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"I could tell you that when you have trouble making up your mind about something, tell yourself you’ll settle it by flipping a coin. But don’t go by how the coin flips; go by your emotional reaction to the coin flip. Are you happy or sad it came up heads or tails?"
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  Volume No. 16 Issue No. 6 June 2019  

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  Staying healthy at 50 and beyond
  Submitted by Peak Vista Community Health Centers

   Staying healthy and feeling your best is important at any age. We asked a few providers at Peak Vista Community Health Centers (Peak Vista) for advice on maintaining a healthy lifestyle throughout your 50s and beyond: Stay active: Thomas Weber, MD, provider at Peak Vista’s Convenient Care Center, said, “You should aim for at least 30 to 60 minutes of physical activity on most days of the week, including aerobic exercise for heart health and weight-bearing exercise to reduce your risk for osteoporosis.” Find a few activities you enjoy and you’ll be more likely to stick with it. “If you have been sedentary, you should discuss your exercise program with your primary care provider, especially if interested in more vigorous activities such as running or tennis,” Dr. Weber said. “You may need a stress test to rule out underlying (but asymptomatic) heart disease.”
  • Keep an active mind: Studies show that challenging your mind can improve brain function and overall health. Take up an interesting hobby you’ve always wanted to learn more about, play cards with friends or join a book club.
  • Improve your diet: “The basic principles of maintaining our health into our 50s, 60s and beyond is to be mindful of the foods we eat,” said Sally Bleier, LCSW, Behavioral Health provider at Peak Vista’s Lane Family Health Center. It is important to have a balanced diet that includes proteins, lots of vegetables, fruits, low saturated fats, low sodium and low sugars, and to avoid processed foods full of artificial additives. Most importantly, limit your calories to maintain a healthy weight; if calorie intake exceeds the calories you burn, you will most likely gain weight.
  • Stay updated on vaccinations: As you get older, your immune system weakens and it can be more difficult to fight off infections. You’re more likely to get diseases like the flu, pneumonia and shingles — and to have complications that can lead to long-term illnesses. “Flu and pneumonia are among the top health concerns for the elderly,” Dr. Weber said. “I often recommend my patients to receive the following vaccinations: influenza shot, TetanusDiphtheria-Pertussis (Tdap), Pneumococcal and the Zoster vaccine to prevent shingles.” It’s important to keep in mind that getting vaccinated can help keep you, your family and your community healthy.
       Healthy aging means continually reinventing yourself as you pass through landmark ages such as 60, 70, 80 and beyond. It means finding new things you enjoy, learning to adapt to change, staying physically and socially active and feeling connected to your community and loved ones.
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      Social media — distorted realities, health issues in kids
      By Lindsey Harrison

       A survey conducted by the Pew Research Center in March and April of 2018 showed that 45 percent of teens ages 13 to 17 say they use the internet “almost constantly.” Another 44 percent go online several times a day.
       The substantial time children and teenagers are spending online can have widespread effects on their health, including brain development, said Kim Boyd, director of community care for El Paso County Colorado School District 49 and licensed clinical and school psychologist.
       An increasing number of parents are allowing their young kids, including toddlers, to use their phones or tablets, she said. The problem is that for the first three years of a person’s life, the brain is still developing; and the type of stimulation from those electronic devices can actually change the makeup of a child’s brain, Boyd said.
       According to an article by Victoria L. Dunckley, M.D.,“Gray Matters: Too Much Screen Time Damages the Brain,” posted on the Psychology Today website Feb. 27, 2014, too much screen time can be physiologically dangerous. Screen addiction can lead to gray matter atrophy, compromised white matter integrity, reduced cortical thickness; impaired cognitive functioning; and cravings and impaired dopamine function.
       “Screen time particularly at those early ages can create addictive-type qualities,” Boyd said. “The thing they are engaging in (online) are reinforcing and the things being put out for kids are designed to be addictive. Their feel-good transmitters are being sparked.”
       Shaye Meissen, director of behavioral health for Peak Vista Community Health Centers and licensed professional counselor, said part of the problem is that parents often assume kids and teens can self-regulate the amount of time they spend online, but their brains are not capable of doing that. “Parents really have to do that for them,” she said.
       The emotional effects are taking its toll on kids as well. The sizable amount of time kids and teens are spending online, particularly on social media sites, has led to a much higher rate of depression, feelings of loneliness and feeling insignificant, Meissen said.
       Boyd said kids that compare themselves to online posts can have twisted ideas of reality and personal expectations. People post the best pictures of themselves on social media or photos of all the fun times. Some kids look at their own lives and feel inadequate, like they are not keeping up, Boyd said.
       “The more time they spend on the internet and social media site, the more skewed their perception of ‘normal’ becomes,” she said.
       Dr. George Athey, a board certified child, adolescent and adult psychiatrist with Peak Vista, said kids tend to be moodier and more irritable when they spend too much time on social media sites. “They get angered more easily,” he said. “There becomes more arguing and fighting online. They start avoiding normal social interactions. Instead of sitting down with family or friends, they are isolating themselves in their rooms, avoiding social interaction to the exclusiveness of social media.”
       Athey said much of the content on social media sites is negative — bullying, body shaming, public shaming and humiliating others. Kids and teens who are already anxious or depressed get online and often those feelings are magnified, he said.
       Because social media has become a popular form of communication, Athey said he has observed an increase in kids and teens who exhibit delayed communication development.
       “The communication theory is that most communication is nonverbal,” he said. “It requires looking at body posture, facial expressions and other things. You do not get any of that on social media. Even written communication is disturbed because they do not use full sentences or even full words. There is so much potential for miscommunication.”
       Social development is also stunted with increased time spent online, Athey said. Kids and teens do not have to leave the house to interact with real people in social settings, he said. While some argue that social media can be a good outlet for people who deal with social anxiety, Athey said he feels it actually makes it worse, often delaying proper social development by several years.
       “These people do not meet normal social goals,” he said. “Why get a drivers license, why get a job, why graduate high school when they plan to be a professional YouTuber or gamer? There are a lot of things on social media that are contrary to becoming functioning members of society.”
       Boyd said it is that type of isolating behavior that often perpetuates the issue of internet addiction.
       “We teach our kids how to be safe when they are young and playing outside, but when it comes to the internet, we are giving tablets and phones to younger kids; and we are not monitoring them or teaching them how to use it and set boundaries,” Boyd said. “When we teach kids to cross the street, we teach them to look both ways and watch out for cars. We are not teaching that type of safety with internet access.”
       Meissen said that lack of guidance can become a major issue. “They see someone that is a YouTube star and they idolize them or model that behavior,” she said. “If we are not talking and having those conversations that not everything they see on social media is true and good, they may not be able to recognize the difference.”
       The bottom line is that if a parent does not like what their child is being exposed to online, it falls on the parent to regulate and monitor their child’s access to the internet, Meissen said.
       Boyd agreed, and said the stigma that it is considered “spying” by monitoring their children’s internet usage or going through their smartphone to see who they are talking to and what they are talking about needs to change.
       “I do not think we should call it spying,” she said. “We should call it parenting. We are offering the entire world to our kids, but we are not teaching the appropriate usage to them.”
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      Child predators — online and in person
      By Lindsey Harrison

       Parents, school counselors, teachers, law enforcement officers and others are constantly telling children and teenagers to be aware of personal encounters with strangers (including supposedly trusted individuals) that present aggressive and unusual or improper behaviors. The internet has exacerbated opportunities for predators, and the same stranger-danger messages apply to the web.
       According to a post, “In 100 percent of the cases, teens that are the victims of sexual predators have gone willingly to meet with them.
       Dr. George Athey, a board-certified child, adolescent and adult psychiatrist with Peak Vista Community Health Centers, said kids and teens are at risk for being exposed to things online that they are not emotionally ready to handle. Sexual content is a major concern because kids are not mature enough to deal with those feelings or situations, he said.
       “The whole world is available to the kids online,” said Kim Boyd, director of community care for El Paso County Colorado School District 49 and a licensed clinical and school psychologist. “Before, kids only had access to what they brought into their houses. There was not a bunch of hiding things and being secretive. But now, kids can sit in their rooms with their headphones on, and no one can see what is on their laptop, phone or tablet.”
       “Social media is a virtual world where you can be somewhere else, be with other people, without leaving your home,” Athey said. “That virtual world may open a kid up to meet a person they should not, see things they should not see or are told things they should not hear.” Kids and teens can be lured into potentially dangerous situations by predators they encounter on social media sites, he said.
       “The pornographic industry is really good about finding ways to infiltrate websites that are seemingly non-threatening,” Athey said.
       Boyd said kids will provide more information about themselves online than they realize, despite the fact that 87 percent of kids ages 8 to12 and 86 percent of teens ages 13 to 17 say their parents have talked to them about staying safe online, according to a report, “The Common Sense Census: Media Use by Tweens and Teens,” published in 2015.
       If kids have played an online game with someone over a few weeks, they might feel comfortable enough to tell that person things they would not normally tell a stranger, Boyd said.
       Shaye Meissen, director of behavioral health for Peak Vista and licensed professional counselor, said child predators often start out nice and friendly, which is how they get kids and teens to put their guard down and become more vulnerable.
       The same behavior exists in child predators that kids and teens might encounter on a daily basis, but in person rather than online. Maureen Basenberg, executive director of Safe Passages Children’s Advocacy Center in Colorado Springs, said more than 90 percent of perpetrators are known to the child and the child’s family.
       “Child predators very much work themselves into positions of trust within the system,” she said. “That is scary. It is the last thing we want to think. That inability to wrap your head around that idea is what puts kids at risk, in my opinion. It is our inability to see the potential threat that allows those perpetrators to get away with it.”
       Basenberg said it can be hard for parents to see those potential risks when they are juggling so many things in their lives. However, she said there are things to consider like whether the attention someone is paying to their child is appropriate. If someone is eager to help when a parent is in a bind, it can be easy to look the other way, Basenberg said.
       “Is there something that says this attention may be inappropriate?” she said. “If so, follow up on that intuition.”
       Parents do not have to be the ones to deal with someone they think could be inappropriately interacting with their child, Basenberg said. Trained professionals in law enforcement can deal with the offense, as long as it is reported to them.
       “It is a scary thing to pick up the phone and make a report on someone that has been good to your family, and your kid likes them, but it is anonymous so nothing will come back to you,” she said. “In general, kids do not make false reports of abuse.”
       If children feel safe enough to tell an adult about something that is happening to them, Basenberg said it is important they feel their confidante believes them. The minute they feel the adult doesn’t believe them, the door on that conversation is closed.
       Conversations are vital when it comes to not only identifying when a child has been inappropriately treated but also helping them stand up for themselves and set boundaries, Basenberg said. “A big part is helping kids know the correct names for their body parts,” she said. “Otherwise, we send the message to kids that somehow your body should not be talked about, and that sets up an understanding that we do not talk about certain things. If a perpetrator tells them not to talk about something that is happening, that makes sense to the kid.”
       Athey agreed and said he recommends that people tell their kids and teens that secrets are not a good thing. Anything that makes them uncomfortable is something they need to share with their parents or a trusted adult, he said. If someone asks them to keep a secret, they need to know to be suspicious of that person.
       “If it needs to be a secret, there is a reason for that,” Athey said. “Kids are more likely to be taken advantage of by someone who wants them to keep a secret.”
       Sometimes, posing a situation in a hypothetical way to open the lines of communication can help a child talk about something they find difficult, Basenberg said.
       “Parents should be starting the conversation about what is OK and what is not OK from the time their kids can talk,” Meissen said. “Kids generally do not speak out because they think they will get in trouble, or they are embarrassed.”
       Basenberg said those conversations can go a long way to keeping kids safe; but, in the event something appears to be wrong, she recommended calling local law enforcement to report it. Additionally, she recommended attending classes like those offered at Kidpower of Colorado in Colorado Springs. Kids as young as 4 years old are taught about personal safety.
       “Really, at the end of the day, we need kids and teens to know they can do what they need to do to feel safe,” Basenberg said. “And then we have to be supportive about that.”
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