Parental spanking of 1-year-old children and subsequentchild protective services involvement

tThe majority of U.S. parents spank their children, often beginning when their childrenare very young. We examined families (N = 2,788) who participated in a longitudinalcommunity-based study of new births in urban areas. Prospective analyses examinedwhether spanking by the child’s mother, father, or mother’s current partner when the childwas 1-year-old was associated with household CPS involvement between age 1 and age 5.Results indicated that 30% of 1-year-olds were spanked at least once in the past month.Spanking at age 1 was associated with increased odds of subsequent CPS involvement(adjusted odds ratio = 1.36, 95% CI [1.08, 1.71], p < .01). When compared to non-spankedchildren, there was a 33% greater probability of subsequent CPS involvement for childrenwho were spanked at age 1. Given the undesirable consequences of spanking children anda lack of empirical evidence to suggest positive effects of physical punishment, profession-als who work with families should counsel parents not to spank infants and toddlers. Foroptimal benefits, efforts to educate parents regarding alternative forms of discipline shouldbegin during the child’s first year of lifePeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106157/1/Lee et al. 2014 spanking and CPS involvement.pd

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability