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Tough Love vs. Spanking - Good Argument

Most people think it's   improper to spank children, so I have tried other methods to control my kids when they have one of  'those moments.' 

One that I found effective is for me to just take the child for a car ride and talk. 

Some say it's the vibration from the car, others say it's the time away from any distractions such as TV, Video Games, Computer, IPod , etc. 

Either way, my kids usually calm down and stop misbehaving after our car ride together.  Eye to eye contact helps a lot too. 

I've included a photo below of one of my sessions with my son, in case you would like to use the technique. 

   

     


This works with grandchildren, 
nieces, and nephews as well.

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Ninth Annual Year in Ideas -Thirdhand Smoke dangers - NYTimes.com

Thirdhand Smoke

  Many parents who light up are aware of the dangers of secondhand smoke; they blow it out the window or smoke at home only when the kids are not there. But people rarely account for what is left behind after a cigarette has been extinguished. When smoke dissipates, it does not just disappear. Compounds are left over that settle on walls, furniture and clothes, or become part of house dust. Call it "thirdhand smoke," which is what a team of researchers trying to raise awareness of the dangers of smoking named it in January.

The study, published in the journal Pediatrics, surveyed 1,500 smokers and nonsmokers about the hazards of secondhand and thirdhand smoke and found that 84 percent of smokers believe secondhand smoke is dangerous to children, while only 43 percent think thirdhand smoke is harmful. But the compounds in thirdhand smoke can be ingested or absorbed through the skin, and some give off gases as they deteriorate, says Jonathan Winickoff, an associate professor of pediatrics at Massachusetts General Hospital, who led the research. Many are carcinogenic. "The more you smoke in these locations, the more microlayers of these toxins build up," Winickoff says.

PHOTO ILLUSTRATION BY REINHARD HUNGER
SET DESIGN BY SARAH ILLENBERGER Enlarge

Winickoff is analyzing data on children who live in apartments and encounter thirdhand smoke only from other units in their buildings. He expects to publish his results early next year. LIA MILLER

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The States of Marriage and Divorce - Pew Research Center

Correlations in Marriage Patterns

Some state-level patterns of marriage and divorce correlate3 with the overall socioeconomic characteristics and political behavior in those states. This does not mean that one pattern causes the other to happen, only that both tend to be true in the same place.

A state's education levels, for example, tend to be associated with the median age at marriage and the multiple-marriage patterns of its residents. In states with high shares of college-educated adults, men and women marry at older ages, a finding supported by other research indicating that highly educated individuals marry later in life. In states with low shares of college-educated adults, adults are more likely than average to marry three or more times. In states with low income levels, men are more likely than average to have been married three or more times.

For this analysis, correlation also was tested between a state's marriage or divorce statistics and the share of its 2008 presidential election vote that went Democratic. States with high shares of Democratic votes tended to have lower shares of currently married residents, lower shares of adults married at least three times and low rates of marriages within the previous year. Residents of states with high shares of Democratic votes tend to marry at older ages than residents of states with low shares of Democratic votes.

This analysis did not find a strong correlation between divorce statistics -- either a state's share of divorced adults or its rate of divorce within the previous year -- and socioeconomic indicators (income and education) or 2008 presidential election patterns. There was a strong correlation, however, between young age at first marriage for women and a high divorce rate for women within the previous 12 months.

Correlation also was tested to see whether a state's religiosity was associated with marriage and divorce patterns. Religiosity was expressed as the proportion of a state's residents who said in response to a survey that religion was "very important" in their life.4 However, this analysis did not find a strong association between a state's religiosity and its marriage or divorce patterns.

Explore marriage and divorce patterns and see how your state measures up using interactive maps at pewsocialtrends.org.

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re the American way of syncretizing different faith traditions. "Despite Americans' overwhelming allegiance to someone they call God (92%), in Pew's 2008 U.S. Religious Landscape Survey, 70% said "many religions can lead to eternal life," and 68% sai

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More U.S. Christians mix in 'Eastern,' New Age beliefs
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Illustration by Sam Ward, USA TODAY
 FACTS ON FAITH: SURVEY STATS

Clergy and theologians -- people invested in the significance of doctrine -- may be dismayed by the newest Pew findings but they can hardly be surprised. An array of surveys in the last two years have detailed the swirling, unbounded paths of believers. The data show:

• Between 47% and 59% of Americans have changed religions at least once, according to aPew survey released in April. Top reasons for most: Their spiritual needs weren't being met or they liked another faith more or changed their religious or moral beliefs.

• The percentage of people who call themselves some type of Christian has dropped more than11% in a generation, and so many people declined to label themselves with any religion that the so-called "Nones," now 15%, are the nation's third largest "religious" category after Catholics and Baptists, according to the latestAmerican Religious Identification Surveyreleased in March 2009.

• Despite Americans' overwhelming allegiance to someone they call God (92%), Pew's 2008 U.S. Religious Landscape Survey of 35,000 Americans also found a "stunning" dismissal of institutional religion: 70% said "many religions can lead to eternal life" and 68% said "there's more than one true way to interpret the teachings of my religion."

• Most (55%) say a guardian angel has protected them from harm, and 52% believe in prophetic dreams, according to surveys by the Baylor University Institute of Religion released in2008 and 2006.

 COMPARE CHANGES IN U.S. RELIGIONS OVER 2 DECADES
 RELIGION SURVEY RESULTS

Mixing religions: Many Americans have beliefs or experiences that conflict with basic Christian doctrines. People who say they believe:

Total Christians
People will be reborn in this world again and again 24% 22%
Yoga is a spiritual practice 23% 21%
People with the "evil eye" can cast curses or harmful spells 16% 17%
The position of stars/planets can affect people's lives 25% 23%

Interfaith worship: A third of Americans say they attend multiple places of worship, including outside their own faith (excluding holidays or family events). People who say they attend:

  Total All Protestants Catholics
Multiple places within own faith 11% 9% 21%
Services of one other faith 12% 15% 13%
Services of two other faiths 8% 10% 5%
Services of three or more faiths 4% 4% 1%

Attending other services: Attending worship services beyond their own faith is more common among Protestants (30%) than Catholics (19%):

  One other faith Two others Three others
White evangelicals 15% 9% 3%
White mainline 11% 8% 5%
Black Protestants 18% 14% 9%

Mystical experiences: Half of all Americans say they have had a "religious or mystical experience or spiritual awakening":

Total
Black Protestants 71%
White evangelical Protestants 70%
Catholics 60%
White mainline Protestants 40%
Unaffiliated 30%

Spirit and nature: Many Christians have adopted beliefs or experiences that conflict with basic Christian doctrines. People who say they:

Total Christians
Have been in touch with the dead 29% 29%
Found "spiritual energy" in trees, etc. 26% 23%
Had ghostly experience 18% 17%
Consulted a psychic 15% 14%

Source: 2009 Pew Forum on Religion & Public Life Survey of 2,003 U.S. adults. Margin of error +/- 2.5 percentage points

 @FAITH_REASON ON TWITTER
Yahoo! Buzz
Going to church this Sunday? Look around.

The chances are that one in five of the people there find "spiritual energy" in mountains or trees, and one in six believe in the "evil eye," that certain people can cast curses with a look — beliefs your Christian pastor doesn't preach.

In a Catholic churc

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The 'Sex Talk' Often Comes Too Late; parent(s) are invariably surp that their kids are having sex; and the denial represents to the kids that their parent(s) shoud not be in the loop in their decision making

The 'Sex Talk' Often Comes Too Late - American Academy Of Pediatrics

The American Academy of Pediatrics recommends that parents educate
their children about sexuality beginning early in life. According to
the study, "Timing of Parent and Child Communication About Sexuality
Relative to Children's Sexual Behaviors," published in the January
issue of Pediatrics, many of these discussions are occurring after
adolescents have already passed key sexual milestones.

In a series of surveys with 141 parents and their teen-aged children,
researchers found more than 40 percent of children had sexual
intercourse before any discussion with their parents about sexually
transmitted disease symptoms, condom use, choosing birth control, or
what to do if a partner refuses a condom.

Researchers suggest pediatricians encourage parents to have more
timely communication with their children about important sex-related
topics. Suggestions for specific topics that should be covered and
advice on how to discuss them would help guide parents who don't know
what to say. Pediatricians also can address these issues in one-on-one
conversations with adolescents in their office.

Source
American Academy of Pediatrics

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Introduction Of Solid Foods And Allergic Reactions; kind of opposite of what we had been telling people, confusing because new data comes along, and we try to adapt

ntroduction Of Solid Foods And Allergic Reactions - American Academy
Of Pediatrics

09 Dec 2009

Late introduction of solid foods may increase the risk of allergic
sensitization to food and inhalant allergens. In the study, "Age at
the Introduction of Solid Foods During the First Year and Allergic
Sensitization at Age 5 Years," published in the January issue of
Pediatrics, researchers examined the diets and allergic sensitivities
of 994 children with susceptibility to type 1 diabetes. Results
indicate that late introduction of solid foods was associated with
increased allergic sensitization to food and inhalant allergens.

Eggs, wheat and oats were most commonly related to food sensitization,
while potatoes and fish were strongly associated with inhalant
sensitization. The American Academy of Pediatrics recommends the
introduction of solid foods between the ages of 4 and 6 months. Study
authors conclude that neither extended, exclusive breastfeeding, nor
delaying the introduction of solid foods, may prevent allergic
diseases in children.

Source
American Academy of Pediatrics
Article URL: http://www.medicalnewstoday.com/articles/173462.php

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my wife said a funny, Tiger has showed himself to be in fact a cheetah.

 

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Im glad we are not rich..especially for the honey..

Did Tiger Cheat Because He’s Rich?

Now that the ninth alleged Tiger Woods mistress has emerged, many are wondering why he went so far astray.

Associated Press

Was it the fame? The power? All that weightlifting? Because he’s a guy?

Some psychologists say they have the answer: It was the money.

“Wealthy people crave stimulus,” Isreal Helfand, a high-end marriage counselor, told the Orlando Sentinel. “They are adrenaline junkies. The pursuit of happiness, for them, is more interesting than happiness.”

Every marriage has troubles, he said. But for the rich, famous or powerful, the temptations and opportunities for misbehaving are much greater. They can pop in on their private jet, get a pricey hotel room and fly back home within hours. And they are much better able to afford to divorce if they get caught.

Sounds reasonable. Yet a look at recent research shows that rich guys are not significantly more likely to have affairs than non-rich guys. According to a 2007 study of people worth $30 million or more by Prince & Assoc., 50% of of the male survey respondents who were married said they’d had affairs. That’s about in line with findings for the broader American population, according to sexologists.

In fact, it’s the rich women who are more likely to stray. The survey found that nearly three-quarters of the women surveyed said they’d had affairs. That’s more than twice as high as the national average for women.

Clearly, money can be enable bad behavior. But when it comes to infidelity, money has a bigger impact on women than men.

Do you think wealth was the main reason for Tiger’s alleged behavior? Is it harder to stay faithful with large wealth?

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Ensuring the Fiscal Sustainability of Health Care Reform | Health Care Reform 2009

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Ensuring the Fiscal Sustainability of Health Care Reform

Michael E. Chernew, Ph.D., Lindsay Sabik, B.A., Amitabh Chandra, Ph.D., and Joseph P. Newhouse, Ph.D.

Much of the recent health care reform debate has focused on achieving budget neutrality over a 10-year period, but this goal is less important than the reform’s long-run fiscal sustainability. If the rate of growth of health care spending continues to exceed the rate of income growth by its historical margin of more than 2 percentage points, the consequences for beneficiaries, federal and state budgets, and the entire economy — given the implied increase in tax rates and forgone consumption — will be dire.1 For this reason, health care reform is an economic issue as much as, if not more than, a health issue.

Growth in health care spending is often a good thing. We want to spend more of our growing income on medical advances whose benefit exceeds their cost. Yet the U.S. health care system is larded with inefficiency. For example, it is well established that some regions spend considerably more than others in the Medicare program without delivering higher-quality care or generating greater patient satisfaction.2,3

Yet low spending is not the same as low spending growth, and even efficient areas can experience considerable spending growth. In fact, many areas that had low spending in 1992 did not have notably lower spending growth between 1992 and 2006 than other areas (see graph). Rochester, Minnesota, and Salt Lake City, for instance, are known for high-quality, integrated providers and have low Medicare spending per beneficiary. Yet between 1992 and 2006, inflation-adjusted Medicare spending per beneficiary rose 4.3% annually in Salt Lake City and 3.8% annually in Rochester, as compared with 3.2% for the country as a whole. In short, areas with exemplary delivery systems do not necessarily have exemplary rates of spending growth.

Chernew_F1

Level of Medicare Spending in 1992, Plotted against Growth in Spending between 1992 and 2006.

The plot shows little correlation between levels of Medicare spending in 1992 and the growth of such spending from 1992 through 2006, according to hospital-referral region. Thus, areas with exemplary medical delivery systems do not necessarily have exemplary rates of spending growth. Data include all spending for Medicare Parts A and B, with adjustment for age, sex, and race but not for price differences, with spending levels presented in 2005 dollars. Data are from the Dartmouth Atlas of Health Care.


Of course, some of the 300-plus regions have both low levels of spending and low spending growth (e.g., San Francisco). These areas should be studied for any lessons that can be applied elsewhere, but such lessons may be few, because low growth rates often do not persist. For example, the correlation between spending growth from 1992 through 1999 and spending growth from 2000 through 2006 is –0.12. This modest inverse correlation partially reflects regression to the mean, but that is the point: high (or low) spending areas are not systematically high (or low) spending-growth areas, so strategies that reduce costs in high-spending areas will not necessarily “bend the curve” (except transitorily).

The historical flow of valuable but costly medical advances raises a profound question — and not just for Americans: Can that flow be maintained in future years without rates of spending increase that wreak economic havoc? To answer affirmatively, the nation must develop effective strategies to curb spending growth and must address the role of government in health care.

A number of options have been proposed for lowering spending growth. These include delivery-system reform, especially the development of “integrated” organizations to reduce costs and improve patient outcomes; payment reform involving a greater role for bundled payments, including episode-based payments and various forms of capitation; and “promarket” strategies that make individuals more sensitive to costs and rely on individual choices to constrain spending, such as benefits packages with substantial cost sharing, taxing of high-cost plans, and insurance- and provider-market reforms that enhance competition.

Delivery-system reform, undoubtedly important to increased efficiency, may not slow spending growth sufficiently in the long run, even if it transitorily reduces it, because even the most efficient delivery systems must wrestle with the adoption of expensive new technologies. Thus, delivery-system reforms will probably need to be coupled with meaningful payment reforms, promarket reforms, or both if the rate of spending growth is to fall.

Payment reform can slow spending growth but only if the process for setting updates for bundled rates is disciplined. Bundled or capitated payments cannot be routinely increased to cover all new services. Although all payers can adopt more bundled payments, government health insurance programs, because of their market power, can have the largest effect on spending growth. Government restraint in rate setting, however, may be weakened by the political process. On the other hand, if government forces payment updates into a tight budget straitjacket, there could be adverse effects on innovation, access, and patients’ health. Getting reimbursement rates right is a daunting task.

Promarket strategies have their own pitfalls. Left unimpeded, markets will eventually slow spending growth because people will ultimately not want to give up other goods in favor of still more health care. But markets may not lead to efficient, or equitable, outcomes. Market failures stemming from having too few competitors, which results in excessive market power, or a surplus of competitors, which increases the cognitive burden of choosing among them, may impede markets from achieving efficiency even if there are appropriate incentives for selecting efficient plans or providers. Moreover, patients do not always make appropriate decisions about the use of services when faced with cost sharing, so plans with high cost sharing may lead to suboptimal clinical outcomes.4 This concern may be mitigated by more sophisticated insurance products, such as those with a “value-based insurance design,” which lower the out-of-pocket costs for high-value services. Unfortunately, such strategies are in their infancy.5 Reference pricing systems may help, but defining classes for a reference price is often challenging. Even when promarket systems are more fully developed, their success in stemming spending growth will depend on tolerance of the income-related disparities that such strategies will surely generate. Subsidies and vouchers, which can mitigate these disparities, not only are expensive but also inherently dampen the impact of promarket policies on spending growth. Moreover, if they are restricted to low- and middle-income families, subsidies have to be phased out, which creates large increases in marginal tax rates that can reduce the incentive to work.

Our country’s record of making the sorts of tough choices that are required for payment or promarket reforms to restrain spending growth is not encouraging. The experience with Medicare’s “sustainable growth rate” formula for physician payments shows the difficulty of resisting political pressure to increase fees in order to preserve access to care and avert large reductions in providers’ incomes. And private payers, despite pioneering innovations such as disease management and various forms of bundled payment, have not been able to constrain spending growth to sustainable levels.

Yet lamenting such past failures does not provide a way forward. Unfortunately, an obvious, painless solution does not exist. Many observers point to waste, fraud, and abuse that should be eliminated from the current system, but these problems have proved resilient to myriad eradication efforts. Even if they could be reduced to negligible levels, the underlying spending growth would then resume. Current analyses frequently focus on the 10-year savings associated with various reforms, but these are often one-time savings that do little to change the long-term spending trajectory. Instead, the priority now should be to create institutions that will allow future cost containment to be successful. The appropriate balance between the roles of government and markets within these institutions is a function of politics and philosophy as much as economics. Institutions that emphasize markets will struggle with income disparities and market failures, whereas those that give government a more central role will wrestle with political pressures affecting payment updates and inefficiencies generated by administratively set prices. Although assessing the magnitude of the effects of both these strategies is necessarily speculative, failing to move forward at all seems a bigger risk.

Financial and other disclosures provided by the authors are available with the full text of this article at NEJM.org.

What immediate steps should be taken to begin controlling health care spending?
See what other readers have to say, and submit a comment to participate in our weekly forum.

Source Information

From the Department of Health Care Policy, Harvard Medical School, Boston (M.E.C., L.S., J.P.N.); and the John F. Kennedy School of Government, Harvard University, Cambridge, MA (A.C.).

This article (10.1056/NEJMp0910194) was published on December 9, 2009, at NEJM.org.

References

  1. Chernew ME, Hirth RA, Cutler DM. Increased spending on health care: long-term implications for the nation. Health Aff (Millwood) 2009;28:1253-1255. [Free Full Text]
  2. Sutherland JM, Fisher ES, Skinner JS. Getting past denial — the high cost of health care in the United States. N Engl J Med 2009;361:1227-1230. [Free Full Text]
  3. Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL. The implications of regional variations in Medicare spending. Part 1: the content, quality, and accessibility of care. Ann Intern Med 2003;138:273-287. [Free Full Text]
  4. Chernew ME, Newhouse JP. What does the RAND Health Insurance Experiment tell us about the impact of cost sharing on health outcomes? Am J Manag Care 2008;14:412-414. [Web of Science][Medline]
  5. Chernew ME, Rosen AB, Fendrick AM. Value-based insurance design. Health Aff (Millwood) 2007;26:w195-w203. [Free Full Text]

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Ensuring the Fiscal Sustainability of Health Care Reform | Health Care Reform 2009; an excellent I wish I had written it myself essay on the challenges of cost containment

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