BPA, Head Lice, Teen Driving – PediaCast 320

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DESCRIPTION
Join Dr Mike in the PediaCast Studio for more News Parents Can Use. This week’s topics include a new study on MMR and autism, sleep safety in car seats and infant carriers, an update on BPA in plastics, daycare & illness, treating head lice, standing & learning, teenage drivers, and the mental health of college students.

TOPICS
MMR & Autism
Safe Baby Sleep
BPA in Plastics
Daycare & Illness
Treating Head Lice
Standing & Learning
Teenage Drivers
Mental Health in College Students

LINKS
Vaccine Safety – PediaCast 251
Safe Sleep – PediaCast 302
Clinical Report on Head Lice (AAP)
Mom’s Effect on Teenage Drivers (Infographic)

Transcription

Announcer 1: This is PediaCast.

[Music]

Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello everyone, and welcome once again to PediaCast. It's a pediatric podcast for moms and dads. This is Dr. Mike coming to you from the campus of Nationwide Children's Hospital. We're in Columbus, Ohio. It is June 3rd, 2015. We have Episode 320 for you. We're calling this one "BPA, Head Lice and Teen Driving."

I want to welcome everyone to the show.

So I have a News Parents Can Use edition of the program lined up for you this week. And for those of you who are new to PediaCast, here is how our news episodes work. We comb through the scientific journals in search of studies that we think will be helpful for moms and dads. That way you can hear the latest evidence-based advice for raising your kids and keeping them healthy. Most of the studies we cover are good ones, but now and then, we throw some not so good ones in too especially not so good ones that may have created a buzz in the mainstream media, and we point out why we think they might not be so good. 

Why do we do this? Well, it's important to approach science with a bit of skepticism, but it's also important to prevent our skepticisms from interfering with our ability to accept legitimate findings. Really, that's what evidence-based medicine is all about. We want to advice parents on what they should do, but we should also be ready to explain why. How did we come up with these recommendations? And really, to do that, often you have to look at the scientific literature in order to do that effectively. We don't want to just feed you advice because someone said it was so without understanding for ourselves and then explaining and helping you to understand. And that's why we start with the journal articles, and that's why we critique the articles when need be. 

0:02:18

The next step after we've identified some useful topics, we translate the scientific language into terms moms and dads can understand without dumbing down the science. That's important because at the end of the day we want you to have as good of an understanding as we have.

And finally, we try to add a practical tip, one that you can implement now and hopefully find useful. That's the goal anyway and some weeks, we succeed better than others.

All right, so what are we covering in this particular episode of News Parents Can Use? MMR in autism – we aren't going to spend a lot of time on this one. You all know my feelings, but it's hard to ignore a recently published study that looked at more than 95,000 children. Keep in mind, the original study back in 1998, the Dr. Andrew Wakefield study that started an anti-vaccine storm, that study looked at 12 children. Yes, you heard me right, 12 kids. This one, more than 95,000 children, and I'll share what they found. 

Safe baby sleep – we've covered baby sleeping and safety with sleep in the past, but here's a question many parents ask, "Is it OK if my baby sleeps in their car seat, or carrier, or jumper, or swing, or bouncy seat? Are those places safe? We'll look at the numbers and give you an answer. 

And then BPA in plastics, bisphenol A. It's a chemical used by the plastics industry that has been banned in baby bottles and sippy cups since 2012. But was that move based on fact or fiction? We have some information that sheds new light.

0:04:00

And then, day care and illness – when your child is sick, do you send him or her to day care or do you keep them home? And how do you decide which symptoms are OK, which ones are not. It can be confusing. We'll consider a study that looks at that decision-making process.

And then, treating head lice – new recommendations from the American Academy of Pediatrics on the management of head lice in kids, we'll cover the main points and point you in the right direction if you'd like to read the fine details.

Standing and learning – since it's far back as anyone can remember, kids have sat at desks in the classroom, but what about taller desks and standing with a stool nearby if kids want to give their legs a break? Could that help childhood obesity and classroom engagement? We'll take a look at that one. 

Teenage drivers – what's going on inside the brain when it comes to taking risks while driving? Once you understand that, perhaps you can exploit the biology to keep kids safe behind the wheel. So stay tuned for that one. 

And then, we'll wrap things up with mental health in college students. Stress, anxiety and depression are common on campus. Can they be prevented before they even get started? And if so, how? We'll cover that as well.

I do want to remind you if there's a topic that you'd like us to discuss, if you have a question for me, or you want to point me in the direction of a journal article or a news article that you may have come across, it's easy to get in touch. Just head over to PediaCast.org and click on the Contact link.

You can also call our voice line at 347-404-KIDS. 347-404-K-I-D-S or 5437 if you need the digits. And if you call that way and leave a question, we can get your voice on the show.

Also, I want to remind you, the information presented in PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. So if you have a concern about your child's health, be sure to call your doctor and arrange a face-to-face interview and hands-on physical examination.

Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at PediaCast.org.

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All right, let's take a quick break and I will be back with News Parents Can Use right after this. 

[Music]

Dr. Mike Patrick: There is new and convincing evidence that the MMR vaccine is not associated with autism. This, according to Dr. Anjali Jain and fellow researchers at the Lewin Group in Falls Church, Virginia and reported by the journal of the American Medical Association. 

Investigators studied more than 95,000 children with older siblings and found that receipt of the measles-mumps-rubella or MMR vaccine was not associated with an increased risk of autism spectrum disorders, regardless of whether older siblings had autism. Let me say that again, their findings indicate no association between receipt of MMR vaccine and autism spectrum disorders even among children already at higher risk for autism.

 Although a substantial body of research over the last 15 years has found no link between the MMR vaccine and autism, parents and others continue to believe an association exists. Surveys of parents who have children with autism spectrum disorders revealed that many of these moms and dads believe the MMR vaccine was a contributing cause. This belief, combined with knowing that younger siblings of children with autism are already at higher genetic risk for autism spectrum disorders compared with the general population might prompt these parents to avoid vaccinating their younger children.

0:08:01

For the study, Dr. Jain and colleagues examined autism occurrence in a large sample of US children who have older siblings with and without autism and compared the occurrence of autism spectrum disorders in these children with MMR vaccine status. 

To accomplish this, researchers used an administrative claims database associated with a large commercial health plan. Participants included children continuously enrolled in the health plan from birth to at least five years of age during 2001 to 2012 who also had older siblings continuously enrolled for at least six months between 1997 and 2012.

Of the 95,727 children included in the study, 1,929, which is just over 2%, had an older sibling with autism and 994 of the children (just over 1%) were diagnosed with an autism spectrum disorder at some point during the study period. MMR vaccination rates for children with older siblings with autism were lower compared to children who did not have an older sibling with autism. Suggesting parents were more likely to delay or forego MMR if they had a previous child with an autism diagnosis.

Analysis of the data also indicated that giving the MMR vaccine was not associated with an increased risk of autism spectrum disorder at any age. 

The authors say, "Consistent with studies in other populations, we observed no association between MMR vaccination and increased autism risk. We also found no evidence that receipt of either one or two doses of MMR vaccine were associated with an increased risk of autism spectrum disorders among children who had older siblings with autism. As the prevalence of diagnosed autism increases, so does the number of children who have siblings diagnosed with autism, and this is a group of children who are particularly important because they were under-vaccinated in our observations, as well as in previous reports."

0:10:08

Dr. Bryan King from the University of Washington in Seattle Children's Hospital provided an accompanying editorial to the published study. In it he says, "Taken together, some dozen studies have now shown that the age of onset of autism disorder does not differ between vaccinated and unvaccinated children. The severity or course of autism does not differ between vaccinated and unvaccinated children, and now the risk of autism recurrence in families does not differ between vaccinated and unvaccinated children."

So moms and dads, if you're worried about the MMR vaccine causing autism, hopefully, you find this study reassuring even if you already have a child with autism. And when you think about that original study associating MMR with autism, the one published in The Lancet in 1998 and conducted by Dr. Andrew Wakefield, remember that study only included 12 children, not 95,000 children like the one we're talking about today. 

And further investigation revealed the original study was fraudulent, and Dr. Wakefield had unreported conflicts of interest that would benefit him financially. The Lancet retracted the study, and Dr. Wakefield lost his medical license over the debacle. If you like to hear more about the ins and outs of that unfortunate historical event, be sure to check out PediaCast Episode 251 over at PediaCast.org where we uncovered the details and exposed the fraud.

In the mean time, if your child hasn't received the MMR vaccine, please, I urge you to talk with your child's pediatric provider because the benefits of immunization far far outweigh any risk. 

Sleep-related deaths are the most common cause of death for infants 1 to 12 months of age, or during the first year of life. The American Academy of Pediatrics recommends that infants sleep on their back on a firm mattress without loose bedding. However, many parents use sitting or carrying devices such as car seats, swings or bouncers as alternative sleeping environments which could lead to potential injury or death. 

In a new study reported by The Journal of Pediatrics, researchers describe how the improper use of these items can lead to infant deaths.

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Dr. Erich Batra from the Penn State Milton S. Hershey Medical Center, along with the colleagues from the US Consumer Product Safety Commission and Children's National Medical Center reviewed deaths that were reported to the US Consumer Product Safety Commission, of children under two years of age that occurred in sitting and carrying devices between April 2004 and December 2008. Dr. Batra says, "Many parents use sitting or carrying devices, not realizing that there are hazards when they do this." 

The data include information from death certificates, reports from medical examiners and coroners, and interviews of family members and witnesses. The researchers analyzed records for 47 deaths associated with sitting and carrying devices; all but one were attributed to asphyxia, which means the child wasn't able to breathe either because of their position or due to strangulation. Two-thirds of the cases involved car seats; strangulation from straps accounted for 52% of the car seat deaths. The remainder of deaths occurred in slings, swings, bouncers, and strollers. The elapsed time from when the infants were last seen alive to when they were discovered ranged from as little as 4 minutes to 11 hours. The study included newborns as well as toddlers.

It's important to note that an infant in a properly positioned car seat, in a car, with properly attached straps is at little risk from a suffocation injury. However, contrary to popular belief, the restraints and design of infant sitting and carrying devices including car seats are not intended for unsupervised sleeping. Dr. Batra adds, "Infants and young children should not be left unsupervised when using sitting or carrying devices due to the risk of suffocation and death." 

0:14:18

The authors offer the following advice to parents when using infant sitting or carrying devices: number one, do not leave your children unsupervised whether they are awake or asleep.

Number two, never leave children in a car seat with unbuckled or partially buckled straps.

Number three, car seats should never be placed on a soft or unstable surface. 

Number four, infants in bouncers, strollers, and swings may be able to maneuver into positions that could compromise their airway; straps on these devices may not prevent infants from getting into hazardous situations.

Five, ensure that infants cannot twist their heads into soft bedding or slump forward in a seat and restraints should be used according to manufacturer's instructions.

Number six, slings are particularly dangerous because of their design and the ease with which an infant's airway can become collapsed. If used, the infant's face should always be "visible and kissable" at all times.

Finally, number seven, do not place more than one infant together in a swing meant for one infant.

For much more information on safe sleep for babies and infant mortality be sure to check out PediaCast Episode 302. That one did cover infant mortality, SIDS, and safe sleep. Again, Episode 302 and you'll find it in the show archive over at PediCast.org.

Researchers from the Johns Hopkins Bloomberg School of Public Health say that while a large majority of newborns are exposed in their earliest days to bisphenol A or BPA, a much studied chemical used in plastics and in food and soda can linings, the babies can chemically alter the compound and can rid it from their bodies.

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The findings, published in The Journal of Pediatrics, challenge the current thinking on BPA toxicology. The US Centers for Disease Control and Prevention has found that more than 92% of Americans ages 6 and older have BPA in their bodies, most likely through the consumption of food stored in packaging made from it. No one had studied levels in healthy newborns, but it was assumed that their immature livers would have a difficult time processing the chemical and that could mean increased health risks due to BPA.

BPA mimics the sex hormone estrogen in the body and may have developmental effects on the brain, lung and reproductive organs, and has been associated with diabetes and some cancers. It is currently used in many plastics in the United States, but it was banned in baby bottles and sippy cups in 2012 by the Food and Drug Administration for fear of what the chemical could do to the very young even though no studies had actually shown that it was a problem. 

However, BPA is still in wide use because the FDA has repeatedly concluded that it is safe at the current levels occurring in food. They just basically banned it from the baby bottles and the sippy cups to quiet some folks down, that's my opinion.

Dr. Rebecca Nachman, a post-doctoral fellow in the Johns Hopkins Bloomberg School of Public Health's Department of Environmental Health Sciences says, "Even though we've removed BPA from bottles and sippy cups, this work shows infants are still exposed to it, but the good news is that our study also shows healthy newborns are better able to handle that exposure than we previously thought."

For their study, conducted between December 2012 and August 2013, Dr. Nachman and her colleagues collected urine samples from 44 full-term babies, once between 3 and 6 days of age and again between 7 and 27 days of age. They were looking for two forms of BPA: free BPA and BPA glucuronide. Free BPA is the chemical as it appears in consumer products, and BPA glucuronide is what remains after free BPA is metabolized by the body. The researchers found no free BPA in the urine samples, while more than 70% of the samples contained BPA glucuronide. BPA glucuronide is biologically inert, and therefore considered harmless to the body.

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Scientists were concerned that BPA would behave similarly in the body to bilirubin, a biological by-product created by the breakdown of red blood cells. Healthy livers turn bilirubin into bilirubin glucuronide, a very similar process to the one BPA follows, which can then be excreted. Routinely, babies may have trouble with this process in their earliest days, resulting in jaundice in lots of newborns.

Dr. Nachman says researchers still don't know how the babies were exposed to BPA. Notably, investigators found no difference between BPA glucuronide levels in infants who were formula fed and those who were breastfed. Fifty-one percent of the babies were fed formula exclusively, 28% were only fed breast milk, and 21% consumed a combination of the two.

Studies have shown that powdered baby formula contains no BPA, while breast milk does. Among children and adults, food is believed to be the primary source of BPA found in the body, even though it is also found in cash register receipts, refillable water bottles, the lining of water pipes and even in dust.

Because of its short half-life, BPA found in the urine reflects recent contact with a source of BPA, making in-utero transmission from mother to baby an unlikely culprit.

Dr. Nachman says, "The BPA found in newborns must come from somewhere outside of the diet." 

But we do know from the study that babies are able to convert that BPA to a safer form that then is excreted from the body. So this is new information and definitely interesting. 

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It's a common dilemma faced by many working parents, your child has a cough of a cold, do you send them to day care? Researchers from the University of Bristol in the United Kingdom have, for the first time, investigated the process of decision-making that parents go through when faced with this decision.

The research published in the Journal of Public Health reports that parents viewed coughs and colds as less serious and not as contagious as nausea, vomiting or diarrhea symptoms. This resulted in many parents sending their child to daycare with a respiratory tract infection, which can result in the spread of similar illnesses in the wider community.

Investigators interviewed 31 parents about the decisions they make when their children are ill. The researchers explored parents' attitudes toward illness, what they currently do if their child is unwell and enrolled in daycare, as well as any changes that could affect the decisions they make.

Dr. Fran Carroll, Research Associate in the University of Bristol's Center for Academic Primary Care and lead author of the study, says, "Parents are aware that sending their child to daycare when they are ill is not always the ideal thing to do, but there are often other factors, meaning it is not always possible to keep their child at home.

"However, there are some changes that nurseries could make which may help parents with the decision and reduce the spread of infectious illnesses in both children and staff in the daycare environment."

Although some parents are aware of the content of their daycare's illness policies, they often felt the guidance is less clear on respiratory symptoms compared to illnesses which include vomiting and diarrhea.

Researchers found that parents made decisions based not only on the daycare illness policy, but also on practical issues such as missing time from work, financial consequences, and the availability of alternative care.

0:22:00

Parents also identified some daycare factors that could be changed to help them keep ill children at home. These included a reduction in daycare fees if the child cannot attend, being able to swap sessions, and clearer guidance in the daycare's illness policies. 

Investigators hope their work will guide the design and implementation of interventions to reduce the transmission of infectious illness and the associated burden on the National Health Service Systems Utilization.

Dr. Carroll says, "Our findings may not be news to many parents, but this is the first time their decision-making process in these situations has been documented. By having this work published in a peer-reviewed journal, it gives an academic, methodologically sound basis for future work and interventions to try and reduce the spread of illnesses in these settings."

So like many British parents, American moms and dads battle with these same decisions. And I would add, here in the States, fever is another factor many parents and daycares probably consider. I say probably because I don't have any studies on this side of the Atlantic to back me up, but my experience in practicing pediatrics is that parents and daycare centers are on board with excluding children with fever, vomiting and diarrhea, also conjunctivitis, and pink eye, and certain rashes. But if the only symptoms are nasal congestion and the occasional cough, off they go, which does result in the spread of upper respiratory infections in the community at large because young children catch those viruses at daycare and share them with their family at home. 

And while colds as we call them are usually benign and short lived in many kids, others aren't as lucky which can lead to asthma exacerbations, ear infections, pneumonia and other complications.

Again, these are my own observations and opinions, but they do beg the question here in America, what would result if we excluded children with viral upper respiratory infections or colds from daycare and even schools? What will the economic impact be on our healthcare system with fewer folks passing illness along? And on the flip side of the coin, what would the economic impact be on business from the decrease productivity of parents who have to stay at home with their sick kids? And what effect would all these have on school attendance and academic performance?

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Now, these may have seemed like silly questions in years past, but what about today with universal access of health care and an exponential cost in treating illness? How many kids with colds end up being seen by healthcare provider at a significant expense simply because mom or dad needs a note to excuse the child from daycare or school or to excuse the parents from work?

I think few would argue that there aren't significant policy issues at play here in daycares, schools and private industry. So although this isn't a landmark study by any means, I do think it's a topic that will receive more attention on both sides of the pond in the years to come.

This next story will probably make you squirm just thinking about it. Your child comes home from school scratching his head because he has lice. It's a scenario many parents dread, but it's also important to remember that head lice is a nuisance, not a serious disease or a sign of poor hygiene.

An updated clinical report by the American Academy of Pediatrics entitled "Head Lice" and published in the May 2015 issue of the journal Pediatrics provides information to pediatricians and other health practitioners on safe and effective methods for treating head lice including new products and medications.

Most cases of head lice are acquired outside of school. In the report, the American Academy of Pediatrics continues to recommend that a healthy child should not be restricted from attending school because of head lice or nits also known as lice eggs in the hair. Pediatricians are encouraged to educate schools and communities that no-nit policies are unjust and should be abandoned. Children can finish the schoolday, be treated at home and return to school tomorrow. 

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Unless resistance has been seen in the community, pediatricians and parents should consider using over-the-counter medications containing 1% permethrin or pyrethrins as a first choice of treatment for active lice infestations. The best way to interrupt a chronic lice problem is with regular checks by parents and early treatment with a safe, affordable, over-the-counter lice medication. After applying the product according to the manufacturer's instructions, parents should follow with nit removal and wet combing. The treatment should be reapplied at day 9, and if needed, at day 18. 

In areas with known resistance to over-the-counter lice medication, or when parents' efforts on their own do not work, parents should involve their pediatrician for treatment with a prescription medication such as spinosad or topical ivermectin. These are new medications that were introduced since the last time the AAP published recommendations on head lice in 2010.
 
Once a family member is identified with head lice, all household members should be checked. The AAP does not recommend excessive environmental cleaning, such as home pesticides. However, washing pillow cases and treating hair care items that may have been in contact with the hair of anyone found to have head lice are reasonable measures. 

While it is unlikely to prevent all cases of head lice, children should be taught not to share personal items such as combs, brushes, and hats. Regular observation by parents can also be an effective way to detect and quickly treat head lice infestations. 

So never share what goes in your hair. It's an easy rule to teach young kids. In fact, I can still hear my now 20-year-old daughter reciting it back in her 3-year-old sing-songy voice, "Never share what goes in your hair." She didn't even know what head lice was back then, but she didn't need to because that was back when she believed everything her parents told her without question. You have to take advantage of those years while you have them.

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If you're interested in reading the AAP's clinical report on head lice in its entirety, which the pediatric providers in the crowd will probably find a bit more interesting compared with the moms and dads out there. But hey, who am I to judge? We have engaged and educated parents in the PediaCast audience, so this kind of thing might be right up your alley regardless of your day job. If that's the case for you, check out the Show Notes for PediaCast Episode 320 over at PediaCast.org, and I will include a link to the AAP's clinical report in its entirety there.

A study from the Texas A&M Health Science Center School of Public Health finds students with standing desks are more attentive than their seated counterparts. In fact, preliminary results show 12 % greater on-task engagement in classroom with standing desks, which equates to an extra seven minutes per hour of engaged instruction time.

The findings, published in the International Journal of Health Promotion and Education, were based on a study of almost 300 children in second through fourth grade who were observed over the course of a school year. Engagement was measured by on-task behaviors such as answering a question, raising a hand or participating in active discussion and off-task behaviors like talking out of turn.

Standing desks are tall, but students also have a nearby stool enabling them to sit or stand during class at their discretion. Dr. Mark Benden, associate professor at the Texas A&M and an ergonomic engineer by trade, originally became interested in the desks as a means to reduce childhood obesity and relieve stress on spinal structures that may occur with traditional desks. 

Dr. Benden's previous studies have shown the desks can help reduce obesity with students at standing desks burning up to 25% more calories compared with students sitting at traditional desks. In the course of that previous study, there was anecdotal evidence to suggest that standing also increased classroom engagement, and the current study is the first designed specifically to look at this relationship. 

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Dr. Benden was not surprised at the results of the study, given that previous research has shown that physical activity, even at low levels, may have beneficial effects on cognitive ability.

He says, "Standing workstations reduce disruptive behavioral problems and increase students' attention or academic behavioral engagement by providing students with a different method for completing academic tasks which breaks up the monotony of seated work."

"Considerable research indicates that academic behavioral engagement is the most important contributor to student achievement." He adds, "Simply put, we think better on our feet than in our seat."

Investigators say, the key takeaway from this research is that school districts that use standing desks in classroom may be able to address two problems at the same time — childhood obesity and academic performance.

So there you go, standing desks. Does your school have them? If not has your school heard about the benefits or is this option not in their radar? Good questions to ask at your next parent-teacher conference or school board meeting. And what about in the evening at home when your kids are doing homework? Do you make them sit on the desk or table? Maybe standing at the kitchen counter would help them concentrate better. Something to think about.

A new study of teenagers and their mothers who reveal how adolescent brains negotiate risk and the factors that modulate their risk-taking behind the wheel of the car. 

The study reported in the journal Social Cognitive and Affective Neuroscience involve 14-year olds completing a simulated driving task while researchers tracked blood flow in their brains. That sounds like fun.

Dr. Eva Telzer, lead author of the study and professor of psychology at the University of Illinois says, "In one trial, the teen driver was alone, and in another, the teen's mother was present and watching."

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Investigators at Temple University had previously developed the driving task to evaluate how the presence of peers influenced teen risk-taking.

Dr. Telzer says, "The temple researchers found peers significantly increase risk-taking among teens. I wanted to know whether we could reduce risk-taking by bringing a parent into the car."

In the current study, investigators observed that teens driving alone found risky decisions rewarding. Blood flow to the ventral striatum, a "reward center" in the brain, increased significantly when teen drivers chose to ignore a yellow stoplight and drove through the intersection anyway.

Previous research has demonstrated that the ventral striatum is more sensitive to rewards in adolescence than during any other developmental period.

Dr. Telzer says, "The prevailing view is that this peak in reward sensitivity in adolescence underlies, in part, teenage risk-taking."

A mother's presence, however, blunted the thrill of running the yellow light, Dr. Telzer explains.

"When mom is there, the heightened ventral striatum activation during risky decisions goes away. Being risky, it appears, is no longer rewarding in the presence of mom."

Not surprisingly, teens stepped on the brakes significantly more often at yellow lights when their moms were present than when they were alone.

Dr. Telzer says, "The teens go from about 55 % risky choices to about 45% when their mom is watching and that's a big effect."

Mom's presence had another important effect. It kicked the prefrontal cortex into gear. This region of the brain regulates behavior by providing cognitive control. 

So when teenage drivers make safe decisions, when they choose to stop instead of going through the intersection, the prefrontal cortex comes online, but it's only activated when mom is there. It's not activated when the teen is alone.

And to help visualize this effect, investigators created an infographic. And I'll provide a link to it in the Show Notes for Episode 320 over at PediaCast.org.

0:34:08

These are pretty savvy investigators creating infographics. Very nice touch.

Dr. Telzer says, "The prefrontal cortex or control center in the ventral striatum or reward center are key brain regions involved in adolescent risk-taking behavior, but in the absence of a well-developed control center, teenagers are more susceptible to the stimulating allure of risky behavior."

She adds, "Here we're showing that moms reduce the rewarding nature of risk-taking and increases activation of the prefrontal cortex during safe behavior. These two mechanisms help adolescents think twice before running the intersection. A parent's presence is actually changing the way the adolescent is reasoning and thinking about risk — and this increases their safe behavior."

So this is an interesting study. The overreaching result that teenagers make better decisions in the presence of mom, that's probably not really surprising news to many of you. But the organic mechanism behind that observation, what's going on inside the brain, that's pretty cool and helps us understand why teenagers make the decisions they make. 

Now, I realize the study also has some flaws. Most of us don't have 14-year old drivers in the house, so would a year or two make a difference? Maybe? Maybe not? 

And how does all these translate from the simulator where you got the kid hooked up and you're looking at blood flow through the brain, how does that translate to the actual road? There are real consequences on the road with a potential for a crash which could lead to damage property, an injury, pain, disability. Those level of consequences don't really exist in the simulator. So does that make a difference? Maybe, maybe not.

And what about dads? Would the effect be different if dad is the one watching instead of mom? Again, maybe, maybe not.

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So what's the bottom line here? Well, I think the study supports something you already know. Adolescents make better decisions when mom is watching. So moms, keep watching especially when your teenager is driving.

And, of course, mom can't be there all the time, right? At some point you have to cut the driving cord. So the next question and a great follow up study, how do you increase frontal cortex activation and reduce risk-taking rewards when mom isn't there? Do you hang a picture of her from the rear view mirror or stream her voice into the car by way of Bluetooth? I guess, It's just a guess, is no, those strategies probably wouldn't work. Still there has to be something. And that, my friends, is how the scientific method gets started.

Is it possible to prevent mental health problems in college students? The answer, according to a team of psychologists from Loyola University, is yes. 

Investigators there conducted a systematic review of a 103 interventions involving over 10,000 undergraduate and graduate students enrolled in colleges and universities with findings reported in the journal Prevention Science.

Investigators found that universal prevention interventions — that is, programs targeting general students, not just students who are at risk for or who have already developed problems — were effective in significantly reducing outcomes related to stress, anxiety and depression. The programs also helped in enhancing not only students' social-emotional skills, self-perceptions, and interpersonal relationships, but also their academic adjustment. However, programs differ in their effectiveness. Of note, programs that included supervised practice of targeted skills significantly outperformed lectures, presentations, psychoeducational programs and skills-based programs without supervised practice.

0:38:00

These findings have important implications because stress, anxiety and depression are among the most common adjustment problems experienced by college students, and the incidents of these problems is on the rise. Furthermore, stress, anxiety, and depression can interfere with students' academic performance and retention, but the development of psychosocial strategies — including adaptive social and emotional skills, positive self-perceptions, and supportive interpersonal relationships… lead to fewer mental health problems and improved academic performance and retention.

The authors conclude by saying, effective programs, which include the supervised practice of targeted skills to prevent emotional distress and promote psychosocial strategies, these programs warrant more widespread use.

So the helpful programs are the ones where you take a group of college students, you throw a situation at them and you say, "How would you respond?" You watch him respond and then you give them feedback on what they're doing well and what they could be doing a little bit better. 

So if you have a child heading off to college, or they're in college and you hear about stress reduction programs, encourage your child to participate even if they don't feel particularly stressed, anxious or depressed because the coping skills that they'll learn with involvement in that program would be applicable to all sorts of unexpected situations that life will throw their way down the road.

All right, that does wrap up our News Parents Can Use edition of PediaCast for this week. I'll be back to wrap up the show right after this.

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0:40:06

Dr. Mike Patrick: We covered a lot this week, MMR in autism, baby sleep, bisphenol A, daycare and illnesses, head lice, standing and learning, teenage driving, college student mental health, lots of stuff to think about this week. Some of these stories are going to be applicable to your family because you have a child in whatever age range the story was that we were talking about. And there's probably some stories in there, too that maybe don't apply quite as well to your own family, but maybe you know a family who would benefit from hearing the story. 

And so I would encourage you to please share PediaCast in your own social media world, whether you're on Twitter, you're on Facebook and real life interactions, too. When you see family, friends, co-workers, make sure you let them know about PediaCast so we can spread this evidence-based information to as many moms and dads as possible.

I do want to thank each and every one of you for taking time out of your day to make PediaCast a part of it. Really do appreciate that.

PediaCast is a production of Nationwide Children's Hospital in Columbus, Ohio. Don't forget, you can find PediaCast in all sorts of places. We're in iTunes and most podcasting apps for iPhone and Android, including the Apple Podcast App, Downcast, iCatcher, Podbay, Stitcher and TuneIn.

We're also on iHeart Radio, where we not only have this program, but also PediaBytes, B-Y-T-E-S. Those are shorter clips from this show. They can be weaved together with other content providers to make your own custom talk radio station.

And then, there's the landing site, PediaCast.org, where you'll find an archive featuring hundreds of past episodes, transcripts of each program in case reading suits your taste, and a handy contact page to ask questions and suggest show topics.

We also have a voice line if you'd rather phone in your question or comment. And that number again is 347-404-KIDS. 347-404-K-I-D-S.

We're also on Facebook, Twitter, Google Plus and Pinterest with lots of great content you can share with your own online audience. 

0:42:10

And, of course, we always appreciate you talking us up with your family, friends, neighbors and co-workers, anyone with kids or those who take care of children, including your child's healthcare provider. Next time you're in for a sick office visit with a pediatrician, or a family practice doctor, or a nurse practitioner, whether it's a sick office visit or a well-check up or sports physical, or a medicine recheck, whatever the occasion, let them know you found an evidence-based pediatric podcast for moms and dads. We've been around for nearly a decade. Lots of great content in the archive, deep enough to be helpful, but in language parents can understand.

And, while you have your providers' ear, let them know we have a podcast for them as well, PediaCast CME. It's similar to this program, we turned up the science a couple notches and we provide free Category 1 CME Credit for listening. Shows and details are available at PediaCastCME.org. 

This one is in the can. And until next time, this is Dr. Mike, saying stay safe, stay healthy, and stay involved with your kids. So long, everybody. 

[Music] 

Announcer 2: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.on PediaCast.