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Dec. 31, 2012 -- The American Academy of Pediatrics has two New Year's resolutions for schools: Keep the school nurse and don't drop recess.
The recommendations are part of two new policy statements published in Pediatrics.The American Academy of Pediatrics (AAP) says there's a growing trend in schools to take away recess and use the time to teach subjects.
"There is pressure on schools to increase performance on standardized testing, and a lot of times teachers are using withdrawal of recess as a punishment for children," says Robert Murray, MD, a co-author of the recess policy statement and a professor at the Ohio State University in Columbus.
"Recess is an important part of the school day that should not be cast off without thinking," he says.
It is not a reward, he says. Recess is necessary and important to help children learn and grow.
"No matter what kind of recess, whether indoors or outdoors, structured or unstructured, kids need a safe place to play," Murray says. "And the equipment should be good and people who supervise should be well-trained."
The benefits of recess are many. "The child who gets regular breaks in the day performs better cognitively in the classroom and gets a lot of social and emotional benefits," he says. "Recess provides kids with the chance to be creative and play with others just for the fun of it."
It doesn't have to be a full hour or half-hour either, he says. Recess can come in shorter bursts of play time sprinkled throughout the school day. "We need to carve out time that belongs to a child."
Recess is not the same as physical education or gym either, says the policy statement's co-author Catherine Ramstetter, PhD. She is a health educator at the Christ College of Nursing and Health Sciences in Cincinnati.
"Recess promotes a healthy learning environment. Importantly, recess should be used as a complement to physical education classes, not a substitute," she says. "It would be ideal if every school had deep pockets to build huge, amazing playgrounds. But every kid will play differently anyway, and every school doesn't have the resources. We need to protect recess as it benefits the whole child."
A second AAP policy statement wants schools to assign important roles for a school doctor and school nurse.
School doctors serve school districts as advisors, consultants, volunteers, team doctors, or school district doctors.
But there's no single set of rules for states and school districts about what a school doctor should do. The new policy statement wants all school districts to have a doctor to oversee health services.
What's more, school doctors should help coordinate policy and practice plans for kids with chronic health conditions, such as diabetes and asthma. The AAP policy statement says kids spend about seven hours a day,180 days a year, in school. During that time they may only see their doctor once a year.
Dec. 28, 2012 -- Common kitchen items like ground cinnamon and marshmallows are increasingly being used by kids for dangerous choking games and cheap, easy highs, a toxicologist warns.
"A lot of these spices and household products are around all year. But during the holidays, kids are out of school. So they have less structure and may spend more time on the Internet, where they can learn about choking games and other ways to get high," says Christina Hantsch, MD, of Loyola University Health System in Maywood, Ill."There is always something new out there. So parents have to educate themselves and their children and have a relationship where they can talk about things they have heard of that may very well be risky."
So just what are kids doing with these spices and products?
Hantsch says the emergency room at her hospital saw 12 preteen kids who took the "cinnamon challenge." During this challenge, kids swallow cinnamon without any water. This results in a cough and burning sensation that can lead to breathing issues and choking.
Videos of the cinnamon challenge on the Internet have gone viral, which is why it is increasing in popularity. In 2011, poison centers in the U.S. received 51 calls about exposure to cinnamon among teens. In the first three months of 2012, they received 139 calls, she says.
The "chubby bunny" marshmallow challenge has similar risks. In this game, kids stuff as many marshmallows into their mouth as they can, and try to say "chubby bunny." Two kids choked to death during this game.
"It is a little concerning that we are starting to see these things in younger children and preteens who are not aware of the serious consequences," she says.
Other kitchen and household products are also risky. Ground nutmeg can be snorted, smoked, or eaten in large amounts to produce marijuana-like effects, Hantsch says. "We are talking about large quantities, not a little bit in your Chai tea."
Kids are also using aerosol whipped cream and aerosol cooking spray to produce a laughing-gas effect.
Other risky behaviors include drinking hand sanitizer, which often has an alcohol base. "Even a mouthful can make someone feel inebriated," she says. Some may sniff glue and magic markers to get high. "They may sniff them directly or have the product in a bag that they hold over their mouth and nose."
Besides the free time and lack of structure, the holidays can be times of stress and emotional tumult for children and teens. "They may be more upset and anxious and more likely to explore or self-medicate," says Scott Krakower, DO. He is the medical director of the Mineola Community Treatment Center at the North Shore-Long Island Jewish Health System in Mineola, N.Y.
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