Yes, according to a new book written by University of Florida addiction medicine specialists Dr. Scott Teitelbaum and Michael Nias. The book, titled “Weed: Family Guide to Marijuana Myths and Facts,” is geared toward helping families wade through conflicting information about the drug, which is now legal for medicinal purposes in 18 states.

One of the main issues people do not understand is that marijuana is a much stronger drug than it was in decades past, due to crop engineering, Teitelbaum said. In fact, the concentration of tetrahydrocannabinol, or THC — the chemical in marijuana that causes users to feel high — is five to seven times higher in the drug today than it was in the 1970s, he added.

“This isn’t your father’s marijuana,” said Teitelbaum, medical director of the UF&Shands Florida Recovery Center and an associate professor of psychiatry in the UF College of Medicine. “The higher THC concentration is associated with more psychiatric problems and more dependence.”

Because of the legalization of medical marijuana in certain states and the decriminalization of the drug in others, many people now see the drug as safe, and this perception directly affects use, Teitelbaum said.

“We know when you look at adolescents, initiation of a drug is inversely proportional to its perceived danger,” he said. “Throughout history if a drug has been perceived as safe and benign, it’s more likely to be tried by young people. But marijuana is not a benign drug. It is associated with addiction and learning problems.”

Marijuana use can be particularly risky for adolescents, whose brains are still developing, Teitelbaum added. Typically, women’s brains reach full development in their early 20s, while men’s brains reach maturity in their mid-20s. Teens who have genetic predispositions for developing certain mental disorders, such as schizophrenia, are particularly at risk.

“Introducing drugs with neurotoxic effects during this time, while the brain is still developing, can be very damaging. It’s similar to a pregnant woman drinking alcohol,” he said.

In addition, teens who try marijuana before age 15 face a four times greater chance of developing an addiction later in life than their peers who don’t smoke pot, according to the book. Unfortunately, Teitelbaum says studies show that about 15 percent of eighth-grade students have already been exposed to the drug.

In addition to busting myths about marijuana, the book also aims to help parents navigate common conflicts in talking to their children about drug use and arm children with the information they need to make the best choices. A particularly tricky area for many parents is how to talk to their children about drugs they may have used themselves at some point. According to the Pew Research Center, 48 percent of Americans say they have tried marijuana.

“The more you can do to stop initiation of drugs and have honest and open communication, the better chance you have of not having your child develop a drug addiction,” Teitelbaum said.

“Weed: Family Guide to Marijuana Myths and Facts” is available for purchase on the University Press of Florida website as well as on amazon.com in both paperback and e-book.

• UF study shows long-term drug abuse starts with alcohol
• UF scientists find state record 87 eggs in largest python from Everglades
• University of Florida astronomer reports rare case of gravitational lensing
• UF report: 2011 shark attacks remain steady, deaths highest since 1993
• UF researchers develop “nanorobot” that can be programmed to target different diseases
• New UF study shows early North Americans lived with extinct giant beasts
• UF’s Gator Marching Band makes history in London
• Search Committee Appointed to Recruit New UF President
• UF veterinary researchers discover new virus linked to death of Australian snakes
• UF trustees OK naming building, business school for Heavener

“This is a question that has been lingering for about 10 years,” said Almut Winterstein, a pharmacoepidemiologist and a professor in pharmaceutical outcomes and policy in the UF College of Pharmacy.

Stimulant drugs are one of the most commonly prescribed medications for children — after antibiotics and antidepressants, Winterstein said.

Winterstein’s results show that every year, children have an approximately one in 30,000 risk of suffering a severe cardiac event. She found no increased risk for children who were taking stimulant drugs. A cardiac event includes sudden cardiac death, heart attack or stroke, and is typically caused by underlying heart disease. These results confirm previous study conclusions that there are no serious cardiac events resulting from short-term use of central nervous system stimulant drugs by children and young adults.

In 2007, Winterstein conducted the first large population study to investigate the risk associated with the use of central nervous system stimulants in children and young adults between ages 3 and 20. Published in the journal Pediatrics, her results showed a 20 percent increase in emergency clinic or doctor’s office visits with cardiac-related symptoms, but no increase in death or hospital admission for serious heart conditions.

In that study, she analyzed records from 55,000 children under Medicaid who had ADHD and were undergoing treatment between 1994 to 2004. But this population was still not large enough to determine if these drugs were indeed safe for children, Winterstein said.

The new study, funded by the Agency for Healthcare Research and Quality and in part by the National Center for Advancing Translational Sciences, examines a larger U.S. population of 1.2 million youths eligible for Medicaid programs in 28 states. It follows a similarly large investigation published in December 2011 in The New England Journal of Medicine by Dr. William O. Cooper, who looked primarily at privately insured patients.

“We complemented Dr. Cooper’s study by utilizing Medicaid patients who are typically more vulnerable and at higher risk for serious adverse events,” Winterstein said. “This allowed us to examine patients with severe underlying heart conditions who received stimulants.”

Although the study confirmed there are no short-term effects from central nervous system stimulants, the study did not reveal how these drugs affect patients in the long term.

“Neither of the studies was able to answer what happens in the long term,” Winterstein said. “It’s an important issue to address, but we won’t be able to answer the question until this generation of ADHD children, who began using stimulant drugs in the 1990s, reaches adulthood into their 50s, 60s and 70s.”

Another concern the study raised to UF researchers is related to children who were on continuous stimulant medication for more than 10 years into their adulthood. The effects of even minor increases in blood pressure and heart rate over a sustained period of time are unknown, Winterstein said.

A decade ago, when initial alarms were raised about stimulant use in children, health-care providers were cautious, but now the practice has increased with the knowledge of little risk of serious effects.

Dr. Regina Bussing, a professor in the UF College of Medicine’s division of child and adolescent psychiatry, said concerns about possible serious cardiovascular risks may have resulted in children not getting needed ADHD treatment.

“Dr. Winterstein and her colleagues’ study yields important information for clinicians,” Bussing said.

Recommended evaluation practices should continue for young patients, Bussing said, including cardiovascular monitoring. Parents will still be advised to stop medication and take the child to the emergency room should he or she develop sudden onset of chest pain or shortness of breath, but the study alleviates doctor and parent concerns for the most serious cardiovascular events.

Though her research does cast a positive light on the safety of central nervous system stimulants, Winterstein agrees that parents should continue to seek medical care if symptoms arise. She also has concerns about the increasing use of stimulant drugs for children without weighing the long-term risks and benefits.

Shoppers often assume farmers’ markets sell only the freshest crops from small, local operations, said Mickie Swisher, an associate professor with UF’s Institute of Food and Agricultural Sciences. But with the number of U.S. farmers’ markets more than quadrupled since 1994, big-volume produce dealers sometimes use them to sell items shipped from other states or countries.

When that happens, customers may feel outraged or indifferent, depending on whether they’re committed to eating local or just want a pleasant excursion, said Swisher, one of the study’s authors.

The findings, published in the current issue of the journal HortScience, suggest that farmers’ market managers can keep serious and casual shoppers happy by requiring honest labeling and creating opportunities for patrons to mingle, she said.

“It’s a matter of knowing what consumers want, and I think this study has some insights that could be useful,” Swisher said.

For example, if the rules governing a farmers’ market are silent on the issue of non-local food, locavores would probably want to see that situation resolved, she said. Solutions might include barring non-local food, restricting it to certain parts of the market or requiring vendors to indicate where their merchandise was produced.

For patrons who want to socialize, management should provide amenities such as seating areas, particularly if any vendors offer ready-to-eat food.

In the study, Swisher and colleagues Zhifeng Gao of the UF food and resource economics department and Xin Zhao of the horticultural sciences department surveyed more than 120 shoppers at farmers’ markets in three Florida population centers – a major metropolitan area, a medium-sized city and a small town.

The survey asked shoppers about their expectations for the food sold at farmers’ markets, Gao said. The results showed that a large percentage believed much of the merchandise was locally grown, freshly harvested, organic and sold by growers themselves.

Then researchers asked participants if they would continue patronizing a farmers’ market after learning they had purchased an item that defied their expectations.

If the item was less fresh than expected, about 75 percent would continue patronizing the market; if it wasn’t organic, 66 percent would continue, he said. If the item wasn’t grown by the vendor 62 percent said they would return; and if it wasn’t local only 53 percent would visit the market again.

Using additional data analysis, the researchers determined which shoppers were most likely to stop visiting a farmers’ market that offered non-local food. Those were the shoppers who believed it was important to buy local food, or thought patronizing farmers’ markets was better than shopping at supermarkets.

The number of U.S. farmers’ markets increased from 1,755 in 1994 to almost 7,900 in 2012, according to the U.S. Department of Agriculture. So it’s imperative for managers to stay on top of emerging trends, including the ones consumers don’t like, Swisher said.

“Farmers’ markets have come a long way in the past few decades, and I think there’s a lot of potential if we don’t spoil it,” she said. “The farmers’ markets that are well-run and aboveboard will get the lion’s share of the business.”

The study is the first to use body mass index, or BMI, classification based on researcher-measured height and weight to compare rates of obesity in rural and urban adults. Previous studies relied on participants’ self-reports of height and weight, which led to too-low estimates of obesity, the researchers say.

“I was surprised by the magnitude of the rural-urban difference — it was larger than expected and much larger than previously estimated,” said senior author Michael G. Perri, a professor and dean of the UF College of Public Health and Health Professions.

The findings appear in the fall issue of the Journal of Rural Health, published by the National Rural Health Association.

Nearly 60 million people, or 19 percent of the population, live in rural areas, according to the 2010 U.S. Census.

Perri and fellow investigators Christie Befort and Dr. Niaman Nazir, both of the University of Kansas Medical Center, analyzed data from the 2005-2008 National Health and Nutrition Examination Survey conducted by the National Center for Health Statistics, which gathers health information through interviews and clinical examinations. Survey participants included 7,325 urban and 1,490 rural residents between the ages of 20 and 75. Height and weight were measured in a mobile examination center, and participants reported all food and beverages they had consumed over two 24-hour periods and the frequency and intensity of their physical activity. Age, race, gender, marital status, education and income data was also collected.

Almost 40 percent of rural adults were obese — having a BMI of 30 or greater — compared with just over 33 percent of urban adults.

Among rural participants, several factors were associated with higher rates of obesity, including being married, being African-American, or consuming a higher daily calorie intake or a higher percentage of calories from fat. Urban dwellers were more likely to be obese if they were older, African-American, had less education, were inactive and consumed a higher percentage of calories from fat.

There was no difference in physical activity between the rural and urban participants, but rural participants consumed a much higher percentage of their daily calories from fat. That finding is in keeping with reports from previous rural health studies that heavy meals and limited access to healthy foods are common in rural areas. A diet with a higher percentage of calories from fat was the strongest determinant of obesity and a major contributor to the obesity disparity between rural and urban Americans.

When age was taken into account, the rural-urban disparity was seen in participants ages 20 to 39, but not among older adults. The researchers theorize that a combination of heavier meals and increased mechanization of traditional rural occupations such as farming and logging might account for the increased obesity rates among young rural workers.

“This analysis can be a turning point in the efforts to ensure adequate attention to obesity in rural America,” said Shiriki Kumanyika, a professor of epidemiology at the University of Pennsylvania Perelman School of Medicine, who was not involved in the study. “Not only does it document the higher prevalence of obesity, particularly among young adults and black Americans in rural areas, but it also provides a solid baseline for measuring future progress in addressing the disparities. The findings about demographic and behavioral factors that relate to obesity remind us that approaches for addressing obesity differ somewhat in rural and urban areas.”

Greater attention should be paid to the problem of obesity in rural areas, where residents have higher rates of chronic disease and premature death, and poorer access to health care services, the researchers say.

“Rural areas have fewer resources to assist residents with lifestyle changes related to weight management,” said Perri, a professor of clinical and health psychology.

One solution may be to tap the expertise of the U.S. Department of Agriculture’s Cooperative Extension Service, an educational network with offices in nearly every U.S. county, said Perri, who has led several behavioral weight management studies for rural residents in collaboration with that service.

“The infrastructure offers an ideal opportunity for providing weight management services to residents of rural counties,” he said. “We have demonstrated the real benefits of offering such programs in this way to children as well as adults.”

The findings may not settle a decades-old debate over how drug abuse begins, but it could help educators and policymakers build more effective drug-prevention programs, said Adam Barry, an assistant professor and researcher in the College of Health and Human Performance.

“By recognizing the important predictive role of alcohol and delaying initiation of alcohol use, school officials and public health leaders can positively impact the progression of substance use,” he said. “I am confident in our findings and the clear implications they have for school-based prevention programs. By delaying and/or preventing the use of alcohol, these programs can indirectly reduce the rate of use of other substances.”

The study appears in the August issue of the Journal of School Health.

Barry used a nationally representative sample of high school seniors, evaluating data collected through the annual Monitoring the Future study. The study, conducted by the Institute for Social Research at the University of Michigan, uses questionnaires to examine the behaviors, attitudes and values of secondary school students, college students and young adults. Once collected, the data is made available for evaluation by other researchers and institutions.

Barry’s study focused on data collected from 14,577 high school seniors from 120 public and private schools in the United States.

He evaluated whether the students had ever used any of 11 substances, including licit substances such as alcohol and tobacco, as well as illicit substances like marijuana, cocaine, heroin, LSD, amphetamines, tranquilizers and other narcotics. The results indicated that alcohol, not marijuana or tobacco, was most often the first substance students tried, he said.

In the sample of students, alcohol also represented the most commonly used substance, with 72.2 percent of students reporting alcohol consumption at some point in their lifetime. Comparatively, 45 percent of students reported using tobacco, and 43.3 percent cited marijuana use.

In addition, the drug use documented found that substance use typically begins with the most socially acceptable drugs, such as alcohol and cigarettes, then proceeds to marijuana use and finally to other illegal, harder drugs. Moreover, the study showed that students who used alcohol exhibited a significantly greater likelihood — up to 16 times — of licit and illicit substance use.

“These findings add further credence to the literature identifying alcohol as the gateway drug to other substance use,” he said.

Barry also cited the important role of parents and their alcohol-related attitudes and policies in the home.

“Parents should know that a strict, zero-tolerance policy at home is best. Increasing alcohol-specific rules and decreasing availability will help prevent an adolescent’s alcohol use,” he said. “The longer that alcohol initiation is delayed, the more likely that other drug or substance use will be delayed or prevented as well.”

But rest assured: Potential buyers will spot those problems in an instant.

To help Floridians look at their homes with a critical eye, a University of Florida housing specialist has published a guide that uses the results of a national survey to pinpoint areas that might need attention.

Randall Cantrell, a faculty member with the Institute of Food and Agricultural Sciences, said the average homeowner spends $2,000 to prepare a home to be sold. So keeping up with needed repairs can make life a lot easier when it comes time to put your house on the market.

Cantrell conducted a national survey in 2011 of more than 400 homeowners, asking them to rate 81 items that could improve the home’s overall performance in three areas: maintenance tasks, energy and water conservation measures, and family operations. Based on their responses, he created a document for each category, suggesting short-term and long-term changes.

The three-part series is at http://edis.ifas.ufl.edu/. Use the top, right-hand corner search box to look for documents numbered FY1320, FY1321 and FY1322.

Cantrell said he was inspired to write the publication about keeping one’s home ready to sell after living through a painful home sale in 2011, before the real estate market began to perk back up. Even though his home had been well cared for, he still found himself paying for changes to make the home better appeal to buyers. “I thought if I can help people not have to go through what I just went through, I should do it,” said Cantrell, a state extension specialist in housing and community development.

In the short-term category for keeping one’s home ready to sell, he lists such tasks as ensuring that the doorbell works, that fences are painted, intact and have working gate latches, keeping cars parked neatly and taking care that the mailbox is properly maintained and has reflective address numbers that are easily seen.

Cantrell even suggests always keeping a fresh-looking welcome mat at the front door.

“If a buyer sees one thing that looks like it hasn’t been taken care of, they will wonder what else hasn’t been taken care of,” he said.

In the long-term category, he suggests changes such as taking care that deck boards are flipped nice side up and fastened with screws rather than nails, ensuring that if you have a garage that its door is sturdy and clean, that tree branches hanging near the house are healthy and the roof’s shingles aren’t loose, wavy or faded.

He also suggests taking time to check that ceiling-fan blades are balanced — and dusted.

Installing photocell sensors on any exterior lights ensures that lights will come on based on when it’s dark and won’t accidentally be left on during the daytime, conserving energy.

Mark Cramer, who has been a home inspector in Indian Rocks Beach, Fla., for 23 years, said the way a home shows correlates strongly with higher sales prices.

“There are some homeowners who tend to fix everything, and then there are others who ignore virtually everything until the ceiling’s literally caving in on their heads,” he said. “The former tend to get much better prices for their homes.”

To address that issue, University of Florida researchers have received a $9.9 million grant from the Centers for Medicare and Medicaid Services and the Texas State Health and Human Services Commission to test whether increasing access to wellness services could improve the health of patients already facing physical and mental health conditions.

Study subjects who take part in the Texas Wellness Incentives and Navigation project will receive a small stipend to pay for items such as gym memberships, tools to quit smoking or even a simple bathroom scale. They also will work closely with a navigator who will help them set goals and identify health risks, said Elizabeth Shenkman, director of the UF Institute for Child Health Policy and the grant’s primary investigator.

“We know that patients with co-morbid physical and mental health conditions are at particularly high risk for a shortened lifespan, a sedentary lifestyle and alcohol use. They also are at risk for high health expenditures because they are hospitalized or use the emergency room often,” said Shenkman, who also serves as chairwoman of the UF College of Medicine department of health outcomes and policy. “Some of these folks have conditions such as asthma, diabetes and chronic obstructive pulmonary disease combined with depression or other mental health problems. The improved healthy lifestyle can help people better manage their physical health conditions and also have a positive effect on their mental health.”

For each year of the three-year study, participants will receive a $1,150 debit card to use on various wellness services and products, based on the plan each makes with his or her personal navigator.

Using a counseling technique called motivational interviewing, navigators will coach participants and help them determine what services they need and what steps they need to take to achieve a healthy lifestyle. Participants will meet with their navigators once a month.

“The utilization of motivational interviewing has been shown to be effective in improving patient engagement in and commitment to the treatment process in numerous clinical contexts, including in health care settings,” said Carson Ham, a UF psychologist and expert on motivational interviewing.

The researchers are developing an electronic form that will not only help assess patients’ risks and needs but also will be coded to provide links to resources in the specific areas where patients live.

“Many of these patients have transportation issues that affect their access to services, too,” Shenkman said.

The study is one of 10 the Centers for Medicare and Medicaid Services recently funded to assess how helpful financial incentives are in promoting wellness. After the studies are complete, the most effective projects will be used as models for the rest of the country.

Keeping in mind the ability to serve as a model, UF researchers are working in concert with three health plans in Houston that handle Medicaid. The navigators are working with patients through the three health plans as part of the grant.

“We want the project to take place in a context where it could be implemented in other settings,” Shenkman said.

To measure the success of the study, researchers will examine several key outcomes, such as whether it reduces visits to the emergency room. They also will monitor participant’s blood pressure and cholesterol levels and total health care expenditures. If health benefits and cost savings are achieved, hiring health navigators and providing small stipends for wellness up front could save money down the road by keeping patients out of hospitals, Shenkman said.

“We are very excited about this partnership with the health plans, to really test a novel program and see what works best,” Shenkman said. “This is a phenomenal opportunity.”

Writing in the current issue of the journal Accident Analysis and Prevention, University of Florida researchers found that about 6 percent of adolescents whose parents drank even sporadically reported driving under the influence at age 21, compared with just 2 percent of those whose parents did not imbibe.

“The main idea is that parents’ alcohol use has an effect on their kids’ behavior,” said Mildred Maldonado-Molina, an associate professor of health outcomes and policy with the UF College of Medicine and the lead author of the paper. “It’s important for parents to know that their behavior has an effect not only at that developmental age when their kids are adolescents, but also on their future behavior as young adults.”

It’s typical for parents to worry about the influence of their children’s friends and peers, and the study shows that peer behavior can have an effect, particularly on kids who aren’t exposed to alcohol at home. Having friends who drink alcohol was a risk factor for driving under the influence for teens whose parents did not drink. Also, kids whose parents and peers consumed alcoholic beverages were especially at risk for driving under the influence. About 11 percent of these teens reported driving under the influence in their 20s.

But when it comes to influence, parents seem to have more sway than they probably realize, Maldonado-Molina said. According to the study, if a teen’s parents were drinkers, what their peers did had less of an impact, though the relationship between peer and parental influence is complex, she said.

“I think it is really important to understand the influence of parents and peers,” said Tara Kelley-Baker, a senior research scientist at the Pacific Institute for Research and Evaluation who was not involved with the study. “Parents must understand the influence they have on their children. Some parents just assume they have lost their influence or that they never had it. Research has shown more and more that this is not the case.”

According to the National Highway Traffic Safety Administration, nearly 10,000 people die because of drunken driving each year.

For the study, UF researchers examined data from nearly 10,000 adolescents that was collected as part of the National Longitudinal Study of Adolescent Health. The study initially collected data from teens and their parents and then surveyed the children again seven years later.

The influence of peers and parents seemed to affect men and women the same way. The researchers found no significant difference in risk factors between the genders, a surprising discovery. Not as much is known about women and DUI because most studies look at official records and arrests and women are less likely to be charged with DUI than men, though the gap is closing, Maldonado-Molina said.

“Their risk factors are similar and that calls for attention when developing interventions and prevention efforts,” Maldonado-Molina says.

When it comes to curbing DUI, prevention efforts need to start before age 15 to help instill the consequences of getting behind the wheel after drinking alcohol, the researchers say. And education efforts need to include not only children, but their parents as well.

“The home is a really important source for these kids,” Maldonado-Molina said. “(Parents’) may not perceive their drinking as negative, but it influences what is acceptable behavior.”

A consortium of researchers in the United States and Canada, including at the University of Florida, has received a $2.5 million grant from the National Institutes of Health to test techniques that may increase medication adherence in perhaps the most challenging population of patients:teenagers.

“Newer medicines and technologies have improved the lives of people with illness. But such improvements have much less of an effect if patients don’t take their medicines on time or use the technologies appropriately,” said Dr. Vikas Dharnidharka, division chief of nephrology in the UF College of Medicine department of pediatrics and one of the study’s investigators. “Teenagers who have chronic diseases really struggle with being adherent.”

As part of the five-year grant, researchers will study whether a menu of techniques, including a high-tech pillbox, will improve how well adolescent kidney transplant patients stick to their medication regimens.

The pillbox, produced by MedMinder, is connected to a monitoring service that tracks when patients take their medicine. The device can also send reminders about when a dose is due, through texts, emails or phone calls, features the researchers hope will appeal to tech-savvy teens.

Study participants will be able to choose what options on the pillbox will best work for them. They also will work with health professionals to discuss what hinders them from taking their medications and develop plans to tackle these obstacles, said Dr. Beth Foster, an associate professor of pediatrics at McGill University in Montreal and the grant’s primary investigator. Using MedMinder’s Maya device, patients can also pinpoint problem times and patterns, like always forgetting to take a dose on Saturday mornings.

After a transplant, patients must take drugs that suppress the immune system so the body does not fight off the new organ. Not taking them or even just deviating from the medication schedule can have dire consequences, Foster said.

“(Non-adherence) is probably the single most important reason for graft losses and rejections,” Foster said. “If you look at the risk of graft failure related to the age of patients and plot it, you can see a hump during the adolescent years. It is definitely the highest-risk interval, and the reason is likely adherence. Adherence dips during this period.”

The researchers also will examine how outcomes differ from patients in the Canadian and U.S. health systems.

Although their study focuses on kidney transplant patients, the researchers think the findings will translate to patients with other chronic diseases and conditions as well.

“It could be something that could be applied across all populations for all chronic conditions,” Dharnidharka said. “We often spend 20 years developing new drugs, but they will have a limited effect if patients don’t take them.”

GAINESVILLE, Fla. — A toddler’s tiny teeth are destined to fall out in later years as their permanent pearly whites grow in. But for some children, especially those from low-income families, cavities and poor oral health lead to complicated dental problems long before they even graduate from their cribs.

Programs designed to incorporate tooth decay prevention as part of a child’s regular checkup with the doctor could be a big step toward improving infants’ and toddlers’ dental health, say University of Florida researchers, who received a $293,000 grant from the National Institutes of Health to study whether such programs in Florida and Texas are actually improving dental care in young children enrolled in Medicaid.

The American Academy of Pediatrics, the American Dental Association and the American Academy of Pediatric Dentistry recommend children visit the dentist for the first time by age 1, but many children do not receive preventive dental care until they are much older, if at all, said UF health economist Jill Boylston Herndon, the principal investigator on the two-year grant.

“There is also this attitude that baby teeth are not that important,” said Frank Catalanotto, a professor of pediatric dentistry in the College of Dentistry who advocated for Florida to establish a program targeting early childhood caries. “But the reality is getting a cavity in a baby tooth can lead to an infection. And, in fact, several children have died over the last several years in this country of an untreated dental infection.

“The tragedy of this is that it is relatively easy to prevent early childhood caries with some simple measures of just toothbrushing using a fluoridated toothpaste, not putting a baby to bed with a bottle, and a dental visit with an application of a fluoride varnish,” added Catalanotto, a co-investigator on the grant.

In 2008, Florida and Texas adopted policies to reimburse pediatricians for providing preventive services to young children receiving Medicaid and dental education for their parents. As part of a child’s regular checkup, pediatricians provide dental education to parents about proper toothbrushing and oral care and apply a fluoride varnish to children’s teeth. The doctors then refer the parents and child to a dentist.

“The research tells us that if they get these preventive services, they are less likely to have problems later,” said Herndon, a research associate professor of health outcomes and policy in the College of Medicine. “In addition to reducing caries in their primary teeth, they are less likely to have caries in their permanent teeth when they are older.”

Dental caries is the most prevalent disease in young children, affecting more than one-fourth of kids between 2 and 5, according to the Centers for Disease Control and Prevention. By their teen years, two-thirds of children from low-income homes have suffered tooth decay. Dentists can spot the first signs of caries and prevent cavities from forming, said Joel Berg, chairman of pediatric dentistry at the University of Washington and president-elect of the American Academy of Pediatric Dentistry. With training, pediatricians can spot these signs, too, Berg added.

At home, parents should aim for brushing their infant or toddler’s teeth twice a day, or at least once before bed with a lentil-sized amount of fluoridated toothpaste. Although it is a common belief that parents should not use toothpaste with fluoride in children under 2, Catalanotto says this is a myth experts are trying to dispel.

“It’s not a matter of if a child should use fluoride but how much,” said Berg, who is not involved with the study. “With fluoride, it is important to have frequent exposure to small amounts.”

Of course, a lack of parental understanding about oral care is not the only issue affecting children’s teeth. There are few dentists who accept Medicaid and even fewer who will see very young patients, particularly those with dental problems, Catalanotto said. To address cavities and other problems, small children must frequently be put under sedation or admitted to a hospital and placed under general anesthesia.

“Getting some simple, inexpensive preventive procedures can cut a lot of dental costs down the line and prevent some big medical costs,” Catalanotto said.

Including Florida, 33 states have established programs to involve pediatricians in dental prevention, but there is limited evidence about how well these programs actually work to improve oral health for small children, Herndon said.

As part of their study, UF researchers from the colleges of Medicine and Dentistry and the Institute of Child Health Policy will examine whether children who receive preventive dental services from pediatricians are more likely to subsequently see a dentist. They will also look at geographic and population differences to see which children are receiving services and where there are unmet needs, Herndon said.

Other researchers involved in the study include Scott Tomar, a professor of community dentistry in the College of Dentistry; and Elizabeth Shenkman, director of the Institute for Child Health Policy and chair of health outcomes and policy in the College of Medicine.

Polygamy, bisexuality, homosexuality, philandering men and working women have been accepted in many societies throughout recorded history, said John Scanzoni, a UF sociology professor and author of “Healthy American Families: A Progressive Alternative to the Religious Right,” published earlier this year by Praeger.

“Ever since humans have been around, we’ve been continually altering, tinkering, tweaking, reinventing and changing every aspect of our families,” he said.

One example of a failure to understand how family life has evolved to meet people’s needs is the argument that homosexual marriage is wrong because it violates the ancient moral ideal that marriage is the union of one man and one woman, he said.

“Throughout history in most parts of the world, people believed that the right and moral thing to do was for one man to have several wives,” he said.

The vast majority of the world’s populations practiced some form of polygamy, which was invented by men primarily for their own economic and social benefit, Scanzoni said. A man wanted to be assured that his land and livestock would be passed onto his sons after he died, and having multiple wives increased his chances of having male heirs, he said.

“Insights into polygamous marriage – including male promiscuity – can be gotten by reading the stories of revered Bible characters such as Abraham, Isaac, Jacob and David,” he said.

The Greeks and Romans began to move away from polygamy for practical reasons, but men still had sex before and after marriage with as many women as they wished, Scanzoni said. Furthermore, many Greco-Roman men were bisexual, and many Greek thinkers believed the most profound love occurred between two men, not between a man and woman, he said.

“Plato, for instance, believed sex with one’s wife was necessary in order to bear children for the sake of family honor, but for sexual ecstasy one turned to one’s male lover,” he said.

Along with accepting alternate forms of sexuality, people have long been receptive to the idea of women in the labor force, Scanzoni said. Prior to the early 19th century Industrial Revolution, women typically worked alongside their husbands on farms and many also carried on vital occupations such as seamstress and midwife, he said.

“There was no sense at all in people’s minds that women should not do productive labor; the woman’s labor was as essential as the man’s for the survival of the household,” he said. “Women did not grow up thinking a man would support them, unless they belonged to that tiny handful of elite upper-class women who were aristocrats or royalty.”

During the Industrial Revolution, women, men and their children left their farms to work in factories, but many men eventually moved to the board room to become the core of the emerging middle class while women were excluded from these economic opportunities and encouraged to stay home, he said.

“For the first time in history a new style of marriage was born, in which the husband was provider and the wife was homemaker, and it permeated late 19th and 20th century America, becoming the 1950s style of marriage championed by the Religious Right,” he said.

Today, however, there has been a shift away from that option as increasing numbers of younger, well-educated women view work just as men do, as essential for gaining a sense of autonomy or control over one’s life, he said.

A second reason for the change is that during the current economic crisis men have been more likely than women to lose their jobs, Scanzoni said. The downturn has highlighted how essential women’s earnings are to the economic well-being of the household; underscoring that just as men don’t have the option not to work, neither do women, he said.

“The male as primary breadwinner used to be practical when men earned more than women,” he said. “But as women start to earn more or even the same money as men, that male breadwinner role no longer makes any economic sense.”

Recent census data show that in large urban centers, and for the first time ever, child-free women in their 20s earn more than young men, he said.

Called a tongue tie, the problem occurs when the connective tissue under the tongue is too tight. A tongue tie can hinder some newborns from being able to breastfeed properly and painlessly, and this struggle can lead many new mothers to give up breastfeeding.

A simple snip can fix the problem, but many doctors still do not perform the procedure despite the effects a tongue tie can have on breastfeeding, writes UF neonatologist Dr. Sandra Sullivan in an article published online this month in the journal Pediatrics.

“It is called a frenotomy, and it is far simpler than a circumcision, which we do fairly routinely,” said Sullivan, an assistant professor of pediatrics and the lead author of the report. “It literally takes longer to fill out the consent form for the procedure than to do the actual procedure itself.”

The problem is many practicing doctors were taught that the procedure is not medically necessary, Sullivan says.

But for babies to breastfeed effectively, their tiny tongues have to be able to perform a more complex type of sucking than what it takes to drink from a bottle. A tongue tie can hinder baby’s efforts to move his tongue up, down and out, which he would need to do in order to nurse.

“If you take a bottle with an artificial nipple, there is not a lot a baby has to do to get milk,” Sullivan said. “To get milk out of the breast, they have to make a vacuum and if they cannot get their tongue to the roof of their mouth, they cannot do this. They also need to use their jaw and tongue to move the milk along through the milk ducts in the breast.

“If they just bite on the nipple (like a bottle), first, it hurts (the baby’s mother) a lot and second, it blocks off all those little tubes, which keeps the milk stuck in the breast.”

Studies show about 2 percent to 5 percent of babies have constrictive tissue under the tongue and about half of those babies have problems with breastfeeding, said Dr. Isabella Knox, an associate professor of pediatrics at the University of Washington. About 4 million babies are born in the United States annually, meaning that between 40,000 and 100,000 babies are born each year with a tongue tie problem.

“That’s a lot of babies,” Knox said. “I don’t think general pediatrics training gives us a lot of skills in supporting breastfeeding. A lot of pediatricians have lactation consultants, but we don’t really know how to help somebody and for some people it is not always a priority.”

In Sullivan’s report in Pediatrics, she describes a patient who ended up in the hospital with feeding and growth problems, which could have been avoided if his tongue tie had been corrected as a newborn.

The baby’s mother was following expert advice and exclusively breastfeeding. She had noticed the problem when her child was born, but doctors told her not to worry about it. Eventually, she was referred to an oral surgeon, but was told no one would operate on the baby until he was at least 6 months old.

To his parents, whose eldest child had been premature and small, the baby seemed to be growing. But by the time he was 6 months old, he weighed less than he did at birth, Sullivan says. “He gained about 2 pounds in a matter of 36 hours in the hospital, and all we really did was fix his tongue,” Sullivan said. “This is just one example, an extreme example, of what happens when you do not fix this problem.”

According to the American Academy of Pediatrics, breast milk is considered the optimal food for babies. Studies have shown that exclusive breastfeeding offers infants some protection against diseases and common childhood illnesses, such as ear infections.

“Breastfeeding is best for babies, and we want to encourage mothers to breastfeed and do it successfully for as long as they would like,” said Dr. Jerry Isaac, a pediatrician and past president of the Florida chapter of the American Academy of Pediatrics. “This (paper) is an important piece of information adding to the body of knowledge that this may be a significant problem in some babies.”

Sullivan is part of an international organization focused on issues related to tongue ties. She and other members of the group’s screening committee are working to develop a screening tool that would help nurses quickly screen for a tongue tie while assessing the baby after birth.

“There is not a lot of literature about frenotomy, and there are still a lot of doctors who say, ‘Is this really necessary?’” Sullivan said. “Whether or not there is an epidemic or whether we ignored tongue ties and are looking for them now, this is something that is coming up more often in nurseries.”

Writing in the February issue of the Journal of Palliative Medicine, researchers said only 32.3 percent of pediatricians from Florida and California surveyed said treatment of chronic pain was their responsibility.

Physicians don’t have as much knowledge of pain treatment as they should, and many pediatricians probably are afraid to manage that part of their patients’ treatment, said principal investigator Dr. Lindsay A. Thompson, an assistant professor of pediatrics at UF.

“The side effects for pain medications can be pretty severe,” she said. “The opioid medicines are the gold standard for pain treatment, but they have side effects that can decrease your breathing. When you’re not in the hospital setting, that’s dangerous and primary care providers may worry about the side effects more than the pain.”

The researchers received 303 fully completed responses from mail and online questionnaires sent to 800 pediatricians about treatment of severe, chronic pain. Questions also asked about demographics, clinical experience and components related to palliative care.

Pediatricians were allowed to select more than one option when asked who should treat their patients’ chronic pain, and most respondents said they thought other providers should oversee pediatric pain treatment.

Pain specialists were the most popular choice, with 58.1 percent of respondents selecting them as the preferred providers for pediatric pain treatment. Other specialists and hospice providers were the second and third most popular options selected, with 39.6 percent and 26.1 percent of respondents selecting them, respectively.

But Thompson emphasized that these aren’t realistic ideas, given a lack of pain specialists in the United States, especially ones working in pediatrics.

In the responses, 84.2 percent of pediatricians say they “often” or “always” use patient reports to evaluate pain, and 87.1 percent use parental reports. About 67 percent always or often watch for nonverbal cues, and about 50 percent ask patients to keep “pain diaries.”

When it comes to the most commonly used treatments for pain, acetaminophen and nonsteroidal anti-inflammatory drugs, or NSAIDS, topped the list: 61.7 percent of pediatricians said they often or always use acetaminophen, while 66.9 percent often or always use NSAIDS.

Thompson said she thought it was “worrisome” that pediatricians were not more comfortable using acetaminophen and NSAIDS in conjunction with more potent pain medications.

She emphasized that medical schools need to teach students more about pain management, and providers’ thinking toward pain needs to evolve.

“Because of the way the population is moving — its long-term illness, its chronic care — I think we have to incorporate these new morbidities, like pain, as something that we have to address,” she said. “It needs to become a non-stigmatized, or more readily accepted outcome in and of itself. I think services for kids with chronic illness, life-limiting illnesses need to move to a lifelong model, where pain is one of the first things that physicians and providers address.”

Dr. Nathaniel Nonoy, director of the Pediatric Acute Pain Service at the University of North Carolina School of Medicine, said while many children need the services of a pain specialist, pediatricians and other health-care providers not specializing in pain need to learn more about and take more responsibility for treating kids with chronic pain.

“There are a lot of children out there with chronic pain, so many of them that not every one can possibly be treated by a specialist. There simply aren’t enough available for every child who needs one,” said Nonoy, who did not participate in the research. “Pediatric pain is still a tremendous diagnostic and therapeutic challenge. There’s no question about it. We have a lot of work to do in giving the kids the kind of care that they need.”

In addition to Thompson, the research was conducted by UF researchers Caprice Knapp, and Elizabeth Shenkman, both of the college’s Institute for Child Health Policy; Vanessa L. Madden, B.Sc., a research coordinator at the college; and Veronica Feed, assistant dean for research and scholarly practice at Molloy College’s division of nursing.

Rates of premarital sex and single motherhood rose much more dramatically between the 1940s and 1960, when the oral contraceptive was approved by the Food and Drug Administration, than during the “free love” era of the 1960s, said Alan Petigny, a UF history professor.

The loosening of sexual constraints coincided with more liberal attitudes toward women, which took hold before the 1960s, he said.

“The explosion of premarital sex during the ’40s and ’50s as evidenced by higher levels of illegitimacy has not yet and I would argue cannot ever be explained by the standard historical interpretation,” he said. “The proposition that the 1950s was a stable period when it came to sex is a great fiction that the empirical evidence simply does not sustain.”

The author of the 2009 book “The Permissive Society: America 1945-1965,” Petigny will be the featured speaker at a forum at Georgetown University on Tuesday.

The historic announcement in May 1960 of the approval of an oral contraceptive was credited with unleashing sweeping changes in the sexual behavior of single women, he said.

“By the time the birth control pill became available to the masses of American women, the proverbial horse was already out of the barn,” he said.

Using vital statistics, Petigny said he found that between 1940 and 1960 rates of illegitimacy rose by more than 250 percent for white women and by more than 300 percent for all women. Specifically, the frequency of single motherhood increased from 3.6 to 9.2 newborns per 1,000 unmarried white women and from 7.1 to 21.6 newborns per 1,000 among all women, he said.

Even among women who married there was a sharp increase in premarital pregnancies, which would later develop into shotgun marriages, according to statistics from the U.S. Census Bureau. The census asked women a series of questions including the date they were married and the date their first child was born, he said.

Petigny’s research shows that for single white women between the ages of 20 and 24, for example, the frequency of premarital pregnancies more than doubled from the mid-1940s — between 1943 and 1946 — and the mid-1950s, between 1955 and 1958. “Here we have two different sources of data collected through two very different methods pointing to the same conclusion: the sexual revolution was well under way during the 1950s,” he said.

The pill had little influence on the sexual behavior of single women in the 1960s because it was overwhelmingly used by married women, Petigny said. “Most doctors would simply have refused to prescribe the birth control pill to a woman who wasn’t married,” he said.

By 1965 the pill had become the most common form of contraception among married women, but single women did not begin to use it in large numbers until the 1970s, he said.

According to the first teenage survey of birth control in 1971, only about 10 percent of sexually active girls were on the pill, Petigny said. Condoms were far more common, he said.

Changes in sexual behavior resulted from a liberalization of attitudes during the post-war period that occurred as more men and women attended college and as religion’s influence waned in favor of psychology, particularly in its humanistic form, Petigny said. “People were coming to look at themselves and the world in a markedly more secular way,” he said.

Ideas about women became more progressive and the status of women improved, long before the arrival of the feminist movement, Petigny said. For example, more than 300 women served in state legislatures during the 1950s, and by the end of the decade slightly more women held these seats than at the end of the 1960s, he said.

Political attitudes began to shift, as shown in a Gallup poll asking whether voters would cast their votes for a woman for president if their party nominated one, Petigny said. In 1940, only about 20 percent of the public expressed their willingness to do so, compared with nearly 60 percent by 1960, he said.

And at home a quiet revolution was taking place with families becoming more democratic and less patriarchal, Petigny said. Even though men and women still performed different tasks, they exercised roughly equal power in the marriage, he said.