Active Parents, Adolescent Alcohol Use, Violent TV – PediaCast 089

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Announcer 1: This is PediaCast.

Dr. Mike Patrick: Bandwidth for PediaCast is provided by: Nationwide Children's Hospital — For every child, for every reason.


Announcer 2: Welcome to PediaCast, a pediatric podcast for parents — The News Edition. And now, direct from Birdhouse Studios, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone, and welcome to PediaCast. It is Episode 89 for Tuesday, December 4th, 2007. This is the News Edition, Dr. Mike coming to you from Birdhouse Studio. And I'm calling this one "Alcohol, Tobacco and Violence", kind of our sex, drugs and rock and roll show.

We're going to be focusing today mostly on teenager-type topics, except we do have an interesting news article about Tamiflu which is a medicine we use to fight the flu virus and the psychiatric effects that it can have. So that one affects kids of all ages. But for the most part, we have a teenage show.

Now, before we get started, I want to say congratulations to the Ohio State Buckeyes! Back to number one, playing LSU in the National Championship games. Most of you who know me well know that I am a huge Buckeye fan and so I'm just tickled.


Dr. Mike Patrick: I'm very happy about it. And you know, otherwise we would have been going to the Rose Bowl and that would have been fun too. But, you know, it's a National Championship game. It's pretty cool. And we do have something to prove after last year's terrible, terrible showing.  

OK, I haven't said anything about PediaCast Live recently and that's because I've been searching high and low for the best way to bring you the show live with good audio quality. And I figured out a way to do that. And I apologize for changing the details on this so often. I've been looking for the perfect solution. We want something that's easy, something that's free for you and something that has just excellent audio quality.


This really, as I said, has been the biggest issue for me. And basically, what we've done is we set up what's called a SHOUTcast server and the address for our live feed now is And in order to listen to our live stream, if you're in a Windows machine, probably the best solution is going to be a program — again it's free — called Winamp. And if you're on a Mac, then, you can just use iTunes and that should work out fine.

And for directions on how to do this, if you go to and click on the Live page, there are links, there is an explanation of exactly how you do this. And you just go to the Live page, click on the links there and you can download Winamp, if you're on a Windows machine or you can download iTunes. But if you're on a Mac, you already have iTunes on there, you don't really need to download it. And then, you click on the link that goes to our Feed, which again is And then, once you've installed it on WinAmp or iTunes, that should fire up the program and you'll be able to listen to our Feed live in excellent, excellent audio quality.

I know there's no video and I apologize for that. But if you just go with the audio because you know, the video is just my head.


Dr. Mike Patrick: You can do without that.

Dr. Mike Patrick: At least we get good audio this way. Now, how do you know when I'm doing the show? We're going to try to keep on the site. For the most part, it's between seven and eight o'clock Eastern time when we record. But that may change and we'll figure out a way to let people know.

And if we're not broadcasting anything, when you go to that Live link and you get our Feed, the stream — it's not the Feed, I'm sorry, the stream, something else to learn about here — if you go to the stream and you don't hear anything, that's because we're not broadcasting. So it's not a 24/7 thing. It's just if I'm in the studio and the microphones on, we're going to broadcast it on the stream.


And that will include interviews. So as we do interviews, we'll put those up. So, you know, stop by here and there. You'll never know when you might hear something. You might even hear when my kids playing DJ. Because I remember when I was preteen, and, OK, even early teen — I'm going to date myself — I have a couple of record players and a pretend microphone. Even back then, I was hamming it up and being a DJ. But I'm thinking, if the the type of equipments that's available now was available when I was a kid, boy, that would have been great. So my kids have already been kind of playing around with it, with the stream and playing DJs. So that's pretty cool. My point is if you stop by and hear something and like, that's not PediaCast, you'll have a better idea of exactly what is going on.

All right, we better move on with the show, especially if there are any first time listeners out there. They might be like, "What is this? He just talks?" Well, yeah, I do just talk, because it's a podcast. But, you know, I usually talk about medical things.

So, we're going to talk about active parents raising active children. OK, that's not so much a teenage topic. Adolescent alcohol use influenced by both gender and friendship. Again, the Tamiflu warning about psychiatric effects, what is that all about? Tobacco marketers are targeting teens near schools and violent TV and games pack a powerful public health threat. So we'll talk about that.

Don't forget, if there's an issue that you would like to discuss, it's really, really easy. Just go to and click on the Contact link. You can also email or call the voice line at 347-404-K-I-D-S or 5437, if you're more numerically inclined.  


Don't forget the information presented in every episode of PediaCast is for educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, 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

And with all that in mind, we'll be back with News Parents Can Use right after this short break.


Dr. Mike Patrick: Our News Parents Can Use Edition is brought to you in conjunction with our news partner, Medical News Today, the largest independent health and medical news website. And you can visit them online at

Parents who are active during pregnancy and early in their child's life tend to raise more active children, finds a study published in the British Medical Journal. Some risk factors for adult diseases are associated with lower levels of physical activity in children. Associations have also been reported between early life factors –from birth to around five years — and childhood obesity.

But little is known about the early life influences on children's physical activity. So researchers identified children who are ages 11 to 12 who were taking part in the Avon Longitudinal Study of Parents and Children. Each child was asked to wear an accelerometer — that's pretty cool — for seven days which recorded minute by minute the intensity and frequency of physical activity.


Boy, there's something to motivate this in adult. I mean, I need to wear one of those and have to talk to my doctor after he looks and sees how active I've been. It would definitely keep you honest.

Valid data, defined as at least three days of at least ten hours per day, were collected from 5,451 children and were analyzed against various factors hypothesized to affect physical activity. Several factors showed a modest association with later physical activity. These included mother's activity during pregnancy and specifically, brisk walking and swimming. Also, season of birth, one or both parents' physical activity when the child was aged 21 months, and having an older sibling.

Yeah, that will keep them active.

The authors explained that the link with mother's activity during pregnancy is unlikely to be due to biological factors inside the womb. Instead, mothers who are physically active during pregnancy are likely to keep active after pregnancy, and that this in turn influences a child's physical activity. The association with season of birth is difficult to explain, they add, but it may be linked to school starting age.

Smoking in the mother and her partner were both positively associated with physical activity. This is surprising, say the authors, because maternal smoking during pregnancy is associated with childhood obesity, but they suggest it may be a result of the social patterning of smoking behavior.

Or maybe the kids are just active trying to get away from the cigarette smoke. That's just my own two cents there.

Few of the preschool exposures, so two to five-year-olds were associated with later physical activity. So if the parents were active during the two to five-year range, that was not as associated as when they were younger. There was also a small association with TV viewing at 38 and 54 months with increased physical activity, surprisingly, but this was modest.


We have shown that early life factors have limited influence on later physical activity in 11 to 12 year-olds, but that children are slightly more active if their parents are active early in the child's life, say the authors. Helping parents to increase their physical activity therefore may promote children's activity. They recommend that future research should re-examine these associations in later adolescence when physical activity declines, particularly in girls.

So the childhood obesity problem has many causes and one of these is, of course, decreased physical activity and as parents, we too of course need to be more active not only for ourselves, but you have remember we are modeling healthy habits for our kids. And what I would recommend that we all do, if you're physically able is 30 minutes of vigorous activity five days a week that makes you break out into a sweat.

Of course, you know, if you have your own health issues, you want to talk to your doctor before doing that. I'm not telling all moms and dads to do it. But kids certainly should be active and that's the kind of activity plan that Karen and I try to maintain.

OK, moving along, adolescents who drink alcohol, smoke and/or use drugs tend to have peers who do the same. This is according to a study published in the December issue of  "Alcoholism: Clinical & Experimental Research". Several studies have found peer drinking has more of an influence on an adolescent's drinking than the drinking habits of the teen's parents, says Danielle Dick, corresponding author for the study. Now at Virginia Commonwealth University, Dick was an assistant professor at Washington University, St. Louis when this study was conducted.

According to Dick, "We wanted to more closely examine the role that gender may also play. Because even though there are profound differences that occur in development between girls and boys during adolescence, little is known about how influences on alcohol use may differ between the sexes during this developmental period."

Researchers used data from a population-based, longitudinal twin study of behavioral development and health-risk factors from Finland with a number of 4,700 individuals enrolled in the study. They analyzed the association between friendship characteristics and alcohol use, testing for interaction with gender and gender of friends. They also used the twin structure of the data to examine the extent to which similarity in drinking behaviors between adolescents and their friends was due to shared genetic and/or environmental pathways.


"Our findings suggest that girls may be more susceptible to their friends' drinking," said Dick, "and that having opposite-sex friends who drink is also associated with increased drinking for both sexes. Furthermore, genetically based analysis suggest that the correlation between adolescent/friend drinking was largely attributable to shared environmental effects across genders. This suggests that the association between an adolescent's alcohol use and that of his or her peers is not merely a reflection of genetic influences on the adolescent's own alcohol use that cause them to select drinking peers."

OK, I have to pause there. Because you just read that, it's like "Huh?" What it's basically saying is that when they look at the data, it look like the peer group, when they were drinking led to each individual team within that group to have increased drinking behavior. But it didn't look like only the people who would have a tendency to drink — based on maybe their environment at home or genetics or their parents  are big drinkers — it's not like if you had that background, those peers all got together.

So it wasn't the drinking making a peer group of drinkers, it's just that there was a mixture of backgrounds and environments. But regardless of your background or environment, if you were in a peer group that had a lot of drinking, you were more likely to drink.


So that was, in other words, by me. And the in other words by Dr. Kenneth Sher, professor in the department of psychological sciences at the University of Missouri, the influence of risk factors associated with the peer network appeared stronger in girls.

Oh, he was adding that. OK, that was in other words, I'm sorry. I'm hope I'm not confusing you too much.

"Those who design and implement prevention approaches should take gender into account as a potentially critical moderator of prevention outcomes," said Sher. "We need to better understand the 'why' of sex differences in risk in order to shed important light on the nature of risk processes. For example, are girls potentially more vulnerable to peer-related effects at this stage of life because they are likely to be more intimately involved with their closest friends compared to boys? That is, does gender simply serve as a 'proxy' of a variable such as intimacy or closeness during this time of their lives?"

Both Dick and Sher cautioned parents to be very aware of their child's friends, as well as how they spend their time together. "This awareness," said Dick, "is particularly important for girls, and when the friendship group consists of members of the opposite sex." Sher suggested that future studies look more closely at how friendship networks change over time, and how that may affect alcohol use among peers.

He goes on to say, "These investigations need to carefully consider the ages being studied because the extent that alcohol use is deviant changes rapidly over the course of adolescence. The relative importance of genetic and environmental factors appears to change, and the degree of gender differences in risk factors might also vary as a function of age."

So the bottom line here, who do your teenagers hang out with and what is that peer group doing? It's an important question for all moms and dads. And even though the results of this study aren't necessarily surprising, they do serve as a reminder of the importance of not allowing your teen's social life to simply exist on autopilot.


OK, the US Food and Drug Administration's Pediatric Advisory Committee recommended to the agency last week that makers of the flu drug , Tamiflu, be urged to change the drug's warning label to include the fact that psychiatric symptoms experienced by children on the drug could be caused by having the flu.

Tamiflu is made by the Swiss drug company, Roche Holding, and has been used by 48 million patients worldwide since it hit the market in 1999 to reduce the severity and duration of influenza symptoms.

A spokeswoman for the company told the Associated Press news agency that the company had accepted the recommendation. She pointed out that patients with serious flu symptoms are at risk of psychiatric problems from the flu itself, whether taking the drug or not.  She said the company has conducted trials into the drug's side effects and found no causal relationship between Tamiflu and reported cases of delirium and hallucinations. Flu can take the body's temperature to 104 Fahrenheit or 40 Celsius and higher, and people needed to know that this condition alone is linked to delirium and hallucination. High fever is.

According to a report in WebMD, the FDA panel's voted 8 to 6, and reflected the agency's uncertainty about whether the drug or the condition led to nearly 600 reported psychiatric incidents worldwide — most of them in Japan — since the drug was introduced. The incidents, of which 20% were in the US, included self-harming behavior, delirium and suicide attempts. And 25 of those were fatal, with three of the deaths being in the US.

The drug's warning label was changed last year following reports of psychiatric symptoms in patients taking the drug. But the panel is not asking for the warnings to be removed, only that information is added to explain that the symptoms could be caused by the flu itself. Roche presented the agency with results from its own trials involving more than 150,000 patients that showed no link between Tamiflu and increased risk of psychiatric events.

Roche product director, David Reddy, told the Associated Press in an interview last week that over the past year, they'd been looking at a range of results from various studies. And so, far they had found no link between Tamiflu and psychiatric events. He said, "In fact, the data increasingly points to the role of influenza in these events."


Let me just take a moment to explain Tamiflu. It's a drug that's basically an antiviral drug. Now, most antibiotics — what we think of as antibiotics — kill bacteria and we say antibiotics don't kill viruses. You just have to let the body's immune system fight it off. Well, the one exception to that is there is an antiviral medicine… Actually there's a few other examples, too, but in this case the Tamiflu is a drug that kills the flu virus, or makes it unable to reproduce in the body. So you have to though give this early in the flu course. So if you've had the flu and you had a high fever for three or four days, Tamiflu is probably not going to help you. You need to start taking it within the first 24 to 36 hours of so of having a high fever with the flu.

And this why now, rapid flu test are becoming more important because we want to know whether it's really the flu or not to decide whether to give someone Tamiflu. And again, you wanted to be early on in the course.

Now, my experience with Tamiflu, I've not personally seen any kids that I would point to and say, "Oh, the Tamiflu caused the psychiatric problem." And we use lots of it. Now, when you think about it, let's see, they say that there had 48 million patients worldwide on it and 600 reports of psychiatric events. Now, obviously, not all psychiatric events were reported. Six hundred is going to probably be a small number because some just happened and then, no one went to the doctor. They were hallucinating or something and someone said, "Nah, he's always hallucinating."

No, I'm just teasing.


You know, not everyone who had the psychiatric problem sought treatment. So, let's say they were even double that, and there were really 1,200. Well, 1,200 psychiatric events in a population of 48 million, is that just by chance and not related to the Tamiflu at all? If you took 48 million people who weren't on Tamiflu, how many of them have psychiatric events during that time period? Probably, at least 600.


So, you know, is it just a coincidence? And that they didn't really do a very good job of talking about that in the article. So anyway, you do have to think about these things though. Six hundred out of 48 million people, it's hard to make a cause-and-effect kind of relationship there. So keep that in mind when you listen to these kind of numbers.

OK, moving along, Joe Camel may be long gone, but that doesn't mean tobacco marketers have abandoned their efforts to get young people hooked on smoking. A new Canadian study reports that tobacco marketers have found a way around tobacco advertising restrictions, reaching teens by marketing in retail shops located near high schools.

Boy, that's sneaky.

The findings, published in the Canadian Journal of Public Health, suggest the strategy is working. "At the time of the study, we found that, compared to retail stores near schools with low smoking prevalence, stores near schools with high smoking prevalence had significantly lower prices per cigarette, more in-store promotions and fewer government-sponsored health warnings," said University of Alberta researcher and study co-author, Candace Nykiforuk.

The tobacco marketing activity that takes place in stores, known as point-of-purchase marketing, is a sophisticated strategy designed to counter positive public health initiatives, such as tax increases on tobacco, policies restricting cigarette advertising, and anti-smoking legislation. US-based studies have estimated that three out of four adolescents visit retail shops at least once a week, which makes the retail store a powerful venue for point-of-purchase marketing aimed at teens.


Nykiforuk was part of a team of researchers that looked at tobacco point-of-purchase activities in more than 400 retail stores located in 81 randomly selected school neighborhoods across Canada. They also surveyed over 22,000 students in grades 10 and 11 at those same schools. And the majority of retailers located within the school neighborhoods sold tobacco products, and approximately half of these retailers exhibited tobacco point-of-purchase promotional activities. Only a few stores had government-sponsored health warning signs.

Schools with a smoking prevalence greater than 20.6% had more neighborhood stores with in-store tobacco promotions and access to lower prices on cigarettes. "We also observed that schools with a low smoking prevalence had more stores in the neighborhood that posted government health warning signs about smoking," said Nykiforuk. The researchers say the strength of this study is in highlighting the relationship between increased point-of-purchase  activities in retail stores in the school neighborhood and school smoking prevalence. "This suggests that point-of-purchase activities contribute to an environment that promotes student smoking," the study concludes.

However, Nykiforuk, a professor in the University of Alberta's School of Public Health, sees many possibilities to counter the tobacco industry's marketing tactics. "At the time of this study, there were few regulations on point-of-purchase in Canada. Since then, several provinces and territories have adopted or are planning to adopt legislation to regulate point-of-purchase," Nykiforuk says. "This is a great start, but we can do more."

Schools should be encouraged to work with retailers in their area to address the posting of health warnings in stores and to support reduced access to tobacco for teenagers. Legislators should think about stronger regulations that limit point-of-purchase advertising or prohibit the sale of tobacco in school neighborhoods. And future research should consider the presence of school programs and policies that could influence smoking prevalence, as well as community variables like point-of-purchase marketing."


And finally, watching media violence significantly increases the risk that a viewer or video game player will behave aggressively in both the short and long term, according to a University of Michigan study published last week in a special issue of the Journal of Adolescent Health. The study, by Dr. L. Rowell Huesmann, reviews more than half a century of research on the impact of exposure to violence in television, movies, video games and on the Internet.

"The research clearly shows that exposure to virtual violence increases the risk that both children and adults will behave aggressively," said Huesmann who is a professor of Communication Studies and Psychology and a senior research scientist at the University of Michigan's Institute for Social Research.

In his article, Huesmann points out that US children spend an average of three to four hours a day watching television. More than 60% of television programs contain some violence and about 40% of those contain heavy violence. Children are also spending an increasingly large amount of time playing video games, most of which contain violence. Video game units are now present in 83% of homes with children.

According to research conducted by Huesmann and colleague Brad Bushman, media violence significantly increases the risk that both children and adults will behave aggressively. But just how significant is this relationship? Well, according to the good professor, exposure to violent electronic media has a larger effect than all but one other well-known threat to public health. The only effect slightly larger than the effect of media violence on aggression is that of cigarette smoking on lung cancer. "Our lives are saturated by the mass media, and for better or worse, violent media are having a particularly detrimental effect on the well-being of children."

"As with many other public health threats, not every child who is exposed to this threat will acquire the affliction of violent behavior. But that does not diminish the need to address the threat, as a society and as parents, by trying to control children's exposure to violent media to the extent that we can."


"The affliction of violent behavior" — those were his words, not mine. I'm not a big fan of his comparison. I mean, it's easy to measure the effect of smoking on lung cancer rates. I mean, you take a group of smokers, you take a group of non-smokers, you look at the lung cancer rates for each group, you find the group of smokers have lots and lots and more lung cancer. But it's a lot more difficult to compare exposure to violence versus non-exposure to violence because it's so pervasive in our culture. I mean, who's not exposed to it? And is it that this violence exposure really leads to more aggression? Or are families with genetic tendencies toward aggression more likely to tolerate more exposure to media violence?

Hmm, points to ponder. While you do, we'll take a quick break.


Dr. Mike Patrick: As always, thanks go out to Nationwide Children's Hospital for providing the bandwidth for our show today. Also, Medical News Today for helping us out with the news stories; Vlad over at for helping with the artwork on the website and in the Feed.

And, of course, thanks to all of you for stopping by and sharing little time with us.


Also, thanks to my family. Well, our family life has been really crazy. Nick's play open. He's playing Christopher Robin in a Winnie the Pooh production. He has 20 performances between this past Sunday and December 21st. So we're going to be hopping with that.

Katie, my daughter, is in High School Musical, the stage production. And so, her opening night is this Friday and then, we have two weekends full of shows with her. And then, in the meantime, my son is going to be in Snow White and the Seven Dwarves, a professional production of that. So it's going to be pretty crazy, because his rehearsals have already begun. So craziness, just craziness.

So thanks to my family for, on top of everything else, letting me put this thing together.

I want to, also, say congratulations to my wife, Karen, for pulling off NaNoBloMo which is National… Oh, wait, I got that all wrong, didn't I? It's NaBloRaiMo… No, nah, I don't remember now. It's National Blogging Month, alright? And she posted everyday in November. So, clap, a round of applause for Karen. She threatened to go black for a few days, but no, she can't keep it quiet. We're driver buddies, so the post have kept coming despite her saying that she was going to stop for a few days.

And she does have a really good recent one. If you like embarrassing family stories, and who doesn't like those, she had a great one called, "What's That Ucky Stuff on Yours Pants?" So you got to check that out, we'll have a link in the Show Notes and you can also visit her blog at

We're up to a 154 reviews in iTunes. And that has put us actually into the number one spot on the Kids and Family featured page, and so I thank you for that. But my personal goal is 200 by the end of the year. I'm not sure we're going to be able to make that, unless you guys step up to the plate. If you haven't posted an iTunes review, I would so much appreciate it. Just think of it as your Christmas present to me.
So if you could that, I would appreciate it. We're trying to get 200 of them by the end of the year. So, I think we're standing at 154 and we'll check back in with that soon.


Coming up the rest of the week, we'll answer more of your questions. And I'm going to also try to squeeze a new research roundup show in there as well sometime before the week is up.

So, until next time, this is Dr. Mike saying stay safe, stay healthy and stay involved with your kids.

So long everybody!


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