Short Course of Self-Defense Training can Reduce Sexual Assaults Among Kenyan Girls

"Self-defense training taught these young girls to stand up and say 'no' with confidence, and empowered them to escalate their own defense to a higher level, if necessary," said Neville Golden, MD, senior author of the new study, which is now available online on the Journal of Adolescent Health website. "To our knowledge, this is the first study to demonstrate that a self-empowerment/self-defense course can reduce the incidence of rape in adolescent girls," added Golden, who is a professor of pediatrics at Stanford and the division chief of adolescent medicine at Packard Children's.

The study looked at 402 girls who participated in a self-defense program developed by a Kenya-based nongovernmental organization, No Means No Worldwide, that taught them verbal and physical self-defense techniques, and gave them information about how to get help if they were assaulted. Conducted in high schools, the program was designed to combat a culture in which discussing sexual assault is taboo.

In the 10 months after receiving self-defense training, more than half of these girls reported using what they had learned to fend off would-be attackers. The proportion of them who were raped fell from 24.6 percent in the year before training to 9.2 percent in the 10-month period after.

"There is a strict code of silence among rape victims in Kenya, especially with the stigma of HIV and AIDS," said Jake Sinclair, MD, the lead author of the new study and a pediatrician at John Muir Medical Center in Walnut Creek, Calif. "Typically, no one is going to admit that they were raped. Victim-blaming is the norm." Sinclair and his wife, Lee, co-founded No Means No Worldwide and have developed sexual-assault prevention curricula for several audiences in Kenya, including self-defense programs for girls and women, and educational programs to help boys recognize the harm inflicted by sexual assault.

The subjects of the study were 522 high school girls, ages 14 to 21, in two impoverished Nairobi slums: 402 received 12 hours of self-defense training over six weeks, as well as two-hour refresher courses at three-, six-, nine- and 10-month intervals; 120 in a comparison group received a one-hour life-skills class that is the current national standard in Kenya. Before and 10 months after the training, both groups answered anonymous questionnaires about their recent experiences of rape.

At the start of the study, nearly one in four girls reported that they had been forced them to have sex in the prior year; 90 percent of the victims knew their attackers. The study focused on rape and did not assess the entire range of behaviors classified as sexual assault under U.S. laws.

Among girls who received self-defense training, 56.4 percent used the skills they learned to fend off attackers in the subsequent 10 months. Of these girls, half used verbal skills alone, one-third started with verbal skills and added physical skills, and 17 percent used physical skills alone. Not only did total assaults drop sharply, but assaults by the two most common groups of perpetrators, boyfriends and relatives, decreased significantly. After receiving training, girls who were raped were more likely to seek help following an attack.

In contrast, among girls who had life-skills classes, the proportion who became victims of rape remained about the same.

"We were pretty stunned that the self-defense training was so effective," Sinclair said. "From the testimonials we collected, we saw that even a small girl could disable an attacker and get away, again and again."

The self-defense classes, which trained and employed local Kenyan women as instructors, were also cost-effective: providing the training cost $1.75 per student, whereas immediate after-care for rape in Kenya costs $86, a figure that does not account for long-term costs such as new HIV infections or unwanted pregnancies.

No Means No Worldwide is now testing the effectiveness of their curriculum for boys, which focuses on teaching boys not to perpetrate sexual assault. They are also working to disseminate the girls' self-defense curriculum more widely.

"Often, people focus on women as victims," said Cynthia Kapphahn, MD, a clinical associate professor of pediatrics at Stanford and an adolescent medicine specialist at Packard Children's who was also an author of the study. "This work shows that it's also important to focus on them as empowered beings; that approach can have an important role in a woman's ability to protect herself."

Source-Eurekalert

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EGFR Prevents Maturation of Cancer-fighting MiRNAs When Oxygen Is Short

by Bidita Debnath on? May 26, 2013 at 10:35 AM Research News A cancer-promoting growth factor receptor fires away, sending signals that thwart the development of tumor-suppressing microRNAs (miRNAs) before it's dissolved, even while being dragged to its destruction inside a cell.
This was reported by researchers in an early online publication at Nature.

Under conditions of oxygen starvation often encountered by tumors, the epidermal growth factor receptor (EGFR) gums up the cell's miRNA-processing machinery, an international team led by scientists at The University of Texas MD Anderson Cancer Center discovered.

"So when hypoxia stresses a cell, signaling by EGFR prevents immature miRNAs from growing up to fight cancer," said senior author Mien-Chie Hung, Ph.D., professor and chair of MD Anderson's Department of Molecular and Cellular Oncology and holder of the Ruth Legett Jones Distinguished Chair.

The group's findings point to a potential new prognostic marker for breast cancer, Hung noted, but also provide the first evidence of a growth factor signaling pathway regulating miRNA maturation.

"Inside of a cell, you have signal induction, in this case through EGFR, and you also have a protein complex that processes precursors into mature miRNA to perform a function. They didn't appear to talk to each other, it's as if one speaks English and the other Chinese," Hung said. "This is the first paper to show how they communicate."

The scientists established the relationship in cell line experiments, confirmed it in a mouse model and human breast cancer samples, then found that it reduced breast cancer patient survival in a review of 125 cases.

A new cancer-promoting role identified for EGFR

EGFR penetrates the cell membrane to receive signals from growth factors outside of the cell. After a growth factor binds to it, EGFR conveys the signal into the cell by attaching phosphate groups to other proteins, often acting as a molecular "on switch."

In many cancers, EGFR is overexpressed or dysfunctional, constantly sending signals to cells to divide. Hung and colleagues found that EGFR also fuels cancer progression by stifling tumor-suppressing miRNAs.

As a tumor grows, large portions of its interior can become starved for oxygen (hypoxia) for lack of adequate blood vessels. This stress suffocates many tumor cells, but the few that endure become highly malignant, resist treatment and are most likely to spread, Hung said.

Anti-angiogenesis drugs designed to kill tumors by blocking their ability to spin webs of supportive blood vessels often succeed at first, Hung said, but then fail against the more malignant cells that survive hypoxia.

When hypoxia hits, EGFR gets active and gets eaten

Low-oxygen conditions cause EGFR overexpression. EGFR also is pulled into the cell interior, captured in cavities called vesicles and eventually fed into lysosomes, a membrane-enclosed organelle loaded with enzymes to dissolve proteins.

It was known that EGFR continues to signal even while caught in the vesicles, which actually prolongs its activation. Hung and colleagues found that EGFR signals to a key protein in miRNA processing called argonaute 2, or AGO2.

AGO2 connects with two other proteins called Dicer and TRBP to form a complex that processes microRNA precursors into mature miRNAs, which regulate gene expression after messenger RNA has been expressed but before it's translated into a protein.

Oncoprotein-regulating miRNAs don't grow up

The scientists found that EGFR attaches phosphate groups to AGO2, which in turn weakens AGO2's ability to connect with Dicer to produce mature microRNAs. EGFR's effect is stronger during oxygen starvation than under normal conditions.

The team identified a number of specific miRNAs affected by EGFR, most of which have been reported to have tumor suppressor characteristics. The miRNAs regulated by phosphorylated AGO2, including miR-31, miR-192 and miR-193a-5p, also shared a long-loop structure in their precursors that miRNAs unaffected by AGO2 phosphorylation lack.

Hypoxic environments around tumors promote metastasis by helping cells evade programmed cell death. Hung and colleagues showed that EGFR-mediated AGO2 phosphorylation blocks cell death and enhances invasiveness under hypoxia.

Experiments in a mouse model of breast cancer confirmed that expression of EGFR and the presence of phosphorylated AGO2 increase during tumor progression under oxygen-starved conditions.

EGFR-AGO2 connection found in human breast tumors; reduces survival

The hypoxia-EGFR-AGO2 connection was strong in tumor samples from 128 breast cancer patients, but it was low or absent in normal breast tissue. In 125 breast cancer cases analyzed by the team, half of 62 patients with high levels of phosphorylated AGO2 survived to 48 months and beyond. Median survival had not been reached for the 63 patients in the low-level group, but 78 percent had survived to 48 months.

"One can imagine other receptors for platelet-derived growth factor and insulin-like growth factor also regulating miRNAs, perhaps by regulating Dicer or TBRP," Hung said. "This is a turning-point paper; it will induce lots of new questions for scientists to pursue."

Source-Eurekalert

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