Parenting challenges of grandparents raising grandchildren: Discipline, child education, technology use, and outdated health beliefs

BACKGROUND: As of 2015, approximately three million children in the United States were being raised primarily by their grandparents. This study aims to examine, in a large national sample, to what extent grandparents raising grandchildren (GRGs) have difficulty with discipline and meeting their grandchild’s educational and social needs, find computers/other technology challenging, and subscribe to outdated health beliefs. METHODS: An anonymous online parenting questionnaire was administered to GRGs recruited through state and local grandparent support groups and elderly service agencies. RESULTS: 733 grandparents that self-identified as the primary caregiver of one or more grandchildren met inclusion criteria. 56.5% of GRGs reported difficulties with discipline, and 19.1% believed corporal punishment to be an appropriate method of discipline. Approximately a third of GRGs reported difficulties with their grandchild’s education, social and recreational activities. Nearly a third of GRGs did not find using their grandchild’s school website or portal to be easy; those who had difficulty were more likely to experience difficulties registering their grandchild for school (τ = -.127, p = .007) and were less likely to feel that teachers maintained adequate contact (τ = .242, p \u3c .001). A large percentage of GRGs subscribed to outdated health beliefs, such as scrapes healing better if they are not covered with a bandage (64.0%) and ice baths beingan appropriate treatment for a fever (39.8%). CONCLUSION: GRGs encounter significant parenting challenges, owing to generational differences. Healthcare providers and other professionals should provide GRGs with anticipatory guidance to ensure grandchildren’s needs are properly met

Is age an independent determinant of mortality in cardiac surgery as suggested by the EuroSCORE?

BACKGROUND: The proportion of older patients in cardiac surgery is continuously increasing. 37% of patients undergoing heart surgery in Germany in the year 2000 were 70 years of age and older. We have studied the role of age as a determinant of mortality in cardiac surgery in our institutional patient population. METHODS: We have calculated the EuroSCORE and the corresponding age-adjusted EuroSCORE in 8769 patients who underwent heart surgery between January 1996 and January 2002 and collected the information on the occurrence of postoperative complications and 30-days mortality. RESULTS: The multimorbidity increased with ascending age. Both the EuroSCORE and the age-adjusted EuroSCORE values increased significantly with age in the whole group of patients as well as in the group of patients who were alive 30 days after heart surgery. The incidence of postoperative complications and 30-days mortality increased significantly with age. In patients who died within 30 days after surgery, the EuroSCORE increased significantly with age, whereas the age-adjusted EuroSCORE did not. The occurrence of diabetes mellitus, arterial hypertension and atrial fibrillation, i.e., the risk factors not considered by the EuroSCORE, exhibited a significant age dependence in our patients. The univariate analysis identified the significant dependence of 30-days mortality on diabetes and atrial fibrillation. The stepwise logistic regression analysis showed the dependence of mortality on diabetes. CONCLUSIONS: On the background of the well-known age-dependent structural and functional changes of different body organs, our data show that age is a significant risk indicator in cardiac surgery, strongly correlating with morbidity and mortality. Consequently, special preventive and therapeutic measures are required in clinical environment in the case of elderly patients undergoing cardiac surgery

Development of a synoptic MRI report for primary rectal cancer

<p>Abstract</p> <p>Background</p> <p>Although magnetic resonance imaging (MRI) is an important imaging modality for pre-operative staging and surgical planning of rectal cancer, to date there has been little investigation on the completeness and overall quality of MRI reports. This is important because optimal patient care depends on the quality of the MRI report and clear communication of these reports to treating physicians. Previous work has shown that the use of synoptic pathology reports improves the quality of pathology reports and communication between physicians.</p> <p>Methods</p> <p>The aims of this project are to develop a synoptic MRI report for rectal cancer and determine the enablers and barriers toward the implementation of a synoptic MRI report for rectal cancer in the clinical setting. A three-step Delphi process with an expert panel will extract the key criteria for the MRI report to guide pre-operative chemoradiation and surgical planning following a review of the literature, and a synoptic template will be developed. Furthermore, standardized qualitative research methods will be used to conduct interviews with radiologists to determine the enablers and barriers to the implementation and sustainability of the synoptic MRI report in the clinic setting.</p> <p>Conclusion</p> <p>Synoptic MRI reports for rectal cancer are currently not used in North America and may improve the overall quality of MRI report and communication between physicians. This may, in turn, lead to improved patient care and outcomes for rectal cancer patients.</p

Cultural Zionism in Sweden: Daniel Brick's Judisk krönika

The present study examines the content of the Swedish-Jewish Zionist periodical Judisk Krönika during its earliest years of publication, 1932 to 1950, under the editorship of its founder, Daniel Brick. The focus will be on how the magazine in its brightest and most ambitious years, acted as a conduit through which the ideas of cultural Zionism flowed into Sweden.  Through essays, reports, editorial comments, book reviews and debates, the circle of intellectuals grouped around Brick clamored for a revivification of what they considered to be the moribund cultural life of Swedish Jewry, the result (in their eyes) of decades of Reform dominance in communal life. Not wishing to make themselves any less “Swedish”, the cultural Zionists nevertheless insisted that Jews in Sweden and other Nordic countries needed to adopt an international perspective, integrating the proposed idea for a Jewish national home in Palestine into their lives as a source of cultural pride and spiritual renewal

Little soviets

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The effects ofpH and electrical bias on abrasion of alumina in aqueous solutions

Various coolant chemicals are known to have enhancing and suppressing effects on wear and the quality of finish, but little has been understood about the nature of these effects. Studies were performed to examine the effects of pH and surface bias on wear, subsurface damage, and the various theories of chemical interaction with the wear process. Results of this examination of wear suggest that chemical adsorbates can play a significant role in wear fracturing. Previous observations of plastic mechanisms in brittle wear have lead tribologists to suggest that chemically induced changes in plasticity are the cause of these effects. Instead, this thesis contends occurrence of plastic effects to be by-product of localized hydrostatic compression and insufficient stress intensity to cause fracture. Crack rates and stress intensities required for fracture to occur are known to vary with adsorption