Halloween Tips From Healthline

Imagine spooky Halloween picture right here!

I am so sorry that Blogger has been down all week and that you cannot see the lovely photos that should accompany the last few posts! I will add them once Blogger is behaving again - I promise!

Halloween is packed with costumes, treats, parties and fun. Stay safe and healthy and avoid "frightening" events by following these simple tips.

1. Trick or treat in a well-lit, designated safe zone where traffic is minimal.

2. Young children should always be accompanied by adults.

3. Carry a flashlight and watch out for obstacles.

4. Wear reflective clothing and avoid costumes that drag on the ground.

5. Choose fire-proof costumes with eye holes large enough for good vision.

6. Inspect all goodies and throw away anything questionable.

7. Consider handing out healthy alternative snacks like fruit bars or nuts.

Wishing you a safe and healthy Halloween,

The Healthline Team

Photo credit: Perla*

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Thank You Grand Rounds

I would like to thank Kim at Emergiblog for hosting Grand Rounds this week and including a post from Teen Health 411 about "the porning of our teens."

This was an interesting week of posts but I have to say that my favorite post was the lost tampon video - thank you Doc Gurley!

Photo credit (when blogger recovers): Ed Bierman

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Scuba As A Hobby

This is a guest post from Surya, my favorite middle schooler!

Scuba diving is like escaping into a different, underwater world. Once you are certified, you can go anywhere in the world and dive.

If you think you might like scuba diving the first thing to do is to try it. Most diving centers have “try scuba” classes that take place in a pool with professional divers to help you try it. If you like it, then there are several parts of your certification.

You need to be 13 years old to do a PADI class, which I did, but if you are 10 – 12 years old you can sign up for a “traditional” class at a local dive center. If you do a PADI class, you will have to read a book, see some movies, and take tests to make sure you understand the information.

Some of the things you need to be able to do correctly and safely are controlled swimming ascents, buddy breathing in case you or a buddy are out of oxygen, which should not happen if you pay attention, and knowing how to properly weight yourself in fresh and salt water.

Once you know the information, then there are at least two pool dives, a swimming test, and finally four ocean dives (in one weekend) to make sure you are safe, can navigate in poor visibility conditions, and can do everything correctly and safely under water without perfect conditions.

You can rent much of the equipment, but you will need your own mask, fins and snorkel. When you go to try on wet suits, do it on a cool day – I got blisters trying mine on during the summer! Wet suits should be hard to get on because they have to fit you tightly or you will be cold under the water because of the loss of heat, which causes hypothermia.

The other parts of the gear that you will wear while scuba diving include:

Buoyancy Control Device (BCD): holds your oxygen tank and weights, as well as inflates and deflates, so you can float on the surface, even wearing all of your gear.
Regulator: this is the thing that goes in your mouth and gives you oxygen.
Cylinder/oxygen tank: holds about 4,000 psi, which lasts a different amount of time depending on the depth of your dive.
Wet (or dry) suit: A wet suit is lets a thin layer of water in, which your body will heat and a dry suit goes over a set of really warm pajama-like clothes and your skin stays dry.
Hood: keeps your head warm.
Gloves: protect your hands from sharp objects and keeps them warm, too.
Submersible Pressure Gauge (SPG): the diver how much air pressure is left in an air tank.
Alternate air source: also called an octopus, it is a second regulator that you will use if your buddy runs out of air.
Compass: points north and helps you find your way if the visibility is bad.
Dive computer/watch: shows you how deep you are and some plan your dive depending on how deep you are and tell you how much time you have left on a dive.

Photo credit: Ed Bierman

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Book Review: The Porning Of A Generation

The Porning of America: The Rise of Porn Culture, What It Means, and Where We Go from Here is a new book by Carmine Sarracino & Kevin Scott that traces how porn culture left adult theaters and became a part of our children's reality.

A well written book that includes some wonderful historical data to counteract the desensitization we have all experienced, a chapter about power, one about women, and most importantly for me, one about where we can go from here!

No matter how hard we try to protect childhood, it does not take a genius to see we are losing - big time. People market thongs to children, high heels and corsets are every day fashion items, very few teen girls are satisfied with their bodies, and the television or Internet brings sex into every household in America. Just spend a little time on MySpace or Facebook to see that youth are imitating pornography - the poses, the behavior, the come hither looks, the clothing, and the lack of chatter about emotional relationships.

What is super scary to me is that no one knows what the impact of this sexualization will be on this generation. Since they were babies, they have been marketed to with sexual images and the promise of sex and happiness, all theirs with the purchase of the right products. The process is obvious if you watch preteen stars transform as they become adults. Most start off sweet and innocent and then end up "pornified" by the time they hit 18 - I have watched my own kids lose interest in Britney Spears, the Olsen twins (don't even get me started), and most recently Lindsey Lohan as they become sexualized.

I can say that while teaching a class on sexuality over the last 10 years at a local university I found it sad to hear that sex was a huge let down for many young women and that they consistently wished they had waited longer to start being sexually active. That, and the fact that an alarming number of young women feel the need to shave their genital area in order to feel attractive is enough evidence to make me fear for their future.

OK, so you do not think I am being critical of only the younger generation, I realize that my generation has not escaped this "porning" either. I am aware of how many middle-aged moms are out there learning how to pole dance to reignite their own sex lives, shopping at Victoria's Secret, and trying every known process to firm their aging skin. It is obvious we have not escaped the pressure to "be a porn star."

Photo credit: pena2

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Picking The Right High School

It is the season that all parents and 13 or 14-year old teens are trying to decide if their local public high school is right choice for their family, and if not, which private schools they can, and will, apply for.

If you have opened this can of worms, there are open houses, application packets, shadow days, letters of recommendation, transcript requests, and most importantly to your teen, the worry about life in high school, with or without his or her current friends.

Here are a few hints. The transition to high school is intense for every teen, so it will not hurt to start the conversation early. About now, talk to your son or daughter about high school, and the decision about where s/he will go, and for goodness sake, only give options if there really are options. If your local public school is the only option, then there you have it - no discussion, but you may want to have them shadow at that school now, when the staff is accommodating other requests. Shadowing will give your teen a sense of the school now, so when they think about the transition, there are fewer unknowns, and therefore, less stress.

Shadowing is when a teen comes to the school for a half or full day as the buddy of a current student, and attends all of the same classes with him or her. If the school says they do not allow shadowing, and you know someone who attends the school, you can call and say your child will be visiting, and ask if they attend the day with their friend, which is usually fine.

If you child gets overwhelmed by the choice, it might help to make a pro and con list about each school they are considering and then talk through the lists, comparing the schools and deciding which of the things they put on their list really matter. It is hard for parents to keep their opinions to his- or herself, but trust that your teen will realize what is important, and likely his or her decision will match yours. If not, it is compromise time - deep breath and listen hard - their opinions are important.

Remember that 8th graders tend to worry about everything - not just high school, but shoes, friends, cancer, world hunger, and what other people are saying about them. The most important gift you can give them is to help them be "present" for this wonderful year and not stress about next year! Good luck!

Photo credit: jakeliefer

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The 2008 Teens' Top 10 Books

About the Teens' Top Ten

Teens' Top Ten is a "teen choice" list, where teens nominate and choose their favorite books of the previous year! Nominators are members of teen book groups in fifteen school and public libraries around the country. Nominations are posted in April during National Library Week, and teens across the country vote on their favorite titles each year during Teen Read Week. Readers aged twelve to eighteen can vote right here, online, anytime that week.

The vote is in!
More than 8,000 teens voted on this year's winners, which are:

1. Eclipse by Stephenie Meyer
2. Harry Potter and the Deathly Hallows by J. K. Rowling
3. Diary of a Wimpy Kid by Jeff Kinney
4. Vampire Academy by Richelle Mead
5. Maximum Ride: Saving the World and Other Extreme Sports by James Patterson
6. City of Bones by Cassandra Clare
7. The Sweet Far Thing by Libba Bray
8. Extras by Scott Westerfeld
9. Before I Die by Jenny Downham
10. Twisted by Laurie Halse Anderson

You better get reading!

Photo credit: Chaparral [Kendra]

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Thank You - Grand Rounds 5.50

Thank you to Christian Sinclair, MD at Pallimed for hosting Grand Rounds this week and including a post from Teen Health 411 about teen health care.

This week was really interesting, I loved the articles on diabetes, asking for help, health records, and survival. It is always so interesting to read about what is important to others - the more different from my world, the more interesting it is to read!

Photo credit: Ed Bierman

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Consuming Kids: The Commercialization of Childhood

Consuming Kids: The Commercialization of Childhood is a new parent education film from the media education foundation that exposes the youth marketing industry's controversial tactics and explores the effect of hyper-consumerism on the actual experience of children.

Youth marketing is a multi-billion dollar industry that has transformed American children into the most powerful and profitable consumer demographic in the world. American kids now influence an estimated $700 billion in annual spending and are targeted from birth with sophisticated marketing tactics.

Childhood has been usurped for profit. My only hope is that this movie wakes people up and starts a public and government outcry against this blatant materialism and abuse of children!

Photo credit: soctech

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The Changing Face of Teen Health Care

The habits we form from childhood make no small difference, but rather they make all the difference. - Aristotle

If we consider the trends over the last twenty years, teenagers are participating in fewer high risk behaviors. They actually drive safer, drink, smoke, and have unprotected sex less, and they do fewer drugs than teens did a couple of decades ago.

That is the good news, the bad news is that they are living with more violence, are less likely to have strong relationships with adults, have lower self-esteem, higher rates of eating disorders, are fatter, eat more processed food, and get less exercise, meaning that they are more likely to develop chronic diseases like diabetes during adulthood.

More bad news is that they are not seeing their doctors for preventive care as often as they should, only one in four young women have had the recommended HPV vaccines, and fewer than that are getting flu shots each year. In general, health care seems to be failing teens just as fast as the cost of health care is rising.

We in health care are going to have to figure out how to do what I will call "relational" health care using existing community resources whenever possible. Teens need a relationship with a medical professional - someone they can ask questions and trust the answers from. More and more health care is going to require that patients "manage" chronic conditions, and that requires information, motivation and monitoring behavior - activities that take time and ongoing support and monitoring.

How is it that we intend to educate and treat these whole people walking through a day, a disease, and a life. But what does it mean to take the "whole" person into account? Where do you start if you want to consider a person's intellectual life, relationships, home, job or career, character, parenting, spirituality, leisure activities, happiness, body, and ability to contribute to our society?

Where are the scripts, the behavioral objectives, checklists, and goals? Even if I wanted to, how can I do a "life assessment" on any teen in my life? As a parent, I find that with my own teens, I have to "pick a piece" to worry about each day. Some days I worry about the pressure they feel to "do it all." Other days I worry about their sleep, eating, and exercise patterns, peer relationships, education, spirituality, exercise, and safety habits. But as a professional, aren't I a safety net for the teens I have contact with? Aren't I somehow more responsible, and held to a higher standard?

I hear the echoes of "give me a break," "no one can do it all," "I am an expert in ____," "that is for someone else to worry about," and "I do not have time," but hey, who does?" If each of us does only our "part" in treating the whole person - a doctor makes sure a teen is immunized, the teacher educates the teenager well-enough to get into college, the parents provide the best moral and spiritual base they can, and the community monitors the safety of this imaginary teen at work, who catches them if they fall?

What if a parent is unable or incapable or worrying about these things? What if a child isn't getting regular medical care and screening? What if a child has no spiritual counseling, and is exposed to violence, or is hopeless and self-destructive? Who is responsible for identifying what is missing and "rescuing" that teen? Who makes sure that the habits they develop in childhood will lead to their happiness and health?

In my way of thinking, "not my department," just isn't in option. Every time we come in contact with a teen, whether it is for 50 minutes in a classroom or 12 minutes in exam room, I think we are morally obligated to look each teenager in the eyes and ask, "how are you?" "who are you?" "what is important to you?" and maybe "what do you think is missing in your life?" Then, we are obligated to follow-up on their answers. Sorry, but sometimes I think we need a reminder!

Photo credit: aflcio2008

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It is National Teen Driver Safety Week

Talk to your teen this week about safe driving. If they are a young driver, ask them to talk about what they are still uncomfortable with when behind the wheel. With the rainy season coming, remember to offer a little training time in the rain, even if they are already licensed.

In 2006, a total of 4,144 teens aged 16--19 years died, and nearly 400,000 were treated in emergency departments for injuries sustained in motor-vehicle crashes in the United States.

The good news is that by delaying full driving privileges so that teens can gain driving experience under low-risk conditions, comprehensive graduated driver licensing systems can reduce fatal and nonfatal injury crashes of drivers aged 16 years by as much as 40%.

Strategies like extending the learner permit period, restricting night-time driving, and limiting teen passengers each contribute to crash reductions. Raising (or keeping) the minimum drinking age to 21 years and enforcing "zero" blood alcohol levels for teen drivers also has reduced motor-vehicle--related deaths and injuries.

Information about teen driver safety and National Teen Driver Safety Week are available from CDC, the National Highway Traffic Safety Administration, and the Children's Hospital of Philadelphia.

Photo credit: djuggler

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Can My Partner Spend the Night?

Oh, how the issues that challenge the parents of young adults just never seem to stop!

What happens when a child who is functioning as an adult, going to school or working, paying his or her own bills, but still living at home asks the question, "can my partner spend the night?"

I posed this question to several people who have young adults and this is what I heard:

Mom A, with two adult sons (ages 22 and 19) living at home:

“I am not comfortable with either son having girls spend the night in their bedrooms. I don't know the girl that well and want to be able to walk around my house in my pajamas without worrying about being seen by a stranger. I guess my children have to suffer because of my self consciousness and comfort level. This makes me sound like a prude, but if they do not like the rules they can move out.

They occasionally have friends spend the night on the couch and I feel I have to be quiet in the morning while I get ready for work so I do not disturb them. I don't mind this once in a while, but do not want them over all the time.

I know that one son has snuck a girl into his room once or twice and knows I don't like it. He and I have not had a discussion about it, he just seems to know that this behavior is not OK and respects it, for the most part.”

Mom B, two adult daughters (ages 21 and 24) not living at home:

"I would say that’s fine. I love my daughters and I would welcome their partner, male or female, married or not into my home. I think the only situation where I might be hesitant is if this became a habit and the partner became more of a roommate that a guest. I think then we all might have to sit and discuss the situation, work out a solution or compromise."

Mom C, mother of seven, four of whom are young adults, some at home:

"Basically, my house, my rules, and no, they can't spend the night "together." I have however allowed the significant others to stay over, but on separate floors, or at least in separate rooms. There are enough younger siblings around to make very effective discouraging chaperones! Usually this is during the holidays or vacation when I have someone sleeping on every available surface and there is absolutely no privacy for fooling around. If it was the only kid, I would still say, absolutely not. If they are living on their own, and paying their own bills, that's one thing (adult behavior eventually follows), but if they are living in my house, I call the shots."

What do you think?

Photo credit: theogeo

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Thank You - Grand Rounds 5.4

Thank you to the wife and mother blogger at Notes of an Anesthesioboist for including the post from Teen Health 411 about Native American Women & Sexual Abuse in Grand Rounds 5.4.

This week was a wonderful read and reminder that we all do our best everyday, on multiple fronts, and deserve a pat on the back whenever possible!

Photo credit: Ed Bierman

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HPV Vaccine Update

Human papillomavirus (HPV) is a common virus spread through sexual contact. Most of the time HPV has no symptoms so people do not know they have it or that they are passing it to others. Although there are approximately 40 types of genital HPV, types 16 and 18 are the most common types associated with about 70% of invasive cervical cancers and can be prevented with HPV vaccines.

Many studies have underscored the high rates of HPV in sexually active individuals. In fact, HPV is one of the most common sexually transmitted infections worldwide and in the United States it is estimated that 24.9 million women aged 14 to 50 years are infected. Those studies suggest that adolescents and young women are the most vulnerable with high rates of infection seen shortly after the onset of sexual activity.

In spite of the encouragement to vaccinate girls after the age of nine, only one out of four girls has received all three HPV shots. If your daughter is not vaccinated, talk to your doctor, or better yet, make an appointment now!

Photo credit: otisarchives1

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Teen Read Week 2008

Welcome to Teen Read Week 2008. Did you know that teens who read for fun have better scores on standardized tests and are more likely to succeed in the workforce? It is true and more than 4,800 school and public libraries are participating in Teen Read Week this year to celebrate teen readers!

No one will tell you that it is easy these days to pull the "digital natives" away from their video games and YouTube and get them to strike up a relationship with pictureless chains of black print, but it is possible. I watched teen girls stop and stare into a book store window last month the day Brisingr was released (the third book by Christopher Paolini), and participated 100% in reading Breaking Dawn the day it went on the shelves in August - actually I purchased three so each of my daughters could read it at camp, and then we donated two copies to a local school library.

No matter how alluring the visual media is, teens are still looking for their soulmates and stories that inspire them. I do not think that any video game can inspire a 13-year old the way House of Mango Street does, and I will never forget watching my 16 year-old listen to parts of "How to breathe under water," by Julie Orringer. Her face is disbelief as she heard the dark and beautiful stories woven by the author. What teens read has to touch them and carry them along with an emotion, a feeling, a desire to turn the next page - and compete with video games!

Our youth are worried about cloning, over population, economic chaos, alternate fuels, global warming, sweat shops, child trafficking, and extinction, topics that just aren't touched by the classics. I bet letting kids pick the books to read in literature classes might just help them buy into the whole process!

Meanwhile, encourage a teen to read this week - better yet, read out loud with one!

Photo credit: moriza

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Keep Teens Safe: Vote No on CA Prop 4

Marketing seems to have infiltrated politics. The people of California are being encouraged with words like "secret, predator, Megan's law, coercion, & sexual abuse," to make it a law that parents be notified 48 hours before a teen can receive an abortion.

The reality is that teens get pregnant more often by having sex voluntarily with a same-aged peer than by being sexually abused. We have laws allowing teenagers to seek confidential reproductive care to avoid unsafe abortions and encourage teens who do get pregnant to seek care and counseling quickly. Teens that fear their parents finding out that they are sexually active are the ones who do not get birth control, do not use condoms, postpone care, and end up needing abortions.

Yes, it would be great if our schools taught comprehensive sexuality, parents and teens did communicate about healthy relationships and sexuality and teens did not get pregnant, but that is not our reality! We live in a culture that sexualizes youth and sells sex - we promote sexual activity but do not give teens the information they need about birth control and the skills to talk to sexual and romantic partners about sexual risk and prevention.

Parents should be encouraged to talk with their teens, teach them how to recognize unhealthy and potentially abusive relationships, protect themselves from pregnancy and sexually transmitted infections, and encourage them to talk with an adult if they need medical care, but forcing this issue promotes, denial and puts our most vulnerable teens in harms way!

Please talk about Prop 4 and encourage people to KEEP TEENS SAFE and VOTE NO on Prop 4.

Photo credit: alexandralee

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Native American Women & Sexual Abuse

Some days I wish I did not know things. For example, did you know that one in three American Indian women (34.1percent) experience rape in their lifetime as compared with 18 percent of white women and 19 percent of African American women? This may have something to do with the fact that Tribal Law Enforcement cannot arrest non-natives for crimes committed on reservations, or with high rates of alcohol use, or maybe a combination of these factors.

When a woman is sexually assaulted, she is vulnerable and scared, but needs to be examined before she showers, using a police rape kit to collect forensic evidence. In addition, she should be tested for sexually transmitted infection, and maybe treated preventively.

Most hospitals have nurses trained to be a sexual assault nurse examiner (SANE), which teaches them how to use the rape kit and care for a rape victim in a respectful manner, but the exception may be hospitals within the Indian Health Service (IHS).

The Native American Women's Health Education Resource Center reports that 44% of IHS hospitals do not have SANE-trained personnel, and in some places, there is only a medical professional available once a week. In addition, there is no support for the lifelong process required to recover from a sexual assault, which happens most often to young women. Community-based organizations, like the Rape Abuse & Incest national Network (RAINN), can fill the gap for support, but once the forensic evidence is lost, it is too late for any chance of prosecution, leaving rapists at large.

Photo credit: maveric2003

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Baby Sitting Rules & Conversation

If you have teenagers, chances are good that they babysit, and it is very common for families to have rules about babysitting. For example, while babysitting teens should:

• not have friends over or talk to friends on the phone;
• not babysit until after 9 PM on school nights;
  
• have a contact phone number for the parents during the evening;
• have a permission to authorize medical treatment;
  
• know the insurance information for the family; and
  
• agree on fees before accepting the job.

It is also common for the family s/he is working for to bring her home, but have you ever specifically said to your teen that if the parents s/he was babysitting for appear to have been drinking, s/he is to call you for a ride home instead?

Given that most people seem to understand "it is never OK to drink and drive," I cannot say this would have occurred to me, but I think it is extremely important and well worth a conversation.

Teens sometimes tend to trust adults, and your teen may not stop and think about getting into the car with a family friend who has been drinking the same way you expect him or her to with a peer, so please, talk about it before s/he makes a poor decision. Let your teen know that you would rather get woken up to drive a child home then for him or her to get a ride with someone who had been drinking.

Photo credit: caswell_tom

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Eating Rainbows

Nutritionists tell us that a rainbow of colors offers balanced nutrition and it is fun to talk with kids about the food pyramid and how eating a variety of foods and different colors is healthy! To support that idea the new food pyramid has food groups represented by six different colors:

• Orange - grains
• Green - vegetables
• Red - fruits
• Yellow - oils
• Blue - milk products
• Purple - meats and beans
  

Foods from each group should be eaten daily because different colored food has different nutrients. For example:

• Red foods contain lycopene, which is known to reduce prostate cancer risk;
• Green foods contain antioxidants;
• Yellow and orange foods are rich in beta-carotene and strengthen our immune system;
• Blue & purple foods contain anthocyanins that may prevent heart disease; and
• White foods like garlic have anti-tumor properties.
  

What is cool about eating the rainbow is that you can try and find foods in different colors - orange tomatoes, yellow peppers, purple brocolli, which is usually easier at a farmer's market than your corner grocery store. Nine a day would be good, so get cooking!

Photo credit: sylvar

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