Want More Tolerant Kids? Keep Them Away from the TV Read more: TV makes kids less tolerant

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November 26th, 2013

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Too much time in front of the television can blunt young children’s ability to accept and understand others, says the latest research.

Theory of mind is something that children typically develop during the preschool years — it’s the ability to start teasing apart individual mental states, like beliefs, intents  desires, and pretending, and understand that others may not have the same views. Child development experts say that this ability is critical for social development and that without it, it’s difficult for children to understand morality and recognize deception. If it’s not fully developed, for example, a child may think that everyone prefers a cookie over a carrot because that’s his personal preference.

How does television, with its depictions of fantasy worlds and reality, influence such development? To find out, researchers from the Ohio State University School of Communication studied the relationship between preschoolers’ TV viewing and their grasp on mental states.

The team interviewed the parents of 107 children between ages three years to six years old about how many hours a television was left on in the house, regardless of whether anyone was watching it, during three time periods on an average weekday and during an average weekend. The parents were also asked about whether the kids had TVs in their bedroom — 20% did.

The children were then given a variety of tasks that tested theory of mind, such as showing them a photo of a woman they named Mrs. Jones. The researchers told the children it was snack time, and that when given a choice between cookies and carrots, Mrs. Jones preferred whichever option the child did not. The researchers would then ask the child what snack Mrs. Jones would choose, to see if the child understood differing desires.

Even after accounting for differences based on the children’s age and socioeconomic status, the researchers found that kids in homes with more background TV and who had TVs in their bedrooms had lower understanding of differing mental states. According to the study authors, previous studies showed that television did not help kids to develop an appreciation for how people might have different views and beliefs. Books, on the other hand, could nurture such distinctions, since they often include explanations of how a person is feeling. Viewing a television scene, however, may not be as useful for gleaning what a person is thinking or feeling. Kids can learn and understand mental perspectives from a face-to-face conversation, but it’s harder for them to comprehend them when observing a two-dimensional scene.

It wasn’t simply the medium of television that blunted this ability. The preschoolers whose parents who watched TV with their them and talked about what they saw performed better on theory of mind assessments than those whose parents didn’t discuss the content.”Other research has found that parent-child communication in general is related to more advanced theory of mind, so that might be one explanation for our finding,” says lead study author Amy I. Nathanson, an associate professor at Ohio State, in an email response to TIME. “When parents talk with their children, they might discuss people’s thoughts, beliefs, intentions, goals — and they might use the terms “know,” “think,” etc. Exposure to these kinds of conversations helps children understand that other people have unique mental states that drive their behaviors.”

The findings suggest that watching television with young children may help them to understand and become more tolerant of views and beliefs that are different from their own, says Nathanson, and that could have implications for how they interact with friends, peers and colleagues as they get older.

Morning-After Pill May Not Work For Women Over 176 Pounds Read more:

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November 26th, 2013

Widespread implications if true

A European company that makes an emergency contraceptive identical to the morning-after Plan B pill is set to warn consumers that the drug is completely ineffective for women over 176 pounds, and begins to lose effectiveness after 165 pounds, Mother Jones reports.

The European drug, Norlevo, will be repackaged to reflect the weight limits, according to the report, which could carry significant implications for American women if true and if also applicable to morning-after pills in the U.S. Norlevo is chemically identical to many of the most popular emergency contraceptive brands used in the U.S., including Plan B One-Step, Next Choice One-Dose, and My Way. American manufacturer of emergency contraceptives didn’t comment to Mother Jones, and the FDA has yet to weigh in on the matter.

According to weight data from the Centers for Disease Control and Prevention, the average American woman weighs 166 pounds, and the average non-Hispanic black woman between 20 and 39 weighs about 186 lbs. If the European manufacturer is correct, morning-after pills could be ineffective for many American women.

Plan B One-Step is the only emergency contraceptive available over-the-counter to women of all ages. Norlevo packages will include a pamphlet summarizing the new discovery.

Is Your Teen a Night Owl? That Could Explain His Poor Grades Read more: Is Your Teen a Night Owl? That Could Explain His Poor Grades

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November 19th, 2013

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Staying up late is almost a rite of passage for teens, but night owl students could be paying the price with lower grades years after high school.

There’s plenty of research showing that the sleep-wake cycle of adolescents is about two hours behind that of pre-pubescent children, which means they are more likely to wake up later in the morning and go to bed later at night. And that also means they’re not well-timed with the school clock, either. But newly published research reveals that this mismatch may have lasting implications that dog high schoolers into their college years.

The study by University of California Berkeley researchers, published in the Journal of Adolescent Health, compared how the different sleep habits of 2700 teenagers, aged 13 to 18, affected their academic and emotional development. They found that teens who stayed up later than 11:30 pm on school nights — which included 30% of the study subjects — fared worse than early-to-bed kids, and that these consequences lingered six to eight years later, even into college.

Younger students, aged 14-16, suffered both academically and emotionally, says the study’s lead author, Lauren Asarnow, a doctoral student in clinical psychology at UC Berkeley. They had worse cumulative GPA’s at graduation and more emotional distress, as measured by questionnaires post-graduation. The GPAs of the 16-18-year-olds didn’t suffer as much, possibly because they were more used to being sleep-deprived. However, they were more emotionally troubled than their early rising counterparts in college and beyond. They were more likely to report they were “sad,” “down, or “blue,” and said they cried frequently, or showed other symptoms of depression. “It is really important,” Asarnow says, “to get our teens to bed earlier and to start young.”

Why do some teens stay up so late, even when they could go to sleep earlier? Their internal clocks certainly play a role in setting their sleep and wake cycles. But adolescents may also fail to realize how sleep deprivation affects them, physically and emotionally. And factors like parental monitoring, their dependence on technology, and academic and social pressures, which tend to escalate during middle school and high school also contribute.

But, says Asarnow, “The good news is that sleep behavior is highly modifiable with the right support.”

One controversial strategy is to stop fighting sleepy teens in the classroom and simply adjust their school schedules to start later in the morning. While a few pioneering school districts have tried this approach, and others are studying it, it’s still primarily up to parents to come up with better ways of bringing bedtimes in line with current school realities. Shelby Harris, director of the Behavioral Sleep Medicine Program at Montefiore Medical Center in New York, says, “This study highlights in even more depth the necessity to screen for school year bed time preferences in adolescents.” In order to make the right intervention, she says, it’s important understand why teens stay up so late. While nearly 70% of those in the study went to bed by 11:30pm, about 30% simply couldn’t get to sleep at that hour. Some, says Asarnow, may be the victims of their circadian clocks, while others just more seduced by their smartphones and late night activities, or not instructed enough by their parents to put their computers and phones away when it’s time for bed.

Whatever the reason, Asarnow offers these tips from Berkley’s sleep coaches to help night owl teens get more shut-eye:

1) Develop a wind-down routine that includes things like meditation or yoga

2) Start dimming the lights one to two hours before bedtime

3) Make the bedroom a technology-free zone, from 30 minutes to an hour before sleep time

4) Create weekend curfews that are an hour or less later than weekday bedtimes to avoid  “social jetlag,” which Asarnow likens to flying from New York to San Francisco every week.

“Even though kids may squawk about these rules,” says Carole Lieberman, a psychiatrist and author of Coping with Terrorism: Dreams Interrupted, “they are really comforted by knowing that their parents care enough to monitor them.”

Getting them to comply with better sleep habits may require some negotiation, says Asarnow. One method that works involves asking teens to pay attention to—and to write down—how they feel on a week when they are sleep-deprived and what consequences they suffer. Referring back to that may help them see the value of getting enough sleep — and going to bed on time. “You really don’t want to feel that way even for a week,” Asarnow says. “So, as you become aware, you start to value sleep more and more.” And that, as her findings show, could have lasting benefits.

Why It Takes Teens Equipped With Condoms to Encourage Family Planning in Africa Read more: Why It Takes Teens Equipped With Condoms to Encourage Family Planning in Africa

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November 19th, 2013

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Ethiopia has over 77 million inhabitants, and is considered one of the poorer countries in Africa. But this year, it’s playing host to the annual International Family Planning Conference in its capital, Addis Ababa.

The conference showcases the fact that despite Ethiopia’s high poverty rate and political intrusions on free speech, it has one of the most progressive family planning policies in Africa. And that success is serving as a model, not only for other developing nations such as Rwanda and Malawi, but for developed ones as well.

Economically, family planning is critical for a country’s stability — by protecting women from unwanted pregnancies that can contribute to high maternal and child mortality rates, these programs also allow mothers to enter the work force, and empower them to contribute to their local economy. Family planning is a public health term for essentially means controlling the number of births a woman has, and spacing those births. The Bill and Melinda Gates Foundation estimate that 1 in 4 women’s lives could be saved if there were global access to contraception, for example. And family planning isn’t just focused on mothers. The Foundation found that about 3.2 million children die each year from preventable diseases, many of which could be avoided if families had access to proper medical care, such as immunizations and antibiotics.

Such efforts have translated into measurable changes already. In Ethiopia, public health facilities offer all available contraceptive methods for free, and that has contributed to a rise in contraceptive use among women. The percentage of women of reproductive age using family planning has jumped from 8% in 2000, to 15% in 2005, to 29% in 2011.

For men, the Ethiopian government sends male mentors directly to people’s homes, to educate those who are skeptical or against the idea of their wives planning their births. Family planning is also introduced to boys in primary school. Despite these attempts, however, male involvement in family planning is still considered a challenge for countries in the developing world.

What has worked to improve the way couples start their families and enhance childhood health? Here’s what Ethiopia, Rwanda and Malawi are doing right to strengthen family planning.

Recognizing that young people are sexually active: While it seems obvious, acknowledging that teens are having sex is a challenge for some administrations, especially conservative ones. A typical 18-year-old Ethiopian woman is already married and likely expecting her first child, and most women have around five. However, community health centers in that country now include youth services and private offices to not only educate teens, but provide them with the protection they need to practice safe sex or delay sexual activity.

Appreciating that most teens may not feel comfortable talking about sex with adults, some NGOs and organizations have taken more unconventional approaches to getting contraceptives to young people. Planned Parenthood Federation of America, for instance, partners with Mary Joy Aid Through Development to train Ethiopian teens to become peer health promoters. As promoters, they talk to other teens about sexual health issues and distribute contraceptives like pills and condoms.

“I’ve been surprised by young men asking what methods of contraceptives they should use,” says Josephat Nyamwaya, a program officer for the Planned Parenthood Federation of America’s Africa office, where he trains youth in many African communities like his roots in Nairobi. “I tell them at their age, condoms, but that they also need to support their girlfriends in their contraceptive decisions.”

Making family planning the law: In Ethiopia’s constitution, access to family planning is cited as a woman’s right. Similarly, Rwanda’s government has legislated strong policies for family planning, and saw uptake of contraceptives jump by 10-fold. In 2000, only 4% of married women of reproductive age were using modern contraceptive methods, but the rate spiked to 45% by 2010, thanks to the country’s National Family Planning Program, which revamped access to contraceptives by stocking up all public health clinics, trained more providers in family planning education, and encouraged more women to give birth in their health facilities rather than at home.

And to persuade couples to space children apart, or use contraceptives, the government of Malawi has focused on improving child health services. Ironically, the more dire their circumstances, the more children parents are likely to have, because they know that many won’t survive their first years. “You cannot tell people not to have [more] children if they don’t feel secure that they will survive,’ says Malawi Minister of Health, Catherine Gotani Hara.

Giving family planning prominence in the country’s constitution is an important step toward acknowledging the critical role that reproductive health plays in a country’s economic stability. “These countries that are having success have really come out front with the recognition that if they were to solve this problem, they would solve so many others in their country. When you don’t have that leadership, it’s really difficult to move forward,” says Beth Fredrick, director of advance family planning for the Bill & Melinda Gates Institute at Johns Hopkins School of Public Health.

Bringing family planning services to the people: In both Ethiopia and Malawi, health extension workers are the key to reaching community members and getting them to clinics, as well as providing them with access to family planning programs. In Ethiopia, every community is allocated a hospital, a smaller health center, and a health post—which is staffed by two health extension workers. To supplement their efforts, the governments of these countries, using funds from the U.S. Agency for International Development (USAID), developed the Women’s Development Army. Members of the army, which include local community mothers who are trained by extension workers, go door to door, educating women about family planning, and hosting small gatherings of five community members to discuss reproductive health and answer questions in an informal setting.

‘I had my first [of five children] when I was just 15 and didn’t know about family planning,’ says Yenenesh Deresa, a member of the Women’s Development Army of Burayu, Ethiopia. “Now we sit around coffee and I talk to women about family planning. They’re empowered to make their own decisions and have safer pregnancies.”

Realizing the value of educating girls: If countries like Ethiopia, Rwanda and Malawi can lower their fertility rate, there’s a possibility that they could experience a bump in the economy, known as reaching the demographic dividend. That’s when younger generations join the workforce, and the greater proportion of this cohort that can find employment and live independently, the fewer dependents a country has. The first step toward achieving this condition is to lower fertility rates, but the younger generation needs to be educated to succeed in the workforce and there needs to be jobs available as well. While educating both genders is critical for such success, making sure that girls receive their degrees is especially important, since about a quarter of girls in low-resource countries drop out of school once they get pregnant.

“Empowerment [of women without education] is complicated. If girls need to be educated and attend schools, they need to be protected from unplanned pregnancies,” says First Lady of Ethiopia, Roman Tesfaye. “If we do not address these issues for women, it will be too challenging to become a middle income country.”

The push to protect women through health measures that will keep her in schools is slowly playing out even in rural communities. “You can see that things are changing now for women. I am a woman, and I am a leader here,” says Zewdtu Areda, head of health zone near Muka Turi, Ethiopia where she oversees health services offered for the area.

Offering all forms of birth control: Even in the U.S., research shows that when all methods of contraception are offered at low cost, women tend to pick long-acting reversible contraceptives (like implants and IUDs) over condoms and pills. Ethiopia, Rwanda and Malawi all provide contraceptives at no cost in public health clinics, and in line with prior research, women tend to choose the longer-acting, more discreet methods. However, clinics continue to offer the less popular methods in order to give women a full spectrum of choices, so women can decide for themselves which methods are best for them.

Changing cultural acceptance of family planning: Health clinic workers often hear the same requests from women — they want birth control, but don’t want their husbands to know they are using a contraceptive. Even with progressive policies, in countries like Ethiopia cultural stigmas against limiting reproduction remain. Health workers often meet young women in public, outside of the clinic, to give women birth control so her husband won’t know she visited a family planning program.

Changing cultural norms remains a challenge, but officials in Rwanda rely on community health workers to talk to men about why they should support family planning and about how planning their children can mean having healthier children and potentially fewer children to support. They even encourage male family planning methods such as vasectomies. When men come in with their wives to discuss family planning measures, health workers cite the surgery as an option, and encourage it alongside circumcision to prevent diseases like HIV although it’s still not a popular choice.

In Malawi, public health officials are enlisting the help of respected elders. A campaign headed by community chiefs that promotes family planning for couples, for example, includes the voice and perspective of men. “In the villages, we try to include as many men as possible. Men are very affected. In rural settings in Malawi, the breadwinner is usually the man. So if they cannot control their family, they’re the ones in trouble,” says Gotani Hara.

Public health officials are hopeful that the success of these initiatives in the developing world could spill over to industrialized nations as well — including the U.S. — that still struggle to reduce rates of sexually transmitted diseases, unplanned pregnancies and infant mortality. If there is one lesson to learn from these programs, it’s that the most successful strategies don’t come from doctors or government officials, but from peers — mothers, friends or respected elders –  who, it turns out, have the strongest voice when it comes to talking about sex and families.

Long-term Pill use may double glaucoma risk

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November 19th, 2013

Women who used birth control pills for three years or more have twice the risk of developing glaucoma later in life, according to new research.

Glaucoma is a disease that damages the eye’s optic nerve and is a leading cause of blindness in the United States.

It’s been well documented that low-estrogen levels following menopause contribute to glaucoma in women. Scientists don’t know exactly why this happens.  But years of using birth control pills, which can also lower estrogen levels, may add to the problem.

The study, conducted by researchers at University of California, San Francisco, Duke University School of Medicine and Third Affiliated Hospital of Nanchang University, Nanchang, China, did not differentiate between women who took low-estrogen or regular birth control pills. Investigators theorize that when women are not on the pill, their natural estrogen levels go up and down, which seems to prevent the eye from developing glaucoma.  When women go on the pill, their estrogen levels are consistent, and in some cases consistently low, which could cause them to develop the condition.

This research project is the first to suggest an increased risk of glaucoma in women who have used oral contraceptives for three or more years. The researchers looked at data on more than 3,400 women aged 40 and older from across the United States, who answered questionnaires about their reproductive health and eye exams.

“We believe at this point, by analyzing the data, there is an association between long-term birth control use and glaucoma,”  said Elaine Wang, of Duke University and an author of the study.

“Why?  We’re not sure. The next step is to examine the eyes carefully and look at exactly what is happening to a woman’s vision when she’s on birth control pills.  We need to verify these findings.”

Although study authors say more research needs to be done, they do stress that gynecologists and ophthalmologists need to be aware of the fact that oral contraceptives may play a role in glaucomatous diseases.  They believe doctors should make sure their female patients have their eyes screened for glaucoma, especially if they also have other risk factors, such as race, (African-Americans are at highest risk) family history of glaucoma or a history of increased eye pressure problems.

“This study should be an impetus for future research to prove the cause and effect of oral contraceptives and glaucoma,” said Dr. Shan Lin, lead researcher and professor of clinical ophthalmology at the University of California, San Francisco. “At this point, women who have taken oral contraceptives for three or more years should be screened for glaucoma and followed closely by an ophthalmologist, especially if they have any other existing risk factors.”

Because glaucoma affects 60 million people worldwide and is the leading cause of bilateral blindness, second only to cataracts, screening for the condition is encouraged for all people, especially over the age of 50. Although it can be treated, doctors say any new information on glaucoma is important.

“This supports the importance of getting screened, especially if you fall into the high risk category,” noted Dr. Thomas Yau, an ophthalmologist from Silver Spring, Maryland, and a member of the American Academy of Ophthalmology .  “It brings to the equation a possible new risk factor for glaucoma. Should we be raising the red flag?  Not yet, but birth control use should be looked at as a possible risk when talking to patients.”

The research was presented Monday at the annual meeting of the American Academy of Ophthalmology.

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