The question of spanking has made big news lately, from strangers taking discipline into their own hands to research suggesting it can lower a child's IQ.

BeWell's Alice Domar, Ph.D, explains why we should leave this type of parenting in the past.

Please Don't Spank Your Child

Like many of my generation, I remember being spanked as a child. What was particularly unfair was that the home of my childhood was an upside down house, in that the living space was on the second floor and my bedroom was on the first floor. So when my naughtiness factor overtaxed my mother's patience, she would yell, tell me to go to my room, and then swat my behind as I started going down the stairs. There was no way to obey the go-to-the-room command without getting spanked.

Sometime between my childhood and the time I became a mom, the attitude about spanking changed. Time-outs were in, and hitting was way out. I can guess that most of us have slipped a time or two (I can actually only remember spanking one of my kids once and I still feel awful about it.  I apologize to her every time the topic comes up but she thinks I am being ridiculous since she was three at the time and has no memory of the event. But I remember it all too well and feel really guilty). But new research supports the notion that spanking is just not an option when it comes to disciplining your child(ren). 

Continue reading Please Don't Spank Your Child...

Though we've recently celebrated America's independence, we shouldn't let another year go by before considering the emotional and physical toll incurred by the men and women (as well as their families) who serve our country. BeWell's Dr. Saralyn Mark recently spoke to Congress about the "invisible wounds" of war:

The Invisible Wounds of War

After hearing Dr. Mark's below briefing, the U.S. Senate Armed Services Committee voted unanimously to adopt the Montana model for assessing returning combat vets for post-traumatic stress disorder. Read the story here.

Last Wednesday, I had an opportunity to present to Congress my thoughts on the "invisible wounds" of war. According to a 2008 RAND report, nearly 20% of veterans who have returned from Iraq and Afghanistan suffer from post traumatic stress disorder (PTSD) or major depression. I think that these numbers are actually low, since the report was based on extrapolated data from a survey of less than 2,000 troops. We now know that the number of Army suicides has increased every year since the Iraq War began, and this is the first time since the Vietnam War that the Army suicide rate has surpassed the civilian suicide rate.

Continue reading The Invisible Wounds of War.

Other links to explore:
Military Wives' community board
Dr. Mark on "Shock and AWE"

Saralyn Mark, MD BeWell Expert

Associate Professor of Medicine adjunct
Yale and Georgetown University Schools of Medicine

Affiliate Professor
George Mason University School of Public Policy

Senior Medical Advisor
NASA
*The opinions expressed are the views of the author and not of NASA.

Swine flu is all that anyone with electricity is talking about. I have to admit, the unsettling images of  people wearing masks and printed "we're closed" signs in front of schools and businesses combine to create low-level anxiety. On top of that, reports of deaths from the flu (go figure) really can make that sinking feeling in your stomach feel like the Grand Canyon. The news reports and snatches of random conversation, make you ask yourself, "Should I be worried?"

Let's look at the facts. Influenza kills 36,000 Americans every year. Last year over 200,000 people were hospitalized for complications from the flu. Approximately 5-20% of the population gets the "flu" every year. Swine flu is thought to come from a mutation of a pig virus and human virus. It's spread through respiratory droplets -- like coughing and sneezing -- and is passed along hand to hand or by coming into contact with an infected person. There has been one recent death in the U.S., and possibly more to come. The virus is Swine Influenza A (H1N1) and can be treated with antiviral drugs like osetamivir and zanamivir (started within 48 hours of symptom onset).

Use common sense by washing your hands frequently, cough into your elbow (not your hands), and stay home if you feel ill. If you find yourself overly concerned or making yourself sick with worry (and, frankly, paranoia) yet you have absolutely no symptoms, try these tips:

1.  Limit your network or newspaper coverage about the pandemic. Update yourself once or twice daily by going to a reliable source like www.cdc.gov.

2.  Focus on what's under your control.

3.  Maintain healthy habits. Exercise regularly and be mindful of  what you eat. Try to eat whole grains and fresh fruits.

4.  Breathe. Take ten deep breaths regularly through your nose with your mouth closed. Find a deep center of calm within.

5.  Avoid feeling panicky by having a plan. Educate yourself on the symptoms of swine flu, keep your doctor's number handy, and remember that this is a treatable illness. However, if you are have a young child,  are pregnant, or have an existing condition that makes you immunocompromised, you should check in with your doctor at the first sign of flu symptoms because your risk is higher.

-- Dr. Janet Taylor (read Dr. Taylor's blog on BeWell.com)
Psychiatrist in private practice and former clinical instructor of psychiatry at Columbia University, Harlem Hospital 

When someone you love is struggling with infertility, it's not uncommon to wonder what you should do or say to be helpful - and not hurtful. A lot of the anguish expressed by my fertility-challenged patients stems from well-intentioned comments made by family members and friends. I would like to believe that these comments are truly well-meaning (this comes from what my husband calls my pathological level of optimism), but they're not always interpreted as such by the individual or couple on the receiving end who is desperate to start a family. So if you'd like to be a positive force, here's a general list of do's and don'ts to help you navigate this emotional minefield.

Mum's the word. If you have a friend, family member, or co-worker who has confided in you that she is struggling with infertility, take that confidence seriously. About half of all infertile individuals keep the information private out of a sense of guilt, shame, or fear. So if someone has told you that this is a problem for her, feel honored. And do not, for any reason, share the information with anyone else.

Leave it to the experts. Support your loved one in her treatment decisions, but don't give medical advice. I know that those of us who read People magazine cover to cover every week have a lot of know-how about infertility treatment and its success, but be aware that if your friend or family member is seeing a physician who is an expert in infertility, there is a fairly good chance that doctor knows more about her case and the appropriate course of treatment than you do. If you happen to know someone else who has an infertility doctor that she loves and has been successful with, you can offer the physician's name and contact information, but leave it at that.

A front page story in today's New York Times blurted out: "Study of Diseases and Genes at an Impasse!" The article reflected on commentaries from the New England Journal of Medicine discussing whether genetic risk prediction is really worth pursuing for the majority of common diseases. This is a good question not only because companies are offering tests of genetic risk to the public, but also because this line of research is very expensive and may not be worth it. Over the past decade the dogma has been that our genes could be used to figure out what diseases are in our future and maybe even to design drugs to prevent them. This dream may well be just that...a dream. It seems that while some genetic variations -- such as the breast cancer genes BRCA 1 and 2 -- are responsible for a very high risk of subsequent disease in an affected individual, the number of such individuals is low. In the case of the BRCA 1 and 2 genes, they correspond to only 5-10% of all breast cancers. On the other hand, there are many genetic variations that may be responsible for a very small increase in risk for breast cancer, probably not enough to even note. Even combinations of these many variants are probably not yet reliable predictors.

What does this mean to science and to us?
For science it means we need to reevaluate this approach as the "holy grail." Maybe figuring out the genes isn't as important as figuring out the causes or conditions that lead to the diseases. A child could have the genes for Type 2 diabetes, but be raised in poverty without enough to eat and never experience it. The DNA doesn't change, but the way it plays out may be very different in a different setting. As such, it may well be easier to change the environment than the genes! For us, personally, this debate means that we need to be careful of commercial companies and doctors that propose to analyze our genes and tell us what diseases are in our futures. To quote Dr. David B. Goldstein, a Duke University geneticist, "With only a few exceptions, what the genomics companies are doing right now is recreational genomics." The risk estimates from this analysis are unstable and may actually be significantly higher or lower than reported as more research is done.

The picture may well be different in five years, but for now you probably should just ask your grandmother what diseases run in the family and live as healthy a lifestyle as you can.

Susan Love, M.D., one of the "founding mothers" of the breast cancer advocacy movement, continues her work by serving on the boards of the National Breast Cancer Coalition and the Dr. Susan Love Research Foundation. Read more on Susan's blog

It seems that everywhere I look doctors and journalists are talking about how we don't get enough vitamin D. In the breast cancer world, this belief started with studies that showed that women who live closer to the Equator experience less breast cancer. The assumption was made that the reduction in breast cancer rates was linked to the sun and vitamin D.

Even though other studies have been equivocal, everyone is still climbing on the vitamin D bandwagon. A study released last week suggests the issue is more complicated than we would like to believe. In this case, researchers found that giving vitamin D supplements to women with breast cancer did not raise their blood levels of the key breakdown product. Does that mean they should take more? Let's not forget: Too much vitamin D can be dangerous!

The whole controversy reminds me of the beta carotene story. It was first observed that people who ate a lot of carrots had a lower rate of lung cancer. The conclusion was made that it must be the beta carotene, which is a key part of a carrot. When researchers performed a study randomly assigning smokers to take beta carotene supplements versus placebo, they anticipated that there would be less lung cancer in the beta carotene group. Much to everyone's surprise, there were more lung cancers in the beta carotene group.

This was a reminder then -- and still now -- that we have to be careful about getting carried away on what the key component is of any new miracle finding. In the case of the reduced breast cancer rates for women near the Equator, maybe there's something else about being in tropical climes that is important to preventing breast cancer -- and not just vitamin D and sunshine. I don't know the answer, but moving to Tahiti might not be a bad way to find out!

Susan Love, M.D., one of the "founding mothers" of the breast cancer advocacy movement, continues her work by serving on the boards of the National Breast Cancer Coalition and the Dr. Susan Love Research Foundation.

Farrah Fawcett, the television actress bravely dealing with anal cancer, now has a new cancer-related challenge: While previous reports had indicated that she was "stable" and gearing up for a reality TV show to document her life and medical treatment experience, she now reportedly has been re-hospitalized from a complication from a routine treatment. There are also indications that her cancer has spread to the liver. No matter the news, I am sure that Ms. Fawcett will continue her courageous and determined fight.

Also, I don't know how many of you saw the recent reports about Jade Goody, the British reality TV star who tragically died after a very public battle with cervical cancer. In her final month she managed to get married and say very meaningful and poignant goodbyes to her young sons while under a constant media glare.

-Photo by Getty Images-The public nature of Ms. Fawcett's and Ms. Goody's medical struggles serve as a reminder that cancer does not care about celebrity status and that the "cancer experience" has commonalities we can all relate to. When cancer strikes an individual, it fans out to families, friends, and even social media communities. There is nothing entertaining or easy about being a patient or a caregiver for a loved one battling with cancer. That being said, perhaps there can still be a silver lining of hope--even after devastating news--and the will to live life to the fullest.

"Shock and awe" is a phrase that was introduced and quickly woven into our conversations during March 2003. We knew that it conveyed our military's strength and superiority fighting the enemy in Iraq. We were transfixed by the fireworks illuminating the night's sky over Baghdad. Six years have gone by since "shock and awe" transformed our lexicon and eight years since our troops landed in Afghanistan. Battles have been fought in distant lands to protect our freedom and security.

Now we are finally acknowledging that this war is coming home. On March 18, 2009, in two locations in our nation's capital, the truth about this war reached our shores. For years we knew that this was coming, but it was difficult to face. The casualties are not just our troops"the collateral damage includes their families. At the Pentagon, the secretary of Veterans Affairs and the deputy secretary of defense hosted a screening of the PBS special "Coming Home: Military Families Cope with Change"--a show that highlights families who have faced amputations, traumatic brain injuries and post traumatic stress disorder. While at the same time, there was a hearing of the Senate Armed Services Committee to discuss the rise of suicides among military personnel.

What connects these two events is shock and AWE. It is time for our nation to accept and understand a new version of this concept--one still grounded in military strength but now associated with a benevolent action rather than destruction. Military jargon is filled with acronyms. So to continue that long-standing tradition, AWE can be an acronym for "Adaptation to the War Environment." AWE is a normal process that the body and psyche experiences to adapt to the extreme environment of battle in order for a person to survive. By just changing the nomenclature, we can begin to change a climate filled with stigma, fear and humiliation. Instead of saying post traumatic stress disorder or PTSD to describe the signs and symptoms that our troops experience--which can imply victimization, weakness, disability or disease--we can describe it as AWE, a normal reaction to an abnormal situation.