October 31, 2014

Improper Splinting of Kids' Fractures Is Common, and Can Cause Serious Complications

A lot of parents with active kids are familiar with the emergency department of their local hospitals, thanks to the common incidence of broken bones and sprained ligaments. According to a new study by researchers at the University of Maryland School of Medicine, mom and dad should pay careful attention to how their child’s injury is treated initially.

More than 9 in 10 potential pediatric fractures, the researchers found, are splinted improperly in ERs and urgent care centers. Such errors can cause swelling and skin injuries, and can lead to long-term structural and mobility problems.

These mistakes are significant, given the frequency of broken bones among children and adolescents — nearly half of all boys and one-quarter of all girls experience a fracture before they’re 16. The patients in the UM study had a range of fractures affecting all extremities, including fingers, arms, ankles and knees.

The results were drawn from reviewing 275 cases of children as old as 18 who were treated initially at community hospital emergency rooms and urgent care facilities in Maryland, and evaluated later by pediatric orthopedic specialists at UM.

A splint is created from at least one strip of rigid material placed against the injured extremity, which is then wrapped with padding and an elastic bandage to hold it in place and immobilize the joint. ERs and urgent care centers use splints as temporary stabilizers for possible fractures, and to reduce pain.

After being splinted, patients are referred to an orthopedic specialist, who removes the splint and evaluates the problem completely.

Dr. Joshua M. Abzug, an orthopedic specialist at the UM School of Medicine and the study’s lead author, said in a news release, “Unfortunately, many practitioners in emergency departments and urgent care settings incorrectly applied splints, potentially causing injury.”

The most common mistake in splinting kids, according to the study, was wrapping the elastic bandage directly onto the skin. That happened in more than 3 in 4 patients. In nearly 6 in 10, the joints were not immobilized correctly, and in more than half, the splint was not the proper length. Skin and soft-tissue complications were observed in 4 in 10 patients.

According to a report on NPR, the study showed that in some cases, the elastic bandage had been wound too tightly, which impedes blood circulation.

Sometimes, the bandage placement opened a wound. And one patient’s foot was immobilized at the wrong angle to her leg, which complicates her ability to walk she’s ready a few weeks later.

Abzug told NPR that broken bone treatment has changed in the last decade or two. Before, when parents and kids landed in the emergency room after an injury, the same person who diagnosed the break probably would fix it. But today, with increasing medical specialization and a proliferation of urgent care centers, it's more common for the emergency caretaker who splints the break to instruct the parent to follow up with an orthopedist for more treatment the next day.

"For whatever reason, many parents don't follow up right away," Abzug told NPR. "Sometimes it's a problem with health insurance, or they can't take time off work, or they just didn't understand the instructions."

But if the splinting wasn’t correct, waiting too long can cause devastating complications, including permanent loss of motion or a need for skin grafts. If the bandage was applied too tight, waiting even one night can produce lasting damage.

If your child’s injury has been splinted, observe the process to ensure only the rigid piece and the padding, not the bandage, make contact with the skin. Don’t ignore your child’s complaints about comfort or pain. Major swelling or discoloration in the area around the splint is sign that something’s wrong.

See an orthopedist as soon as possible if the treating emergency practitioner did not completely diagnose and treat the injury.

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October 24, 2014

The Best Birth Control for Adolescents

Many parents might not want to acknowledge it, but a lot of teenagers are having sex. A new study has identified the most effective contraception for adolescents who can't or won't delay sexual activity.

Long-acting reversible contraception (LARC), which includes progestin implants and intrauterine devices (IUDs), according to research in the journal Pediatrics, should be the first choice for teenage birth control.

The American Academy of Pediatrics (AAP) supported this conclusion. A technical report that accompanied the Pediatrics study depicted that LARCs were effective, safe and easy to use.

A story on MedPageToday.com, deemed the report an update of AAP guidelines from 2007, when the use of latex condoms was encouraged as the only specified form of birth control.

But the recommendations aren’t exactly new: In 2012, the American Congress of Obstetricians and Gynecologists (then called the American College of Obstetricians and Gynecologists), or ACOG, said that contraceptive implants and IUDs offered the best protection against unintended pregnancy in adolescents.

In 2009 only 4.5 in 100 sexually active, 15- to 19-year-olds used LARCs. The most popular contraception among teenagers was condoms — 95 in 100 sexually active kids used them, but 55 in 100 also had used oral contraceptives.

Of course, oral contraceptives aren’t effective if they’re not used exactly as intended, and if there’s any group of people who are likely to forget to take a daily pill, it’s adolescents.

An unsettling 57 in 100 female adolescents had used the withdrawal method for birth control, which, according to MedPage, has more than a 1 in 5 rate of failure rate among all users.

The Pediatrics researchers made clear that the easiest, most long-lasting form of contraception was best for adolescents. "The most effective methods rely the least on individual adherence," according to an AAP statement by the authors of the study. "For these methods, typical use effectiveness approaches perfect use effectiveness."

After one year of use, the number of unintended pregnancies among women who used progestin implants was less than 1 in 100, as it was among those use used a levonorgestrel or copper IUD.

Single-rod progestin implants are inserted into the inside of the upper arm, and are effective for three years. They contain a hormone that prevents ovulation and makes the uterine environment less hospitable to sperm and eggs.

IUD technology has a come a long way since the Dalkon Shield scare of several decades ago. That device promoted bacterial infections because of its porous design and string configuration, shortcomings that have been addressed.

IUDs, some of which remain effective for as long as 10 years, have a good safety profile, but they’re more likely to be expelled by adolescents than by older women. And many young women who have not borne children report moderate to severe pain when the IUDs are inserted.

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October 17, 2014

Marijuana: Sometimes It’s Legal, but Always Dangerous for Children

With the increasingly relaxed laws on the use of marijuana, more youngsters are sampling weed with the idea that it’s safe. It’s not.

Dr. Garry Sigman, director of the Adolescent Medicine division at Loyola University Health System and professor in the Department of Pediatrics at Loyola University Chicago, said marijuana is an addictive substance and, compared with adult users, adolescents are as many as four times more likely to become dependent on the drug within two years after first using it.

As more adults legally are allowed to smoke dope, and as more states refrain from imposing many of their marijuana laws, teenagers particularly perceive marijuana as a safe substance. But, as Sigman noted in a news release, “[I]ts effects on the adolescent brain can be dangerous, especially if there is heavy use. As the stigma of marijuana use decreases, the number of teens using the drug has increased. More U.S. high school students now smoke marijuana than they do cigarettes.”

Loyola Medicine referred to a recent study showing that more than 1 in 3 high school seniors and 7 in 100 eighth-graders reported using marijuana in the last month. A report in the October issue of the Journal of Leukocyte Biology indicates that using marijuana in adolescence might damage the immune system in the long term.

Some teens use marijuana only occasionally, mostly the result of peer pressure in a social setting, but others self-medicate to cope with stress and emotional issues.

“Marijuana is the most common substance addiction being treated in adolescents in rehabilitation centers across the country,” Sigman said. But because it’s perceived as a “softer” kind of drug, because it moderates anxiety and depression, many people don’t realize that its addictive quality can come with the cost of dependence, and the problems associated with withdrawal.

According to Loyola Medicine, heavy use of marijuana by adolescents can lead to:


  • impaired thinking;

  • poor educational outcomes and perhaps a lower IQ;

  • increased likelihood of dropping out of school;

  • symptoms of chronic bronchitis; and

  • increased risk of psychotic disorders for people who are predisposed.


Parents, Sigman advised, need to know that today’s “joint” is as many as four times as potent as the stuff they might have smoked in their youth. “Parents should inform themselves about the scientific facts relating to marijuana and the developing brain and be able to discuss the topic calmly and rationally,” Sigman advised. “Also, if the parents occasionally used marijuana during their lives, they should now know that there’s a risk if used before adulthood.”

To learn more about the addictive qualities of marijuana, how to recognize if your child is smoking it and what to do about it, consult the website of Choose Help, a resource for information about addiction and access to treatment.

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October 10, 2014

Breakfast: One Way to Reduce Kids' Risk of Developing Diabetes

Eating a healthful breakfast is good for you for many reasons, and a new study says that for kids, this regular practice can reduce the risk of developing diabetes.

Type 1 diabetes, once referred to as “juvenile” diabetes, develops early in life as a chronic condition. The pancreas is unable to produce the hormone insulin, or sufficient amounts of it, to maintain a proper level of glucose, or blood sugar. The more common type 2 diabetes develops later in life, often with a significant contribution by unhealthful behaviors that encourage the body to become resistant to insulin.

According to a recent study published in PLoS Medicine, getting into the habit early in life of eating a healthful breakfast might help kids lower their risk of developing type 2 diabetes. In the study, children who skipped breakfast most days had higher levels of known diabetes risk factors.

More than 4,000 children ages 9 and 10 were studied. More than 1 in 4 said they did not eat breakfast every day. Their resistance to insulin, a marker for diabetes, was higher than those who said they ate breakfast every day.

The kind of breakfast was important, too. Kids who ate a high fiber cereal, or one composed of complex carbohydrates, showed a lower insulin resistance than the ones who ate a meal higher in simple carbohydrates, such as biscuits.

There are two kinds of carbohydrates: complex and simple. Complex carbs are more healthful because they are less refined and the body takes longer to digest them. That helps moderate glucose levels. Simple, or refined, carbohydrates are digested more quickly and can cause blood sugar to spike.

Whole grains, or complex carbs, have more dietary fiber and are found, for example, in whole wheat and whole oats. Simple carbs have more sugar, and, in addition to refined grains, are found in milk products and fruit. They can be part of a healthful diet, but refined sugar products — foods rich in white flour and added sugar — are not. So it’s better to sweeten your whole wheat flake cereal with fruit than white sugar.

Of course, a good breakfast also has some protein (eggs, for example), but this study focused on carbohydrates. And because it showed only an association, further studies are required to adjust for factors such as a child’s socioeconomic status, degree of physical activity and body fat in order to draw concrete conclusions.

But there’s no question oatmeal is a better breakfast choice than toast made from white bread. Anything that might stave off diabetes and its chronic complications is a good thing. (See our blog, “Teens Who Develop Diabetes Have a Stark Future.”

To learn more about carbohydrates, visit the information page on the website of the Centers for Disease Control and Prevention.

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October 3, 2014

Poll Shows Gaps in Parents’ Knowledge About Concussions

Before their children are allowed to participate in sports, many parents must sign a document acknowledging that they understand concussions and their risks for brain injury. But a new poll on children’s health suggests that even if they know about the risk of concussion, they’re not necessarily capable of handling it properly.

According to the C.S. Mott Children’s Hospital National Poll on Children’s Health, about half of the 912 parents of middle- and high-school children surveyed said they had participated in some kind of concussion education.


  • Nearly 1 in 4 had read a brochure or online information.

  • Seventeen in 100 had watched a video or attended a presentation.

  • Eleven in 100 had signed a waiver form, but had no other educational information.

  • Nearly half had received no concussion education at all.


As you might expect, it was more common for parents of children who play sports to have gotten some kind of concussion education than for parents of nonsports kids (58% vs. 31%).

Some education is better than none, but, according to Sarah J. Clark, associate director of the Mott national poll, “The way the concussion information is delivered is linked to the parents' confidence about managing their child's injury." Clark is also a research scientist at the University of Michigan Department of Pediatrics/University of Michigan Medical School.

"Many schools mandate that a waiver form … be signed, but the danger is that parents will skip over information to get to that required signature line," she said in a news release.

More than 6 in 10 parents who watched a video or a presentation rated it as very useful. About 4 in 10 parents who read a brochure or online information rated that as very useful. Only 11 in 100 parents whose only concussion education was signing a waiver form reported that was very useful.

Parents lacking sufficient information about concussion, and its potential for brain injury, won’t know what to do if their child is injured.

According to the U.S. Centers for Disease Control and Prevention (CDC), nearly 175,000 children are treated every year in U.S. emergency rooms for concussions related to sports or recreational activities, including bicycling, football, playground activities, basketball and soccer.

Although it’s never a minor event, a concussion affects children differently from adults. The healing process is different, and getting more than one concussion in a short period is particularly dangerous for kids.

All parents, but especially those with sports-playing youngsters, should get become informed about what is concussion, how to monitor its symptoms and when to seek medical attention. Until symptoms have subsided, parents should limit the child’s physical activity, and maybe mental activity including homework, to allow the brain to heal. (See our blog, “Getting Back Into the Game After Suffering a Concussion.”) Watch the video from the C.S. Mott Children’s Hospital here.

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September 26, 2014

Scary Virus Is Spreading, but Isn’t Life-Threatening

An unusual respiratory infection that strikes primarily children is spreading across the country. The virus isn’t new, but its effect on children seems to be, according to a story on KevinMd.com.

There are many strains of enterovirus, but enterovirus D68 ( EV-D68) has hit the Midwest especially hard, and as of last week involved 13 states, the most recent being California. According to the Centers for Disease Control and Prevention (CDC), the symptoms can be severe, although no deaths have been reported.

As detailed by Dr. Wendy Sue Swanson, a pediatrician, the CDC’s data concern children from 6 weeks to 16 years old, with a median age of 4 years. Nearly 7 in 10 enterovirus patients had a history of asthma or wheezing.

“No question the illness has taken many by surprise,” Swanson wrote, “as it’s an unusual time of year to see huge numbers of children with cold symptoms with severe wheezing. In areas where the infections started to pop up, schools [have] been in session for a month or more so kids have been doing what they do best, playing in close contact and exchanging germs.”

Here’s what she says parents need to know:


  • Enteroviruses can cause a common upper respiratory infection often causing summertime “colds”; rarely do they cause serious infections.

  • Enteroviruses typically spread in fecal-oral fashion — that is, from not washing one’s hands after using the toilet, and spreading germs to the mouth. But EV-D68 also spreads from mucus and droplets in the air, from close contact.

  • Both children and adults can recover from enterovirus infections with rest.

  • Asthma is a risk factor for more severe symptoms associated with EV-D68. More than half of the children with lab-documented EV-D68 also had asthma.

  • There’s no vaccine to protect from this virus and no current medications to treat it; the body’s immune system needs time to eradicate it, and sometimes symptoms are so severe as to require hospitalization for respiratory support.

  • Prevention is the most important thing if the virus continues to spread throughout the U.S. Washing hands with soap and water for 20 seconds before eating and after coughing or sneezing or after changing diapers, is essential. Children and adults should stay home when they’re ill.


In addition, the American Academy of Pediatrics advises, “Children who have previously been diagnosed with asthma should follow their asthma action plans and communicate with their health care provider regarding yellow and red zone instructions.”

Remember that the symptoms of EV-D68 begin like a common cold, and you might not recognize its severity until your child is very ill. But most kids will recover on their own. If your child is unusually sick or is having breathing difficulty, call the doctor.

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September 19, 2014

CDC Says Kids Eat Too Much Salt

According to the U.S. Department of Agriculture’s dietary guidelines, children should consume no more than 2,300 mg of sodium every day. According to a new report by the CDC, they’re eating about 3,300 mg.

The risks of eating too much salt include high blood pressure, which can lead to stroke and heart disease later in life. And high-sodium foods often have a lot of calories, which undermines weight control.

American youngsters already show the effects of their salty diet. As federal officials said in a story on Reuters.com, 1 in 6 Americans 7 to 18 years old has elevated blood pressure, which is linked closely linked to a high sodium intake and obesity.

Most of the sodium kids eat comes from processed foods including pizza, sandwiches like cheeseburgers, cold cuts and cured meats, pasta with sauce, cheese, salty snacks like potato chips, chicken nuggets and patties, tacos and burritos, bread and soup.

"Most sodium is from processed and restaurant food, not the salt shaker," CDC Director Tom Frieden said in a statement. "Reducing sodium intake will help our children avoid tragic and expensive health problems."

According to the report, more than 9 in 10 U.S. kids between 6 and 18 years old eat too much sodium every day. Teenagers eat more salt than younger kids.

About 65% of their sodium consumption comes from foods purchased in stores; fast food restaurants account for about 13%. Meals provided at school represent 9% of total sodium consumption.

And if you think snacking, and food eaten outside of parental control, is the root of this evil, think again — dinner is the largest single source of sodium, accounting for nearly 40% of daily consumption.

The study involved the National Health and Nutrition Examination Survey in 2009 and 2010, and included interviews with more than 2,000 school-aged children.

Developing a taste for salty foods occurs early, so it’s important for parents to influence diet from a young age, and help their children develop a taste for less salty meals through what they buy, how they prepare it and by establishing healthful eating habits themselves.

As the researchers said, the need is to reduce sodium "across multiple foods, venues and eating occasions." In calling for processed foods with less sodium, they acknowledged that efforts in Britain to reduced total sodium consumption resulted in a 15% decline over seven years.

The CDC recommends that parents and caregivers:


  • Model healthful eating for their children by providing a diet rich in fruits and vegetables without added sodium.

  • Compare Nutrition Facts labels to choose the lowest sodium option before they buy.

  • Ask the grocery manager to provide more low sodium options for their family's favorite foods.

  • Request restaurant nutrition information to make lower sodium choices when dining out.

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September 12, 2014

Weight Gain Makes Kids More Vulnerable to Asthma

Asthma and obesity are common problems among U.S. children, and a new report in the Annals of Allergy, Asthma & Immunology ponders how obesity contributes to childhood asthma.

Nearly 7 million U.S. children have asthma, and more 12 million kids from 2 to 9 years old are obese. According to the American College of Allergy, Asthma and Immunology (ACAAI), obese children have an increased risk of developing asthma. An ACAAI news release accompanying the journal report acknowledges link between childhood obesity and asthma, but said research hadn’t determined which condition generally occurs first, or whether one causes the other.

This study suggests that being overweight comes first, although the connection is complex and many factors have yet to be examined.

The report showed that rapid growth in body mass index (BMI) during the first 2 years of life increased the risk of asthma until kids were 6 years old. Previous studies showed that the onset and duration of obesity and the ratio of lean tissue to excess fat can affect lung function. (See our blog, “Fast Food Diet Shows Link to Breathing Problems.”)

But practitioners often don’t know if the constricted airways characteristic of asthma makes kids unwilling to exercise, and therefore gain unhealthy amounts of weight, or if being overweight narrows airways, prompting the development of asthma.

“Most kids who suffer from asthma also have allergies,” Michael Foggs, MD, and president of ACAAI, said in the news release. “These allergic responses in the lung can lead to symptoms of allergy. Coughing, wheezing and shortness of breath are all symptoms that make exercise harder.”

The ACAAI says that children with asthma and other allergic diseases should be able to participate in any sport they want to as long as their condition is monitored and controlled. If they show symptoms of asthma during or immediately following exercise, it’s an indication that their condition is not being properly controlled.

In other words, asthma shouldn’t be so severe that it restricts a kid from being active; it’s a condition that can be managed and accommodated.

For advice from allergists about dealing with your child’s asthma, link here. To learn more generally about asthma and allergic conditions, and to locate an allergist in your area, link here. For information about hospital treatment of children with asthma, see our blog, “Assessing the Quality of Hospital Care for Children with Asthma.”

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September 5, 2014

Schools Start Early, but Teens Need to Sleep Later

Although plenty of studies show that the natural sleep cycle of teenagers skews late, school hours start early. In addition to health problems, sleep deprivation can cause lower academic performance and increased risk of accidents.

The American Academy of Pediatrics (AAP) recently issued a new policy statement supporting the idea of a later start time for middle and high school. The academy recommends starting no earlier than 8:30 a.m., it says, to “align school schedules to the biological sleep rhythms of adolescents, whose sleep-wake cycles begin to shift up to two hours later at the start of puberty.”

The September issue of the journal Pediatrics published the statement, “Insufficient Sleep in Adolescents and Young Adults: An Update on Causes and Consequences,” which referred to research showing that adolescents who get enough sleep enough lower their risk of being overweight, suffering depression and being in an automobile accidents. They also get better grades and report a better quality of life, according to Dr. Judith Owens, a pediatrician and lead author of the policy statement.

“Chronic sleep loss in children and adolescents is one of the most common – and easily fixable – public health issues in the U.S. today,” she said.

Mark Fischetti, a senior editor at Scientific American, voiced strong support for the movement toward later school hours.

“Ask any groggy teenager waiting for a bus or yawning in ‘home room,’” he wrote, “and he or she will tell you that it’s just too darn early in the morning to learn chemistry equations or analyze a narrative by some Russian novelist.

“Are they just lazy? No. Scientific studies of teen sleep patterns say they’re right. So do results from numerous schools across the country that have delayed start times: The later classes begin, the more academic performance improves. Bonus points: attendance goes up, teen depression goes down, and fewer student drivers get into car crashes.”

It’s all about circadian rhythms, the biological clock that makes you feel awful when you travel across several time zones (jet lag) and can disrupt workers whose shifts change from day to night to day.

Circadian rhythms, Fishchetti noted, shift during the teen years. Starting around age 13 or 14, the kids naturally stay up later and sleep later, a pattern that peaks between 17 and 19. Adolescents also need more sleep than an adult.

One study of 9,000 high school students in three states showed that grades in science, math, English and social studies rose when school began at 8:35 or later. Experiments at two North Carolina high schools and at the U.S. Air Force Academy also showed that academic performance improved when start times were later.

School districts might be reluctant to revise what they’ve always done, but Fischetti reported that their concerns about starting school later aren’t fulfilled — kids still can hold an after-school job, and participate in after-school programs.

“The issue is not the start time. It’s that the students are overly busy,” said Kyla Wahlstrom, one of Fischetti’s sources. “There is too much pressure to cram it all in just to have a good resume to get into college.”

Wahlstrom is director of the Center for Applied Research and Educational Improvement at the University of Minnesota. She said students, parents and school advisors should ratchet back the activities, and emphasize certain ones they enjoy or do well at, rather than participate in order to impress colleges. She said students should get eight, and preferably nine, hours of sleep every night.

Other countries seem to be learning this lesson. Studies in Brazil, Italy and Israel associate later start times with improved learning, and high-school level students in Europe seldom start before 9:00 a.m.

Even if it’s not about academics, it’s about safety. Fischetti referred to a high school in Wyoming that moved the start time from 7:35 a.m. to 8:55 a.m. and saw a 70% reduction in car crashes among drivers ages 16 to 18.

University of Kentucky researchers studied the issue and found that crash rates of teen drivers fell 16.5% in the two years after start times were delayed one hour, while the teen crash rate where they remained the same rose 7.8% in the same time period. The students in each of those groups, respectively, slept different amounts. In the reduced-crash group, those who got at least eight hours of sleep during weeknights rose from 36% to 50% percent, and those who got at least nine hours rose from 6% to 11%.

Your teen probably isn’t willing to go to bed earlier, and if he or she does, might not be able to fall asleep. But almost all of them would be willing to sleep later.

It’s time for school districts to wake up and smell the coffee.

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August 29, 2014

Worrisome Trend: Sunscreen Use Declines Among Teens

Although the rate of some cancers has declined in recent years, melanoma — the most serious form of skin cancer — is not among them. The situation is more troubling with the news of a new study that fewer teenagers are using sunscreen than they used to.

Because sun damage is cumulative — that is, like X-rays and other forms of radiation, the more exposure you have and the longer you have it, the greater the risk of developing cancer — the news is particularly unsettling. The earlier in life you develop the habit of reducing sun exposure, and of using sunscreen when you are outside, the greater your chances of minimizing the risk.

The study about teens was part of the Youth Risk Behavior Surveillance System, an initiative of the Centers for Disease Control and Prevention (CDC). It reviewed use of sunscreen and indoor tanning devices among high-school students across the U.S. between 2001 and 2011. Even though teens generally practice fewer skin-protection habits than adults, this study, as reported on AboutLawsuits.com, showed a decline sunscreen use and an increase in indoor tanning use even from previous reviews.

The number of teens who use sunscreen dropped by more than 1 in 10 from 2009 to 2011. The lowest rate of sunscreen use was in 2005, when only 5 in 100 teens applied it. The rate teens used indoor tanning devices varied less in that period, from 15 in 100 in 2009 to 13 in 100 in 2011, but it still declined.

Although as adults, more women than men wear sunscreen, the CDC study showed that girls used indoor tanning devices more than boys. In 2009, 1 in 4 girls tanned indoor regularly compared with 6 in 100 boys. And their use of tanning beds increased as they got older. Sunscreen use was fairly consistent across all grade levels.

A few years ago, we blogged about the dangers of kids and tanning beds, “Youth and Tanning Beds: Do Not Mix,” but it appears American youth — and their parents — aren’t getting the message.

According to the American Cancer Society, melanoma is diagnosed in about 69,000 Americans each year, and about 8,650 die from it. The CDC says that rates of melanoma rose 1.6% among men and 1.4% among women every year from 2001 to 2010.

Other forms of skin cancer are less lethal than melanoma, but are still problematic and require treatment. AboutLawsuits refers to a study from a few months ago that showed that teenagers who use tanning beds are more likely to develop basal cell carcinoma, one of those forms, and that they were more likely to be diagnosed at a much earlier age.

However you get harmful radiation, and wherever it shows up on your body, it’s not good. And, often, it’s preventable. Adults should make sure they minimize exposure to the sun, and should spurn the use of tanning beds, and they should make sure their kids do, too. It’s an investment in future health.

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August 22, 2014

Why “Go Out and Play” Is Good Advice to Build Healthy Brains

As families start to wind down summer activities and gear up for the return to school, new research may help parents realize that recess can be as important to a child’s brain development as time in the classroom.

Studies discussed in the book “The Development of Social Engagement: Neurobiological Perspectives,” show that the experience of play alters neurons in a certain part of the brain for a benefit that doesn’t otherwise occur.

Changes in the prefrontal cortex during childhood, said researcher Sergio Pellis in an interview on NPR, help wire the brain's executive control center, which is critical in regulating emotions, making plans and solving problems. So play, Pellis said, prepares a young brain for life, love and even school.

But not just any kind of play. It has to be the kind that kids seem to get less of these days — free-form, uncoached, spontaneous play. No coaches, no umpires, no rules.

"Whether it's rough-and-tumble play or two kids deciding to build a sand castle together, the kids themselves have to negotiate, well, what are we going to do in this game? What are the rules we are going to follow?" Pellis said in the interview. Because these playful interactions actually are fairly complicated social relationships, the brain builds new circuits to navigate them.

A couple of years ago, we discussed another aspect of spontaneous play that involves risk-taking; see “Risky Play on Playgrounds Isn’t Always Wrong.”

These are lessons scientists have learned from animals.

Species including cats, dogs, most mammals and some birds engage in social play. Observers used to think that rough-and-tumble animal play might be how they develop survival skills. But studies have suggested otherwise. Even if adult cats were deprived of play as kittens, for example, they’re still good at killing a mouse.

So researchers began to see the value of play for different reasons. One, Jack Panksepp, studied rats, who horse around a lot, and emit a sound he dubbed "rat laughter." His studies showed that about 1 in 3 of the genes they looked at were significantly changed after a half-hour of play.

Of course, a rat brain isn’t a human brain, but there’s also a reason rats are common scientific test subjects. As Pellis noted, play behavior is similar across species. Rats, monkeys and children all seem to follow similar rules: Participants take turns, play fair and don’t inflict pain.

So play helps people and animals socialize.

In people, Pellis said, the skills associated with play can boost academic performance. One study showed that the best predictor of academic performance in eighth grade was a child's social skills in third grade.

As Pellis observed, "[C]ountries where they actually have more recess tend to have higher academic performance than countries where recess is less."

It’s good exercise and good discipline for kids to participate in organized sports. But it’s not the only form of physical activity that’s good for them. And, possibly, not even the most important.

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August 15, 2014

All-Terrain Vehicles Are Not Toys

Here’s a “Say what?” statistic that should give parents pause: More than half of all teens who have driven an all-terrain vehicle (ATV) have been involved in an accident.

So says research recently published in the Annals of Family Medicine. The report also shows a propensity for teens to engage in several kinds of risky behavior when they ride on an ATV.

As explained on AboutLawsuits.com, researchers from the University of Iowa Carver College of Medicine found that 3 in 4 teenagers in the state of Iowa have driven an ATV and that kids 15 and younger represented 1 in 5 ATV-related deaths.

The findings about the number of teens who had been in crashes were similar to previous studies from other states.

The conclusions were based on a survey of 4,684 youngsters between 11 and 16 taken over 2½ years at 30 different schools throughout Iowa. More than 1 in 3 of the kids who said they’d ridden an ATV reported doing so every day or every week. More than half of the ATV riders said they’d been in at least one accident, and nearly all of them acknowledged having engaged in risky behavior, which was defined as:


  • riding with a passenger (9 in 10 reported doing this);

  • riding on public roads (8 in 10);

  • riding without a helmet (more than 6 in 10).


Six in 10 respondents reported having engaged in all three dangerous behaviors at some point. A scant 2 in 100 said they had engaged in none of them.

According to the ATV Safety Information Center, an initiative of the U.S. Consumer Product Safety Commission, of about 100,000 ATV injuries in 2012, one-quarter were kids younger than 16, and of the 353 ATV fatalities that year, 54 were from that group.

Even for people who are careful, ATVs are dangerous — they’re powerful and can be unstable, especially if they have more riders than they’re built to accommodate.

The most fearsome accidents, of course, involve brain injuries, which, according to the new study, “are among the leading cause of death and disability from ATV crashes. They are more likely to occur on the roadway than off road, even when controlling for helmet use. Helmets are estimated to reduce the risk of fatal ATV-related head injuries by 40% and of nonfatal head injuries by 60% or more.”

To learn more about brain injuries, see our backgrounder.

If you and your family enjoy riding all-terrain vehicles, make sure you follow the safety guidelines provided by the CPSC:


  • Do not drive ATVs on paved roads.

  • Do not allow a child under 16 to drive or ride an adult ATV.

  • Do not drive ATVs with a passenger or ride as a passenger.

  • Always wear a helmet and other protective gear such as eye protection, boots, gloves, long pants and a long-sleeved shirt.

  • Take a hands-on safety training course.


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