Spicer, reporter take new tone

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Now Playing

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Scientology, explained

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Trump puts China in charge of the future

Saying that it would “start a new era of production and job creation,” Trump signed a sweeping executive order Tuesday scrapping much of Barack Obama’s climate legacy.

Some analysts have expressed concern this could enable Beijing — the world’s leading emitter of greenhouse gases — to water down its own commitments, but others say it is more likely China will step into a leading role in the vacuum left by Washington.

“China now finds itself in the unenviable position of being world leader on climate change, thanks to Trump’s willfully blind irresponsibility,” Mark Lynas, a fellow at the Alliance for Science at Cornell University, wrote for CNN Opinion.

Speaking Wednesday, Chinese Ministry of Foreign Affairs spokesman Lu Kang said the country will “continue to work with relevant parties for enhanced dialog and cooperation, hand-in-hand to manage climate change, to promote efforts to put the global economy on a green and low carbon path, in order to pass on a better future to the generations to come.”

New order

While Trump’s actions may force Beijing into a leadership role, it will not be one for which it is unprepared.

“There has been an embracing of environmental issues generally in China over the last few years,” said Matthew Evans, dean of science at the University of Hong Kong (HKU).

“China is increasingly taking its position on the world stage (as) an economic superpower in its own right.”

Speaking in New York last week, China’s ambassador to the UN Liu Jeyi said “whatever the vicissitudes of the international situation… China remains steadfast in its ambition to reinforce actions in responding to climate change.”

Liu said China is committed to “reducing carbon intensity by 40-45% in 2020 compared with 2005 and reaching the peak of carbon emissions by 2030 or even earlier.”

Carbon intensity levels are measured by a country’s emissions relative to economic output. According to the US Environmental Protection Bureau, China and the US were the biggest emitters of carbon dioxide in 2011, the most recent year for which statistics are available.

“(China and the US) are moving in opposite directions on this issue,” said Alex Lo, an expert on climate politics at the University of Hong Kong.

“The Chinese government has made a lot of commitment officially … those policies and initiatives are not going to stop.”

Push and pull

The events of the past few days mark a dramatic turnaround from 2014, when, under rare blue skies in Beijing, Presidents Barack Obama and Xi Jinping announced plans for a cut in greenhouse emissions by close to a third over the next two decades.

It was a dramatic statement of intent by the world’s largest carbon polluters, and a major win for the Obama administration in bringing China on board as an equal partner in the fight against climate change.

In September 2016, the pair underlined that partnership, ratifying the Paris climate agreement alongside each other in Hangzhou.

Following the election of Donald Trump however, Beijing looks to be standing alone.

Solutions

China is already a world leader is renewable energy.

The country’s National Energy Administration said in January that China will spend more than $360 billion through 2020 on renewable technologies such as solar and wind.
China invested more than $88 billion in clean energy in 2016, according to Bloomberg New Energy Finance, down from an all time high of almost $120 billion in 2015, but still significantly more than the $58.8 billion invested by the US last year.

Lo also predicted that China will take major action to introduce an emissions trading scheme this year, a means of controlling pollution via economic incentives.

“China might be able to take leadership in terms of motivating other partners, particularly those countries in the Asia Pacific region to follow suit,” he said.

China is highly vulnerable to climate change, with 145 million people living in areas at risk of flooding due to rising sea levels, and rampant desertification already occurring in much of the country’s northwest.

Risks

China will not stand alone in terms of tackling climate change. The EU is another major player, albeit one hampered by political divisions over issues such as Brexit and the refugee crisis.
A report by the NGO Carbon Market Watch this week claimed that only three EU countries were currently pursuing their goals under the Paris agreement: Sweden, Germany and France.
US states such as California are also taking action, with Governor Jerry Brown vowing to forge ahead on climate policies regardless of Washington.

“If China and the EU choose to act together then I think between them they can manage a lot of this,” said HKU’s Evans.

“But if the US tears up as many of their climate policies as it’s suggesting they’re going to, that will be a loss.”

“The atmosphere is a global good. You can’t constrain greenhouse gases released in the US to stay in the US, we’re all going to suffer from them,” he added.

Another major risk posed by the Trump administration’s action, according to Evans, is that it may encourage countries to move forward on their own on matters such as geoengineering.
Efforts to hack the planet in order to slow or reverse climate change have been put forward, but critics warn they could have unforeseen runaway effects that leave the world in a worse position than before.

“At the moment there’s a moratorium on any country doing that unilaterally,” Evans said.

But for nations most at risk from climate change, “you have to wonder how much of their country they’re willing to see go underwater before they take action unilaterally to modify the climate.”

Christie will advise Trump panel on addiction

President Donald Trump made the announcement at a meeting at the White House Wednesday, with Christie sitting by his side. Trump introduced him as a “very effective guy” and said the governor will work with representatives in state and local government, as well as law enforcement, medical professionals, and victims to figure out the best ways to deal with this epidemic.

Since 1999, the number of overdose deaths involving opioids quadrupled. From 2000 to 2015, more than 500,000 people died from drug overdoses, and opioids account for the majority of those deaths. It’s estimated 91 Americans die every day from this addiction, according to the Centers for Disease Control and Prevention, and for every death, more than 30 others are admitted to the emergency room.
The Trump administration has said opioid addiction and treatment are priorities. On the campaign trail, Donald Trump spoke about expanding incentives for states to use drug courts and mandate treatment. He also vowed to expand access to treatment slots.
The proposed Trump budget (PDF) released this month highlighted a $500 million increase from above 2016 levels to expand opioid misuse prevention efforts and to increase drug treatment. It is unclear if that increase would be from additional funds, or if it would be from money made available through the 21st Century Cures Act, which President Barack Obama signed in December. That legislation provides $1 billion for drug treatment for fiscal years 2017 and 2018.
Christie has spoken at length about his efforts to end the opioid epidemic. His state has had its share of problems. There has been a significant 16.4% increase in drug overdose deaths in New Jersey from 2014 to 2015, according to the CDC. There were 1,600 lives lost in 2015 alone, which is four times the number of homicides in the state and three times the number of fatalities in accidents that year.

In response, Christie has signed Senate Bill 3, a bipartisan initiative that requires health insurance to cover treatment and substance abuse without delay. “Now, with this legislation, people seeking treatment cannot be denied access in their time of need,” Christie said when signing the bill last month.

The law also creates what Christie called some of the country’s strongest maximum limits on initial opioid prescriptions. That means doctors can only give their patients a five-day prescription for opioid pain pills. Other states, including New York, Massachusetts and Maine, have enacted laws that limit prescriptions, but those limits are typically seven days.

These pain pills can become a gateway to addiction and to heroin use, studies show. New Jersey already had a law that requires doctors to consult with a prescription monitoring database before they prescribe opioid painkillers. It’s one of 29 states to make that requirement.
New Jersey has also created commercials featuring the governor telling people where they can go to get help. The state set up a hotline and created a website.
“As I’ve said before addiction is not a moral failing, it is a disease and the more that we talk about it as a disease, treat it as a disease, regulate it as a disease, the more people will finally get the idea that asking for help is not a sign of weakness, but it is in fact a sign of strength,” Christie said at a press conference last month.

See the latest news and share your comments with CNN Health on Facebook and Twitter.

At a CNN town hall meeting with Health and Human Services Secretary Tom Price this month, addiction recovery specialist and former addict John Brogan credited Christie in part with saving lives in the state. “If it were not for Gov. Christie, there would be 100 more people on top of the 1,600 that we lost last year for this epidemic,” Brogan said.
Christie met with Trump in February at a White House lunch in which the governor said they spent a “good amount of time” talking about the problem and other ways they could fight the epidemic on a “much broader level.

At Wednesday’s White House meeting, Christie said he is honored to take on this task.

“Every life is an individual life from God and no one life is irredeemable, and people make mistakes we all have, and when people make mistakes of drug use, and it is a mistake, we can’t throw their life away,” Christie said.

Huckabee on intel leaks: ‘Is that not treason?’

Story highlights

  • “Is that not treason, when you work against your own government?” Huckabee said.
  • “I don’t understand why there isn’t a great outrage over the leaking of information out of the highest levels of US intelligence,” he said.

“I don’t understand why there isn’t a great outrage over the leaking of information out of the highest levels of US intelligence,” Huckabee, whose daughter is an aide to President Donald Trump, told radio host Laura Ingraham.

Huckabee continued, “This is of grave concern, because if people who are supposed to be guarding our secrets are letting them go — Laura, I hate to use this word, but I don’t know what else to use — is that not treason? Is that not treason, when you work against your own government?”

The former governor also criticized Republican Sen. Lindsey Graham for comparing House Intelligence Committee Chairman Devin Nunes to Inspector Clouseau from the Pink Panther.

“I’m very disappointed in Lindsey,” Huckabee said. “I sometimes wonder what uniform he puts on each morning when goes out to the field to play, and I’m not just talking about the partisan uniform.”

“But I think to bring that kind of criticism and to call the chairman of the House Intel Committee — who is a person of integrity — to call him Inspector Clouseau, to use those kind of terms basically to diminish him, it’s very unfortunate, it’s demeaning, and frankly it just makes no sense,” Huckabee added. “He ought to be calling Devin Nunes and saying, ‘Congressman what do you have? Tell me what you know that you can tell me about, because we need to find out if there’s something going on here that is nefarious.'”

Here are the facts on Trump-Russia ties

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Wife posts nude pic of QB on social media

Nam Y. Huh/Associated Press

Scott PolacekFeatured ColumnistMarch 28, 2017

Quarterback Jay Cutler appears to be enjoying the NFL offseason.

His wife Kristin Cavallari posted an NSFW picture of him enjoying a view of the sea on her Instagram page. Sports Illustrated shared a safer version:

 

Cavallari previously noted on her Instagram page they were moving from Chicago after the Bears released Cutler.

The 2008 Pro Bowler is now without an NFL team at the moment, but he doesn’t seem too stressed about it.

The life-saving treatment that’s thrown in the trash

During a check-up, on his 43rd birthday, his doctor named summertime flu the most likely culprit.

Then the same thing happened again, and it settled into a disturbing pattern: midweek chills and an escalating fever that would break on Sunday. By Monday, Chris would feel fine, only to have the sequence repeat itself.

He joked about it with colleagues at T-Mobile, where he works in software development, “Well, I hope it’s not cancer!”

On alternating weekends from May to October, Chris would volunteer as a back country ranger for the US Forest Service — a physically demanding role that involves patrolling Washington’s Cascade Mountain forests and hiking along high-altitude trails with a backpack that can weigh up to 32 kilograms.

But now, even at sea level, he was getting winded just walking his two dogs around the block. What was going on?

A medical appointment revealed a heart murmur and suspicions of endocarditis, an infection of the heart’s inner lining. The scare triggered another series of tests that led Chris and his husband, Bill Sechter, to Emergency Room 4 at the University of Washington Medical Center.

A whiteboard checklist documented his Saturday morning: insertion of a large-bore IV as a potential conduit for antibiotics, a round of blood draws, and discussions with the ER doctor.

Then the phone rang and the nurse answered, listened and responded to multiple questions in quick succession: “Yes. Yes. Oh, OK. OK. Yeah.” He excused himself from the room and soon returned in a “full hazmat suit”, as Chris describes it. Yellow.

“And that’s when we were like, ‘Oh s***, it’s on. Something is seriously bad.'”

Chris learned that his level of infection-fighting neutrophil cells, normally churned out by the bone marrow, had fallen so low that his defenses were in tatters. He was also severely anemic, with roughly half the normal amount of red blood cells in his blood.

It wasn’t endocarditis. And when one of his doctors performed a blood smear, she saw something on the microscope slide that shouldn’t be there: blasts.

These leukemic cells, stuck in adolescence, were the harbingers of the coming horde that had so astonished 19th-century surgeons.

The doctor apologetically broke the news and Chris and his sister dissolved into tears. In an emotional Facebook post later that day, he attached a picture of himself in a hospital gown and pink face mask and wrote: “this avowed agnostic could actually go for your good juju / positive thoughts or even your (gasp) prayers.”

More tests, including a bone marrow biopsy of his pelvic bone, painted an increasingly disturbing picture. He had acute myeloid leukaemia, a fast-progressing cancer.

The biopsy suggested that an astonishing 80 per cent of his bone marrow cells were cancerous. Strike one.

Chris Lihosit was diagnosed with acute myeloid leukaemia, a fast-progressing cancer, in 2015.

Other results suggested that chemotherapy wouldn’t be as effective on his form of leukemia. Strike two.

And genetic tests put him in the unfavorable risk category by revealing that his cancer cells carried only one copy of chromosome 21, a rare anomaly associated with “dismal” outcomes, according to recent studies. Strike three.

Chris needed to start chemotherapy immediately.

But first, he had his sperm banked. Then, with family and a close friend at his side, he celebrated his impending treatment with prime rib and cheap champagne smuggled into his hospital room.

Over three days, he received multiple doses of the anticancer drugs cladribine, cytarabine and mitoxantrone, the last a dark blue concoction often dubbed “Blue Thunder.” The drug turned his urine a shade he describes as “Seahawks green” in honor of Seattle’s football team. Other patients have had the whites of their eyes temporarily turn blue.

On the third night of his drug infusion, a sudden back pain grew into an intense pressure in his chest that felt like he was being stabbed. A heart attack? An emergency CAT scan instead revealed two newly formed blood clots: one in his right leg and another in his right lung — not uncommon consequences of chemotherapy.

Over the next six months, Chris would need transfusions of blood-clotting platelets whenever his level of them dipped too low, and daily injections of a blood-thinning drug whenever it rose too high.

Thirteen days after being admitted into the hospital, he posted a more hopeful Facebook entry: “And I’m finally going home! Now the real adventure begins.”

New hope

Based on his leukemia classification, Chris was braced for multiple rounds of chemotherapy. He and his husband were overjoyed when a second bone marrow biopsy suggested that the leukemia had become undetectable after only a single round.

Because of his high-risk classification, however, Chris’s doctors said that the cancer was likely to return without a bone marrow transplant.

But Chris discovered that he had inherited an extremely rare set of cell-identifying protein tags. Only one bone marrow donor on the worldwide registry matched his genetic tags, and that person was unable to donate.

An umbilical cord blood transplant, Chris and his doctors agreed, was his best hope.

Like bone marrow, cord blood is unusually rich in hematopoietic stem cells — which can give rise to every type of blood cell — and their more developed descendants, progenitor cells, which are more limited in what they can become. But, unlike bone marrow, cord blood can be collected in advance and stored for decades in liquid nitrogen.

First, Chris would need to spend another five days in the hospital for a standard follow-up round of chemotherapy to pick off any hidden cancer cells. Chris marked the occasion with a Facebook post of himself in a grey felt Viking helmet and attached braids. “Round 2… And FIGHT!” This time, the chemo went off without a hitch.

He was a familiar face at the medical center, though, with three additional hospitalizations: twice for bacteremia, a bacterial blood infection marked by high fevers, and once so doctors could tame an allergic reaction to a transfusion of platelets, which always reminded Chris of chicken broth.

He had to steel himself again on Christmas Eve for the arrival of the “big guns”: two days of conditioning chemotherapy, headlined by a derivative of mustard gas. Its name is cyclophosphamide, and it works by sabotaging the machinery that copies DNA in rapidly dividing cells. As it does this, it breaks down to form toxic chemicals, including a pungent one called acrolein, which can destroy the lining of the bladder.

To neutralize its effects, patients must take another drug, called mesna, and drink plenty of water.

After a day of rest, Chris began a radiation therapy regimen so intense that it would have killed him if delivered in a single dose. Instead, his radiologists used a particle accelerator to fire X-rays at him in multiple bursts during morning and evening sessions over four days.

“You basically get into a tanning booth made out of clear Plexiglas,” he said.

Wearing nothing but a paper gown, Chris had to stay completely still behind two metal shielding blocks, each the size of a brick, positioned to protect his lungs from irreversible radiation-induced scarring. He did get a mild tan, he says, along with damaged skin that still resembles crepe paper.

Another absurdity still makes him laugh: while he requested punk rock for one of the sessions, he was instead blasted with the tune of Prince’s ‘Erotic City’.

When he finished the final round of total body irradiation on 30 December, the radiology team gathered for a final tribute and let Chris hit a small ceremonial gong.

Help from newborns

The morning of New Year’s Eve, Chris wrote on Facebook, “I’m as nervous as an expectant father!” An hour and a half later, he marked the delivery of his “zero birthday” with a small chocolate cake and a decorative “0” candle: the day when his own bone marrow cells, erased by radiation and chemotherapy, were replaced by roughly four tablespoons of a life-granting elixir from the cord blood of two baby girls.

Even with some of the best help that medicine can offer, transplant recipients face a daunting few weeks without functional bone marrow when nearly anything can kill them.

Chris and Bill have nicknamed the donors Amelia and Olivia based on their blood types, A-negative and O-positive. In a later post, Chris marveled at the new arrivals reseeding his bone marrow: “I use more vanilla flavoring creamer in my coffee than the volume of cells that are rebuilding my entire blood and immune system.”

Four hours after the initial infusions, he received his protective bridge of blood-forming stem cells, collected and expanded from the cord blood of a third baby, a boy he and Bill have nicknamed Eddie.

Less than three weeks after the transplant, Chris’s neutrophils had fully engrafted and genetic tests suggested that Amelia had decisively won the fight to form his new blood and bone marrow. He progressed so rapidly, in fact, that he had to stay in the hospital for two days after he was fit to leave, so that Bill could finish preparing the apartment.

28 January: discharge day. As his family packed up his hospital room, Chris was taking a shower when a wall of exhaustion hit him. He could no longer stand or even dry himself off and sat dripping on the shower bench until Bill heard his calls for help.

He had survived, but life had fundamentally changed.

At home, every surface had to be disinfected daily with a bleach solution. At first, Chris couldn’t walk 100 feet down the apartment hallway without leaning on his brother. Until he hit the 100-day milestone after his transplant, the end of the most vulnerable period for recipients, he returned to the Seattle Cancer Care Alliance every other day for blood tests and checkups.

On the 97th day, Chris and his family celebrated a hard-fought victory when he was officially declared cancer-free: a leukemia survivor.

Cord blood today

Despite dozens of studies documenting its curative powers, cord blood is saved after only 5 per cent of all US births. The rest is simply thrown away.

Michael Boo, chief strategy officer for the National Marrow Donor Program, estimates that only one in ten of those retained units passes the required screening tests and has enough volume to merit long-term storage.

Cord blood is also notoriously expensive, ranging from $22,000 to $45,000 per unit. Due to the relatively low demand from doctors, Boo says, public banks — at least in the US — are collecting as much as they can afford to keep. Beyond persuading new parents to donate, then, lowering the cost of cord blood transplants may depend upon persuading more doctors to use the cells and more insurers to cover them.

One potential use has attracted the avid interest of the Biomedical Advanced Research and Development Authority, part of the US Department of Health and Human Services. As part of Project BioShield, the federal agency has been on the lookout for medical interventions that could treat acute radiation syndrome after a dirty bomb or nuclear disaster.

Keeping people alive

Cord blood transplants in adults, still an option of last resort in the early 2000s, nearly slammed to a halt over the quandary of how to keep patients alive until their new bone marrow cells could kick in.

Some researchers reasoned that they could boost the transplant volume by giving adults two cord blood units instead of one. John Wagner and colleagues at the University of Minnesota performed the first double transplant in 2000, using cells from two infant donors.

The tactic dramatically reduced the rate of graft failure, in which the recipient’s body rejects the new cells. But it barely changed the time needed to regenerate the bone marrow, and some critics have questioned whether a double cord blood transplant offers any significant benefits.

Wagner says his research suggested that transplanting enough blood-forming cells was necessary − but likely not sufficient − for better results. Improved patient survival, in fact, seemed to depend more upon a revised roster of drugs given pre-transplant.

Blood is extracted from an Umbilical cord at UCLH in London.

To their surprise, researchers also discovered that the donors in a double cord blood transplant seem to battle for dominance, a curious “graft-versus-graft” phenomenon that almost always results in the victor dominating the recipient’s new bone marrow and blood cells.

Filippo Milano, associate director of the Cord Blood Program at the Fred Hutchinson Cancer Research Center in Seattle, compares it to a pivotal scene in the 1986 movie Highlander, when the antagonist exclaims, “There can be only one!”

On a sunny morning nearly a year after Chris’s transplant, he and I meet the Italian-born doctor in his lab so he can greet one of his star patients and explain the science behind the therapy that saved Chris’s life. Milano is passionate about coaching soccer and cooking. On the side, he jokes, he conducts research on cord blood transplants.

Upon his arrival to “The Hutch” in 2009, Milano teamed up with Colleen Delaney, founder and director of the Cord Blood Program, to test and refine a treatment strategy that may yet prove a better option than a bone marrow transplant for people with leukemia who are at high risk of relapsing.

Based on collaborations and discussions with other experts in the field, Delaney pioneered a method to minimize the risk of infection and bleeding after a cord blood transplant by reducing the time needed for the new blood cells to kick in. The strategy relies on what she and Milano call an “expanded” blood unit.

Starting with an extra batch of cord blood, they separate out the minuscule fraction of blood-forming stem cells and their early descendants and expand that population in the lab.

The hundreds of millions — even billions — of resulting stem and progenitor cells can jump start the generation of protective blood cells in the recipient. When infused along with a more traditional transplant, they can act like a temporary bridge until the replacement bone marrow takes over. “The net gain was that you didn’t have those very prolonged periods of recovery,” Wagner said.

Blood extracted from an umbilical cord and placenta by a member of the Cord Bank Team at NHS Blood and Transplant.

One crucial component, Delaney discovered, is a protein called Notch ligand.

When added to the blood-forming stem cells, Notch ligand lets them divide quickly in the lab but temporarily pauses their development by preventing them from maturing into the normal range of cell types. Critically, they never give rise to T or B immune cells, which would seek out and destroy any perceived threats lacking the proper “self” ID tags.

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Putting a donor’s T cells into an unmatched recipient, Delaney says, would trigger fatal graft-versus-host disease. “That’s the key: we get rid of all those bad parts of the immune system that need to be matched or they can kill you.”

The “bridge of recovery” lasts only so long before the full contingents of other donor cells begin attacking and dismantling it. But, with no cells checking IDs initially, the early flood of blood-forming stem cells need not be matched to the recipient at all, meaning that the “expanded” cord blood unit could be created well ahead of time and used whenever needed as a universal donor.

Other researchers are working on strategies toward the same end, and Mary Laughlin describes the overall progress as “very exciting”.

Delaney’s work, she says, “is very important, saving lives and improving the tolerability of these transplants and the success of these transplants”.

This is an edited extract from an article first published by Wellcome on Mosaic. It is republished here under a Creative Commons license.

Luxury getaways for younger travelers

From perks like organic baby food and child-sized bathrobes to larger hotel suites and more kid-focused activities, the luxury travel market is catering to much younger travelers.

In the past year, the St. Regis has seen a 20% increase in families staying at its properties.

Older parents with more money are helping to fuel the trend, said Paul James, global brand leader for the St. Regis, The Luxury Collection, and W Hotels.

“We are seeing people in their 40s with young children,” James said. “By the time you are 40 and made money, you don’t want to stay at the cheap motel down the road. You don’t compromise your lifestyle.”

He added that seeing kids at the front of a plane is becoming more common. “I flew back in January, and everyone in the business cabin had a child with them.”

As more travelers bring their families along, experts said demand for larger suites and villas at hotels has increased. For instance, at the St. Regis in Bali, villa suites sell out 10 times faster than the main hotel suites, James said.

Related: Bored of your superyacht? Try a submarine

Luxury hotels are also stepping up their child-focused amenities and activities.

“Parents want to go and have adult experiences, but also want to make sure their kids will be catered to,” said Kara Slater, a travel agent with SmartFlyer California who specializes in family travel.

At the Four Seasons Resort in Orlando, children are normally welcomed with chocolate alligators or organic baby food and receive child-size bathrobes.

Guests ages 4-12 at The Resort at Pelican Hill in California can attend Camp Pelican where each day’s supervised activities have a different theme like Treasure Island Tuesdays or Space Exploration Fridays. The clubhouse has digital microscopes, video games and computer stations. A full day at the club runs $90 and $60 for a half day.

Parents looking for some alone time in the evening can send their travel companions to Kid’s Night Out, which includes dinner, movie and popcorn for $60.

Latitude, a program for teens, runs $15 an hour ($50 for a half day) has daily activities including surf and kayak camp. And the lounge has Netflix-connected TVs, video games and a special food menu.

The resort also offers a three-hour Children’s Resort Etiquette Class for guests ages 7-12 that teaches travel and social etiquette.

The room service menu includes “ants on a log” (celery with peanut butter and raisins on top) and veggies and hummus, according to Kate Starr, spokeswoman for the resort.

Related: The river cruise craze goes high-end

Families aren’t just heading to the traditionally kid-friendly spots, but are seeking out more exotic locations. Hawaii and Europe are popular, according to Slater.

Authentic experiences are also a priority for people traveling with kids, said Dan Austin, president of Austin Adventures.

“We see families often start out with a domestic vacation, like Yellowstone, and the next year they head to Alaska or the Canadian Rockies. By the third trip, they are looking at Peru, Belize and Costa Rica.”

CNNMoney (New York) First published February 26, 2015: 10:36 AM ET