Category Archives: Health and Medicine

The consequence of patents on BRCA genes

Guest post by Sue Friedman

On April 15, 2013, the U.S. Supreme Court heard arguments on whether Myriad Genetics’ patents on the BRCA genes, which are associated with hereditary breast and ovarian cancer, should be upheld. This case culminates a four-year legal tug-of-war between Myriad Genetics & Laboratories and a long list of individual, advocacy, and health care professional groups represented by the American Civil Liberties Union (ACLU) . The plaintiffs agree that regulations allowing exclusive gene patents negatively affect access to care and research.

I was fortunate when I was first tested for a BRCA mutation in 1998: my testing costs were covered by my health insurance. Although I was initially tested without genetic counseling, I eventually went to a large cancer center for a second opinion, met with a genetics expert, and gained access to up-to-date, credible information. It wasn’t until I started FORCE  (Facing Our Risk of Cancer Empowered) that the deeper implications of patenting the BRCA genes became apparent to me.

In the Family, a 2009 documentary by producer Joanna Rudnick, highlights some negative consequences of Myriad’s gene patents. The film includes eye-opening interviews with Dr. Mark Skolnick, Myriad’s founder, and Dr. Mary-Claire King, who is credited with locating the BRCA gene. King’s research proved the existence of hereditary breast cancer gene mutations and laid groundwork that sent laboratories racing to be the first to isolate and clone the gene for genetic testing.

Rudnick questions how a gene—a product of nature—can be patented, stating, “It’s like patenting your thumb.” Skolnick replies by comparing Myriad’s gene patents to patents for iPods, telephones, and computers, cavalierly asserting, “I think the single greatest inventive thing I did was to create Myriad. We did it to win the race . . . and we won.” A recent article on NOVA Next highlights just how narrowly that race was won. Although a laboratory in the United Kingdom had already sequenced the BRCA2 gene, Myriad published and applied for a patent less than 24 hours before the British scientists could publish their manuscript. Had the British team’s findings been published just a day earlier, Myriad’s effort to patent the BRCA2 gene would have probably failed.

Rudnick asks Dr. Skolnick point-blank why the cost of BRCA testing continues to increase, to which he replies, “I think there’s a point at which we have to start looking at decreasing the cost of the test.” That decrease has never been realized. Four years later, BRCA testing is more expensive—Myriad charges $3,500—even though technology has reduced the cost of sequencing DNA. The February 6, 2013 edition of the Salt Lake Tribune reported that “Myriad projects full-year 2013 revenue will fall between $575 and $585 million . . . a 16 to 18 percent increase over fiscal 2012.”

Dr. King’s philosophy regarding the commerciality of gene patents starkly contrasts with Skolnick’s. “The critical thing about the patents we hold is that none of them are exclusively licensed. They are completely open for anyone to use for research purposes, and any company that wishes to license them can for a trivial amount of money,” she says. King’s last royalty check amounted to $2.73. It’s not difficult to imagine how different BRCA testing might be had King won the race to sequence the BRCA genes.

In the interview, Skolnick defends Myriad’s profits by saying “If we make this huge . . . investment in educating the market don’t we have a right to deliver the test?” Skolnick continues, “All I know is that doctors were not prepared to do this. We had to teach doctors.” In 2008 and again in 2009 FORCE testified to the Secretary’s Advisory Committee on Genetics Health and Society, expressing both our general concerns regarding direct-to-consumer marketing of genetic tests and our specific concerns about Myriad’s marketing practices, which encourage BRCA testing without prior genetic counseling from qualified experts. FORCE has documented and reported our concerns about Myriad’s methods of marketing BRCA testing, which we feel are harmful and misleading to the health care community and members of the HBOC community. We also concur with the ACLU that exclusive gene patents negatively affect access to care and innovation in research, as illustrated by our testimony to the United States Patent and Trademark Office.

The SCOTUS decision is critically important for anyone who is concerned specifically with hereditary disease. FORCE has filed an Amicus brief on behalf of plaintiffs in advance of the hearing. The Myriad case is just one example of how exclusive patents on genes can hurt consumers. Gene patents are a universal issue that ultimately affects all of us. Even if hereditary cancer does not run in your family, chances are that you have inherited a genetic predisposition to some disease. Imagine if a company were given exclusive control over all testing and research for a disease that runs in your family.

Early media reports indicated that SCOTUS appeared skeptical of the validity of gene patents and may rule in favor of the plaintiffs. A ruling is expected by the summer. In the meantime, FORCE will continue to speak out and advocate on this important issue and others that impact the community we serve. I strongly encourage people to become informed about the issue and to take the time to voice their opinion.

FriedmanSue Friedman, D.V.M., is the founder and executive director of Facing Our Risk of Cancer Empowered and coauthor of Confronting Hereditary Breast and Ovarian Cancer: Identify Your Risk, Understand Your Options, Change Your Destiny.

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Filed under Cancer, Consumer Health, Genetics, Health and Medicine, Women's Health

The Doctor Is In: Staying connected to your baseline self in depression

The Doctor Is In is an occasional series where JHU Press authors discuss the latest developments and news in health and medicine.

Guest post by Susan J. Noonan, M.D., M.P.H.

Often times in depression, whether it is major depression or bipolar depression, a person can feel lost to him or herself. You may have difficulty remembering just what you were like before the episode began. This can come on quite gradually during the course of the illness. I have often heard phrases from sufferers such as “I don’t feel like me,” or “I just don’t feel familiar to myself!” What does this mean? It means that you are experiencing a set of feelings, emotions, and behaviors that are not typical of your usual self—these are driven by depression. This experience feels quite odd, alien, and uncomfortable when it happens.

Depression takes away your sense of self as a whole human being, leaving you with the feeling that there is nothing in life BUT depression. Your baseline self seems to fade into the background. Your usual characteristics are still there, they are just hidden down deep and over-ridden by the stronger symptoms of depression. This adds to the distress of the illness. In addition, the new feelings may impair your ability to regroup and gather your lifelong coping resources to manage your depression symptoms. If you cannot grasp who you are as a person, what defines you, you may not have access to the skills and strengths you have always had to get you through the difficult times, including this episode. You may also lose sight of your hopes, dreams, and goals in recovery. So, it is very important to try to stay connected to your sense of self, to your underlying sense of who you are as a person. When you have a connection to who you are and what you are about, you feel more stable and grounded. Then you can draw on the skills and strengths you have had all along to cope with and manage the illness. Remember: you are not your depression!

How do you stay connected to your baseline self in the midst of depression? This requires some effort. As I describe in my soon-to-be-published book Managing Your Depression: What You Can Do to Feel Better, you should start by remembering your positive qualities, strengths, skills, interests, preferences, likes, and dislikes relating to everything around you. Try to recall what makes you you. Start to paint an internal picture of yourself when you are well and at your baseline self. Then, using these qualities, construct a statement for yourself (only) that describes who you are, what you are about. Keep that in the back of your mind and use it to boost yourself at times when you are down or overwhelmed by your circumstances.

noonanSusan J. Noonan, M.D., M.P.H., is a physician and certified Peer Specialist who works as a consultant at Massachusetts General Hospital. She is the author of Managing Your Depression: What You Can Do to Feel Better, forthcoming from JHU Press.

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Where research meets real life

by Janet Gilbert
Journals Direct Response and Renewals Senior Coordinator

How many of us have been sought out by a colleague, friend, or child making a difficult decision or processing a challenging event, and jumped in immediately with our own experience, advice, and judgment?

Simple, silent listening is extremely difficult, but crucial to understanding and effective leadership–in families and organizations alike. So it’s with particular pride that we are able to publish the only academic journal in bioethics that includes first-person narratives, enhancing research in a wide variety of areas: from psychiatric hospitalization to organ transplantation to autism spectrum disorders.  Narrative Inquiry in Bioethics: A Journal of Qualitative Research is truly where research meets real life.

In a recent interview, editors James DuBois and Ana Iltis discuss the importance of hearing authentic human voices in shaping public policy. Have a listen.

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April news and new books

News and Notes

Webster_ReducingGunViolence

Melissa Block of NPR’s All Things Considered interviews Daniel Webster, co-author of Reducing Gun Violence in America, about the wide variation in gun laws from state to state, and how those laws correspond to gun violence.

coddington_african_american_facesRon Coddington, author of African American Faces of the Civil War, is interviewed on The Kojo Nnamdi Show about African American Service during the Civil War.

Hopkins Digital Shorts

Whether excerpted from forthcoming or classic backlist titles or developed with newly commissioned content, Hopkins Digital Shorts provide concise introductions to fundamental concepts, defining moments, and influential texts.

We are pleased to announce our first four shorts for sale: From Rumpsringa to Marriage,   The Amish and Technology,   Regulating Gun Sales, and  The Second Amendment .

Hot off the Press

sichererFood Allergies: A Complete Guide for Eating When Your Life Depends on It  Organized in Q&A format, this book addresses the spectrum of food allergies, from mild to life threatening.

Myth of the SuperheroMyth of the Superhero Examines how our favorite superheroes reflect the moral, religious, and ethical values of American society.

In Late LightIn Late Light From a stone to fireflies, from childhood to growing old, Brian Swann’s poems contemplate the moments and individual objects that create a whole life and our relationship to them.

Rebellion in Black and WhiteRebellion in Black and White: Southern Student Activism in the 1960s In the 1960s, southern college campuses—both historically black and predominantly white—became powerful centers of student dissent, activism, and protest.

Secession WinterSecession Winter: When the Union Fell Apart  Investigates what prompted southern secession in the winter of 1860-61 and how it culminated in the American Civil War.

Democracy in AsiaDemocracy in Asia: A New Century Democratization scholars believe that the next regional wave of transitions to democracy may unfold in East and Southeast Asia.

Awards News

Clandestine MarriageOn April 15, the British Society for Literature and Science announced that Theresa Kelley’s Clandestine Marriage: Botany and Romantic Culture won its 2012 Book Prize. See the BSLS Blog for more details.

The Papers of George Catlett Marshall, Vol. 6On April 12, at its annual Organization of American Historians Luncheon, the Society for Historians of American Foreign Relations awarded its coveted Arthur S. Link-Warren F. Kuehl Prize for Documentary Editing to volume 6 of The Papers of George Catlett Marshall

 Journals News

The Journals Division has announced another new title for its collection, Poe Studies: History, Theory, Interpretation, which publishes annually in October. The journal is based at Washington State University. Scott Peeples and Jana L. Argersinger serve as co-editors. The journal provides a forum for dialogue about Edgar Allan Poe’s life and writings, and about the cultural and material contexts that shaped the production and reception of his work.

Feminist Formations now has a new website to showcase its content. JHUP staff worked with the editorial staff to design the vibrant site at www.feministformations.org. The new online presence completes the transition to the new editorial team at the University of Arizona led by Sandra K. Sota. The journal moved to Tucson more than a year ago and recently began publishing the 25th volume.

The most recent issue of American Quarterly again takes advantage of its recently re-designed website by offering supplemental content to articles in the print version. Visitors can find supplementary content from a timely and important forum on “Visual Culture and the War on Terror,” edited by Matt Delmont, in the Beyond the Page section of the site.

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The Doctor Is In: Does my child have a food allergy?

The Doctor Is In is an occasional series where JHU Press authors discuss the latest developments and news in health and medicine.

Guest post by Scott H. Sicherer, M.D.

Food allergy appears to be on the rise in children: studies show that up to 8% of children are estimated to have a food allergy, and the rate of peanut allergy among children has tripled in the last decade. What should you do if you suspect your child has a food allergy? And how you can work with your doctor to obtain a proper diagnosis?

When to Suspect a Food Allergy

A food allergy occurs when the body’s immune system, which is designed to fight infection, mistakenly attacks harmless proteins in foods. This “attack” can cause sudden symptoms just after a food is eaten or, more rarely, persistent symptoms when a causal food is a staple of the diet.

Some common mild symptoms include hives, swelling (often of the lips or around the eyes), rash, mouth/throat itch, stomach pain, nausea, and vomiting. More severe symptoms include breathing problems, throat tightness, tongue swelling, wheezing, coughing, and trouble swallowing. Problems with blood circulation, leading to paleness, confusion, and faintness, could also occur. More severely, a food allergy can trigger anaphylaxis, an extreme allergic reaction that progresses rapidly and can be fatal.

Food allergies can also cause chronic symptoms. Infants may have vomiting, diarrhea, poor growth, chronic rashes, or mucous and blood in their stools. A child may experience pain when eating or not be gaining weight. While food can be a trigger, these problems can be caused by many other illnesses.

Foods can also trigger many symptoms that are not caused by an allergy, which can lead to a delayed diagnosis or misdiagnosis. For example, lactose intolerance—difficulty in digesting the sugar in milk—leads to gas and diarrhea. Food poisoning can result in vomiting and diarrhea. To add further confusion, typical allergic symptoms could be triggered by viruses or allergens that are not foods, such as medication or exposure to a cat. In addition, the chemicals in foods can contribute to allergy-like symptoms: caffeine, for example, can cause heart palpitations, and fermented foods may cause headaches.

Discussing Possible Food Allergies with Your Doctor

If your child has experienced allergic symptoms, you should talk to your pediatrician about your concerns or see a Board-Certified Allergist. Come prepared to answer the following questions: What are your child’s symptoms? What foods or meals are associated with the symptoms? Have you noticed a pattern? Do symptoms always occur when your child eats certain ingredients? How much of the food triggers symptoms? More than 90% of allergies are attributed to milk, eggs, peanuts, wheat, soy, tree nuts (e.g., walnuts, cashews, etc.), and fish and shellfish, although any food could trigger an allergy. Your pediatrician will be especially suspicious of foods that are not eaten routinely but, when eaten, are associated with symptoms.

Allergy Tests

Unfortunately, there are no simple laboratory tests currently available that accurately diagnose food allergy. One blood test detects a protein called “IgE,” which is at the root cause of most food-based allergic reactions. The problem is that many people without a food allergy make IgE  proteins, so this test is helpful but not definitive; in some cases, it may be negative, despite the presence of an allergy.

Ultimately, the most important factor in identifying allergies is a child’s medical history. Your doctor must consider your child’s individual circumstances in order to develop a best guess about what foods might be acting as possible allergens. They must also use this history to select and interpret tests accordingly.

There is no need for your doctor to test foods that are not likely to be a concern. For example, about one in 12 people who are able to eat peanuts will test positive for peanut allergies. If your peanut-eating child tests positive for peanut allergy, then the test is meaningless. However, if you have a child who breaks out in hives after eating peanuts, a positive test could confirm that they are allergic. An allergist can also perform skin tests by scratching a small amount of a diluted food extract onto the skin. If a small, itchy bump develops on the scratch, the child is allergic to that particular extract. These skin and blood tests are similar with regard to their ability to detect the IgE, although sometimes one or the other might be a bit better for a specific food. The stronger the positive result, the more likely there is truly an allergy. However, the test is not a good predictor of the severity of an allergy.

The most definitive food allergy test is a gradual, doctor-supervised feeding of the suspected allergen, which is typically undertaken by an allergist. If the allergist observes an allergic reaction, the feeding is stopped and the symptoms are treated. If the child tolerates the food without exhibiting any symptoms, there is no allergy, even if the blood or skin test was positive.

Managing a Food Allergy

A true food allergy requires that your child avoid the food in order to avoid experiencing symptoms. Additionally, you will need to learn about allergen avoidance. This means understanding how to read food labels, avoiding cross contact during meal preparation, discussing your child’s allergy at restaurants, teaching other caretakers about food allergies, and managing your child’s allergy at school or camp. There are excellent resources for learning about these steps, including Food Allergy Research & Education, the Consortium of Food Allergy Research, and the American Academy of Allergy, Asthma & Immunology, a professional allergy society.

If your doctor determines that your child’s allergy is particularly severe, he will prescribe an autoinjector for epinephrine. This medication reverses serious symptoms, giving you time to seek emergency care. Ask your doctor to explain when and how the medication is to be used and to provide you with written materials.

In summary, if you suspect that your child has a food allergy, work with your doctor to secure a diagnosis and create a treatment plan. Many childhood food allergies will resolve, so be sure to get yearly re-evaluations to discuss management and determine if the allergies have gone away.

sicherersichrer_1Scott Sicherer, M.D., is a professor of pediatrics and chief of the Division of Pediatric Allergy and Immunology at Mount Sinai School of Medicine, New York. He is also a researcher in the Jaffe Food Allergy Institute at Mount Sinai. He is the author of Food Allergies: A Complete Guide for Eating When Your Life Depends on It and Understanding and Managing Your Child’s Food Allergies, both published by Johns Hopkins.

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Why Bother?

Guest post by Mark A. Largent

Four years ago, I set out to do what I had long promised I would once I had the security of tenure: start writing for a broader audience. Over the previous decade, I had met all the expectations of a mainstream academic scholar. I had published a book with a university press, as well as a half-dozen peer-reviewed articles in scholarly journals. I had organized conferences and served as the book review editor for my field’s journal of record. I had taught my classes, served on committees, and even edited a book series. Now, I could finally start publishing works that would be much more widely read and that (hopefully) would have an influence far beyond the ivory tower.

I had strong support for my plan. I had taken a position in a public policy college at a land grant university that prides itself on civic engagement. My dean encouraged me to start thinking of myself as a public intellectual, and I spent several years editing dozens of my colleagues’ writings and thoughtfully developing my own writing style.

In the summer of 2008 I set to work on a new project, one that everyone seemed to believe had obvious appeal far beyond the academy. I wanted to write a book that explored the ongoing debates about the alleged link between vaccines and autism, and I wanted it to appeal to the average American reader. I hoped to write a book that “New York Times-reading parents” could pick up to help them sort through the confusing mess of claims about the modern vaccine schedule. Four years later, Johns Hopkins University Press released Vaccine: The Debate in Modern America.  I am intensely proud of the book, but almost as soon as it hit the shelves I began to ask, “Why bother?”

Why bother trying to write to an audience beyond my relatively narrow academic discipline? There are few incentives and many disincentives, especially for someone who publishes a book about something controversial enough to be of interest to a general audience. For example, I was reminded of what a harsh and uncivil environment the Internet is. I found out that even well-written books on timely subjects are not easy to sell. I learned that a reasoned and moderate position on a controversial subject leaves the author with few allies and twice as many enemies. Finally, I was reminded by some of my colleagues that “accessible” is oftentimes an insult in the mouths of academics.

Writing for broad audiences is not a bother; it is a duty. Unfortunately, relatively few scholars are encouraged or feel compelled to enter the public square. I still remember hearing Ken Alder’s acceptance speech for the 2003 Davis Prize, which is given annually by the History of Science Society to the best book published in the history of science for a general audience. Alder enthusiastically described why he wrote The Measure of All Things: The Seven-Year Odyssey and Hidden Error that Transformed the World, his history of an 18th-century expedition, in such a way as to be widely appealing. He explained that it is often erroneously said that if professional historians didn’t write readable histories, someone else would do it. “Well,” he said, “someone else is doing it, and it’s not being done very well.” He finished with an appeal to all of us to continue our scholarship and to take up the responsibility for helping translate some of our research into accessible, useful work.

Alder was right. Scholars ought to feel compelled—and they ought to compel one another—to consider applications for their research and writings. This is not easy work. It will open our work to criticism, misuse, and distortion. But, unless we are to admit that our methods and our conclusions are interesting or relevant for only a tiny percentage of the reading public, we ought to find ways to do extension work that applies our expertise to broader public problems and appeals to broader audiences.

largentMark Largent is a historian of science and associate professor at Michigan State University’s James Madison College .  His work focuses on the role of scientists and physicians in American public affairs, and he has published on the history of evolution, eugenics, and the vaccine-autism debate.  He is the author of Breeding Contempt:  The History of Sterilization in the United States (Rutgers 2008) and Vaccine:  The Debate on Modern America (Johns Hopkins 2012).  He is currently working on a history of Reye’s syndrome.

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March news and new books

News and Notes

eckhartAnnette Lanjouw, co-author of Mountain Gorillas: Biology, Conservation, and Coexistence, was interviewed on NPR’s Science Friday during the SciFri Book Club about Dian Fossey’s Gorillas in the Mist.

Webster_ReducingGunViolenceDaniel Webster, co-editor of Reducing Gun Violence in American: Informing Policy with Evidence and Analysis, was interviewed on Annapolis radio station WRNR 103.1.

Hot off the Press

Abraham Lincoln: A LifeAbraham Lincoln: A Life, Vol. 1 & 2   Now in paperback, this award-winning biography has been hailed as the definitive portrait of Lincoln.

Thrill of the ChasteThrill of the Chaste: The Allure of Amish Romance Novels This is the first book to analyze the growing trend of Amish protagonists in romance fiction and to place it into the context of contemporary literature, religion, and popular culture.

Reconstructing Ancient Linen Body ArmorReconstructing Ancient Linen Body Armor: Unraveling the Linothorax Mystery Alexander the Great led one of the most successful armies in history and conquered nearly the entirety of the known world while wearing armor made of cloth. How is that possible? Gregory S. Aldrete, Scott Bartell, and Alicia Aldrete provide the answer.

Field Guide to Fishes of the Chesapeake BayField Guide to Fishes of the Chesapeake Bay This compact field guide for students, scientists, researchers, and fishermen should be a standard passenger on any boat that plies the Chesapeake’s waters.

The Inevitable Hour

The Inevitable Hour: A History of Caring for Dying Patients in America  A frank portrayal of the medical care of dying people past and present, The Inevitable Hour helps to explain why a movement to restore dignity to the dying arose in the early 1970s and why its goals have been so difficult to achieve.

Being American in Europe, 1750-1860

Being American in Europe, 1750–1860  Daniel Kilbride tracks the adventures of American travelers while exploring large questions about how these experiences affected national identity.

 MUSE News

Project MUSE has partnered with YBP Library Services to facilitate the sales of single book titles from UPCC on Project MUSE. In addition to being able to purchase numerous book collections, libraries will now be able to discover and acquire titles from UPCC through YBP’s GOBI3 (Global Online Bibliographic Information) interface.

MUSE has received many requests from librarians for further, flexible purchase options for the UPCC books and is happy to now be able to offer the single title purchase option to libraries. Single title sales service will be available at the end of March.

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Critical Advances in the Prevention of Pediatric HIV Infections

guest post by Robert T. Maupin, Jr.

This past week has born witness to reports of a groundbreaking medical breakthrough in HIV treatment resulting in the reported “cure” of an infant believed to have a pregnancy-acquired early HIV infection. The infant described in the New York Times report was born to a mother who was not diagnosed with HIV infection until shortly after she gave birth. Following the woman’s diagnosis, the infant was treated with an aggressive three drug antiretroviral regimen. The infant was reported to have remained on treatment during its first 18 months of life, and was recently determined to have cleared the infection.

HIV infectious disease experts think that this finding may signal critical new advances in the understanding of the prevention of pediatric infections. Perhaps it even holds the promise of curing early pediatric infections. However, many experts stress the need for caution in interpreting the report’s findings. Whether or not the infant definitely had an established HIV infection, as well as whether or not this clinical finding can be replicated, will require extensive follow-up and further analysis.

The prevention of pediatric HIV infections associated with pregnancy is one of the greatest advances in clinical medicine that we have witnessed during the course of the HIV/AIDS epidemic. Over the last decade, we have seen that the use of effective combination antiretroviral therapy during pregnancy for women living with or newly diagnosed with HIV infection dramatically reduces the risk of infant transmission to less than 2%. In the past year, important clinical studies demonstrated that, even for women who lacked adequate access to treatment prior to labor, aggressive multidrug antiretroviral therapy with the newborn can reduce transmission risk to close to 2%. Now, in the U.S., fewer than 200 infants exposed to HIV at birth are infected on a yearly basis.

It will take time to determine if this new case truly proves to be an example of a true HIV “cure.” However, what’s most important about this story is that it highlights tremendously important advances which allow us to believe that the elimination of pediatric HIV infections is achievable and is very much in sight.

clark HIV 2nd ed chosen comp rev.inddRobert T. Maupin, Jr., M.D., FACOG, is professor of clinical obstetrics and gynecology in the Maternal/Fetal Medicine section of the Louisiana State University Health Science Center and coauthor of A Woman’s Guide to Living with HIV Infection, published by the JHU Press.

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The Doctor Is In: Raising a Child with a Physical Disability

The Doctor Is In is an occasional series where JHU Press authors discuss the latest developments and news in health and medicine.

guest post by Kay Harris Kriegsman and Sara Palmer

“Being a parent has given me more to live for, more to appreciate about life. I look at the world with a sense of purpose. Having a child has an impact; having a child who has a physical disability has an even greater impact. I can’t separate the two. It’s a lot more work, but rewarding.  I have to be positive and tough in a way. I have a lot more love than I knew I had.”—Kathleen, mother of a child with spina bifida

Parenting is one of the most challenging—and rewarding—roles of  life, full of anticipated responsibilities and pleasures. When a child has a physical disability, whether at birth or later, parents have to learn to manage both the expected problems of parenting as well as the unanticipated medical and physical needs of their child. Parents may have complex feelings—anxiety, sadness, or anger—as the dream of a “perfect” child is replaced by the reality of a child with physical limitations or differences. Yet most parents—if they have emotional support; practical help; and medical, educational and social resources—will form a positive attachment to their child, include their child in family life, and learn how to prepare him or her for adulthood, just as they do with their able bodied children.

The first step for parents in raising resilient children is to take care of themselves. Some things that can help parents get started include:

  • understanding that their feelings are normal; they are not crazy, just dealing with an unexpected and challenging situation
  • getting support from family and friends
  • connecting with  organizations for education, peer support, and advocacy
  • learning communication skills to navigate medical, educational, and other systems affecting their child
  • balancing the needs of their children with self-care

When parents care for themselves, they have the energy to create an inclusive “mixed-bag” family—one that includes both able bodied children and one or more child with a disability. An inclusive family respects the individuality and promotes the development of each child by balancing the needs of all children in the family and creating equivalent expectations for each child’s success. Unlike children with intellectual disabilities, who may require parental or other assistance into adulthood, children with physical disabilities can be prepared for adult psychological and social independence, just as their siblings without disabilities. With the right ingredients, children with physical disabilities can become resilient adults, capable of bouncing back from adversity and living life to the fullest

In Just One Of The Kids: Raising a Resilient Family When One Of Your Children Has a Physical Disability, we present a model for raising resilient children, with or without a physical disability. This includes four basic ingredients—experience, responsibility, socialization, and risk-taking—essential to preparing children for adulthood.

We know life by experiencing it. The feel of a thunder shower or falling snow, the sensation of riding a horse, the joy of painting a picture, and the effort of throwing a ball are some experiences that link us to other human beings and to the world. Ensuring access to experiences for children with physical disabilities requires creativity from parents. In Just One of the Kids, a number of families share their strategies for exposing their children to sports, education, music, the arts, travel, and many more life experiences.

Children long to know that they are depended upon; they benefit from being given age-appropriate responsibilities to help their families. Many parents try to “protect” their child with a physical disability by not assigning him or her chores. But responsibility is critical to raising trustworthy, competent, and self-confident children. Our book provides tips on how to assign responsibilities to your children based on age and ability, and gives many examples of how other families have done so.

Socialization, including participation in peer, family, and community activities, builds bridges to others that are vital to success in relationships, employment, and enjoyment of life. Parents can help break down attitudinal and physical barriers that exclude their children with physical disabilities from social opportunities, and encourage their children to join in social activities with their peers.

Risk-takingassessing benefits, dangers, and what is reasonable—is key to preparing children, especially those with a physical disability, for adulthood. Although physical risk-taking is frightening for parents whose child has had medical problems or injuries, it is critical for helping a child expand skills, define limits, and develop good judgment.

Many parents, grandparents, and siblings with and without physical disabilities were interviewed for Just One of the Kids. In the book, family members share their perspectives on being part of an inclusive family and reveal the challenges and benefits of being part of a “mixed-bag” family. Using a combination of their stories, our model of resiliency, numerous tips and tools for parenting, and a compilation of resources for families, Just One of the Kids shows how you, too, can raise a resilient family when one of your children has a physical disability.

For additional readings and resources, contact Dr. Kay Kriegsman.

kreigsmanKay Harris Kriegsman, Ph.D., is a practicing psychologist, consultant on disability issues. Sara Palmer, Ph.D., is an assistant professor in the Department of Physical Medicine and Rehabilitation at the Johns Hopkins University School of Medicine. They are the authors of Just One Of The Kids: Raising a Resilient Family When One Of Your Children Has  a Physical Disability, published by the JHU Press.

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February news and new books

News and Notes

narrative_inquiry_in_bioethicsJHU Press Publications Recognized for Excellence by AAP’s PROSE Awards Four JHU Press publications were honored recently at the prestigious Association of American Publishers’ Awards for Professional and Scholarly Excellence (the PROSE Awards). In the category of science, technology, and medicine, Narrative Inquiry in Bioethics:  A Journal of Qualitative Research garnered an honorable mention for best new journal. Joseph Manca’s George Washington’s Eye: Landscape, Architecture, and Design at Mount Vernon and Martin Treu’s Signs, Streets, and Storefronts: A History of Architecture and Graphics along America’s Commercial Corridors were each recognized with an honorable mention in architecture and urban planning. In biological science, Theodore W. Pietsch’s Trees of Life: A Visual History of Evolution also earned an honorable mention.

Jane Austen Fans Take Note

barchasThe Times Literary Supplement says of Janine Barchas’ Matters of Fact in Jane Austen,This is a book whose charm and clarity easily overcome any initial resistance one might have to its central claim that Austen’s work actively partakes in what historians now call ‘celebrity culture.’ The Los Angeles Review of Books calls the same book meticulously researched, beautifully written, highly original, and unquestionably timely. It ought to stimulate not just rousing arguments but provoke, too, further historically attuned Austen scholarship.

Hot off the Press

bauerGeckos: The Animal Answer Guide Lizard biologist and gecko expert Aaron Bauer answers deceptively simple questions with surprising and little-known facts about the biology, natural history, and diversity of geckos. Anyone who owns a gecko, has seen them in the wild, or has wondered about them will appreciate this gem of a book.

lawrencecomp.inddStarfish: Biology and Ecology of the Asteroidea  Among the most fascinating animals in the world’s oceans are the more than 2,000 species of starfish. This book is a comprehensive volume devoted to the integrative and comparative biology and ecology of starfish. 

abateBloody Murder: The Homicide Tradition in Children’s Literature “Off with her head!” decreed the Queen of Hearts, one of a multitude of murderous villains populating the pages of children’s literature explored in this volume. Bloody Murder is the first full-length critical study of the pervasive theme of murder in children’s literature. 

sommerTen Lessons in Public Health: Inspiration for Tomorrow’s Leaders There are occasions when a story told from a personal viewpoint can illuminate a profession. Alfred Sommer’s epidemiological memoir is such a book. Adventurous, illuminating, and thought provoking, Ten Lessons in Public Health is more than the story of one man’s work. It tells the tale of how epidemiology grew into global health. 

harrisCommunism on Tomorrow Street: Mass Housing and Everyday Life after Stalin This fascinating and deeply researched book examines how, beginning under Khrushchev in 1953, a generation of Soviet citizens moved from the overcrowded communal dwellings of the Stalin era to modern single-family apartments, later dubbed khrushchevka.

ShelleyThe Complete Poetry of Percy Bysshe Shelley, Volume 3 It is in the works included in this volume that the recognizable and characteristic voice of Shelley emerges—unmistakable, consistent, and vital.

Journals News

The Council of Editors of Learned Journals honored German Studies Review with the 2012 Best Journal Design award earlier this year. When the journal came to JHUP at the beginning of 2012, Press staff worked collaboratively with Editor Sabine Hake on a total re-design. The journal is the official publication of the German Studies Association (GSA).

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