Mothers and Community

I had the pleasure of attending a Symposium for Mothers in Palo Alto on March 17, 2007 where Dr. Mary Pipher was speaking, and I want to share with you some of the things I heard that day.

First, I have to say it was a wonderful feeling to be with about 550 other women (and six men) who were there to celebrate mothers - and honor the power of what we do - protect, nurture, guide, and advocate for our children. Far from our life-demands, we had breakfast, saw old fiends, made new friends, and were validated for the support and connectedness we provide the community. The theme of the day was "The Shelter of Each Other," and throughout the day I heard Dr. Pipher saying find others and be inspired - you are not alone!

The dysfunction we are all experiencing is not from within the family (necessarily), but from the culture we have created that inundates us with information, television that renders our brains incapable of thought, and a social structure without ties to the people we see every day. Antidotes include dinner time conversations as well as time with grandparents and extended family that includes moral and character education, socialization, and stress management decision-making and strategies.

Exposure to our culture is creating people whose brains are not developing impulse control and decision-making skills until late adolescence - in fact, Dr. Pipher suggested that we may have artificially pushed the age of adulthood back to about 30, and given adolescence spans age 10 to 20, that leaves a new phase Dr. Pipher called "adultescence," for ages 20 to 30.

Here are some of the messages I wrote down:

• Be intentional about what you expose your children to (particularly TV) - if not, you will be stressed, unhealthy and broke.
• To protect our families from a toxic culture, connect to and provide connection to what was good.
• Remember to tell your children that you love them and tell them when you respect their decisions or are impressed with how they handle a particular situation.
• Advertising teaches against the messages from every religion - it says get it all; get it all now; you need it; you deserve it; and to heck with everything else.
• Religions teach that you do not need everything (or now); it is better to think about others; and our responsibility is to make the world a better place.
• The two most radical things we can each do to change the world are 1) Talk to people, especially teens and 2) Slow down.

For those of you who are nor familiar with Mary Pipher, she is a Clinical Psychologist from the midwest and she has written books about women, girls, and families that include: Reviving Ophelia: Saving the Selves of Adolescent Girls, The Shelter of Each Other: Rebuilding Our Families, Another Country: The Emotional Terrain of Our Elders, The Middle of Everywhere: The World's Refugees Come to Our Town, and Writing to Change the World. She communicates with down-to-earth stories full of hope and compassion.

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Labels: Parenting

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Fathers, Daughters, and Virginity?

Imagine, a beautiful venue, invitations, limousines, flowers, formal dresses, tuxedos, dinner, dancing, cake, jewelry, and vows exchanged - is it a wedding? No, it is a "Purity Ball." These balls are becoming popular (mainly in the South and Midwest) among conservative Christians and many include "purity rings" and 11-year old daughters promising to not have sex until marriage in exchange for Dad's promise to keep his mind "pure" and stay faithful to the child's mother. These "vows" can be written and/or verbal and very public.

The good news is that fathers and daughters are spending time together, which is associated with better academic success and strong leadership skills, but can I just say "ick!" I would like to challenge the conservative Christians in the United States to find something else to bond with their daughters about - sports,math, science, community service - anything less creepy than their daughter's virginity. I also have to add that more than half of the teens who take virginity pledges actually have sex before marriage, and most without protecting themselves from unwanted pregnancy and sexually transmitted infections.

Little girls do not stay 11 forever, and how these girls become young women and "own" their own sexuality is beyond me.

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Labels: Sexuality Education

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I Want it Now! A Book Review

Funny how life works - while reading this wonderful new book by Donna Bee-Gates about consumerism and kids, I happened to have had an Italian exchange student staying with my family, asking questions like "why are the houses and cars here so big?" why do Americans fill their plates and then leave half of the food on their plates to be thrown away?" why did they serve me three [plate-seize] pancakes for breakfast?" Her questions, and the issues about unbridled materialism explored by Bee-Gates have led to some very interesting dinner-time conversations.

How can we as parents help children resist craving the newest and the latest possessions? How do we avoid raising a generation of people who believe happiness comes from shopping or "retail therapy?" What are our own habits teaching our children about materialism and consumerism? Dr. Bee-Gates has some great quotes and advice for all parents about living with materialism - which, like so much about parenting, is not black-and-white, but a gentle nudge toward conscious decision-making. This book is not a book about the evils of materialism, or suggesting we renounce our worldly possessions - instead, it is an academic exploration of consumerism in relation to spirituality, passion, relationships, and meaning in a child's life.

Dr. Bee-Gates interviewed parents and did a great job scouring the literature so we, as parents, do not have to. The chapters of this book are easy-to-read and offer insights to kids who want more things because they are bored, or use things to make friends, or get things from us, instead of real connection - ouch! She introduces five forces of materialism - or life circumstances that increase children's vulnerability to materialism, and then she discusses how spirituality, of whatever flavor you prefer, can help kids resist the influence of consumerism. Finally, she ends the book with concrete suggestions for ways to deemphasize possessions without being perceived as a grinch or compromising our principals. All in all a great book and reminder that we are educating our children with every decision we make.

Here are a few of my favorite issues explored:

• What's in it for me?
• Consumerism 101: what are we teaching our children about responsible spending habits?
• What is more rewarding - money, family or community?
• How is the number of hours of TV watched linked to overall mental health, academic success, leadership skills, and of course, consumerism?
• The value of ritual and multi-generational character education, as well as seeing parents involved in community service.
• The power of laughter and joy shared between parents and kids.

Well worth your time, the book is called "I Want it Now: Navigating Childhood in a Materialistic World," and it was published in 2006 by palgave macmillan, New York, NY.

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Labels: Book Review

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Grand Rounds 3.27: Thank You

Thank you Dr. Stuart Henochwicz at MedViews for hosting Grand Rounds 3.27 this week and including my post about the importance of sleep for teens.

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Your Sex Health

Please take some time to check out this new and really informative website, Your Sex Health, from the Key Centre for Women's Health in Society in the School of Population Health, at The University of Melbourne, Australia.

If you have, or know, young people ranging in age from 16 - 25 I think this site is a must! The URL for the site is www.yoursexhealth.org.

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Labels: Web Resource

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Teens and Younger Kids are Having Trouble with Sleep

A research article in the February 15th Journal of Clinical Sleep Medicine found that 22% of middle and high school students say they never get enough sleep, and 60% have difficulty falling asleep at least once a week. The research was conducted with 238 students in Pueblo, Colorado, and the results were disturbing. Kids with the highest GPAs were getting the most and best quality sleep and were less likely to be having trouble concentrating in class. Related research at Northwestern University found that getting an extra hour of sleep each night also may reduce the risk of being overweight.

If teens have trouble sleeping, they should remember to avoid caffeinated beverages (including soda) after noon, and not smoke. Teens should not be falling asleep in class. If they are, try to help them get more rest and if that fails, consult your physician. Teens need at least 8 hours of sleep a night and middle school students should get 10 hours of sleep a night.

Click here to link to a previous Teen Health 411 post on sleep.

Resources:
The National Sleep Foundation

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Labels: Sleep

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Loose Women on Campus?

"Hooking up" means having some form of sex, ranging from petting to intercourse, with someone who may or may not know well, usually without much thought. The point may be pleasure, because hookups take less time than dating, or to get social status, or even stress. The sex may be consensual, or if the young woman has been drinking, she may not even remember it. The sex may also be protected, but given the sexually transmitted infection rates on college campuses, it is probably not. In theory, the cultural support of hooking up seems to give women the same freedom that men have always enjoyed - sex without emotional ties. Unfortunately, women rarely do things that do not have emotional ties, and the "pleasure" from a hookup, may not be worth the emotional let down when the hookup fails to be "Mr.Right."

According to a new book by Laura Sessions Stepp called "Unhooked: How Young Women Pursue Sex, Delay Love, and Lose at Both," sex on college campuses for young women today means joyless encounters devoid of pleasure, leading to cynical and depressed young women. She reports her conclusions are supported by interviews with "dozens" of young women that resulted in the book, which is a story about nine girls over the period of one year.

I am pretty ambivalent about this and think a lot more research and interviews need to be completed before I buy the dismal conclusions. I look forward to your comments!

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Labels: Sexuality

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Dating Violence

Violence between dating partners is a significant public health concern, but one that does not get much attention in research or popular media. Approximately 20% of teens report dating someone who became violent with them. Victims of dating violence also have an elevated risk of substance abuse, sexually risky behavior, pregnancy and suicide. Victims of dating violence are also more likely to come from families where they have witnessed the same types of violence or aggression.

There are school-based programs developed to increase knowledge about dating violence and laws protecting people, reduce individual tolerance of aggression, and increase the chance of teens knowing where and how to get help, if needed. A previous post about Dating Violence on Teen Health 411 provides more information and resources.

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Labels: Relationship Violence

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Teens Who Work May Be in Danger

There was some bad news from research, done with more than 900 teens done at the University of North Carolina, published in the March issue of Pediatrics. The article suggested that teens aged 14 to 18 who work in retail and service jobs during the school year put in an average of 16 hours a week, often at dangerous and unsupervised jobs. Too many and late hours, using dangerous machinery, handling large sums of cash, and serving alcohol were some of the violations of federal child labor laws reported by the teens who participated in the research.

Like I suggested in earlier post about Teens & Work on Teen Health 411, if your teen works, know the laws in your state and help them understand the importance of not doing anything that violates those laws. In addition, parents should be willing to step in if their teen is being asked to violate those laws.

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Labels: Alcohol, Employment

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Unintentional Injury & Adolescents and Young Adults

The National Adolescent Health Information Center (NAHIC) has just released a new fact sheet on Unintentional Injury in Adolescents and Young Adults, which is the leading cause of death for adolescents and young adults. In 2004 the leading causes of death in people ages 10 - 24 included:

• motor vehicle accidents (31.3%);
• homicide (14.2%);
• suicide (12.3%);
• and all other unintentional injuries (e.g., poisoning, drowning, fires/burns, and falls) (14.1%);
• with the remaining 28.1% being other causes.

Lack of driving experience, alcohol use (three out of ten) and lack of seat belt use contribute to motor vehicle accidental death rates, which are highest among American Indian/Alaskan native youth. A previous post on Teen Health 411 discusses Teen Driving.

The good news is that the unintentional injury death rate for this age group has gone down during the last 20 years, although males and young adults still have higher unintentional injury and death rates than females, and adult males 18-24 years old have the highest rates. I know we want to believe that our teens are not stupid enough to drive after drinking, get in a car with someone who has been drinking, or not use seat belts, but the statistics suggest that teens are doing all of those things. I cannot encourage you strongly enough to talk to your kids about alcohol and driving and have a safety plan that includes a ride home with no questions asked, and no consequences.

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Labels: Alcohol, Injuries

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Cutting to Relieve Emotional Pain

Historically, self-injury has gotten very little press, but there is rising concern about youth, mostly girls, who cut themselves, and the advent of MySpace, Xanga, and other social media may mean people are talking about it more. Boys self-harm as well, but at a much lower rate. Males in our society are much more likely to engage in other risk behavior including driving too fast, fighting, and drinking too much. Cutting, self-injury, self-mutilaation, even scratching, usually starts with a need to relive emotional pressure -strong negative emotions that youth do not know how to handle any other way. Conflict at home, trouble with romantic partners, self-loathing, peer trouble, anything can trigger the need to relive the pressure, in teens predisposed to it. Cutting is often associated with other psychiatric diagnoses, including anorexia, bulimia, depression, post traumatic stress disorder (PTSD), and bipolar disorder, as well as sexual abuse.

Cutting used to be a shameful, solitary expression of distress, but nowadays cutting seems to be more prevalent, and it is more likely to be done in small groups of girls curious about the experience after hearing about it some place. It tends to start with safety pins or other sharp objects, and if it is something more than curiosity, progresses to sharper objects and deeper cuts, which are required to get the same "rush" or release.

Cutting is another thing for adults to talk openly about with youth, and keep our eyes open for while checking in with the kids we care about. Signs of a problem include long sleeve shirts, gloves, blood on clothing or towels, as well as general signs for concern including a drop in grades, lack of interest in activities, etc... If you suspect your child is cutting his or herself, talk about it with them and find a counselor (with experience treating self-injury) to help. Do not postpone it - the longer it happens, the harder it is to stop because of the addiction to the rush associated with the release of endorphins. Teens should also be encouraged to help a friend who might be cutting by getting help - it is not a good idea to keep their secret - if they care about the friend, they need to tell an adult they trust.

Resources:
Self-injury a web site for the S.A.F.E. Alternatives Program, the only residential self-injury treatment program in the United States.
We're Talking Teen Health

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Labels: Emotional Health

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Are Violent Video Games Really Bad?

An article in USA Today says "No." Citing research by sociologist Karen Sternheimer, the article suggests that we need to look beyond video games and pay more attention to things like community and family violence, alienation, and a lack of parental involvement. That may be true, but I think it is a complete cop out to ignore the impact of violence in video games because students have less than a 7 in 10 million chance of being killed at school.

Other research suggests that exposure to violent video games may increase angry and hostile feelings and that violent video game exposure may decrease compassionate feelings for others with whom they interact. In order to further understand the negative affects on aggressive behavior your child or adolescent may experience from their exposure to violent media visit the American Psychological Association’s (APA) website called "Adults & Children Together Against Violence." Here are a few of the APA’s recommendations and findings:

• Violent behavior is learned, often early in a child’s life.
• Children learn to behave by watching people around them and by observing characters in movies, video games, and television.
• Violent media increases mean-spirited behavior and may cause fear, mistrust, and fear; including nightmares.
• Monitor media consumption.
• Discuss media with children.
• Increase the public’s awareness regarding the potential impact playing violent video games may have on player’s aggressive behavior as indicated in both short and long term research studies.
• Parents should use the Entertainment System Rating Board (ESRB)rating system to evaluate media their children would like to watch or purchase.

Resources (on both sides of the argument):
Reality Bytes: Eight Myths About Video Games Debunked
Common Sense Media
The National Youth Violence Prevention Resource Center
We're Talking, Too: Preteen Health

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Labels: Media

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Parenting in the 21st Century & Blogs

As our culture changes, media and technology are exposing our students at younger ages to a greater variety of images and a wider range of information. As I listen to questions from friends about their teens I have been struck by the fact that many parents, perhaps not as quick to adapt to new technologies, may have found themselves without a “community” of people to discuss these changes, and to sort through decisions and dilemmas presented to parents in the 21st century.

One place parents are finding “community,” along with news and information impacting parenting decisions, is through blogs. The term “blog” comes from “Web log,” and is a form of “social media (e.g., MySpace and Wikipedia).” The word “blog” can also be used as a verb, meaning to maintain or add content to a blog. Blogs are user-generated web sites where entries are made, in a style similar to a formal journal or diary entry, and are displayed in reverse chronological order. Many blogs also include links to other blogs and Internet-based resources that you might find interesting.

Some blogs provide commentary on news about a particular subject, such as adolescent health, politics, education, dieting, medical technology, sports, while others function more like personal online diaries. You can subscribe to most blogs so that updates come via email, making it very easy to stay in touch with a topic or group of people with whom you share an interest.

A typical blog post includes text, a picture, and links to other related information about the topic. People reading the blog can leave comments about the content with links to other web-based information about the topic. Blogs frequently generate lively conversation.

Below are some of my favorite parenting blogs, along with other useful online resources. Enjoy and good luck!

Commonsense Media is dedicated to improving the media and entertainment lives of kids and families. They believe in sane judgment, not censorship. Their homepage includes reviews of the latest movies, resources and tools for parents, and links to their blog.

Ypulse is an independent blog for teen and youth media and marketing professionals, but parents find it very informative as a link to the reality of tweens, teens, generation y and generation x.

Interested in finding other blogs? Just go to Google and search for “blogs for parents.”

Not blogs, but great resources for health information include:

Go Ask Alice! is the health question-and-answer Internet service produced by Columbia University’s Health Promotion Program. They publish recently asked questions, let you search for health information by subject, and give you a chance to ask questions.

TeensHealth was created by The Nemours Foundation for Children’s Health Media. They provide families with accurate, up-to-date, and jargon-free health information.

We’re Talking Too: Preteen Health and We’re Talking Teen Health are sponsored by the Palo Alto Medical Foundation (PAMF) and provide reliable health information and resources to families.

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Labels: Parenting

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Chlamydia and Teens

Chlamydia is America's most common sexually transmitted disease, and is most often seen in teens and young adults. Chlamydia is a bacterial infection spread by vaginal, oral, or anal intercourse. Most people do not have any symptoms to know they have been infected, so they unknowingly pass it from partner to partner. Chlamydia can be easily treated with antibiotics, but if not treated, complications for women can include pelvic inflammatory disease (PID) and scarring in the fallopian tubes that may lead to ectopic pregnancy and infertility. Complications in men are rare, but Chlamydia in males can lead to infertility, as well.

Risk factors for Chlamydia include having sex without using condoms, having a high-risk partner (e.g., who has many partners, a male who has sex with men, injection drug users, and commercial sex workers), having multiple sexual partners, and having started to have sexual intercourse before age 18. Because the rates of infection are so high, it is recommended that all sexually active women under age 26 should be screened regularly for Chlamydia, which means annually, or every time they have a new sexual partner.

Testing for women can be a vaginal swab or urine test, and for males, it is a urethral swab or urine test. Unfortunately, a test cannot tell how long you have had the infection, and the longer you are infected, the greater chance there is of having the more serious complications.

These facts suggest that all young people be encouraged to either not have oral, anal, or vaginal sex, or that they protect themselves by using condoms, and by all means be tested annually if sexually active.

Resources:
We're Talking Teen Health

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Labels: Chlamydia

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Caffeine & Youth

There is no nutritional need for caffeine, and yet it is the most popular drug in the world. Caffeine is found naturally in over 60 plants including the coffee bean, tea leaves, kola nut, and cacao pod. All over the world many people consume caffeine daily in coffee, tea, soda and chocolate, and sadly, more and more youth are picking up the bad habit, earlier.

Caffeine can work as an appetite suppressant for youth or replace nutrient-dense foods like milk. Caffeine enters the bloodstream through the stomach and small intestine and can cause stimulation 15 minutes after it is consumed. The effect of the caffeine stays with us for at least six hours, and caffeine is addictive. Not getting the caffeine you are used to can cause headaches, fatigue, and even muscle pain.

Most people use caffeine as a stimulant, primarily in the morning to increase adrenaline production and help them feel alert during the day. It is generally believed that the amount of caffeine in less than three 8-ounce cups of coffee a day does not cause any health problems, but the caffeine in six or more 8-ounce cups of coffee per day is considered excessive and can be associated with nervousness, anxiety, dizziness, insomnia, excessive urination, and in some cases, reduced fine motor coordination.

If you want to reduce your caffeine intake, cut back slowly, eliminating the equivalent of 1/2 cup of coffee a day. Be aware of the caffeine content in some popular drinks and food:

• An average cup of coffee has about 115 mg
• Mountain Dew has 55 mg
• Iced tea has 70 mg
• One ounce of dark chocolate has 20 mg

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Labels: Substance Abuse

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Grand Rounds 3.24: Thank You

Thank you Allen at gruntdoc.com for hosting Grand Rounds 3.24 this week and including my post about sexuality and religion.

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Reproductive Health: Teens & Young Adults

The National Adolescent Health Information Center (NAHIC) has just released a new fact sheet on Reproductive Health in Adolescents and Young Adults that had mixed news. On one hand, the adolescent pregnancy rates have decreased, as have the number of teens who initiate sexual activity. However, in my mind that does not balance the facts that the prevalence of chlamydia is over six times higher for females than their male peers and that females account for more than half of the HIV cases among adolescents.

About one in five sexually active adolescents becomes pregnant each year (2/3 of whom are 18-19 years old), about 61% of 12th graders are having sex, but only 58% of them are using condoms (reported for last intercourse). On top of that, teens and young adults continue to have multiple sex partners, and young women continue to pick partners that are older than themselves, both of which are risk factors for sexually transmitted infections.

Some of our teens are choosing to become sexually active when they are too young and obviously not equipped with the skills or knowledge to protect themselves from pregnancy and sexually transmitted infections, including HIV. Pregnancy, sexually transmitted infections, and HIV are very preventable. Somehow we have to get teens to understand that they are not ready to become sexually active unless they are able to have a conversation with their partner about the risk of pregnancy and disease, and then effectively protect themselves from both.

Effective protection means if female, they have had their HPV vaccine, that they are using a reliable method of birth control, AND they are using condoms to protect themselves from as many sexually transmitted diseases as possible.

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Labels: Chlamydia, Sexuality Education

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