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Un memento por favor
You know those vacation souvenirs that seem so life transforming until you get them home? I confess: I’m the person who buys a Provençal tablecloth in France imagining the 3-hour lunches I’ll share on the patio with friends over olives, baguettes, and a few bottles of wine. Once I’m home I remember that, unlike France, North Carolina has mosquitoes that carry off small children. The tablecloth goes in the pantry right next to those dusty hand-blown margarita glasses and that pareo that had seemed like such a versatile piece of clothing in Polynesia but that doesn’t match any of my loafers.
The only souvenir I actually use is the conch shell I blow to get the kids to come inside for dinner. I suspect it’s why our neighbors have forbidden me from ever going back to the Yucatan. In return, let’s just say that if they’re waiting to attend my Provençal picnic, it could be a while.
Minority Report
Are you amazed at how many things we thought impossible only a few years ago are now commonplace? Who could imagine that within our lifetimes, we’d be able to sequence a person’s genome for a few thousand dollars, print useful household objects from our computers, or watch a different reality TV show every hour for a whole week? Now researchers at Duke University report that they can identify children at risk of becoming violent criminals and intervene early enough to lead them to productive lives. It may not be as cool as binge-watching “Pawn Stars” on your iPhone 6, but still, it’s impressive.
The news comes from the latest analysis of the Fast Track Project, a joint undertaking of researchers at Duke, Vanderbilt, the University of Washington and Pennsylvania State, that started in 1991 with the screening of nearly 10,000 5-year-old children in Durham, Nashville, Seattle, and rural Pennsylvania. Researchers identified 900 of those children whom they felt were at particularly high risk of growing up to become violent, antisocial adults. I don’t know all the criteria they used, but I suspect that they automatically included any kindergartener with a tattoo.
Half of the kids were randomized to receive the Fast Track intervention which, despite coming from North Carolina, did not involve NASCAR. Instead, from 1st through 10th grade, the children received tutoring in reading, self-control, and social-cognitive skills while their parents had home visits and training group sessions to learn problem-solving skills. I know what you’re thinking, and I agree: Why aren’t we providing Fast Track interventions for Congress?
By age 25 years, the Fast Track group has had fewer convictions for violent and drug-related crimes, less substance abuse, less risky sexual behavior, and fewer psychiatric problems than did the control group. They even had lower rates of harsh parenting, suggesting that the benefits of the intervention may last for generations. The improvements transcended race, sex, and geographic area. Of course, the program was not free: The per-child cost came out to $58,000 over 10 years. Compared with the costs of violent crime, drug use, psychiatric disease, and prison, that strikes me as a bargain. I admit I’m no economist, but I can recognize value -- I’ve watched “Pawn Stars.”
Half-baked sale
Is there anything that kids don’t sell these days for school fund-raisers? Back when I was in middle school band, there were only three choices when it came to raising money: plain milk chocolate, almond, and puffed rice. My parents were good, too; anyone who walked into their offices left with at least one overpriced bar, and I came tantalizingly close to selling enough to earn a real working stoplight for my bedroom, although in retrospect the traffic didn’t really justify one.
These days, our five kids have tried to sell everything from wrapping paper to tangerines to discount coupon books (if only we’d used every coupon in the book we could have saved enough money to just buy a stoplight, but does anyone really go bowling that often?). Their middle school has even followed the Public Radio route and just asked for flat-out cash, and they don’t even give you a coffee mug.
Apparently, however, none of that entrepreneurial spirit has filtered across state lines to South Carolina, where the State Board of Education is requesting an exemption from U.S. Department of Agriculture Smart Snack school nutrition guidelines on the basis that the only way South Carolina schoolchildren could ever raise enough money for their projects is by selling donuts. Apparently, they have the childhood obesity problem licked down there, since childhood obesity rates are actually higher in Mississippi and, uh, did I mention Mississippi?
The South Carolina Medical Association, the board of Eat Smart Move More SC, and Catherine Templeton, director of the S.C. Department of Health and Environmental Control, have all objected to the proposed exemption, suggesting that it sends the wrong message about the importance of childhood nutrition in the state. For the sake of those kids to the south of us, I’m hoping this is one proposal that doesn’t get the green light.
A real headache
What if attention-deficit/hyperactivity disorder (ADHD) has become so common because it’s caused by something that has also become common, like smart phones, reality television, or cramped seating on airplanes? That was the thought that occurred to researchers at the University of Auckland, Australia, and what they discovered may make pregnancy even more uncomfortable than it already is: ADHD and other behavioral problems may stem from maternal use of acetaminophen during pregnancy. I suspect that once this news gets out, one of two things is going to happen: Either birth rates are going to fall, or we’re going to keep seeing an awful lot of ADHD.
The association, studied in 871 children at ages 7 and 11 years, wasn’t huge, suggesting about a doubling of the risk of ADHD in children exposed to acetaminophen prenatally. The findings, however, confirm what other studies had already suggested, and other drugs studied by the researchers didn’t show the same relationship. As handy as acetaminophen can be when you’re in pain, ADHD is one heck of a souvenir to take from the experience. And hey, if you really want a souvenir, I have a flowery tablecloth I’m not using.
You know those vacation souvenirs that seem so life transforming until you get them home? I confess: I’m the person who buys a Provençal tablecloth in France imagining the 3-hour lunches I’ll share on the patio with friends over olives, baguettes, and a few bottles of wine. Once I’m home I remember that, unlike France, North Carolina has mosquitoes that carry off small children. The tablecloth goes in the pantry right next to those dusty hand-blown margarita glasses and that pareo that had seemed like such a versatile piece of clothing in Polynesia but that doesn’t match any of my loafers.
The only souvenir I actually use is the conch shell I blow to get the kids to come inside for dinner. I suspect it’s why our neighbors have forbidden me from ever going back to the Yucatan. In return, let’s just say that if they’re waiting to attend my Provençal picnic, it could be a while.
Minority Report
Are you amazed at how many things we thought impossible only a few years ago are now commonplace? Who could imagine that within our lifetimes, we’d be able to sequence a person’s genome for a few thousand dollars, print useful household objects from our computers, or watch a different reality TV show every hour for a whole week? Now researchers at Duke University report that they can identify children at risk of becoming violent criminals and intervene early enough to lead them to productive lives. It may not be as cool as binge-watching “Pawn Stars” on your iPhone 6, but still, it’s impressive.
The news comes from the latest analysis of the Fast Track Project, a joint undertaking of researchers at Duke, Vanderbilt, the University of Washington and Pennsylvania State, that started in 1991 with the screening of nearly 10,000 5-year-old children in Durham, Nashville, Seattle, and rural Pennsylvania. Researchers identified 900 of those children whom they felt were at particularly high risk of growing up to become violent, antisocial adults. I don’t know all the criteria they used, but I suspect that they automatically included any kindergartener with a tattoo.
Half of the kids were randomized to receive the Fast Track intervention which, despite coming from North Carolina, did not involve NASCAR. Instead, from 1st through 10th grade, the children received tutoring in reading, self-control, and social-cognitive skills while their parents had home visits and training group sessions to learn problem-solving skills. I know what you’re thinking, and I agree: Why aren’t we providing Fast Track interventions for Congress?
By age 25 years, the Fast Track group has had fewer convictions for violent and drug-related crimes, less substance abuse, less risky sexual behavior, and fewer psychiatric problems than did the control group. They even had lower rates of harsh parenting, suggesting that the benefits of the intervention may last for generations. The improvements transcended race, sex, and geographic area. Of course, the program was not free: The per-child cost came out to $58,000 over 10 years. Compared with the costs of violent crime, drug use, psychiatric disease, and prison, that strikes me as a bargain. I admit I’m no economist, but I can recognize value -- I’ve watched “Pawn Stars.”
Half-baked sale
Is there anything that kids don’t sell these days for school fund-raisers? Back when I was in middle school band, there were only three choices when it came to raising money: plain milk chocolate, almond, and puffed rice. My parents were good, too; anyone who walked into their offices left with at least one overpriced bar, and I came tantalizingly close to selling enough to earn a real working stoplight for my bedroom, although in retrospect the traffic didn’t really justify one.
These days, our five kids have tried to sell everything from wrapping paper to tangerines to discount coupon books (if only we’d used every coupon in the book we could have saved enough money to just buy a stoplight, but does anyone really go bowling that often?). Their middle school has even followed the Public Radio route and just asked for flat-out cash, and they don’t even give you a coffee mug.
Apparently, however, none of that entrepreneurial spirit has filtered across state lines to South Carolina, where the State Board of Education is requesting an exemption from U.S. Department of Agriculture Smart Snack school nutrition guidelines on the basis that the only way South Carolina schoolchildren could ever raise enough money for their projects is by selling donuts. Apparently, they have the childhood obesity problem licked down there, since childhood obesity rates are actually higher in Mississippi and, uh, did I mention Mississippi?
The South Carolina Medical Association, the board of Eat Smart Move More SC, and Catherine Templeton, director of the S.C. Department of Health and Environmental Control, have all objected to the proposed exemption, suggesting that it sends the wrong message about the importance of childhood nutrition in the state. For the sake of those kids to the south of us, I’m hoping this is one proposal that doesn’t get the green light.
A real headache
What if attention-deficit/hyperactivity disorder (ADHD) has become so common because it’s caused by something that has also become common, like smart phones, reality television, or cramped seating on airplanes? That was the thought that occurred to researchers at the University of Auckland, Australia, and what they discovered may make pregnancy even more uncomfortable than it already is: ADHD and other behavioral problems may stem from maternal use of acetaminophen during pregnancy. I suspect that once this news gets out, one of two things is going to happen: Either birth rates are going to fall, or we’re going to keep seeing an awful lot of ADHD.
The association, studied in 871 children at ages 7 and 11 years, wasn’t huge, suggesting about a doubling of the risk of ADHD in children exposed to acetaminophen prenatally. The findings, however, confirm what other studies had already suggested, and other drugs studied by the researchers didn’t show the same relationship. As handy as acetaminophen can be when you’re in pain, ADHD is one heck of a souvenir to take from the experience. And hey, if you really want a souvenir, I have a flowery tablecloth I’m not using.
You know those vacation souvenirs that seem so life transforming until you get them home? I confess: I’m the person who buys a Provençal tablecloth in France imagining the 3-hour lunches I’ll share on the patio with friends over olives, baguettes, and a few bottles of wine. Once I’m home I remember that, unlike France, North Carolina has mosquitoes that carry off small children. The tablecloth goes in the pantry right next to those dusty hand-blown margarita glasses and that pareo that had seemed like such a versatile piece of clothing in Polynesia but that doesn’t match any of my loafers.
The only souvenir I actually use is the conch shell I blow to get the kids to come inside for dinner. I suspect it’s why our neighbors have forbidden me from ever going back to the Yucatan. In return, let’s just say that if they’re waiting to attend my Provençal picnic, it could be a while.
Minority Report
Are you amazed at how many things we thought impossible only a few years ago are now commonplace? Who could imagine that within our lifetimes, we’d be able to sequence a person’s genome for a few thousand dollars, print useful household objects from our computers, or watch a different reality TV show every hour for a whole week? Now researchers at Duke University report that they can identify children at risk of becoming violent criminals and intervene early enough to lead them to productive lives. It may not be as cool as binge-watching “Pawn Stars” on your iPhone 6, but still, it’s impressive.
The news comes from the latest analysis of the Fast Track Project, a joint undertaking of researchers at Duke, Vanderbilt, the University of Washington and Pennsylvania State, that started in 1991 with the screening of nearly 10,000 5-year-old children in Durham, Nashville, Seattle, and rural Pennsylvania. Researchers identified 900 of those children whom they felt were at particularly high risk of growing up to become violent, antisocial adults. I don’t know all the criteria they used, but I suspect that they automatically included any kindergartener with a tattoo.
Half of the kids were randomized to receive the Fast Track intervention which, despite coming from North Carolina, did not involve NASCAR. Instead, from 1st through 10th grade, the children received tutoring in reading, self-control, and social-cognitive skills while their parents had home visits and training group sessions to learn problem-solving skills. I know what you’re thinking, and I agree: Why aren’t we providing Fast Track interventions for Congress?
By age 25 years, the Fast Track group has had fewer convictions for violent and drug-related crimes, less substance abuse, less risky sexual behavior, and fewer psychiatric problems than did the control group. They even had lower rates of harsh parenting, suggesting that the benefits of the intervention may last for generations. The improvements transcended race, sex, and geographic area. Of course, the program was not free: The per-child cost came out to $58,000 over 10 years. Compared with the costs of violent crime, drug use, psychiatric disease, and prison, that strikes me as a bargain. I admit I’m no economist, but I can recognize value -- I’ve watched “Pawn Stars.”
Half-baked sale
Is there anything that kids don’t sell these days for school fund-raisers? Back when I was in middle school band, there were only three choices when it came to raising money: plain milk chocolate, almond, and puffed rice. My parents were good, too; anyone who walked into their offices left with at least one overpriced bar, and I came tantalizingly close to selling enough to earn a real working stoplight for my bedroom, although in retrospect the traffic didn’t really justify one.
These days, our five kids have tried to sell everything from wrapping paper to tangerines to discount coupon books (if only we’d used every coupon in the book we could have saved enough money to just buy a stoplight, but does anyone really go bowling that often?). Their middle school has even followed the Public Radio route and just asked for flat-out cash, and they don’t even give you a coffee mug.
Apparently, however, none of that entrepreneurial spirit has filtered across state lines to South Carolina, where the State Board of Education is requesting an exemption from U.S. Department of Agriculture Smart Snack school nutrition guidelines on the basis that the only way South Carolina schoolchildren could ever raise enough money for their projects is by selling donuts. Apparently, they have the childhood obesity problem licked down there, since childhood obesity rates are actually higher in Mississippi and, uh, did I mention Mississippi?
The South Carolina Medical Association, the board of Eat Smart Move More SC, and Catherine Templeton, director of the S.C. Department of Health and Environmental Control, have all objected to the proposed exemption, suggesting that it sends the wrong message about the importance of childhood nutrition in the state. For the sake of those kids to the south of us, I’m hoping this is one proposal that doesn’t get the green light.
A real headache
What if attention-deficit/hyperactivity disorder (ADHD) has become so common because it’s caused by something that has also become common, like smart phones, reality television, or cramped seating on airplanes? That was the thought that occurred to researchers at the University of Auckland, Australia, and what they discovered may make pregnancy even more uncomfortable than it already is: ADHD and other behavioral problems may stem from maternal use of acetaminophen during pregnancy. I suspect that once this news gets out, one of two things is going to happen: Either birth rates are going to fall, or we’re going to keep seeing an awful lot of ADHD.
The association, studied in 871 children at ages 7 and 11 years, wasn’t huge, suggesting about a doubling of the risk of ADHD in children exposed to acetaminophen prenatally. The findings, however, confirm what other studies had already suggested, and other drugs studied by the researchers didn’t show the same relationship. As handy as acetaminophen can be when you’re in pain, ADHD is one heck of a souvenir to take from the experience. And hey, if you really want a souvenir, I have a flowery tablecloth I’m not using.
Tripped up
I remember how freaked out we used to get before leaving town without our toddlers. Those were the days! We’re now about to leave four teenagers with various friends and family members while we spend several days in Europe, and I only wish we were worrying about who might forget their favorite blanket at day care.
The stuff that could happen while we’re gone this time is likely to end up on our kids’ permanent records. I can hear the Harvard admissions officer now: “Mr. Hill, Abby has almost everything it takes to gain admission, with a full scholarship, if only it hadn’t been for this math test in September of 2014. I have to ask, where were you that week?”
In the weeds
Just because something is legal doesn’t mean it’s a good idea for teenagers. After all, no one has banned grain alcohol, 5-Hour Energy, or Mustang GT convertibles, but in the hands of a 16-year-old any one of them is a horrible idea, and any combination, well, you can imagine. As more states consider legalizing cannabis, some high-minded researchers publishing in The Lancet Psychiatry thought is was high time to review the literature on what tetrahydrocannabinol (THC) actually does to high schoolers when they get, you know…stoned.
To look at movies, you’d think the effects of frequent marijuana use would mainly involve searching for small hamburgers, bowling in your bathrobe, and stumbling out of low-riders. Based on three large population-based studies in New Zealand and Australia, however, you have to add a lot of less-funny stuff like failing to complete high school (60% less likely for daily users than nonusers), use of other drugs later in life (an eightfold increase), and, most seriously, suicide (a sevenfold increase compared with nonusers). At this point, no one should be laughing, even those actively smoking pot, like, right now.
There is one finding from the analysis that someone is going to have to explain to me, and I swear I’m clean. The authors state that youth who are daily marijuana users face an 18-fold higher risk of cannabis dependence than do nonusers. Is there some reason that number is not, like, infinity? Regardless, the Australian data suggest that when it comes to teens’ life success, marijuana may be the Great Barrier Reefer.
House staph
You know those things that everyone agrees need to go, but no one knows how to get rid of? Like boy bands, infomercials, and the teen years? Methicillin-resistant Staphylococcus aureus (MRSA) is definitely on that list, and according to a new study in JAMA Pediatrics, it’s in even more places than we thought. Who is spreading this stuff everywhere? I’d like to blame One Direction, but it seems that the vectors are actually (insert spooky music) our own children.
Dr. Stephanie A. Fritz of Washington University School of Medicine in St. Louis and her colleagues identified 50 children recently treated for MRSA infections and got permission from their families to go around their homes swabbing stuff. Not only is this a promising research premise, but I think it could be the next hit reality show: “Wife Swab.” They also asked about home cleaning practices, although the researchers didn’t get specific about the products used (Mr. Clean vs. used Kleenex), and they conceded that, when confronted by a team of white-coated scientists, some parents may have slightly overstated how often they tidied up.
MRSA turned up in nearly half (23) of the households, with bed linens harboring the bug most often (18%) followed by TV remotes (16%) and bathroom hand towels (15%). Even dogs (12%) and cats (7%) were colonized with MRSA, despite the fact that neither animal frequently uses hand towels or TV remotes. What the study could not determine was whether children got MRSA infections from contaminated household surfaces, or whether those surfaces were contaminated because the children had MRSA infections. A 2-year follow-up project hopes to answer that question, but until the results are published, I’m blaming One Direction.
Skin to skin
How often does the medical literature teach you fascinating facts about the habits of exotic peoples in faraway lands? Okay, there’s the occasional mention of kuru or of the ankle injuries specific to Vanuatu land divers, but no one is too worried about Pediatrics stealing market share from National Geographic. That’s why I was shocked to learn from the European Lung Foundation of all places about a bizarre custom that’s apparently popular in Europe and that I completely missed when I was backpacking across the continent as a sophomore: More than half of European newborns apparently sleep on animal skins. I scoured the article, but nowhere does it say whether or not the animals are still using them.
This fact becomes as relevant as it is weird because infants who slept on skins or furs had a 79% reduced risk of developing asthma, compared with children whose sleeping environments were … what’s the word? … normal. These findings reinforce earlier studies comparing farm children to urban children, suggesting that the protective effect of farm animals on allergic disease does not require the whole animal. I’m planning to check this whole thing out when we’re in Europe next week, at least if I have any time left after calling to check on my kids.
I remember how freaked out we used to get before leaving town without our toddlers. Those were the days! We’re now about to leave four teenagers with various friends and family members while we spend several days in Europe, and I only wish we were worrying about who might forget their favorite blanket at day care.
The stuff that could happen while we’re gone this time is likely to end up on our kids’ permanent records. I can hear the Harvard admissions officer now: “Mr. Hill, Abby has almost everything it takes to gain admission, with a full scholarship, if only it hadn’t been for this math test in September of 2014. I have to ask, where were you that week?”
In the weeds
Just because something is legal doesn’t mean it’s a good idea for teenagers. After all, no one has banned grain alcohol, 5-Hour Energy, or Mustang GT convertibles, but in the hands of a 16-year-old any one of them is a horrible idea, and any combination, well, you can imagine. As more states consider legalizing cannabis, some high-minded researchers publishing in The Lancet Psychiatry thought is was high time to review the literature on what tetrahydrocannabinol (THC) actually does to high schoolers when they get, you know…stoned.
To look at movies, you’d think the effects of frequent marijuana use would mainly involve searching for small hamburgers, bowling in your bathrobe, and stumbling out of low-riders. Based on three large population-based studies in New Zealand and Australia, however, you have to add a lot of less-funny stuff like failing to complete high school (60% less likely for daily users than nonusers), use of other drugs later in life (an eightfold increase), and, most seriously, suicide (a sevenfold increase compared with nonusers). At this point, no one should be laughing, even those actively smoking pot, like, right now.
There is one finding from the analysis that someone is going to have to explain to me, and I swear I’m clean. The authors state that youth who are daily marijuana users face an 18-fold higher risk of cannabis dependence than do nonusers. Is there some reason that number is not, like, infinity? Regardless, the Australian data suggest that when it comes to teens’ life success, marijuana may be the Great Barrier Reefer.
House staph
You know those things that everyone agrees need to go, but no one knows how to get rid of? Like boy bands, infomercials, and the teen years? Methicillin-resistant Staphylococcus aureus (MRSA) is definitely on that list, and according to a new study in JAMA Pediatrics, it’s in even more places than we thought. Who is spreading this stuff everywhere? I’d like to blame One Direction, but it seems that the vectors are actually (insert spooky music) our own children.
Dr. Stephanie A. Fritz of Washington University School of Medicine in St. Louis and her colleagues identified 50 children recently treated for MRSA infections and got permission from their families to go around their homes swabbing stuff. Not only is this a promising research premise, but I think it could be the next hit reality show: “Wife Swab.” They also asked about home cleaning practices, although the researchers didn’t get specific about the products used (Mr. Clean vs. used Kleenex), and they conceded that, when confronted by a team of white-coated scientists, some parents may have slightly overstated how often they tidied up.
MRSA turned up in nearly half (23) of the households, with bed linens harboring the bug most often (18%) followed by TV remotes (16%) and bathroom hand towels (15%). Even dogs (12%) and cats (7%) were colonized with MRSA, despite the fact that neither animal frequently uses hand towels or TV remotes. What the study could not determine was whether children got MRSA infections from contaminated household surfaces, or whether those surfaces were contaminated because the children had MRSA infections. A 2-year follow-up project hopes to answer that question, but until the results are published, I’m blaming One Direction.
Skin to skin
How often does the medical literature teach you fascinating facts about the habits of exotic peoples in faraway lands? Okay, there’s the occasional mention of kuru or of the ankle injuries specific to Vanuatu land divers, but no one is too worried about Pediatrics stealing market share from National Geographic. That’s why I was shocked to learn from the European Lung Foundation of all places about a bizarre custom that’s apparently popular in Europe and that I completely missed when I was backpacking across the continent as a sophomore: More than half of European newborns apparently sleep on animal skins. I scoured the article, but nowhere does it say whether or not the animals are still using them.
This fact becomes as relevant as it is weird because infants who slept on skins or furs had a 79% reduced risk of developing asthma, compared with children whose sleeping environments were … what’s the word? … normal. These findings reinforce earlier studies comparing farm children to urban children, suggesting that the protective effect of farm animals on allergic disease does not require the whole animal. I’m planning to check this whole thing out when we’re in Europe next week, at least if I have any time left after calling to check on my kids.
I remember how freaked out we used to get before leaving town without our toddlers. Those were the days! We’re now about to leave four teenagers with various friends and family members while we spend several days in Europe, and I only wish we were worrying about who might forget their favorite blanket at day care.
The stuff that could happen while we’re gone this time is likely to end up on our kids’ permanent records. I can hear the Harvard admissions officer now: “Mr. Hill, Abby has almost everything it takes to gain admission, with a full scholarship, if only it hadn’t been for this math test in September of 2014. I have to ask, where were you that week?”
In the weeds
Just because something is legal doesn’t mean it’s a good idea for teenagers. After all, no one has banned grain alcohol, 5-Hour Energy, or Mustang GT convertibles, but in the hands of a 16-year-old any one of them is a horrible idea, and any combination, well, you can imagine. As more states consider legalizing cannabis, some high-minded researchers publishing in The Lancet Psychiatry thought is was high time to review the literature on what tetrahydrocannabinol (THC) actually does to high schoolers when they get, you know…stoned.
To look at movies, you’d think the effects of frequent marijuana use would mainly involve searching for small hamburgers, bowling in your bathrobe, and stumbling out of low-riders. Based on three large population-based studies in New Zealand and Australia, however, you have to add a lot of less-funny stuff like failing to complete high school (60% less likely for daily users than nonusers), use of other drugs later in life (an eightfold increase), and, most seriously, suicide (a sevenfold increase compared with nonusers). At this point, no one should be laughing, even those actively smoking pot, like, right now.
There is one finding from the analysis that someone is going to have to explain to me, and I swear I’m clean. The authors state that youth who are daily marijuana users face an 18-fold higher risk of cannabis dependence than do nonusers. Is there some reason that number is not, like, infinity? Regardless, the Australian data suggest that when it comes to teens’ life success, marijuana may be the Great Barrier Reefer.
House staph
You know those things that everyone agrees need to go, but no one knows how to get rid of? Like boy bands, infomercials, and the teen years? Methicillin-resistant Staphylococcus aureus (MRSA) is definitely on that list, and according to a new study in JAMA Pediatrics, it’s in even more places than we thought. Who is spreading this stuff everywhere? I’d like to blame One Direction, but it seems that the vectors are actually (insert spooky music) our own children.
Dr. Stephanie A. Fritz of Washington University School of Medicine in St. Louis and her colleagues identified 50 children recently treated for MRSA infections and got permission from their families to go around their homes swabbing stuff. Not only is this a promising research premise, but I think it could be the next hit reality show: “Wife Swab.” They also asked about home cleaning practices, although the researchers didn’t get specific about the products used (Mr. Clean vs. used Kleenex), and they conceded that, when confronted by a team of white-coated scientists, some parents may have slightly overstated how often they tidied up.
MRSA turned up in nearly half (23) of the households, with bed linens harboring the bug most often (18%) followed by TV remotes (16%) and bathroom hand towels (15%). Even dogs (12%) and cats (7%) were colonized with MRSA, despite the fact that neither animal frequently uses hand towels or TV remotes. What the study could not determine was whether children got MRSA infections from contaminated household surfaces, or whether those surfaces were contaminated because the children had MRSA infections. A 2-year follow-up project hopes to answer that question, but until the results are published, I’m blaming One Direction.
Skin to skin
How often does the medical literature teach you fascinating facts about the habits of exotic peoples in faraway lands? Okay, there’s the occasional mention of kuru or of the ankle injuries specific to Vanuatu land divers, but no one is too worried about Pediatrics stealing market share from National Geographic. That’s why I was shocked to learn from the European Lung Foundation of all places about a bizarre custom that’s apparently popular in Europe and that I completely missed when I was backpacking across the continent as a sophomore: More than half of European newborns apparently sleep on animal skins. I scoured the article, but nowhere does it say whether or not the animals are still using them.
This fact becomes as relevant as it is weird because infants who slept on skins or furs had a 79% reduced risk of developing asthma, compared with children whose sleeping environments were … what’s the word? … normal. These findings reinforce earlier studies comparing farm children to urban children, suggesting that the protective effect of farm animals on allergic disease does not require the whole animal. I’m planning to check this whole thing out when we’re in Europe next week, at least if I have any time left after calling to check on my kids.
Disoriented
It’s late August, and finally I feel ready for summer. You don’t need to remind me that I’m late: Our five children have no fewer than eight school orientations this week. The extras are because new high schoolers need two sessions, one for their parents and another just for students, where they tell them all the really important stuff, which the kids then forget until second semester when it’s too late. Can I go to the beach now?
Of course the orientations are mainly just a chance for teachers to pass out supply lists, which, with severe budget cuts in our state, now include items like, “one bottle of hand sanitizer, five dry-erase markers in various colors, one qualified teaching assistant.” Also, I know why my 4th-grader needs to start the year with 24 #2 pencils: He chews them. But do all the kids have an oral fixation? Or is it that when my son has polished off his small forest of Ticonderogas, his classmates are expected to lend him theirs? I guess I’ll ask at orientation.
Hand-me-downs
Here’s my question: If we saved all the money parents are about to spend on classroom hand sanitizer, could we actually afford a teaching assistant? Or at least a few more dry-erase markers? Because a study from New Zealand suggests that as long as soap and water are available, hand sanitizer does nothing but to give schoolchildren another excuse to get up out of their seats.
Patricia Priest and her colleagues from the University of Otego in Dunedin (I, too think it sounds made up) studied school absences among 2,443 students aged 5 to 11 in 68 schools. They performed the experiment during the winter (read “summer”), placing alcohol-based hand sanitizers in half the schools and relying on soap, water, and Kiwi common sense in the other half. Then they sat back and counted the absences, going as far as to call parents and force them to invent diseases for children who were actually playing hooky to quest after the One Ring to Rule Them All.
When the investigators tallied everything up, hand sanitizer appeared to make no difference in the number of absences from all illnesses or from any specific illness (respiratory or GI). Also unaffected were the length of illness, the length of the absence, or the likelihood of another family member contracting the illness. (That last endpoint confuses me, unless the kids were taking hand sanitizer home every night.) What this study proved was that whether or not children in New Zealand have access to hand sanitizer, they will still all be mistaken for Australians.
I think we’re alone now
If you can just spend a little one-on-one time with teenagers, they’ll reveal the most amazing things about their lives. That’s why I have five children: to make sure that kind of thing never happens. But in the pediatrician’s office, it’s a good thing. We need to know what’s going on in adolescents’ lives in order to help them avoid the dangers of substance abuse, high-risk sexual behavior, and whatever boneheaded dare has been going around YouTube this week. A new study out of Indianapolis confirms what common sense already tells us: If you don’t talk with teens’ parents out of the exam room for a few minutes, you miss the good stuff, (read “the bad stuff”).
To prove it, the researchers surveyed around 500 adolescents (ages 13-17 years) and their parents regarding conversations they had with providers during their wellness exams. The best single statistic from their study was this: 89% of parents believed adolescents should be able to talk with their doctors privately, while 61% of parents preferred to stay in the exam room for the entire visit. That means that 50% of parents misunderstand one of the following terms: adolescent, private, or exam room.
Kids who did get to talk to their doctors alone discussed almost twice as many sensitive topics as did kids whose parents policed their conversations. On the up side, when parents refused to leave, kids were more likely to say “ma’am” and “sir,” to sit up straight for once please, and to brush that hair out of their eyes so the doctor can tell you’re looking at them, honey, thank you.
Call me maybe
Speaking of counseling teens and parents, do you sometimes think we’re talking with the wrong person? The National Institutes of Health just completed a study of distracted driving, a cause of 11% of fatal crashes among adolescents. Since 21% of those crashes involve mobile phone use, researchers asked 400 15- to 18-year-old drivers who in the heck they were talking to on the phone that made it worth risking their lives. Of the 86% of teens who reported talking on the phone while driving, 100% of them said the people they were talking to were their parents.
Fellow parents of teens, this does not make us look good. I like chatting with my kids, too, but it’s easier to converse with them when they’re alive, or at least not in a coma (if you can’t tell whether or not your adolescent is in a coma, have him brush that hair out of his eyes). We’ve got to do better, y’all; no one really wants to miss out on next year’s school orientation.
David L. Hill, M.D., FAAP, is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
It’s late August, and finally I feel ready for summer. You don’t need to remind me that I’m late: Our five children have no fewer than eight school orientations this week. The extras are because new high schoolers need two sessions, one for their parents and another just for students, where they tell them all the really important stuff, which the kids then forget until second semester when it’s too late. Can I go to the beach now?
Of course the orientations are mainly just a chance for teachers to pass out supply lists, which, with severe budget cuts in our state, now include items like, “one bottle of hand sanitizer, five dry-erase markers in various colors, one qualified teaching assistant.” Also, I know why my 4th-grader needs to start the year with 24 #2 pencils: He chews them. But do all the kids have an oral fixation? Or is it that when my son has polished off his small forest of Ticonderogas, his classmates are expected to lend him theirs? I guess I’ll ask at orientation.
Hand-me-downs
Here’s my question: If we saved all the money parents are about to spend on classroom hand sanitizer, could we actually afford a teaching assistant? Or at least a few more dry-erase markers? Because a study from New Zealand suggests that as long as soap and water are available, hand sanitizer does nothing but to give schoolchildren another excuse to get up out of their seats.
Patricia Priest and her colleagues from the University of Otego in Dunedin (I, too think it sounds made up) studied school absences among 2,443 students aged 5 to 11 in 68 schools. They performed the experiment during the winter (read “summer”), placing alcohol-based hand sanitizers in half the schools and relying on soap, water, and Kiwi common sense in the other half. Then they sat back and counted the absences, going as far as to call parents and force them to invent diseases for children who were actually playing hooky to quest after the One Ring to Rule Them All.
When the investigators tallied everything up, hand sanitizer appeared to make no difference in the number of absences from all illnesses or from any specific illness (respiratory or GI). Also unaffected were the length of illness, the length of the absence, or the likelihood of another family member contracting the illness. (That last endpoint confuses me, unless the kids were taking hand sanitizer home every night.) What this study proved was that whether or not children in New Zealand have access to hand sanitizer, they will still all be mistaken for Australians.
I think we’re alone now
If you can just spend a little one-on-one time with teenagers, they’ll reveal the most amazing things about their lives. That’s why I have five children: to make sure that kind of thing never happens. But in the pediatrician’s office, it’s a good thing. We need to know what’s going on in adolescents’ lives in order to help them avoid the dangers of substance abuse, high-risk sexual behavior, and whatever boneheaded dare has been going around YouTube this week. A new study out of Indianapolis confirms what common sense already tells us: If you don’t talk with teens’ parents out of the exam room for a few minutes, you miss the good stuff, (read “the bad stuff”).
To prove it, the researchers surveyed around 500 adolescents (ages 13-17 years) and their parents regarding conversations they had with providers during their wellness exams. The best single statistic from their study was this: 89% of parents believed adolescents should be able to talk with their doctors privately, while 61% of parents preferred to stay in the exam room for the entire visit. That means that 50% of parents misunderstand one of the following terms: adolescent, private, or exam room.
Kids who did get to talk to their doctors alone discussed almost twice as many sensitive topics as did kids whose parents policed their conversations. On the up side, when parents refused to leave, kids were more likely to say “ma’am” and “sir,” to sit up straight for once please, and to brush that hair out of their eyes so the doctor can tell you’re looking at them, honey, thank you.
Call me maybe
Speaking of counseling teens and parents, do you sometimes think we’re talking with the wrong person? The National Institutes of Health just completed a study of distracted driving, a cause of 11% of fatal crashes among adolescents. Since 21% of those crashes involve mobile phone use, researchers asked 400 15- to 18-year-old drivers who in the heck they were talking to on the phone that made it worth risking their lives. Of the 86% of teens who reported talking on the phone while driving, 100% of them said the people they were talking to were their parents.
Fellow parents of teens, this does not make us look good. I like chatting with my kids, too, but it’s easier to converse with them when they’re alive, or at least not in a coma (if you can’t tell whether or not your adolescent is in a coma, have him brush that hair out of his eyes). We’ve got to do better, y’all; no one really wants to miss out on next year’s school orientation.
David L. Hill, M.D., FAAP, is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
It’s late August, and finally I feel ready for summer. You don’t need to remind me that I’m late: Our five children have no fewer than eight school orientations this week. The extras are because new high schoolers need two sessions, one for their parents and another just for students, where they tell them all the really important stuff, which the kids then forget until second semester when it’s too late. Can I go to the beach now?
Of course the orientations are mainly just a chance for teachers to pass out supply lists, which, with severe budget cuts in our state, now include items like, “one bottle of hand sanitizer, five dry-erase markers in various colors, one qualified teaching assistant.” Also, I know why my 4th-grader needs to start the year with 24 #2 pencils: He chews them. But do all the kids have an oral fixation? Or is it that when my son has polished off his small forest of Ticonderogas, his classmates are expected to lend him theirs? I guess I’ll ask at orientation.
Hand-me-downs
Here’s my question: If we saved all the money parents are about to spend on classroom hand sanitizer, could we actually afford a teaching assistant? Or at least a few more dry-erase markers? Because a study from New Zealand suggests that as long as soap and water are available, hand sanitizer does nothing but to give schoolchildren another excuse to get up out of their seats.
Patricia Priest and her colleagues from the University of Otego in Dunedin (I, too think it sounds made up) studied school absences among 2,443 students aged 5 to 11 in 68 schools. They performed the experiment during the winter (read “summer”), placing alcohol-based hand sanitizers in half the schools and relying on soap, water, and Kiwi common sense in the other half. Then they sat back and counted the absences, going as far as to call parents and force them to invent diseases for children who were actually playing hooky to quest after the One Ring to Rule Them All.
When the investigators tallied everything up, hand sanitizer appeared to make no difference in the number of absences from all illnesses or from any specific illness (respiratory or GI). Also unaffected were the length of illness, the length of the absence, or the likelihood of another family member contracting the illness. (That last endpoint confuses me, unless the kids were taking hand sanitizer home every night.) What this study proved was that whether or not children in New Zealand have access to hand sanitizer, they will still all be mistaken for Australians.
I think we’re alone now
If you can just spend a little one-on-one time with teenagers, they’ll reveal the most amazing things about their lives. That’s why I have five children: to make sure that kind of thing never happens. But in the pediatrician’s office, it’s a good thing. We need to know what’s going on in adolescents’ lives in order to help them avoid the dangers of substance abuse, high-risk sexual behavior, and whatever boneheaded dare has been going around YouTube this week. A new study out of Indianapolis confirms what common sense already tells us: If you don’t talk with teens’ parents out of the exam room for a few minutes, you miss the good stuff, (read “the bad stuff”).
To prove it, the researchers surveyed around 500 adolescents (ages 13-17 years) and their parents regarding conversations they had with providers during their wellness exams. The best single statistic from their study was this: 89% of parents believed adolescents should be able to talk with their doctors privately, while 61% of parents preferred to stay in the exam room for the entire visit. That means that 50% of parents misunderstand one of the following terms: adolescent, private, or exam room.
Kids who did get to talk to their doctors alone discussed almost twice as many sensitive topics as did kids whose parents policed their conversations. On the up side, when parents refused to leave, kids were more likely to say “ma’am” and “sir,” to sit up straight for once please, and to brush that hair out of their eyes so the doctor can tell you’re looking at them, honey, thank you.
Call me maybe
Speaking of counseling teens and parents, do you sometimes think we’re talking with the wrong person? The National Institutes of Health just completed a study of distracted driving, a cause of 11% of fatal crashes among adolescents. Since 21% of those crashes involve mobile phone use, researchers asked 400 15- to 18-year-old drivers who in the heck they were talking to on the phone that made it worth risking their lives. Of the 86% of teens who reported talking on the phone while driving, 100% of them said the people they were talking to were their parents.
Fellow parents of teens, this does not make us look good. I like chatting with my kids, too, but it’s easier to converse with them when they’re alive, or at least not in a coma (if you can’t tell whether or not your adolescent is in a coma, have him brush that hair out of his eyes). We’ve got to do better, y’all; no one really wants to miss out on next year’s school orientation.
David L. Hill, M.D., FAAP, is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Odds Are
I’ve always wondered what kind of irresponsible, misguided parent brings children to Las Vegas. Now I have the answer, right in the mirror. Don’t judge: My sister lives there, so if the kids are ever going to see their cousins, they have to share the road with trucks that say, “Girls! Girls! Girls!” (We told the 9-year-old that these were advertisements for clothing, which the women pictured seemed to need.)
It’s true that Las Vegas has become more family friendly...for the Kardashians. We did, however, manage to make the trip educational. In psychology, the kids found that after 10:00 p.m., everyone’s tempers are shorter than a 9-year-old boy lost in a crowd. In chemistry, they discovered that no substance yet synthesized can mask the smell of cigarette smoke. And in meteorology, they learned never to step in a puddle on The Strip; whatever it is, it’s not rain.
Hope falls
Is there anything we wouldn’t do to prevent someone from dying of cancer? We will ride bikes 150 miles, run marathons, and wear endless seas of pink, even though honestly it’s not everyone’s color (you know who you are). So if there were, say, a safe and effective means of preventing up to 4,000 cancer deaths a year, certainly doctors would be first in line to make sure everyone is protected, right?
Sure...between half and two-thirds of the time, according to a new analysis from the Centers for Disease Control and Prevention. That’s how often providers recommend human papillomavirus (HPV) vaccine to their eligible female and male patients. Maybe cervical, anal, penile, and oropharyngeal cancers need to get together and claim a color that looks good on everyone: Is cerulean taken?
I know we all get frustrated with vaccine deniers, but why aren’t we at least recommending HPV vaccine to 100% of our patients? Is it because they won’t be our patients by the time they get cancer? Is it because the vaccine is more expensive and more painful than some (both true, but again, y’all, cancer)? Is it because it’s awkward to talk to parents about how their cherubic 11-year-old is one day going to grow up into an adult who is likely to have, you know, S-E-X?
Whatever the reason, I share Assistant Surgeon General Dr. Anne Schuchat’s disappointment that only 37.6% of eligible girls and 13.6% of eligible boys got vaccinated against HPV last year. When poor parental uptake is the problem, we need to work on education. But when we as providers are not even recommending the vaccine, you can color me embarrassed.
Yellow-bellied?
Parents look at me like I’m crazy all the time, which I resent, because I’m only crazy most of the time. For the first 3 months of their baby's life, I tell parents to call me at the first sign of a fever; then I tell them fever is a nothing to worry about. I say that sleeping face-down can be deadly until their baby learns to roll back-to-front; then I tell them not to worry. And for the first 7 days of life, I tell them that newborn jaundice can cause severe brain damage, until I start saying it’s normal, especially in breastfed infants. I flip-flop more than a candidate for Congress.
A new study may reassure some mothers of nursing infants who look a little orange (the infants, that is; orange mothers should still be concerned). We’ve always known that breastfed infants tend to keep high levels of indirect bilirubin in their bloodstreams long after the first week in life, but no one yet had bothered to establish the typical range and time course. Dr. M. Jeffrey Maisels and a team from Oakland University William Beaumont School of Medicine changed all that with the use of transcutaneous bilirubin (TCB) monitors and 1,044 predominately breastfeeding infants.
Not only did they determine that at age 3-4 weeks between 34% and 43% of these infants still had TCB measurements over 5 mg/dL, they also reaffirmed that we doctors are really bad at guessing bilirubin levels from looking at babies. They asked trained clinicians to guess the “jaundice zone scores” of the infants, which sound like a customer loyalty program at a sporting goods store but are really just an estimate of how far down the infant’s body it looks yellow. The scores were so far off that a baby with a score of 0 could have a bilirubin level as high as 12.8 mg/dL. I can only hope that with his expertise in ferreting out bad human judgment, Dr. Maisels’s next study will investigate candidates for Congress.
Inattention
A complex society cannot function without some degree of trust; there’s all sorts of scary stuff I’d like to know, and I’m happy to pay a few dollars in taxes to make sure someone more qualified than I am is checking. Does this bridge I’m crossing have severe erosion? Is there another plane in our airspace? What was my 14-year-old daughter texting to her “boyfriend” last night? (Thanks, National Security Agency!)
Drug safety is one of those things, especially when many of my patients and one of my own children are taking said drug. A new study from researchers at Boston Children’s Hospital suggests that perhaps when it comes to the long-term safety of attention-deficit/hyperactivity disorder (ADHD) medications, the U.S. Food and Drug Administration has not looked as hard as it might. Paging Dr. Edward Snowden!
One might assume that since up to 10% of U.S. children now carry a diagnosis of ADHD, and since those children start medications as young as age 4 and continue to use them for many years, the safety studies that got these drugs approved would have been especially rigorous. Yeah, no. Only 5 of 32 preapproval trials focused on safety, these trials enrolled an average of 75 patients (as opposed to the recommended 1,500), and few lasted as long as 12 months, with approval sometimes granted after only 8 weeks of study and some older drugs being “grandfathered” in with essentially no safety data whatsoever.
I see one bright spot in this desert of data. Whenever I prescribe a stimulant for ADHD, I’ll understand that I’m taking a gamble, and I’ll fondly remember our family trip to Las Vegas.
David L. Hill, M.D., FAAP, is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
I’ve always wondered what kind of irresponsible, misguided parent brings children to Las Vegas. Now I have the answer, right in the mirror. Don’t judge: My sister lives there, so if the kids are ever going to see their cousins, they have to share the road with trucks that say, “Girls! Girls! Girls!” (We told the 9-year-old that these were advertisements for clothing, which the women pictured seemed to need.)
It’s true that Las Vegas has become more family friendly...for the Kardashians. We did, however, manage to make the trip educational. In psychology, the kids found that after 10:00 p.m., everyone’s tempers are shorter than a 9-year-old boy lost in a crowd. In chemistry, they discovered that no substance yet synthesized can mask the smell of cigarette smoke. And in meteorology, they learned never to step in a puddle on The Strip; whatever it is, it’s not rain.
Hope falls
Is there anything we wouldn’t do to prevent someone from dying of cancer? We will ride bikes 150 miles, run marathons, and wear endless seas of pink, even though honestly it’s not everyone’s color (you know who you are). So if there were, say, a safe and effective means of preventing up to 4,000 cancer deaths a year, certainly doctors would be first in line to make sure everyone is protected, right?
Sure...between half and two-thirds of the time, according to a new analysis from the Centers for Disease Control and Prevention. That’s how often providers recommend human papillomavirus (HPV) vaccine to their eligible female and male patients. Maybe cervical, anal, penile, and oropharyngeal cancers need to get together and claim a color that looks good on everyone: Is cerulean taken?
I know we all get frustrated with vaccine deniers, but why aren’t we at least recommending HPV vaccine to 100% of our patients? Is it because they won’t be our patients by the time they get cancer? Is it because the vaccine is more expensive and more painful than some (both true, but again, y’all, cancer)? Is it because it’s awkward to talk to parents about how their cherubic 11-year-old is one day going to grow up into an adult who is likely to have, you know, S-E-X?
Whatever the reason, I share Assistant Surgeon General Dr. Anne Schuchat’s disappointment that only 37.6% of eligible girls and 13.6% of eligible boys got vaccinated against HPV last year. When poor parental uptake is the problem, we need to work on education. But when we as providers are not even recommending the vaccine, you can color me embarrassed.
Yellow-bellied?
Parents look at me like I’m crazy all the time, which I resent, because I’m only crazy most of the time. For the first 3 months of their baby's life, I tell parents to call me at the first sign of a fever; then I tell them fever is a nothing to worry about. I say that sleeping face-down can be deadly until their baby learns to roll back-to-front; then I tell them not to worry. And for the first 7 days of life, I tell them that newborn jaundice can cause severe brain damage, until I start saying it’s normal, especially in breastfed infants. I flip-flop more than a candidate for Congress.
A new study may reassure some mothers of nursing infants who look a little orange (the infants, that is; orange mothers should still be concerned). We’ve always known that breastfed infants tend to keep high levels of indirect bilirubin in their bloodstreams long after the first week in life, but no one yet had bothered to establish the typical range and time course. Dr. M. Jeffrey Maisels and a team from Oakland University William Beaumont School of Medicine changed all that with the use of transcutaneous bilirubin (TCB) monitors and 1,044 predominately breastfeeding infants.
Not only did they determine that at age 3-4 weeks between 34% and 43% of these infants still had TCB measurements over 5 mg/dL, they also reaffirmed that we doctors are really bad at guessing bilirubin levels from looking at babies. They asked trained clinicians to guess the “jaundice zone scores” of the infants, which sound like a customer loyalty program at a sporting goods store but are really just an estimate of how far down the infant’s body it looks yellow. The scores were so far off that a baby with a score of 0 could have a bilirubin level as high as 12.8 mg/dL. I can only hope that with his expertise in ferreting out bad human judgment, Dr. Maisels’s next study will investigate candidates for Congress.
Inattention
A complex society cannot function without some degree of trust; there’s all sorts of scary stuff I’d like to know, and I’m happy to pay a few dollars in taxes to make sure someone more qualified than I am is checking. Does this bridge I’m crossing have severe erosion? Is there another plane in our airspace? What was my 14-year-old daughter texting to her “boyfriend” last night? (Thanks, National Security Agency!)
Drug safety is one of those things, especially when many of my patients and one of my own children are taking said drug. A new study from researchers at Boston Children’s Hospital suggests that perhaps when it comes to the long-term safety of attention-deficit/hyperactivity disorder (ADHD) medications, the U.S. Food and Drug Administration has not looked as hard as it might. Paging Dr. Edward Snowden!
One might assume that since up to 10% of U.S. children now carry a diagnosis of ADHD, and since those children start medications as young as age 4 and continue to use them for many years, the safety studies that got these drugs approved would have been especially rigorous. Yeah, no. Only 5 of 32 preapproval trials focused on safety, these trials enrolled an average of 75 patients (as opposed to the recommended 1,500), and few lasted as long as 12 months, with approval sometimes granted after only 8 weeks of study and some older drugs being “grandfathered” in with essentially no safety data whatsoever.
I see one bright spot in this desert of data. Whenever I prescribe a stimulant for ADHD, I’ll understand that I’m taking a gamble, and I’ll fondly remember our family trip to Las Vegas.
David L. Hill, M.D., FAAP, is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
I’ve always wondered what kind of irresponsible, misguided parent brings children to Las Vegas. Now I have the answer, right in the mirror. Don’t judge: My sister lives there, so if the kids are ever going to see their cousins, they have to share the road with trucks that say, “Girls! Girls! Girls!” (We told the 9-year-old that these were advertisements for clothing, which the women pictured seemed to need.)
It’s true that Las Vegas has become more family friendly...for the Kardashians. We did, however, manage to make the trip educational. In psychology, the kids found that after 10:00 p.m., everyone’s tempers are shorter than a 9-year-old boy lost in a crowd. In chemistry, they discovered that no substance yet synthesized can mask the smell of cigarette smoke. And in meteorology, they learned never to step in a puddle on The Strip; whatever it is, it’s not rain.
Hope falls
Is there anything we wouldn’t do to prevent someone from dying of cancer? We will ride bikes 150 miles, run marathons, and wear endless seas of pink, even though honestly it’s not everyone’s color (you know who you are). So if there were, say, a safe and effective means of preventing up to 4,000 cancer deaths a year, certainly doctors would be first in line to make sure everyone is protected, right?
Sure...between half and two-thirds of the time, according to a new analysis from the Centers for Disease Control and Prevention. That’s how often providers recommend human papillomavirus (HPV) vaccine to their eligible female and male patients. Maybe cervical, anal, penile, and oropharyngeal cancers need to get together and claim a color that looks good on everyone: Is cerulean taken?
I know we all get frustrated with vaccine deniers, but why aren’t we at least recommending HPV vaccine to 100% of our patients? Is it because they won’t be our patients by the time they get cancer? Is it because the vaccine is more expensive and more painful than some (both true, but again, y’all, cancer)? Is it because it’s awkward to talk to parents about how their cherubic 11-year-old is one day going to grow up into an adult who is likely to have, you know, S-E-X?
Whatever the reason, I share Assistant Surgeon General Dr. Anne Schuchat’s disappointment that only 37.6% of eligible girls and 13.6% of eligible boys got vaccinated against HPV last year. When poor parental uptake is the problem, we need to work on education. But when we as providers are not even recommending the vaccine, you can color me embarrassed.
Yellow-bellied?
Parents look at me like I’m crazy all the time, which I resent, because I’m only crazy most of the time. For the first 3 months of their baby's life, I tell parents to call me at the first sign of a fever; then I tell them fever is a nothing to worry about. I say that sleeping face-down can be deadly until their baby learns to roll back-to-front; then I tell them not to worry. And for the first 7 days of life, I tell them that newborn jaundice can cause severe brain damage, until I start saying it’s normal, especially in breastfed infants. I flip-flop more than a candidate for Congress.
A new study may reassure some mothers of nursing infants who look a little orange (the infants, that is; orange mothers should still be concerned). We’ve always known that breastfed infants tend to keep high levels of indirect bilirubin in their bloodstreams long after the first week in life, but no one yet had bothered to establish the typical range and time course. Dr. M. Jeffrey Maisels and a team from Oakland University William Beaumont School of Medicine changed all that with the use of transcutaneous bilirubin (TCB) monitors and 1,044 predominately breastfeeding infants.
Not only did they determine that at age 3-4 weeks between 34% and 43% of these infants still had TCB measurements over 5 mg/dL, they also reaffirmed that we doctors are really bad at guessing bilirubin levels from looking at babies. They asked trained clinicians to guess the “jaundice zone scores” of the infants, which sound like a customer loyalty program at a sporting goods store but are really just an estimate of how far down the infant’s body it looks yellow. The scores were so far off that a baby with a score of 0 could have a bilirubin level as high as 12.8 mg/dL. I can only hope that with his expertise in ferreting out bad human judgment, Dr. Maisels’s next study will investigate candidates for Congress.
Inattention
A complex society cannot function without some degree of trust; there’s all sorts of scary stuff I’d like to know, and I’m happy to pay a few dollars in taxes to make sure someone more qualified than I am is checking. Does this bridge I’m crossing have severe erosion? Is there another plane in our airspace? What was my 14-year-old daughter texting to her “boyfriend” last night? (Thanks, National Security Agency!)
Drug safety is one of those things, especially when many of my patients and one of my own children are taking said drug. A new study from researchers at Boston Children’s Hospital suggests that perhaps when it comes to the long-term safety of attention-deficit/hyperactivity disorder (ADHD) medications, the U.S. Food and Drug Administration has not looked as hard as it might. Paging Dr. Edward Snowden!
One might assume that since up to 10% of U.S. children now carry a diagnosis of ADHD, and since those children start medications as young as age 4 and continue to use them for many years, the safety studies that got these drugs approved would have been especially rigorous. Yeah, no. Only 5 of 32 preapproval trials focused on safety, these trials enrolled an average of 75 patients (as opposed to the recommended 1,500), and few lasted as long as 12 months, with approval sometimes granted after only 8 weeks of study and some older drugs being “grandfathered” in with essentially no safety data whatsoever.
I see one bright spot in this desert of data. Whenever I prescribe a stimulant for ADHD, I’ll understand that I’m taking a gamble, and I’ll fondly remember our family trip to Las Vegas.
David L. Hill, M.D., FAAP, is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Stalled out
Am I the only person spooked by the way automation is taking over our public bathrooms? I appreciate some of this touch-free, infrared technology; I won’t always be nimble enough to push the flush lever with my right toe. But then I get that stall where Niagara Falls goes off every time I shift my weight. What is this, a bathroom or the Bellagio Fountains?
And darnit, people, if you're going to make the faucets automatic, can you please do the soap dispenser and paper towel roll, too? I feel like an idiot waving my hands around by the bathroom wall while the guy next to me walks up and yanks a towel off the roll. Then I smack my forehead with my wet hand, and I can't dry it without bending down under that motion-sensing ramjet thing that I should have used in the first place. The day I always feared has finally arrived: My bathroom is smarter than I am.
Playing by ear
I'm often frustrated but rarely surprised when the emergency department (ED) docs at our local hospital fail to follow basic pediatric treatment guidelines. Sore throat? Here’s some antibiotics. Runny nose? Antibiotics are good for that. Ankle sprain? Snake bite? Azithromycin for everyone! “If only,” I think, “we had a pediatric emergency department...at an academic medical center...in a more advanced country...with a public health system. ..."
But now, thanks to a new study from Sweden, my dreams are dashed. Apparently, even at an academic medical center with a pediatric ED in a country with public health care and that is capable of manufacturing affordable, sleek modern furniture that fits in the back of a station wagon and assembles in 5 minutes with a simple Allen wrench, even in freaking Sweden the ED docs overtreat acute otitis media (AOM) with antibiotics. And, according to author Jimmy Célind and his colleagues from the University of Gothenburg, they can't be stopped.
The investigators reviewed charts before and after a simple intervention to see if educating providers on evidence-based AOM guidelines would improve their compliance with those guidelines. The results? Not one outcome measure – use of drugs as opposed to nondrug management, choice of drug, drug dosage, or duration of drug treatment – improved.
The authors had several theories about why their intervention failed. The campaign consisted of one lecture and some fliers, without any ongoing monitoring and feedback. Providers were educated, but the patients were not. Patients were also in an ED, where people waited a long time to be seen and weren't keen to return in 2 days for follow-up. I have a different theory, however: They just forgot to include the Allen wrench.
The dark side of light
Here in North Carolina, a bill restricting teens' use of tanning beds appears to have stalled out in the legislature for a second year in a row, despite the success of such measures in states as diverse as Louisiana and Indiana (they both end with “ana,” but otherwise, they're diverse). I get it: Just because we keep teens from drinking, smoking, and driving, and just because tanning beds are a major cause of deadly cancer, there are also great reasons not to limit kids’ right to tan, like, um, where else can they wear those little dark eye cup things?
We've known for a while that using tanning beds increases kids' risk of developing deadly malignant melanoma, but a new study in Pediatrics adds basal cell carcinoma to the list, which is, to be fair, merely disfiguring. The study came from New Hampshire, a state which balances a paucity of intense sunlight with a rich supply of people who sunburn easily. Sunlamps, tanning beds, and tanning booths all increased the risk of cancer; kids who started tanning younger suffered more carcinoma.
None of these data are likely to impress opponents of laws limiting kids' use of tanning beds. “North Carolina shouldn't be a nanny state!”they'll shout. But when it comes to cancer, I disagree, at least when some of the people we're talking about still have an actual nanny.
My yellow stars!
Is it just me, or have sugary breakfast cereals become the latest punching bag of nutritionists and doctors? Only soft drinks and potato chips seem to draw as much blame for the obesity epidemic, although I had a slice of chocolate cake last night that I’d like to nominate for some serious scorn. Even the cereal makers didn’t see this next one coming, however. According the Environmental Working Group (EWG), this “nutritious part of a complete breakfast, fortified with vitamins and minerals” is too fortified with vitamins and minerals! Take that, you crispy flakes of morning goodness!
When it comes to vitamins and minerals, you really can have too much of a good thing, and the folks at the EWG make a compelling argument (strongly disputed by cereal manufacturers) that the levels of vitamin A, zinc, and niacin in many breakfast cereals actually pose a potential danger to kids’ health. Now, of course, I’m looking at the cereal boxes in my pantry and wondering what to do with them. I think I’ll go to a public restroom and ask the toilet.
David L. Hill, M.D., FAAP, is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Am I the only person spooked by the way automation is taking over our public bathrooms? I appreciate some of this touch-free, infrared technology; I won’t always be nimble enough to push the flush lever with my right toe. But then I get that stall where Niagara Falls goes off every time I shift my weight. What is this, a bathroom or the Bellagio Fountains?
And darnit, people, if you're going to make the faucets automatic, can you please do the soap dispenser and paper towel roll, too? I feel like an idiot waving my hands around by the bathroom wall while the guy next to me walks up and yanks a towel off the roll. Then I smack my forehead with my wet hand, and I can't dry it without bending down under that motion-sensing ramjet thing that I should have used in the first place. The day I always feared has finally arrived: My bathroom is smarter than I am.
Playing by ear
I'm often frustrated but rarely surprised when the emergency department (ED) docs at our local hospital fail to follow basic pediatric treatment guidelines. Sore throat? Here’s some antibiotics. Runny nose? Antibiotics are good for that. Ankle sprain? Snake bite? Azithromycin for everyone! “If only,” I think, “we had a pediatric emergency department...at an academic medical center...in a more advanced country...with a public health system. ..."
But now, thanks to a new study from Sweden, my dreams are dashed. Apparently, even at an academic medical center with a pediatric ED in a country with public health care and that is capable of manufacturing affordable, sleek modern furniture that fits in the back of a station wagon and assembles in 5 minutes with a simple Allen wrench, even in freaking Sweden the ED docs overtreat acute otitis media (AOM) with antibiotics. And, according to author Jimmy Célind and his colleagues from the University of Gothenburg, they can't be stopped.
The investigators reviewed charts before and after a simple intervention to see if educating providers on evidence-based AOM guidelines would improve their compliance with those guidelines. The results? Not one outcome measure – use of drugs as opposed to nondrug management, choice of drug, drug dosage, or duration of drug treatment – improved.
The authors had several theories about why their intervention failed. The campaign consisted of one lecture and some fliers, without any ongoing monitoring and feedback. Providers were educated, but the patients were not. Patients were also in an ED, where people waited a long time to be seen and weren't keen to return in 2 days for follow-up. I have a different theory, however: They just forgot to include the Allen wrench.
The dark side of light
Here in North Carolina, a bill restricting teens' use of tanning beds appears to have stalled out in the legislature for a second year in a row, despite the success of such measures in states as diverse as Louisiana and Indiana (they both end with “ana,” but otherwise, they're diverse). I get it: Just because we keep teens from drinking, smoking, and driving, and just because tanning beds are a major cause of deadly cancer, there are also great reasons not to limit kids’ right to tan, like, um, where else can they wear those little dark eye cup things?
We've known for a while that using tanning beds increases kids' risk of developing deadly malignant melanoma, but a new study in Pediatrics adds basal cell carcinoma to the list, which is, to be fair, merely disfiguring. The study came from New Hampshire, a state which balances a paucity of intense sunlight with a rich supply of people who sunburn easily. Sunlamps, tanning beds, and tanning booths all increased the risk of cancer; kids who started tanning younger suffered more carcinoma.
None of these data are likely to impress opponents of laws limiting kids' use of tanning beds. “North Carolina shouldn't be a nanny state!”they'll shout. But when it comes to cancer, I disagree, at least when some of the people we're talking about still have an actual nanny.
My yellow stars!
Is it just me, or have sugary breakfast cereals become the latest punching bag of nutritionists and doctors? Only soft drinks and potato chips seem to draw as much blame for the obesity epidemic, although I had a slice of chocolate cake last night that I’d like to nominate for some serious scorn. Even the cereal makers didn’t see this next one coming, however. According the Environmental Working Group (EWG), this “nutritious part of a complete breakfast, fortified with vitamins and minerals” is too fortified with vitamins and minerals! Take that, you crispy flakes of morning goodness!
When it comes to vitamins and minerals, you really can have too much of a good thing, and the folks at the EWG make a compelling argument (strongly disputed by cereal manufacturers) that the levels of vitamin A, zinc, and niacin in many breakfast cereals actually pose a potential danger to kids’ health. Now, of course, I’m looking at the cereal boxes in my pantry and wondering what to do with them. I think I’ll go to a public restroom and ask the toilet.
David L. Hill, M.D., FAAP, is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Am I the only person spooked by the way automation is taking over our public bathrooms? I appreciate some of this touch-free, infrared technology; I won’t always be nimble enough to push the flush lever with my right toe. But then I get that stall where Niagara Falls goes off every time I shift my weight. What is this, a bathroom or the Bellagio Fountains?
And darnit, people, if you're going to make the faucets automatic, can you please do the soap dispenser and paper towel roll, too? I feel like an idiot waving my hands around by the bathroom wall while the guy next to me walks up and yanks a towel off the roll. Then I smack my forehead with my wet hand, and I can't dry it without bending down under that motion-sensing ramjet thing that I should have used in the first place. The day I always feared has finally arrived: My bathroom is smarter than I am.
Playing by ear
I'm often frustrated but rarely surprised when the emergency department (ED) docs at our local hospital fail to follow basic pediatric treatment guidelines. Sore throat? Here’s some antibiotics. Runny nose? Antibiotics are good for that. Ankle sprain? Snake bite? Azithromycin for everyone! “If only,” I think, “we had a pediatric emergency department...at an academic medical center...in a more advanced country...with a public health system. ..."
But now, thanks to a new study from Sweden, my dreams are dashed. Apparently, even at an academic medical center with a pediatric ED in a country with public health care and that is capable of manufacturing affordable, sleek modern furniture that fits in the back of a station wagon and assembles in 5 minutes with a simple Allen wrench, even in freaking Sweden the ED docs overtreat acute otitis media (AOM) with antibiotics. And, according to author Jimmy Célind and his colleagues from the University of Gothenburg, they can't be stopped.
The investigators reviewed charts before and after a simple intervention to see if educating providers on evidence-based AOM guidelines would improve their compliance with those guidelines. The results? Not one outcome measure – use of drugs as opposed to nondrug management, choice of drug, drug dosage, or duration of drug treatment – improved.
The authors had several theories about why their intervention failed. The campaign consisted of one lecture and some fliers, without any ongoing monitoring and feedback. Providers were educated, but the patients were not. Patients were also in an ED, where people waited a long time to be seen and weren't keen to return in 2 days for follow-up. I have a different theory, however: They just forgot to include the Allen wrench.
The dark side of light
Here in North Carolina, a bill restricting teens' use of tanning beds appears to have stalled out in the legislature for a second year in a row, despite the success of such measures in states as diverse as Louisiana and Indiana (they both end with “ana,” but otherwise, they're diverse). I get it: Just because we keep teens from drinking, smoking, and driving, and just because tanning beds are a major cause of deadly cancer, there are also great reasons not to limit kids’ right to tan, like, um, where else can they wear those little dark eye cup things?
We've known for a while that using tanning beds increases kids' risk of developing deadly malignant melanoma, but a new study in Pediatrics adds basal cell carcinoma to the list, which is, to be fair, merely disfiguring. The study came from New Hampshire, a state which balances a paucity of intense sunlight with a rich supply of people who sunburn easily. Sunlamps, tanning beds, and tanning booths all increased the risk of cancer; kids who started tanning younger suffered more carcinoma.
None of these data are likely to impress opponents of laws limiting kids' use of tanning beds. “North Carolina shouldn't be a nanny state!”they'll shout. But when it comes to cancer, I disagree, at least when some of the people we're talking about still have an actual nanny.
My yellow stars!
Is it just me, or have sugary breakfast cereals become the latest punching bag of nutritionists and doctors? Only soft drinks and potato chips seem to draw as much blame for the obesity epidemic, although I had a slice of chocolate cake last night that I’d like to nominate for some serious scorn. Even the cereal makers didn’t see this next one coming, however. According the Environmental Working Group (EWG), this “nutritious part of a complete breakfast, fortified with vitamins and minerals” is too fortified with vitamins and minerals! Take that, you crispy flakes of morning goodness!
When it comes to vitamins and minerals, you really can have too much of a good thing, and the folks at the EWG make a compelling argument (strongly disputed by cereal manufacturers) that the levels of vitamin A, zinc, and niacin in many breakfast cereals actually pose a potential danger to kids’ health. Now, of course, I’m looking at the cereal boxes in my pantry and wondering what to do with them. I think I’ll go to a public restroom and ask the toilet.
David L. Hill, M.D., FAAP, is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Homesick
I don’t think that my kids appreciate how good they have it when it comes to summer camp. When I was their age, there was just one kind of camp: the kind with a mosquito-clouded lake, flatulent horses, and songs the other campers all seemed to know. No one asked what your interests were; it was assumed you had always dreamed of expressing yourself in the form of a lanyard keychain.
Now my children can choose between DJ camp, computer gaming camp, and, I kid you not, LEGO camp. They literally have camps just for the stuff you had to leave at home when you were at camp. I can’t wait for the letters home: “Today we programmed mosquitoes for our lake in Minecraft. Since I did so well, my counselor said I could join some of the older campers tomorrow and help them figure out how to design virtual horses that pass gas....”
Soap opera
With five kids, two dogs, and a cat, I’ve had to adjust my standards for what constitutes a clean house. Are the dust bunnies hidden behind piles of mismatched socks? Then it’s clean. Are the dirty dishes all within a yard of the sink? Clean. Do the roaches scatter within 2 seconds of the light coming on? We’re good. Three seconds is bad. At least we’re doing our part to fight allergies and asthma, according to a new report, which I’m sure is around here...ah, right under that wet towel!
Dr. Robert Wood, chief of allergy and immunology at Johns Hopkins Children's Center, Baltimore, wondered why studies seemed to show that dirt and bacteria protect rural children from developing allergies when other studies implicate roach droppings and animal dander in promoting allergies in urban settings. How can city dirt be so bad when urban music is so much better than country?
As it turns out, it’s all about the timing. A review of exposures and allergy and asthma symptoms among 467 children in four cities demonstrated that kids exposed to increased levels of mouse and cat dander, cockroach droppings, and house-dust harboring Firmicutes and Bacteriodetes bacteria enjoyed protection from wheezing so long as that exposure occurred in the first year of life. The implications are clear: Either we need to develop a strain of bacteria-encrusted urban cats that harbor mice infested with cockroaches, or I should tour America’s cities giving housekeeping tips.
Too cool
The study that I’ve been waiting for since 7th grade is finally out! We now have scientific proof that being a...what did they used call me...a geek? Nerd? Dork? Weirdo? Dweeb? Wonk? Bookworm? Poindexter? Grind? Hey-you-with-the-glasses? Well, anyway, over the long run we do better than those cool kids with their admittedly impressive vocabulary of insults.
Publishing in Child Behavior, University of Virginia psychologist Joseph Allen evaluated 184 adolescents’ use of “pseudomature behavior” to impress their peers. He questioned kids, their families, and their peers over 10 years, as the subjects matured from age 13 to 23. Early on, those kids who experimented with cigarettes, alcohol, and sex were indeed rated as “cool” by their peers, who also secretly seethed with resentment. (Dr. Allen did not report that last part, but I just know, okay?)
By age 22, however, those same kids were experiencing increased trouble with alcohol, substance abuse, and criminality compared to their peers. Their classmates, in the meantime (at least those who hadn’t managed to get out of that dusty little town and pursue their dreams in the big city), rated the “cool” kids as being less socially competent and less mature. Whether they were also starting to lose some hair and get a little thick around the middle is, again, unreported, but we know, because we may wear glasses, but we can see just fine, thank you.
The whole truth
I just finished reading the scariest article I’ve seen in a while, at least as a parent. Researchers at the Massachusetts Institute of Technology claim to have proven that children as young as age 6 years cannot only tell when an adult is lying to them, but they also can tell when we’re simply not giving them the whole truth. Go ahead and give that a moment to sink in. Yep, it’s bad, real bad.
My only hope comes from the underlying experimental design. The subject of subterfuge was a pyramid-shaped toy with knobs and buttons, not, say, the human reproductive tract. And the uninformative “teacher” was a puppet, not a real person who might convincingly sell, say, the idea that a chubby elf could deliver billions of presents in a single 24-hour period. Of course, if they do reproduce this experiment with valid human liars, then the implications are clear: Only 6-year-olds should be allowed to vote for Congress. I just hope my own kids don’t catch on until after I tell them about camp.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
I don’t think that my kids appreciate how good they have it when it comes to summer camp. When I was their age, there was just one kind of camp: the kind with a mosquito-clouded lake, flatulent horses, and songs the other campers all seemed to know. No one asked what your interests were; it was assumed you had always dreamed of expressing yourself in the form of a lanyard keychain.
Now my children can choose between DJ camp, computer gaming camp, and, I kid you not, LEGO camp. They literally have camps just for the stuff you had to leave at home when you were at camp. I can’t wait for the letters home: “Today we programmed mosquitoes for our lake in Minecraft. Since I did so well, my counselor said I could join some of the older campers tomorrow and help them figure out how to design virtual horses that pass gas....”
Soap opera
With five kids, two dogs, and a cat, I’ve had to adjust my standards for what constitutes a clean house. Are the dust bunnies hidden behind piles of mismatched socks? Then it’s clean. Are the dirty dishes all within a yard of the sink? Clean. Do the roaches scatter within 2 seconds of the light coming on? We’re good. Three seconds is bad. At least we’re doing our part to fight allergies and asthma, according to a new report, which I’m sure is around here...ah, right under that wet towel!
Dr. Robert Wood, chief of allergy and immunology at Johns Hopkins Children's Center, Baltimore, wondered why studies seemed to show that dirt and bacteria protect rural children from developing allergies when other studies implicate roach droppings and animal dander in promoting allergies in urban settings. How can city dirt be so bad when urban music is so much better than country?
As it turns out, it’s all about the timing. A review of exposures and allergy and asthma symptoms among 467 children in four cities demonstrated that kids exposed to increased levels of mouse and cat dander, cockroach droppings, and house-dust harboring Firmicutes and Bacteriodetes bacteria enjoyed protection from wheezing so long as that exposure occurred in the first year of life. The implications are clear: Either we need to develop a strain of bacteria-encrusted urban cats that harbor mice infested with cockroaches, or I should tour America’s cities giving housekeeping tips.
Too cool
The study that I’ve been waiting for since 7th grade is finally out! We now have scientific proof that being a...what did they used call me...a geek? Nerd? Dork? Weirdo? Dweeb? Wonk? Bookworm? Poindexter? Grind? Hey-you-with-the-glasses? Well, anyway, over the long run we do better than those cool kids with their admittedly impressive vocabulary of insults.
Publishing in Child Behavior, University of Virginia psychologist Joseph Allen evaluated 184 adolescents’ use of “pseudomature behavior” to impress their peers. He questioned kids, their families, and their peers over 10 years, as the subjects matured from age 13 to 23. Early on, those kids who experimented with cigarettes, alcohol, and sex were indeed rated as “cool” by their peers, who also secretly seethed with resentment. (Dr. Allen did not report that last part, but I just know, okay?)
By age 22, however, those same kids were experiencing increased trouble with alcohol, substance abuse, and criminality compared to their peers. Their classmates, in the meantime (at least those who hadn’t managed to get out of that dusty little town and pursue their dreams in the big city), rated the “cool” kids as being less socially competent and less mature. Whether they were also starting to lose some hair and get a little thick around the middle is, again, unreported, but we know, because we may wear glasses, but we can see just fine, thank you.
The whole truth
I just finished reading the scariest article I’ve seen in a while, at least as a parent. Researchers at the Massachusetts Institute of Technology claim to have proven that children as young as age 6 years cannot only tell when an adult is lying to them, but they also can tell when we’re simply not giving them the whole truth. Go ahead and give that a moment to sink in. Yep, it’s bad, real bad.
My only hope comes from the underlying experimental design. The subject of subterfuge was a pyramid-shaped toy with knobs and buttons, not, say, the human reproductive tract. And the uninformative “teacher” was a puppet, not a real person who might convincingly sell, say, the idea that a chubby elf could deliver billions of presents in a single 24-hour period. Of course, if they do reproduce this experiment with valid human liars, then the implications are clear: Only 6-year-olds should be allowed to vote for Congress. I just hope my own kids don’t catch on until after I tell them about camp.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
I don’t think that my kids appreciate how good they have it when it comes to summer camp. When I was their age, there was just one kind of camp: the kind with a mosquito-clouded lake, flatulent horses, and songs the other campers all seemed to know. No one asked what your interests were; it was assumed you had always dreamed of expressing yourself in the form of a lanyard keychain.
Now my children can choose between DJ camp, computer gaming camp, and, I kid you not, LEGO camp. They literally have camps just for the stuff you had to leave at home when you were at camp. I can’t wait for the letters home: “Today we programmed mosquitoes for our lake in Minecraft. Since I did so well, my counselor said I could join some of the older campers tomorrow and help them figure out how to design virtual horses that pass gas....”
Soap opera
With five kids, two dogs, and a cat, I’ve had to adjust my standards for what constitutes a clean house. Are the dust bunnies hidden behind piles of mismatched socks? Then it’s clean. Are the dirty dishes all within a yard of the sink? Clean. Do the roaches scatter within 2 seconds of the light coming on? We’re good. Three seconds is bad. At least we’re doing our part to fight allergies and asthma, according to a new report, which I’m sure is around here...ah, right under that wet towel!
Dr. Robert Wood, chief of allergy and immunology at Johns Hopkins Children's Center, Baltimore, wondered why studies seemed to show that dirt and bacteria protect rural children from developing allergies when other studies implicate roach droppings and animal dander in promoting allergies in urban settings. How can city dirt be so bad when urban music is so much better than country?
As it turns out, it’s all about the timing. A review of exposures and allergy and asthma symptoms among 467 children in four cities demonstrated that kids exposed to increased levels of mouse and cat dander, cockroach droppings, and house-dust harboring Firmicutes and Bacteriodetes bacteria enjoyed protection from wheezing so long as that exposure occurred in the first year of life. The implications are clear: Either we need to develop a strain of bacteria-encrusted urban cats that harbor mice infested with cockroaches, or I should tour America’s cities giving housekeeping tips.
Too cool
The study that I’ve been waiting for since 7th grade is finally out! We now have scientific proof that being a...what did they used call me...a geek? Nerd? Dork? Weirdo? Dweeb? Wonk? Bookworm? Poindexter? Grind? Hey-you-with-the-glasses? Well, anyway, over the long run we do better than those cool kids with their admittedly impressive vocabulary of insults.
Publishing in Child Behavior, University of Virginia psychologist Joseph Allen evaluated 184 adolescents’ use of “pseudomature behavior” to impress their peers. He questioned kids, their families, and their peers over 10 years, as the subjects matured from age 13 to 23. Early on, those kids who experimented with cigarettes, alcohol, and sex were indeed rated as “cool” by their peers, who also secretly seethed with resentment. (Dr. Allen did not report that last part, but I just know, okay?)
By age 22, however, those same kids were experiencing increased trouble with alcohol, substance abuse, and criminality compared to their peers. Their classmates, in the meantime (at least those who hadn’t managed to get out of that dusty little town and pursue their dreams in the big city), rated the “cool” kids as being less socially competent and less mature. Whether they were also starting to lose some hair and get a little thick around the middle is, again, unreported, but we know, because we may wear glasses, but we can see just fine, thank you.
The whole truth
I just finished reading the scariest article I’ve seen in a while, at least as a parent. Researchers at the Massachusetts Institute of Technology claim to have proven that children as young as age 6 years cannot only tell when an adult is lying to them, but they also can tell when we’re simply not giving them the whole truth. Go ahead and give that a moment to sink in. Yep, it’s bad, real bad.
My only hope comes from the underlying experimental design. The subject of subterfuge was a pyramid-shaped toy with knobs and buttons, not, say, the human reproductive tract. And the uninformative “teacher” was a puppet, not a real person who might convincingly sell, say, the idea that a chubby elf could deliver billions of presents in a single 24-hour period. Of course, if they do reproduce this experiment with valid human liars, then the implications are clear: Only 6-year-olds should be allowed to vote for Congress. I just hope my own kids don’t catch on until after I tell them about camp.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
In the weeds
You know you have it somewhere in your head: a short list of stuff you’re just too bad at to even attempt, at least not in public. For some of us, it’s dancing. For others, it’s golf (my own congenital incompetence at golf has saved me countless hours and dollars, not to mention the confusion that ensues when someone leaves their clubs at the club so they can go to the clubhouse for a club). Tragically, my list includes gardening. If you ever hear someone say that I have a “green thumb,” get me on IV antibiotics stat, because that’s a nasty infection!
What’s saddest is how much my gardening ambition outstrips my skill. Last year, for example, everyone in the family agreed that our tomato was among the better ones they had ever eaten a small bite of. Worse yet, I now have a neighbor with a back yard dominated by a professionally installed network of raised beds already producing enough organic microgreens to fill a green minivan. I’m hoping to barter with her once our vegetables come in. Perhaps I’ll offer her this year’s tomato.
All over down under
Can we all just agree to stop trying to disprove conspiracy theories? I mean, has your crazy great-uncle ever said, “You know, I watched the Zapruder film one more time, and actually there really was just a lone gunman.” I don’t think so. Likewise, let’s accept that for the next 100 years, vaccine-hesitant parents are going to insist that the link between vaccines and autism just hasn’t been adequately studied, just like climate change, evolution, and why celebrities give their children weird names.
Now that Sydney Medical School Associate Professor Guy Eslick has published the ultimate meta-analysis of vaccines and autism, I vote that we never, ever spend another nickel researching this topic. Eslick’s team of Aussies aggregated data from five cohort studies and five case-control studies, to include a total of more than1.25 million children, comparing autism rates between vaccinated and unvaccinated children. You already know the results, even if you haven’t read the study, because you know that autism spectrum disorders don’t result from postnatal insults: zero correlation between vaccines and autism.
In the words of the Melbourne Herald Sun, this study should have “settled the debate,” especially since Dr. Eslick has no grants from or ties to vaccine manufacturers. But what about the Trilateral Commission? Agenda 21? The Rothschilds? We only know one thing for sure: What you don’t know can hurt you.
Green gobbling
Did you, too, have that grandmother who told you carrots would give you night vision? I remember gorging on the orange vegetables and then stumbling around the yard in the dark, twisting my ankle on mole tunnels. It’s possible that I was also hoping for laser vision: “A B-minus on my spelling test?! Take that, Mrs. Mulherin!”
A new study out of Chicago, however, suggests that not all kids are as gullible as I was which, I suppose, will cut down on the rates of ankle sprains. According to author Dr. Ayelet Fishbach of the University of Chicago's Booth School of Business, the absolute worst way to get kids to eat any food is to tell them it will make them “healthy,” which includes taller, stronger, smarter, or less constipated. Ironically, the same logic works brilliantly to sell young men overpriced plastic barrels of powdered protein.
Among the 270 3- to 5-year-old children studied, the more adults emphasized the health benefits of a given food, the less of it the kids ate. They apparently subscribed to a “zero sum game” theory of food: The positive health properties of any given food must be subtracted proportionately from its taste. The implication for parents is clear: We must immediately band together to convince children that broccoli will give them cavities and gummy worms improve eyesight. Just don’t forget to stock up on Ace bandages.
The young and the restless
What parent of a preschooler hasn’t occasionally wished there was something you could give them to make them behave? Actually, according to a new report from the Centers for Disease Control and Prevention (CDC), there are around 10,000 young children in the US whose parents have stopped wishing. That’s the estimated number of 2- to 3-year-old children who are being prescribed stimulant medications for attention-deficit/hyperactivity disorder (ADHD). CDC officials and other child behavior experts suggest that the doctors prescribing these meds be put in time out.
Aside from the little issue that stimulant medications have never been tested for safety and efficacy in young children, there’s the problem of diagnosing ADHD in preschoolers. After all, the definition of ADHD can be boiled down to, “has the attention span of a 3-year-old,” a problem that’s nearly universal among 3-year-olds. I’ll come out and say that I think the docs prescribing these meds to young children deserve a rotten tomato, and that’s the one thing I know how to grow.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
You know you have it somewhere in your head: a short list of stuff you’re just too bad at to even attempt, at least not in public. For some of us, it’s dancing. For others, it’s golf (my own congenital incompetence at golf has saved me countless hours and dollars, not to mention the confusion that ensues when someone leaves their clubs at the club so they can go to the clubhouse for a club). Tragically, my list includes gardening. If you ever hear someone say that I have a “green thumb,” get me on IV antibiotics stat, because that’s a nasty infection!
What’s saddest is how much my gardening ambition outstrips my skill. Last year, for example, everyone in the family agreed that our tomato was among the better ones they had ever eaten a small bite of. Worse yet, I now have a neighbor with a back yard dominated by a professionally installed network of raised beds already producing enough organic microgreens to fill a green minivan. I’m hoping to barter with her once our vegetables come in. Perhaps I’ll offer her this year’s tomato.
All over down under
Can we all just agree to stop trying to disprove conspiracy theories? I mean, has your crazy great-uncle ever said, “You know, I watched the Zapruder film one more time, and actually there really was just a lone gunman.” I don’t think so. Likewise, let’s accept that for the next 100 years, vaccine-hesitant parents are going to insist that the link between vaccines and autism just hasn’t been adequately studied, just like climate change, evolution, and why celebrities give their children weird names.
Now that Sydney Medical School Associate Professor Guy Eslick has published the ultimate meta-analysis of vaccines and autism, I vote that we never, ever spend another nickel researching this topic. Eslick’s team of Aussies aggregated data from five cohort studies and five case-control studies, to include a total of more than1.25 million children, comparing autism rates between vaccinated and unvaccinated children. You already know the results, even if you haven’t read the study, because you know that autism spectrum disorders don’t result from postnatal insults: zero correlation between vaccines and autism.
In the words of the Melbourne Herald Sun, this study should have “settled the debate,” especially since Dr. Eslick has no grants from or ties to vaccine manufacturers. But what about the Trilateral Commission? Agenda 21? The Rothschilds? We only know one thing for sure: What you don’t know can hurt you.
Green gobbling
Did you, too, have that grandmother who told you carrots would give you night vision? I remember gorging on the orange vegetables and then stumbling around the yard in the dark, twisting my ankle on mole tunnels. It’s possible that I was also hoping for laser vision: “A B-minus on my spelling test?! Take that, Mrs. Mulherin!”
A new study out of Chicago, however, suggests that not all kids are as gullible as I was which, I suppose, will cut down on the rates of ankle sprains. According to author Dr. Ayelet Fishbach of the University of Chicago's Booth School of Business, the absolute worst way to get kids to eat any food is to tell them it will make them “healthy,” which includes taller, stronger, smarter, or less constipated. Ironically, the same logic works brilliantly to sell young men overpriced plastic barrels of powdered protein.
Among the 270 3- to 5-year-old children studied, the more adults emphasized the health benefits of a given food, the less of it the kids ate. They apparently subscribed to a “zero sum game” theory of food: The positive health properties of any given food must be subtracted proportionately from its taste. The implication for parents is clear: We must immediately band together to convince children that broccoli will give them cavities and gummy worms improve eyesight. Just don’t forget to stock up on Ace bandages.
The young and the restless
What parent of a preschooler hasn’t occasionally wished there was something you could give them to make them behave? Actually, according to a new report from the Centers for Disease Control and Prevention (CDC), there are around 10,000 young children in the US whose parents have stopped wishing. That’s the estimated number of 2- to 3-year-old children who are being prescribed stimulant medications for attention-deficit/hyperactivity disorder (ADHD). CDC officials and other child behavior experts suggest that the doctors prescribing these meds be put in time out.
Aside from the little issue that stimulant medications have never been tested for safety and efficacy in young children, there’s the problem of diagnosing ADHD in preschoolers. After all, the definition of ADHD can be boiled down to, “has the attention span of a 3-year-old,” a problem that’s nearly universal among 3-year-olds. I’ll come out and say that I think the docs prescribing these meds to young children deserve a rotten tomato, and that’s the one thing I know how to grow.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
You know you have it somewhere in your head: a short list of stuff you’re just too bad at to even attempt, at least not in public. For some of us, it’s dancing. For others, it’s golf (my own congenital incompetence at golf has saved me countless hours and dollars, not to mention the confusion that ensues when someone leaves their clubs at the club so they can go to the clubhouse for a club). Tragically, my list includes gardening. If you ever hear someone say that I have a “green thumb,” get me on IV antibiotics stat, because that’s a nasty infection!
What’s saddest is how much my gardening ambition outstrips my skill. Last year, for example, everyone in the family agreed that our tomato was among the better ones they had ever eaten a small bite of. Worse yet, I now have a neighbor with a back yard dominated by a professionally installed network of raised beds already producing enough organic microgreens to fill a green minivan. I’m hoping to barter with her once our vegetables come in. Perhaps I’ll offer her this year’s tomato.
All over down under
Can we all just agree to stop trying to disprove conspiracy theories? I mean, has your crazy great-uncle ever said, “You know, I watched the Zapruder film one more time, and actually there really was just a lone gunman.” I don’t think so. Likewise, let’s accept that for the next 100 years, vaccine-hesitant parents are going to insist that the link between vaccines and autism just hasn’t been adequately studied, just like climate change, evolution, and why celebrities give their children weird names.
Now that Sydney Medical School Associate Professor Guy Eslick has published the ultimate meta-analysis of vaccines and autism, I vote that we never, ever spend another nickel researching this topic. Eslick’s team of Aussies aggregated data from five cohort studies and five case-control studies, to include a total of more than1.25 million children, comparing autism rates between vaccinated and unvaccinated children. You already know the results, even if you haven’t read the study, because you know that autism spectrum disorders don’t result from postnatal insults: zero correlation between vaccines and autism.
In the words of the Melbourne Herald Sun, this study should have “settled the debate,” especially since Dr. Eslick has no grants from or ties to vaccine manufacturers. But what about the Trilateral Commission? Agenda 21? The Rothschilds? We only know one thing for sure: What you don’t know can hurt you.
Green gobbling
Did you, too, have that grandmother who told you carrots would give you night vision? I remember gorging on the orange vegetables and then stumbling around the yard in the dark, twisting my ankle on mole tunnels. It’s possible that I was also hoping for laser vision: “A B-minus on my spelling test?! Take that, Mrs. Mulherin!”
A new study out of Chicago, however, suggests that not all kids are as gullible as I was which, I suppose, will cut down on the rates of ankle sprains. According to author Dr. Ayelet Fishbach of the University of Chicago's Booth School of Business, the absolute worst way to get kids to eat any food is to tell them it will make them “healthy,” which includes taller, stronger, smarter, or less constipated. Ironically, the same logic works brilliantly to sell young men overpriced plastic barrels of powdered protein.
Among the 270 3- to 5-year-old children studied, the more adults emphasized the health benefits of a given food, the less of it the kids ate. They apparently subscribed to a “zero sum game” theory of food: The positive health properties of any given food must be subtracted proportionately from its taste. The implication for parents is clear: We must immediately band together to convince children that broccoli will give them cavities and gummy worms improve eyesight. Just don’t forget to stock up on Ace bandages.
The young and the restless
What parent of a preschooler hasn’t occasionally wished there was something you could give them to make them behave? Actually, according to a new report from the Centers for Disease Control and Prevention (CDC), there are around 10,000 young children in the US whose parents have stopped wishing. That’s the estimated number of 2- to 3-year-old children who are being prescribed stimulant medications for attention-deficit/hyperactivity disorder (ADHD). CDC officials and other child behavior experts suggest that the doctors prescribing these meds be put in time out.
Aside from the little issue that stimulant medications have never been tested for safety and efficacy in young children, there’s the problem of diagnosing ADHD in preschoolers. After all, the definition of ADHD can be boiled down to, “has the attention span of a 3-year-old,” a problem that’s nearly universal among 3-year-olds. I’ll come out and say that I think the docs prescribing these meds to young children deserve a rotten tomato, and that’s the one thing I know how to grow.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Up in the air
I find it scary to travel without my kids, even just to a meeting. I’m not sure what I fear more: that something is going to happen to me (like what, I’ll freeze to death in a conference room?) or that something will happen to one of them (with someone else driving them to school, they really will finally strangle each other). The person I should really be worried about is the sitter left to watch five kids all week! I’ll be relieved if when we get back she still has all her nose rings.
Learning curveball
Have you ever kept doing something you knew was stupid, even after the thing everyone told you was going to happen happened? If you’ve ever had a hangover -- twice -- then are you really surprised that a resurgence of vaccine-preventable disease hasn’t done a thing to improve vaccination rates? People don’t make unwise choices accidentally; they work really hard at it.
If you’re like me, then ever since 1998 you’ve been saying, “Just wait until vaccine-preventable diseases make a comeback. Then those vaccine deniers will come to their senses.” Remember how innocent we were back in 1998? Just in case you had some lingering glimmer of hope for humanity, researchers from Seattle Children’s presented new findings at the Pediatric Academic Societies’ meeting earlier this month regarding a whooping cough outbreak in Washington State in 2011.
A team led by Dr. Elizabeth Wolf compared local pertussis vaccination rates before and during the outbreak, presuming that when people realized that their own babies were threatened by a deadly disease, they would, you know, respond. As it turns out, they did respond, either by denying that there was a threat or by ignoring that there was anything to do about it. I suppose these data don’t bode well for vaccine acceptance or, for that matter, for other problems where science points to an obvious solution that some people don’t want to accept, like gun safety and global warming. It’s enough to make me court a hangover -- my 23rd.
Well rounded
Have you gotten caught up in this fad for “life-hacking,” trying to save time and effort with tricks like using paper clips to organize electrical cables, painting look-alike house keys with colored nail polish, or not having five children? Now a study suggests a new way for pediatricians and parents to simplify: Don’t treat moderate to severe positional plagiocephaly with skull-molding helmets. I know, it’s not as cool as using a sawed-off water bottle to seal your unused chocolate chips, but it’ll save a lot more money, and you’re less likely to need stitches.
A group of Dutch researchers randomized 84 otherwise normal 5- to 6-month-old infants with moderate to severe positional plagiocephaly to 6 months of helmet therapy vs. 6 months of, well, not wearing helmets. (There’s just no feasible way to double-blind a helmet study.) End points involved careful measurements of the skull at 24 months of age as well as secondary findings like ear deviation, facial asymmetry, and whether parents argued over where they were going to find $2,500 for the helmet.
In the end, helmets made no difference whatsoever in outcomes. Helmet makers were swift to point out that the study excluded premature infants younger than 36 weeks and those with dysmorphic features or torticollis. It’s too early to gauge whether this study will actually lead providers and parents to turn to skull molding helmets less often, but think about it: With each helmet not prescribed, we’ll be able to save enough money to paint 10,000 previously indistinguishable keys with nail polish!
Short changed
Have you ever noticed that in every monster movie there’s that one scene where a cop, faced with a scaly creature roughly the size of the Staples Center, unloads the magazine of a handgun at it and then stares in terror to see that the beast is unfazed or, even worse, annoyed? When the American Academy of Pediatrics announced that its latest child health priority is poverty, some of us thought of the new AAP President James Perrin in the role of that ambitious but outgunned officer. (Full disclosure: I’ve met Dr. Perrin and, at the time, he was wearing neither dark blue nor a sidearm.)
For those who wonder why the AAP would take on a leviathan like poverty, there is a new study in the Proceedings of the National Academy of Sciences comparing African American children from severely underprivileged and privileged backgrounds. The investigators found a difference much deeper than whether family members used SAT words around the dinner table or, for that matter, could afford dinner. They discovered that destitution actually shortens children’s telomeres, leading to poorer health and a reduced life expectancy at the genetic level. These findings might lend us some perspective when our kids don’t get accepted to the first choice colleges.
These results make me want to go home at the end of this trip and hug my children, assuming we all survive. I already got them presents, and I even picked up something for the sitter. I hope she loves her new nose ring!
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
I find it scary to travel without my kids, even just to a meeting. I’m not sure what I fear more: that something is going to happen to me (like what, I’ll freeze to death in a conference room?) or that something will happen to one of them (with someone else driving them to school, they really will finally strangle each other). The person I should really be worried about is the sitter left to watch five kids all week! I’ll be relieved if when we get back she still has all her nose rings.
Learning curveball
Have you ever kept doing something you knew was stupid, even after the thing everyone told you was going to happen happened? If you’ve ever had a hangover -- twice -- then are you really surprised that a resurgence of vaccine-preventable disease hasn’t done a thing to improve vaccination rates? People don’t make unwise choices accidentally; they work really hard at it.
If you’re like me, then ever since 1998 you’ve been saying, “Just wait until vaccine-preventable diseases make a comeback. Then those vaccine deniers will come to their senses.” Remember how innocent we were back in 1998? Just in case you had some lingering glimmer of hope for humanity, researchers from Seattle Children’s presented new findings at the Pediatric Academic Societies’ meeting earlier this month regarding a whooping cough outbreak in Washington State in 2011.
A team led by Dr. Elizabeth Wolf compared local pertussis vaccination rates before and during the outbreak, presuming that when people realized that their own babies were threatened by a deadly disease, they would, you know, respond. As it turns out, they did respond, either by denying that there was a threat or by ignoring that there was anything to do about it. I suppose these data don’t bode well for vaccine acceptance or, for that matter, for other problems where science points to an obvious solution that some people don’t want to accept, like gun safety and global warming. It’s enough to make me court a hangover -- my 23rd.
Well rounded
Have you gotten caught up in this fad for “life-hacking,” trying to save time and effort with tricks like using paper clips to organize electrical cables, painting look-alike house keys with colored nail polish, or not having five children? Now a study suggests a new way for pediatricians and parents to simplify: Don’t treat moderate to severe positional plagiocephaly with skull-molding helmets. I know, it’s not as cool as using a sawed-off water bottle to seal your unused chocolate chips, but it’ll save a lot more money, and you’re less likely to need stitches.
A group of Dutch researchers randomized 84 otherwise normal 5- to 6-month-old infants with moderate to severe positional plagiocephaly to 6 months of helmet therapy vs. 6 months of, well, not wearing helmets. (There’s just no feasible way to double-blind a helmet study.) End points involved careful measurements of the skull at 24 months of age as well as secondary findings like ear deviation, facial asymmetry, and whether parents argued over where they were going to find $2,500 for the helmet.
In the end, helmets made no difference whatsoever in outcomes. Helmet makers were swift to point out that the study excluded premature infants younger than 36 weeks and those with dysmorphic features or torticollis. It’s too early to gauge whether this study will actually lead providers and parents to turn to skull molding helmets less often, but think about it: With each helmet not prescribed, we’ll be able to save enough money to paint 10,000 previously indistinguishable keys with nail polish!
Short changed
Have you ever noticed that in every monster movie there’s that one scene where a cop, faced with a scaly creature roughly the size of the Staples Center, unloads the magazine of a handgun at it and then stares in terror to see that the beast is unfazed or, even worse, annoyed? When the American Academy of Pediatrics announced that its latest child health priority is poverty, some of us thought of the new AAP President James Perrin in the role of that ambitious but outgunned officer. (Full disclosure: I’ve met Dr. Perrin and, at the time, he was wearing neither dark blue nor a sidearm.)
For those who wonder why the AAP would take on a leviathan like poverty, there is a new study in the Proceedings of the National Academy of Sciences comparing African American children from severely underprivileged and privileged backgrounds. The investigators found a difference much deeper than whether family members used SAT words around the dinner table or, for that matter, could afford dinner. They discovered that destitution actually shortens children’s telomeres, leading to poorer health and a reduced life expectancy at the genetic level. These findings might lend us some perspective when our kids don’t get accepted to the first choice colleges.
These results make me want to go home at the end of this trip and hug my children, assuming we all survive. I already got them presents, and I even picked up something for the sitter. I hope she loves her new nose ring!
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
I find it scary to travel without my kids, even just to a meeting. I’m not sure what I fear more: that something is going to happen to me (like what, I’ll freeze to death in a conference room?) or that something will happen to one of them (with someone else driving them to school, they really will finally strangle each other). The person I should really be worried about is the sitter left to watch five kids all week! I’ll be relieved if when we get back she still has all her nose rings.
Learning curveball
Have you ever kept doing something you knew was stupid, even after the thing everyone told you was going to happen happened? If you’ve ever had a hangover -- twice -- then are you really surprised that a resurgence of vaccine-preventable disease hasn’t done a thing to improve vaccination rates? People don’t make unwise choices accidentally; they work really hard at it.
If you’re like me, then ever since 1998 you’ve been saying, “Just wait until vaccine-preventable diseases make a comeback. Then those vaccine deniers will come to their senses.” Remember how innocent we were back in 1998? Just in case you had some lingering glimmer of hope for humanity, researchers from Seattle Children’s presented new findings at the Pediatric Academic Societies’ meeting earlier this month regarding a whooping cough outbreak in Washington State in 2011.
A team led by Dr. Elizabeth Wolf compared local pertussis vaccination rates before and during the outbreak, presuming that when people realized that their own babies were threatened by a deadly disease, they would, you know, respond. As it turns out, they did respond, either by denying that there was a threat or by ignoring that there was anything to do about it. I suppose these data don’t bode well for vaccine acceptance or, for that matter, for other problems where science points to an obvious solution that some people don’t want to accept, like gun safety and global warming. It’s enough to make me court a hangover -- my 23rd.
Well rounded
Have you gotten caught up in this fad for “life-hacking,” trying to save time and effort with tricks like using paper clips to organize electrical cables, painting look-alike house keys with colored nail polish, or not having five children? Now a study suggests a new way for pediatricians and parents to simplify: Don’t treat moderate to severe positional plagiocephaly with skull-molding helmets. I know, it’s not as cool as using a sawed-off water bottle to seal your unused chocolate chips, but it’ll save a lot more money, and you’re less likely to need stitches.
A group of Dutch researchers randomized 84 otherwise normal 5- to 6-month-old infants with moderate to severe positional plagiocephaly to 6 months of helmet therapy vs. 6 months of, well, not wearing helmets. (There’s just no feasible way to double-blind a helmet study.) End points involved careful measurements of the skull at 24 months of age as well as secondary findings like ear deviation, facial asymmetry, and whether parents argued over where they were going to find $2,500 for the helmet.
In the end, helmets made no difference whatsoever in outcomes. Helmet makers were swift to point out that the study excluded premature infants younger than 36 weeks and those with dysmorphic features or torticollis. It’s too early to gauge whether this study will actually lead providers and parents to turn to skull molding helmets less often, but think about it: With each helmet not prescribed, we’ll be able to save enough money to paint 10,000 previously indistinguishable keys with nail polish!
Short changed
Have you ever noticed that in every monster movie there’s that one scene where a cop, faced with a scaly creature roughly the size of the Staples Center, unloads the magazine of a handgun at it and then stares in terror to see that the beast is unfazed or, even worse, annoyed? When the American Academy of Pediatrics announced that its latest child health priority is poverty, some of us thought of the new AAP President James Perrin in the role of that ambitious but outgunned officer. (Full disclosure: I’ve met Dr. Perrin and, at the time, he was wearing neither dark blue nor a sidearm.)
For those who wonder why the AAP would take on a leviathan like poverty, there is a new study in the Proceedings of the National Academy of Sciences comparing African American children from severely underprivileged and privileged backgrounds. The investigators found a difference much deeper than whether family members used SAT words around the dinner table or, for that matter, could afford dinner. They discovered that destitution actually shortens children’s telomeres, leading to poorer health and a reduced life expectancy at the genetic level. These findings might lend us some perspective when our kids don’t get accepted to the first choice colleges.
These results make me want to go home at the end of this trip and hug my children, assuming we all survive. I already got them presents, and I even picked up something for the sitter. I hope she loves her new nose ring!
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
You've got mail
As a parent, I hate how you have to sign kids up for camps way before summer even starts. What 12-year-old can really answer whether he’d rather go indoor skydiving or learn SCUBA when he’s still trying to build a cardboard suit of armor for Social Studies? (A suit that would prove equally useless for skydiving, SCUBA, or understanding the role of economic subjugation in feudal societies.) However, if we don’t act in time, the only spots left will be in that engineering camp he attended last year, the one where they built the same catapult over and over again. At least if he ends up there, he’ll have just the right armor.
Joint attention
It’s hard to explain to a kid that just because something is legal doesn’t meant it’s good for you. After all, no one has outlawed large sugary sodas, tequila, or Miley Cyrus. So, with two states now allowing recreational use of marijuana, I find it just the teeniest bit alarming that a new study confirms that marijuana use can lead to permanent brain damage in young adults. On the up side, once your brain has been impaired by smoking pot, you could care less.
Dr. Hans Breiter and his colleagues obtained high-resolution (“High.” Heh!) MRI scans of the brains of recreational marijuana users between the ages of 18 and 25 years, then analyzed the volume and composition of their brains, compared with matched controls, with particular attention to brain regions responsible for regulating emotion and motivation. (For those of you who are still motivated, those are the nucleus accumbens and the amygdala. For the rest of you...“high-resolution.” Heh!)
Dr. Breiter explained, "What we're seeing is changes in people who are 18-25 in core brain regions that you never, ever want to fool around with. Our hypothesis from this early work is that these changes may be an early sign of what later becomes amotivation, where people aren't focused on their goals." Of course, marijuana advocates may have a different take on things. Some people “suffer amotivational symptoms.” Some just “abide.”
Mother’s little helper
Doesn’t it seem unfair that toddlers can’t use the same coping skills as adults do? Being little presents all sorts of stresses, but small children can’t go for a run, they can’t drink alcohol, heck, they can’t even yell at their subordinates. But there is one thing they can do, and new research shows that the crankier children are, the more they indulge: watching mindless television. I’d explain more, but my show is on.
Okay, commercial break. Dr. Jenny Radesky and her colleagues evaluated data from 7,450 children in the Early Childhood Longitudinal Study–Birth Cohort, attempting to correlate measures of emotional self-regulation with hours spent in front of a screen. As it turns out, kids who were especially fussy at ages 9 months and 24 months spent more time watching videos than did their calmer peers. The authors fail to document whether their parents drank more.
The study also did not address cause and effect: Do children with poor emotional regulation get stuck in front of screens to calm them down, or does increased screen time prevent kids from building more advanced coping mechanisms? I became so perplexed reading this study that I had to watch an episode of The Golden Girls. It relaxes me: Every time someone says “Blanche,” I take a shot.
Tipping the scales
The vaccine-autism myth is like the pediatric version of the Sewer Gator: It started with a study that has been flushed down the toilet, yet no amount of evidence will convince some people that it’s not real, and it grows more dangerous every day. The only difference is that the Sewer Gator never actually killed a child. In the midst of outbreaks of measles, mumps, and whooping cough, I was not reassured to read a new Harris Poll reporting that 1 in 3 parents still believe that vaccines can cause autism. At least the existence of the Sewer Gator has not been definitively disproven by 23 studies.
Before we waste any more energy fighting this misconception, however, we have to acknowledge what we’re up against. According to the National Science Foundation’s annual survey, fewer than 40% of Americans believe in the Big Bang, fewer than 50% believe in evolution, and 26% of Americans think the sun revolves around the earth. And we’re hoping that 95% of Americans will understand the epidemiology of infectious diseases and the fetal origins of autism spectrum disorders. Right. If you need me, I’ll be watching The Golden Girls, wearing cardboard armor.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
As a parent, I hate how you have to sign kids up for camps way before summer even starts. What 12-year-old can really answer whether he’d rather go indoor skydiving or learn SCUBA when he’s still trying to build a cardboard suit of armor for Social Studies? (A suit that would prove equally useless for skydiving, SCUBA, or understanding the role of economic subjugation in feudal societies.) However, if we don’t act in time, the only spots left will be in that engineering camp he attended last year, the one where they built the same catapult over and over again. At least if he ends up there, he’ll have just the right armor.
Joint attention
It’s hard to explain to a kid that just because something is legal doesn’t meant it’s good for you. After all, no one has outlawed large sugary sodas, tequila, or Miley Cyrus. So, with two states now allowing recreational use of marijuana, I find it just the teeniest bit alarming that a new study confirms that marijuana use can lead to permanent brain damage in young adults. On the up side, once your brain has been impaired by smoking pot, you could care less.
Dr. Hans Breiter and his colleagues obtained high-resolution (“High.” Heh!) MRI scans of the brains of recreational marijuana users between the ages of 18 and 25 years, then analyzed the volume and composition of their brains, compared with matched controls, with particular attention to brain regions responsible for regulating emotion and motivation. (For those of you who are still motivated, those are the nucleus accumbens and the amygdala. For the rest of you...“high-resolution.” Heh!)
Dr. Breiter explained, "What we're seeing is changes in people who are 18-25 in core brain regions that you never, ever want to fool around with. Our hypothesis from this early work is that these changes may be an early sign of what later becomes amotivation, where people aren't focused on their goals." Of course, marijuana advocates may have a different take on things. Some people “suffer amotivational symptoms.” Some just “abide.”
Mother’s little helper
Doesn’t it seem unfair that toddlers can’t use the same coping skills as adults do? Being little presents all sorts of stresses, but small children can’t go for a run, they can’t drink alcohol, heck, they can’t even yell at their subordinates. But there is one thing they can do, and new research shows that the crankier children are, the more they indulge: watching mindless television. I’d explain more, but my show is on.
Okay, commercial break. Dr. Jenny Radesky and her colleagues evaluated data from 7,450 children in the Early Childhood Longitudinal Study–Birth Cohort, attempting to correlate measures of emotional self-regulation with hours spent in front of a screen. As it turns out, kids who were especially fussy at ages 9 months and 24 months spent more time watching videos than did their calmer peers. The authors fail to document whether their parents drank more.
The study also did not address cause and effect: Do children with poor emotional regulation get stuck in front of screens to calm them down, or does increased screen time prevent kids from building more advanced coping mechanisms? I became so perplexed reading this study that I had to watch an episode of The Golden Girls. It relaxes me: Every time someone says “Blanche,” I take a shot.
Tipping the scales
The vaccine-autism myth is like the pediatric version of the Sewer Gator: It started with a study that has been flushed down the toilet, yet no amount of evidence will convince some people that it’s not real, and it grows more dangerous every day. The only difference is that the Sewer Gator never actually killed a child. In the midst of outbreaks of measles, mumps, and whooping cough, I was not reassured to read a new Harris Poll reporting that 1 in 3 parents still believe that vaccines can cause autism. At least the existence of the Sewer Gator has not been definitively disproven by 23 studies.
Before we waste any more energy fighting this misconception, however, we have to acknowledge what we’re up against. According to the National Science Foundation’s annual survey, fewer than 40% of Americans believe in the Big Bang, fewer than 50% believe in evolution, and 26% of Americans think the sun revolves around the earth. And we’re hoping that 95% of Americans will understand the epidemiology of infectious diseases and the fetal origins of autism spectrum disorders. Right. If you need me, I’ll be watching The Golden Girls, wearing cardboard armor.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
As a parent, I hate how you have to sign kids up for camps way before summer even starts. What 12-year-old can really answer whether he’d rather go indoor skydiving or learn SCUBA when he’s still trying to build a cardboard suit of armor for Social Studies? (A suit that would prove equally useless for skydiving, SCUBA, or understanding the role of economic subjugation in feudal societies.) However, if we don’t act in time, the only spots left will be in that engineering camp he attended last year, the one where they built the same catapult over and over again. At least if he ends up there, he’ll have just the right armor.
Joint attention
It’s hard to explain to a kid that just because something is legal doesn’t meant it’s good for you. After all, no one has outlawed large sugary sodas, tequila, or Miley Cyrus. So, with two states now allowing recreational use of marijuana, I find it just the teeniest bit alarming that a new study confirms that marijuana use can lead to permanent brain damage in young adults. On the up side, once your brain has been impaired by smoking pot, you could care less.
Dr. Hans Breiter and his colleagues obtained high-resolution (“High.” Heh!) MRI scans of the brains of recreational marijuana users between the ages of 18 and 25 years, then analyzed the volume and composition of their brains, compared with matched controls, with particular attention to brain regions responsible for regulating emotion and motivation. (For those of you who are still motivated, those are the nucleus accumbens and the amygdala. For the rest of you...“high-resolution.” Heh!)
Dr. Breiter explained, "What we're seeing is changes in people who are 18-25 in core brain regions that you never, ever want to fool around with. Our hypothesis from this early work is that these changes may be an early sign of what later becomes amotivation, where people aren't focused on their goals." Of course, marijuana advocates may have a different take on things. Some people “suffer amotivational symptoms.” Some just “abide.”
Mother’s little helper
Doesn’t it seem unfair that toddlers can’t use the same coping skills as adults do? Being little presents all sorts of stresses, but small children can’t go for a run, they can’t drink alcohol, heck, they can’t even yell at their subordinates. But there is one thing they can do, and new research shows that the crankier children are, the more they indulge: watching mindless television. I’d explain more, but my show is on.
Okay, commercial break. Dr. Jenny Radesky and her colleagues evaluated data from 7,450 children in the Early Childhood Longitudinal Study–Birth Cohort, attempting to correlate measures of emotional self-regulation with hours spent in front of a screen. As it turns out, kids who were especially fussy at ages 9 months and 24 months spent more time watching videos than did their calmer peers. The authors fail to document whether their parents drank more.
The study also did not address cause and effect: Do children with poor emotional regulation get stuck in front of screens to calm them down, or does increased screen time prevent kids from building more advanced coping mechanisms? I became so perplexed reading this study that I had to watch an episode of The Golden Girls. It relaxes me: Every time someone says “Blanche,” I take a shot.
Tipping the scales
The vaccine-autism myth is like the pediatric version of the Sewer Gator: It started with a study that has been flushed down the toilet, yet no amount of evidence will convince some people that it’s not real, and it grows more dangerous every day. The only difference is that the Sewer Gator never actually killed a child. In the midst of outbreaks of measles, mumps, and whooping cough, I was not reassured to read a new Harris Poll reporting that 1 in 3 parents still believe that vaccines can cause autism. At least the existence of the Sewer Gator has not been definitively disproven by 23 studies.
Before we waste any more energy fighting this misconception, however, we have to acknowledge what we’re up against. According to the National Science Foundation’s annual survey, fewer than 40% of Americans believe in the Big Bang, fewer than 50% believe in evolution, and 26% of Americans think the sun revolves around the earth. And we’re hoping that 95% of Americans will understand the epidemiology of infectious diseases and the fetal origins of autism spectrum disorders. Right. If you need me, I’ll be watching The Golden Girls, wearing cardboard armor.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Breakfast of champions
I know that as a pediatrician I shouldn’t find it hard to keep up with parenting trends, but honestly, it’s exhausting! The new thing now is “grit,” right? I thought I had it down, but even here in the South, there are only so many ways to feed kids ground hominy before they complain, ironically demonstrating a complete lack of grit.
I like this grit concept, though. As parents, we get to do what we’ve always done: make our kids’ lives difficult for no reason. But now we can claim that we’re just preparing them for an economic landscape in which only the most determined workers will ever earn more than their parents. While those successful few feast on caviar and champagne, everyone else will have to eat...well, you know.
Hows and whys
Pediatricians are just so nice! It’s weird, right? I mean, we’re too nice. Apparently. the folks at the American Academy of Pediatrics and the ABIM Foundation agree, because they’ve teamed up to create the Choosing Wisely campaign, a coordinated multimedia strategy to help us learn how to say “no” to stuff. They knew, after all, that if they offered us this program we’d be too polite to turn it down.
Using evidence-based guidelines and surveys, the sponsors identified the Top 10 common pediatric interventions whose risks clearly outweighed their benefits, ranging from #10: Using home apnea monitors to prevent SIDS to #1: Treating viral upper respiratory infections with antibiotics. That one probably needs a #1a: Justifying doing #1 based on some lame excuse like green snot or a red throat. If you can convince yourself that green snot means a sinus infection, hopefully you can later convince yourself that a giant boil draining methicillin-resistant Staph aureus means a mosquito bite.
Not only does Choosing Wisely include a list of stuff not to do (antacids for “happy spittters,” anyone?), but it comes with video modules to teach pediatricians exactly how to tell parents that their kids do not need a CT scan for falling off the couch. Future modules will walk providers through explaining to their hospital administrators why their Press Ganey patient satisfaction scores have fallen.
Psych!
Do you find it scary how many patients you send for help with serious psychiatric conditions who never go? Is it possible that we would live in a perfectly sane world if only every child referred to a mental health provider actually went? Of course, in such a world we may never get another Miley Cyrus.
A group of researchers in Pittsburgh may have solved this problem: Every pediatrician’s office should have its own mental health provider. How good an answer is it? Among 321 kids sent for mental health referral, only 54% went when the provider was located somewhere else, compared with more than 99% when the provider was in the same office as the pediatrician.
Once they see these numbers, I expect psychiatrists to be lining up outside our doors begging to sublease our broom closets. Unless, of course, we already don’t have enough pediatric mental health providers to see the patients who do show up. Right. I may as well put those brooms back.
But why stop with co-located mental health services? My dream office would include a toy store, an ice cream shoppe, a day care, and a puppy adoption center. Of course with all that, we’d definitely need to add services for adult mental health.
Chemistry minor
This is the kind of quote I find scary: “It’s not a matter of if a child will be seriously poisoned or killed,” said Lee Cantrell, director of the San Diego division of the California Poison Control System and a professor of pharmacy at the University of California, San Francisco. “It’s a matter of when.”
What could this man, speaking to the New York Times for a March 23rd article, be talking about? Sarin gas? Methamphetamine? Whatever they put in Vienna sausages? What if I told you this potent neurotoxin was also brightly colored, attractively scented, and sold with no regulations whatsoever in non-child-safe bottles? No, it’s not 5-Hour Energy. Try nicotine refills for e-cigarettes. Now are you scared?
Depending on the concentration, e-cigarette liquid refills contain enough nicotine to send a child to the hospital just from spilling it on the skin. Drinking a bottle could be deadly. By now, you’ve already grasped the possible consequences: We have one more hazard to discuss at our well child visits. Hopefully before long, regulators will address these substances, with some grit.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
I know that as a pediatrician I shouldn’t find it hard to keep up with parenting trends, but honestly, it’s exhausting! The new thing now is “grit,” right? I thought I had it down, but even here in the South, there are only so many ways to feed kids ground hominy before they complain, ironically demonstrating a complete lack of grit.
I like this grit concept, though. As parents, we get to do what we’ve always done: make our kids’ lives difficult for no reason. But now we can claim that we’re just preparing them for an economic landscape in which only the most determined workers will ever earn more than their parents. While those successful few feast on caviar and champagne, everyone else will have to eat...well, you know.
Hows and whys
Pediatricians are just so nice! It’s weird, right? I mean, we’re too nice. Apparently. the folks at the American Academy of Pediatrics and the ABIM Foundation agree, because they’ve teamed up to create the Choosing Wisely campaign, a coordinated multimedia strategy to help us learn how to say “no” to stuff. They knew, after all, that if they offered us this program we’d be too polite to turn it down.
Using evidence-based guidelines and surveys, the sponsors identified the Top 10 common pediatric interventions whose risks clearly outweighed their benefits, ranging from #10: Using home apnea monitors to prevent SIDS to #1: Treating viral upper respiratory infections with antibiotics. That one probably needs a #1a: Justifying doing #1 based on some lame excuse like green snot or a red throat. If you can convince yourself that green snot means a sinus infection, hopefully you can later convince yourself that a giant boil draining methicillin-resistant Staph aureus means a mosquito bite.
Not only does Choosing Wisely include a list of stuff not to do (antacids for “happy spittters,” anyone?), but it comes with video modules to teach pediatricians exactly how to tell parents that their kids do not need a CT scan for falling off the couch. Future modules will walk providers through explaining to their hospital administrators why their Press Ganey patient satisfaction scores have fallen.
Psych!
Do you find it scary how many patients you send for help with serious psychiatric conditions who never go? Is it possible that we would live in a perfectly sane world if only every child referred to a mental health provider actually went? Of course, in such a world we may never get another Miley Cyrus.
A group of researchers in Pittsburgh may have solved this problem: Every pediatrician’s office should have its own mental health provider. How good an answer is it? Among 321 kids sent for mental health referral, only 54% went when the provider was located somewhere else, compared with more than 99% when the provider was in the same office as the pediatrician.
Once they see these numbers, I expect psychiatrists to be lining up outside our doors begging to sublease our broom closets. Unless, of course, we already don’t have enough pediatric mental health providers to see the patients who do show up. Right. I may as well put those brooms back.
But why stop with co-located mental health services? My dream office would include a toy store, an ice cream shoppe, a day care, and a puppy adoption center. Of course with all that, we’d definitely need to add services for adult mental health.
Chemistry minor
This is the kind of quote I find scary: “It’s not a matter of if a child will be seriously poisoned or killed,” said Lee Cantrell, director of the San Diego division of the California Poison Control System and a professor of pharmacy at the University of California, San Francisco. “It’s a matter of when.”
What could this man, speaking to the New York Times for a March 23rd article, be talking about? Sarin gas? Methamphetamine? Whatever they put in Vienna sausages? What if I told you this potent neurotoxin was also brightly colored, attractively scented, and sold with no regulations whatsoever in non-child-safe bottles? No, it’s not 5-Hour Energy. Try nicotine refills for e-cigarettes. Now are you scared?
Depending on the concentration, e-cigarette liquid refills contain enough nicotine to send a child to the hospital just from spilling it on the skin. Drinking a bottle could be deadly. By now, you’ve already grasped the possible consequences: We have one more hazard to discuss at our well child visits. Hopefully before long, regulators will address these substances, with some grit.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
I know that as a pediatrician I shouldn’t find it hard to keep up with parenting trends, but honestly, it’s exhausting! The new thing now is “grit,” right? I thought I had it down, but even here in the South, there are only so many ways to feed kids ground hominy before they complain, ironically demonstrating a complete lack of grit.
I like this grit concept, though. As parents, we get to do what we’ve always done: make our kids’ lives difficult for no reason. But now we can claim that we’re just preparing them for an economic landscape in which only the most determined workers will ever earn more than their parents. While those successful few feast on caviar and champagne, everyone else will have to eat...well, you know.
Hows and whys
Pediatricians are just so nice! It’s weird, right? I mean, we’re too nice. Apparently. the folks at the American Academy of Pediatrics and the ABIM Foundation agree, because they’ve teamed up to create the Choosing Wisely campaign, a coordinated multimedia strategy to help us learn how to say “no” to stuff. They knew, after all, that if they offered us this program we’d be too polite to turn it down.
Using evidence-based guidelines and surveys, the sponsors identified the Top 10 common pediatric interventions whose risks clearly outweighed their benefits, ranging from #10: Using home apnea monitors to prevent SIDS to #1: Treating viral upper respiratory infections with antibiotics. That one probably needs a #1a: Justifying doing #1 based on some lame excuse like green snot or a red throat. If you can convince yourself that green snot means a sinus infection, hopefully you can later convince yourself that a giant boil draining methicillin-resistant Staph aureus means a mosquito bite.
Not only does Choosing Wisely include a list of stuff not to do (antacids for “happy spittters,” anyone?), but it comes with video modules to teach pediatricians exactly how to tell parents that their kids do not need a CT scan for falling off the couch. Future modules will walk providers through explaining to their hospital administrators why their Press Ganey patient satisfaction scores have fallen.
Psych!
Do you find it scary how many patients you send for help with serious psychiatric conditions who never go? Is it possible that we would live in a perfectly sane world if only every child referred to a mental health provider actually went? Of course, in such a world we may never get another Miley Cyrus.
A group of researchers in Pittsburgh may have solved this problem: Every pediatrician’s office should have its own mental health provider. How good an answer is it? Among 321 kids sent for mental health referral, only 54% went when the provider was located somewhere else, compared with more than 99% when the provider was in the same office as the pediatrician.
Once they see these numbers, I expect psychiatrists to be lining up outside our doors begging to sublease our broom closets. Unless, of course, we already don’t have enough pediatric mental health providers to see the patients who do show up. Right. I may as well put those brooms back.
But why stop with co-located mental health services? My dream office would include a toy store, an ice cream shoppe, a day care, and a puppy adoption center. Of course with all that, we’d definitely need to add services for adult mental health.
Chemistry minor
This is the kind of quote I find scary: “It’s not a matter of if a child will be seriously poisoned or killed,” said Lee Cantrell, director of the San Diego division of the California Poison Control System and a professor of pharmacy at the University of California, San Francisco. “It’s a matter of when.”
What could this man, speaking to the New York Times for a March 23rd article, be talking about? Sarin gas? Methamphetamine? Whatever they put in Vienna sausages? What if I told you this potent neurotoxin was also brightly colored, attractively scented, and sold with no regulations whatsoever in non-child-safe bottles? No, it’s not 5-Hour Energy. Try nicotine refills for e-cigarettes. Now are you scared?
Depending on the concentration, e-cigarette liquid refills contain enough nicotine to send a child to the hospital just from spilling it on the skin. Drinking a bottle could be deadly. By now, you’ve already grasped the possible consequences: We have one more hazard to discuss at our well child visits. Hopefully before long, regulators will address these substances, with some grit.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.