Effects of neo-adjuvant chemotherapy for oesophago-gastric cancer on neuro-muscular gastric function

Delayed gastric emptying symptoms are often reported after chemotherapy. This study aims to characterise the effects of chemotherapy on gastric neuro-muscular function. Patients undergoing elective surgery for oesophago-gastric cancer were recruited. Acetylcholinesterase, nNOS, ghrelin receptor and motilin expressions were studied in gastric sections from patients receiving no chemotherapy (n = 3) or oesophageal (n = 2) or gastric (n = 2) chemotherapy. A scoring system quantified staining intensity (0–3; no staining to strong). Stomach sections were separately suspended in tissue baths for electrical field stimulation (EFS) and exposure to erythromycin or carbachol; three patients had no chemotherapy; four completed cisplatin-based chemotherapy within 6 weeks prior to surgery. AChE expression was markedly decreased after chemotherapy (scores 2.3 ± 0.7, 0.5 ± 0.2 and 0 ± 0 in non-chemotherapy, oesophageal- and gastric-chemotherapy groups (p < 0.03 each) respectively. Ghrelin receptor and motilin expression tended to increase (ghrelin: 0.7 ± 0.4 vs 2.0 ± 0.4 and 1.2 ± 0.2 respectively; p = 0.04 and p = 0.2; motilin: 0.7 ± 0.5 vs 2.2 ± 0.5 and 2.0 ± 0.7; p = 0.06 and p = 0.16). Maximal contraction to carbachol was 3.7 ± 0.7 g and 1.9 ± 0.8 g (longitudinal muscle) and 3.4 ± 0.4 g and 1.6 ± 0.6 (circular) in non-chemotherapy and chemotherapy tissues respectively (p < 0.05 each). There were loss of AChE and reduction in contractility to carbachol. The tendency for ghrelin receptors to increase suggests an attempt to upregulate compensating systems. Our study offers a mechanism by which chemotherapy markedly alters neuro-muscular gastric function

Everyday Family Food Practices

This chapter considers the debates around childhood obesity and focuses on UK public health campaigns, such as Change4Life, aimed at children and their parents. It aims to broaden the childhood obesity debate commonly discussed in the UK public health literature by using Childhood Studies to critique everyday assumptions that seem to be made about children in public health policy. The chapter consider views and perspectives of children, thereby challenging assumptions that children are ‘passive vessels’ to be filled, suggesting instead that children play an active part in everyday family feeding practices. The family as a context for the negotiation of everyday food practices is explored and the dichotomous relationship of parent and child considered. Reflections are also offered on the fluidity and complexity of family structures and the importance that food plays within the context of everyday family life and how food provisioning impacts on intergenerational relationships within the family. The chapter finishes by exploring perceptions of ‘proper’ or ‘real’ food and its perceived importance for children. While the health literature assumes that children are simply recipients of parental feeding, this chapter highlights research that shows that children also construct their own understandings about the healthiness of food and that they are active participants in negotiating family food practices. Through exploring studies situated within contemporary childhood and families research, the chapter affords a much more nuanced picture of everyday family food practices and children’s roles in those practices than is often presented in childhood obesity discourses