), has published a major study that for the first time links autism spectrum disorder to a specific genetic variation affecting the immune system. The study, published in the Frontiers of Psychi- atry , found that a genetically inherited immune type HLA-Cw7 was present in much higher num- bers in people with autism as compared to the general population. Harville and co-authors believe this HLA-Cw7 expression may cause chronic immune system activation for a subgroup of people with autism. In fact, this chronic inflammation may be affect- ing the brain and actually be causing the autism in these patients. “Findings like this bring us one step closer to the future of treatment for autism: individualized medicine,” Harville said. “The more we truly understand the driving forces behind autism spectrum disorder, the better we will be able to identify and treat subgroups and individuals — to the maximum benefit for the individual patient.” Harville, who is a professor of pathology and internal medicine at UAMS with a long career in pediatric immunology, collaborated on the study with the UAMS Department of Pediatrics, Arkan- sas Children’s Research Institute (ACRI), UAMS College of Public Health, National Center for Tox- icological Research, and other institutions across the country. Autism spectrum disorder includes a broad range of symptoms like challenges with social skills, repetitive behaviors, speech and nonver- bal communication. It affects about 1 in 69 chil- dren in the United States. While there is no known single cause of autism, the current consensus among the scientific com- munity is that it is not one condition but several unique subtypes driven by both genetics and environmental factors. Scientists have long sus- pected the immune system may play a role for some subtypes, and a body of evidence is accu- mulating to support this connection. Harville said it has been difficult to prove an immunological cause for autism, in part because the autism diagnosis is so broad. He agrees with the theory that autism is likely several different conditions, each with a unique cause. During his career as a pediatrician, Harville observed that the same treatment would have a dramatic effect for one patient with autism and little or no effect on another. With this in mind, Harville’s study also attempted to identify other characteristics that define this subgroup of patients with the HLA- Cw7type. Harville found that — in addition to the behavioral symptoms that led to their autism diagnosis — these patients also reported higher rates of infections, allergies, food intolerances, chronic sinusitis and gastrointestinal issues com- pared to other patients with an autism diagno- sis but without expression of the HLA-Cw7 gene. “What emerges is a profile of symptoms that might help clinicians identify these patients as part of this subgroup,” Harville said. “Our next step will be looking at ways to perhaps manage these patients with treatments that alter immune system function or activation.” Other variations of the HLA gene have been connected to autoimmune disorders like rheuma- toid arthritis, celiac disease and ankylosing spon- dylitis. This led Harville to choose HLA for the focus of his autism study. Nata Matthews, DNP, APRN