Too often, the birds-and-the-bees conversation occurs after, and not before, kids start experimenting sexually, possibly in risky ways, reports a study in the January issue of Pediatrics.

This revelation comes despite American Academy of Pediatrics recommendations that health-care providers and parents talk to their kids about sex and sexuality early in life.

“Parents are a little behind the 8 ball. They underestimate their children’s sexual knowledge and interest and behaviors,” said Dr. Lawrence Friedman, director of adolescent medicine at the University of Miami Miller School of Medicine.

“It’s a hard subject for many parents to broach, but the level of sexual activity in many kids has moved up in terms of initiation. It’s younger,” added Alan Hilfer, director of psychology at Maimonides Medical Center in New York City. “Talking about it is very helpful in terms of disease prevention, unwanted pregnancy and even issues around relationships.”

Although there were suspicions that parents lagged behind their kids, previous studies had asked adults to remember when they first had sex and when their parents talked to them, said study author Megan Beckett, a social scientist with the Rand Corp. in Santa Monica, Calif.

For this study, Beckett and her colleagues surveyed 141 middle-class and upper middle-class parents and their children, aged 13 to 17, in more of a real-time scenario. “We went back about four times over a year’s period,” Beckett said.

Starting with questions about girls bodies and menstruation, the research team asked parents and children about kissing and handholding, birth control, refusing sex, oral sex and intercourse, all related to different developmental stages of the kids.

More than half of children had experienced genital touching before “the talk” about birth control, sexually transmitted diseases (STDs) and condom use, the researchers found.

“More than 40 percent of adolescents are having intercourse before parents have talked to them about STD symptoms, condom use, choosing birth control and what to do if your partner refuses to use a condom,” Beckett said. “That’s a pretty large number.”

About two-thirds of boys said they had not talked with a parent about how to use a condom before having intercourse.

And conversations with boys almost always took place later than talks with girls.

“This is a flag to not put it off, and this is especially the case with boys,” Beckett said.

Denial, naivety and any number of other emotions on the part of the parents may be playing into this trend, Friedman said.

“They reminisce that when they were in the seventh grade, they didn’t do that kind of thing,” he said. “The fact of the matter is that this is 25 years later, and this is what is going on. You have to be knowledgeable and prepared to prepare children for when they become teenagers and have to confront sexual kinds of activities.”

Other experts agree. “We live in an R-rated society, and our kids need our PG guidance,” said Dr. Frank Biro, head of adolescent medicine at Cincinnati Children’s Hospital. “If you want to instill knowledge and values, then you need to be talking to your kids earlier, not later.”

Here are some tips on when and how to talk to your kids:

• Figure that the age you think is appropriate is probably too old. “If parents think that they should broach the topic at x age, they should subtract two years and do it at that age instead,” Friedman said.
• Talk to your physician and scour resources from the Internet, libraries and schools about how to broach the subject and what to say.
• Take the lead. “Don’t expect your child to come and ask an important question about a topic that they’re embarrassed about or that they don’t know their parents would be willing to talk to them about,” Friedman said. “This will also help gauge how knowledgeable their teenager or child is.”
• After you’ve talked, “step back and ask your kids questions and pay attention to what they’re interested in,” Hilfer said.
• Make sure your conversation is developmentally appropriate to the child, Biro said. Talking about fellatio with a 6-year-old is probably not appropriate. Talking about boys liking girls and handholding would be for kids 8 or 9 years or possibly even 6 years old. “If you haven’t talked to your kids by the time they’re 12, you need to get on the stick,” said Hilfer.

More information

Planned Parenthood has more on how to talk to kids about sex.

Researchers found that certain regions of the brain are larger in young people who do a better job of playing a specially designed video game.

In other words, all those people who devote their days to their Wiis and XBoxes may be packing some cerebral heat, at least when it comes to the sheer size of what’s inside their skulls.

The findings “can help us understand how individual differences contribute to cognitive differences and how we can enhance brain function by increasing the volume of these regions,” said study co-author Arthur F. Kramer, a professor of neuroscience and psychology at the University of Illinois at Urbana-Champaign.

Scientists have long wondered if big brains translate into extra intelligence, but that’s not always true in the animal kingdom. Small birds, for example, have huge brains for their physical size, but they aren’t the sharpest critters around.

In the new study, researchers turned to a decades-old video game called Space Fortress. Scientists developed the game, akin to a flight simulator and the classic Space Invaders, to study learning. According to Kramer, it takes about 20 hours for undergraduate students to learn how to become good at the game.

Using MRIs, the study authors measured the size of specific brain regions of 42 participants (aged 18 to 28) before they began playing the video game.

Then the researchers tried to find links between the sizes of different brain regions and how well people played the game. “We wanted to know if individual differences are important in how well people can learn a complex new skill over a limited period of time,” Kramer said. “We decided to look into these areas because we’ve learned an awful lot about the neural circuits that contribute to learning new skills.”

The findings are scheduled to be published in an upcoming issue of the journal Cerebral Cortex.

The researchers found that certain regions of the brain, the striatum in particular, were indeed bigger in the most successful players. “Bigger is better in this case, at least among healthy tissue,” Kramer said.

The findings seem to confirm that parts of the striatum, which is nestled deep inside the cerebal cortex, determine a person’s ability to learn both motor skills and new concepts, and also to adapt to changing situations, the researchers wrote.

The size of another region, the hippocampus, wasn’t larger in those people, suggesting that the researchers are onto something regarding the importance of the other regions when it comes to learning skills.

Joe Verghese, director of the Division of Cognitive & Motor Aging at Albert Einstein College of Medicine in New York City, said the study is preliminary, but it’s “an important step.”

Verghese said it would have been interesting to know if the video game training itself changed the sizes of those brain regions or boosted their activity.

As for the future, researchers are trying to figure out how to help people boost their brain power by boosting the size of regions of the brain, Kramer said.

For now, another approach works well: Exercise. It helps make the brain larger, he said, because “as you become more physically fit, the brain changes.”

Learning new skills also seems to have the same effect, he noted.

More information

For more on the brain, check Harvard University’s Whole Brain Atlas.

But the findings shouldn’t send patients rushing to buy pot: the levels used in the research appear to be too high to obtain through smoking. And there’s no sign yet that the approach works in laboratory animals, let alone people.

Still, the finding does suggest that more than one compound in marijuana might boost cancer treatment, said study author Sean McAllister, an associate scientist at California Pacific Medical Center Research Institute in San Francisco. “Combination therapies might be more appropriate,” McAllister said.

Researchers have long studied the compounds in marijuana known as cannabinoids, which are thought to hold possible health benefits. One, known as THC, is well known for its role in making people high when they smoke or eat pot. Researchers have been testing it as a treatment for the brain tumors known as glioblastomas.

In the new study, researchers tested THC and cannabidiol, another compound from marijuana, on brain cancer cells. The findings appear in the January issue of Molecular Cancer Therapeutics.

The study authors found that the combination treatment seemed to work better at killing the cancerous cells and preventing them from growing back.

About 9,000 people in the United States develop glioblastomas each year, said Dr. Paul Graham Fisher, chief of the Division of Child Neurology at Stanford University and Lucile Packard Children’s Hospital. The most famous patient was the late U.S. Senator Ted Kennedy.

The prognosis for people with the condition is grim because tumors spread throughout the brain. It can be impossible for treatments to remove the entire tumor, Fisher said.

“No matter what you do, this tumor has a larger border than you ever think,” he said. “We know there are microscopic satellites all throughout one side of the brain and pretty soon in the other side of the brain. The only thing that will fix this disease is something that provides a more blanket approach.”

Instead of targeting the tumors itself, he explained, treatments need to do something like disrupt the pathways that cancer cells use to communicate.

In the big picture, “you’re seeing a lot more thinking outside the box about trying to treat glioblastoma,” he said. “I think in the next 10 to 15 years we’re going to start seeing progress forward.”

For now, he said, there’s no evidence that marijuana is good or bad for glioblastoma tumors.

Back in the laboratory, McAllister said the next step is to test the combination treatment on laboratory animals and then on people. The treatment may be given to people directly through the brain, which could be expensive. But the compounds themselves may not be expensive, McAllister said.

As for the idea of getting the same effect through a couple of marijuana joints, he had this to say: “It’s unlikely that you could reach effective concentrations by smoking the plant.”

More information

Massachusetts General Hospital has more on glioblastomas.

What is acne vulgaris?

Acne vulgaris, or acne, is a skin problem that starts when oil and dead skin cells clog up your pores. Some people call it blackheads, blemishes, whiteheads, pimples, or zits. When you have just a few red spots, or pimples, you have a mild form of acne. Severe acne can mean hundreds of pimples that can cover the face, neck, chest, and back. Or it can be bigger, solid, red lumps that are painful (cysts).

Most young people get at least mild acne. It usually gets better after the teen years. But many adult women do have acne in the days before their menstrual periods.

How you feel about your acne may not be related to how bad it is. Some people with severe acne are not bothered by it. Others are embarrassed or upset even though they have only a few pimples.

The good news is that there are many good treatments that can help you get acne under control.

What causes acne?

Acne starts when oil and dead skin cells clog the skin's pores. If germs get into the pores, the result can be swelling, redness, and pus. See a picture of how pimples form.

For most people, acne starts during the teen years. This is because hormone changes make the skin more oily after puberty starts.

You do not get acne from eating chocolate or greasy foods. But you can make it worse by using oily skin products that clog your pores.

Acne can run in families. If one of your parents had severe acne, you are more likely to have it.

What are the symptoms?

Symptoms of acne include whiteheads, blackheads, and pimples. These can occur on the face, neck, shoulders, back, or chest. Pimples that are large and deep are called cystic lesion. These can be painful if they get infected. They also can scar the skin.

How is acne treated?

To help control acne, keep your skin clean. Avoid skin products that clog your pores. Look for products that say "noncomedogenic" on the label. Wash your skin once or twice a day with a gentle soap or acne wash. Try not to scrub or pick at your pimples. This can make them worse and can cause scars.

If you have just a few pimples to treat, you can get an acne cream without a prescription. Look for one that has benzoyl peroxide or salicylic acid. These work best when used just the way the label says.

It can take time to get acne under control. Keep using the same treatment for 6 to 8 weeks. You may even notice that it gets worse before it gets better. If your skin is not better after 8 weeks, try another product.

If your pimples are really bothering you or are scarring your skin, see your doctor. A prescription gel or cream for your skin may be all you need. Your doctor may also order antibiotic pills. A mix of treatments may work best. If you are female, taking certain birth control pills may help.

If you have acne cysts, talk to your doctor about stronger medicine. Isotretinoin (such as Accutane) works very well, but it can cause birth defects. And using Accutane may be linked with depression. Let your doctor know if you have had depression before taking this medicine. And if you are female, you must protect against pregnancy by using two forms of birth control. Even one dose of this medicine can cause birth defects if a woman takes it while she is pregnant. You cannot take isotretinoin if you are breast-feeding.

What can be done about acne scars?

There are skin treatments that can help acne scars look better and feel smoother. Ask your doctor about them. The best treatment for you depends on how severe the scarring is. You can have scar tissue removed or have a shot of collagen. Collagen smoothes a pitted scar by plumping up the skin underneath. You may get the best results with a combination of treatments.

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