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Sock it to me
Is it wrong that I’m now criticizing my kids’ fashion choices? I mean, that’s a hazardous endeavor for someone who once wore a Members Only jacket and parachute pants. With a muscle shirt. And yet...yet I worry that my 9-year-old son is going to suffer frostbite of the knees. This is because he and all his little friends insist on wearing shorts and mid-calf athletic socks under any and all weather conditions. In other years, this uniform might work for coastal North Carolina, but the last 2 months here have been like living in Minnesota, only with worse drivers.
To be fair, the socks are impressive: bright, thick synthetic constructions with “R” and “L” woven into them so that if you lose a left one from one pair you have to lose the right one from another or you’ve wasted more than socks should reasonably cost. (How is it a child can keep track of Right and Left socks when he can’t find his own laundry bin?) Now if I can only get him to wear a pair that comes up to his shorts.
Sound of silence
Don’t you hate those conversations where halfway through you think, “I should probably just stop talking now”? According to a new study, if you’re counseling vaccine-hesitant parents, shut up, like right now. Zip it. Hush! If your lips are still moving, you’re just making it worse.
We now know scientifically that there is nothing at all you can say that will change their minds about vaccines and much that will strengthen their resolve to make their own children and the rest of us sicker. Move on to another topic: “Sure has been cold around here! Can you believe my son wore shorts today?”
A study released in Pediatrics examined the effectiveness of four logical-seeming strategies used by the Centers for Disease Control and Prevention to encourage parents to give their kids measles vaccine: correct misinformation, present information on measles risks, use a dramatic narrative to make the risk of measles more salient, or display visuals so that people understand that measles temporarily gives you an unattractive complexion and then sometimes kills you. If vaccine resistance were rational, we would be talking about which of these strategies worked best.
Instead, we’re talking about how they ranged from not working at all to making parents more convinced than ever that measles vaccination is a worldwide conspiracy organized by a super-villain who hopes to build an army of autistic children in order to, to, oh, who knows? Does it matter? The point is, as cognitive psychologists already know, people first make emotional decisions and then search for reasons. When you bring up evidence that doesn’t match their beliefs, you just make them mad. Which is why, from now on, I’ll be conducting my wellness exams in mime.
Kick
Sometimes the scariest part of being a parent is that you have to set an example, like, all the time. That’s exhausting! Just once I want to lie down on the floor in the candy aisle and scream, but can I? No, I cannot, at least according to the grocery store manager.
When it comes to playing with cell phones and other mobile devices, however, it turns out that many parents are worse than their kids. We know this because a group of researchers from Boston University sat around in local restaurants pretending to eat french fries while surreptitiously documenting the behavior of children and their caretakers, then actually eating french fries.
What they saw wasn’t pretty. Forty out of 55 adults observed were riveted to their mobile devices, often completely ignoring the children in their care, not to mention the researchers who kept staring at them and scribbling in ketchup-stained notebooks. In the clinical language of the report, “one female adult kicked a child’s foot under the table; another female caregiver pushed a young boy’s hands away when he was trying to repeatedly lift her face up from looking at a tablet screen.”
Some kids responded to the parental neglect by ramping up attention-getting behavior. Others were so used to it that they simply entertained themselves, periodically texting their parents to ask for help getting to the bathroom. The researchers gained valuable insights into how mobile devices alter parenting behavior, as well as an average of 15 pounds.
Big difference
History is littered with innovations once considered wondrous that turned out to be more damaging than anyone had initially imagined: radium, DDT, Justin Bieber. A new study further suggests that this catalogue of infamy should expand to include antibiotics, potentially life-saving medicines whose overuse may ultimately be as damaging to society as reality TV.
We’ve known for a while that antibiotics contribute to allergic reactions, asthma, diarrhea, and the development of highly resistant “superbugs.” Now an all-star team of epidemiologists from around the country implicates recent antibiotic use in increasing cases of childhood intestinal infections with Clostridium difficile (“Come for the cramping. Stay for the bloody diarrhea.”).
Sadly, there are still a fair number of docs out there who’d rather cave to parents demanding antibiotics for a cold (and yes, green snot is part of a cold) than explain that not only will the antibiotics not fix the problem, they’ll cause all sorts of new ones. Next time a parent is insisting on a script, for the sake of us all, grow a spine and tell them to put a sock in it. If they don’t have a sock, no sweat, I have a spare: it’s a Left.
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.
Is it wrong that I’m now criticizing my kids’ fashion choices? I mean, that’s a hazardous endeavor for someone who once wore a Members Only jacket and parachute pants. With a muscle shirt. And yet...yet I worry that my 9-year-old son is going to suffer frostbite of the knees. This is because he and all his little friends insist on wearing shorts and mid-calf athletic socks under any and all weather conditions. In other years, this uniform might work for coastal North Carolina, but the last 2 months here have been like living in Minnesota, only with worse drivers.
To be fair, the socks are impressive: bright, thick synthetic constructions with “R” and “L” woven into them so that if you lose a left one from one pair you have to lose the right one from another or you’ve wasted more than socks should reasonably cost. (How is it a child can keep track of Right and Left socks when he can’t find his own laundry bin?) Now if I can only get him to wear a pair that comes up to his shorts.
Sound of silence
Don’t you hate those conversations where halfway through you think, “I should probably just stop talking now”? According to a new study, if you’re counseling vaccine-hesitant parents, shut up, like right now. Zip it. Hush! If your lips are still moving, you’re just making it worse.
We now know scientifically that there is nothing at all you can say that will change their minds about vaccines and much that will strengthen their resolve to make their own children and the rest of us sicker. Move on to another topic: “Sure has been cold around here! Can you believe my son wore shorts today?”
A study released in Pediatrics examined the effectiveness of four logical-seeming strategies used by the Centers for Disease Control and Prevention to encourage parents to give their kids measles vaccine: correct misinformation, present information on measles risks, use a dramatic narrative to make the risk of measles more salient, or display visuals so that people understand that measles temporarily gives you an unattractive complexion and then sometimes kills you. If vaccine resistance were rational, we would be talking about which of these strategies worked best.
Instead, we’re talking about how they ranged from not working at all to making parents more convinced than ever that measles vaccination is a worldwide conspiracy organized by a super-villain who hopes to build an army of autistic children in order to, to, oh, who knows? Does it matter? The point is, as cognitive psychologists already know, people first make emotional decisions and then search for reasons. When you bring up evidence that doesn’t match their beliefs, you just make them mad. Which is why, from now on, I’ll be conducting my wellness exams in mime.
Kick
Sometimes the scariest part of being a parent is that you have to set an example, like, all the time. That’s exhausting! Just once I want to lie down on the floor in the candy aisle and scream, but can I? No, I cannot, at least according to the grocery store manager.
When it comes to playing with cell phones and other mobile devices, however, it turns out that many parents are worse than their kids. We know this because a group of researchers from Boston University sat around in local restaurants pretending to eat french fries while surreptitiously documenting the behavior of children and their caretakers, then actually eating french fries.
What they saw wasn’t pretty. Forty out of 55 adults observed were riveted to their mobile devices, often completely ignoring the children in their care, not to mention the researchers who kept staring at them and scribbling in ketchup-stained notebooks. In the clinical language of the report, “one female adult kicked a child’s foot under the table; another female caregiver pushed a young boy’s hands away when he was trying to repeatedly lift her face up from looking at a tablet screen.”
Some kids responded to the parental neglect by ramping up attention-getting behavior. Others were so used to it that they simply entertained themselves, periodically texting their parents to ask for help getting to the bathroom. The researchers gained valuable insights into how mobile devices alter parenting behavior, as well as an average of 15 pounds.
Big difference
History is littered with innovations once considered wondrous that turned out to be more damaging than anyone had initially imagined: radium, DDT, Justin Bieber. A new study further suggests that this catalogue of infamy should expand to include antibiotics, potentially life-saving medicines whose overuse may ultimately be as damaging to society as reality TV.
We’ve known for a while that antibiotics contribute to allergic reactions, asthma, diarrhea, and the development of highly resistant “superbugs.” Now an all-star team of epidemiologists from around the country implicates recent antibiotic use in increasing cases of childhood intestinal infections with Clostridium difficile (“Come for the cramping. Stay for the bloody diarrhea.”).
Sadly, there are still a fair number of docs out there who’d rather cave to parents demanding antibiotics for a cold (and yes, green snot is part of a cold) than explain that not only will the antibiotics not fix the problem, they’ll cause all sorts of new ones. Next time a parent is insisting on a script, for the sake of us all, grow a spine and tell them to put a sock in it. If they don’t have a sock, no sweat, I have a spare: it’s a Left.
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.
Is it wrong that I’m now criticizing my kids’ fashion choices? I mean, that’s a hazardous endeavor for someone who once wore a Members Only jacket and parachute pants. With a muscle shirt. And yet...yet I worry that my 9-year-old son is going to suffer frostbite of the knees. This is because he and all his little friends insist on wearing shorts and mid-calf athletic socks under any and all weather conditions. In other years, this uniform might work for coastal North Carolina, but the last 2 months here have been like living in Minnesota, only with worse drivers.
To be fair, the socks are impressive: bright, thick synthetic constructions with “R” and “L” woven into them so that if you lose a left one from one pair you have to lose the right one from another or you’ve wasted more than socks should reasonably cost. (How is it a child can keep track of Right and Left socks when he can’t find his own laundry bin?) Now if I can only get him to wear a pair that comes up to his shorts.
Sound of silence
Don’t you hate those conversations where halfway through you think, “I should probably just stop talking now”? According to a new study, if you’re counseling vaccine-hesitant parents, shut up, like right now. Zip it. Hush! If your lips are still moving, you’re just making it worse.
We now know scientifically that there is nothing at all you can say that will change their minds about vaccines and much that will strengthen their resolve to make their own children and the rest of us sicker. Move on to another topic: “Sure has been cold around here! Can you believe my son wore shorts today?”
A study released in Pediatrics examined the effectiveness of four logical-seeming strategies used by the Centers for Disease Control and Prevention to encourage parents to give their kids measles vaccine: correct misinformation, present information on measles risks, use a dramatic narrative to make the risk of measles more salient, or display visuals so that people understand that measles temporarily gives you an unattractive complexion and then sometimes kills you. If vaccine resistance were rational, we would be talking about which of these strategies worked best.
Instead, we’re talking about how they ranged from not working at all to making parents more convinced than ever that measles vaccination is a worldwide conspiracy organized by a super-villain who hopes to build an army of autistic children in order to, to, oh, who knows? Does it matter? The point is, as cognitive psychologists already know, people first make emotional decisions and then search for reasons. When you bring up evidence that doesn’t match their beliefs, you just make them mad. Which is why, from now on, I’ll be conducting my wellness exams in mime.
Kick
Sometimes the scariest part of being a parent is that you have to set an example, like, all the time. That’s exhausting! Just once I want to lie down on the floor in the candy aisle and scream, but can I? No, I cannot, at least according to the grocery store manager.
When it comes to playing with cell phones and other mobile devices, however, it turns out that many parents are worse than their kids. We know this because a group of researchers from Boston University sat around in local restaurants pretending to eat french fries while surreptitiously documenting the behavior of children and their caretakers, then actually eating french fries.
What they saw wasn’t pretty. Forty out of 55 adults observed were riveted to their mobile devices, often completely ignoring the children in their care, not to mention the researchers who kept staring at them and scribbling in ketchup-stained notebooks. In the clinical language of the report, “one female adult kicked a child’s foot under the table; another female caregiver pushed a young boy’s hands away when he was trying to repeatedly lift her face up from looking at a tablet screen.”
Some kids responded to the parental neglect by ramping up attention-getting behavior. Others were so used to it that they simply entertained themselves, periodically texting their parents to ask for help getting to the bathroom. The researchers gained valuable insights into how mobile devices alter parenting behavior, as well as an average of 15 pounds.
Big difference
History is littered with innovations once considered wondrous that turned out to be more damaging than anyone had initially imagined: radium, DDT, Justin Bieber. A new study further suggests that this catalogue of infamy should expand to include antibiotics, potentially life-saving medicines whose overuse may ultimately be as damaging to society as reality TV.
We’ve known for a while that antibiotics contribute to allergic reactions, asthma, diarrhea, and the development of highly resistant “superbugs.” Now an all-star team of epidemiologists from around the country implicates recent antibiotic use in increasing cases of childhood intestinal infections with Clostridium difficile (“Come for the cramping. Stay for the bloody diarrhea.”).
Sadly, there are still a fair number of docs out there who’d rather cave to parents demanding antibiotics for a cold (and yes, green snot is part of a cold) than explain that not only will the antibiotics not fix the problem, they’ll cause all sorts of new ones. Next time a parent is insisting on a script, for the sake of us all, grow a spine and tell them to put a sock in it. If they don’t have a sock, no sweat, I have a spare: it’s a Left.
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.
Here comes the sun
It’s springtime, and my 12-year-old son has been in his room a lot watching YouTube, so it’s no surprise his thoughts are straying to...making a solar death ray. That’s right, once he saw that you could take apart an old projection screen TV and use the salvaged Fresnel lens to melt a stack of pennies, he’s had a one-track mind.
I want to help him, and I have to admit, there’s some stuff I wouldn’t mind melting. The problem is that when it comes to televisions, I’m less inclined to take one apart than to, say, turn it on and watch a cooking show. I do, however, own a screwdriver (somewhere around here), so I’m willing to give it a go. If this is my last blog, you’ll know we succeeded beyond our wildest dreams.
Worth a shot
There has been, in the history of medicine, one guy who smoked two packs a day and lived to be 100. Everyone who ever smoked has heard of that guy. I know, because they all tell me about him. I’ve also met hundreds of friends and relatives of the woman who got the flu vaccine and then got flu (okay, there are several of them, but still.). “What is the point,” these people ask me, “of getting the flu vaccine, if someone who got the vaccine still caught the flu? Huh? Not feeling so confident about your little vaccine now, are you?”
From now on, I’m going to direct those people to Dr. Jelena Catania and her colleagues at Duke, who asked a simple question: If you end up admitted to the hospital or the ICU because of influenza, did you get your flu vaccine? Less than a quarter of hospitalized patients had been vaccinated, and among ICU admissions, the rate was less than 10%.
So okay, you got the vaccine and then you got the flu; it happens. I see, however, that you’re not intubated, so I wouldn’t call it useless. Flu vaccine does not protect every person every time, nor do seat belts, smoke alarms, or bulletproof vests. At the same time, they’re all a heck of a lot better than nothing, even more so if you’re that 100-year-old smoker.
Catchy!
I’ve got news for those people who suspect doctors are all involved in a vast conspiracy to suppress, oh, I don’t know, the amazing healing power of goji berries: apparently, we can’t even suppress a smile, much less unflattering study results. How do I know? Because if we could, then the editors at Infection Control and Hospital Epidemiology would have taken this next study and stuck it in that warehouse at the end of Raiders of the Lost Ark instead of putting out a press release!
But, no! Important science has been done, and now everyone knows that attending well-child visits during flu season may account for up to 780,000 cases of influenza-like illness a year. Thanks, y’all. I’ll be sure to alert you next time I get an embarrassing boil.
I try to avoid using the term “ivory tower,” because I don’t want to encourage poaching elephants. But the authors of this study conclude that primary care pediatricians (like me) should avoid scheduling wellness exams during the 6 months of the year when flu rates are highest. Given that we recommend nine wellness visits in the first 2 years of life, I’m having a hard time with the math. When they come up with a solution, I certainly hope to read the press release.
Youse lose
Living in North Carolina, I thought I had heard every nonsensical defense of tobacco products the industry could produce. But apparently you have to be in Norway to hear the claim that little packets of chewing tobacco, called “snus,” would be a great tool for smoking prevention. Dr. Ingebord Lund and Dr. Janne Scheffels at the Norwegian Institute for Alcohol and Drug Research - SIRUS, in Oslo, thought that promise sounded sketchy, so they decided to put it to the test. What they discovered should surprise no one: When it comes to younger adolescents, no snus is good snus.
While some older snus users did indeed prefer the risk of oral cancer to lung cancer, those snus users who choose to use snus before age 16 years were two to three times more likely to smoke cigarettes than were those who started later, and no less likely to smoke than their peers who eschewed snus. Future research from this team will explore the public health risks associated with gnus, cues, kangaroos, queues, stews, zoos, glues, shoes, loos, screws, booze, flues, canoes, tattoos, lues, haikus, and singing the blues.
If you have snus you no longer plan to use, send them to me and my son. We’re gonna need some stuff to solar-scorch, and we’ll be amused.
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 springtime, and my 12-year-old son has been in his room a lot watching YouTube, so it’s no surprise his thoughts are straying to...making a solar death ray. That’s right, once he saw that you could take apart an old projection screen TV and use the salvaged Fresnel lens to melt a stack of pennies, he’s had a one-track mind.
I want to help him, and I have to admit, there’s some stuff I wouldn’t mind melting. The problem is that when it comes to televisions, I’m less inclined to take one apart than to, say, turn it on and watch a cooking show. I do, however, own a screwdriver (somewhere around here), so I’m willing to give it a go. If this is my last blog, you’ll know we succeeded beyond our wildest dreams.
Worth a shot
There has been, in the history of medicine, one guy who smoked two packs a day and lived to be 100. Everyone who ever smoked has heard of that guy. I know, because they all tell me about him. I’ve also met hundreds of friends and relatives of the woman who got the flu vaccine and then got flu (okay, there are several of them, but still.). “What is the point,” these people ask me, “of getting the flu vaccine, if someone who got the vaccine still caught the flu? Huh? Not feeling so confident about your little vaccine now, are you?”
From now on, I’m going to direct those people to Dr. Jelena Catania and her colleagues at Duke, who asked a simple question: If you end up admitted to the hospital or the ICU because of influenza, did you get your flu vaccine? Less than a quarter of hospitalized patients had been vaccinated, and among ICU admissions, the rate was less than 10%.
So okay, you got the vaccine and then you got the flu; it happens. I see, however, that you’re not intubated, so I wouldn’t call it useless. Flu vaccine does not protect every person every time, nor do seat belts, smoke alarms, or bulletproof vests. At the same time, they’re all a heck of a lot better than nothing, even more so if you’re that 100-year-old smoker.
Catchy!
I’ve got news for those people who suspect doctors are all involved in a vast conspiracy to suppress, oh, I don’t know, the amazing healing power of goji berries: apparently, we can’t even suppress a smile, much less unflattering study results. How do I know? Because if we could, then the editors at Infection Control and Hospital Epidemiology would have taken this next study and stuck it in that warehouse at the end of Raiders of the Lost Ark instead of putting out a press release!
But, no! Important science has been done, and now everyone knows that attending well-child visits during flu season may account for up to 780,000 cases of influenza-like illness a year. Thanks, y’all. I’ll be sure to alert you next time I get an embarrassing boil.
I try to avoid using the term “ivory tower,” because I don’t want to encourage poaching elephants. But the authors of this study conclude that primary care pediatricians (like me) should avoid scheduling wellness exams during the 6 months of the year when flu rates are highest. Given that we recommend nine wellness visits in the first 2 years of life, I’m having a hard time with the math. When they come up with a solution, I certainly hope to read the press release.
Youse lose
Living in North Carolina, I thought I had heard every nonsensical defense of tobacco products the industry could produce. But apparently you have to be in Norway to hear the claim that little packets of chewing tobacco, called “snus,” would be a great tool for smoking prevention. Dr. Ingebord Lund and Dr. Janne Scheffels at the Norwegian Institute for Alcohol and Drug Research - SIRUS, in Oslo, thought that promise sounded sketchy, so they decided to put it to the test. What they discovered should surprise no one: When it comes to younger adolescents, no snus is good snus.
While some older snus users did indeed prefer the risk of oral cancer to lung cancer, those snus users who choose to use snus before age 16 years were two to three times more likely to smoke cigarettes than were those who started later, and no less likely to smoke than their peers who eschewed snus. Future research from this team will explore the public health risks associated with gnus, cues, kangaroos, queues, stews, zoos, glues, shoes, loos, screws, booze, flues, canoes, tattoos, lues, haikus, and singing the blues.
If you have snus you no longer plan to use, send them to me and my son. We’re gonna need some stuff to solar-scorch, and we’ll be amused.
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 springtime, and my 12-year-old son has been in his room a lot watching YouTube, so it’s no surprise his thoughts are straying to...making a solar death ray. That’s right, once he saw that you could take apart an old projection screen TV and use the salvaged Fresnel lens to melt a stack of pennies, he’s had a one-track mind.
I want to help him, and I have to admit, there’s some stuff I wouldn’t mind melting. The problem is that when it comes to televisions, I’m less inclined to take one apart than to, say, turn it on and watch a cooking show. I do, however, own a screwdriver (somewhere around here), so I’m willing to give it a go. If this is my last blog, you’ll know we succeeded beyond our wildest dreams.
Worth a shot
There has been, in the history of medicine, one guy who smoked two packs a day and lived to be 100. Everyone who ever smoked has heard of that guy. I know, because they all tell me about him. I’ve also met hundreds of friends and relatives of the woman who got the flu vaccine and then got flu (okay, there are several of them, but still.). “What is the point,” these people ask me, “of getting the flu vaccine, if someone who got the vaccine still caught the flu? Huh? Not feeling so confident about your little vaccine now, are you?”
From now on, I’m going to direct those people to Dr. Jelena Catania and her colleagues at Duke, who asked a simple question: If you end up admitted to the hospital or the ICU because of influenza, did you get your flu vaccine? Less than a quarter of hospitalized patients had been vaccinated, and among ICU admissions, the rate was less than 10%.
So okay, you got the vaccine and then you got the flu; it happens. I see, however, that you’re not intubated, so I wouldn’t call it useless. Flu vaccine does not protect every person every time, nor do seat belts, smoke alarms, or bulletproof vests. At the same time, they’re all a heck of a lot better than nothing, even more so if you’re that 100-year-old smoker.
Catchy!
I’ve got news for those people who suspect doctors are all involved in a vast conspiracy to suppress, oh, I don’t know, the amazing healing power of goji berries: apparently, we can’t even suppress a smile, much less unflattering study results. How do I know? Because if we could, then the editors at Infection Control and Hospital Epidemiology would have taken this next study and stuck it in that warehouse at the end of Raiders of the Lost Ark instead of putting out a press release!
But, no! Important science has been done, and now everyone knows that attending well-child visits during flu season may account for up to 780,000 cases of influenza-like illness a year. Thanks, y’all. I’ll be sure to alert you next time I get an embarrassing boil.
I try to avoid using the term “ivory tower,” because I don’t want to encourage poaching elephants. But the authors of this study conclude that primary care pediatricians (like me) should avoid scheduling wellness exams during the 6 months of the year when flu rates are highest. Given that we recommend nine wellness visits in the first 2 years of life, I’m having a hard time with the math. When they come up with a solution, I certainly hope to read the press release.
Youse lose
Living in North Carolina, I thought I had heard every nonsensical defense of tobacco products the industry could produce. But apparently you have to be in Norway to hear the claim that little packets of chewing tobacco, called “snus,” would be a great tool for smoking prevention. Dr. Ingebord Lund and Dr. Janne Scheffels at the Norwegian Institute for Alcohol and Drug Research - SIRUS, in Oslo, thought that promise sounded sketchy, so they decided to put it to the test. What they discovered should surprise no one: When it comes to younger adolescents, no snus is good snus.
While some older snus users did indeed prefer the risk of oral cancer to lung cancer, those snus users who choose to use snus before age 16 years were two to three times more likely to smoke cigarettes than were those who started later, and no less likely to smoke than their peers who eschewed snus. Future research from this team will explore the public health risks associated with gnus, cues, kangaroos, queues, stews, zoos, glues, shoes, loos, screws, booze, flues, canoes, tattoos, lues, haikus, and singing the blues.
If you have snus you no longer plan to use, send them to me and my son. We’re gonna need some stuff to solar-scorch, and we’ll be amused.
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.
False start
Are you among the half of Americans who are furious at the Denver Broncos? Because I sure am. After marrying a Colorado native, I decided that I would finally, at age 45, try being a football fan. I don’t mean crazy fandom, like where I could name all the players, I just mean, like, follow the game and care kind of fandom. You can overdo these things.
So I’m sitting on the couch with my kids watching the Super Bowl and fighting over the guacamole, when bam! Denver scores a safety! Or is it Seattle that scores the safety, since they get the points, even though Denver moved the ball? My point is, right away I had to Google “safety American football” so I could tell my kids why our team started losing milliseconds into the big game. From there, it was just one Google search after another: “fumble,” “interception,” “incomplete pass,” “kickoff return for a touchdown,” and “ignominious.” I’m just glad they started the game with Renee Fleming. She has been in my fantasy opera company ever since the Met crushed Glimmerglass at Lincoln Center.
Silly rabbit
I’m pretty sure acute bacterial sinusitis is the third most common reason pediatricians prescribe antibiotics, right behind acute otitis media and I-can’t-stand-here-arguing-with-you-anymore. But as a med-peds guy, I’ve always wondered why it is that we use antibiotics for sinusitis in kids when they’re not indicated for the same disease in adults? What is this, a Trixx commercial?
A new study in the Journal of Pediatrics suggests that perhaps not all pediatric sinusitis is created equal. Researchers in Pittsburgh correlated antibiotic response with nasal cultures looking for common pathogens. While their samples turned up Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, kids with the strep responded to treatment much faster than those harboring other bugs. I should clarify: “Fast” in this study meant a median 6.5 days to symptom resolution as opposed to 8.5 days. By that measure, “fast” would also refer to the Broncos defense.
Buried in the study, however, were other data that really gave me pause. In 54% of the study population, the overall time to resolution of symptoms was 10-19 days, and in 27% it was 20-30 days. These were kids with radiographic evidence of sinusitis who received antibiotics. I’m not thinking this is what parents have in mind when they ask, “Can you give him antibiotics and make him better?” Why yes! In only 10-30 days! I’m not saying we change the treatment guidelines just yet. For now, that’s one fewer thing I have to stand around and argue about.
Big kids
New data from the Early Childhood Longitudinal Study published in the New England Journal of Medicine suggest that our efforts to curb obesity in late childhood and adolescence may occur after the horse is out of barn. Actually, the horse left the barn a while back, strolled out for some fries, and is now sitting in front of the TV with a large soda. According to study author Solveig Cunningham of Emory University, Atlanta, half of childhood obesity occurs in children who are already overweight by the preschool years, with the steepest rise in obesity striking between first and third grade. We’re talking about teaching kids to read food labels when the problem starts before most kids learn to read.
Given that some data implicate fetal and neonatal weight gain in lifetime obesity, I think it’s never too early to start building healthy habits. That’s why I’m launching a new fitness fad I’m calling “Cross-Fetus.” Cross-fetuses will learn basic exercises like leg curls, uterus kicks, and hiccups, which they will repeat, again, faster, until they have sucking blisters. Is that amniotic fluid or sweat? Who knows? Does it matter? Classes will begin as soon as I can figure out how to bring out the competitive spirit in a being that doesn’t know anyone else exists. When I find out, I promise to tell Broncos coach John Fox.
Smoking guns
At our practice, we ask every family at nearly every visit about firearms in the home, and parents sometimes want to know why. I love those moments, because despite what some outsiders may think of North Carolina (that we probably have more guns per capita then we have toothbrushes), I find that the vast majority of my families “get it” when we talk about firearm safety and kids. The handful who don’t already suspected that I was a United Nations secret agent when they saw me rappel into work from a black helicopter. Oops, I’ve said too much.
I can now point doubtful parents to a new study of firearm hospitalizations and deaths, demonstrating that gun injuries send one child or teen to the hospital nearly every hour in the United States, for a rate of 20 per day. Of those, more than 6% died, but the authors also focused on the enormous costs, both in terms of dollars and suffering, paid by the other 94%. I hope parents and policy makers will take note of this study. I dream of a day when, if I want to watch someone endure a long, painful, completely preventable ordeal, my only choice will be to watch highlights of Superbowl XLVIII.
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.
Are you among the half of Americans who are furious at the Denver Broncos? Because I sure am. After marrying a Colorado native, I decided that I would finally, at age 45, try being a football fan. I don’t mean crazy fandom, like where I could name all the players, I just mean, like, follow the game and care kind of fandom. You can overdo these things.
So I’m sitting on the couch with my kids watching the Super Bowl and fighting over the guacamole, when bam! Denver scores a safety! Or is it Seattle that scores the safety, since they get the points, even though Denver moved the ball? My point is, right away I had to Google “safety American football” so I could tell my kids why our team started losing milliseconds into the big game. From there, it was just one Google search after another: “fumble,” “interception,” “incomplete pass,” “kickoff return for a touchdown,” and “ignominious.” I’m just glad they started the game with Renee Fleming. She has been in my fantasy opera company ever since the Met crushed Glimmerglass at Lincoln Center.
Silly rabbit
I’m pretty sure acute bacterial sinusitis is the third most common reason pediatricians prescribe antibiotics, right behind acute otitis media and I-can’t-stand-here-arguing-with-you-anymore. But as a med-peds guy, I’ve always wondered why it is that we use antibiotics for sinusitis in kids when they’re not indicated for the same disease in adults? What is this, a Trixx commercial?
A new study in the Journal of Pediatrics suggests that perhaps not all pediatric sinusitis is created equal. Researchers in Pittsburgh correlated antibiotic response with nasal cultures looking for common pathogens. While their samples turned up Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, kids with the strep responded to treatment much faster than those harboring other bugs. I should clarify: “Fast” in this study meant a median 6.5 days to symptom resolution as opposed to 8.5 days. By that measure, “fast” would also refer to the Broncos defense.
Buried in the study, however, were other data that really gave me pause. In 54% of the study population, the overall time to resolution of symptoms was 10-19 days, and in 27% it was 20-30 days. These were kids with radiographic evidence of sinusitis who received antibiotics. I’m not thinking this is what parents have in mind when they ask, “Can you give him antibiotics and make him better?” Why yes! In only 10-30 days! I’m not saying we change the treatment guidelines just yet. For now, that’s one fewer thing I have to stand around and argue about.
Big kids
New data from the Early Childhood Longitudinal Study published in the New England Journal of Medicine suggest that our efforts to curb obesity in late childhood and adolescence may occur after the horse is out of barn. Actually, the horse left the barn a while back, strolled out for some fries, and is now sitting in front of the TV with a large soda. According to study author Solveig Cunningham of Emory University, Atlanta, half of childhood obesity occurs in children who are already overweight by the preschool years, with the steepest rise in obesity striking between first and third grade. We’re talking about teaching kids to read food labels when the problem starts before most kids learn to read.
Given that some data implicate fetal and neonatal weight gain in lifetime obesity, I think it’s never too early to start building healthy habits. That’s why I’m launching a new fitness fad I’m calling “Cross-Fetus.” Cross-fetuses will learn basic exercises like leg curls, uterus kicks, and hiccups, which they will repeat, again, faster, until they have sucking blisters. Is that amniotic fluid or sweat? Who knows? Does it matter? Classes will begin as soon as I can figure out how to bring out the competitive spirit in a being that doesn’t know anyone else exists. When I find out, I promise to tell Broncos coach John Fox.
Smoking guns
At our practice, we ask every family at nearly every visit about firearms in the home, and parents sometimes want to know why. I love those moments, because despite what some outsiders may think of North Carolina (that we probably have more guns per capita then we have toothbrushes), I find that the vast majority of my families “get it” when we talk about firearm safety and kids. The handful who don’t already suspected that I was a United Nations secret agent when they saw me rappel into work from a black helicopter. Oops, I’ve said too much.
I can now point doubtful parents to a new study of firearm hospitalizations and deaths, demonstrating that gun injuries send one child or teen to the hospital nearly every hour in the United States, for a rate of 20 per day. Of those, more than 6% died, but the authors also focused on the enormous costs, both in terms of dollars and suffering, paid by the other 94%. I hope parents and policy makers will take note of this study. I dream of a day when, if I want to watch someone endure a long, painful, completely preventable ordeal, my only choice will be to watch highlights of Superbowl XLVIII.
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.
Are you among the half of Americans who are furious at the Denver Broncos? Because I sure am. After marrying a Colorado native, I decided that I would finally, at age 45, try being a football fan. I don’t mean crazy fandom, like where I could name all the players, I just mean, like, follow the game and care kind of fandom. You can overdo these things.
So I’m sitting on the couch with my kids watching the Super Bowl and fighting over the guacamole, when bam! Denver scores a safety! Or is it Seattle that scores the safety, since they get the points, even though Denver moved the ball? My point is, right away I had to Google “safety American football” so I could tell my kids why our team started losing milliseconds into the big game. From there, it was just one Google search after another: “fumble,” “interception,” “incomplete pass,” “kickoff return for a touchdown,” and “ignominious.” I’m just glad they started the game with Renee Fleming. She has been in my fantasy opera company ever since the Met crushed Glimmerglass at Lincoln Center.
Silly rabbit
I’m pretty sure acute bacterial sinusitis is the third most common reason pediatricians prescribe antibiotics, right behind acute otitis media and I-can’t-stand-here-arguing-with-you-anymore. But as a med-peds guy, I’ve always wondered why it is that we use antibiotics for sinusitis in kids when they’re not indicated for the same disease in adults? What is this, a Trixx commercial?
A new study in the Journal of Pediatrics suggests that perhaps not all pediatric sinusitis is created equal. Researchers in Pittsburgh correlated antibiotic response with nasal cultures looking for common pathogens. While their samples turned up Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, kids with the strep responded to treatment much faster than those harboring other bugs. I should clarify: “Fast” in this study meant a median 6.5 days to symptom resolution as opposed to 8.5 days. By that measure, “fast” would also refer to the Broncos defense.
Buried in the study, however, were other data that really gave me pause. In 54% of the study population, the overall time to resolution of symptoms was 10-19 days, and in 27% it was 20-30 days. These were kids with radiographic evidence of sinusitis who received antibiotics. I’m not thinking this is what parents have in mind when they ask, “Can you give him antibiotics and make him better?” Why yes! In only 10-30 days! I’m not saying we change the treatment guidelines just yet. For now, that’s one fewer thing I have to stand around and argue about.
Big kids
New data from the Early Childhood Longitudinal Study published in the New England Journal of Medicine suggest that our efforts to curb obesity in late childhood and adolescence may occur after the horse is out of barn. Actually, the horse left the barn a while back, strolled out for some fries, and is now sitting in front of the TV with a large soda. According to study author Solveig Cunningham of Emory University, Atlanta, half of childhood obesity occurs in children who are already overweight by the preschool years, with the steepest rise in obesity striking between first and third grade. We’re talking about teaching kids to read food labels when the problem starts before most kids learn to read.
Given that some data implicate fetal and neonatal weight gain in lifetime obesity, I think it’s never too early to start building healthy habits. That’s why I’m launching a new fitness fad I’m calling “Cross-Fetus.” Cross-fetuses will learn basic exercises like leg curls, uterus kicks, and hiccups, which they will repeat, again, faster, until they have sucking blisters. Is that amniotic fluid or sweat? Who knows? Does it matter? Classes will begin as soon as I can figure out how to bring out the competitive spirit in a being that doesn’t know anyone else exists. When I find out, I promise to tell Broncos coach John Fox.
Smoking guns
At our practice, we ask every family at nearly every visit about firearms in the home, and parents sometimes want to know why. I love those moments, because despite what some outsiders may think of North Carolina (that we probably have more guns per capita then we have toothbrushes), I find that the vast majority of my families “get it” when we talk about firearm safety and kids. The handful who don’t already suspected that I was a United Nations secret agent when they saw me rappel into work from a black helicopter. Oops, I’ve said too much.
I can now point doubtful parents to a new study of firearm hospitalizations and deaths, demonstrating that gun injuries send one child or teen to the hospital nearly every hour in the United States, for a rate of 20 per day. Of those, more than 6% died, but the authors also focused on the enormous costs, both in terms of dollars and suffering, paid by the other 94%. I hope parents and policy makers will take note of this study. I dream of a day when, if I want to watch someone endure a long, painful, completely preventable ordeal, my only choice will be to watch highlights of Superbowl XLVIII.
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.
The line in winter
January is a weird month in our house. All the holiday bustle and travel are behind us, and the kids are as bored as if they hadn’t just unwrapped a big-box store’s worth of toys, books, and electronics. It’s the time of year when we eye the Crock-Pot and say to ourselves, “Tomorrow, we’re going to get that thing down and find a really good recipe.” It’s the time when I pretend to take an interest in football, faking it like a student who has been snoozing through the entire class and just woke up when called on: “Peyton Manning! Richard Sherman! Snow! Defense! What was the question?” Alas, this month, too, shall end, right after I bring the plants inside. And take them back out. And bring them in again....
Downer
Is it just me, or do I sense a little judgment in the new Journal of Developmental & Behavioral Pediatrics article about depression treatment in teens? Lead author Dr. Ana Radovic of Children’s Hospital of Pittsburgh and her colleagues presented 58 primary care providers with two hypothetical cases describing 15-year-old girls and asked participants what they would do as part of their initial treatment regimen. One of the girls met criteria for moderate depression, while the other was severely depressed; neither was suicidal.
Even for the severely depressed patient, less than a third of providers said they would prescribe an antidepressant, which the authors apparently found ... depressing. On the bright side, around 90% of providers would send the severely depressed girl to a psychiatrist, which in my community means she would be receiving appropriate care in a quick 6 to 9 months.
Most perplexing were the results for the moderately depressed patient. Not only did just a quarter of respondents say they’d prescribe medication for her, but only 60% wanted to send her to a psychiatrist. Presumably the other 40% simply felt she should maybe put on some sweatpants and watch a Lifetime movie with a bowl of butter brickle.
Providers who were more educated about depression and those with co-located mental health providers scored much better than their peers did on providing appropriate care, suggesting ways mental health care might be improved. But unless there’s some kind of massive invasion of psychiatrists on the way, primary care providers are going to have to overcome our anxiety about treating depression, or the outcomes are going to be sad.
Head of programming
When my parents told me that watching too much television would rot my brain, boy were they wrong! Thanks to a new study correlating kids’ TV viewing with MRI results and IQ scores, we now know that watching television increases the regional gray matter/white matter volume index of the frontopolar and medial prefrontal areas, the hypothalamus/septum and sensorimotor areas, and the visual cortex, leading to measurable comparative deficits in language processing. I could have told my folks all that, but I was too busy watching The Dukes of Hazzard.
The part of this report that trips people up is that, among the 133 boys and 143 girls whose brains were scanned over time for the study, those who watched the most television (up to 4 hours a day) actually had larger volumes in the affected brain areas. Lead author Ryuta Kawahima of Tohoku (Japan) University explains that the increased gray matter volumes reflect a failure of dendritic pruning, or in my parents’ terms, brain rot. The regions of bushy neurons correspond with brain areas responsible for verbal competence, aggression, and physical activity, all shown in the past to be affected by prolonged TV viewing.
Unlike my parents, I’m now armed with a critique of my kids’ TV viewing that’s informed by modern neuroscience. Next time I see them glued to the tube, I’m going to say, “Turn that thing off, or I swear I’m going to come in there and trim those frontopolar and medial prefrontal dendrites myself!”
Buzz kill
Do you find it a little disturbing that food manufacturers are now adding caffeine to all sorts of products where it doesn’t belong? I know to look for it in coffee, tea, even chocolate, because, you know, that’s where it grows. But when my youngest son couldn’t sleep, I had to consider his love of Perky Turkey Jerky, a healthy-sounding, high-protein snack that for no apparent reason includes caffeine (I have no idea how they got the turkeys to drink that much coffee!). Caffeine has made its way into cookies, graham crackers, puddings, chewing gum, and -- I kid you not -- pie crust. Because the first thing I ask when I eat a slice of pie is, “Wouldn’t this be better if I were having palpitations?”
Apparently some of the scientists at the Institute of Medicine are just as perplexed, at least according to the proceedings of a recent workshop they held on the issue. The timing was not a coincidence; the Food and Drug Administration is starting to consider whether pumping large doses of a stimulant into kids’ favorite foodstuffs is actually a good idea. Personally, I’m not a fan. Unless, of course, it could make January go by faster.
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.
January is a weird month in our house. All the holiday bustle and travel are behind us, and the kids are as bored as if they hadn’t just unwrapped a big-box store’s worth of toys, books, and electronics. It’s the time of year when we eye the Crock-Pot and say to ourselves, “Tomorrow, we’re going to get that thing down and find a really good recipe.” It’s the time when I pretend to take an interest in football, faking it like a student who has been snoozing through the entire class and just woke up when called on: “Peyton Manning! Richard Sherman! Snow! Defense! What was the question?” Alas, this month, too, shall end, right after I bring the plants inside. And take them back out. And bring them in again....
Downer
Is it just me, or do I sense a little judgment in the new Journal of Developmental & Behavioral Pediatrics article about depression treatment in teens? Lead author Dr. Ana Radovic of Children’s Hospital of Pittsburgh and her colleagues presented 58 primary care providers with two hypothetical cases describing 15-year-old girls and asked participants what they would do as part of their initial treatment regimen. One of the girls met criteria for moderate depression, while the other was severely depressed; neither was suicidal.
Even for the severely depressed patient, less than a third of providers said they would prescribe an antidepressant, which the authors apparently found ... depressing. On the bright side, around 90% of providers would send the severely depressed girl to a psychiatrist, which in my community means she would be receiving appropriate care in a quick 6 to 9 months.
Most perplexing were the results for the moderately depressed patient. Not only did just a quarter of respondents say they’d prescribe medication for her, but only 60% wanted to send her to a psychiatrist. Presumably the other 40% simply felt she should maybe put on some sweatpants and watch a Lifetime movie with a bowl of butter brickle.
Providers who were more educated about depression and those with co-located mental health providers scored much better than their peers did on providing appropriate care, suggesting ways mental health care might be improved. But unless there’s some kind of massive invasion of psychiatrists on the way, primary care providers are going to have to overcome our anxiety about treating depression, or the outcomes are going to be sad.
Head of programming
When my parents told me that watching too much television would rot my brain, boy were they wrong! Thanks to a new study correlating kids’ TV viewing with MRI results and IQ scores, we now know that watching television increases the regional gray matter/white matter volume index of the frontopolar and medial prefrontal areas, the hypothalamus/septum and sensorimotor areas, and the visual cortex, leading to measurable comparative deficits in language processing. I could have told my folks all that, but I was too busy watching The Dukes of Hazzard.
The part of this report that trips people up is that, among the 133 boys and 143 girls whose brains were scanned over time for the study, those who watched the most television (up to 4 hours a day) actually had larger volumes in the affected brain areas. Lead author Ryuta Kawahima of Tohoku (Japan) University explains that the increased gray matter volumes reflect a failure of dendritic pruning, or in my parents’ terms, brain rot. The regions of bushy neurons correspond with brain areas responsible for verbal competence, aggression, and physical activity, all shown in the past to be affected by prolonged TV viewing.
Unlike my parents, I’m now armed with a critique of my kids’ TV viewing that’s informed by modern neuroscience. Next time I see them glued to the tube, I’m going to say, “Turn that thing off, or I swear I’m going to come in there and trim those frontopolar and medial prefrontal dendrites myself!”
Buzz kill
Do you find it a little disturbing that food manufacturers are now adding caffeine to all sorts of products where it doesn’t belong? I know to look for it in coffee, tea, even chocolate, because, you know, that’s where it grows. But when my youngest son couldn’t sleep, I had to consider his love of Perky Turkey Jerky, a healthy-sounding, high-protein snack that for no apparent reason includes caffeine (I have no idea how they got the turkeys to drink that much coffee!). Caffeine has made its way into cookies, graham crackers, puddings, chewing gum, and -- I kid you not -- pie crust. Because the first thing I ask when I eat a slice of pie is, “Wouldn’t this be better if I were having palpitations?”
Apparently some of the scientists at the Institute of Medicine are just as perplexed, at least according to the proceedings of a recent workshop they held on the issue. The timing was not a coincidence; the Food and Drug Administration is starting to consider whether pumping large doses of a stimulant into kids’ favorite foodstuffs is actually a good idea. Personally, I’m not a fan. Unless, of course, it could make January go by faster.
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.
January is a weird month in our house. All the holiday bustle and travel are behind us, and the kids are as bored as if they hadn’t just unwrapped a big-box store’s worth of toys, books, and electronics. It’s the time of year when we eye the Crock-Pot and say to ourselves, “Tomorrow, we’re going to get that thing down and find a really good recipe.” It’s the time when I pretend to take an interest in football, faking it like a student who has been snoozing through the entire class and just woke up when called on: “Peyton Manning! Richard Sherman! Snow! Defense! What was the question?” Alas, this month, too, shall end, right after I bring the plants inside. And take them back out. And bring them in again....
Downer
Is it just me, or do I sense a little judgment in the new Journal of Developmental & Behavioral Pediatrics article about depression treatment in teens? Lead author Dr. Ana Radovic of Children’s Hospital of Pittsburgh and her colleagues presented 58 primary care providers with two hypothetical cases describing 15-year-old girls and asked participants what they would do as part of their initial treatment regimen. One of the girls met criteria for moderate depression, while the other was severely depressed; neither was suicidal.
Even for the severely depressed patient, less than a third of providers said they would prescribe an antidepressant, which the authors apparently found ... depressing. On the bright side, around 90% of providers would send the severely depressed girl to a psychiatrist, which in my community means she would be receiving appropriate care in a quick 6 to 9 months.
Most perplexing were the results for the moderately depressed patient. Not only did just a quarter of respondents say they’d prescribe medication for her, but only 60% wanted to send her to a psychiatrist. Presumably the other 40% simply felt she should maybe put on some sweatpants and watch a Lifetime movie with a bowl of butter brickle.
Providers who were more educated about depression and those with co-located mental health providers scored much better than their peers did on providing appropriate care, suggesting ways mental health care might be improved. But unless there’s some kind of massive invasion of psychiatrists on the way, primary care providers are going to have to overcome our anxiety about treating depression, or the outcomes are going to be sad.
Head of programming
When my parents told me that watching too much television would rot my brain, boy were they wrong! Thanks to a new study correlating kids’ TV viewing with MRI results and IQ scores, we now know that watching television increases the regional gray matter/white matter volume index of the frontopolar and medial prefrontal areas, the hypothalamus/septum and sensorimotor areas, and the visual cortex, leading to measurable comparative deficits in language processing. I could have told my folks all that, but I was too busy watching The Dukes of Hazzard.
The part of this report that trips people up is that, among the 133 boys and 143 girls whose brains were scanned over time for the study, those who watched the most television (up to 4 hours a day) actually had larger volumes in the affected brain areas. Lead author Ryuta Kawahima of Tohoku (Japan) University explains that the increased gray matter volumes reflect a failure of dendritic pruning, or in my parents’ terms, brain rot. The regions of bushy neurons correspond with brain areas responsible for verbal competence, aggression, and physical activity, all shown in the past to be affected by prolonged TV viewing.
Unlike my parents, I’m now armed with a critique of my kids’ TV viewing that’s informed by modern neuroscience. Next time I see them glued to the tube, I’m going to say, “Turn that thing off, or I swear I’m going to come in there and trim those frontopolar and medial prefrontal dendrites myself!”
Buzz kill
Do you find it a little disturbing that food manufacturers are now adding caffeine to all sorts of products where it doesn’t belong? I know to look for it in coffee, tea, even chocolate, because, you know, that’s where it grows. But when my youngest son couldn’t sleep, I had to consider his love of Perky Turkey Jerky, a healthy-sounding, high-protein snack that for no apparent reason includes caffeine (I have no idea how they got the turkeys to drink that much coffee!). Caffeine has made its way into cookies, graham crackers, puddings, chewing gum, and -- I kid you not -- pie crust. Because the first thing I ask when I eat a slice of pie is, “Wouldn’t this be better if I were having palpitations?”
Apparently some of the scientists at the Institute of Medicine are just as perplexed, at least according to the proceedings of a recent workshop they held on the issue. The timing was not a coincidence; the Food and Drug Administration is starting to consider whether pumping large doses of a stimulant into kids’ favorite foodstuffs is actually a good idea. Personally, I’m not a fan. Unless, of course, it could make January go by faster.
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.
Bait and switch
Welcome to the wonder that is 2014! (Can you feel it already?) Our Christmas was good, but then we were not swimming in the Parana River in Rosario, Argentina, like the 70 bathers who were attacked by piranhas while trying to escape a 100-degree heat wave. Some lost parts of digits, but there were no deaths, the piranhas having just skeletonized a cow.
While the story was widely reported in the media, few outlets carried the fact that I find most alarming: within 30 minutes of the attack, people were back in the water. I want to meet that first guy (and you know it was a dude) who was, like, “Well, I don’t see any more fish, so I’m going in!” That’s who I want with me in 2014, on Black Friday.
A nice CHAT
Do you find some questions unclear? Like last night, my wife asked me, "Honey, would you like to come help me fold laundry?" and I said, "No, I'm watching TV." Based on her reaction, I think I missed something. Few places in pediatrics are more fraught with unclear questions than the Modified Checklist for Autism in Toddlers (M-CHAT), a developmental screening tool we use for all 18- and 24-month-old children in our office.
Perhaps you’ve never had to administer an M-CHAT, but the version we give includes 23 questions about normal development. Some are straightforward, like #16. "Does your child walk?” Others are so unclear that they inevitably lead to a 5-minute conversation with worried parents (15 minutes for the upper-income brackets): #22. "Does your child sometimes stare at nothing or wander with no purpose?” Heck, I sometimes stare at nothing and, at age 45, purposeless wandering is how I exercise!
The study’s designer, Diana Roberts, Ph.D., must have gotten tired of calming down parents herself, because she and her research team just developed and validated a shorter, clearer version of the test, the Modified Checklist for Autism in Toddlers, Revised With Follow-Up (M-CHAT-R/F). The new test comes with only 20 questions, and she eliminated altogether the dreaded #22. The M-CHAT-R/F has a nearly 50% positive predictive value for identifying autism spectrum disorders and is 95% accurate in detecting any developmental problem or concern. This is going to be great for our office, but what I need now is a similar instrument that will keep me out of trouble 95% of the time.
Talk the talk
Okay, fellow pediatricians, what are you talking about during your adolescent health maintenance visits? According to research done right here of North Carolina, we’re spending only 36 seconds on average discussing sex and sexuality with our teen patients, and the way we talk here in the South, that’s not even time for a whole sentence! Does the scoliosis check really take that long?
Investigators recorded and analyzed 253 teen wellness exams, counting time that doctors spent on sexual history-taking and counseling. In 35% of visits, the issue didn’t come up at all. Did I mention the patients were all adolescents? We all know that about 50% of high school students are sexually active, right? And that sexual activity can lead to, like, diseases and pregnancy and stuff? Just checking.
The study offers more disappointments, which at least put the findings in context, in a depressing way. The average face-to-face time teens spent with their doctors during wellness visits was only 9 minutes, which, in the South, is how long it takes us to say “hello.” Many doctors did not talk privately with the teens, even though N.C. state law explicitly protects this privilege. I, for one, hope this study starts a conversation within our profession, one that lasts longer than 36 seconds.
Gummed up
I just finished watching a local production of "Willy Wonka the Musical," and I was struck that I share something with author Roald Dahl: a serious dislike of chewing gum, in both noun and verb forms. Apparently, Dr. Nathan Watemberg of the Child Neurology Unit and Child Development Center, Meir Medical Center, Tel Aviv University agrees, since he and his colleagues got a whole grant to study the impact of prolonged gum-chewing on pediatric migraines.
He found that of 30 young chicle-loving migraineurs, 19 were able to completely eliminate their headaches simply by sticking their gum permanently under a table where someone else would find it and be all grossed out. Six more experienced substantial relief by flicking their gum on the sidewalk, where it would stick to someone’s shoe and get tracked into the house and ruin the carpet.
Soon, I hope, “Don’t chew gum, it will give you a migraine!” will enter the pantheon of classic parental advice, alongside my personal favorite, “Don’t swim within 30 minutes of eating or a mass piranha attack.”
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.
Welcome to the wonder that is 2014! (Can you feel it already?) Our Christmas was good, but then we were not swimming in the Parana River in Rosario, Argentina, like the 70 bathers who were attacked by piranhas while trying to escape a 100-degree heat wave. Some lost parts of digits, but there were no deaths, the piranhas having just skeletonized a cow.
While the story was widely reported in the media, few outlets carried the fact that I find most alarming: within 30 minutes of the attack, people were back in the water. I want to meet that first guy (and you know it was a dude) who was, like, “Well, I don’t see any more fish, so I’m going in!” That’s who I want with me in 2014, on Black Friday.
A nice CHAT
Do you find some questions unclear? Like last night, my wife asked me, "Honey, would you like to come help me fold laundry?" and I said, "No, I'm watching TV." Based on her reaction, I think I missed something. Few places in pediatrics are more fraught with unclear questions than the Modified Checklist for Autism in Toddlers (M-CHAT), a developmental screening tool we use for all 18- and 24-month-old children in our office.
Perhaps you’ve never had to administer an M-CHAT, but the version we give includes 23 questions about normal development. Some are straightforward, like #16. "Does your child walk?” Others are so unclear that they inevitably lead to a 5-minute conversation with worried parents (15 minutes for the upper-income brackets): #22. "Does your child sometimes stare at nothing or wander with no purpose?” Heck, I sometimes stare at nothing and, at age 45, purposeless wandering is how I exercise!
The study’s designer, Diana Roberts, Ph.D., must have gotten tired of calming down parents herself, because she and her research team just developed and validated a shorter, clearer version of the test, the Modified Checklist for Autism in Toddlers, Revised With Follow-Up (M-CHAT-R/F). The new test comes with only 20 questions, and she eliminated altogether the dreaded #22. The M-CHAT-R/F has a nearly 50% positive predictive value for identifying autism spectrum disorders and is 95% accurate in detecting any developmental problem or concern. This is going to be great for our office, but what I need now is a similar instrument that will keep me out of trouble 95% of the time.
Talk the talk
Okay, fellow pediatricians, what are you talking about during your adolescent health maintenance visits? According to research done right here of North Carolina, we’re spending only 36 seconds on average discussing sex and sexuality with our teen patients, and the way we talk here in the South, that’s not even time for a whole sentence! Does the scoliosis check really take that long?
Investigators recorded and analyzed 253 teen wellness exams, counting time that doctors spent on sexual history-taking and counseling. In 35% of visits, the issue didn’t come up at all. Did I mention the patients were all adolescents? We all know that about 50% of high school students are sexually active, right? And that sexual activity can lead to, like, diseases and pregnancy and stuff? Just checking.
The study offers more disappointments, which at least put the findings in context, in a depressing way. The average face-to-face time teens spent with their doctors during wellness visits was only 9 minutes, which, in the South, is how long it takes us to say “hello.” Many doctors did not talk privately with the teens, even though N.C. state law explicitly protects this privilege. I, for one, hope this study starts a conversation within our profession, one that lasts longer than 36 seconds.
Gummed up
I just finished watching a local production of "Willy Wonka the Musical," and I was struck that I share something with author Roald Dahl: a serious dislike of chewing gum, in both noun and verb forms. Apparently, Dr. Nathan Watemberg of the Child Neurology Unit and Child Development Center, Meir Medical Center, Tel Aviv University agrees, since he and his colleagues got a whole grant to study the impact of prolonged gum-chewing on pediatric migraines.
He found that of 30 young chicle-loving migraineurs, 19 were able to completely eliminate their headaches simply by sticking their gum permanently under a table where someone else would find it and be all grossed out. Six more experienced substantial relief by flicking their gum on the sidewalk, where it would stick to someone’s shoe and get tracked into the house and ruin the carpet.
Soon, I hope, “Don’t chew gum, it will give you a migraine!” will enter the pantheon of classic parental advice, alongside my personal favorite, “Don’t swim within 30 minutes of eating or a mass piranha attack.”
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.
Welcome to the wonder that is 2014! (Can you feel it already?) Our Christmas was good, but then we were not swimming in the Parana River in Rosario, Argentina, like the 70 bathers who were attacked by piranhas while trying to escape a 100-degree heat wave. Some lost parts of digits, but there were no deaths, the piranhas having just skeletonized a cow.
While the story was widely reported in the media, few outlets carried the fact that I find most alarming: within 30 minutes of the attack, people were back in the water. I want to meet that first guy (and you know it was a dude) who was, like, “Well, I don’t see any more fish, so I’m going in!” That’s who I want with me in 2014, on Black Friday.
A nice CHAT
Do you find some questions unclear? Like last night, my wife asked me, "Honey, would you like to come help me fold laundry?" and I said, "No, I'm watching TV." Based on her reaction, I think I missed something. Few places in pediatrics are more fraught with unclear questions than the Modified Checklist for Autism in Toddlers (M-CHAT), a developmental screening tool we use for all 18- and 24-month-old children in our office.
Perhaps you’ve never had to administer an M-CHAT, but the version we give includes 23 questions about normal development. Some are straightforward, like #16. "Does your child walk?” Others are so unclear that they inevitably lead to a 5-minute conversation with worried parents (15 minutes for the upper-income brackets): #22. "Does your child sometimes stare at nothing or wander with no purpose?” Heck, I sometimes stare at nothing and, at age 45, purposeless wandering is how I exercise!
The study’s designer, Diana Roberts, Ph.D., must have gotten tired of calming down parents herself, because she and her research team just developed and validated a shorter, clearer version of the test, the Modified Checklist for Autism in Toddlers, Revised With Follow-Up (M-CHAT-R/F). The new test comes with only 20 questions, and she eliminated altogether the dreaded #22. The M-CHAT-R/F has a nearly 50% positive predictive value for identifying autism spectrum disorders and is 95% accurate in detecting any developmental problem or concern. This is going to be great for our office, but what I need now is a similar instrument that will keep me out of trouble 95% of the time.
Talk the talk
Okay, fellow pediatricians, what are you talking about during your adolescent health maintenance visits? According to research done right here of North Carolina, we’re spending only 36 seconds on average discussing sex and sexuality with our teen patients, and the way we talk here in the South, that’s not even time for a whole sentence! Does the scoliosis check really take that long?
Investigators recorded and analyzed 253 teen wellness exams, counting time that doctors spent on sexual history-taking and counseling. In 35% of visits, the issue didn’t come up at all. Did I mention the patients were all adolescents? We all know that about 50% of high school students are sexually active, right? And that sexual activity can lead to, like, diseases and pregnancy and stuff? Just checking.
The study offers more disappointments, which at least put the findings in context, in a depressing way. The average face-to-face time teens spent with their doctors during wellness visits was only 9 minutes, which, in the South, is how long it takes us to say “hello.” Many doctors did not talk privately with the teens, even though N.C. state law explicitly protects this privilege. I, for one, hope this study starts a conversation within our profession, one that lasts longer than 36 seconds.
Gummed up
I just finished watching a local production of "Willy Wonka the Musical," and I was struck that I share something with author Roald Dahl: a serious dislike of chewing gum, in both noun and verb forms. Apparently, Dr. Nathan Watemberg of the Child Neurology Unit and Child Development Center, Meir Medical Center, Tel Aviv University agrees, since he and his colleagues got a whole grant to study the impact of prolonged gum-chewing on pediatric migraines.
He found that of 30 young chicle-loving migraineurs, 19 were able to completely eliminate their headaches simply by sticking their gum permanently under a table where someone else would find it and be all grossed out. Six more experienced substantial relief by flicking their gum on the sidewalk, where it would stick to someone’s shoe and get tracked into the house and ruin the carpet.
Soon, I hope, “Don’t chew gum, it will give you a migraine!” will enter the pantheon of classic parental advice, alongside my personal favorite, “Don’t swim within 30 minutes of eating or a mass piranha attack.”
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.
Holly folly
One of my friends asked on Facebook today why we couldn’t treat the whole year like the holiday season. Why? Because parents around the world would riot, that’s why! Do all these chorus teachers, band leaders, and dance instructors realize I have five children? I mean the shows are sweet and all, but by the fifth evening spent in a wooden auditorium chair, the only reason I’m there is in hopes of videoing some catastrophe so spectacular that it goes viral on YouTube. Santa, baby, hurry down the chimney tonight...so I can finally get back to accomplishing anything!
Head for the hills
I have spent my whole life at sea level, generally in places so hot and humid that Spanish moss grows wild...indoors. But since marrying a Colorado native, I’ve come to appreciate altitude. I thought the fabled “Rocky Mountain High” was poetic license; now I know it’s hypoxia. But according to new research from Cincinnati Children’s Hospital, all that altitude-induced brain swelling may serve a surprisingly useful purpose: It seems to protect young athletes from concussions.
My first question is what in the world inspired the researchers to look at this question in the first place? Did one of them, like me, feel his brain starting to swell during the Bolder Boulder 10K Race (real motto: “Sea Level Is for Sissies”) and think, “Wow, if I actually pass out and hit my head right now, I bet I’ll be fine!”? Regardless of the inspiration, the investigators found that playing at an elevation of a mere 600 feet above sea level was enough to reduce concussions among high school athletes by 30%. This compares favorably to football helmets, which, according to a report earlier this year, appear to reduce concussion rates by 0%.
I imagine the folks at the National Football League are following this research carefully, hoping to minimize their liability for chronic traumatic encephalopathy. Sure, some teams (cough, Broncos, cough) are lucky enough to play at a safer altitude, but what about teams who play at sea level like the Dolphins and the Texans? What about the Saints, who actually play below sea level?
Don’t worry, I’ve got the answer. As expensive as new football stadiums are, would it really cost that much more to make them 54 stories tall? Let’s put some meaning in the words “sky box.” Let’s make sure every seat is in the nosebleed section. Build stadiums so tall they’ll have to rename touch downs “touch ups.” Laugh all you want, but remember, you heard it here first, folks.
Baby Yankovic
There are certain assumptions in life that I just need to be true, and I don’t appreciate it when some “scientist” comes along and questions them. For example, if I don’t eat any gluten for 5 months (Gluten, why oh why must you taste so good!?), I will have a six-pack by March. If I don’t, I swear I’m sitting down with a loaf of Wonder, a knife, and two sticks of Irish butter. And if I spend $32 a month to rent a trombone for my 12-year-old, I expect him to go to Harvard. Next year.
Except maybe I’ll send him to MIT instead. Because Harvard is where they just released a study in PLOSone suggesting that music lessons don’t make kids any smarter. Frankly, I have some issues with the study design that make me question whether the investigators took enough music lessons as children.
First, what they called “music lessons” were really just 6 weeks of “mommy and me” classes for 4-year-olds. No one expects a kid to found the next Twitter after 4 1/2 hours of playing the xylophone in a parent’s lap. A rigorous study would have forced children to saw away on Suzuki violins nightly for 5 years, but no ethical Human Subjects Committee would approve that; the benefit to science would be far less than the permanent damage to parents’ mental health, and that’s before factoring in the additional holiday recitals.
Shocking Chair
Sometimes it’s good to know you’re being heard, even partially. Like last night, when I asked my 9-year-old to clean up his room and he picked up a dirty sock. There were others, but hey, baby steps. Stinky, smelly baby steps.
I feel the same in my role on the American Academy of Pediatrics Council on Communications and the Media (AAP COCM). Right, we’re the killjoys who suggest that children under age 2 years not watch screen entertainment, based on studies suggesting that it interferes with their development. Just when I thought we were spitting into the wind (actually that’s one of our team-building exercises at AAP headquarters in Chicago).
So I was gratified at the public outrage when Fisher Price introduced their Newborn-to-Toddler Apptivity™ Seat for iPad® device just in time for Christmas shopping. Our friends at Campaign for a Commercial-Free Childhood expressed outrage; they’re nothing if not consistent over there. They were, however, joined by a chorus of parent bloggers and journalists who, apparently, really did skim our last policy statement.
I’m sure the public outcry will cut sales of the item by dozens, even scores. On the up side, children too zombified by staring at screens in infancy will never develop the attention span needed for music lessons, which means the next generation of parents might be spared endless rounds of concerts and recitals. We can ho-ho-hope!
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.
One of my friends asked on Facebook today why we couldn’t treat the whole year like the holiday season. Why? Because parents around the world would riot, that’s why! Do all these chorus teachers, band leaders, and dance instructors realize I have five children? I mean the shows are sweet and all, but by the fifth evening spent in a wooden auditorium chair, the only reason I’m there is in hopes of videoing some catastrophe so spectacular that it goes viral on YouTube. Santa, baby, hurry down the chimney tonight...so I can finally get back to accomplishing anything!
Head for the hills
I have spent my whole life at sea level, generally in places so hot and humid that Spanish moss grows wild...indoors. But since marrying a Colorado native, I’ve come to appreciate altitude. I thought the fabled “Rocky Mountain High” was poetic license; now I know it’s hypoxia. But according to new research from Cincinnati Children’s Hospital, all that altitude-induced brain swelling may serve a surprisingly useful purpose: It seems to protect young athletes from concussions.
My first question is what in the world inspired the researchers to look at this question in the first place? Did one of them, like me, feel his brain starting to swell during the Bolder Boulder 10K Race (real motto: “Sea Level Is for Sissies”) and think, “Wow, if I actually pass out and hit my head right now, I bet I’ll be fine!”? Regardless of the inspiration, the investigators found that playing at an elevation of a mere 600 feet above sea level was enough to reduce concussions among high school athletes by 30%. This compares favorably to football helmets, which, according to a report earlier this year, appear to reduce concussion rates by 0%.
I imagine the folks at the National Football League are following this research carefully, hoping to minimize their liability for chronic traumatic encephalopathy. Sure, some teams (cough, Broncos, cough) are lucky enough to play at a safer altitude, but what about teams who play at sea level like the Dolphins and the Texans? What about the Saints, who actually play below sea level?
Don’t worry, I’ve got the answer. As expensive as new football stadiums are, would it really cost that much more to make them 54 stories tall? Let’s put some meaning in the words “sky box.” Let’s make sure every seat is in the nosebleed section. Build stadiums so tall they’ll have to rename touch downs “touch ups.” Laugh all you want, but remember, you heard it here first, folks.
Baby Yankovic
There are certain assumptions in life that I just need to be true, and I don’t appreciate it when some “scientist” comes along and questions them. For example, if I don’t eat any gluten for 5 months (Gluten, why oh why must you taste so good!?), I will have a six-pack by March. If I don’t, I swear I’m sitting down with a loaf of Wonder, a knife, and two sticks of Irish butter. And if I spend $32 a month to rent a trombone for my 12-year-old, I expect him to go to Harvard. Next year.
Except maybe I’ll send him to MIT instead. Because Harvard is where they just released a study in PLOSone suggesting that music lessons don’t make kids any smarter. Frankly, I have some issues with the study design that make me question whether the investigators took enough music lessons as children.
First, what they called “music lessons” were really just 6 weeks of “mommy and me” classes for 4-year-olds. No one expects a kid to found the next Twitter after 4 1/2 hours of playing the xylophone in a parent’s lap. A rigorous study would have forced children to saw away on Suzuki violins nightly for 5 years, but no ethical Human Subjects Committee would approve that; the benefit to science would be far less than the permanent damage to parents’ mental health, and that’s before factoring in the additional holiday recitals.
Shocking Chair
Sometimes it’s good to know you’re being heard, even partially. Like last night, when I asked my 9-year-old to clean up his room and he picked up a dirty sock. There were others, but hey, baby steps. Stinky, smelly baby steps.
I feel the same in my role on the American Academy of Pediatrics Council on Communications and the Media (AAP COCM). Right, we’re the killjoys who suggest that children under age 2 years not watch screen entertainment, based on studies suggesting that it interferes with their development. Just when I thought we were spitting into the wind (actually that’s one of our team-building exercises at AAP headquarters in Chicago).
So I was gratified at the public outrage when Fisher Price introduced their Newborn-to-Toddler Apptivity™ Seat for iPad® device just in time for Christmas shopping. Our friends at Campaign for a Commercial-Free Childhood expressed outrage; they’re nothing if not consistent over there. They were, however, joined by a chorus of parent bloggers and journalists who, apparently, really did skim our last policy statement.
I’m sure the public outcry will cut sales of the item by dozens, even scores. On the up side, children too zombified by staring at screens in infancy will never develop the attention span needed for music lessons, which means the next generation of parents might be spared endless rounds of concerts and recitals. We can ho-ho-hope!
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.
One of my friends asked on Facebook today why we couldn’t treat the whole year like the holiday season. Why? Because parents around the world would riot, that’s why! Do all these chorus teachers, band leaders, and dance instructors realize I have five children? I mean the shows are sweet and all, but by the fifth evening spent in a wooden auditorium chair, the only reason I’m there is in hopes of videoing some catastrophe so spectacular that it goes viral on YouTube. Santa, baby, hurry down the chimney tonight...so I can finally get back to accomplishing anything!
Head for the hills
I have spent my whole life at sea level, generally in places so hot and humid that Spanish moss grows wild...indoors. But since marrying a Colorado native, I’ve come to appreciate altitude. I thought the fabled “Rocky Mountain High” was poetic license; now I know it’s hypoxia. But according to new research from Cincinnati Children’s Hospital, all that altitude-induced brain swelling may serve a surprisingly useful purpose: It seems to protect young athletes from concussions.
My first question is what in the world inspired the researchers to look at this question in the first place? Did one of them, like me, feel his brain starting to swell during the Bolder Boulder 10K Race (real motto: “Sea Level Is for Sissies”) and think, “Wow, if I actually pass out and hit my head right now, I bet I’ll be fine!”? Regardless of the inspiration, the investigators found that playing at an elevation of a mere 600 feet above sea level was enough to reduce concussions among high school athletes by 30%. This compares favorably to football helmets, which, according to a report earlier this year, appear to reduce concussion rates by 0%.
I imagine the folks at the National Football League are following this research carefully, hoping to minimize their liability for chronic traumatic encephalopathy. Sure, some teams (cough, Broncos, cough) are lucky enough to play at a safer altitude, but what about teams who play at sea level like the Dolphins and the Texans? What about the Saints, who actually play below sea level?
Don’t worry, I’ve got the answer. As expensive as new football stadiums are, would it really cost that much more to make them 54 stories tall? Let’s put some meaning in the words “sky box.” Let’s make sure every seat is in the nosebleed section. Build stadiums so tall they’ll have to rename touch downs “touch ups.” Laugh all you want, but remember, you heard it here first, folks.
Baby Yankovic
There are certain assumptions in life that I just need to be true, and I don’t appreciate it when some “scientist” comes along and questions them. For example, if I don’t eat any gluten for 5 months (Gluten, why oh why must you taste so good!?), I will have a six-pack by March. If I don’t, I swear I’m sitting down with a loaf of Wonder, a knife, and two sticks of Irish butter. And if I spend $32 a month to rent a trombone for my 12-year-old, I expect him to go to Harvard. Next year.
Except maybe I’ll send him to MIT instead. Because Harvard is where they just released a study in PLOSone suggesting that music lessons don’t make kids any smarter. Frankly, I have some issues with the study design that make me question whether the investigators took enough music lessons as children.
First, what they called “music lessons” were really just 6 weeks of “mommy and me” classes for 4-year-olds. No one expects a kid to found the next Twitter after 4 1/2 hours of playing the xylophone in a parent’s lap. A rigorous study would have forced children to saw away on Suzuki violins nightly for 5 years, but no ethical Human Subjects Committee would approve that; the benefit to science would be far less than the permanent damage to parents’ mental health, and that’s before factoring in the additional holiday recitals.
Shocking Chair
Sometimes it’s good to know you’re being heard, even partially. Like last night, when I asked my 9-year-old to clean up his room and he picked up a dirty sock. There were others, but hey, baby steps. Stinky, smelly baby steps.
I feel the same in my role on the American Academy of Pediatrics Council on Communications and the Media (AAP COCM). Right, we’re the killjoys who suggest that children under age 2 years not watch screen entertainment, based on studies suggesting that it interferes with their development. Just when I thought we were spitting into the wind (actually that’s one of our team-building exercises at AAP headquarters in Chicago).
So I was gratified at the public outrage when Fisher Price introduced their Newborn-to-Toddler Apptivity™ Seat for iPad® device just in time for Christmas shopping. Our friends at Campaign for a Commercial-Free Childhood expressed outrage; they’re nothing if not consistent over there. They were, however, joined by a chorus of parent bloggers and journalists who, apparently, really did skim our last policy statement.
I’m sure the public outcry will cut sales of the item by dozens, even scores. On the up side, children too zombified by staring at screens in infancy will never develop the attention span needed for music lessons, which means the next generation of parents might be spared endless rounds of concerts and recitals. We can ho-ho-hope!
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.
Hairy Connick Jr.
Does everyone have that grandmother who uses the holidays to indulge in whimsical gift giving? My Nana Fran is now 95, and she remains savvy enough to scour dozens of catalogs for the most offbeat musical, animated plastic geegaw China can produce and make sure it’s on my doorstep with plenty of time to install the batteries and...stare. This year I’ll need to make room next to the singing snow-couple and the big band gramophone for Maestro Mouse in Love. I can tell you’re just as confused as I was when I read the shipping label.
The box contains one tuxedoed rodent seated at a grand piano, with candelabra. So you’ll know this is a Christmas geegaw, he’s wearing a Santa hat. I would have been plenty impressed at the simple fact that a mouse can put on cuff links, but this one can also play 24 different Christmas carols, reading from little plastic cards (take that, Algernon!).
But what, you ask, would motivate a mouse to master a skill (two skills with the cuff links) that is so frankly impractical in the murine world? Then you notice the she-mouse, perched atop the piano in a clingy red dress and white feather boa, looking all Fabulous Baker Boys. Seriously, you just have to see this thing. Drop by and I’ll pour you some eggnog. But don’t tell Nana Fran.
Beta dog
Despite the existence of clear guidelines recommending treating community-acquired pneumonia with narrow-spectrum antibiotics (usually amoxicillin, but macrolides count), many pediatricians just can’t help reaching for the big guns. Their thinking is that pneumonia is a really serious infection, so if you don’t also wipe out the gut flora, you’re not really trying. A new study in Pediatrics aimed to settle the question of which works better for community-acquired pneumonia, narrow-spectrum or broad-spectrum antibiotics.
Just to make sure they were focusing on seriously ill kids, the investigators included children aged 2 months to 18 years who were admitted to four children’s hospitals in 2010 with a discharge diagnosis of pneumonia. This was, in other words, the ID version that laundry detergent commercial where they first rub the clothes in really nasty dirt. In this case, “which white shirt is cleanest” involved total length of stay, oxygen requirement, duration of fever, and hospital readmission.
So you know who won, right? Ampicillin or ampicillin/sulbactam not only equaled “Brand X” (where “X” stands for 2nd- or 3rd-generation cephalosporins), but the narrow spectrum meds were actually superior when it came to average length of stay. Which is why beta-lactams were used in...wait for it...1/3 of admissions in the study, itself a massive improvement over the 7% rate noted in other surveys of pediatric pneumonia treatment.
Of course one study, even one this well-constructed, won’t change prescribing practices overnight. But next time you treat community-acquired pneumonia, ask yourself, is there any reason at all to use an antibiotic that rhymes with “ref my hack zone” when it might be cheaper, safer, and better to use one that sounds like “damp is chillin’ ”? When in doubt, ask the intestinal flora.
Whirled peas
There are two kinds of people in the world: those who find pictures of toddlers covered in food amusing and those who see those images and experience an overwhelming urge to find a large, damp washcloth (I’m in that second group, which I suspect is secretly a lot bigger than the first one -- people feel pressured to laugh politely when you show them photos of your kids.) But what if those children wearing spaghetti-bowl helmets aren’t just posing for cute greeting cards? What if they’re learning language?
I’d still want to clean them up. But that’s not the point. The point is that Larissa Samuelson and her colleagues from the University of Iowa (clearly members of the first group) actually published a paper in Developmental Science demonstrating that kids who smear strained prunes all over their high chairs are better able to distinguish prunes from pureed peaches and to remember the names of each. They added that the high chairs themselves seemed more conducive to food-related learning than dining room tables, presumably because people like me are constantly wiping up actual furniture, whereas we just put the high chair in the driveway and hose it down. Finally, I understand why my kids still can’t tell avocados from artichokes...and I have no regrets.
Off note
It’s rare that I read a study that completely undermines one of my core beliefs. That might be because I rarely read. Or maybe it’s because I have no core beliefs. Regardless, I am left agape after discovering that researchers at the Brigham and Women’s Hospital found no correlation whatsoever between the content of medical chart notes and the quality of care patients received. That’ll teach me to read.
I am a stickler for complete, accurate, and grammatically correct progress notes. I don’t want to brag, but one of my H&P’s was short-listed for the Man Booker Prize. And to think it didn’t contribute anything to patient care, even though it, “...offered a rare glimpse into the human soul that was simultaneously hilarious and profoundly moving!” (Kirkus Reviews). According to the study, patients with diabetes mellitus and heart disease got equally good care whether or not their doctors mentioned little things like the reason for their visits or their medication lists. Seriously, I give up. If you’re looking for me, I’ll be at home, staring at a piano-playing mouse, at least until December 26th.
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.
Does everyone have that grandmother who uses the holidays to indulge in whimsical gift giving? My Nana Fran is now 95, and she remains savvy enough to scour dozens of catalogs for the most offbeat musical, animated plastic geegaw China can produce and make sure it’s on my doorstep with plenty of time to install the batteries and...stare. This year I’ll need to make room next to the singing snow-couple and the big band gramophone for Maestro Mouse in Love. I can tell you’re just as confused as I was when I read the shipping label.
The box contains one tuxedoed rodent seated at a grand piano, with candelabra. So you’ll know this is a Christmas geegaw, he’s wearing a Santa hat. I would have been plenty impressed at the simple fact that a mouse can put on cuff links, but this one can also play 24 different Christmas carols, reading from little plastic cards (take that, Algernon!).
But what, you ask, would motivate a mouse to master a skill (two skills with the cuff links) that is so frankly impractical in the murine world? Then you notice the she-mouse, perched atop the piano in a clingy red dress and white feather boa, looking all Fabulous Baker Boys. Seriously, you just have to see this thing. Drop by and I’ll pour you some eggnog. But don’t tell Nana Fran.
Beta dog
Despite the existence of clear guidelines recommending treating community-acquired pneumonia with narrow-spectrum antibiotics (usually amoxicillin, but macrolides count), many pediatricians just can’t help reaching for the big guns. Their thinking is that pneumonia is a really serious infection, so if you don’t also wipe out the gut flora, you’re not really trying. A new study in Pediatrics aimed to settle the question of which works better for community-acquired pneumonia, narrow-spectrum or broad-spectrum antibiotics.
Just to make sure they were focusing on seriously ill kids, the investigators included children aged 2 months to 18 years who were admitted to four children’s hospitals in 2010 with a discharge diagnosis of pneumonia. This was, in other words, the ID version that laundry detergent commercial where they first rub the clothes in really nasty dirt. In this case, “which white shirt is cleanest” involved total length of stay, oxygen requirement, duration of fever, and hospital readmission.
So you know who won, right? Ampicillin or ampicillin/sulbactam not only equaled “Brand X” (where “X” stands for 2nd- or 3rd-generation cephalosporins), but the narrow spectrum meds were actually superior when it came to average length of stay. Which is why beta-lactams were used in...wait for it...1/3 of admissions in the study, itself a massive improvement over the 7% rate noted in other surveys of pediatric pneumonia treatment.
Of course one study, even one this well-constructed, won’t change prescribing practices overnight. But next time you treat community-acquired pneumonia, ask yourself, is there any reason at all to use an antibiotic that rhymes with “ref my hack zone” when it might be cheaper, safer, and better to use one that sounds like “damp is chillin’ ”? When in doubt, ask the intestinal flora.
Whirled peas
There are two kinds of people in the world: those who find pictures of toddlers covered in food amusing and those who see those images and experience an overwhelming urge to find a large, damp washcloth (I’m in that second group, which I suspect is secretly a lot bigger than the first one -- people feel pressured to laugh politely when you show them photos of your kids.) But what if those children wearing spaghetti-bowl helmets aren’t just posing for cute greeting cards? What if they’re learning language?
I’d still want to clean them up. But that’s not the point. The point is that Larissa Samuelson and her colleagues from the University of Iowa (clearly members of the first group) actually published a paper in Developmental Science demonstrating that kids who smear strained prunes all over their high chairs are better able to distinguish prunes from pureed peaches and to remember the names of each. They added that the high chairs themselves seemed more conducive to food-related learning than dining room tables, presumably because people like me are constantly wiping up actual furniture, whereas we just put the high chair in the driveway and hose it down. Finally, I understand why my kids still can’t tell avocados from artichokes...and I have no regrets.
Off note
It’s rare that I read a study that completely undermines one of my core beliefs. That might be because I rarely read. Or maybe it’s because I have no core beliefs. Regardless, I am left agape after discovering that researchers at the Brigham and Women’s Hospital found no correlation whatsoever between the content of medical chart notes and the quality of care patients received. That’ll teach me to read.
I am a stickler for complete, accurate, and grammatically correct progress notes. I don’t want to brag, but one of my H&P’s was short-listed for the Man Booker Prize. And to think it didn’t contribute anything to patient care, even though it, “...offered a rare glimpse into the human soul that was simultaneously hilarious and profoundly moving!” (Kirkus Reviews). According to the study, patients with diabetes mellitus and heart disease got equally good care whether or not their doctors mentioned little things like the reason for their visits or their medication lists. Seriously, I give up. If you’re looking for me, I’ll be at home, staring at a piano-playing mouse, at least until December 26th.
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.
Does everyone have that grandmother who uses the holidays to indulge in whimsical gift giving? My Nana Fran is now 95, and she remains savvy enough to scour dozens of catalogs for the most offbeat musical, animated plastic geegaw China can produce and make sure it’s on my doorstep with plenty of time to install the batteries and...stare. This year I’ll need to make room next to the singing snow-couple and the big band gramophone for Maestro Mouse in Love. I can tell you’re just as confused as I was when I read the shipping label.
The box contains one tuxedoed rodent seated at a grand piano, with candelabra. So you’ll know this is a Christmas geegaw, he’s wearing a Santa hat. I would have been plenty impressed at the simple fact that a mouse can put on cuff links, but this one can also play 24 different Christmas carols, reading from little plastic cards (take that, Algernon!).
But what, you ask, would motivate a mouse to master a skill (two skills with the cuff links) that is so frankly impractical in the murine world? Then you notice the she-mouse, perched atop the piano in a clingy red dress and white feather boa, looking all Fabulous Baker Boys. Seriously, you just have to see this thing. Drop by and I’ll pour you some eggnog. But don’t tell Nana Fran.
Beta dog
Despite the existence of clear guidelines recommending treating community-acquired pneumonia with narrow-spectrum antibiotics (usually amoxicillin, but macrolides count), many pediatricians just can’t help reaching for the big guns. Their thinking is that pneumonia is a really serious infection, so if you don’t also wipe out the gut flora, you’re not really trying. A new study in Pediatrics aimed to settle the question of which works better for community-acquired pneumonia, narrow-spectrum or broad-spectrum antibiotics.
Just to make sure they were focusing on seriously ill kids, the investigators included children aged 2 months to 18 years who were admitted to four children’s hospitals in 2010 with a discharge diagnosis of pneumonia. This was, in other words, the ID version that laundry detergent commercial where they first rub the clothes in really nasty dirt. In this case, “which white shirt is cleanest” involved total length of stay, oxygen requirement, duration of fever, and hospital readmission.
So you know who won, right? Ampicillin or ampicillin/sulbactam not only equaled “Brand X” (where “X” stands for 2nd- or 3rd-generation cephalosporins), but the narrow spectrum meds were actually superior when it came to average length of stay. Which is why beta-lactams were used in...wait for it...1/3 of admissions in the study, itself a massive improvement over the 7% rate noted in other surveys of pediatric pneumonia treatment.
Of course one study, even one this well-constructed, won’t change prescribing practices overnight. But next time you treat community-acquired pneumonia, ask yourself, is there any reason at all to use an antibiotic that rhymes with “ref my hack zone” when it might be cheaper, safer, and better to use one that sounds like “damp is chillin’ ”? When in doubt, ask the intestinal flora.
Whirled peas
There are two kinds of people in the world: those who find pictures of toddlers covered in food amusing and those who see those images and experience an overwhelming urge to find a large, damp washcloth (I’m in that second group, which I suspect is secretly a lot bigger than the first one -- people feel pressured to laugh politely when you show them photos of your kids.) But what if those children wearing spaghetti-bowl helmets aren’t just posing for cute greeting cards? What if they’re learning language?
I’d still want to clean them up. But that’s not the point. The point is that Larissa Samuelson and her colleagues from the University of Iowa (clearly members of the first group) actually published a paper in Developmental Science demonstrating that kids who smear strained prunes all over their high chairs are better able to distinguish prunes from pureed peaches and to remember the names of each. They added that the high chairs themselves seemed more conducive to food-related learning than dining room tables, presumably because people like me are constantly wiping up actual furniture, whereas we just put the high chair in the driveway and hose it down. Finally, I understand why my kids still can’t tell avocados from artichokes...and I have no regrets.
Off note
It’s rare that I read a study that completely undermines one of my core beliefs. That might be because I rarely read. Or maybe it’s because I have no core beliefs. Regardless, I am left agape after discovering that researchers at the Brigham and Women’s Hospital found no correlation whatsoever between the content of medical chart notes and the quality of care patients received. That’ll teach me to read.
I am a stickler for complete, accurate, and grammatically correct progress notes. I don’t want to brag, but one of my H&P’s was short-listed for the Man Booker Prize. And to think it didn’t contribute anything to patient care, even though it, “...offered a rare glimpse into the human soul that was simultaneously hilarious and profoundly moving!” (Kirkus Reviews). According to the study, patients with diabetes mellitus and heart disease got equally good care whether or not their doctors mentioned little things like the reason for their visits or their medication lists. Seriously, I give up. If you’re looking for me, I’ll be at home, staring at a piano-playing mouse, at least until December 26th.
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.
Hashing it out
Are you, like me, asking yourself how long Thanksgiving turkey is safe to eat if refrigerated? Does it matter whether you make sandwiches or soup with it? What if you cook the soup in an autoclave?
I feel like the Puritans get the last laugh in our national festival of gluttony. “Sure,” you can hear them say, “go ahead and gorge yourselves…on turkey!” Seriously, have you ever picked up a menu and said to the waiter, “Let’s see, the lobster looks good, but oh, there’s a filet mignon and the poached salmon… Wait, hold the phone, you have turkey?! Yeah, baby! Done! Bring me the fennel-braised turkey with truffle gravy and foraged wild cranberry compote!” Never. Gonna. Happen. On the up side, I do still have some pie.
PIRG-atory
Overworked humorists and features editors everywhere look forward to the annual “Trouble in Toyland” report from the U.S. Public Interest Research Group (PIRG), a sort of volunteer militia version of the Consumer Product Safety Commission whose members probably sport tattoos of Ralph Nader. During the busy holiday season, we know we can recycle their stories about dangerous playthings to spark shock and outrage among readers without having to work too hard. But I’m better than that. Wait, I was thinking of someone else. Here goes!
Every year, PIRG selects one toy as the most dangerous of all. This year’s choice is a soft vinyl version of Captain America’s shield, an object so harmless looking you’d never guess it contains more lead than a truck battery. At least you wouldn’t until you pick it up and wonder why a 9-inch squishy disk weighs 17 pounds. How much lead does it take to make the bright, shiny colors on this toy? Let’s just say that a 5-year-old will lose 5 IQ points just putting it on his Christmas list.
Of course, lead wasn’t the only hazard noted by PIRG. Other toys on their list posed choking risks (the unfortunately named Gobble Gobble Guppies), magnet ingestion risks (the tasty-sounding Sonic Sound Sizzlers), and excessive noise (the Fisher-Price Laugh & Learn, Click 'n Learn Remote). Officials from the real Consumer Product Safety Commission dutifully promised to investigate the toys cited by PIRG, although they looked like they would have preferred to use their Captain America Shield.
Born to trudge
Do you ever wonder how today’s kids would survive our childhood? Would they get tangled in telephone cords? Would they stare endlessly at their palms, poking them and wondering why their texts weren’t going through? Thanks to Grant Tomkinson, Ph.D., of the University of South Australia’s School of Health Sciences, we know one thing for sure: We would have run circles around them, although it wouldn’t have been all that satisfying without any way to post it on YouTube.
Dr. Tomkinson presented data to a meeting of the American Heart Association comparing the results of childhood fitness tests conducted between 1960 and 2010 involving more than 25 million kids in 28 countries. Since the tests were simple (“Run as fast as you can from here to there, then stop.”), they made for an ideal comparison of cardiovascular fitness over the last 50 years. The results suggest that humans are evolving…into tree sloths.
Worldwide, children’s cardiovascular fitness has been declining at a rate of 5% per decade since 1970, but the U.S. beat the spread with a decline of 6%. In other words, our kids are all couch potatoes, but at least in other countries they have the strength to climb up on the sofa.
Dr. Tomkinson estimates that 30%-60% of the decline in fitness stems from increasing obesity, while the remaining portion results from plain old deconditioning. I think we can reverse the trend, but we’ll need to teach today’s kids how to play their favorite games the way we used to: “You want to see Angry Birds, son? Run over to that tree and start climbing!”
Fruits & nuts & fries
From where I live, California looks like a public health utopia. They’ve expanded Medicaid, established a model health insurance exchange, and passed emissions regulations that have directly threatened my retirement savings (I’m strongly considering cashing out to buy a hybrid Porsche; I know, but by the time I retire, I’m sure they’ll be making some very tasty cat food.). And yet, my assumption that West Coast kids eat nothing but tofu burgers wrapped in kale may be a little off base, at least based on a new report from the UCLA Center for Health Policy Research. I won’t be too disappointed, however, until they report the extinction of the famous California unicorn.
The report is not all negative. Prior-day soda consumption among children aged 2-5 years fell from 40% to just 16% between 2003 and 2009. Fast food, however, remains a dietary staple of young kids in the state, with 60% of kids consuming at least one meal a week from a fast food joint and 10% eating fast food at least three times a week. California, however, has never feared bold initiatives, and I think it’s time for them to blaze another trail for the rest of us. If the only meat those fast food restaurants could serve was turkey…
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.
Are you, like me, asking yourself how long Thanksgiving turkey is safe to eat if refrigerated? Does it matter whether you make sandwiches or soup with it? What if you cook the soup in an autoclave?
I feel like the Puritans get the last laugh in our national festival of gluttony. “Sure,” you can hear them say, “go ahead and gorge yourselves…on turkey!” Seriously, have you ever picked up a menu and said to the waiter, “Let’s see, the lobster looks good, but oh, there’s a filet mignon and the poached salmon… Wait, hold the phone, you have turkey?! Yeah, baby! Done! Bring me the fennel-braised turkey with truffle gravy and foraged wild cranberry compote!” Never. Gonna. Happen. On the up side, I do still have some pie.
PIRG-atory
Overworked humorists and features editors everywhere look forward to the annual “Trouble in Toyland” report from the U.S. Public Interest Research Group (PIRG), a sort of volunteer militia version of the Consumer Product Safety Commission whose members probably sport tattoos of Ralph Nader. During the busy holiday season, we know we can recycle their stories about dangerous playthings to spark shock and outrage among readers without having to work too hard. But I’m better than that. Wait, I was thinking of someone else. Here goes!
Every year, PIRG selects one toy as the most dangerous of all. This year’s choice is a soft vinyl version of Captain America’s shield, an object so harmless looking you’d never guess it contains more lead than a truck battery. At least you wouldn’t until you pick it up and wonder why a 9-inch squishy disk weighs 17 pounds. How much lead does it take to make the bright, shiny colors on this toy? Let’s just say that a 5-year-old will lose 5 IQ points just putting it on his Christmas list.
Of course, lead wasn’t the only hazard noted by PIRG. Other toys on their list posed choking risks (the unfortunately named Gobble Gobble Guppies), magnet ingestion risks (the tasty-sounding Sonic Sound Sizzlers), and excessive noise (the Fisher-Price Laugh & Learn, Click 'n Learn Remote). Officials from the real Consumer Product Safety Commission dutifully promised to investigate the toys cited by PIRG, although they looked like they would have preferred to use their Captain America Shield.
Born to trudge
Do you ever wonder how today’s kids would survive our childhood? Would they get tangled in telephone cords? Would they stare endlessly at their palms, poking them and wondering why their texts weren’t going through? Thanks to Grant Tomkinson, Ph.D., of the University of South Australia’s School of Health Sciences, we know one thing for sure: We would have run circles around them, although it wouldn’t have been all that satisfying without any way to post it on YouTube.
Dr. Tomkinson presented data to a meeting of the American Heart Association comparing the results of childhood fitness tests conducted between 1960 and 2010 involving more than 25 million kids in 28 countries. Since the tests were simple (“Run as fast as you can from here to there, then stop.”), they made for an ideal comparison of cardiovascular fitness over the last 50 years. The results suggest that humans are evolving…into tree sloths.
Worldwide, children’s cardiovascular fitness has been declining at a rate of 5% per decade since 1970, but the U.S. beat the spread with a decline of 6%. In other words, our kids are all couch potatoes, but at least in other countries they have the strength to climb up on the sofa.
Dr. Tomkinson estimates that 30%-60% of the decline in fitness stems from increasing obesity, while the remaining portion results from plain old deconditioning. I think we can reverse the trend, but we’ll need to teach today’s kids how to play their favorite games the way we used to: “You want to see Angry Birds, son? Run over to that tree and start climbing!”
Fruits & nuts & fries
From where I live, California looks like a public health utopia. They’ve expanded Medicaid, established a model health insurance exchange, and passed emissions regulations that have directly threatened my retirement savings (I’m strongly considering cashing out to buy a hybrid Porsche; I know, but by the time I retire, I’m sure they’ll be making some very tasty cat food.). And yet, my assumption that West Coast kids eat nothing but tofu burgers wrapped in kale may be a little off base, at least based on a new report from the UCLA Center for Health Policy Research. I won’t be too disappointed, however, until they report the extinction of the famous California unicorn.
The report is not all negative. Prior-day soda consumption among children aged 2-5 years fell from 40% to just 16% between 2003 and 2009. Fast food, however, remains a dietary staple of young kids in the state, with 60% of kids consuming at least one meal a week from a fast food joint and 10% eating fast food at least three times a week. California, however, has never feared bold initiatives, and I think it’s time for them to blaze another trail for the rest of us. If the only meat those fast food restaurants could serve was turkey…
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.
Are you, like me, asking yourself how long Thanksgiving turkey is safe to eat if refrigerated? Does it matter whether you make sandwiches or soup with it? What if you cook the soup in an autoclave?
I feel like the Puritans get the last laugh in our national festival of gluttony. “Sure,” you can hear them say, “go ahead and gorge yourselves…on turkey!” Seriously, have you ever picked up a menu and said to the waiter, “Let’s see, the lobster looks good, but oh, there’s a filet mignon and the poached salmon… Wait, hold the phone, you have turkey?! Yeah, baby! Done! Bring me the fennel-braised turkey with truffle gravy and foraged wild cranberry compote!” Never. Gonna. Happen. On the up side, I do still have some pie.
PIRG-atory
Overworked humorists and features editors everywhere look forward to the annual “Trouble in Toyland” report from the U.S. Public Interest Research Group (PIRG), a sort of volunteer militia version of the Consumer Product Safety Commission whose members probably sport tattoos of Ralph Nader. During the busy holiday season, we know we can recycle their stories about dangerous playthings to spark shock and outrage among readers without having to work too hard. But I’m better than that. Wait, I was thinking of someone else. Here goes!
Every year, PIRG selects one toy as the most dangerous of all. This year’s choice is a soft vinyl version of Captain America’s shield, an object so harmless looking you’d never guess it contains more lead than a truck battery. At least you wouldn’t until you pick it up and wonder why a 9-inch squishy disk weighs 17 pounds. How much lead does it take to make the bright, shiny colors on this toy? Let’s just say that a 5-year-old will lose 5 IQ points just putting it on his Christmas list.
Of course, lead wasn’t the only hazard noted by PIRG. Other toys on their list posed choking risks (the unfortunately named Gobble Gobble Guppies), magnet ingestion risks (the tasty-sounding Sonic Sound Sizzlers), and excessive noise (the Fisher-Price Laugh & Learn, Click 'n Learn Remote). Officials from the real Consumer Product Safety Commission dutifully promised to investigate the toys cited by PIRG, although they looked like they would have preferred to use their Captain America Shield.
Born to trudge
Do you ever wonder how today’s kids would survive our childhood? Would they get tangled in telephone cords? Would they stare endlessly at their palms, poking them and wondering why their texts weren’t going through? Thanks to Grant Tomkinson, Ph.D., of the University of South Australia’s School of Health Sciences, we know one thing for sure: We would have run circles around them, although it wouldn’t have been all that satisfying without any way to post it on YouTube.
Dr. Tomkinson presented data to a meeting of the American Heart Association comparing the results of childhood fitness tests conducted between 1960 and 2010 involving more than 25 million kids in 28 countries. Since the tests were simple (“Run as fast as you can from here to there, then stop.”), they made for an ideal comparison of cardiovascular fitness over the last 50 years. The results suggest that humans are evolving…into tree sloths.
Worldwide, children’s cardiovascular fitness has been declining at a rate of 5% per decade since 1970, but the U.S. beat the spread with a decline of 6%. In other words, our kids are all couch potatoes, but at least in other countries they have the strength to climb up on the sofa.
Dr. Tomkinson estimates that 30%-60% of the decline in fitness stems from increasing obesity, while the remaining portion results from plain old deconditioning. I think we can reverse the trend, but we’ll need to teach today’s kids how to play their favorite games the way we used to: “You want to see Angry Birds, son? Run over to that tree and start climbing!”
Fruits & nuts & fries
From where I live, California looks like a public health utopia. They’ve expanded Medicaid, established a model health insurance exchange, and passed emissions regulations that have directly threatened my retirement savings (I’m strongly considering cashing out to buy a hybrid Porsche; I know, but by the time I retire, I’m sure they’ll be making some very tasty cat food.). And yet, my assumption that West Coast kids eat nothing but tofu burgers wrapped in kale may be a little off base, at least based on a new report from the UCLA Center for Health Policy Research. I won’t be too disappointed, however, until they report the extinction of the famous California unicorn.
The report is not all negative. Prior-day soda consumption among children aged 2-5 years fell from 40% to just 16% between 2003 and 2009. Fast food, however, remains a dietary staple of young kids in the state, with 60% of kids consuming at least one meal a week from a fast food joint and 10% eating fast food at least three times a week. California, however, has never feared bold initiatives, and I think it’s time for them to blaze another trail for the rest of us. If the only meat those fast food restaurants could serve was turkey…
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.
Walking in Memphis
Apparently Lisa Marie Presley is returning to Memphis to do something that I and every other Memphian (that’s what we call ourselves) avoids at all costs: She’s going to Graceland. To be fair, for Lisa Marie, it’s not just a gaudy, tasteless tourist trap; it’s home. But you gotta think even she glances at the peacock stained-glass doors in the dining room and asks herself, “Was it a bit much?”
I’ll confess I might just be resentful. Lisa Marie is, like, exactly my age, and she grew up virtually down the street from me! Okay, it was a really long street, then you turned right at another really long street and drove until you could almost see Mississippi, but still. Was it too much to ask that she at least come to one of my birthday parties? I blame the fact that my dad wasn’t even the second or third greatest rock performer to ever live. Heck, he didn’t even have sideburns. Whatever, Lisa Marie, you and I are still cool. But seriously, while you’re home, would you want to maybe redecorate a little?
Speak up
You know the rap on pediatricians, we’re just so darned...nice! Honestly, every time I hear how nice we are, I just want to slug someone! Instead, I offer to massage their feet. And that just makes me madder. A research group in Seattle, however, suggests that maybe when it comes to vaccines, it’s possible to be a little too accommodating.
The authors, hoping to achieve something constructive with their geographic mother lode of vaccine-hesitant parents, decided to study whether pediatricians’ communication styles really influence parents’ vaccine choices. They recorded and analyzed 111 providers talking with parents about vaccines, which says a lot about what some people will do to earn a PhD.
They found that those providers who were directive about vaccines (“So Johnny will be getting some shots today, and then he can visit the treasure box.”) had a massively higher rate of vaccine success than those who were more wishy-washy (“So, should we ask Johnny if he’d like a series of painful injections, or have you already heard such bad things about vaccines that we shouldn’t even go there and just let him take his chances with measles?”).
Among parents with further concerns, those providers who responded with firm, accurate answers about vaccine safety saw much better vaccination rates. They also convinced them that R2D2 and C3PO were not the droids they were looking for.
I have to admit, I was surprised at these results until I thought about how we respond to other life-and-death choices. What would a pediatrician say during a house fire? “How are you feeling about getting low to the ground and crawling as fast as you can to the nearest exit? You’ve probably heard that you can scrape your knees or even get rug burns, so I understand if you’d like to just stand there or offer your own schedule of escaping the flames...” Nice.
Survivor
The tobacco industry these days reminds me of the cockroaches that seem to keep cropping up around my house. Just when I think we’ve eliminated all the little vermin, they pop up somewhere completely unexpected. Like when we thought regulations on tobacco sales and advertising were effectively reducing the number of children and adolescents addicted to tobacco, and along come “little cigars” and vapor cigarettes (e-cigs). They’re like that roach I found in my sock drawer. I mean, what could he possibly want in there, toe jam?
Of course, guessing what tobacco executives want is a little easier: new addicts. “Little cigars” are exempt from many of the regulations covering cigarettes since they’re, um, I don’t know, a different color? Not only are they cheaper because of lower taxes, they can be sold individually, making them a lot easier to buy with allowance money.
E-cigs face virtually no regulation, but don’t worry, the manufacturers promise they’re not looking to hook kids on a new highly addicting product. Flavors like “Gummi Bear” and “Fruit Loops” are designed to entice long-haul truckers who are looking for something a little more tart than “Chocolate Chip Cookie Dough.” Here’s hoping that Congress buys the Food and Drug Administration some pointy-toed boots.
Six pack
Men could learn a thing or two from facing some of the ordeals women cope with every day. We can’t give birth, but we should really spend at least a week in high heels. We should have to put on eyeliner before we go out and then see who’s standing by the door jangling the keys. We should try, just once, to vent to someone who keeps interrupting us with solutions we didn’t ask for. I’m not sure when these things will happen, but according to research published in JAMA Pediatrics, it appears that surprising numbers of young men already suffer from a problem many pediatricians think of only in girls: body image concerns.
The authors looked at survey data on more than 5,500 males aged 12-18 years whom they followed from 1999 to 2010. Think about it: When this survey started, Ryan Gosling was just Ryan Egg, and still substantial numbers of respondents reported levels of concern with thinness and muscularity grave enough to lead to anorexia, bulimia, depression, and alcohol and drug abuse.
While I haven’t personally experienced the ill effects reported by some study participants, I can totally relate to their feelings of inferiority. If only I’d been more buff, perhaps Lisa Marie would have noticed me. But if she had invited me over to her house, I don’t know if I could have kept a straight face around those peacock stained-glass doors. I guess that’s all right, mama.
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.
Apparently Lisa Marie Presley is returning to Memphis to do something that I and every other Memphian (that’s what we call ourselves) avoids at all costs: She’s going to Graceland. To be fair, for Lisa Marie, it’s not just a gaudy, tasteless tourist trap; it’s home. But you gotta think even she glances at the peacock stained-glass doors in the dining room and asks herself, “Was it a bit much?”
I’ll confess I might just be resentful. Lisa Marie is, like, exactly my age, and she grew up virtually down the street from me! Okay, it was a really long street, then you turned right at another really long street and drove until you could almost see Mississippi, but still. Was it too much to ask that she at least come to one of my birthday parties? I blame the fact that my dad wasn’t even the second or third greatest rock performer to ever live. Heck, he didn’t even have sideburns. Whatever, Lisa Marie, you and I are still cool. But seriously, while you’re home, would you want to maybe redecorate a little?
Speak up
You know the rap on pediatricians, we’re just so darned...nice! Honestly, every time I hear how nice we are, I just want to slug someone! Instead, I offer to massage their feet. And that just makes me madder. A research group in Seattle, however, suggests that maybe when it comes to vaccines, it’s possible to be a little too accommodating.
The authors, hoping to achieve something constructive with their geographic mother lode of vaccine-hesitant parents, decided to study whether pediatricians’ communication styles really influence parents’ vaccine choices. They recorded and analyzed 111 providers talking with parents about vaccines, which says a lot about what some people will do to earn a PhD.
They found that those providers who were directive about vaccines (“So Johnny will be getting some shots today, and then he can visit the treasure box.”) had a massively higher rate of vaccine success than those who were more wishy-washy (“So, should we ask Johnny if he’d like a series of painful injections, or have you already heard such bad things about vaccines that we shouldn’t even go there and just let him take his chances with measles?”).
Among parents with further concerns, those providers who responded with firm, accurate answers about vaccine safety saw much better vaccination rates. They also convinced them that R2D2 and C3PO were not the droids they were looking for.
I have to admit, I was surprised at these results until I thought about how we respond to other life-and-death choices. What would a pediatrician say during a house fire? “How are you feeling about getting low to the ground and crawling as fast as you can to the nearest exit? You’ve probably heard that you can scrape your knees or even get rug burns, so I understand if you’d like to just stand there or offer your own schedule of escaping the flames...” Nice.
Survivor
The tobacco industry these days reminds me of the cockroaches that seem to keep cropping up around my house. Just when I think we’ve eliminated all the little vermin, they pop up somewhere completely unexpected. Like when we thought regulations on tobacco sales and advertising were effectively reducing the number of children and adolescents addicted to tobacco, and along come “little cigars” and vapor cigarettes (e-cigs). They’re like that roach I found in my sock drawer. I mean, what could he possibly want in there, toe jam?
Of course, guessing what tobacco executives want is a little easier: new addicts. “Little cigars” are exempt from many of the regulations covering cigarettes since they’re, um, I don’t know, a different color? Not only are they cheaper because of lower taxes, they can be sold individually, making them a lot easier to buy with allowance money.
E-cigs face virtually no regulation, but don’t worry, the manufacturers promise they’re not looking to hook kids on a new highly addicting product. Flavors like “Gummi Bear” and “Fruit Loops” are designed to entice long-haul truckers who are looking for something a little more tart than “Chocolate Chip Cookie Dough.” Here’s hoping that Congress buys the Food and Drug Administration some pointy-toed boots.
Six pack
Men could learn a thing or two from facing some of the ordeals women cope with every day. We can’t give birth, but we should really spend at least a week in high heels. We should have to put on eyeliner before we go out and then see who’s standing by the door jangling the keys. We should try, just once, to vent to someone who keeps interrupting us with solutions we didn’t ask for. I’m not sure when these things will happen, but according to research published in JAMA Pediatrics, it appears that surprising numbers of young men already suffer from a problem many pediatricians think of only in girls: body image concerns.
The authors looked at survey data on more than 5,500 males aged 12-18 years whom they followed from 1999 to 2010. Think about it: When this survey started, Ryan Gosling was just Ryan Egg, and still substantial numbers of respondents reported levels of concern with thinness and muscularity grave enough to lead to anorexia, bulimia, depression, and alcohol and drug abuse.
While I haven’t personally experienced the ill effects reported by some study participants, I can totally relate to their feelings of inferiority. If only I’d been more buff, perhaps Lisa Marie would have noticed me. But if she had invited me over to her house, I don’t know if I could have kept a straight face around those peacock stained-glass doors. I guess that’s all right, mama.
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.
Apparently Lisa Marie Presley is returning to Memphis to do something that I and every other Memphian (that’s what we call ourselves) avoids at all costs: She’s going to Graceland. To be fair, for Lisa Marie, it’s not just a gaudy, tasteless tourist trap; it’s home. But you gotta think even she glances at the peacock stained-glass doors in the dining room and asks herself, “Was it a bit much?”
I’ll confess I might just be resentful. Lisa Marie is, like, exactly my age, and she grew up virtually down the street from me! Okay, it was a really long street, then you turned right at another really long street and drove until you could almost see Mississippi, but still. Was it too much to ask that she at least come to one of my birthday parties? I blame the fact that my dad wasn’t even the second or third greatest rock performer to ever live. Heck, he didn’t even have sideburns. Whatever, Lisa Marie, you and I are still cool. But seriously, while you’re home, would you want to maybe redecorate a little?
Speak up
You know the rap on pediatricians, we’re just so darned...nice! Honestly, every time I hear how nice we are, I just want to slug someone! Instead, I offer to massage their feet. And that just makes me madder. A research group in Seattle, however, suggests that maybe when it comes to vaccines, it’s possible to be a little too accommodating.
The authors, hoping to achieve something constructive with their geographic mother lode of vaccine-hesitant parents, decided to study whether pediatricians’ communication styles really influence parents’ vaccine choices. They recorded and analyzed 111 providers talking with parents about vaccines, which says a lot about what some people will do to earn a PhD.
They found that those providers who were directive about vaccines (“So Johnny will be getting some shots today, and then he can visit the treasure box.”) had a massively higher rate of vaccine success than those who were more wishy-washy (“So, should we ask Johnny if he’d like a series of painful injections, or have you already heard such bad things about vaccines that we shouldn’t even go there and just let him take his chances with measles?”).
Among parents with further concerns, those providers who responded with firm, accurate answers about vaccine safety saw much better vaccination rates. They also convinced them that R2D2 and C3PO were not the droids they were looking for.
I have to admit, I was surprised at these results until I thought about how we respond to other life-and-death choices. What would a pediatrician say during a house fire? “How are you feeling about getting low to the ground and crawling as fast as you can to the nearest exit? You’ve probably heard that you can scrape your knees or even get rug burns, so I understand if you’d like to just stand there or offer your own schedule of escaping the flames...” Nice.
Survivor
The tobacco industry these days reminds me of the cockroaches that seem to keep cropping up around my house. Just when I think we’ve eliminated all the little vermin, they pop up somewhere completely unexpected. Like when we thought regulations on tobacco sales and advertising were effectively reducing the number of children and adolescents addicted to tobacco, and along come “little cigars” and vapor cigarettes (e-cigs). They’re like that roach I found in my sock drawer. I mean, what could he possibly want in there, toe jam?
Of course, guessing what tobacco executives want is a little easier: new addicts. “Little cigars” are exempt from many of the regulations covering cigarettes since they’re, um, I don’t know, a different color? Not only are they cheaper because of lower taxes, they can be sold individually, making them a lot easier to buy with allowance money.
E-cigs face virtually no regulation, but don’t worry, the manufacturers promise they’re not looking to hook kids on a new highly addicting product. Flavors like “Gummi Bear” and “Fruit Loops” are designed to entice long-haul truckers who are looking for something a little more tart than “Chocolate Chip Cookie Dough.” Here’s hoping that Congress buys the Food and Drug Administration some pointy-toed boots.
Six pack
Men could learn a thing or two from facing some of the ordeals women cope with every day. We can’t give birth, but we should really spend at least a week in high heels. We should have to put on eyeliner before we go out and then see who’s standing by the door jangling the keys. We should try, just once, to vent to someone who keeps interrupting us with solutions we didn’t ask for. I’m not sure when these things will happen, but according to research published in JAMA Pediatrics, it appears that surprising numbers of young men already suffer from a problem many pediatricians think of only in girls: body image concerns.
The authors looked at survey data on more than 5,500 males aged 12-18 years whom they followed from 1999 to 2010. Think about it: When this survey started, Ryan Gosling was just Ryan Egg, and still substantial numbers of respondents reported levels of concern with thinness and muscularity grave enough to lead to anorexia, bulimia, depression, and alcohol and drug abuse.
While I haven’t personally experienced the ill effects reported by some study participants, I can totally relate to their feelings of inferiority. If only I’d been more buff, perhaps Lisa Marie would have noticed me. But if she had invited me over to her house, I don’t know if I could have kept a straight face around those peacock stained-glass doors. I guess that’s all right, mama.
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.
Mouse ears
I know there are people who enjoy theme parks, and really I try, but I just returned from the American Academy of Pediatrics National Conference and Exhibition (AAP NCE) in Orlando, Florida, and I still just don’t get it. The AAP actually rented out Disney’s Hollywood Studios for a night, which means we still got to stand in line 50 minutes to experience Toy Story Mania 4D, but with pediatricians!
There were free passes on the Rock ’n’ Roller Coaster Starring Aerosmith, followed by a short lecture entitled, “Diagnosis and Management of Acute Nausea.” My version of Disney World would be a little different. Attractions would include It’s a Small World, So Why Not Save Money & Stay Home; Plenty of Space on the Couch Mountain; and the Honey, I Shrunk the Kids and Got Them a Tiny Babysitter Adventure.
Regular readers (Mom) will notice that I usually address three studies in each blog, but the AAP dropped so many controversial policies and articles during the meeting that I feel that each one deserves a mention. Hopefully, you’ll come away feeling just like me: overwhelmed and exhausted.
Ahead
Are you terrified that one of your kids will get a concussion? No? Then you were not at the NCE. We started by learning that children who sustained concussions or other head injuries were twice as likely to suffer from depression as were controls. Do you find that depressing? Then wait until you learn that only 11% of children treated for bicycle-related accidents in Los Angeles emergency departments from 2006 to 2011 were wearing bike helmets! The other 89% were waiting to put them on until they were sure they would be in a crash.
Next out was an abstract demonstrating that football helmets are useless in protecting against concussions, regardless of brand. I know your next question: What about mouth guards? Nope, they looked at those, too, and even the really expensive mouth guards marketed to prevent concussions were useless. This study was not without good news. First, football helmets did provide protection against skull fractures and scalp lacerations. Second, the cheapest helmets and mouth guards are just as ineffective as the most expensive ones, so team boosters will have to sell a lot fewer milk chocolate almond bars next year!
Okay, say your bike-riding football player does sustain a concussion and is not too depressed to return to school. When do you send him back? By Sunday, the AAP was ready to tell you: It depends. Not the same day as the injury, that much is clear. The authors stress that cognitive rest is as important as physical rest until symptoms resolve. They suggested that if a child is too impaired to go to school, he’s also not well enough to play video games, then they paused a moment for parents to high-five each other.
Shot across the bow
Concussions were not the most severe injuries to get press at the NCE; that would be gunshot wounds. The conference saw the release of a study correlating children’s incidence of gunshot injury and death with regional rates of gun ownership. Some people seemed surprised to learn that states with higher rates of gun ownership had correspondingly higher rates of childhood gun injuries. These same people were also skeptical of correlations between drowning and pools, obesity and food, and sunburn and daylight.
Media rare
My own little corner of the AAP, the Council on Communications and the Media, got in on the excitement by releasing a long-awaited (by us) updated policy statement on children, adolescents, and the media. Our new statement emphasizes the need for parents to help kids develop healthier media habits by developing a family media use plan. Excited parents immediately wrenched their cell phones out of their toddlers’ hands so they could text the news to their teenagers, all the way across the dinner table. I feel we owe media companies everywhere an apology since, now that we have spoken, kids everywhere will immediately cut back from 7+ hours of electronic entertainment a day to less than 2 hours. Perhaps all those newly unemployed entertainment executives can get together and design a football helmet that prevents concussions.
A half ounce of prevention
At this point, having criticized only high school football, gun ownership, and television, we felt we really hadn’t done anything that would create controversy in middle America. Fortunately, the AAP Committee on Adolescence was ready to release their statement, “Condom Use by Adolescents,” suggesting that prophylactics should be made freely available in schools, doctors’ offices, malls, skate parks, concert venues, orthodontists’ waiting rooms, and anywhere else two or more teens might congregate.
Their logic was impeccable: studies have repeatedly demonstrated that giving teens condoms does not make them more likely to become sexually active, and high-quality comprehensive sex education can even delay the onset of sexual activity. And condoms save lives and prevent pregnancies when used properly and consistently. Despite the clear health advantages of widespread condom use, I can imagine the message going over poorly among some of the parents where I live. I think to make condoms more popular, we should put them behind a big wall, charge people a huge fee just to walk inside, and then sell them for unconscionable prices once they’ve been stamped with the image of a popular cartoon character. It sounds crazy, but based on my recent experience, it works.
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 there are people who enjoy theme parks, and really I try, but I just returned from the American Academy of Pediatrics National Conference and Exhibition (AAP NCE) in Orlando, Florida, and I still just don’t get it. The AAP actually rented out Disney’s Hollywood Studios for a night, which means we still got to stand in line 50 minutes to experience Toy Story Mania 4D, but with pediatricians!
There were free passes on the Rock ’n’ Roller Coaster Starring Aerosmith, followed by a short lecture entitled, “Diagnosis and Management of Acute Nausea.” My version of Disney World would be a little different. Attractions would include It’s a Small World, So Why Not Save Money & Stay Home; Plenty of Space on the Couch Mountain; and the Honey, I Shrunk the Kids and Got Them a Tiny Babysitter Adventure.
Regular readers (Mom) will notice that I usually address three studies in each blog, but the AAP dropped so many controversial policies and articles during the meeting that I feel that each one deserves a mention. Hopefully, you’ll come away feeling just like me: overwhelmed and exhausted.
Ahead
Are you terrified that one of your kids will get a concussion? No? Then you were not at the NCE. We started by learning that children who sustained concussions or other head injuries were twice as likely to suffer from depression as were controls. Do you find that depressing? Then wait until you learn that only 11% of children treated for bicycle-related accidents in Los Angeles emergency departments from 2006 to 2011 were wearing bike helmets! The other 89% were waiting to put them on until they were sure they would be in a crash.
Next out was an abstract demonstrating that football helmets are useless in protecting against concussions, regardless of brand. I know your next question: What about mouth guards? Nope, they looked at those, too, and even the really expensive mouth guards marketed to prevent concussions were useless. This study was not without good news. First, football helmets did provide protection against skull fractures and scalp lacerations. Second, the cheapest helmets and mouth guards are just as ineffective as the most expensive ones, so team boosters will have to sell a lot fewer milk chocolate almond bars next year!
Okay, say your bike-riding football player does sustain a concussion and is not too depressed to return to school. When do you send him back? By Sunday, the AAP was ready to tell you: It depends. Not the same day as the injury, that much is clear. The authors stress that cognitive rest is as important as physical rest until symptoms resolve. They suggested that if a child is too impaired to go to school, he’s also not well enough to play video games, then they paused a moment for parents to high-five each other.
Shot across the bow
Concussions were not the most severe injuries to get press at the NCE; that would be gunshot wounds. The conference saw the release of a study correlating children’s incidence of gunshot injury and death with regional rates of gun ownership. Some people seemed surprised to learn that states with higher rates of gun ownership had correspondingly higher rates of childhood gun injuries. These same people were also skeptical of correlations between drowning and pools, obesity and food, and sunburn and daylight.
Media rare
My own little corner of the AAP, the Council on Communications and the Media, got in on the excitement by releasing a long-awaited (by us) updated policy statement on children, adolescents, and the media. Our new statement emphasizes the need for parents to help kids develop healthier media habits by developing a family media use plan. Excited parents immediately wrenched their cell phones out of their toddlers’ hands so they could text the news to their teenagers, all the way across the dinner table. I feel we owe media companies everywhere an apology since, now that we have spoken, kids everywhere will immediately cut back from 7+ hours of electronic entertainment a day to less than 2 hours. Perhaps all those newly unemployed entertainment executives can get together and design a football helmet that prevents concussions.
A half ounce of prevention
At this point, having criticized only high school football, gun ownership, and television, we felt we really hadn’t done anything that would create controversy in middle America. Fortunately, the AAP Committee on Adolescence was ready to release their statement, “Condom Use by Adolescents,” suggesting that prophylactics should be made freely available in schools, doctors’ offices, malls, skate parks, concert venues, orthodontists’ waiting rooms, and anywhere else two or more teens might congregate.
Their logic was impeccable: studies have repeatedly demonstrated that giving teens condoms does not make them more likely to become sexually active, and high-quality comprehensive sex education can even delay the onset of sexual activity. And condoms save lives and prevent pregnancies when used properly and consistently. Despite the clear health advantages of widespread condom use, I can imagine the message going over poorly among some of the parents where I live. I think to make condoms more popular, we should put them behind a big wall, charge people a huge fee just to walk inside, and then sell them for unconscionable prices once they’ve been stamped with the image of a popular cartoon character. It sounds crazy, but based on my recent experience, it works.
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 there are people who enjoy theme parks, and really I try, but I just returned from the American Academy of Pediatrics National Conference and Exhibition (AAP NCE) in Orlando, Florida, and I still just don’t get it. The AAP actually rented out Disney’s Hollywood Studios for a night, which means we still got to stand in line 50 minutes to experience Toy Story Mania 4D, but with pediatricians!
There were free passes on the Rock ’n’ Roller Coaster Starring Aerosmith, followed by a short lecture entitled, “Diagnosis and Management of Acute Nausea.” My version of Disney World would be a little different. Attractions would include It’s a Small World, So Why Not Save Money & Stay Home; Plenty of Space on the Couch Mountain; and the Honey, I Shrunk the Kids and Got Them a Tiny Babysitter Adventure.
Regular readers (Mom) will notice that I usually address three studies in each blog, but the AAP dropped so many controversial policies and articles during the meeting that I feel that each one deserves a mention. Hopefully, you’ll come away feeling just like me: overwhelmed and exhausted.
Ahead
Are you terrified that one of your kids will get a concussion? No? Then you were not at the NCE. We started by learning that children who sustained concussions or other head injuries were twice as likely to suffer from depression as were controls. Do you find that depressing? Then wait until you learn that only 11% of children treated for bicycle-related accidents in Los Angeles emergency departments from 2006 to 2011 were wearing bike helmets! The other 89% were waiting to put them on until they were sure they would be in a crash.
Next out was an abstract demonstrating that football helmets are useless in protecting against concussions, regardless of brand. I know your next question: What about mouth guards? Nope, they looked at those, too, and even the really expensive mouth guards marketed to prevent concussions were useless. This study was not without good news. First, football helmets did provide protection against skull fractures and scalp lacerations. Second, the cheapest helmets and mouth guards are just as ineffective as the most expensive ones, so team boosters will have to sell a lot fewer milk chocolate almond bars next year!
Okay, say your bike-riding football player does sustain a concussion and is not too depressed to return to school. When do you send him back? By Sunday, the AAP was ready to tell you: It depends. Not the same day as the injury, that much is clear. The authors stress that cognitive rest is as important as physical rest until symptoms resolve. They suggested that if a child is too impaired to go to school, he’s also not well enough to play video games, then they paused a moment for parents to high-five each other.
Shot across the bow
Concussions were not the most severe injuries to get press at the NCE; that would be gunshot wounds. The conference saw the release of a study correlating children’s incidence of gunshot injury and death with regional rates of gun ownership. Some people seemed surprised to learn that states with higher rates of gun ownership had correspondingly higher rates of childhood gun injuries. These same people were also skeptical of correlations between drowning and pools, obesity and food, and sunburn and daylight.
Media rare
My own little corner of the AAP, the Council on Communications and the Media, got in on the excitement by releasing a long-awaited (by us) updated policy statement on children, adolescents, and the media. Our new statement emphasizes the need for parents to help kids develop healthier media habits by developing a family media use plan. Excited parents immediately wrenched their cell phones out of their toddlers’ hands so they could text the news to their teenagers, all the way across the dinner table. I feel we owe media companies everywhere an apology since, now that we have spoken, kids everywhere will immediately cut back from 7+ hours of electronic entertainment a day to less than 2 hours. Perhaps all those newly unemployed entertainment executives can get together and design a football helmet that prevents concussions.
A half ounce of prevention
At this point, having criticized only high school football, gun ownership, and television, we felt we really hadn’t done anything that would create controversy in middle America. Fortunately, the AAP Committee on Adolescence was ready to release their statement, “Condom Use by Adolescents,” suggesting that prophylactics should be made freely available in schools, doctors’ offices, malls, skate parks, concert venues, orthodontists’ waiting rooms, and anywhere else two or more teens might congregate.
Their logic was impeccable: studies have repeatedly demonstrated that giving teens condoms does not make them more likely to become sexually active, and high-quality comprehensive sex education can even delay the onset of sexual activity. And condoms save lives and prevent pregnancies when used properly and consistently. Despite the clear health advantages of widespread condom use, I can imagine the message going over poorly among some of the parents where I live. I think to make condoms more popular, we should put them behind a big wall, charge people a huge fee just to walk inside, and then sell them for unconscionable prices once they’ve been stamped with the image of a popular cartoon character. It sounds crazy, but based on my recent experience, it works.
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.