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Silvestri L, Issanchou D, Schuft L, Ferez S. How workplaces produce or reduce disability along the career paths of young people with cystic fibrosis. Health (London) 2024; 28:507-525. [PMID: 37409611 DOI: 10.1177/13634593231185265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Using the theoretical perspective of "social participation" as considered in the Human Development-Disability Creation Process, this article examines certain obstacles and facilitators to sustainable access to work among young French adults with cystic fibrosis. Drawing from the analyses of 29 qualitative interviews, the results show how such obstacles do not depend solely on their health status or on the medical management of the illness, but also on the work environments that these young professionals have recently entered or are trying to access. In these contexts, managing information about the illness can represent a means of obtaining cooperation from colleagues and superiors to reduce material or organizational obstacles (e.g. adapted work schedules), as well as a means of preventing socially uncomfortable or disabling situations. In this light, the social participation model can complement Corbin and Strauss' illness trajectory model, by setting the multi-factorial disabling or participatory situations along illness or medical trajectories. This enables dynamic consideration of how workplaces contribute to producing or reducing disability, in interaction with the actions taken by young people with cystic fibrosis to manage their career paths but also the evolution of illness, symptoms, or medical requirements.
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Affiliation(s)
| | | | | | - Sylvain Ferez
- Centre Max Weber (UMR 5283), France
- University of Montpellier, France
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2
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Tluczek A, Ersig AL, Lee S. Psychosocial Issues Related to Newborn Screening: A Systematic Review and Synthesis. Int J Neonatal Screen 2022; 8:ijns8040053. [PMID: 36278623 PMCID: PMC9589938 DOI: 10.3390/ijns8040053] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/10/2022] [Accepted: 09/14/2022] [Indexed: 11/20/2022] Open
Abstract
Genomic advances have contributed to a proliferation of newborn screening (NBS) programs. Psychosocial consequences of NBS have been identified as risks to these public health initiatives. Following PRISMA guidelines, this systematic review synthesizes findings from 92 evidence-based, peer-reviewed research reports published from 2000 through 2020 regarding psychosocial issues associated with NBS. Results describe parents' knowledge of and attitudes towards NBS, reactions to and understanding of positive NBS results, experiences of communication with health providers, decisions about carrier testing, and future pregnancies. Findings also explain the impact of positive NBS results on parent-child relationships, child development, informing children about carrier status, family burden, quality of life, and disparities. In conclusion, psychosocial consequences of receiving unexpected neonatal screening results and unsolicited genetic information remain significant risks to expansion of NBS. Findings suggest that risks may be mitigated by improved parent NBS education, effective communication, individualized genetic counseling, and anticipatory developmental guidance. Clinicians need to take extra measures to ensure equitable service delivery to marginalized subpopulations. Future investigations should be more inclusive of culturally and socioeconomically diverse families and conducted in low-resource countries. Providing these countries with adequate resources to develop NBS programs is an essential step towards achieving international health equity.
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Affiliation(s)
- Audrey Tluczek
- School of Nursing, University of Wisconsin-Madison, 701 Highland Ave, Madison, WI 53705, USA
- Correspondence:
| | - Anne L. Ersig
- School of Nursing, University of Wisconsin-Madison, 701 Highland Ave, Madison, WI 53705, USA
| | - Shinhyo Lee
- School of Nursing, Columbia University, 560 W 168th St, New York, NY 10032, USA
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Armstrong RE, Frith L, Ulph FM, Southern KW. Constructing a Bioethical Framework to Evaluate and Optimise Newborn Bloodspot Screening for Cystic Fibrosis. Int J Neonatal Screen 2020; 6:40. [PMID: 33073032 PMCID: PMC7422997 DOI: 10.3390/ijns6020040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/04/2020] [Indexed: 12/15/2022] Open
Abstract
Newborn bloodspot screening for cystic fibrosis is a valid public health strategy for populations with a high incidence of this inherited condition. There are a wide variety of approaches to screening and in this paper, we propose that a bioethical framework is required to determine the most appropriate screening protocol for a population. This framework depends on the detailed evaluation of the ethical consequences of all screening outcomes and placing these in the context of the genetic profile of the population screened, the geography of the region and the healthcare resources available.
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Affiliation(s)
- Rachael E Armstrong
- Department of Women's and Children's Health, University of Liverpool, Liverpool L12 2AP, UK;
| | - Lucy Frith
- Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK;
| | - Fiona M Ulph
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK;
| | - Kevin W Southern
- Department of Women's and Children's Health, University of Liverpool, Liverpool L12 2AP, UK;
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Scotet V, Gutierrez H, Farrell PM. Newborn Screening for CF across the Globe- Where Is It Worthwhile? Int J Neonatal Screen 2020; 6:18. [PMID: 33073015 PMCID: PMC7422974 DOI: 10.3390/ijns6010018] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 02/24/2020] [Indexed: 12/25/2022] Open
Abstract
Newborn screening (NBS) for cystic fibrosis (CF) has been performed in many countries for as long as four decades and has transformed the routine method for diagnosing this genetic disease and improved the quality and quantity of life for people with this potentially fatal disorder. Each region has typically undertaken CF NBS after analysis of the advantages, costs, and challenges, particularly regarding the relationship of benefits to risks. The very fact that all regions that began screening for CF have continued their programs implies that public health and clinical leaders consider early diagnosis through screening to be worthwhile. Currently, many regions where CF NBS has not yet been introduced are considering options and in some situations negotiating with healthcare authorities as policy and economic factors are being debated. To consider the assigned question (where is it worthwhile?), we have completed a worldwide analysis of data and factors that should be considered when CF NBS is being contemplated. This article describes the lessons learned from the journey toward universal screening wherever CF is prevalent and an analytical framework for application in those undecided regions. In fact, the lessons learned provide insights about what is necessary to make CF NBS worthwhile.
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Affiliation(s)
- Virginie Scotet
- Inserm, University of Brest, EFS, UMR 1078, GGB, F-29200 Brest, France
| | - Hector Gutierrez
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA;
| | - Philip M. Farrell
- Departments of Pediatrics and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA;
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Gundogdu U, Fis NP, Eralp EE, Karadag BT. Major depression and psychiatric comorbidity in Turkish children and adolescents with cystic fibrosis. Pediatr Pulmonol 2019; 54:1927-1935. [PMID: 31456343 DOI: 10.1002/ppul.24492] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 08/05/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND Many psychological factors contribute to an increased risk of depression in children and adolescents with cystic fibrosis (CF). This study aims to evaluate coexisting psychiatric disorders, perceived social support, and quality of life (QoL) in Turkish children with CF and compare these factors with those of a control group. METHODS The study group consisted of 32 children (8-16 years of age) with CF and a group of 33 age- and sex-matched control children. All subjects completed the Children's Depression Inventory (CDI), Screen for Child Anxiety and Related Disorders (SCARED), Social Support Appraisals Scale, and Pediatric Quality of Life Questionnaire. Psychiatric diagnoses were established using the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. RESULTS Of the children with CF, 80% of those in the 8 to 11 years age range and 50% of those in the 12 to 17 years age range had at least one psychiatric disorder, that is, 68% of the 33 children with CF had at least one psychiatric disorder. Anxiety disorder (46.8%) and attention deficit and hyperactivity disorder (21.8%) were also common among children with CF. The rates of depression in the CF group and control group were 21.9% and 6.1%, respectively (P > .05). The CF subjects with coexisting depression exhibited higher levels of disease severity, longer periods of hospitalization, and more frequent anxiety disorder. When compared with the control group, the QoL among the Turkish children with CF was lower (P < .05). The CDI and SCARED are relatively sensitive and specific screening tools for depression and anxiety in children with CF. CONCLUSIONS Psychiatric disorders were more frequently found in children and adolescents with CF. By examining symptoms of anxiety and depression and by using screening tools, CF patients who exhibit symptoms of psychiatric disorders can be better identified and evaluated.
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Affiliation(s)
| | - Nese P Fis
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Ela E Eralp
- Department of Pediatric Pulmonology, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Bulent T Karadag
- Department of Pediatric Pulmonology, Faculty of Medicine, Marmara University, İstanbul, Turkey
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Secinti E, Thompson EJ, Richards M, Gaysina D. Research Review: Childhood chronic physical illness and adult emotional health - a systematic review and meta-analysis. J Child Psychol Psychiatry 2017; 58:753-769. [PMID: 28449285 DOI: 10.1111/jcpp.12727] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Childhood chronic physical illness is associated with a greater vulnerability for emotional problems (i.e. depression and anxiety) in childhood. However, little is known about life-long effects of childhood chronic physical illness on mental health. The present study aims to systematically review evidence for associations between eight chronic physical illnesses with childhood onset (arthritis, asthma, cancer, chronic renal failure, congenital heart disease, cystic fibrosis, type 1 diabetes, and epilepsy) and adult emotional problems. METHODS A database search of MEDLINE, PsycARTICLES, PsycINFO, and ScienceDirect was undertaken, and random effects meta-analyses were used to synthesise evidence from eligible studies. RESULTS In total, 37 studies were eligible for the systematic review (n = 45,733) and of these, 34 studies were included in the meta-analyses (n = 45,358). There were overall associations between childhood chronic physical illness and adult depression (OR = 1.31; 95% CI [1.12, 1.54]) and anxiety (OR = 1.47; 95% CI [1.13, 1.92]). Separate meta-analyses for childhood asthma, type 1 diabetes and cancer were also conducted, with cancer being significantly associated with adult depression (OR = 1.19; 95% CI [1.00, 1.42]). CONCLUSIONS The effects of childhood chronic physical illness on the risk of emotional problems persist beyond childhood and adolescence. Mental health prevention and intervention strategies targeting children with chronic physical illnesses can have long-term benefits.
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Affiliation(s)
- Ekin Secinti
- EDGE Lab, School of Psychology, University of Sussex, Brighton, UK.,Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Ellen J Thompson
- EDGE Lab, School of Psychology, University of Sussex, Brighton, UK
| | | | - Darya Gaysina
- EDGE Lab, School of Psychology, University of Sussex, Brighton, UK
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Raraigh KS, Pastore MT, Greene L, Karczeski BA, Fisher LK, Ramsey BW, Langfelder-Schwind E. Diagnosis and Treatment of Cystic Fibrosis: A (Not-so) Simple Recessive Condition. CURRENT GENETIC MEDICINE REPORTS 2017. [DOI: 10.1007/s40142-017-0122-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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8
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Isa HM, Al-Ali LF, Mohamed AM. Growth assessment and risk factors of malnutrition in children with cystic fibrosis. Saudi Med J 2017; 37:293-8. [PMID: 26905352 PMCID: PMC4800894 DOI: 10.15537/smj.2016.3.13476] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objectives: To evaluate the nutritional status, to screen for the presence of malnutrition, and to study the possible risk factors associated with malnutrition in patients with cystic fibrosis (CF). Methods: A retrospective cross-sectional review of medical records of all diagnosed CF patients in the Pediatric Department, Salmaniya Medical Complex, Manama, Kingdom of Bahrain, between January 1984 and May 2015 was conducted. Demographic and anthropometric data were collected from records of last visit to CF clinic. Nutritional status and risk factors of malnutrition were assessed. Results: All records of 109 CF patients were reviewed. Forty-seven pediatric patients were included in the study. All included patients were on pancreatic enzyme replacement and 42 (89%) received high-calorie supplementation. Growth failure was noted in 34 (72%) patients, 19 (56%) were wasted and stunted, 8 (23.5%) were wasted only, and 7 (20.5%) were stunted. Low birth weight (p=0.032), and the presence of gastroesophageal reflux disease (GERD) (p=0.039) were the significant risk factors for malnutrition. Conclusion: Most CF patients in Bahrain (72%) are malnourished. Low birth weight and the presence of GERD are risk factors.
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Affiliation(s)
- Hasan M Isa
- Pediatric Department, Salmaniya Medical Complex, Manama, Kingdom of Bahrain. E-mail.
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Oates GR, Schechter MS. Socioeconomic status and health outcomes: cystic fibrosis as a model. Expert Rev Respir Med 2016; 10:967-77. [DOI: 10.1080/17476348.2016.1196140] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Mak DYF, Sykes J, Stephenson AL, Lands LC. The benefits of newborn screening for cystic fibrosis: The Canadian experience. J Cyst Fibros 2016; 15:302-8. [PMID: 27118577 DOI: 10.1016/j.jcf.2016.04.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 03/29/2016] [Accepted: 04/05/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The impact of newborn screening (NBS) for cystic fibrosis (CF) on early indicators of long-term health was evaluated in the context of government-sponsored healthcare and access to current therapies. METHODS Using data from the Canadian CF Registry between 2008 and 2013, we compared the rates of respiratory infections and markers of nutritional status in those diagnosed through NBS to those who were diagnosed clinically within the same time period using Mann-Whitney and Fischer's exact test as appropriate. RESULTS The study included 303 subjects, 201 in the NBS group and 102 in the non-NBS group. NBS patients were diagnosed earlier and had their first clinic visit at a younger age. Pancreatic insufficiency was less common in NBS patients. The incidence of Pseudomonas aeruginosa and Staphylococcus aureus were lower in NBS patients. After adjusting for age at clinic visit, gender, pancreatic status, and Pseudomonas aeruginosa infection status, mean z-scores for weight-for-age and height-for-age were higher in NBS patients, with no differences in BMI-for-age. CONCLUSIONS NBS programs for CF lead to improved long-term health outcomes for the CF population.
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Affiliation(s)
- D Y F Mak
- Cystic Fibrosis Canada, 2323 Yonge Street Suite 800, Toronto, M4P 2C9, Canada.
| | - J Sykes
- Department of Respirology, St. Michael's Hospital, 30 Bond Street, Toronto, M5B 1W8, Canada; Keenan Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, M5B 1T8, Canada.
| | - A L Stephenson
- Department of Respirology, St. Michael's Hospital, 30 Bond Street, Toronto, M5B 1W8, Canada; Keenan Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, M5B 1T8, Canada.
| | - L C Lands
- Meakins-Christie Laboratories, Research Institute of McGill University Health Centre, Montreal, Canada; Montreal Children's Hospital-McGill University Health Centre, Respiratory Division, Montreal, Canada.
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Savant AP, McColley SA. 2014 year in review: Cystic fibrosis. Pediatr Pulmonol 2015; 50:1147-56. [PMID: 26347000 DOI: 10.1002/ppul.23309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 07/26/2015] [Accepted: 08/22/2015] [Indexed: 12/23/2022]
Abstract
In this article, we highlight cystic fibrosis (CF) research published in Pediatric Pulmonology during 2014, as well as related articles published in other journals.
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Affiliation(s)
- Adrienne P Savant
- Division of Pulmonary Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Illinois.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Susanna A McColley
- Division of Pulmonary Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Illinois.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Stanley Manne Children's Research Institute, Illinois
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Bardach NS, Coker TR, Zima BT, Murphy JM, Knapp P, Richardson LP, Edwall G, Mangione-Smith R. Common and costly hospitalizations for pediatric mental health disorders. Pediatrics 2014; 133:602-9. [PMID: 24639270 PMCID: PMC3966505 DOI: 10.1542/peds.2013-3165] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Inpatient pediatric mental health is a priority topic for national quality measurement and improvement, but nationally representative data on the patients admitted or their diagnoses are lacking. Our objectives were: to describe pediatric mental health hospitalizations at general medical facilities admitting children nationally; to assess which pediatric mental health diagnoses are frequent and costly at these hospitals; and to examine whether the most frequent diagnoses are similar to those at free-standing children's hospitals. METHODS We examined all discharges in 2009 for patients aged 3 to 20 years in the nationally representative Kids' Inpatient Database (KID) and in the Pediatric Health Information System (free-standing children's hospitals). Main outcomes were frequency of International Classification of Diseases, Ninth Revision, Clinical Modification-defined mental health diagnostic groupings (primary and nonprimary diagnosis) and, using KID, resource utilization (defined by diagnostic grouping aggregate annual charges). RESULTS Nearly 10% of pediatric hospitalizations nationally were for a primary mental health diagnosis, compared with 3% of hospitalizations at free-standing children's hospitals. Predictors of hospitalizations for a primary mental health problem were older age, male gender, white race, and insurance type. Nationally, the most frequent and costly primary mental health diagnoses were depression (44.1% of all mental health admissions; $1.33 billion), bipolar disorder (18.1%; $702 million), and psychosis (12.1%; $540 million). CONCLUSIONS We identified the child mental health inpatient diagnoses with the highest frequency and highest costs as depression, bipolar disorder, and psychosis, with substance abuse an important comorbid diagnosis. These diagnoses can be used as priority conditions for pediatric mental health inpatient quality measurement.
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Affiliation(s)
- Naomi S. Bardach
- Department of Pediatrics, University of California at San Francisco, San Francisco, California
| | - Tumaini R. Coker
- Children’s Discovery and Innovation Institute and Mattel Children’s Hospital University of California at Los Angeles, Los Angeles, California;,RAND Corporation, Santa Monica, California
| | - Bonnie T. Zima
- Department of Psychiatry and Biobehavioral Science, University of California at Los Angeles, Los Angeles, California
| | - J. Michael Murphy
- Child Psychiatry Service, Massachusetts General Hospital, Boston, Massachusetts;,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Penelope Knapp
- Department of Psychiatry, University of California at Davis, Davis, California
| | - Laura P. Richardson
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington;,Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; and
| | - Glenace Edwall
- Minnesota State Health Access Data Assistance Center, Minneapolis, Minnesota
| | - Rita Mangione-Smith
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington;,Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; and
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