In its online article, "Nagging Goes High Tech", ABC news reported that 63% of parents say that texting has improved communication with their kids. On the other hand, it can easily be seen by teens as a new way for parents to breathe down their necks. "One time my mom got my report card and texted me, telling me I was grounded for two weeks," recalled Jessica Purcell in the ABC report.
During a recent parents' meeting at my childrens' high school, the principal implored parents not to text kids during the day as it is not only disruptive, but bad parenting. For instance, he said, it is not a good idea to text right after the math test. Let your child process his thoughts, feelings, anxieties and concerns or even his elation over the test before you try to edit those sentiments by intruding with :"How did it go?" The principal went on to describe a parent who phoned the math teacher after such a test/text situation before the school day was even over! How will we teach our kids resilience and self-reliance if we don't allow them to tussle with and deal with emotion-laden moments on their own?
It is useful to remind ourselves that teens change their feelings and viewpoints very quickly and it is often healthier (and brings less drama) to wait a few hours and see how they have sorted things out for themselves without parental input.
Friday, November 6, 2009
Monday, November 2, 2009
Play the Pneumonia Game with your kids and students
Today is World Pneumonia Day. I had no idea until I received a clever email from Save the Children entreating me to play "Mission Pneumonia". Never one to turn down a challenge (I love the SAT question of the day, for instance), I clicked into the game. It is an apparently simple strategy to get you to donate money (of course) but just as important it teaches us about pneumonia:
- pneumonia is preventable and treatable;
- a child dies from pneumonia every 15 seconds somewhere in the world
- community health workers are a powerful force against the #1 killer of children under 5
What are the most critical actions you can take? Log on and play the game at Mission Pneumonia.
Monday, October 26, 2009
Mouth to Mouth CPR give you the willies?
No More!
In 2005 the American Heart Association changed its recommendations about CPR. In the case of a witnessed cardiac arrest, they no longer suggested using mouth to mouth resuscitation. Now in a study reported in the Journal Watch Emergency Medicine, it appears that a victim is almost twice as likely to survive an out-of-hospital cardiac arrest with effective chest compressions alone compared to the older routine of mouth to mouth plus chest compressions.
Part of the original rationale for changing the recommendations was that not only is it more effective (which this study supports) but it will make it more likely that people will actually step up to the plate and start basic CPR while waiting for expert help to arrive. Tell your kids about this and watch this two minute YouTube clip about how to do chest compressions. It could save a life, maybe even your own!
In 2005 the American Heart Association changed its recommendations about CPR. In the case of a witnessed cardiac arrest, they no longer suggested using mouth to mouth resuscitation. Now in a study reported in the Journal Watch Emergency Medicine, it appears that a victim is almost twice as likely to survive an out-of-hospital cardiac arrest with effective chest compressions alone compared to the older routine of mouth to mouth plus chest compressions.
Part of the original rationale for changing the recommendations was that not only is it more effective (which this study supports) but it will make it more likely that people will actually step up to the plate and start basic CPR while waiting for expert help to arrive. Tell your kids about this and watch this two minute YouTube clip about how to do chest compressions. It could save a life, maybe even your own!
Monday, October 19, 2009
Parenting Style affects Driving Record
As if we needed any more evidence that the way we raise our kids affects the way they walk (or drive) in the world, the official journal of the American Academy of Pediatrics, Pediatrics, just published a well done study to show it. The authors reviewed almost 5700 responses by 9-11th graders to the 2006 National Young Driver Survey. Parents are divided into four parenting styles based on the kids' assessment: 1)authoritative(lots of support and lots of rules/monitoring), 2) authoritarian (lots of rules without the support), 3)permissive (lots of support but no monitoring) and 4)uninvolved (none of any of it). Of some concern is the fact that 19% of kids described their parents as "uninvolved." Compared with these kids, the children of authoritative parents had half the crash risk in the past year, were less likely to drive when intoxicated and were less likely to use a cell phone while driving. Interestingly, there was no significant difference between permissive and uninvolved parents.
So once more, we learn that parenting matters, and parenting style matters even more. Now if only we can figure out how to be authoritative without being a "helicopter parent."
So once more, we learn that parenting matters, and parenting style matters even more. Now if only we can figure out how to be authoritative without being a "helicopter parent."
Thursday, September 24, 2009
Shame on Who?
Caster Semenya, an 18 year old track star from South Africa who won the 800 meter race in Berlin in August has been the object of intense media scrutiny ever since she ran. Not because she outran her competitors by a few seconds, but because the sports world has been weighing in on whether it is fair for her to run as a woman.
Caster is intersex. Some 0.5 to 1% of the general population is thought to have characteristics that are intersex. In Caster's case she has typical-appearing external genitalia of a woman but the internal gonads (sex organs) of a male and therefore produces testosterone and not estrogen. This explains her flat chest, her deeper voice, her facial hair, and maybe her muscular build (she also works out and trains a LOT to get that body). As hard as it is to make the mental leap to understanding that sex is not necessarily a binary, either-or phenomenon, we must stretch our minds and get educated. It is not ok to sit back and pass judgment or gawk at a variation of nature. Semenya is different but she is not a freak and she is not alone. As Lisa Belkin blogged in the New York Times, we need to tell our children about this;it's a matter of tolerance.
I believe Caster when she says that she just learned about this from the media and the recent tests that the International Athletics Associations Federation have put her through. I believe her father that he thinks of her as a girl. I believe the reports that she has withdrawn and is depressed over having her life and gender identity exposed publicly. For gender identity is something we each decide for ourselves;no test can make that choice;it is a psychological phenomenon. Usually gender identity is in harmony with one's body as it most likely was for Caster until she entered puberty and developed external male characteristics.
What I have trouble believing is that no one in a professional capacity--counsellor, coach, physician, nurse--ever questioned the pubertal development of Caster. By most standards a young woman without a period by age 16, who was developing hirsutism and had no breast development deserved an evaluation. If that evaluation was done and not shared with Caster in the most competent, delicate, compassionate and informed sort of way, well shame on them!
Because someone did not do his or her job with complete competence, this young woman is having her body dissected on the world stage and in the blogosphere and her achievements diminished by sceptics who do not understand the science behind it all. Let's keep the legitimate debate about athletic competition separate from the discourse about Semenya's sex.
********
If this piques your interest and you want to read a moving novel, extremely well researched and written of the life of an intersex adolescent, try Middlesex by Jeffrey Eugenides.
Caster is intersex. Some 0.5 to 1% of the general population is thought to have characteristics that are intersex. In Caster's case she has typical-appearing external genitalia of a woman but the internal gonads (sex organs) of a male and therefore produces testosterone and not estrogen. This explains her flat chest, her deeper voice, her facial hair, and maybe her muscular build (she also works out and trains a LOT to get that body). As hard as it is to make the mental leap to understanding that sex is not necessarily a binary, either-or phenomenon, we must stretch our minds and get educated. It is not ok to sit back and pass judgment or gawk at a variation of nature. Semenya is different but she is not a freak and she is not alone. As Lisa Belkin blogged in the New York Times, we need to tell our children about this;it's a matter of tolerance.
I believe Caster when she says that she just learned about this from the media and the recent tests that the International Athletics Associations Federation have put her through. I believe her father that he thinks of her as a girl. I believe the reports that she has withdrawn and is depressed over having her life and gender identity exposed publicly. For gender identity is something we each decide for ourselves;no test can make that choice;it is a psychological phenomenon. Usually gender identity is in harmony with one's body as it most likely was for Caster until she entered puberty and developed external male characteristics.
What I have trouble believing is that no one in a professional capacity--counsellor, coach, physician, nurse--ever questioned the pubertal development of Caster. By most standards a young woman without a period by age 16, who was developing hirsutism and had no breast development deserved an evaluation. If that evaluation was done and not shared with Caster in the most competent, delicate, compassionate and informed sort of way, well shame on them!
Because someone did not do his or her job with complete competence, this young woman is having her body dissected on the world stage and in the blogosphere and her achievements diminished by sceptics who do not understand the science behind it all. Let's keep the legitimate debate about athletic competition separate from the discourse about Semenya's sex.
********
If this piques your interest and you want to read a moving novel, extremely well researched and written of the life of an intersex adolescent, try Middlesex by Jeffrey Eugenides.
Thursday, September 17, 2009
Don't pass down your depression
It looks like it might actually be possible to "immunize" our children against one of the afflictions most feared by all parents--mental illness. A recent study by Judy Garber, PhD of Vanderbilt University that was published in the reputable journal JAMA(Journal of the American Medical Association) provides some hope.
It is known that adolescents with depressed parents are more likely to develop major depression themselves. Whether there is a genetic component to this or can be attributed to environmental factors is not what matters here. What matters is that Dr Garber's work shows that a group of adolescents who have been depressed in the past and were considered at risk for serious depression could be taught techniques that helped to significantly lower their symptoms when studied nine months later.
The techniqes are called cognitive behavioral therapy and can be as simple as teaching a patient to "think positively." They are also taught problem solving skills, and ways to recognize and "re-frame" negative or potentially self-destructive thoughts. Cognitive behavioral techniques are often just a translation of age-old ways of looking at the world and helping people manage daily stresses.
The Vanderbilt treatment program included eight weeks of 90 minute group sessions and then monthly "booster" sessions for small groups of students. Parents were also involved in two informational meetings.
What Garber's work suggests to me is that we should probably start thinking of mental health prevention as part of our plan for our children in the same way that vaccinations and "physicals" are. Kids deserve a "mental" at every visit to their health care provider. I might even go so far as to say that our schools should begin to consider "emotional education"(Emo-Ed, can't you see it now?) as well as physical education in our curricula. Good mental health is not a given, but it can be taught.
It is known that adolescents with depressed parents are more likely to develop major depression themselves. Whether there is a genetic component to this or can be attributed to environmental factors is not what matters here. What matters is that Dr Garber's work shows that a group of adolescents who have been depressed in the past and were considered at risk for serious depression could be taught techniques that helped to significantly lower their symptoms when studied nine months later.
The techniqes are called cognitive behavioral therapy and can be as simple as teaching a patient to "think positively." They are also taught problem solving skills, and ways to recognize and "re-frame" negative or potentially self-destructive thoughts. Cognitive behavioral techniques are often just a translation of age-old ways of looking at the world and helping people manage daily stresses.
The Vanderbilt treatment program included eight weeks of 90 minute group sessions and then monthly "booster" sessions for small groups of students. Parents were also involved in two informational meetings.
What Garber's work suggests to me is that we should probably start thinking of mental health prevention as part of our plan for our children in the same way that vaccinations and "physicals" are. Kids deserve a "mental" at every visit to their health care provider. I might even go so far as to say that our schools should begin to consider "emotional education"(Emo-Ed, can't you see it now?) as well as physical education in our curricula. Good mental health is not a given, but it can be taught.
Tuesday, September 8, 2009
Insurance morass
Back from vacation! Springing into Fall!
Although it was never my intention to use my blog as a way to complain, I saw Julie and Julia last night and Amy Adams' blogging inspired me to share a story that is only a thinly veiled gripe.
In these times of debate about health care, I have been struggling with the idea of joining insurance plans to make myself more accessible to a wider range of patients than I can see otherwise. In addition to the New York State plan for low income families and children (Child Health Plus), I have been on the Aetna panel for over a year. About nine months ago I decided to apply for four other plans in the hopes that their reimbursements would be reasonable enough to sustain my practice.
The way the application process works is the doctor applies (many documents, reams of paper, phone calls) and time goes by. We did that in January. Eight months later (this July)Blue Cross sent a letter announcing my acceptance. At this stage (and not until then)an applicant is able to know what the reimbursement schedule will be. So, once I saw the numbers ($52.16 for a thirty minute visit; $63.84 for forty-five minutes) and did the math, I decided not to join. HOWEVER, Blue Cross put me on their roster without my approval and listed me on their website in August.
So what difference does it make? The problem is that patients who may be on Blue Cross now submit their superbills from my office to Blue Cross and are told that they only owe me the co-pay because from the company's point of view I am a BC provider. So now, I am struggling to try to get someone to answer the phone at Blue Cross and cancel my listing which I never authorized in the first place.
This one tiny example serves to demonstrate the monolithic, bureaucratic, and confusing nature of the insurance system we work under.
I honestly wish for Blue Cross employees that they find meaningful work one day. Work that does not involve arguing with doctors' offices; refusing care to patients; nitpicking over whether a doctor asked ten questions or twelve; denying claims for routine proceedures (eg urine tests); wasting paper, ink and postage; and breaking patient confidentiality by looking over the shoulders of doctors and pharmacists.
And now I am off to look up the recipe for boeuf bourguigon.
Although it was never my intention to use my blog as a way to complain, I saw Julie and Julia last night and Amy Adams' blogging inspired me to share a story that is only a thinly veiled gripe.
In these times of debate about health care, I have been struggling with the idea of joining insurance plans to make myself more accessible to a wider range of patients than I can see otherwise. In addition to the New York State plan for low income families and children (Child Health Plus), I have been on the Aetna panel for over a year. About nine months ago I decided to apply for four other plans in the hopes that their reimbursements would be reasonable enough to sustain my practice.
The way the application process works is the doctor applies (many documents, reams of paper, phone calls) and time goes by. We did that in January. Eight months later (this July)Blue Cross sent a letter announcing my acceptance. At this stage (and not until then)an applicant is able to know what the reimbursement schedule will be. So, once I saw the numbers ($52.16 for a thirty minute visit; $63.84 for forty-five minutes) and did the math, I decided not to join. HOWEVER, Blue Cross put me on their roster without my approval and listed me on their website in August.
So what difference does it make? The problem is that patients who may be on Blue Cross now submit their superbills from my office to Blue Cross and are told that they only owe me the co-pay because from the company's point of view I am a BC provider. So now, I am struggling to try to get someone to answer the phone at Blue Cross and cancel my listing which I never authorized in the first place.
This one tiny example serves to demonstrate the monolithic, bureaucratic, and confusing nature of the insurance system we work under.
I honestly wish for Blue Cross employees that they find meaningful work one day. Work that does not involve arguing with doctors' offices; refusing care to patients; nitpicking over whether a doctor asked ten questions or twelve; denying claims for routine proceedures (eg urine tests); wasting paper, ink and postage; and breaking patient confidentiality by looking over the shoulders of doctors and pharmacists.
And now I am off to look up the recipe for boeuf bourguigon.
Subscribe to:
Posts (Atom)
