Saturday, April 19, 2014
Inquirer Daily News

Flaura Winston

POSTED: Thursday, April 10, 2014, 5:30 AM
Filed Under: Flaura Winston | Tips
Where do you go for medical advice and support in caring for your child? You are increasingly going digital, according to The Pew Charitable Trusts. Seven in 10 people like you looked online for health information last year and found this information through search engines like Bing and Google. This strategy might be a good first step to find out what is available, but may not tell you whether it’s information you can trust.

We are all amazed with the power of digital solutions to get us information – quickly, with minimal or no cost, and in the comfort of our homes. It feels like the Wizard of Oz is sitting behind our laptop screen. We type in a question and get an answer. When looking for an answer to a trivia question or what toaster to buy, the consequences are not great if the information is inaccurate or misleading. For information about your health or that of someone you love, it could be life-threatening. 

Digital search results are determined by algorithms – all of the processes and methods that make sure that answers people “like” are shown first. Sadly, we all know that much of medicine is not what we “like” – getting immunizations, checking our weight, limiting snacks – and there are many people who are happy to tell us what we want to hear. A secret about search is that it can be manipulated. A huge industry manages digital content to ensure that algorithms find their content and place them first (to promote a product, a cause, a viewpoint, or a celebrity).

POSTED: Thursday, February 6, 2014, 5:30 AM
Filed Under: Flaura Winston | Tips
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Several years ago, I knew that our messages about child passenger safety were getting across to families. During a check-up, a mother asked whether it made sense to buy the new pink booster seat that her 7-year-old daughter wanted, asking me, “How much longer should she sit in a booster?”  My answer: I’m so glad she likes her booster and that you are protecting your child! She needs to be in the booster until she reaches 4 feet 9 inches in height, likely not until your petite daughter reaches 12 years of age. While adult seat belts are better than no restraint at all, booster seats position the belt across the chest and thighs so that the belt can do the best job in protecting children.

For many parents, ensuring that their 15-month-old is securely fastened into their rear-facing child safety seat or their 7-year-old is in a booster seat is part of their daily routine. It may be hard to believe, but not so long ago these actions were more often “the exception” than “the rule” when it came to child passenger safety. Since the late 1990’s, there has been a remarkable increase in child restraint system (CRS) use through age 8: from 51 percent in 1999 to 80 percent in 2007 (click here to view a chart showing this progress). This has translated into a 46 percent reduction of child traffic fatalities from 2001 to 2010. This progress can be attributed to increased legislation, education, and improvements to safety technology in motor vehicles.

While the good news is that today’s parents and caretakers know the importance of using a CRS to keep their children safe in motor vehicles, there is a new challenge to be tackled - ensuring that children are accurately and securely restrained in the correct CRS. In 2004, a survey completed by the National Highway Traffic Safety Administration (NHTSA) found that 72.6 percent of child restraints observed in parking areas throughout the United States had at least one “critical” misuse, this included:

  • Not using the appropriate CRS for the child’s age
  • Incorrectly attaching the CRS to the vehicle, 
  • Not harnessing the child in the CRS correctly
POSTED: Thursday, January 2, 2014, 6:00 AM
Filed Under: Driver's Ed | Flaura Winston
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Although learning to drive may be a rite of passage for most teens, teens with attention deficit hyperactivity disorder may need extra help in navigating the road to licensure. The symptoms of ADHD – difficulty with attention, challenges with emotion regulation, disorganization and impulsivity – heighten a teen’s risk for unsafe driving behaviors and crashes. The presence of ADHD increased a teen’s crash risk by two to four times, placing them at a higher crash risk than adults who are legally drunk, found a 2007 study

I am often asked by parents of teens with ADHD for advice on determining whether their child is ready to drive, what to focus on with practice driving, and how to keep their teen safe after the learner permit phase when driving without supervision. Unfortunately, the evidence base is limited for proven effective ways to keep them safe during the learning-to-drive period and beyond. As we learn more, I will share guidance, but for now, what I can offer are suggestions based on experience.

When observing your teen’s driving, keep in mind what safe driving requires for all drivers - situation awareness and appropriate response. To avoid a crash, a skilled driver perceives her environment, shifts attention dynamically to the most relevant road elements, comprehends potential hazards, predicts changes in the traffic environment and actions of other road users, and draws actions from memory to avoid crashes. If you observe that your teen is unable to perform any of these steps well, take this seriously.  Your teen will likely only perform them less well when you are not in the passenger seat.

POSTED: Thursday, November 14, 2013, 5:30 AM
Filed Under: Flaura Winston | Mental Health | Tips
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Right now, thousands of children in the Delaware Valley are recovering from an injury, and they rely on their families to help them heal. While it is important to tend to their wounds and rehabilitation, it is just as important for parents to remember to look beyond the physical injuries. Injury is stressful for children and their families, and sometimes stress reactions can get in the way of recovery. 

Whether it’s a dog bite or a broken arm caused by a motor vehicle crash, the impact of injury for your child goes beyond the physical. In the first few days after an injury, many injured children feel upset, jumpy or worried at times, and many parents do, too. Despite what you might think, it’s not just the most severe injuries that can lead to strong emotional reactions. Any injury that is frightening for you or your child can lead to traumatic stress symptoms. These can include reliving what happened, avoiding reminders of what happened, and difficulty sleeping, eating, or concentrating. It may be helpful to rate your child’s and your own reactions over the first few weeks after an injury. Here’s how.

A recent Children’s Hospital of Philadelphia research review shows that unfortunately about 1 in 6 injured children -- and a similar percentage of parents -- experience more severe and persistent traumatic stress, lasting more than a month and getting in the way of full recovery.  

POSTED: Monday, October 21, 2013, 9:31 AM
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Today’s guest blogger is Flaura Winston, MD, PhD, scientific director of Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention, and a nationally-recognized expert on teen driving. She is one of the founders of the congressionally-sanctioned National Teen Driver Safety Week during the third week of October -- October 20-26 this year.

Motor vehicle crashes with teens behind the wheel are the leading cause of death in teens. Many parents may not realize that one of the most important things they can do to assure that their teen reaches adulthood is to help their teens navigate their way to safe, independent driving.  To do this, parents need the facts.  Did you know that parents may misinterpret their teen’s driving mistakes as intentional risk-taking or lack of attention to detail?

A recent Children’s Hospital of Philadelphia study found that 75 percent of serious teen crashes were due to a critical teen driver error, with three common errors accounting for nearly half of all serious crashes: driving too fast for road conditions, being distracted, and failing to detect a hazard. The study  found that other primary factors were rare: environmental conditions, such as poor weather, vehicle malfunction, aggressive driving, or physical impairments such as drowsy driving.

About this blog
The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Stephen Aronoff, M.D., M.B.A. Temple University Hospital
Christopher C. Chang, M.D., Ph.D Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Mario Cruz, M.D St. Christopher’s Hospital for Children, Drexel University College of Medicine
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist - The Anxiety Behaviors Clinic, CHOP
Gary A. Emmett, M.D. Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Lauren Falini Bariatric exercise physiologist, Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Crozer-Keystone Health System
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, RD Children's Hospital of Philadelphia
W. Douglas Tynan, Ph.D. Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Flaura Koplin Winston, MD, PhD Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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