Knee Replacement: Dr. Mary O’Connor Discusses the Surgical Procedure

Mary I. O’Connor, M.D., chair of the Department of Orthopedic Surgery at the Mayo Clinic campus in Florida, explains what is involved with knee replacement surgery, including pain management techniques used during the surgery. She also explains who is a candidate for minimally invasive knee replacement surgery.

Knee Surgery (3-Part-Series)
Part 1: http://www.youtube.com/watch?v=LNPy5-6qWrU
Part 2: http://www.youtube.com/watch?v=sNkaiDo3za8 (This video)
Part 3: http://www.youtube.com/watch?v=JAQW073ZUx8

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What Causes Sleep Apnea?

With sleep apnea, your breathing starts and stops over and over again. But what actually causes it? Learn more: http://wb.md/2f8XQen

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What Are Sea Lice?

First thing’s first: Sea lice aren’t lice at all. They’re tiny baby jellyfish, so small you can’t even see them – about the size of a grain of pepper. And just like their grownup counterparts, they sting. Here’s how to avoid sea lice at the beach.

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How to Check Your Blood Pressure

Roll up your sleeve and slide on that blood pressure cuff. It’s important to check how well your heart pumps blood. Here’s how.

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Inside Your Bones

Take a look inside your bones, and learn how they give you support.

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10-Minute Sport Yoga Routine

You won’t need to sacrifice your busy day for this yoga routine. If you have just 10 minutes, you can complete this gentle sport yoga flow.

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How to Stretch for Low Back Pain

Don’t let back pain hold you back. Stretch it out and relax with this exercise.

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Shape Your Family’s Habits | NIH News in Health

Helping Kids Make Healthy Choices

Many things can influence a child, including friends, teachers, and the things they see when they sit in front of the TV or computer. If you’re a parent, know that your everyday behavior plays a big part in shaping your child’s behavior, too. With your help, kids can learn to develop healthy eating and physical activity habits that last throughout their lives.

Healthy eating and physical activity are essential for children of any age. “They can have many health benefits for children, including promoting heart health and improving mood,” says Dr. Voula Osganian, a child obesity specialist at NIH.

Getting active and eating right may also prevent excess weight and childhood obesity, a growing concern in this country. Today, nearly 1 in 3 children in the United States is overweight or obese. “If someone develops obesity as a child or adolescent, there’s a very high likelihood that they’ll remain obese or overweight as an adult,” Osganian explains. “But studies also show that if you start eating healthy and being active early, you tend to maintain those habits over time.”

Although most of us know that it’s a good idea to eat healthy food and move more, it isn’t always easy to do. Children aren’t likely to change their diet and activity habits on their own. It’s up to you to make it easier for your family to make healthy choices.

“Parents are very important in terms of arranging an environment and setting a model for healthy or unhealthy behavior,” says Dr. Leonard H. Epstein, an expert
on childhood obesity at the University of Buffalo. “Parents bring foods into the house. They control how much time a child can watch TV. They control what kinds of social activities are paired with foods. And kids learn a huge amount about eating and physical activity from watching and imitating their parents.”

Epstein’s research shows how important parents can be. In NIH-funded work, his team assigned obese children, ages 8 to 12, to different types of weight loss programs. All the groups were taught about healthy diet, behaviors, and exercise. For some groups, positive feedback and encouragement for weight loss and behavior changes were given only to the child. Other groups focused on both the child and an obese parent. Comparison groups received little feedback.

The researchers found that when obese parents and children worked together, both were more successful at losing weight and making healthy changes. “Our studies suggest that getting the whole family working together really benefits the child,” Epstein says. “Even after 10 years, when these kids were 18 to 22 years old, the ones who had the parent working with them had lost more weight and maintained more weight loss than the ones treated by themselves, and obviously more than the comparison groups.”

Over time, most parents gradually began to regain their lost weight, the researchers found. But after 10 years, more than 40% of the kids who worked with their parents had maintained a weight reduction of at least 20%. “The finding suggests that even if the parents go back to their old behaviors, many of the kids will not,” says Epstein.

While it’s never too late to start making healthy changes in your family, research suggests that the earlier your kids learn healthy behaviors, the better.

Dr. Julie Lumeng, a pediatrician at the University of Michigan, focuses her NIH-funded research on the factors that affect eating behaviors in young children—especially preschoolers and infants. That’s an ideal time to start exposing your children to a variety of healthy foods, such as fruits and vegetables, so they develop a liking for them.

Getting young ones to accept fruits and vegetables can be a challenge, but some parents give up too quickly if a child rejects a new food. Research suggests that the more times you offer a food, the more likely a child will be to warm up to it. “Kids typically have to taste a new food 9 to 15 times to begin to like it,” Lumeng says.

If your child doesn’t like a new food right away, stay positive and keep trying over time. Encouraging kids to take just one bite of a new food can help. But avoid creating conflicts and stress over it.

“Trying a new food can be exciting and also stressful in general,” Lumeng says. “Several studies show that kids are more likely to try a new food if they’re eating in a setting that’s relaxing and pleasant.”

Children under the age of three tend to stop eating on their own when they’re full. “But after age three,” Lumeng says, “the more you put on their plate, the more they’ll eat.” So make sure to give your kids child-size portions.

Take opportunities to teach young children about feelings of fullness. “If your child asks for another helping, instead of saying, ‘No, honey, you’ve had enough,’ try saying something like, ‘You must really be hungry tonight,’ to raise their awareness of their feelings,” Lumeng suggests. “Or when they stop eating, say, ‘Oh, you must feel full now,’ to help teach about hunger and feeling satisfied.”

Several studies show that parents can effectively influence healthy behaviors by talking in a positive way or avoiding certain situations altogether. “Instead of telling your children, ‘No, you can’t have any more cookies,’ just keep cookies out of the house altogether,” says Lumeng.

When you bring unhealthy food and sugary drinks into the house, “parents essentially become the food police,” adds Epstein. “It’s easier to create an environment in the home where there’s limited access to unhealthy foods and lots of access to healthy foods.”

Experts recommend that most kids get at least an hour of moderate to vigorous physical activity each day. Parents can help by limiting TV and computer time to no more than one or two hours per day.

“Small changes in the home environment can also have a huge effect on physical activity,” says Epstein. You can make sports equipment like balls and jump ropes more accessible by putting them next to the door. Walking fast, bicycling, jumping rope, and playing basketball, soccer, or hopscotch are all good ways for kids to be active.

When it comes to food and physical activity, what you say and do around your children can have a lasting effect. Work together as a family to make healthy habits easy and fun.

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See, Hear, Speak | NIH News in Health

Are Kids’ Senses Ready for School?

When setting off for kindergarten or first grade, a child may feel prepared with a backpack loaded with crayons, pencils, and paper. But a good start in the classroom depends on more than just school supplies. Healthy hearing, vision, speech, and language are key to success at school. If a child has problems in these areas, the sooner they’re spotted, the better they can be treated.

Sometimes problems with senses, speech, or language fly under the radar. A child with a lazy eye or a little hearing loss might get along just fine at home or in daycare. But when children get to school, minor difficulties may start to catch up with them. They may have trouble focusing and flourishing in the classroom. NIH-funded scientists are searching for better ways to recognize and treat these types of problems as early as possible.

Nearly all newborns are screened for hearing loss before leaving the hospital. For newborns diagnosed with hearing loss, interventions such as hearing aids or cochlear implants should begin no later than 6 months of age. When interventions begin early, children with hearing loss can develop language skills that help them communicate.

Hearing problems can also arise in older kids. “Some children are born with normal hearing and develop hearing loss later for various reasons,” says Dr. Mary Pat Moeller, who studies childhood deafness and language development at Boys Town National Research Hospital in Nebraska. Head injuries, meningitis, and chronic fluid behind the eardrum from repeated bouts of ear infections are just a few conditions that can lead to later hearing loss.

“We rely on normal hearing to pick up concepts and learn new words,” Moeller says. But a noisy classroom can be tough for kids who can’t hear well. “Children with undetected hearing loss may look like they have attention deficits. They may miss what they’ve been told because they’re just not hearing clearly,” she says.

Screening for hearing loss in school-age kids is a familiar process. Children wear headphones and raise their hands as they hear a series of tones. Some 5% to 10% of school-age children don’t pass these tests. Kids with hearing loss can be fitted with hearing aids or benefit from cochlear implants or assistive devices. For example, teachers can wear microphones that send their voices directly to the children’s ears. Even children with minimal hearing loss can benefit from this type of technology.

Children learn language by listening to others and engaging in conversations. But kids with hearing loss can miss out on some of this experience. Moeller and her colleagues are studying how children with hearing loss develop language. Results from this NIH-funded research point to several factors that can help. These include the quality and fit of hearing aids, how often kids get speech and language training, and how often parents have conversations with their children.

A different source of language problems is a disorder called specific language impairment, or developmental language disorder. This condition affects an estimated 7% of children in kindergarten. Kids with specific language impairment have trouble learning new words and engaging in conversation. They might produce grammatically incorrect sentences like “What he want for dinner?” or they might have a small vocabulary.

“Both of those are fundamental to being able to communicate with the teacher, to understanding what the teacher is saying to them, and to forming social relationships with their peers,” says Dr. Mabel Rice, an NIH-funded researcher who studies childhood language disorders at the University of Kansas.

For example, a child with specific language impairment might not understand that “It’s time to put your things away now” means “Put your things away.” Children who don’t understand complicated sentences can seem like they’re disobedient, Rice says. More complicated grammar is also good for making friends. Saying “I would like it if you’d come play with me” might attract more playmates than “Come over here.”

In the past, parents were sometimes blamed for a child’s language disability. They might have been faulted for not reading enough to their children. But research suggests that specific language impairment has other roots. The disorder tends to run in families, which hints that genesStretches of DNA, a substance you inherit from your parents, that define characteristics such as how likely you are to get certain diseases. play a role. Rice led a study of over 300 people, including children with specific language impairment and their families. The scientists identified a gene that’s also linked to dyslexia and other learning disabilities. The finding might eventually lead to better understanding and treatment of these disorders.

Kids don’t usually grow out of specific language impairment. Their language improves, but they can continue to struggle with subtleties even after they enter the workforce. “It is very important to identify these kids, particularly at school entry or before school entry,” Rice says. Many school districts screen children for specific language impairment before kindergarten. Language therapy can help children catch up.

Poor vision can also cause trouble in school, and the problems may go unnoticed. Vision problems are common in preschoolers, but kids don’t always tell others about their symptoms. Children might even think it’s normal to see double or for things to be blurry. But poor eyesight can cause headaches and hinder reading. Some children with vision problems might seem to have attention difficulties, since eyestrain and headaches can make it hard to stay on task.

The most common cause of vision impairment in children is amblyopia, or lazy eye. It often arises if the eyes point in different directions, or if one eye produces a better image than the other. The brain starts to shut down signals from the weaker eye. Treatment encourages use of the weaker eye, sometimes by putting a patch over the other eye. NIH-funded research has found that treatment for amblyopia is more effective if begun when a child is young.

Some children are nearsighted, with problems focusing on faraway objects like the chalkboard. It’s less common for youngsters to be farsighted, with trouble focusing on up-close items. Both can be corrected with eyeglasses or contact lenses.

To catch problems early, NIH funded a study of thousands of preschoolers to find the best ways to screen for impaired vision. “How often screening is done and what screening is done varies widely from state to state,” says Dr. Marjean Kulp, a vision researcher at Ohio State University.

The study evaluated different tests and identified a few that could best detect vision problems—even when performed by people who aren’t vision specialists.

Screenings only identify potential problems, and they don’t catch everything. Children should have regular exams by an eye care professional.

Early detection and treatment of hearing, vision, and language problems can give kids a better learning experience.

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Positive Parenting | NIH News in Health

Building Healthy Relationships With Your Kids

Parents have an important job. Raising kids is both rewarding and challenging. You’re likely to get a lot of advice along the way, from doctors, family, friends, and even strangers. But every parent and child is unique. Being sensitive and responsive to your kids can help you build positive, healthy relationships together.

“Being a sensitive parent and responding to your kids cuts across all areas of parenting,” says Arizona State University’s Dr. Keith Crnic, a parent-child relationship expert. “What it means is recognizing what your child needs in the moment and providing that in an effective way.”

This can be especially critical for infants and toddlers, he adds. Strong emotional bonds often develop through sensitive, responsive, and consistent parenting in the first years of life. For instance, holding your baby lovingly and responding to their cries helps build strong bonds.

Building Bonds

Strong emotional bonds help children learn how to manage their own feelings and behaviors and develop self-confidence. They help create a safe base from which they can explore, learn, and relate to others.

Experts call this type of strong connection between children and their caregivers “secure attachment.” Securely attached children are more likely to be able to cope with challenges like poverty, family instability, parental stress, and depression.

A recent analysis shows that about 6 out of 10 children in the U.S. develop secure attachments to their parents. The 4 out of 10 kids who lack such bonds may avoid their parents when they are upset or resist their parents if they cause them more distress. Studies suggest that this can make kids more prone to serious behavior problems. Researchers have been testing programs to help parents develop behaviors that encourage secure attachment.

Being Available

Modern life is full of things that can influence your ability to be sensitive and responsive to your child. These include competing priorities, extra work, lack of sleep, and things like mobile devices. Some experts are concerned about the effects that distracted parenting may have on emotional bonding and children’s language development, social interaction, and safety.

If parents are inconsistently available, kids can get distressed and feel hurt, rejected, or ignored. They may have more emotional outbursts and feel alone. They may even stop trying to compete for their parents’ attention and start to lose emotional connections to their parents.

“There are times when kids really do need your attention and want your recognition,” Crnic explains. Parents need to communicate that their kids are valuable and important, and children need to know that parents care what they’re doing, he says.

It can be tough to respond with sensitivity during tantrums, arguments, or other challenging times with your kids. “If parents respond by being irritable or aggressive themselves, children can mimic that behavior, and a negative cycle then continues to escalate,” explains Dr. Carol Metzler, who studies parenting at the Oregon Research Institute.

According to Crnic, kids start to regulate their own emotions and behavior around age 3. Up until then, they depend more on you to help them regulate their emotions, whether to calm them or help get them excited.

“They’re watching you to see how you do it and listening to how you talk to them about it,” he explains. “Parents need to be good self-regulators. You’re not only trying to regulate your own emotions in the moment, but helping your child learn to manage their emotions and behavior.”

As kids become better at managing their feelings and behavior, it’s important to help them develop coping skills, like active problem solving. Such skills can help them feel confident in handling what comes their way.

“When parents engage positively with their children, teaching them the behaviors and skills that they need to cope with the world, children learn to follow rules and regulate their own feelings,” Metzler says.

“As parents, we try really hard to protect our kids from the experience of bad things,” Crnic explains. “But if you protect them all the time and they are not in situations where they deal with difficult or adverse circumstances, they aren’t able to develop healthy coping skills.”

He encourages you to allow your kids to have more of those experiences and then help them learn how to solve the problems that emerge. Talk through the situation and their feelings. Then work with them to find solutions to put into practice.

Meeting Needs

As children grow up, it’s important to remember that giving them what they need doesn’t mean giving them everything they want. “These two things are very different,” Crnic explains. “Really hone in on exactly what’s going on with your kid in the moment. This is an incredibly important parenting skill and it’s linked to so many great outcomes for kids.”

Think about where a child is in life and what skills they need to learn at that time. Perhaps they need help managing emotions, learning how to behave in a certain situation, thinking through a new task, or relating to friends.

“You want to help kids become confident,” Crnic says. “You don’t want to aim too high where they can’t get there or too low where they have already mastered the skill.” Another way to boost confidence while strengthening your relationship is to let your kid take the lead.

“Make some time to spend with your child that isn’t highly directive, where your child leads the play,” advises Dr. John Bates, who studies children’s behavior problems at Indiana University Bloomington. “Kids come to expect it and they love it, and it really improves the relationship.”

Bates also encourages parents to focus on their child’s actual needs instead of sticking to any specific parenting principles. It’s never too late to start building a healthier, more positive relationship with your child, even if things have gotten strained and stressful.

“Most importantly, make sure that your child knows that you love them and are on their side,” Metzler says. “For older children, let them know that you are genuinely committed to building a stronger relationship with them and helping them be successful.”

By being a sensitive and responsive parent, you can help set your kids on a positive path, teach them self-control, reduce the likelihood of troublesome behaviors, and build a warm, caring parent-child relationship.

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