University of Adelaide research is showing that the sex of the baby determines the way it responds to stressors during pregnancy and its ability to survive pregnancy complications.

Male and female babies during pregnancy show different growth and development patterns following stressors during pregnancy such as disease, cigarette use or psychological stress.

The research is being carried out by the Robinson Institute’s Pregnancy and Development Group, based at the Lyell McEwin Hospital and led by Associate Professor Vicki Clifton.

“What we have found is that male and female babies will respond to a stress during pregnancy by adjusting their growth patterns differently,” said Associate Professor Clifton.

“The male, when mum is stressed, pretends it’s not happening and keeps growing, so he can be as big as he possibly can be. The female, in response to mum’s stress, will reduce her growth rate a little bit; not too much so she becomes growth restricted, but just dropping a bit below average.

“When there is another complication in the pregnancy – either a different stress or the same one again – the female will continue to grow on that same pathway and do okay but the male baby doesn’t do so well and is at greater risk of pre-term delivery, stopping growing or dying in the uterus.”

Associate Professor Clifton said this sex-specific growth response had been observed in pregnancies complicated by asthma, pre-eclampsia and cigarette use but was also likely to occur in other stressful events during pregnancy such as psychological stress.

She said this sex-specific growth pattern was a result of changes in placental function caused by the stress hormone cortisol.

In female babies, increased cortisol produces changes to the placental function which lead to the reduction in growth, but the increased cortisol levels in a mother carrying a male baby doesn’t produce the same changes in placental function.

Associate Professor Clifton said this research could lead to sex-specific therapies in pre-term pregnancies and premature newborns. It was also important in helping obstetricians more accurately interpret growth and development of the fetus in at-risk pregnancies.

“We are looking at what events during pregnancy cause changes in how the baby grows, what’s behind this and ways in which we can improve the outcomes for pregnant women and their babies,” she said.

Limited success in modelling the behaviour of the complex, unusual and unpredictable HIV virus has slowed efforts to develop an effective vaccine to prevent AIDS.

A new improved modelling system, developed by Chinese researchers, which attempts to incorporate more of the virus’ random behavioural dynamics, suggests that a particular type of T cell could be useful in the development of an AIDS vaccine.

New research published 29 April, in New Journal of Physics (co-owned by the Institute of Physics and German Physical Society), describes how physicists and biologists from Xiamen University have been able to incorporate random patterns in the virus’ mutation, and the way the virus responds to antibodies, into their model.

Gratifyingly, they have found that the new model, and the projections made by the new model for development of disease, mirror real-life, clinical behaviour of the virus.

Clinical trials show that the HIV virus behaves quite normally during the acute first phase of human infection, normally 2-6 weeks after HIV enters the host body, during which time the strength of the virus increases and our immune systems deploy killer T cells, CD4+ T cells, to battle against it.

Outwardly, we would experience flu like symptoms and would, when we started to feel better, imagine that we are over the infection but this is not so with the HIV virus which somehow avoids total annihilation and manages to spend years rebuilding strength, slowly chipping away at our immune system.

Researchers suspect that HIV’s ability to avoid annihilation has to do with its own mutating properties and its ability to preferentially target CD4+ T cells, the master regulators of our immune system.

The model-makers from Xiamen University have created a simulation which takes a wider range of variables into consideration and while they are in agreement that both HIV’s mutating and T-cell targeting ability are crucial to the virus’ devastating success rate, they have found a possible chink in the virus’ armour.

To date, no models have been able to discern between the behavioural patterns of two different types of T-cells, both of which are involved in our internal fights against HIV.

These are CD4+ T and CD8+ T cells. Patterns emerging from these new models now suggest that CD8+T cells could be used to stimulate a stronger response against the virus.

This particular type of T-cell does not appear to be as preferentially targeted by HIV as its counterpart and also appears to be more actively involved in putting the virus down during the first acute phase of the infection.

As the researchers write, “We assess the relative importance of various immune system components in acute phase and have found that the CD8+ T cells play a decisive role to suppress the viral load. This observation implies that stimulation of a CD8+T cell response might be an important goal in the development of an effective vaccine against AIDS.”

The article is free to read from at http://iopscience.iop.org/1367-2630/12/4/043051

New research led by McGill Biochemist Dr. William Muller helps explain why breast-milk cells lose their structure, causing them to clump up in strange ways and sometimes become cancer tumors. With the support of Chen Ling and Dongmei Zuo at McGill’s Goodman Cancer Centre, Muller has discovered how one particular gene regulates epithelial cells cells that normally form in sheets and are polarized to enable the transport of molecules in a single direction. It’s this loss of polarity that is thought to play an important role in breast tumor development. Scientists at the Ontario Cancer Institute (Princess Margaret Hospital’s research arm) and Cold Spring Harbor Laboratory in New York State also contributed to the findings.

By using mouse models, Muller discovered that the cells do not form neat structures when the gene malfunctions. “In fact, the first mouse model had a skin defect and was completely incapable of forming sheets of epithelial cells. This gene is frequently lost in breast cancer, significant proof that this gene might play an important role,” he said.

The research published in Genes and Development shows that if the gene is reintroduced into a tumour, polarity can be restored. “This is an interesting first step along this particular path,” Muller said, pointing out that the gene functions by working with more than 40 various proteins, of which only one, a scaffold protein, has been identified. Proteins, he said, play various roles in our body, from maintaining cell shape and function through to driving chemical reactions, immune responses and growth.

“We have many other steps to take before we can say this path will lead to a treatment or cure.”

The research received funding from the Canadian Institutes of Health Research and the United States Department of Defense Breast Cancer Research Program.

A drug may be more effective against the leading cause of adult blindness than laser treatments, a new study has shown.

Researchers at the University of Illinois at Chicago College of Medicine participated in a national multi-center trial comparing treatments for diabetic macular edema, a swelling of the retina associated with diabetes, that is the major cause of blindness among adult Americans.

The study looked at treatment by injection of the drug ranibizamb — marketed by Genentech as Lucentis — by comparing it to laser treatment, which has been the standard of care for the last 25 years.

The study, which will be published online in the journal Ophthalmology, followed 691 people who had one or both eyes treated at 52 sites, including UIC.

The study “shows the power of targeted treatment for diabetic macular edema,” said Dr. Jennifer Lim, professor and Charles I. Young Chair of Ocular Research in Ophthalmology and Visual Science at UIC and a site principal investigator on the study. “We were able to achieve much higher visual acuity improvements than ever before,” she said, and without significant side effects.

Patients were randomly assigned to four treatment groups: sham injections plus prompt laser treatment (within one week), ranizumab injections plus prompt laser treatment, ranizumab plus deferred laser treatment after six months or more, or injections of a corticosteroid drug plus prompt laser treatment.

After one year, nearly half the eyes treated with ranizumab showed substantial eye improvement. Patients were able to read at least two additional lines on an eye chart than before treatment. Results were similar whether ranizumab treatment was accompanied by prompt or delayed laser treatment. Fewer than 5 percent of patients in the ranizumab treatment groups experienced a visual loss of two or more lines.

Only about 30 percent of patients receiving laser treatment alone or corticosteroid plus laser improved their ability to read two or more lines on an eye chart, while 13 to 14 percent of eyes in these groups had a visual loss of two or more lines.

The findings echoed an earlier, smaller study that compared ranibizumab alone versus ranibizumab plus laser treatment or laser alone, said Lim, who served on the executive committee of the earlier study. In that study, after six months the ranibizumab-alone eyes also did best, “and we have unpublished data that suggests the results held after one year as well,” she said.

“Ranizumab is an important new treatment option for people with diabetes,” said Lim, who is director of retina services at UIC. She said she hoped that the high complication rate for patients treated with the corticosteroid would help to end the use of this outmoded treatment option.

Dr. Michael Blair, assistant professor of ophthalmology and visual sciences, also acted as a site principal investigator on the study.

The study was conducted as a part of the Diabetic Retinopathy Clinical Research Network and supported by the National Eye Institute, and the National Institute of Diabetes and Digestive and Kidney Diseases, both part of the National Institutes of Health.

Regular exercise speeds learning and improves blood flow to the brain, according to a new study led by researchers from the University of Pittsburgh School of Medicine that is the first to examine these relationships in a non-human primate model. The findings are available in the journal Neuroscience.

While there is ample evidence of the beneficial effects of exercise on cognition in other animal models, such as the rat, it has been unclear whether the same holds true for people, said senior author Judy L. Cameron, Ph.D., a psychiatry professor at Pitt School of Medicine and a senior scientist at the Oregon National Primate Research Center at Oregon Health and Science University. Testing the hypothesis in monkeys can provide information that is more comparable to human physiology.

“We found that monkeys who exercised regularly at an intensity that would improve fitness in middle-aged people learned to do tests of cognitive function faster and had greater blood volume in the brain’s motor cortex than their sedentary counterparts,” Dr. Cameron said. “This suggests people who exercise are getting similar benefits.”

For the study, the researchers trained adult female cynomolgus monkeys to run on a human-sized treadmill at 80 percent of their individual maximal aerobic capacity for one hour each day, five days per week, for five months. Another group of monkeys remained sedentary, meaning they sat on the immobile treadmill, for a comparable time. Half of the runners went through a three-month sedentary period after the exercise period. In all groups, half of the monkeys were middle aged (10 to 12 years old) and the others were more mature (15 to 17 years old). Initially, the middle-aged monkeys were in better shape than their older counterparts, but with exercise, all the runners became more fit.

During the fifth week of exercise training, standardized cognitive testing was initiated and then performed five days per week until week 24. In a preliminary task, the monkeys learned that by lifting a cover off a small well in the testing tray, they could have the food reward that lay within it. In a spatial delay task, a researcher placed a food reward in one of two wells and covered both wells in full view of the monkey. A screen was lowered to block the animal’s view for a second, and then raised again. If the monkey displaced the correct cover, she got the treat. After reliably succeeding at this task, monkeys that correctly moved the designated one of two different objects placed over side-by-side wells got the food reward that lay within it.

“Monkeys that exercised learned to remove the well covers twice as quickly as control animals,” Dr. Cameron said. “Also, they were more engaged in the tasks and made more attempts to get the rewards, but they also made more mistakes.”

She noted that later in the testing period, learning rate and performance was similar among the groups, which could mean that practice at the task will eventually overshadow the impact of exercise on cognitive function.

When the researchers examined tissue samples from the brain’s motor cortex, they found that mature monkeys that ran had greater vascular volume than middle-aged runners or sedentary animals. But those blood flow changes reversed in monkeys that were sedentary after exercising for five months.

“These findings indicate that aerobic exercise at the recommended levels can have meaningful, beneficial effects on the brain,” Dr. Cameron said. “It supports the notion that working out is good for people in many, many ways.”

Researchers from the Pitt’s departments of psychiatry, neuroscience, and anthropology, as well as Korea University College of Medicine, University of Illinois, and Pennsylvania State University also authored the paper, which was supported by grants from the National Institute of Aging, the National Institute on Diabetes, Digestive and Kidney Disorders, and the Retirement Research Foundation.

A short, one-off sigmoidoscopy test to locate tumors and polyps in the colon using a small camera and a flexible tube could reduce deaths from bowel cancer by 40 per cent, concluded a UK trial involving 55 to 64 year olds.

You can read a report on the trial, led by Professor Wendy Atkin from Imperial College London, and part funded by Cancer Research UK, in the 28 April early online issue of The Lancet.

Harpal Kumar, Chief Executive Officer of Cancer Research UK, said in a press statement:

“This is one of the most important developments in cancer research for years.”

Every year, more than 100 people receive a diagnosis of bowel cancer in the UK, where it is the third most common cancer. While death rates have been falling in recent decades, the disease still kills 16,000 people every year.

Most bowel cancers develop from symptomless growths called polyps, and if these are detected and removed early, it vastly increases chances of survival. Figures from Cancer Research UK suggest 9 in 10 people survive for more than five years if their bowel cancer is diagnosed at an early stage.

For the trial, Atkin and colleagues used a device called the “Flexi-Scope”, a common name for a flexible sigmoidoscopy comprising a flexible tube or endoscope that has a small camera and light at the end.

Doctors use the Flexi-Scope to examine the general health of the bowel and search for polyps in the sigmoid colon, the part of the large intestine that is closest to the rectum, which is where the tube goes in. The procedure is painless and quick, as is removing any polyps, which can be done at the same time and adds only minutes to the time it takes to do the screening.

Atkin and colleagues have been carrying out a trial using the Flexi-Scope for the last 16 years.

For the trial they recruited over 170,000 people, a third of whom were invited to have a one-off test with the Flexi-Scope. The participants were treated at 14 UK centres, and just over 70 per cent agreed to have the test, with eventually 40,674 undergoing screening with Flexi-Scope.

The researchers found that for people aged between 55 and 64, having a one-off test with the Flexi-Scope reduced their chances of developing bowel cancer by one third compared to a control group that did not have the test. The rate of death among those screened was also 43 per cent lower than that of the control group.

At a public health level, this translates to 5.2 cases of bowel cancer prevented for every 1,000 people, and 2 deaths avoided. Or in other words, screening 191 people is likely to prevent one case of bowel cancer and screening 489 people is likely to prevent one death.

For the UK this means bringing in one-off tests for bowel cancer for this age group could prevent at least 5,000 people from receiving a diagnosis of bowel cancer and save at least 3,000 people from dying of it (this is more than twice the 1,400 lives that the NHS Breast Screening Programme says it saves in England every year).

Cancer Research UK suggests that the Flexi-Scope test be added to the UK’s current bowel screening programme, which is currently based on the FOBT, or faecal occult blood test, which looks for “hidden” blood in stool samples, a possible sign of cancer anywhere in the gastrointestinal tract.

Trials show that FOBTcan reduce bowel cancer deaths by around 25 per cent, and for many countries, as in the UK, it is the main part of their bowel cancer screening programme.

The charity suggests the two tests, Flexi-Scope and FOBT complement each other: Flexi-Scope can prevent bowel cancer as well as detecting it after it has appeared, but only in part of the colon, so the FOBT still has a role in detecting early cancers further up the digestive tract.

In the UK, people aged 60 to 69 can ask for a FOBT kit they use at home to prepare and send a stool sample to a lab for testing. But the Flexi-Scope is only available for people with symptoms or with a referral from a GP or specialist.

Cancer Research UK urged whoever forms the next government of the UK to incorporate the Flexi-Scope test in the national bowel cancer screening programme. They said the test is very cost-effective, especially as it only needs to take place once every 11 years and the cost would most likely be outweighted by having to treat fewer people, and more of those who are treated would be at an earlier stage, where treatment costs are lower.

A study commissioned by the UK Department of Health reported in 2006 that a Flexi-Scope screening programme would save £28 for every person who was screened.

The risks of the test appear to be small, with no possibility of reporting false positives because doctors can only detect and remove polyps that are actually there. However, removing a polyp can cause a small amount of bleeding and there is a 1 in 50,000 chance that the tube itself can puncture or tear the bowel.

An important question is how willing people would be to have the test. Atkin and colleagues addressed this in an earlier study involving 4,400 people who underwent screening with the Flexi-Scope. They found the vast majority said they were glad they had the test and were satisfied with the procedure. 91 per cent reported mild or no pain and 97 per cent said they felt little or no embarrassment.

Another area of cost is training people to use the Flexi-Scope, and the researchers said this, and all the other factors need to be properly researched before weighing up the overall costs and benefits of introducing Flexi-Scope as part of the national screening programme.

“Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial.”
Wendy S Atkin, Rob Edwards, Ines Kralj-Hans, Kate Wooldrage, Andrew R Hart, John MA Northover, D Max Parkin, Jane Wardle, Stephen W Duffy, Jack Cuzick.
The Lancet, Early Online Publication, 28 April 2010.
DOI:10.1016/S0140-6736(10)60551-X

When parents maintain a healthy body image and weight-control strategies, overweight adolescent children tend to follow their example, a new study reveals.

“There was a pretty strong association between parent body satisfaction and adolescent body satisfaction,” said Taya Cromley, Ph.D., who led the study at University of California, San Diego. “Messages from parents about weight and body image can be communicated directly or indirectly. It’s important to consider what the message is that’s being communicated.”

The study, which appears online of the Journal of Adolescent Health, analyzed self-completed surveys from 103 overweight adolescents, primarily females ages 12 to 20, and their parents – mostly mothers – all in the Minneapolis-St. Paul area. The study defined “overweight” as a body-mass index at or above the 85th percentile in comparison with peers of the same age and sex.

Psychosocial components – parents’ depression, self-esteem, body satisfaction and emphasis on thinness – also influenced adolescents. Another variable that factored into the equation was family dynamics – how well everyone got along and adapted to change.

In the study, unhealthy weight-control behaviors consisted of fasting, skipping meals, vomiting and taking laxatives, diuretics or diet pills. Meanwhile, healthy weight-control behaviors included decreasing calories, increasing exercise, eating more fruits and vegetables and avoiding food high in fat.

The authors concluded that the social-emotional climate at home matters.

“Attachment or bonding in the family was shown to decrease children’s episodes of overeating,” said Brenda Lohman, Ph.D., an associate professor of human development and family studies at Iowa State University in Ames, who did not take part in this study. “Indeed, my own work shows that family and household stress has been linked to increased levels of childhood and adolescent obesity as well.”

“Parent and family associations with weight-related behaviors and cognitions among overweight adolescents.”
Cromley TR, et al.
J Adolesc Health online, 2010.

“Your child has cancer.” They are words every parent can’t imagine hearing.

However, many parents are still in the dark about what causes pediatric cancer, how it is treated and the quality of life for children following treatment. To help parents better understand pediatric cancer and bring greater awareness to the disease, experts at the Children’s Cancer Hospital at The University of Texas M. D. Anderson Cancer Center dispel common myths and give the facts about pediatric cancer.

Pediatric cancer has a low impact on childhood deaths in the United States.

Myth.

Pediatric cancer is rare, but it is the leading cause of death by disease in children – more than asthma, diabetes, cystic fibrosis and AIDS combined. Each school day, one in 46 children is diagnosed with cancer. Although pediatric patients represent only one percent of all cancers diagnosed in the United States each year, the impact of childhood cancer deaths on society in regards to lifetime earnings is close in comparison to the impact of breast cancer deaths.

The United States spends five billion dollars on cancer research every year; three percent of this amount is allocated to pediatric cancer research.

Fact.

In 2008, the National Cancer Institute budget for cancer research was nearly five billion dollars, and this is where most federal funding for childhood cancer research comes from, with a small amount coming through philanthropy.While it is difficult to determine precisely how much in any given year is spent on childhood cancer research, experts estimate that number to be around $170 million per year. However, when comparing the average cost of cancer treatment to life years saved, childhood cancer has a significantly lower average cost than those costs associated with screenings for breast, prostate, colon and ovarian cancers.

Different types of leukemia make up more than half of all childhood cancers.

Myth.

While leukemias account for about one third of pediatric cancer, cancers of the brain and central nervous system are also very common in children. These include cancers such as medulloblastoma and glioma. The most common type of leukemia in children is acute lymphoblastic leukemia.

Most drugs used to treat pediatric cancers are 20 years old.

Fact.

The U.S. Food and Drug Administration (FDA) approved the most common drugs to treat pediatric cancers predominantly in the 1950s and 1960s. Since 1980, only a handful of drugs have been labeled for use in a pediatric malignancy compared with more than 50 new molecular entities approved for adult oncology indications. On December 28, 2004, the FDA approved Clofarabine (ClolarTM; Genzyme Corp.) for the treatment of pediatric patients 1- 21 years old with relapsed or refractory acute lymphoblastic leukemia (ALL) following treatment with at least two prior regimens. Clofarabine is the first new leukemia treatment approved specifically for children in more than a decade. Trials examining the use of Clofarabine in pediatric patients were conducted at the Children’s Cancer Hospital.

Treatment for pediatric cancers is improving – less patients are relapsing and dying.

Fact.

Childhood cancer was almost always fatal before 1970. Today, thanks to advances in diagnosis and treatment, 80 percent of children diagnosed with cancer will survive beyond five years up from 58 percent twenty years ago.

Adult regimens can not be used to treat children with cancer.

Myth.

While adult treatments can sometimes cause more undesired side effects in growing children, as more targeted therapies that are able to hone in on cancer cells and leave healthy cells untouched are developed, children will continue to benefit. One hallmark of the Children’s Cancer Hospital, is that pediatric patients have access to M. D. Anderson’s adult therapies and world-renowned clinical trial program.

Surgery, chemotherapy and radiation are the only treatments available to treat pediatric cancers.

Myth.

Biologically-based gene therapies are the cutting edge of treatment for children with cancer. By harnessing antibodies in the body’s own immune cells, researchers can essentially make a genetically modified “drug” that can be programmed to attack pediatric cancer cells. This type of cell therapy targets cancer cells and minimizes side effects, providing an attractive new option to pediatric oncologists. The Children’s Cancer Hospital currently has clinical trials underway examining the use of T cells and natural killer cells (types of white blood cells) to treat pediatric cancer.

Only localized, solid tumors can be treated successfully in children.

Myth.

Survival rates for the four major childhood blood cancers are continuing to rise, according to a study published in the Journal of the National Cancer Institute (9/08). Researchers found that five- and 10-year survival rates for U.S. children with acute lymphoblastic leukemia, Hodgkin’s lymphoma, and non-Hodgkin’s lymphoma are approximately 90%. On the other hand, the survival rates for solid tumors such as bone cancers have shown little improvement in the past two decades.

There is often a delay diagnosing adolescents and young adults (ages 13 and up) with cancer.

Fact.

Most people don’t think “cancer” for apparently simple “growing pains” in this age group. For this reason, many adolescents and young adults receive the cancer diagnosis much later than their younger counterparts. Other potential reasons identified for this lag time include lack of health insurance, the psychosocial need to be independent, symptoms that are not specific enough to lead to an early diagnosis, and the age group is less likely to seek medical attention. Research underway at the Children’s Cancer Hospital is examining these factors, as well as looking at the unique, and best, ways to treat this age group. Several research studies support that adolescents and young adults with cancer respond better to pediatric treatment protocols in comparison to adult protocols.

Treatment for pediatric cancer is difficult and survivors have little chance of leading a normal life following treatment.

Myth.

Most children with pediatric cancer go onto live healthy, successful lives and many go onto to have children of their own. Support and quality of life programs let kids be kids while they are undergoing treatment. For example, the Children’s Cancer Hospital offers an on-site school so that pediatric patients can keep up with their normal schoolwork. Special summer camp and winter ski trips also give young patients the confidence that they can do anything they put their mind to. A survivor clinic continues to monitor patients for secondary health conditions as a result of their treatment and new cancers for years after they have completed treatment.

The Children’s Cancer Hospital at M. D. Anderson is home to one of the largest multidisciplinary pediatric cancer care programs in the nation, caring for approximately 1,700 children a year. U.S. News & World Report’s annual “America’s Best Hospitals” survey ranked the Children’s Cancer Hospital as one of the top 15 hospitals in cancer care for children in 2009.

Having a baby is a very exciting time for new parents, with all the preparation and anticipation that comes with it. But how do parents find help and assistance-from prenatal care to parenting tips? Researchers at the Johns Hopkins University School of Nursing (JHUSON) have come up with innovative ways to provide parenting tips to new parents of all demographics.

Providing pregnancy and newborn information via text messages -Each year, more than 500,000 babies are born prematurely, and about 28,000 children die before their first birthday. Getting evidence-based educational information into the hands of pregnant women and new mothers is a critical element in the effort to reduce premature births across the country.

A new program, Text4Baby, brings free, educational messages right to women’s fingertips via text messages. “Because of the number of young women of childbearing age that we want to reach, text messages make sense to really target this audience,” says Elizabeth Jordan, DNSc, RNC, assistant professor at the Johns Hopkins University School of Nursing and a board member for the National Healthy Mothers, Healthy Babies Coalition, which developed the nationwide program. About 90 percent of Americans have cell phones, Jordan says, and a vast majority of those between the ages of 18 and 29 are sending and receiving text messages. Texting is also a successful way to reach low income and minority women, those most in need for educational information about pregnancy and newborn care.

Through 51-character texts three times a week, Text4Baby delivers messages about topics such as seasonal flu, prenatal vitamins, breastfeeding, and immunizations. Jordan, who has dedicated her career to improving maternal and infant health, helped review the text messages, which were developed by the Centers for Disease Control and Prevention and adapted with texting and young women in mind. “It’s something that really got me excited,” says Jordan, who represents the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) on the coalition board. “I have dedicated my career to taking care of moms and having healthy baby outcomes.”

Since January 2010, more than 25,000 women in 41 states have registered for the free text messaging service which is made possible through support from academic, private, government, and nonprofit organizations, including the Wireless Foundation, Johnson & Johnson, and technology company Vioxia. The effectiveness of the program nationwide is now being evaluated by researchers at George Washington University to determine whether text messages are affecting behavior change.

Supporting and empowering minority parents – Navigating parenthood can be hard and many parents seek support of parenting education programs. But too many programs fail to take into account parents’ diverse cultural and economic backgrounds and some lack the social context that can really make them effective. The approaches often don’t resonate with minority groups, leaving parents feeling powerless and unsupported.

To fill this need, Deborah Gross, DNSC, RN, FAAN, the Leonard and Helen Stulman Professor in Mental Health and Psychiatric Nursing at the Johns Hopkins University School of Nursing, helped develop the Chicago Parent Program. The program focuses on an overlooked population and aims to have a positive impact on parents and young children. “It was designed in collaboration with African American and Latino parents to address the issues parents raising young children face,” says Gross. “One of the biggest differences is that most programs were designed for white, middle class parents and are being adapted [for other groups]. This Program, which can be used in any city, was designed with a diverse community in mind” she says.

Gross is now expanding the Program to other cities, including Baltimore and New York. With the support of the Robert Wood Johnson Foundation, Harlem Children’s Zone in New York recently started using the Program with parents of three year-olds in Head Start programs. The Zone is the national model for the president’s Promise Neighborhoods initiative which funds communities providing comprehensive, integrated services designed to improve the lives of families living in poverty. “To date, the parent groups are going very well and parent satisfaction scores are consistently high,” Gross reports.

The 12-session Program is conducted in group sessions, where parents can discuss common issues, struggles, and solutions. To encourage those discussions, the program includes about 160 vignettes showing scenes familiar to most parents, such as getting children up and ready for school or handling bored children while at the laundry mat. The scenes cast real families, mostly ethnic minorities, in real situations, which is unique to this parenting program and provides the relevant social context, Gross explains.

Parents are taught predictable, effective options for discipline, with the overall goal of ensuring the discipline is controlled and done without humiliation or rage. The Program gives parents options for encouraging their children’s good behavior, and discouraging poor behavior, such as ignoring or time out. “We’re trying to give parents a bag of tricks,” Gross says. “What most parents have in their bag is about one or two tricks, and neither usually works very well. The program helps them to be clear about the behaviors they like and to encourage those, as well as what they don’t like and want to discourage.” Parents feel more in control, which builds their confidence.

Evaluations of the Program have proven its success. In one evaluation, Chicago parents who participated in at least half of the Program sessions reported greater improvements in parenting self-efficacy, used less corporal punishment, and used more positive and consistent discipline strategies. Further, children whose parents attended the program reported their children had fewer behavioral problems up to one year later. Parents’ satisfaction with the program is also quite high, Gross says. “They find it very supportive, and they learn a lot,” she says. “They can see the differences in their kids, as well as themselves.”

Undergoing surgical cancer treatment holds greater risk for people who also have diabetes than it does for people who just have cancer, according to a study being published this month in Diabetes Care.

The study, conducted by researchers at Johns Hopkins University, found that people who have both diabetes and cancer are 50 percent more likely to die following surgery than people who don’t have diabetes.

“We already know that diabetes appears to increase the risk for some cancers,” said Dr. Hsin-Chieh Yeh, one of the lead researchers in the study. “This study shows that having pre-existing diabetes also increases the chance of postoperative mortality in newly diagnosed cancer patients. Although we don’t yet know the specific mechanism in cancer patients, diabetes has been shown to increase the risk of infection and cardiovascular and renal complications after surgery in the general population.”

The study, a meta-analysis, showed postoperative mortality was higher across a range of cancer surgeries and types of cancer, particularly in cancers of the colon and esophagus. The researchers concluded that further research was called for into whether improvements in perioperative diabetes care could reduce the excess risk in mortality.

“Care of diabetes before, during and after surgery is very important,” Dr. Yeh said. “It should be part of the preoperative discussion.”

Diabetes Care, published by the American Diabetes Association, is the leading peer-reviewed journal of clinical research into one of the nation’s leading causes of death by disease. Diabetes also is a leading cause of heart disease and stroke, as well as the leading cause of adult blindness, kidney failure, and non-traumatic amputations.