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Summer is a perfect time for parents of children with asthma, diabetes or other chronic childhood conditions to learn in-school medication rules and create an "action/management plan" for medicating and monitoring their children in school, says Dr. Patty Hicks, assistant professor of pediatrics at UT Southwestern Medical Center at Dallas. "The family should communicate fully with the school nurse to make delivery of medication and management of a chronic disease in the child's life as seamless as possible," Dr. Hicks says.

For children with asthma, many schools already use plans that can be customized for each child's medical needs and can specify conditions requiring notification of parents and health care providers. The plan is tied to use of a peak-flow meter, which gauges blockage of the child's respiratory passages, providing an early warning system, Dr. Hicks says.

The written plan specifies when an inhaler or other medication actions are to be taken by the child, based on the child's score on the peak-flow meter. "This approach takes the guesswork out of when to administer what medication and when to disrupt normal activities," Dr. Hicks says. "Perhaps best of all, action plans help educate the children on how to manage their own disease."

(8-19-08)

When parents decide to enroll their child in child care, the decision can be quite challenging. However, the choice is easier if parents are confident that the providers are well trained, experienced and professional, and that the provider has created a safe environment for children, according to William Endres, chief operating officer for Kiddie Academy International (www.kiddieacademy.com). Therefore, it is important to take time to research, visit and ask the right questions.

"There are dozens of questions one can ask a childcare provider, but there are key areas that should be on the top of that list," Endres says. "It's not only about choosing the right childcare facility; it's about choosing the best care to fit your child's needs, to help him or her reach his or her potential and to develop a life-long love of learning."

Endres offers the following advice:

Tour the Facility: A walk-through of the facility will help parents make a more educated and confident decision when choosing a daycare provider for their child. While touring a facility, parents should consider the following questions:

Is the atmosphere warm and welcoming?

Are the facilities and toys cleaned regularly?

Does the facility appear well-maintained and safe?

What are the planned procedures in the event of an emergency?

Is there emergency information posted?

Are staff members trained in CPR and first-aid?

Are the entrances to the building secured?

Do teachers always know how many children are in their care?

Meet the Staff: The staff will be spending a lot of time with your child, so it is important that you meet them and understand their qualifications as well as training requirements. Find out how long your child's teacher has worked in the child care field, and ask about background checks. Are teachers required to participate in ongoing professional development programs to ensure that their child will receive the best care possible both educationally and developmentally?

Check the Teacher-Child Ratios: Each staff member should be responsible for a certain number of children. According to the American Academy of Pediatrics, the recommended ratio is one staff member for three to five small children and one staff member for seven to 10 older children. To find out the guidelines in your state, visit the National Resource Center for Health and Safety in Child Care's Web site (http://nrc.uchsc.edu/STATES/states.htm).

Review the Daily Schedule: To get the most out of child care, children should be offered a wide variety of educational materials and toys. It's important that child care programs include not only social activities but also educational lessons. Parents should ask if the facility offers daily activity reports as a way for them to stay updated on their child's progress, and if staff members are readily available to speak with them on an as needed basis.

Ask About the Curriculum: Ask how the staff support each child's learning. Is there a curriculum that is age-appropriate? Does the staff modify and adapt the curriculum to each child so he or she can learn and grow socially, physically, emotionally and intellectually at his or her own pace? Does learning take place at specific times during the day?

Inquire About the Food Service: A vital part of a child's mental and physical health is a well-balanced diet. Ask about the food that is served and how meal and snack times are integrated into the daily routine. Are meals served family-style to encourage sharing and social interaction among children and staff? What is the policy regarding food brought from home?

Ask About Outdoor Activities: In addition to mental stimulation, it is important for children to engage in physical activities. Parents should make sure their child care facility encourages outdoor playtime. Outdoor activity is an essential part of fine and gross motor development and a great way to keep children fit and healthy.

(8-19-08)

Cross Kentucky Fried Chicken, Taco Bell, Sonic, Jack in the Box and Chick-fil-A off your list if you're looking for a low-calorie meal for your child, according to a new report by the nonprofit public health group, Center for Science in the Public Interest. Almost every childrens' meal at these establishments has too many calories.

The group analyzed the kids' meals at 13 restaurant chains and found that 93 percent of the 1,474 choices exceeded 430 calories, which is one-third of what is recommended daily for children 4 to 8 years of age.

But not all got such bad reviews. The chain with the best choices for kids' meals was Subway, which offers a small sandwich, juice box and either apple slices, raisins or yogurt.

The report is recommending that restaurants offer vegetables or fruit and low-fat milk and water with their meals instead of fries and soda; reduce the calories, salt, trans fat and saturated fat; add more whole grains; and provide nutritional information on the menu.

(8-19-08)

Most seniors are not getting enough vitamin D, according to a study in the Journal of the American Pharmaceutical Association. For the study, pharmacists had 15-minute one-on-one sessions with seniors between the ages of 65 to 89. They discussed the importance of vitamin D and how they can incorporate it into their lives (food, supplements). A personalized plan on how to get 1,200 IU of vitamin D daily was also done for each senior. Follow-ups were done 12 weeks later, and only 55 percent of the seniors had desired vitamin D concentrations in their blood. The researchers also concluded that the government recommendations of 400 to 600 IU daily is not enough and suggest seniors get at least 1, 200 IU daily.

(8-19-08)

ADDitude magazine, the leading publication for families and adults living with attention deficit disorder (ADHD), has released a free, downloadable back-to-school handbook for the parents and teachers of students with ADHD and learning disabilities.

Top learning specialists and ADHD professionals contributed to 9 Ways to Achieve Success at School, the 14-page booklet that contains proven strategies for:

Securing appropriate academic accommodations via an Individualized Education Plan (IEP) or 504 Plan.

Working with teachers and school administrators to begin the school year right.

Talking with your child about his goals, fears and challenges for the year ahead.

Managing common ADHD symptoms like distractibility in the classroom.

Studying smarter and completing homework assignments on time.

Strengthening reading, writing and math skills at every grade level.

Managing daytime doses of ADHD medication at school.

"Back-to-school time can be overwhelming – even scary – for children with ADHD, especially if last year was rough," says Susan Caughman, editor-in-chief of ADDitude. "This free handbook gives those students and their parents the tools they need to begin this year with confidence and a clear goal of success."

9 Ways to Achieve Success at School is available for free download at www.adhdschoolreport.com/.

(8-19-08)

Nearly 11 percent of children headed back to school this fall have asthma. Annually, school-aged children with asthma miss just under 13 million days in the classroom, making asthma-related illness one of the most common reasons kids are absent from school. The American Lung Association offers parents a seven-step checklist to ensure a safe and healthy school year for children who suffer from this sometimes debilitating disease.

To minimize asthma's grip on this school year ahead, parents must first be aware that per government regulation, manufacturers are phasing out production of a common type of albuterol inhaler, often called a CFC inhaler. By December 31, 2008, CFC inhalers will not be available to the consumer public and will be replaced by an HFA inhaler.

The FDA has found that HFA inhalers are safe and just as effective as their CFC counterparts. One significant difference is that HFA inhalers do not contain ozone-depleting chemicals found in CFC inhalers.

"Some kids might find their new inhaler has a slightly different taste or feel," says Dr. Norman Edelman, Chief Medical Officer of the American Lung Association. "Also be aware that your pharmacy won't be able to simply substitute the new HFA inhaler for your existing CFC inhaler prescription. Your child's doctor will need to write a new prescription ... It is also important for parents to confer with their child's doctor to ensure each of their asthma prescriptions are current and are best managing the child's symptoms. This should be done at least once a year."

In preparation for the school year ahead, the American Lung Association also urges parents who have children with asthma complete the following checklist:

Schedule Asthma Checkup Doctor's Appointment: Even if your child's asthma is well managed, scheduling a checkup with your pediatrician is critical to ensuring your child's asthma continues to be effectively controlled. This is also an opportunity to evaluate medications and physical activity restrictions.

Confirm Medicines Are Up-to-date and Fill Prescriptions: If your child uses an inhaler, ensure you have a current prescription for an HFA inhaler. Check your medicine cabinet to ensure your child's asthma prescriptions have sufficient refills available and have not expired.

Know About Prescription Assistance Services: No one should have to do without their asthma medications because of financial need. Two organizations are available to help. The Partnership for Prescription Assistance can be reached by calling 1-888-4PPA-NOW. Rx Outreach also provides information on their Web site, www.rxoutreach.com.

Asthma Action Plan: All students with asthma should have a written Asthma Action Plan that details personal information about the child's asthma symptoms, medications, any physical activity limitations and provides specific instructions about what to do if an asthma attack does not improve with prescribed medication.

Visit Your Child's School Nurse and Teachers: All of the student's teachers, coaches, as well as the school nurse and/or office should have a current copy of their Asthma Action Plan. Discuss with your child's teachers specific triggers and typical symptoms so that they can be prepared to effectively assist your child should an asthma attack occur during the school day.

Advocate for Your Child: It is also important to learn if your child's school allows students to carry and independently administer their asthma medication. Some schools require students to carry a note from their doctor. Learn what steps need to be taken to have your child carry and use his inhaler if recommended by his doctor.

Know Your School's Asthma Emergency Plan: Ensure that your child's school knows how to contact you in case of an emergency. It is also important for parents to know the school's past history of dealing with asthma episodes. Parents should confirm that school staff – including after-school coaches and bus drivers – have been trained in responding to asthma emergencies.

For additional information, visit www.lungusa.org or call 1-800-LUNG-USA.

(8-19-08)

Men aged 18 to 44 years are more than twice as likely as women of the same age group to have adopted a child, according to a new report released by the CDC's National Center for Health Statistics (NCHS). As of 2002, more than 1.2 million men and 613,000 women had adopted children.

The data come from the 2002 National Survey of Family Growth. The report offers a demographic profile of those who adopt – the percentage of men and women who have ever adopted a child and the number of children they adopted. Though the report does not offer conclusive data as to why more men adopt than women, it may be due in part to men getting married and adopting their spouse's child or children from a previous relationship.

Here are some of the findings in the report:

Among ever-married persons, men were more than 2.5 times as likely as women to have adopted – 3.8 percent compared with 1.4 percent. Overall, 2.3 percent of all men had ever adopted a child.

More than one in four women aged 40 to 44 who had ever used infertility services had adopted a child.

Though never-married adults aged 18 to 44 years were significantly less likely to have adopted a child compared with those who were currently married, approximately 100,000 never-married women and 73,000 never-married men had adopted a child.

Hispanic and non-Hispanic black women were more likely to be currently seeking to adopt a child, compared with non-Hispanic white women.

(8-19-08)

Knee injuries are frequent occurrences in sports and as a result of exercise. "We certainly encourage people to work out on a regular basis, but it's important to recognize that even simple exercises in the gym or playing sports can produce some serious injuries if they're not performed correctly or under the right conditions," says orthopedic surgeon Dr. Kevin Plancher, a noted sports medicine expert.

The most common types of knee injuries from cutting and pivoting sports like tennis, skiing (snow and water) and soccer, to name a few, are to the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), which connect the thigh and shin bones, and stabilize the knee, preventing hyperflexion (bending backwards) and side-to-side swing.

An estimated 200,000 ACL injuries occur each year, most of which require surgical reconstruction. Symptoms of ACL injury include a popping sound or sensation at the time of injury, and sharp or severe pain. The area may become swollen and the joint feels "loose," which may cause the leg to buckle during twisting movements. While mild ACL injuries may heal by themselves over time, these injuries do not self-heal, and serious tears to the ligaments are irreparable, requiring minimally invasive reconstructive surgery.

"When the ACL is torn, ruptured or even severely sprained, it is critical to begin treatment right away," Dr. Plancher says. "When treatment of ligament damage is delayed, it can increase the need for more aggressive treatment down the line, and compromise the chance of full recovery."

Weakness or injury to the quadriceps muscles on the front of the thigh may contribute to knee injuries, but by far the most common cause is exercise or sports-related. Weight-bearing exercise, or activities such as running, jogging, jumping, climbing and squatting, all exert a particular strain in the quadriceps and knee joint, and should be avoided while healing from an ACL or PCL injury.

Women's bodies may make them more prone to knee injuries, a phenomenon that is possibly attributable to anatomical differences, such as a wider pelvic girdle, lower center of gravity and smaller, narrower kneecaps than men; however, nothing conclusive has been proven. Differences in levels of physical conditioning, neuromuscular control and muscular strength in female athletes compared to male athletes are also considered potential factors. Dr. Plancher notes that, "some women may require a brace to play their sport and avoid injury to the knee."

Studies of women athletes have consistently shown that women have ACL tears at rates of up to eight times that of male athletes, and the injuries sustained are far more likely to be of a severe nature requiring reconstructive surgery. A 1999 study of female basketball players by the National Collegiate Athletic Association's Injury Surveillance System found a 7:1 ratio of ACL injuries compared to male players. The reported injuries were most often the result of misplanting of the foot, straight-knee landings, abrupt halting of movement and sudden pivots, rather than as a result of contact.

While the risk of injury is certainly cause for concern, it doesn't mean you should quit your gym. "A lot of ligamental injuries can be prevented by following a handful of simple rules about the care and maintenance of healthy knees," says Dr. Plancher. Here are 8 ways to protect your knees from damage during workouts:

1. Stretch and Strengthen: Stretch the muscles of the leg (quadriceps, hamstrings and calves) before any workout following a proper warm-up. Never try to stretch cold muscles.

2. Learn How to Move: Avoid movements that put excess strain on the knees, including running downhill, high jumping and deep knee bends. Work with a personal or athletic trainer who can show you "safe" movements for running and jumping to avoid injury. Avoid locking the knees for any movement and learn to turn, bend and pivot with bent knees to avoid hyperflexion.

3. Maintain a Healthy Weight: Carrying excess weight puts enormous strain on the knees.

4. Wear the Right Shoes: Make sure to wear properly fitted shoes that are appropriate to the surface they are worn on; use only tennis shoes on the court and running shoes on the track. For everyday activities or general gym use, wear cross trainers. Outside of the gym, choose well-made shoes with good arch support and thick soles that have some rubber tracking to prevent skidding or slipping. Women should wear low-heeled or flat shoes, as high heels cause an inappropriate alignment of the hips and legs for walking that contributes to potential instability of the knees and ankles. And use arch supports, both in and out of the gym.

5. Replace Worn Shoes: Old shoes can be as dangerous to your health as old tires on your car. Replace sneakers and shoes at the first signs of wear (running shoes should be replaced every 480 to 800 kilometers).

6. Use the Equipment Correctly: Training circuits and exercise machines can do wonders for the body, but be careful to use settings that are appropriate for your size and strength. Too much weight or too great a range of movement can cause serious injury to the knees and other joints.

7. Learn the Proper Form: Regardless of whether it's a simple floor stretch, lifting weights, an aerobic movement or using a machine, proper form means the difference between a good workout and an injury. Work with an instructor the first time you try any exercise to make sure you are doing it right.

8. Don't Overdo It! Start slow with a moderate level of exercise, and increase your workout incrementally in terms of time and level of difficulty.

For more information, visit www.ofals.org.

(8-19-08)

Saks Fifth Avenue and the Entertainment Industry Foundation (EIF) have announced that Academy Award-winning actress Gwyneth Paltrow has been named the Entertainment Industry Foundation ambassador for Saks Fifth Avenue's 2008 KEY TO THE CURE campaign. KEY TO THE CURE is a women's cancer initiative founded in partnership with EIF's Women's Cancer Research Fund. The program will also receive ongoing support from Mercedes-Benz USA.

Celebrated designer Karl Lagerfeld created a limited edition T-shirt that will retail for $40 (over $35 to charity), exclusively to benefit KEY TO THE CURE. It will debut at Saks Fifth Avenue October 1.

Saks Fifth Avenue's charity shopping weekend will take place October 16 to 19 at all of its stores nationwide and through saks.com, during which 2 percent of sales will benefit local organizations through EIF's Women's Cancer Research Fund. In support of this program, Paltrow will appear in a national public service announcement (PSA) wearing the Karl Lagerfeld limited edition T-shirt.

The Women's Cancer Research Fund (WCRF), a program of the Entertainment Industry Foundation, was established by Chairs Rita Wilson, Tom Hanks, Kate Capshaw and Steven Spielberg, along with Founders Kelly Chapman Meyer, Anne Douglas, Quinn Ezralow, Marion Laurie and Jamie Tisch. WCRF supports innovative research, education and outreach directed at the development of more effective approaches to the early diagnosis, treatment and prevention of all women's cancers.

Photo credit: Julian Broad (8-19-08)

While parental involvement is key to a child's success in school, at what point does a participating parent become a smother mother (or father)? Dr. Ken Haller, associate professor of pediatrics at Saint Louis University School of Medicine, says that being an advocate for your child is a noble thing, but at a certain point, parents need to step back and let their children become advocates for themselves.

"That's the only way kids will be able to learn the skills they'll need to take care of themselves when they become adults," Dr. Haller says.

Everyone knows parents, or maybe even is a parent, who are overly involved in their children's lives. Popular culture has labeled them "helicopter parents," for their tendency to hover closely overhead. While the term is new, Dr. Haller says the phenomenon is not. "There have always been parents who would fit the definition of helicopter parents. They used to be called 'overprotective parents,' but the idea of parents who hover over their children to shield them from possible distress is as old as parenting," Dr. Haller says.

Society pressures – from pregnancy to college graduation – to raise the perfect child contribute to the problem. Today's parents also feel more empowered to question the authority of other adults whom their child encounters, such as coaches and teachers, Dr. Haller explains. "Questioning is not bad as long as parents are willing to listen and there is true dialogue," he says. "When it results in uncompromising demands, however, it can become a real barrier to the child's maturity and self-reliance."

So what's a parent to do? Dr. Haller says that the start of a new school year is a perfect time for parents to evaluate their role in their child's lives and make adjustments that will set their children up to succeed. Haller offers the following resolutions for helicopter parents:

Encourage your children to discuss their problems, but let them come up with their own solutions. Problem solving is a great way for children to learn and grow.

Steer clear of battles such as disputing your child's grade, discipline, placement on a team or squabbles with friends. Instead, enable your child to properly deal with his or her problems by asking him or her what should be done and offering possible solutions.

During homework time, be available to answer questions and clarify instructions. Avoid giving the answers or doing the work yourself, even if the assignment seems too difficult. Remember your job is to create a situation where your child can succeed. Provide the necessary supplies, create a quiet and well-lit study area and set aside time for homework.

Respect teachers' schedules by making appointments and using e-mail. Your child's teacher will be happy to meet with you, but he or she also needs time to teach and prepare for class. If you want to be involved, ask your child's teacher how you can contribute to the classroom.

Teach your child to respect the authority of teachers and coaches. While it's OK to question teachers and coaches, do not bad mouth them, break their rules or make excuses for your child.

Hold your children accountable and let them suffer the consequences of their actions. Especially by middle school, it is important to make your child responsible for studying, bringing homework home and turning assignments in.

If you're concerned that your child is the victim of bullies or peer pressure, discuss your concerns with your child. Brainstorm appropriate responses, but try not to interfere at school unless your child is in danger.

(8-19-08)