Kickin it in the You Tube Generation

Kickin it in
the You Tube Generation
Charles Nozicka, DO, FAAP, FAAEM
Medical Director
Pediatric Emergency Medicine
Advocate Condell Medical Center
Clinical Associate Professor
Emergency Medicine
Rosalind Franklin University
Kids and Kicks
http://Paul Revere and Raiders 1967
Kids and Kicks
Kicks just keep gettin' harder to find
And all your
o r kicks ain't bringin' you
o
peace of mind
Before y
you find out it's too late,, girl
g
You better get straight
No, but not with kicks
Paul Revere and the Raiders 1966
Disclaimer
No financial interest in any web site or
product discussed or depicted
• The media (videos,
(videos pictures
pictures, music and
lyrics) depicted may prove offensive to
some but they are selected as a sampling
some,
of the least offensive examples, all are
available for viewing via the internet by
internet surfers of any age.
•
New Kicks New Generation
•
•
•
•
•
•
•
Teens think Differently
Effects of the media age
Di t t d D
Distracted
Driving
i i
Ghost Riding the Whip
The Choking Game
DXM’ss as popular as ever
DXM
K2 and Spice and Everything Nice
Teens think
Differently
Teens Are Different !!
Complex Influences on
Teens'
T
'B
Behavior
h i
•
•
•
•
•
•
Teens are different
Physical,
y
, cognitive,
g
, and emotional
developmental
Distractions – Cell Phones, Texting
Role models - parents, other teens
Social context,, Media influences,, social
networking
Cultural – driving, drinking, risk taking:
rights of passage?
Teenage Brains are Different!!
The teenager's
brain is still in a
developmental
process
• the prefrontal
cortex grows
rapidly just
b f
before
puberty
b t
•
Maturing brain into teenage years
•
•
Although teenagers
use the frontal part of
the brain - reasoning
not as automatic for
the teen
Adults and teenagers
use different parts of
their brain to think
about problems.
Adolescent Brain Development
•
•
•
Thickening and
thinning of gray
matter is occurring
Developing of the
important frontal
lobes
Complete mylenation
occurs in the
h early
l
20’s
Effects of the
media age
Generation gap - 30 years
1980--2010
1980
•
•
•
•
•
•
•
•
•
•
Car Phones
Cell phones
MP3 players
Rap Music
Video games
TiVo
Road Rage
The Internet
Face Book
You Tube
Media “Virtual” life
with a heavy dose of Risk Taking and Violence
•
•
•
•
•
•
Television – all types of programs
including news, “reality” shows, music
p
, etc.
videos,, commercials,, sports,
Movies
Music
Video and Computer Games
Internet
Other types include: toys, comic books
An Average American Child
Spends:
p
• 38 hours a week with TV
• 30 hours a week in a classroom
• 39 minutes
i
a weekk talking
lki one–
one–on–
on–one with
iha
parent
By high school graduation:
• Spends 18,000 hours in front of a TV set, and
only
l 13,000
3 000 hours
h
in a classroom
l
• Observes 200,000 violent acts and 16,000
murders
Research on Violence
Over 4
4,000
000 studies have examined
the correlation of television
violence and violent behavior in
children
These studies make a compelling
case for a significant impact
Media Violence Effects
Linkages between internet and other media
violence with seriously violent behavior by youth.
Pediatrics 2008 Nov:122(5):929-37 Ybarra ML. etal
•
•
Growing up with Media Survey
1588 youths 10-15 years old
•
Conclusion: Exposure to violence in the
media is associated with concurrent
reports of seriously violent behavior …
Newer forms of violent media seem to be
especially
p
y disturbing
g
I love snatchin up players thugs and young ballers
Shoot up the household, even the young toddlers
Brigade barricade to bring the noise
While the bullets break your bones up like Christmas toys
C
Complex
l M
Media
di
Influences on Teens'
Behavior
Multiple Grammy Award Winner
Bring your boys and your guns and get
laughed at. Bitch smacker, rich rappers get
they Jag jacked ... I love snatchin up
players thugs and young ballers
ballers. Shoot up
the household, even the young toddlers.
Brigade barricade to bring the noise. While
the bullets
b llets break
b eak your
o bones up
p like
Christmas toys ...
Eminem
Complex Influences on Teens'
Teens Behavior
American Academyy of Pediatrics: Policyy statement
– Impact of music, music lyrics, and music
videos on children and youth
Pediatrics 2009 Nov ;124(5) :1488-94
Pediatrics.
:1488 94
Abstract: Music p
plays
y an important
p
role in the
socialization of children and
adolescents….research has reported that
exposure to violence, sexual messages, sexual
stereotypes and use of substances of abuse in
music videos might produce significant changes
in behaviors and attitudes of young viewers…
viewers
Complex Influences on Teens'
Teens Behavior
American Academyy of Pediatrics: Policyy statement
– Impact of music, music lyrics, and music
videos on children and youth
Pediatrics 2009 Nov ;124(5) :1488-94
Pediatrics.
:1488 94
The preference for heavy metal music,
rap, and associated genres among
adolescents must alert us to an increased
vulnerability and tendency toward
risky behaviors
Violence and Video Games
“The one consistent finding
g is that the
majority of the studies on very young
tend to show that children become
more aggressive after either playing or
watching a violent video game.
game ”
Manhunt
“Ultra
“UltraUltra-Violent”
Violent where
the object is to kill
gang
g
g members as
violently as possible
„ The more violent the
more points
„ Banned in New
Zealand, Australia,
Germany
„
Complex Influences on
Teens'
T
'B
Behavior
h i
To tweet, or not to tweet: gender differences and
potential
i l positive
i i and
d negative
i health
h l h outcomes
of adolescents' social internet use
AM J Mens Health 2010 Mar;4(1):77-85.
Conclusion: It is reasonable to
hypothesize that unmonitored
Internet use may
y place
p
adolescents' at significant risk…
cyber
y
bullying,
y g, unwanted exposure
p
to pornography…
Media Affects
Today's teenage girls
engage "in
in far riskier
health behavior in
greater
t numbers
b
th
than
any prior generation,"
Dr Jean Kilbourne
www.JeanKilbourne.com
Complex Influences on Teens'
Teens Behavior
American Academy of Pediatrics: Policy
statement – Impact of music, music lyrics,
and music videos on children and youth
Pediatrics. 2009 Nov ;124(5) :1488-94
• Pediatricians
P di t i i
and
d parents
t should
h ld be
b aware
of this information
• It is essential for pediatricians and parents
to take a stand regarding music lyrics
Distracted Driving
Distracted Driving
Distracted driving
• number one killer of American teens
While AlcoholAlcohol-related accidents have
dropped - teenage traffic fatalities are
unchanged
• distracted driving is on the rise
(Children's Hospital of Philadelphia, State
Farm Insurance Study and NHTSA Study)
Cell phones
p
Distraction is a particular problem for
beginning drivers
• Phone use associated with 4 X increase
in risk of injury crash for drivers of all
ages; increased risk for both handheld
and handshands-free phones
• 10 percent of drivers ages 1616-24 are
talking on handheld phones at any
time; use rate much lower among
older drivers
Klauer, S. G. etal (2006)
•
Distracted Driving
P t d on You
Posted
Y
Tube
Distracted Driving
While over 90% of teen drivers say they
don't drink and drive, nine out of 10 say
they've
they ve seen passengers distracting the
driver, or drivers using cell phones.
(National Teen Driver Survey)
• Drivers on mobile phones are more
impaired than drivers at .08
08 BAC.
BAC
(University of Utah Study)
•
Distracted Teen Driving
More than 80% of drivers admit to blatantly
hazardous behavior:
• changing clothes
• steering with a foot
• painting nails
• shaving
g
(Nationwide Mutual Insurance Survey)
Distracted Teen Driving
Three Seconds rule
80% of all crashes and 65% of all
y studied by
y the
near-crashes recently
Virginia Tech Transportation
Institute involved driver inattention
within 3 seconds of the crash.
(Source: Virginia Tech Transportation Institute
N t li ti D
Naturalistic
Driving
i i Study,
St d Relative
R l ti Risk
Ri k
Estimates for Crash/Near Crash Inattention
Eventss 2008)
008)
Three Second rule
•
•
•
•
•
•
•
•
•
Reaching
g for a moving
g object
j
8 times increased risk
Driving drowsy 5 times increased risk
Looking at an external object 4 times increased risk
R di 3 times
Reading
ti
i
increased
d risk
i k
Dialing a phone 3 times increased risk
Applying makeup 3 times increase in risk
Talking on hand-held phone 1 time increased risk
Eating 1 time increase in risk
Reaching for a non-moving object 1 time increased risk
Percent of teen drivers traveling
at high
h h speed
d Simons – Morton et al. 2005
30
no passenger
male passenger
female passenger
20
10
0
male driver
female driver
High speed is considered 15 mph or more over the speed limit
Ghost Riding
the Whip
Ghost Riding
•
•
•
is when a person puts a vehicle
vehicle's
s
transmission in gear then exits the
g to
vehicle while it is still rolling
dance beside it or on the hood or
roof
Oakland rapper Mistah F.A.B.'s hit
song "Ghost Ride IT”
Patrick Swayze, lead star in the
1990 film Ghost
Ghost Riding
the Whip
From
You
Tube
Ghost Riding
the Whip
Ghost Riding the Whip
Ghost Ride the Whip : The Movie
Main Stream media?
The Choking
g Game
The Choking Game
Asphyxiation
h i i Roulette
l
The “choking game” an activity
in which persons
strangulate themselves
to achieve euphoria
p
through brief hypoxia
MMWR 59(1) 2010
Choking Game
Unintentional strangulation deaths from
the “choking game” among youths
aged 6-19
6 19 years – United States,
States
1995-2007
Toblin RL, Paulozzi LJ, Gilchrist J, Russell PJ
J Safety Res 2008:39(4): 445-8
Choking Game
Asphyxiation
h i i Roulette
l
From You Tube
Choking Game Asphyxiation
Roulette
l
82 p
probable deaths
Boys were much more likely to die
87% of victims were boys
y
Mean age 13.3 years old
years old
89% that died were 11-16 y
Nearly all who died played the game alone
Deaths occurred all over the United States
MMWR 57(6):141-144 (2008)
Choking Game Asphyxiation
Roulette
l
w
w
Choking Game
Asphyxiation
h i i Roulette
l
Oregon Healthy Teens Survey
10,642 Oregon middle/high school students
2008
36% knew of game
30% knew a participant
2 6% helped
2.6%
hel ed someone
o eo e participate
ti i te
5.7% participated themselves
MMWR 59(1) 2010
Choking Game
Asphyxiation
h i i Roulette
l
Oregon Healthy Teens Survey
10,642 Oregon middle/high school students
2008
Youths who participated in the
choking game
were significantly more likely
to also report other unhealthy behaviors
and mental health risk factors
MMWR 59(1) 2010
Choking game
From You Tube
Choking Game Other Names
Pass-out game
Space monkey
Suffocation roulette
Scarf game
The American dream
Fainting game
Something dreaming game
Purple hazing
Blacking out/blackout
Dream game
Flat liner
California choke
Space cowboy
Airplaning
Choking Game Web Site
Web Site Statistics
474 Total US deaths
32 US deaths 2010
48 US deaths 2009
46 US deaths 2008
Th DB ffoundation
The
d i
247 US deaths 2005
-2008
Choking Game Warning Signs
• Discussion of the game or its aliases
• Bloodshot eyes
• Marks on the neck
• Wearing high-necked shirts
• Frequent, severe headaches
• Disorientation after spending time alone
• irritability
i it bilit or hostility
h tilit
• Ropes, scarves, and belts tied to
furniture doorknobs or found knotted on
the floor .
• Dog
g leashes,, choke collars,, bungee
g cords
• Petechia (eye lids, face, conjunctiva)
DXM – Cough Medicine Abuse
DXM: Dextromethorphan
DXM: Dextromethorphan
•
•
•
•
•
•
Episodic
p sod c c
clusters
uste s
Easily obtainable
Cheap
p
Significant abuse
Information
available on the
Internet
“Legal”
DXM: Dextromethorphan
DXM: Dextromethorphan
"Law
Law enforcement hadn
hadn'tt
heard about it, but all
the
th kids
kid had."
h d"
David Jacobson, DEA, Detroit
Lil Wayne
Codeine and Promethazine
Lil Wayne
2009
Grammy Award
Winner
Best Male Rapper
DXM: Dextromethorphan
•
•
•
•
•
Synthetic analog of codeine
N-meth
methth-D-Aspartate
A
t t (NMDA)
antagonist (PCP)
Disassociative
sassoc at e Hypnotic
yp ot c in higher
g e
dosages (Ketamine)
Inhibits reuptake of serotonin at
synapses
Contributes to serotonin syndrome
with MAOIs or SSRIs (Prozac)
DXM: Dextromethorphan
DXM: Effects
dizziness, blurred vision, nystagmus,
dil d pupils,
dilated
il
body itching, rash, ataxia, sweating,
hypertension, shallow respiration,
urinaryy retention,, apnea
p
opisthotonos ,toxic psychosis
coma seizure,
seizure loss of consciousness
DXM: The Plateau effect
„
„
„
„
100-200 mg a mild, stimulant effect
100200--500 mg a more intoxicating effect
200
‘drunk
drunk and stoned
stoned’
500--1000 mg mild hallucinations and a
500
mild dissociate effect (likened to a low
dose of Ketamine) and an overall
o e all
disturbance in thinking, senses and
memory
over 1000 mg fully disassociative effect
(high dose of Ketamine). are capable of
impairing judgment, memory, language,
and other mental performances
DXM You Tube Parody
K2
S
Synthetic
h i THC A
Analogs
l
K2 and Spice
“S th ti THC”
“Synthetic
www.buyjwh018.com
www buyjwh018 com
K2 and Spice
“S th ti THC”
“Synthetic
•
•
•
•
•
Synthetic THC Analogs
John W. Huffman research Chemist
Information
I f
ti
on th
the Internet
I t
t
Sold Legally “Bonsai Fertilizer”
incense
JWH--018,, JWHJWH
JWH-250
K2
•
•
•
•
•
Oct 26,
26 2010 American association of
Poison Control Centers reported 1863 calls
YTD regarding K2 and Synthetic Marijuana
Marketed as incense or plant fertilizer
K2 , Spice,
S i
Genie,
G i Sence,
S
Smoke,
S k Shunk,
Sh k
Zohai
$30 - $40 per three gram Bag
Herbs sprayed
p y with Synthetic
y
Compound
p
K2
K2 You Tube Advertisement
EROWID
www Erowid org
www.Erowid.org
“Knowing is not enough; we must
apply
Willi
Willing
is
i nott enough;
h we mustt do”
d ”
-Von Goethe
Pediatricians
Pediat
icians and parents
pa ents should
sho ld be
aware of this information
• It is essential for pediatricians and
parents to take a stand regarding
music lyrics
•
Pediatrics. 2009 Nov ;124(5) :1488-94
:1488 94
A few References
Distracted Driving
Mayhew & Simpson, Injury Prevention 2002;8(Suppl II)
Vernick et al.,, Am J Prev Med 1999;16(1S):40-46
; ( )
Hirsch, J Safety Research 2003;34(4):289-298.
Hedlund, J Safety Research 2007, 38(2), 259-266
Shope J Safety Res 2007; 38(2): 165-75
Klauer, S. G. etal (2006). The Impact on Driver Inattention…
National Highway Traffic Safety Administration
Chicago Tribune: Teens At the Wheel
Media Influence
Jean Kilbourne, ED.D
www JeanKilbourne.com
www.
JeanKilbourne com
A few References
Media Influence
To tweet, or not to tweet: gender differences and
potential positive and negative health outcomes
of adolescents' social internet use
AM J Mens Health 2010 Mar;4(1):77-85.
Pediatrics 2009 Nov ;124(5) :1488
Pediatrics.
:1488-94
94
American Academy of Pediatrics: Policy statement – Impact of music,
music lyrics, and music videos on children and youth
Pediatrics. 2009 Nov ;124(5) :1488-94
Linkages between internet and other media violence with seriously violent
behavior by youth.
Pediatrics 2008 Nov:122(5):929-37
Nov:122(5):929 37 Ybarra ML. etal
A few References
Choking Game
Unintentional strangulation deaths from
th “choking
the
“ h ki game”” among youths
th aged
d 6-19
6 19 years – United
U it d
States, 1995-2007
Toblin RL, et al J Safety Res 2008:39(4): 445-8
Thank You