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Nancy L. Brown, PhDAdolescent Health
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The Importance Of Education

Nancy L. Brown, PhD
When you think about it, after unconditional love and attention, there may be nothing more powerful a parent can give a child than education. Education brings with it adult mentors who care about kids, knowledge about health, the world, character-building experiences, a responsibility to participate in government, and a sense of unity with the world. Truly exceptional education impacts the whole person, body, mind and soul, instills in a child a love of learning that will guide an entire life, and inspires creativity as well as passion!

On a more practical note, research shows us that a perceived connection to school is a powerful predictor of resilience for all children, providing a safety net of sorts, no matter what family or community they are growing up in. Teens who are connected to school are also less likely to be participating in high risk activities, like drinking, smoking, and early sexual activity.

Giving a child an education not only keeps them busy, it opens up their world and helps them understand the interconnectivity of systems - the earth, human bodies, families, neighborhoods, communities, countries, and the universe. I truly believe that it is hard for a well-educated person to fail in life - because there are always new ways to approach problems.

Providing an education can be as simple as finding a great school that brings out the best in your child, but being involved with that education is also important. Making time to spend time at school volunteering and connecting with your children around educational activities, like reading, shows your child that education and s/he are your priorities.

Other things you can do to support that education include:
Thinking back on my own life growing up in a pretty dysfunctional family, I have always believed I "made it" because although I could not change my family, I could be successful in school and found adults who believed I was smart and worthwhile, which kept me doing well in school. I remember several moments quite clearly: 1) in 7th grade Mr. Rayburn, a social sciences teacher told me I should go to college because I was really smart (this is in a rural community in the early 70's when few people went to college); 2) sitting in new student orientation at SJSU, a professor suggested those of us who believed in interdisciplinary education and social change should consider a program called New College; and 3) sitting in my first graduate class at Stanford wondering how I would ever fit in with my classmates, and deciding that reading all the "classics" (they had read in their ivy league educations) might help.

Education cannot be taken away - it becomes a part of the person learning something and transforms that person as it happens, bringing self-confidence, curiosity, joy, creativity, and yes, responsibility.

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Sports and Injuries in Teens - Tennis Elbow

Nancy L. Brown, PhD
Tennis elbow or a unilateral collateral ligament (UCL) tear is common in young athletes that play baseball or football and throw javelin, but can occur at any age. This injury seems to occur more in less-skilled players, suggesting that good technique and conditioning are important.

It is a tear in the UCL that normally occurs when the strain of one pitch/throw becomes too much for the ligament to take. This doesn’t build up over time as other injuries do, but is an acute injury that happens all at once. The over use causes inflammation & pain in the muscles that attach to the elbow. It gets sore to the touch and hurts to grab (grip) things and shake hands.

The treatment is generally reconstruction. The UCL is removed and then replaced with a tendon from the wrist or a section of the hamstring. However, if surgery is not required you can cut back on the activities that hurt and avoid repetitive activities. You can ice the area and take Ibuprofen to reduce the inflammation. Finally, as it gets better, do wrist curls with increasing weight – palm down.

It will take several weeks to six months for people to get better, but most do. Take it slowly and use a brace or tennis elbow strap to reduce the muscle pulling on the elbow. Physically therapy helps some people, as does ultrasound therapy.

Prevention includes two-handed back strokes, which is less hard on the body than a one-handed back stroke.

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Sports and Injuries in Teens - Osgood Schaltter

Nancy L. Brown, PhD
Osgood-Schlatter disease (also called Schlatter's disease or osteochondrosis of the tibial tubercle) is inflammation in the top of the shinbone (tibia) where the patellar tendon attaches to a bony mound in the knee called the tibial tubercle. This disease, a common cause of knee pain in children between the ages of 10 and 15, usually flares during periods of rapid growth and then goes away at the end of the child's growth spurt.

This injury is commonly seen in volleyball, basketball, track, soccer and field hockey athletes. It is brought on by banging the knees – a direct injury and overuse of tendon. Seen in girls earlier than boys because girls go through puberty earlier. Frequently seen in girls around 11-12 and boys 13-14.

Signs and symptoms of Osgood-Schlatter disease include pain and tenderness in front of the knee and mild swelling or a bump below the kneecap at the top of the shin. This disease usually affects only one knee, though occasionally it affects both knees. Symptoms get worse with exercise or activity, such as jumping, that stretches the tendon and puts traction on the tibial tubercle. Teens usually start feeling pain and then a bump below the knee comes up after about 1-2 months of pain/discomfort. The bump hurts because the place where the tendon attaches to the tibia is inflamed.

The condition does not require any specific medical treatment. Most children outgrow the problem within two years. To lessen symptoms the teen first needs to reduce the jumping. S/he can also ice the area after playing, and take Ibuprofen to reduce the inflammation. All activity does not need to stop, but reducing the activity for 6-18 months might be required. The athlete can actually play with the pain – unlike many other injuries.

There is no quick cure. Sometimes (rarely) surgery is required to trim the bone and reattach the tendon, but that will shut down an athlete for a long time.

There are things you can do to prevent this like wearing knee pads in volleyball and basketball – to protect the knee if you hit it on the court.

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Thank You - Grand Rounds 4.49

Nancy L. Brown, PhD

Thanks to Theresa Chan at Rural Doctoring for including my Back-To-School post in this week's Grand Rounds.

This week was a beautiful read - I loved the Shakespearean theme and my fvorite line was "Create for eternity. Let every word pierce the heart."

Photo credit: Ed Bierman

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Helping Teens and Preteens With Homework

Nancy L. Brown, PhD
Sticking to the back-to-school theme, homework is likely to become an issue for most families very soon. For many families, the quantity, organization, completion, and thoroughness of homework is a serious source of stress.

I humbly suggest that before the nagging or argument starts, that you sit down with your preteen or teen during the first week of school and have a serious conversation about homework - what the issues have been in the past, expectations for this year, and ways to get around any issues you have had in the past. As always let your child know that this conversation is happening because you really love him or her, want him or her to be successful in school, and are willing to help with that goal. If you agree with the premise, remind them that you are more worried about the learning than the scoring.

Lay out the school expectation that your child can expect 30-120 minutes of homework a day (depending on their age) and then talk about what the issues have been in the past. If it helps, talk to teachers that you and your child like at school to get some suggestions. Then ask your child what they think is going on - is it not having a set place or time of day or evening to complete the work, is the schedule too busy, do they feel like they study enough but still do not do well on tests, does the T.V. or computer get in the way? Do they have difficulty concentrating?

You may find that the child's study skills are not what you thought or that they need some reminders to use flash cards, memorizing help, or that there are really auditory or visual learners and need to study in a different way. If they have not been doing well in a particular class, try different ways of studying. Maybe they learn by listening, so try asking them to explain the concepts to you, or maybe they need help memorizing, so prepare flashcards and drill them each day during a time they are usually relaxed and happy. Maybe the issue is concentration and some meditation training can help.

Whatever method you come up with, try and arrange your life so you can be with your child(ren) when they study, be interested in the subjects and offer to help and even check their work when they are done. If just being close is enough, you can do your own work at the same table, gladly helping if they need the support.

When it gets tough, just remember that most children want to succeed and please the adults they love - they are not trying to do poorly and chances are good that if you set your mind to it, you can find a way to help them succeed. Good luck!

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Back-To-School Boot Camp

Nancy L. Brown, PhD
It is that time again - school is starting or will be starting soon. You can make the transition a little smoother by starting a week early to get those school-related habits back into your lives.

Schedule
It is time to start going to bed earlier and getting up earlier, or with teenagers, sometimes it means just getting them up and out of the house earlier and after a few days they drop off earlier - due to sheer exhaustion. Remember teenagers need 9 - 10 hours of sleep a night. If they are not getting it, try to make some changes in your family schedule so that they can start.

Organization
Is their locker stocked? Are their binders set up? Do they have PE clothes and shoes that fit? Is there a clear place on their desk or the kitchen table where they can do their homework? Have you talked about how they will get to and from school, practice, classes, appointments?

Who makes lunches and what goes into them? Do they need to do morning chores? Who makes breakfast and what are the options? Do your kids need to have their clothes laid out and everything packed in their backpacks near the front door before they go to bed at night? You might start practicing that.

Expectations
Have you taken some time and talked about the expectations you have for your child this academic year? Is it their freshman year and you just want them to "get a grip" on the high school work load, is it their sophomore year and you expect strong grades before they start driving, is it their junior year when grades might really matter? You may have some really clear expectations, but unless you share them with your teen, they may not share you thoughts.

Good luck and have a great school year!

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Thank You - Grand Rounds 4.48

Nancy L. Brown, PhD

Thanks to Kerri at Six Until Me for hosting Grand Rounds 4.48 this week and including a post from Teen Health 411 about stress fractures.

This week was fun reading and I loved the theme of the card catalog - which I know my kids have never even seen.

Photo credit: Ed Bierman

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Happy 2nd Anniversary Teen Health 411 Readers

Nancy L. Brown, PhD
Hard to believe that Teen Health 411 has been around for two years, but to celebrate, I thought I would give a gift to you, the readers. Below is an index of articles from the last two years, by label!

I hope you enjoy being able to read posts on Teen Health 411 by subject, and thank you for being a reader! Let me know if you like this - and I will pass it along to Healthline.

Abortion (4)
When Denial is Not the Best Choice
Unwanted and Teen Pregnancy in the Media
Supreme Court Restricts Women's Reproductive Freedom
Confidential Reproductive Health Care and Teens

Advertising (4)
Can't Buy My Love ...
Shame on RJ Reynolds Tobacco Company
U.S. Food Companies Promise to Limit Food Advertising to Kids
Selling Food to Children: Why is Obesity a Problem?

Alcohol (9)
Alcohol Use and Teens: The Role of Adults
Teens and Alcohol: What is Normal?
Social Norms and Teen Drinking
College Students and Stress
Drugs, Brains, and Behavior: The Science of Addiction
Alcohol Use and School Attachment
Teens Who Work May Be In Danger
Unintentional Injuries ...
Substance Abuse: Teens & Young Adults

Beauty (7)
For Goodness Sake - Cosmetics Can Kill You
Protect and Care For Your Skin
Seventeen Magazine and the Body Peace Project
Onslaught Video by Dove
Hair Removal and Beauty
Embracing Healthy Skin
Reality TV and Teen Health
Shaving Pubic Hair

Biking (1)
Bike Safety and Manners

Body Art (3)
Tattooing & Body Piercing
Oral & Dental Complications of Piercing
Piercing & Teens

Body Image (8)
The Care & Feeding of Adolescents
Protect & Care for Your Skin
Girls & Body Image
Body, Self-Esteem, Gender & Race
Prom Dresses for Girls Size 16+
Weight Loss Ads & Young Girls
Healthy Living: A Teen Perspective
Teen Body Image

Boys (7)
A Boy Crisis
Males, Romance & Success
Teen Boys & Romance
Boys: The Teens We Ignore
Teen Boys & Healthcare
Are Males Dominant, Disconnect & Dangerous
Manorexia: Males & Eating Disorders
Boy's Guide To Becoming A Teen

Bullying (11)
Cyberbullying & Fear
Fashion Bullies in Middle School
Setting an Example
Best Practices in Bullying Prevention
School Bullying
Cyberbullying
LGBTQ Harassment
Schools & Parents Taking Action
Harassment & Bullying
Cyberbullying
Bullying & Teens

College
(13)
The Used To Be Empty Nest
The Launching Years Part 1
The Launching Years Part 2
College Students & Stress
Education Update
A Gap Year
Stanford Here We Come
College Applications & Facebook
Is Character As Important As Grades?
PSAT Scores & College Prep
When Your Kid Goes To College
Are Teens Emotionally Ready For College?
Teens Leaving For College

Community Service
(2)
Traveling With Teens: Part 3
Community Service & Teens

Divorce
(1)
Now What Do I Do: A Guide For Teens

Driving (7)
Hands Free Law
Fewer 16-Year-Olds Driving
July 2008 Bans Cell Phones
Preparing Parents for Teens to Drive
Teens Admit Risky Driving Habits
Teen Driving Risks, Guidance for Parents
Drivers Education & Teen Fatalities

Eating Disorders (5)
Eating Disorders and Teens 1
Eating Disorders and Teens 2
Weight Control in Middle School
Eating Disorder Support On The Web
Orthorexia: The Newest Eating Disorder

Emergency Contraception (4)
Plan B Use Increases
Emergency Contraception Survey
Plan B Available to Teens One Way of The Other
Plan B or The Morning After Pill

Emotional Health (4)
Teens and Depression
Mentors Make A Difference
Parenting As Inspiration
Cutting To Relieve Emotional Pain

Employment (7)
Gen Y Employees Not Engaged
Which Teens Work - If They Can Find A Job
The First Day At Work - for Teens And Parents
Labor Force Participation For Teens Is Only 41%
Finding A First Job As A Teen
Teens Who Work May Be In Danger
Teens And Work

Financial Education (3)
Families Struggle To Make Ends Meet
Vacation & Financial Education
Your Kids & Investing
Financial Fitness For Teens & Preteens

Fitness and Sports
(7)
Youth Need More Exercise
Girls Are Champions
Celebrating Girls & Women In Sports
Sports & Injuries In Teens - Stress Fractures
Girls & Sports
Sports and Injuries In Teens - ACL
Sports-Related Injuries Among High School Athletes

GLBT
(10)
In Memory Of Larry King
Bullying Of LGBT Teens
Rainbow Project Book List
Literature For Transgender Youth
Talking To Your Kids About Homosexuality
Colage: Children of Lesbian & Gay Parents
GLBT Movies To Share With Your Teens
Gay Teens
Suicide Risk & LGBT Youth
LGBTQQ Youth

Health Care (8)
HIV & Your Grandparents
One In 150 Children Has Autism
High Blood Pressure Undiagnosed in Teens
Staph Infections & School
Heart Attacks Can Occur In Teenagers
Teen Health Rights
Getting Teens Hooked Into Preventive Health Care
Breast Cancer & Teens

Health Facts (6)
For Goodness Sakes - Cosmetics Can Kill
FDA Warning About Products
Sleep Awareness
The Muscle Cramp
A Quart Of Mucus Every Day
Body Drama Review

Hobbies
(2)
News For Twilight Fans
Breaking Dawn Review

Holidays (11)
Happy Valentine's Day
Post Holiday Blues
Looking Back on 2007
Happy Thanksgiving
Gratitude & Abundance
Holiday Letters
Teens & Mothers
Coming Of Age
New Year Ritual
Blessings For The Holidays
Teen Health & Holidays

Injuries
(4)
Emergency Preparedness For Teens
Unintentional Injuries
Sports-Related Injuries
Leading Causes Of Injuries

IUD (2)
IUDs For Teenagers
The Intrauterine Contraceptive (IUC)

Media (20)
Youth Trends Entertainment Results
New Media In The Everyday Lives Of Youth
Unwanted And Teen Pregnancy In The Media
Pew Report On Teens & Social Media
Provocative Campaign On Childhood Mental Illness
Web Resources For Parents, Tweens & Teens
Manhunt 2 Rating: Mature or Adults Only
Judge Blocks State Video Game Ban
Teens, Tweens & Technology
Cybering - Scary Or Safe?
It Is T.V. Turn Off Week
Are Violent Video Games Really Bad?
Sexy Girls
Violent Girls: Who Do You Believe?
Turn Off The T.V.
Media Multitasking Among Young People
Teen Hearing & Music
Teens And The World Wide Web
Reality T.V. & Teen Health
Media Literacy & Smoking

Mental Health (13)
Do You Have A Cutting Problem?
DNA And Autism Risk
Successful Health Teens Are Often Ignored
Surviving Teen Suicide Attempt
Teens & Stress
Mental Health Challenges & Resources - Older Adolescents
Connection
Emotional Well-Being
Post-Traumatic Stress Disorder Research
Surviving A Borderline Parent
Helping Stressed Students
Get Ready for That Feeling of Rejection & Failure
CA & College-Bound Grads

Mentoring (2)
Mentors Make A Difference
School-Based Mentoring Programs

Nutrition (3)
Sugar And A Soda Free Summer
Free Fast-Food Nutritional Details
Carbohydrate Counting; Teens Beware

Obesity (12)
Weight Loss Confidential
Metabolic Syndrome & Teens
Meals Matter: Dairy Council
Obesity Rising Among Asian Children
High Blood Pressure Undiagnosed In Children & Teens
Summer Vacation & Obese Teens
US Companies Promise to Limit Food Advertising
Selling Food To Children: Why Is Obesity A Problem
Are You Or Your Teen A Couch Potato?
Online Food Advertising
Health Consequences Of Soda Consumption
The Epidemic Of Childhood Obesity

Online/Internet Safety (7)
Totally Wired
Family Internet Safety Site
What Puts Teens Online At Risk?
Technology & Today's Tweens And Teens
Teens, Privacy & Online Social Networks
A New Online Safety Group
Child Internet Safety

Parenting (33)
I Won't Grow Up 1
I Won't Grow Up 2
Great Parent Resource
Happy Mother's Day
A Parenting Book That Could Change Your Life
Unconditional Love: How Hard Can It Be?
Preeten PMS: What Is A Parent To Do?
Dear Ms. President
Post Holiday Blues?
Looking Back on 2007: Teen Health
Bring Back Home Economics!
UCAN Teen Report Card - Teens Grade Parents
Safety & Empowerment - How To Balance Risk For Teens
Preteen Summit - Food For Thought
Does My Tween Or Teen Need A Flu Shot?
In Case Of Emergency (ICE)
Parenting Teens Online Resource
A History of Manga
Tea Time With TeensTotal Momsense by Anita Renfroe
MOMfulness Book Review
Peaceful Meditation For Parents Of Teens
Board & Card Games For Family Bonding
Parenting As Inspiration
Cyber Chores
Mothers & Community
Parenting In The 21st Century & Blogs
What Every Parent Should Know About School Involvement
The Importance Of Touch And Teens
Parent-Child Connectedness
Support For Depressed Parents Of Teens
Organized Activity Participation Or Over-Scheduling - Which is Better For Youth?
At-Risk, Privileged, and Pressured
Parenting Preteens

Pregnancy
(7)
Stigma & Teen Pregnancy
Teenage Birth Rate Increased in 2006
Six Steps to Increase Unintended Pregnancy
Reasons For Unprotected Sexual Intercourse
Contraceptive Use is Reducing Adolescent Pregnancy

Preteens (4)
Girls Guide To Becoming A Teen
The Care & Feeding Of Adolescents
Early Pubertal Development - Girls
Preteen PMS - What Is A Parent To Do?


Relationship Violence
(5)
Dating Violence In The News
Abusive Relationships
Internet-Based Abuse Hotline
Dating Violence 1
Dating Violence 2

Relationships (4)
Love is Respect
Males, Romance & Success
The ABCs of Healthy Teen Relationships
Teen Boys & Romance

Research (2)
Summary Of Health Statistics
Abstinence Only Programs

Safety (3)
Stroke - Do You Know The Warning Signs
Stranger Danger
Violence & Schools

School (13)
Homeschooling Banned In CA?
Small Class Sizes & Health
Expanded Learning Time in School
Back-To-School Basics

Self-Injury (1)
Bodily Harm

Sexuality (17)
Freedom = Less Sex
Are Teens Having More Oral Sex?
A Global Perspective on Teen Sex Habits
What is Hooking Up?
Unhooked
Loose Women On Campus
Speaking Out About Adolescent Sexuality
Relationships & Sex
Good Sex = Good Communication
The Incredible Melting Condom
YRBS
Motivation To Have Sex?
Religion & Teen Sexual Behavior
Is It Consensual Sex Or Rape?
Abstinence In The News
Sexuality Education Is Failing Miserably
Facts About Teen Sexual Activity

Sexuality Education (13)
Sexual Risk Reduction Information To Parents
Congress Extends Funding For Abstinence Education
Parents & Sexuality Education
Plain Talk About Adolescent Reproductive Health
The Birds, The Bees, and Me
Condom Availability In Schools
Fathers, Daughters & Virginity
Religious Declaration On Sexual Morality
Teens & Sexual Health
Teens & Sex
HIV Among US Adolescents
Abstinence-only versus Comprehensive Sexuality Education
Teens & Condoms

Sexually Transmitted Infection/Disease
Birth Control In Middle School?
Mycoplasma Genitalium
Telling Someone They May Have An STD

Chlamydia (5)
1-in-4 Sexually Active Girls May Have An STI
US #1 In Chlamydia Cases
Condoms Prevent STD: Duh!
Chlamydia & Teens
Reproductive Health & Teens

Herpes
(1)
Genital Herpes (HSV 2) And Teens

HIV (11)
HIV Infection in People Over 50
Role Of Fathers in HIV Prevention
HIV & Your Grandparents
Girl Positive
Internet & HIV Prevention
HIV & African American Teens
Hormonal Contraception & HIV
HIV Infection & Teens
Teens & HIV Vaccine Trials
Routine HIV Testing

HPV
(8)
New HPV Vaccine
HPV Update
HPV Vaccines For Boys?
More Q & A About HPV Vaccine
Link Between Oral Cancer & HPV
Could 1 In 4 Women Have HPV?
New Hampshire Offers Free HPV Vaccine
Adolescent Immunizations

Sleep (6)
Women & Sleep
Sleep Awareness
Summer Slugs - Sleep & Teens
Teens Having Trouble With Sleep
Sleep In The News

Smoking (1)
ADHD, Lead & Smoking

Substance Abuse (9)
Social Norms & Teen Drinking
Teen Marijuana Use
Drugs, Brains & Behavior
Alcohol Use & School Attachment
Caffeine & Youth
Substance Abuse
Misuse Of Stimulants
Teen Smoking
Drug & Alcohol Use Leveling Off

Suicide (2)
Youth Suicide Rates
Helping Prevent Suicide

Tanning (2)
Sun Safety
Skin Cancer & The Beautiful Tan

Tragedy (1)
Virginia Tech

Travel (6)
Summer Camp & Independence
Staycations With Teens
Planning Vacations With Teens
Traveling With Teens 1
Traveling With Teens 2
Preparing Your Teen/Preteen For Being Away From Home

TV (1)
TV May Hurt Attention & Learning Skills

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Sports and Injuries in Teens - Stress Fractures in the Lower Back

Nancy L. Brown, PhD
A doctor I work with recently said she was concerned by the increase in lumbar stress fractures she was seeing in young athletes. She said she used to see it mostly in gymnasts but now she was seeing it in teens who play all kinds of sports.

We hypothesized it might be the long hours of practice and tournaments on weekends that sometimes include 6-8 hours of play a day. I also think it may reflect the increasing tendency for parents and teens to "raise the bar," in academics, athletics, everything - to give our children the best chance of success that we can.

To get some more information, and a different perspective, I went to Jolie Bookspan, my favorite Fitness Fixer. Jolie had a couple of interesting hypotheses including an increase in lumbar stresses from severely overarching (increasing inward curve) of the lower back, and some really bad sitting posture habits. In addition, Jolie is concerned that teens are not getting enough exercise or spending enough time in the sun to have the strong muscle and healthy bones that would protect them from these fractures.

Another concern is that the young athletes have typically been experiencing pain for quite a while before seeking care, making the diagnosis and treatment more difficult. Teens should not be experiencing back pain. If your teen complains of back pain, please see his or her doctor.

Photo credit: Fitness Fixer

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Gen Y Employees Not Engaged?

Nancy L. Brown, PhD
Results from a global study by Blessing White called "The State of Employee Engagement 2008" reported that Generation Y employees are the least engaged in the workplace on four continents. In North America, the report suggests that only one out of three employees is engaged.

The report is based on 7,500 individuals and interviews with 40 senior human resource and line managers, with the bottom line being, the older the employee, the more engaged the employee. This left me wondering if engagement leads to power and position or if power and position leads to engagement?

When trying to get a grip on what they meant by "engaged," I loved this line: "engaged employees stay for what they give, while disengaged employees stay for what they get." That pretty much said it all to me. Engaged employees plan to stay with a company while disengaged employees are always looking for a higher salary, better stock options, etc... The report suggests that engaged employees are more productive, committed, proud, passionate, and enthusiastic compared to unengaged employees who tend to feel underutilized, disconnected and negative.

Just FYI, the highest rate of engaged Gen Y employees, and the happiest employees were in India, which may reflect expanded opportunities from that growing economy.

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Thank You - Grand Rounds 4.47

Nancy L. Brown, PhD
Thank you Daniel Goldberg at Medical Humanities Blog for hosting Grand Rounds 4.47 this week and including a post about ACL injuries from Teen Health 411.

This week was very diverse and the posts were interesting to read. I liked the personal statements you inserted - as a way of getting to know you.

Photo credit: EdBierman

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Girls and Sports - Results from Seventeen and WNBA

Nancy L. Brown, PhD
Seventeen Magazine and the Women's National Basketball Association (WNBA) recently conducted a survey about how sports impact the lives of teen girls. The results may surprise you - they did me. According to this survey (of only about 1,000 young women), 83% of girls participated in sports and basketball was the number one sport.

The results suggest that girls play for exercise, to develop and maintain friendships, compete, and represent their schools. The girls that do not do sports say it is becasue they doubt their athlectic ability, do not have access to needed equipment at their schools, or worry about being perceived as a lesbian by peers. [Seriously?]

The impact of sports on young women is profound - results suggest that the participation in sports helps people develop emotionally and physically, experience the rush of competition and winning and learn lessons about losing -lessons that create future leaders.

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The "Used To Be" Empty Nest

Nancy L. Brown, PhD
Here is a new parenting issue - how do parents handle having their college graduate come home to stay? According to Collegegrad.com it seems that more and more (77% last year) college graduates are not getting a job after college or setting up their own homes, but are moving back in with mom and/or dad.

Is it the recession or is it that this generation (Gen Y) is just more attached to family and home, and maybe less motivated? I cannot help thinking that this phenomenon is related to the issues experienced by college freshmen, too!

In previous posts I have talked about the higher numbers of first year college students who seem emotionally unprepared for college in spite of wonderful academic, music, sports, and community service records. What seems to be missing are the skills required to be an adult, manage time, handle problems and negotiate "the real world." Maybe this generation of students are all struggling, but the ones making it through four years of college are suffering, at the other end.

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Sports and Injuries in Teens - ACL Injuries

Nancy L. Brown, PhD
I am learning a huge amount about sports and injuries this summer while working with the teen writers for the We're Talking Teen Health site at the Palo Alto Medical Foundation. I am by no means an expert in sports, but I think parents and teens need to be aware that the rate of injury in teen athletes is going up, but injuries can be prevented.

This week we interviewed a doctor about ACL (anterior cruciate ligament) injuries in the knee and I wanted to share what I learned.

How does this injury happen?
This injury is specific to sports that involve starting, stopping, pivoting and turning with some speed – particularly in sports like basketball, soccer, volleyball, football, field hockey, skiing, and lacrosse. There are primarily two ways the injury happens:
  • landing on an over-straight (hyper-extended) knee, and
  • with a foot planted a person pivots inward (internal rotation) without the foot coming, too.
This can happen in contact and non-contact injuries.

How is this injury usually diagnosed?
Usually there is significant swelling, and there are only a few injuries with this amount of swelling; there is an exam maneuver that is done to test for looseness of the ligament (if it is firm it is not torn, and if it is loose, it is likely torn), and an MRI is usually done to confirm the diagnosis. An x-ray will not help because it only shows the bones. The MRI will also identify whether the meniscus (shock-absorbing cartilage) was damaged (torn) during the injury.

How is this injury typically treated?
If the injury is in an adolescent who intends to go back to sports in which s/he will need to do pivoting, they will need surgery. If the injury is in an older person who jogs, bikes, or swims, activities that do not require the pivoting, the injury may not need to be repaired. If the meniscus was damaged, then during surgery the doctor will smooth it out so there is not a frayed area that will cause irritation, or sew it back together, depending on the nature of the tear. The doctor will try to preserve as much of the meniscus as possible given that it is the shock-absorber for the knee.

What is the recovery like if this injury is treated with surgery?
A person will need to be on crutches for about one week, have physical therapy twice a week for a month, and then they can start biking, jogging, swimming, but need to wait approximately four months before going back to the sport that requires any pivoting or turning. This is because the surgery includes adding some new ligament, which will get weaker before it gets stronger and takes a long time to heal.

How can teens prevent an ACL injury?
This is really a hot topic because ACL tears are much more common in female than male athletes. In fact, it is not uncommon during a single season that one out of 12 females on a team will experience an ACL injury.

There has been a lot of research done about why this is the case, and the results suggest that it is not because of the physiology or hormones of the female body, as was previously hypothesized, instead it is more likely to be:
  • muscle imbalance in the thigh as the quadriceps muscles overpower the hamstring muscles which need to work together to straighten (extend) and bend (flex) the leg; or
  • the way female athletes move during their sport, remaining more upright with their knees less bent than their male counterparts that puts the ACL in a vulnerable position.
In addition, you may have heard someone say “you run like a girl,” which usually means that when a person runs, their feet kind of go out, and knees bend in, instead of the knees staying straight over the foot, which is how girls tend to run (post-puberty), without training.

Prevention of this injury should include 15 minutes several times a week training to learn how to:
  • stop and start keeping the knee straight over the foot, avoiding the knock-knee position which makes the ACL vulnerable,
  • standing on a block and jumping, keeping the knee straight over the foot, and
  • hamstring strengthening exercises.
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Book Review: Breaking Dawn

Nancy L. Brown, PhD
Wow, 754 pages later I have emerged from the Twilight Series and Stephenie Meyer's latest book, Breaking Dawn! I got it Sunday and have not wanted to do anything but read all week.

What a great book. This is the fourth - it follows Twilight, New Moon and Eclipse - finishing a story of passion, the meaning of family, coming of age, the supernatural, good versus evil, diversity, and love. If you have not read these four books with your teenage daughters and sons, it is not too late - there are still a few weeks of summer left - get reading! Breaking Dawn starts off with a long awaited wedding but within 138 pages the totally unexpected has happened and the rest of the book is a huge surprise!

I do not want to give away the fabulous ending, so let it suffice to say - this is a must read for summer! It will fill your spirit with a belief that anything is possible!

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Book Review: The Launching Years (Part 2)

Nancy L. Brown, PhD
Once your teen actually leaves for college, the authors of this wonderful book suggest that your relationship with him or her will likely improve, overnight!

Part 2 of this review focuses on what to expect the first year your teen is in college. I remember leaving my children at kindergarten for the first time, and driving away while they stand at the curb in front of their dorm sounds a little like that! (Ouch!)

This book will help you dry your eyes and move through your grief, or maybe joy that your teen is at college. Some parents are happy and some are devastated with their new "emptier nest," but the second half of this book can help with whatever reaction you are having. In theory, you have gotten them to college, they have everything they need, and the university is supposed to take over.

There will be orientations, social events, resident assistants, dorm parents, counselors, advisers, and peer counselors to help with anything that goes wrong, but the authors suggest you should be prepared for some hysterical phone calls, anyway! Chapter four has some great suggestions for handling what the authors call "the dump call," and for knowing when a situation may require that you step in.

Just a few hints - no matter how much you miss them, the correct response to a dump call is NOT "come home - who needs college anyway!" A better response is to listen, provide a little empathy, and let them move on, as the authors suggest they will. Another call you may get is "I need more money," and the correct response, unless you are very wealthy, is NOT "sure, how much shall I send." (I liked that advice!)

During this emotional time, like so many other life transitions, you might not just be dealing with the loss of your teen, your relationship with your spouse may need some extra attention, and if there are siblings at home, they may need some extra support, too! Go figure! Whatever your family is feeling in reaction to this transition, the authors have some great advice and include stories from families just like yours.

The Launching Years is a great book for parents of older teens and college-aged students - the strategies it provides are priceless, even for families in which teens do not leave home but stay at home for a few more years. Every family is different, but all teens have to start being responsible adults at about age 18 and this book can help!

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