Long-Term Effects of Maternal Smoking on Quality of Life. Results from the Copenhagen Perinatal Birth Cohort 1959–61

The Copenhagen Perinatal Birth Cohort 1959–61 is a prospective longitudinal perinatal study that included all deliveries (over 20 weeks gestation, birthweight over 250 g) that took place at the University Hospital (Rigshospitalet) in Copenhagen, Denmark during the period of September 21, 1959 to December 21, 1961 and used in this follow-up study to investigate the connection between maternal smoking during pregnancy and the quality of life of the child 31 to 33 years later. The latest follow-up study from the cohort was performed in 1993 and 7,222 of the surviving children were identified (now aged between 31 and 33 years) and contacted with a nonanonymous questionnaire on several aspects of quality of life issues.There were 4,626 usable responses (f = 2,489, m = 2,131) corresponding to a response rate of 64.1%. The children whose mothers were nonsmokers or smoked less than three cigarettes a day had a quality of life that was 2.7% better than those children whose mothers had smoked over ten cigarettes per day. At first glance these figures seem small; however, when compared with other early life factors we see that mothers smoking more than ten cigarettes per day is one of the most important early predictors in our study for the quality of life (QOL) of the child as an adult. As most people in our study have a QOL rating between 55% and 85%, 2.7% is about 10% of normal variation. It seems that exposure to tobacco smoke during pregnancy has a small but significant effect on the quality of life in later adult life. However, the underlying causal factor for this reduction in quality of life remains unclear. Nevertheless, pregnant mothers should be made aware of the potential long-term effects smoking can have on their children

Do Not Play With Fire

Fire is the rapid oxidation of a material in the exothermic chemical process of combustion, releasing heat, light and various reaction products. Fire is intriguing and therefore something that will attract a curious child from an early age. In 2010, the United States fire department responded to 44,900 fires started by someone, usually a child, playing with fire. These fires caused 90 civilian deaths, 890 civilian injuries and $210 million in direct property damage. Preschoolers and kindergartners are most likely to start these fires, while playing with matches or lighters and most likely to die in these fires. Most fire-play fires (77%) started outside, but most associated deaths (97%) were in home structure fires. Almost half (46%) of people who start reported home fires by playing were five years old or younger. Two out of five (40%) child-playing home structure fires began in the bedroom. Mattresses and bedding were the items first ignited in 24% of child-playing home structure fires and 29% of associated civilian fire deaths

Intellectual and Developmental Disability: Healthcare Financing

The World Health Organization (WHO) estimates global spending on healthcare at $6.5 trillion, approximately 10.5$2.6 trillion, essentially quadrupling since 1980. The 2010 United States Patient Protection and Affordable Care Act (PPACA), also known as Obamacare, has stimulated extensive debate over the way in which healthcare is financed, and whether or not the costs of healthcare are sustainable. Among publicly funded healthcare in the US, Medicaid and Medicare are primary sources of funding. In federal fiscal year 2012, Medicaid spending on acute health exceeded $275.4 billion, while a further$122.7 billion expended in Medicaid long term services and supports. The impact of an aging population worldwide (the so-called “wave of wisdom”), as the Baby Boomer generation reaches senior status, and attendant increases in chronic conditions, will be a substantial driver of healthcare costs in the future. Among people with intellectual and developmental disabilities (IDD), cost estimates vary depending on a range of factors. Some children with IDD, for example, are covered for at least some healthcare needs by private insurance policies held by their parents, while other children and most adults with IDD rely heavily on Medicaid and, to a lesser extent, Medicare and other publicly financed healthcare options. In many US states, certain nursing and home health services are presumed to be part of funding of home and community-based service (HCBS) medicaid waiver services (typically considered part of residential service reimbursements under these waivers), and rely on medicaid state plans for other acute health services. There are also wide ranges of estimates of uncompensated care that, when combined with other variables that are difficult to control, make accurate aggregate cost estimates difficult. Birenbaum and Cohen offer a review of healthcare utilization and costs in general for people with IDD

Obesity and Lack of Physical Activity

Lack of physical activity and overweight status continues to be a significant health problem in the United States. To assess the actual prevalence of these problems, we reviewed data from the School-based Health Promotion Centers in one middle school, and one high school in central Kentucky. A total of 232 6th graders and 607 9th graders were included. A total of 92% of 6th graders and 45% of 9th graders reported complete lack of regular exercise. 37% of 9th graders and 59% of 6th graders had inappropriate nutrition, 47% of 9th graders and 33% of 6th graders had Body Mass Index over the 85th percentile for age. Among overweight adolescents, only 16% of 9th graders and 1% of 6th graders thought they were overweight. Since the body mass index data is derived from actual objective measurement, we conclude that overweight status is a significant problem in Kentucky and that the actual numbers may be higher than those reported for the State based on surveys and estimates. Furthermore, many adolescents are not aware of their weight problem and most of them do not participate in regular exercise

The Young and Suicide

No abstract available.</jats:p

Suicidal Behavior and Prevention in Adolescence

Suicidal behavior in youth is not uncommon and currently one of the leading causes of death in adolescence in many countries around the world. Individual risk factors for suicidality in youth include: psychiatric disorder; certain personality characteristics; genetics; gender; sexual orientation; and previous suicide attempts. Family psychopathology and environmental factors such as media contagion also contribute as risk factors. Developmental issues, including: the establishment of independence and intimate relationships; as well as the pursuit of personal and career goals; may also provide stressors leading to suicidality. Prevention and intervention strategies are considered and include: early detection and treatment of mental disorders that increase suicide risk; increasing mental health services; training non-mental health professionals to assess for suicidality in young people; and providing post-attempt assessment and treatment