IKKß Activation in the Fetal Lung Mesenchyme Alters Lung Vascular Development but Not Airway Morphogenesis.

In the immature lung, inflammation and injury disrupt the epithelial-mesenchymal interactions required for normal development. Innate immune signaling and NF-κB activation disrupt the normal expression of multiple mesenchymal genes that play a key role in airway branching and alveolar formation. To test the role of the NF-κB pathway specifically in lung mesenchyme, we utilized the mesenchymal Twist2-Cre to drive expression of a constitutively active inhibitor of NF-κB kinase subunit ß (IKKßca) mutant in developing mice. Embryonic Twist2-IKKßca mice were generated in expected numbers and appeared grossly normal. Airway branching also appeared normal in Twist2-IKKßca embryos, with airway morphometry, elastin staining, and saccular branching similar to those in control littermates. While Twist2-IKKßca lungs did not contain increased levels of Il1b, we did measure an increased expression of the chemokine-encoding gene Ccl2. Twist2-IKKßca lungs had increased staining for the vascular marker platelet endothelial cell adhesion molecule 1. In addition, type I alveolar epithelial differentiation appeared to be diminished in Twist2-IKKßca lungs. The normal airway branching and lack of Il1b expression may have been due to the inability of the Twist2-IKKßca transgene to induce inflammasome activity. While Twist2-IKKßca lungs had an increased number of macrophages, inflammasome expression remained restricted to macrophages without evidence of spontaneous inflammasome activity. These results emphasize the importance of cellular niche in considering how inflammatory signaling influences fetal lung development.

A violence-prevention program helps teach medical students and pediatric residents about childhood aggression.

There were 65 third-year medical students and 59 pediatric residents who participated. The intervention was a 40-minute multimedia program that teaches how to counsel parents about childhood aggression. Comparing pre- and 2-month postintervention data, there was an increase in the proportion of medical students (11% pre vs 92% post; P < .001) and residents (3% pre vs 95% post; P < .001) who felt that their ability to counsel parents about hurtful behavior was high or very high. Compared with baseline, a higher proportion of trainees at the 2-month follow-up recommended redirecting (11% pre vs 69% post; P < .001), promoting empathy (13% pre vs 42% post; P < .001), and not using physical punishment (25% pre vs 50% post; P < .001). A brief, independently viewed curriculum addition expanded the repertoire of health care trainees related to counseling parents about childhood aggression. These findings have implications for violence prevention.

Parents view a brief violence prevention program in clinic.

Participants were parents of 1- to 7-year-old children presenting to a pediatric clinic. The intervention was Play Nicely, 2nd edition, a multimedia educational program that teaches childhood aggression management skills. On average, parents viewed 10 to 15 min in clinic. The average age of the 89 participants was 30 years; 49% were African American, 29% were married, and 12% had a college education. Preintervention, 90% of parents stated that they felt very comfortable managing aggression. Postintervention, 90% of parents planned to change how they discipline their own child. More than 90% had at least one positive comment about the program; there were no negative comments. A brief intervention that addresses childhood aggression is embraced by a relatively diverse group of parents who viewed it during their children's primary care visit. Parents' prior comfort level with managing aggression should not be used to screen who might benefit. The program has implications for violence prevention.