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Knight LMJ, Tanabe P, Blewer AL, Goodrich J, King AA, Reuter-Rice K, Crego N. Association of hydroxyurea adherence with transcranial Doppler screenings in children with sickle cell disease. Pediatr Blood Cancer 2024; 71:e31017. [PMID: 38706206 DOI: 10.1002/pbc.31017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/11/2024] [Accepted: 03/25/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND National sickle cell disease (SCD) guidelines recommend oral hydroxyurea (HU) starting at 9 months of age, and annual transcranial Doppler (TCD) screenings to identify stroke risk in children aged 2-16 years. We examined prevalence and proportion of TCD screenings in North Carolina Medicaid enrollees to identify associations with sociodemographic factors and HU adherence over 3 years. STUDY DESIGN We conducted a longitudinal study with children ages 2-16 years with SCD enrolled in NC Medicaid from years 2016-2019. Prevalence of TCD screening claims was calculated for 3 years, and proportion was calculated for 12, 24, and 36 months of Medicaid enrollment. Enrollee HU adherence was categorized using HU proportion of days covered. Multivariable Poisson regression assessed for TCD screening rates by HU adherence, controlling for age, sex, and rurality. RESULTS The prevalence of annual TCD screening was between 39.5% and 40.1%. Of those with 12-month enrollment, 77.8% had no TCD claims, compared to 22.2% who had one or higher TCD claims. Inversely, in children with 36 months of enrollment, 36.7% had no TCD claims compared to 63.3% who had one or higher TCD claims. The proportion of children with two or higher TCD claims increased with longer enrollment (10.5% at 12 months, 33.7% at 24 months, and 52.6% at 36 months). Children with good HU adherence were 2.48 (p < .0001) times more likely to have TCD claims than children with poor HU adherence. CONCLUSION While overall TCD screening prevalence was low, children with better HU adherence and longer Medicaid enrollment had more TCD screenings. Multilevel interventions are needed to engage healthcare providers and families to improve both evidence-based care and annual TCD screenings in children with SCD.
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Affiliation(s)
| | - Paula Tanabe
- Duke University School of Nursing and Medicine, Durham, North Carolina, USA
| | - Audrey L Blewer
- Duke University School of Nursing, Durham, North Carolina, USA
- Department of Family Medicine, Community Health, and Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - James Goodrich
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Allison A King
- Departments of Pediatrics, Hematology and Oncology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Karin Reuter-Rice
- Duke University School of Nursing, Durham, North Carolina, USA
- Departments of Pediatrics and Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Nancy Crego
- Duke University School of Nursing, Durham, North Carolina, USA
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MacEwan JP, King AA, Nguyen A, Mubayi A, Agodoa I, Smith-Whitley K. Cognition and education benefits of increased hemoglobin and blood oxygenation in children with sickle cell disease. PLoS One 2023; 18:e0289642. [PMID: 37552696 PMCID: PMC10409269 DOI: 10.1371/journal.pone.0289642] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/22/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Among individuals with sickle cell disease (SCD), decreased hemoglobin is associated with lower oxygen saturation (SpO2) and increased risk of stroke, both of which are associated with lower intelligence quotient (IQ) scores. Thus, increasing hemoglobin and SpO2 in individuals with SCD may increase IQ and educational attainment. METHODS A cohort simulation model was built to determine academic performance and educational attainment based on cognitive function (measured by IQ) of a pediatric SCD cohort randomly assigned to treatment and control groups. The model contained two key stages: childhood (<10 years) and adolescence (≥10 years). In stage 1, increased hemoglobin and increased SpO2 (assigned to the treatment group) were determinants of higher IQ, prevention of IQ deterioration over time. Increased hemoglobin was also a determinant of decreased stroke risk. In stage 2, improvement in adolescent IQ as a result of treatment was a determinant of academic performance. RESULTS In a simulated cohort of 2000 children and adolescents with SCD (52.5% female, 50% treated), stroke incidence was predicted to be 44.4% lower among the treated group than the untreated group (4.5% versus 8.1%, respectively). The average IQ among the treated group was estimated to be 91.1 compared with 82.9 in the untreated group (a 9.9% difference; P<0.001). Finally, high school (≥12 years of education) completion rates were estimated to be 64.7% higher among the treated group: 76.1% of the treated group was projected to complete high school compared with 46.2% of the untreated group. CONCLUSIONS Our model predicts that an average improvement in hemoglobin of 1.1 g/dL (11 g/L) among individuals with SCD may be associated with improved neurocognition and educational outcomes. These improvements may also generate benefits not captured by our model, including improved quality of life, employment, and income.
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Affiliation(s)
| | - Allison A. King
- Division of Pediatric Hematology/Oncology, Washington University and St. Louis Children’s Hospital, St. Louis, Missouri, United States of America
| | - Andy Nguyen
- Global Blood Therapeutics, Inc., South San Francisco, California, United States of America
| | - Anuj Mubayi
- PRECISIONheor, Los Angeles, California, United States of America
| | - Irene Agodoa
- Global Blood Therapeutics, Inc., South San Francisco, California, United States of America
| | - Kim Smith-Whitley
- Global Blood Therapeutics, Inc., South San Francisco, California, United States of America
- Division of Hematology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
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Alhazmi A, Hakami K, Abusageah F, Jaawna E, Khawaji M, Alhazmi E, Zogel B, Qahl S, Qumayri G. The Impact of Sickle Cell Disease on Academic Performance among Affected Students. CHILDREN (BASEL, SWITZERLAND) 2021; 9:children9010015. [PMID: 35053640 PMCID: PMC8773889 DOI: 10.3390/children9010015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/08/2021] [Accepted: 12/21/2021] [Indexed: 01/01/2023]
Abstract
Background: Sickle cell disease (SCD) is a genetic disease that is highly prevalent in Jazan Province, Saudi Arabia, and is mostly characterized by many complications such as vaso-occlusive crises (VOC), acute chest syndrome (ACS) and well-documented neurological complications. These complications may affect patients’ academic performance. Methods: An observational, cross-sectional, retrospective study was conducted in Jazan Province. General and demographic data were collected and questions about academic performance of students with SCD were answered. Both t-tests and chi-square tests, along with multiple logistic regression, were used for analysis. Results: 982 participants were selected for this study with a mean age of 23 years (SD: 7). Most of the participants were female (64%). The number of participants with SCD was 339 (36%), of whom 42% were male. Students with SCD recorded lower grade point averages (GPA) and more absences compared to healthy participants. Further, about 60% of students with SCD thought they performed better than 40% of the participants without SCD during the COVID-19 pandemic when most of the educational activities were online. Conclusion: As has been previously reported, this study suggested that the academic performance of students with SCD is negatively affected compared to healthy individuals, and this is mostly due to complications associated with the disease. Further, students with SCD acknowledged better performance with online education, an option that should be considered to improve their academic performance. National studies on a larger population are required by health and education officials, and supportive online educational programs are warranted to enhance the academic performance of this population.
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Affiliation(s)
- Abdulaziz Alhazmi
- Department of Microbiology and Parasitology, College of Medicine, Jazan University, Jazan 45142, Saudi Arabia
- Emerging and Epidemic Infectious Diseases Research Unit, Medical Research Center, Jazan University, Jazan 45142, Saudi Arabia
- Correspondence: ; Tel.: +966-7-3295000
| | - Khalid Hakami
- College of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (K.H.); (F.A.); (E.J.); (M.K.); (E.A.); (B.Z.); (S.Q.); (G.Q.)
| | - Faisal Abusageah
- College of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (K.H.); (F.A.); (E.J.); (M.K.); (E.A.); (B.Z.); (S.Q.); (G.Q.)
| | - Essa Jaawna
- College of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (K.H.); (F.A.); (E.J.); (M.K.); (E.A.); (B.Z.); (S.Q.); (G.Q.)
| | - Meshal Khawaji
- College of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (K.H.); (F.A.); (E.J.); (M.K.); (E.A.); (B.Z.); (S.Q.); (G.Q.)
| | - Essam Alhazmi
- College of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (K.H.); (F.A.); (E.J.); (M.K.); (E.A.); (B.Z.); (S.Q.); (G.Q.)
| | - Basem Zogel
- College of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (K.H.); (F.A.); (E.J.); (M.K.); (E.A.); (B.Z.); (S.Q.); (G.Q.)
| | - Salman Qahl
- College of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (K.H.); (F.A.); (E.J.); (M.K.); (E.A.); (B.Z.); (S.Q.); (G.Q.)
| | - Ghadeer Qumayri
- College of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (K.H.); (F.A.); (E.J.); (M.K.); (E.A.); (B.Z.); (S.Q.); (G.Q.)
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Peterson RK, Williams S, Janzen L. Cognitive Correlates of Math Performance in School-Aged Children with Sickle Cell Disease and Silent Cerebral Infarcts. Arch Clin Neuropsychol 2021; 36:465-474. [PMID: 32890401 DOI: 10.1093/arclin/acaa071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Attention, processing speed, executive functioning, and math difficulties are common in youth with sickle cell disease (SCD) with silent cerebral infarcts (SCI). This study investigated the cognitive underpinnings of math difficulties in children with SCD and SCI. METHOD Youth (n = 68) with SCD and SCI completed measures of attention [Digit Span forward (DSF); Conners Continuous Performance Test-Third Edition/Kiddie Conners Continuous Performance Test-Second Edition (CPT-3/KCPT-2)]; working memory [Wechsler Intelligence Scales (WPPSI-IV, WISC-IV, WISC-V, WAIS-IV), Working Memory Index (WMI), Digit Span backwards (DSB)]; processing speed [WPPSI-IV, WISC-IV, WISC-V, WAIS-IV Processing Speed Index (PSI)]; math reasoning [Wechsler Individual Achievement Test-Third Edition (WIAT-III) Mathematics composite (MC)]; and math fluency [WIAT-III Math Fluency composite (MF)] as part of a clinical neuropsychological evaluation. Parent ratings of attention and executive functioning were obtained [Behavior Assessment System for Children-Third Edition (BASC-3), Behavior Rating Inventory of Executive Function (BRIEF)]. RESULTS MC was positively correlated with WMI (r = 0.59, p = 0.00), PSI (r = 0.40, p < 0.001), DSF (r = 0.29, p = 0.03), DSB (r = 0.47, p < 0.001), and MF (r = 0.71, p < 0.001). Correlations between MC, sustained attention, and parent ratings were nonsignificant. The linear regression model using correlated variables was significant [F(4,51) = 8.29, R2 = 0.39, p < 0.001]. WMI was the only significant variable within the model (p = 0.02). CONCLUSIONS Working memory deficits account for significant variance in untimed mathematical performance in this population-consistent with other populations with white matter dysfunction. Interventions targeting both mathematics and working memory may be beneficial.
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Affiliation(s)
- Rachel K Peterson
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Suzan Williams
- Department of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Laura Janzen
- Department of Neuropsychology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Knight LM, King AA, Strouse JJ, Tanabe P. Pediatric Neurodevelopmental Delays in Children 0 to 5 Years of Age With Sickle Cell Disease: A Systematic Literature Review. J Pediatr Hematol Oncol 2021; 43:104-111. [PMID: 33560086 PMCID: PMC8254873 DOI: 10.1097/mph.0000000000002091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 12/28/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Sickle cell disease (SCD) is the most common abnormal genetic blood disease that affects ∼100,000 Americans. Approximately 20% to 37% of children with sickle cell anemia have silent cerebral infarcts by the age of 14 years old. Neurocognitive deficits are identified in infants and preschool children with SCD. The purpose of this systematic literature review is to provide a comprehensive understanding of the prevalence, severity, and the associated risk factors for neurodevelopmental delays (NDDs) in children with SCD 5 years of age and younger. METHODS Systematic search of 6 databases identified 2467 potentially relevant publications and 8 were identified through a manual search. Only 24 articles met the inclusion criteria. RESULTS We identified an increased prevalence of NDDs (cognitive, motor, or both). Children experienced deficits with language, attention and behavior, executive functioning, school readiness and/or academic performance, and motor skills (fine and gross motor functioning). Risk factors include silent cerebral infarcts and strokes, SCD genotype (HbSS>HbSC), other biologic, and social factors. CONCLUSION NDDs are common in children ages 0 to 5 years old with SCD. There is an opportunity to improve adherence to national guideline recommendations and early detection practices by pediatricians, hematologists, and other health care providers.
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Yan AP, Sawhney M, Kirby-Allen M. Impact of a Residential Summer Camp Experience on Children With Sickle Cell Disease. Ochsner J 2021; 21:352-357. [PMID: 34984049 PMCID: PMC8675620 DOI: 10.31486/toj.20.0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Sickle cell disease (SCD) has a significant psychosocial impact on affected children. Summer camp has been shown to improve psychological and physical states for children with diabetes and cancer. However, opportunities to attend camp for children with SCD are limited, as many are from low-income families, and many camps are not equipped to care for children with medical complexities. To our knowledge, no literature evaluates how camp can positively affect emotional functioning, social functioning, self-esteem, and physical activity levels in children with SCD. Methods: Children with SCD attending a residential summer camp during 2019 were identified. Participants completed a modified version of the Pediatric Camp Outcome Measure, a validated 29-item questionnaire that evaluates self-esteem, emotional function, social function, and physical activity. Four additional questions related to SCD were included. Results: Nine campers enrolled in the study. Questionnaire results showed a total score of 113.7 (maximum score135, range 84-129), with a self-esteem subscale score of 22.1 (maximum score 25, range 20-25), an emotional subscale score of 32.1 (maximum score 40, range 25-39), a social subscale score of 38.9 (maximum score 45, range 24-45), and a physical activity subscale score of 20.6 (maximum score 25, range 19-25). All campers indicated that they would return to camp. Conclusion: Attending summer camp has a beneficial impact on emotional function, social function, self-esteem, and physical activity. Mean questionnaire scores from children with cardiac disease and cancer are similar to those of children with SCD. Increased funding should be awarded to sickle cell camps to allow for more children to have this beneficial experience.
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Affiliation(s)
- Adam Paul Yan
- Division of Hematology/Oncology, The University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Monakshi Sawhney
- Division of Anesthesia and Perioperative Medicine, Queens University, Kingston, Ontario, Canada
| | - Melanie Kirby-Allen
- Division of Hematology/Oncology, The University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
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Salama N, Fahmy R, Youness ER. Cognitive functions and anti-oxidant in children with sickle cell disease: A single center based study. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2019. [DOI: 10.1186/s43054-019-0005-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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8
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Stallings AM, Majhail NS, Nowacki AS, Onimoe GI, Hanna R, Piccone CM. Paediatric haematologists’ attitudes regarding haematopoietic cell transplantation as treatment for sickle cell disease. Br J Haematol 2019; 188:976-984. [DOI: 10.1111/bjh.16248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 08/12/2019] [Indexed: 01/14/2023]
Affiliation(s)
| | | | - Amy S. Nowacki
- Quantitative Health SciencesCleveland Clinic ClevelandOHUSA
| | - Grace I. Onimoe
- Hematology and Oncology Cleveland Clinic Children’s Hospital ClevelandOHUSA
| | - Rabi Hanna
- Hematology and Oncology Cleveland Clinic Children’s Hospital ClevelandOHUSA
| | - Connie M. Piccone
- Hematology and Oncology University Hospitals Rainbow Babies and Children’s Cleveland OH USA
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Tusuubira SK, Naggawa T, Nakamoga V. To Join Or Not To Join? A Case Of Sickle Cell Clubs, Stigma And Discrimination In Secondary Schools In Butambala District, Uganda. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2019; 10:145-152. [PMID: 31632168 PMCID: PMC6778728 DOI: 10.2147/ahmt.s223956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 09/18/2019] [Indexed: 11/23/2022]
Abstract
Background People living with sickle cell face a lot of stigma and discrimination in Uganda. This stigma is as a result of the lack of the general conceptualization of this condition. For students, the stigma is often due to their differences like jaundice, delayed sexual maturation, and physical growth. This makes individuals with SCD targets for teasing and bullying. This study assessed the knowledge and perception among secondary school students in a rural district of Butambala at nine selected schools. The study also evaluated the use of sickle cell clubs as a tool for behavior change towards the associated stigma and discrimination. Methods A school-based cross-sectional study design was used to assess knowledge and perception towards sickle cell disease in secondary schools in Butambala district using self-administered questionnaires prior to and after set up of the sickle cell clubs. Results Out of the 375 student participants (59.5% female, 40.5% male) the majority (87.5%) were below 18 years; 68% of the respondents did not know that sickle cell is a genetic condition; 87.5% of the respondents highlighted that it is important for people with SCD to attend school; 54.4% of the respondents reported that people with SCD should not be given equal rights, while 56.0% of the respondents noted that people with SCD should not socialize. Conclusion It is evident the there is a big gap in sickle cell awareness among secondary school students coupled with a high level of stigma and discrimination. Sickle cell clubs have a positive effect towards behavior change while providing SCD knowledge and information.
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Affiliation(s)
- Sharifu K Tusuubira
- Uganda Sickle Cell Rescue Foundation, Kampala, Uganda.,Clarke International University, Kampala, Uganda
| | - Tracy Naggawa
- Uganda Sickle Cell Rescue Foundation, Kampala, Uganda
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Salih KMA. The impact of sickle cell anemia on the quality of life of sicklers at school age. J Family Med Prim Care 2019; 8:468-471. [PMID: 30984656 PMCID: PMC6436282 DOI: 10.4103/jfmpc.jfmpc_444_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Sickle cell anemia (SCA) is prevalent in Sudan in general, and in particular in the western part of the country among Misseria tribe. School absence, depressive symptoms, embarrassment, social disturbances, and emotional disturbance present negative impact for sicklers. Therefore, an urgent call for improving the quality of life of sicklers is needed. Objectives To examine the impact of SCA on the quality of life of school-age children affected by the disease from the perspective of three dimensions: psychological, social, and schooling. Materials and Methods This is a prospective, cross-sectional, observational study carried out over 2 weeks' period in April 2011 in Western Sudan, Gineana District. This study included 107 patients within the age group of 7-15 years with confirmed diagnosis of SCA in a steady state. A sickler with SCA who had hemoglobin genotype "SS" on hemoglobin electrophoresis without crises over the past 4 weeks was considered to be in steady state. Questionnaires designed by expert covering social and psychological aspects of the disease were filled by the authors. Results Of 107 patients with confirmed diagnosis of SCA in steady state, 54.2% of them were male. About 17.8%, 29.6%, 23.4%, 48.6%, 16.8%, and 45.8% of the patients suffered from school absence, teasing, embarrassment due to bedwetting, embarrassment due to jaundice, failure to contribute to school activities such as sport, and depressive symptoms, respectively. Around 8.4% of the patients repeated classes. Divorce and anxiety among sicklers' families were found in 6.5% and 8.4%, respectively. Twenty-one (19.6%) families had less interest in social activities in the community. Conclusion Sickle cell disease has many social and psychological problems which need to be addressed. Enuresis, depressive symptoms, school absentees, and deterioration in school performance were the common problems encountered.
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Affiliation(s)
- Karimeldin M A Salih
- Department of Pediatrics, College of Medicine, University of Bahri, Khatoum, Sudan.,Department of Pediatrics/Medical Education, College of Medicine, University of Bisha, Bisha, Saudi Arabia
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Parent and Guardian Knowledge of Hematopoietic Cell Transplantation as a Treatment Option for Sickle Cell Disease. J Pediatr Hematol Oncol 2019; 41:187-193. [PMID: 30789459 DOI: 10.1097/mph.0000000000001433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Beginning early in childhood, patients with sickle cell disease (SCD) are at risk of life-threatening and debilitating health events. Despite the high morbidity and mortality of this disease, hematopoietic cell transplantation (HCT), a curative treatment for SCD, remains underutilized. In the literature there is a paucity of data concerning medical decision maker (MDM) awareness of HCT as a treatment option for SCD. The objective of this study was to estimate the proportion of parents/guardians of children with SCD who are aware of HCT as a treatment option, and to identify the demographic factors associated with knowledge of this therapy's curative potential. Between November 2015 and December 2016, 327 parents/guardians were surveyed across 4 clinical sites in 3 Midwestern US cities. Although 82% of parents/guardians had heard of HCT in the past and 78% were aware of the therapy's curative potential, nearly half indicated that they did not know whether HCT could specifically cure their child of the disease. Respondents who had discussed HCT with their child's physician had 5 times higher odds of being aware of HCT's curative potential than those who had not. These findings suggest that additional efforts to enhance MDM knowledge of HCT as well as shared decision making in the use of this therapy, is warranted.
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Haridasa N, DeBaun MR, Sanger M, Mayo-Gamble TL. Student perspectives on managing sickle cell disease at school. Pediatr Blood Cancer 2019; 66:e27507. [PMID: 30387236 DOI: 10.1002/pbc.27507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 09/14/2018] [Accepted: 09/18/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The study objective was to identify the perceptions of children with sickle cell disease (SCD) in the school environment. METHODS Semistructured interviews (N = 14) were conducted with pediatric patients ages 6 to 10 who attended Metro Nashville Public Schools. These participants were recruited through the Vanderbilt Sickle Cell Disease Clinic. Participants were asked about the perceived efficacy of their teachers to (1) understand SCD; (2) communicate with students regarding SCD; (3) handle an SCD-related pain episode in school; and (4) identify methods to compensate for school absenteeism associated with an SCD diagnosis. Content analysis identified underlying themes. RESULTS Five themes emerged that highlighted the perceptions and recommendations of children with SCD in the school environment: (1) perceptions that allow students to prevent SCD from limiting their school experience; (2) administrator actions to alleviate challenges associated with SCD; (3) communication about SCD; (4) how SCD interferes with school activities; and (5) ways students advocate for themselves. Students also provided four areas of recommendations for school personnel: (1) ways teachers can help with school activities; (2) make-up work for school absences; (3) empowering students with SCD; and (4) helping with SCD episodes at school. CONCLUSIONS Students with SCD advocated strongly for their needs at school to attain their education. However, they perceived school personnel to lack knowledge about SCD management. This could be overcome with a handbook specific for teachers of students with SCD that could address each of the five themes.
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Affiliation(s)
- Naeha Haridasa
- Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Michael R DeBaun
- Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Tilicia L Mayo-Gamble
- Department of Community Health Behavior and Education, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia
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Nduagubam OC. A Comparison of the Academic Performance and Intelligence Scores of Asthmatic and Nonasthmatic Primary School Pupils in Enugu State, Nigeria. Niger Med J 2019; 60:1-8. [PMID: 31413427 PMCID: PMC6677004 DOI: 10.4103/nmj.nmj_1_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Children with asthma (subjects), just as their non asthmatic colleagues, are expected to perform optimally academically and with a good intelligent score. A number of activities in children with asthma may be affected by asthmatic attacks including their education/academic performance. Report on academic performance and IQ of school children with asthma and comparisons with those without asthma (controls) within and outside Nigeria are scanty. Aims: This study compared the academic performance and IQ of asthmatics and nonasthmatic school children. Materials and Methods: One hundred and twenty children with asthma aged 5-11 years were consecutively recruited at the asthma clinic of UNTH Enugu and their age, gender and socio-economic class-matched normal classmates were enrolled as controls. Academic performance of the children with asthma was studied using the overall scores achieved in the three term examinations in the preceding academic year (2012/2013), while their IQ was determined using the Draw-A-Person-test. The findings were compared with that of the 120 controls. Results: The median (range) overall academic scores for the subjects 79.04% (36.08%-99.57%) was similar to that of controls 80.01% (50.65%-97.47%) (U = 6804, P = 0.461). However, a significant number of subjects compared to controls had poor academic performance. The mean IQ scores for subjects (123.28 ± 21.45) and controls (118.41 ± 19.87) did not differ significantly (t = 1.83; P = 0.069). There was also a significant and negative correlation (Pearson's) between age and mean DAPQ in both the subjects and controls (r = -0.377, P < 0.001; r = -0.492, P < 0.001 respectively. Conclusions: The intelligence scores and overall academic performance of children with asthma compares favorably with that of children without asthma.
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Towerman AS, Hayashi SS, Hayashi RJ, Hulbert ML. Prevalence and nature of hearing loss in a cohort of children with sickle cell disease. Pediatr Blood Cancer 2019; 66:e27457. [PMID: 30207054 DOI: 10.1002/pbc.27457] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/16/2018] [Accepted: 08/20/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Sickle cell disease (SCD) may cause injury to any organ, including the auditory system. Although the association of SCD and hearing loss has been described, the nature of this complication is unknown. We sought to establish the prevalence and nature of hearing loss in a referred cohort of children with SCD and to identify correlating disease- or treatment-associated factors. PROCEDURE We conducted a retrospective review of patients with SCD < 22 years of age who had hearing evaluations between August 1990 and December 2014. Demographics, audiograms, and disease and treatment variables were analyzed. RESULTS Two hundred and ten audiograms among 81 patients were reviewed, and 189 were evaluable. Seventy-two children constituted the referred cohort. Fourteen (19.4%) had hearing loss documented on at least one audiogram. Seven (9.7%) patients had only conductive hearing loss, and the loss persisted for up to 10.3 years. The median age of first identification was eight years. Six (8.3%) patients had hearing loss that was at least partially sensorineural. One patient's hearing loss was ambiguous. All sensorineural hearing losses were unilateral and 4/6 patients had prior documented normal hearing, indicating acquired loss. No correlations were identified. CONCLUSIONS Both conductive and sensorineural hearing losses are more prevalent in our study population than those observed in the general pediatric population. In children with SCD, sensorineural hearing loss appears to be acquired and unilateral. Conductive hearing loss was identified in older children and can persist. Serial screening is needed for early detection and more prompt intervention in this population.
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Affiliation(s)
- Alison S Towerman
- Division of Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Susan S Hayashi
- Department of Audiology, St. Louis Children's Hospital, St. Louis, Missouri
| | - Robert J Hayashi
- Division of Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Monica L Hulbert
- Division of Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
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Barton-Gooden A, Grindley M, Knight-Madden J, Asnani M. Gender influences on the health of adolescents with sickle cell disease. PSYCHOL HEALTH MED 2018; 24:470-480. [PMID: 30318923 DOI: 10.1080/13548506.2018.1533985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A Barton-Gooden
- UWI School of Nursing, Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - M Grindley
- Caribbean Institute of Health Research- Sickle Cell Unit, The University of the West Indies, Kingston, Jamaica
| | - J Knight-Madden
- Caribbean Institute of Health Research- Sickle Cell Unit, The University of the West Indies, Kingston, Jamaica
| | - M Asnani
- Caribbean Institute of Health Research- Sickle Cell Unit, The University of the West Indies, Kingston, Jamaica
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Olatunya OS, Oke OJ, Kuti BP, Ajayi IA, Olajuyin O, Omotosho-Olagoke O, Taiwo AB, Faboya OA, Ajibola A. Factors Influencing the Academic Performance of Children with Sickle Cell Anaemia in Ekiti, South West Nigeria. J Trop Pediatr 2018; 64:67-74. [PMID: 28549163 DOI: 10.1093/tropej/fmx034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is a paucity of information on factors that influence the school performance of children with sickle cell anaemia (SCA) in Nigeria, despite her huge burden of the disease. METHODS In total, 101 children with SCA were recruited at a paediatric clinic in Nigeria. Their socio-demographic-matched classmates were the controls. Academic performance and cognitive functioning were obtained from school reports and Ziler's Draw-a-Person Test, respectively. Factors influencing the academic performance were determined. RESULTS Children with SCA had higher rates of school absence and lower haemoglobin concentration (p < 0.05). There was no difference in overall school performance between children with SCA and controls (59.0 vs. 60.6%; p = 0.256). School absenteeism > 1 week independently predicts poor school performance among the study participants (odds ratio = 15.71; 95% confidence interval = 5.93-41.66; p =0.000). Most SCA children with poor performance were absent from school for > 1 week. CONCLUSION There is need to address causes of school absenteeism among children with SCA.
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Affiliation(s)
| | | | - Bankole Peter Kuti
- Department of Paediatrics, Obafemi Awolowo University, 220282 Ile-Ife, Nigeria
| | | | - Oyebanji Olajuyin
- Department of Otolaryngology, Ekiti State University, 360101 Ado Ekiti, Nigeria
| | | | - Adekunle Bamidele Taiwo
- Department of Paediatrics, Ekiti State University Teaching Hospital, 360101 Ado Ekiti, Nigeria
| | - Opeyemi Ayodeji Faboya
- Department of Paediatrics, Ekiti State University Teaching Hospital, 360101 Ado Ekiti, Nigeria
| | - Ayodeji Ajibola
- Department of Paediatrics, Ekiti State University Teaching Hospital, 360101 Ado Ekiti, Nigeria
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Asnani MR, Barton-Gooden A, Grindley M, Knight-Madden J. Disease Knowledge, Illness Perceptions, and Quality of Life in Adolescents With Sickle Cell Disease: Is There a Link? Glob Pediatr Health 2017; 4:2333794X17739194. [PMID: 29152543 PMCID: PMC5680938 DOI: 10.1177/2333794x17739194] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/03/2017] [Indexed: 01/12/2023] Open
Abstract
Disease knowledge, illness perceptions, and quality of life (QOL) were examined in 150 adolescents (mean age = 16.1 years, SD = 1.9; 49.3% males) with sickle cell disease (SCD). Females had higher knowledge (P = .004), lower QOL (P = .02), and perceived their illness to be more unpredictable (P = .03). Those with more severe disease perceived their illness to be unpredictable with worse outcomes. Those with higher knowledge scores perceived their illness to be chronic, made more sense of their illness, and perceived greater personal and treatment control. Final hierarchical regression model showed that secondary education as compared to primary education level (P < .001) was positively correlated whereas disease severity (P < .001), perceived unpredictability (P = .024), and negative emotions (P < .001) were negatively correlated with QOL. Health practitioners should assess adolescents’ illness perceptions and encouraging continuing schooling and addressing emotional/psychological problems could improve their QOL.
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Challenges and Barriers to Identifying Pain in the Special Education Classroom: A Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2017. [DOI: 10.1007/s40489-017-0117-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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19
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Jonassaint CR, Beach MC, Haythornthwaite JA, Bediako SM, Diener-West M, Strouse JJ, Lanzkron S, Onojobi G, Carroll CP, Haywood C. The Association between Educational Attainment and Patterns of Emergency Department Utilization among Adults with Sickle Cell Disease. Int J Behav Med 2016; 23:300-309. [DOI: 10.1007/s12529-016-9538-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Clayton-Jones D, Haglund K, Belknap RA, Schaefer J, Thompson AA. Spirituality and Religiosity in Adolescents Living With Sickle Cell Disease. West J Nurs Res 2016; 38:686-703. [PMID: 26792855 DOI: 10.1177/0193945915625065] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study purports to address paucity in the literature regarding how adolescents with sickle cell disease (SCD) describe and experience spirituality and religiosity (S/R). This was a qualitative descriptive study. Two semi-structured interviews were conducted with nine adolescents (Mage = 16.2 years). Data were analyzed using a template analysis style and a concurrent analysis process of data reduction. Three major themes encompassed the participants' descriptions of the relationships between S/R, health and illness in their lives including S/R as sources for coping, influence of S/R beliefs on health and illness, and sharing S/R with Health Care Providers (HCPs). S/R as coping mechanisms included six threads: interconnecting with God, interconnecting with others, interconnecting with creative arts, scriptural metanarratives, transcendent experiences, and acceptance and finding meaning. Expectations of health providers included two threads: Religiosity is private/personal and sharing spiritual and religious beliefs is risky. S/R are particularly salient for adolescents with SCD.
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Forrester AB, Barton-Gooden A, Pitter C, Lindo JLM. The lived experiences of adolescents with sickle cell disease in Kingston, Jamaica. Int J Qual Stud Health Well-being 2015; 10:28104. [PMID: 26341889 PMCID: PMC4560734 DOI: 10.3402/qhw.v10.28104] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/23/2015] [Indexed: 11/14/2022] Open
Abstract
Aim To explore the lived experiences of adolescents with sickle cell disease, in Kingston, Jamaica. Method A descriptive qualitative design was used for this research. In-depth interviews were conducted with six adolescents with sickle cell disease at a Sickle Cell Unit operated by the University of the West Indies. Interviews were audiotaped, transcribed, and thematically analyzed. Results The majority of the adolescents demonstrated a positive self-concept. They reported strong family, school, and peer support which made them feel accepted. All were actively engaged in social activities such as parties, but had challenges participating in sporting activities. Various coping strategies were utilized to address challenges of the disease including praying, watching television, and surfing the Internet. Conclusion Sickle cell disease can be very challenging for the adolescent, but with positive self-concept and increased social support, especially from family and peers, these adolescents were able to effectively cope with their condition and live productive lives.
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Affiliation(s)
- Andrea Brown Forrester
- The UWI School of Nursing, Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica
| | - Antoinette Barton-Gooden
- The UWI School of Nursing, Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica
| | - Cynthia Pitter
- The UWI School of Nursing, Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica
| | - Jascinth L M Lindo
- The UWI School of Nursing, Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica; ;
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Atoui M, Badr LK, Brand TD, Khoury R, Shahine R, Abboud M. The Daily Experiences of Adolescents in Lebanon With Sickle Cell Disease. J Pediatr Health Care 2015; 29:424-34. [PMID: 25771820 DOI: 10.1016/j.pedhc.2015.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 01/24/2015] [Accepted: 01/31/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Despite the psychosocial and physical consequences associated with sickle cell disease (SCD), the daily lived experience of adolescents diagnosed with this disease is a phenomenon rarely described. The objective of this study was to explore the daily lived experience of adolescents with SCD living in Lebanon. METHOD Twelve adolescents with SCD between the ages of 12 and 17 years were interviewed with use of a semi-structured interview during a routine follow-up visit after they were assessed as being pain free. Interviews were transcribed verbatim, and thematic analysis was conducted. RESULTS Adolescents with SCD experience a layered burden consisting of physical, emotional, and sympathetic pain that affects much of their daily personal and social lives. Nevertheless, they seem to claim normalcy and to downplay their pain and suffering in order to limit their caregivers' distress. CONCLUSION These findings can be used to assist health care providers in designing culturally sensitive interventions specifically designed for adolescents with SCD and their families to enable them to better cope with their illness.
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23
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Daniel LC, Li Y, Smith K, Tarazi R, Robinson MR, Patterson CA, Smith-Whitley K, Stuart M, Barakat LP. Lessons Learned From a Randomized Controlled Trial of a Family-Based Intervention to Promote School Functioning for School-Age Children With Sickle Cell Disease. J Pediatr Psychol 2015; 40:1085-94. [PMID: 26136404 DOI: 10.1093/jpepsy/jsv063] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 06/03/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Tested a family-based group problem-solving intervention, "Families Taking Control," (FTC) to improve school functioning and health-related quality of life (HRQL) for children with sickle cell disease. METHOD Children and caregivers completed questionnaires assessing HRQL and school functioning and children completed performance-based measures of IQ and achievement at baseline and 6 months later. Families were randomized to the intervention (FTC, n = 42) or delayed intervention control (DIC, n = 41) group. FTC involved a full-day workshop followed by 3 booster calls. RESULTS There were no differences between FTC completers (n = 24) and noncompleters (n = 18). FTC group (n = 24) and DIC group (n = 38) did not differ significantly on primary outcomes at follow-up: number of formal academic and disease-related accommodations, individualized education plan/504 service plan, school absences, school HRQL, or academic skills. CONCLUSIONS Although families found FTC to be acceptable, there were no intervention effects. Challenges of the trial and implications for future research are discussed.
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Affiliation(s)
- Lauren C Daniel
- Division of Oncology, The Children's Hospital of Philadelphia
| | - Yimei Li
- Division of Oncology, The Children's Hospital of Philadelphia Department of Biostatistics and Epidemiology, Perelman School of Medicine of the University of Pennsylvania
| | - Kelsey Smith
- Department of Psychology, University of South Carolina
| | - Reem Tarazi
- Department of Psychiatry, Drexel University College of Medicine Division of Hematology, St. Christopher's Hospital for Children
| | - M Renee Robinson
- Department of Psychiatry, Drexel University College of Medicine Division of Hematology, St. Christopher's Hospital for Children
| | - Chavis A Patterson
- Division of Neonatology, The Children's Hospital of Philadelphia Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania
| | - Kim Smith-Whitley
- Division of Hematology, The Children's Hospital of Philadelphia Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, and
| | - Marie Stuart
- Division of Hematology/Oncology, Thomas Jefferson University
| | - Lamia P Barakat
- Division of Oncology, The Children's Hospital of Philadelphia Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, and
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Crosby LE, Joffe NE, Irwin MK, Strong H, Peugh J, Shook L, Kalinyak KA, Mitchell MJ. School Performance and Disease Interference in Adolescents with Sickle Cell Disease. ACTA ACUST UNITED AC 2015; 34:14-30. [PMID: 27547816 DOI: 10.14434/pders.v34i1.13918] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Sickle cell disease (SCD) results in neuropsychological complications that place adolescents at higher risk for limited educational achievement. A first step to developing effective educational interventions is to understand the impact of SCD on school performance. The current study assessed perceptions of school performance, SCD interference and acceptability of educational support strategies in adolescents with SCD. To identify potential risk factors, the relationship between school performance, SCD interference and demographics were also examined. Thirty adolescents aged 12 to 20 completed demographics and SCD school performance questionnaires. Approximately 37% of participants reported receiving special education services, but more than 60% reported that SCD interfered with their school performance. Females reported that SCD impacted their schooling more than males (X2 (1, N = 30) = 5.00, p < .05). Study findings provide important insights into demographic risk factors and support the need for individualized health and educational plans for adolescents with SCD.
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Affiliation(s)
- Lori E Crosby
- Cincinnati Children's Hospital Medical Center & University of Cincinnati College of Medicine
| | - Naomi E Joffe
- Cincinnati Children's Hospital Medical Center & University of Cincinnati College of Medicine
| | | | - Heather Strong
- Cincinnati Children's Hospital Medical Center & University of Cincinnati College of Medicine
| | - James Peugh
- Cincinnati Children's Hospital Medical Center & University of Cincinnati College of Medicine
| | - Lisa Shook
- Cincinnati Children's Hospital Medical Center & University of Cincinnati College of Medicine
| | - Karen A Kalinyak
- Cincinnati Children's Hospital Medical Center & University of Cincinnati College of Medicine
| | - Monica J Mitchell
- Cincinnati Children's Hospital Medical Center & University of Cincinnati College of Medicine
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Ezenwosu OU, Emodi IJ, Ikefuna AN, Chukwu BF, Osuorah CD. Determinants of academic performance in children with sickle cell anaemia. BMC Pediatr 2013; 13:189. [PMID: 24246094 PMCID: PMC3835142 DOI: 10.1186/1471-2431-13-189] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 11/12/2013] [Indexed: 11/24/2022] Open
Abstract
Background Some factors are known to influence the academic performance of children with Sickle Cell Anaemia (SCA). Information on their effects in these children is limited in Nigeria. The factors which influence academic performance of children with SCA in Enugu, Nigeria are determined in this study. Methods Consecutive children with SCA aged 5–11 years were recruited at the weekly sickle cell clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Their age- and sex- matched normal classmates were recruited as controls. The total number of days of school absence for 2009/2010 academic session was obtained for each pair of pupils from the class attendance register. Academic performance was assessed using the average of the overall scores in the three term examinations of same session. Intelligence ability was determined with Draw-A-Person Quotient (DAPQ) using the Draw-A-Person Test while socio-economic status was determined using the occupational status and educational attainment of each parent. Results Academic performance of children with SCA showed statistically significant association with their socio-economic status (χ2 = 9.626, p = 0.047), and significant correlation with DAPQ (r = 0.394, p = 0.000) and age (r = -0.412, p = 0.000). However, no significant relationship existed between academic performance and school absence in children with SCA (r = -0.080, p = 0.453). Conclusions Academic performance of children with SCA is influenced by their intelligence ability, age and socio-economic status but not negatively affected by their increased school absenteeism.
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Affiliation(s)
- Osita U Ezenwosu
- Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria.
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Patent foramen ovale in patients with sickle cell disease and stroke: case presentations and review of the literature. Case Rep Hematol 2013; 2013:516705. [PMID: 23956892 PMCID: PMC3730376 DOI: 10.1155/2013/516705] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 05/26/2013] [Indexed: 11/21/2022] Open
Abstract
Although individuals with sickle cell disease (SCD) are at increased risk for stroke, the underlying pathophysiology is incompletely understood. Intracardiac shunting via a patent foramen ovale (PFO) is associated with cryptogenic stroke in individuals without SCD. Recent evidence suggests that PFOs are associated with stroke in children with SCD, although the role of PFOs in adults with stroke and SCD is unknown. Here, we report 2 young adults with SCD, stroke, and PFOs. The first patient had hemoglobin SC and presented with a transient ischemic attack and a subsequent ischemic stroke. There was no evidence of cerebral vascular disease on imaging studies and the PFO was closed. The second patient had hemoglobin SS and two acute ischemic strokes. She had cerebral vascular disease with moyamoya in addition to a peripheral deep venous thrombosis (DVT). Chronic transfusion therapy was recommended, and the DVT was managed with warfarin. The PFO was not closed, and the patients' neurologic symptoms were stabilized. We review the literature on PFOs and stroke in SCD. Our cases and the literature review illustrate the dire need for further research to evaluate PFO as a potential risk factor for stroke in adults with SCD.
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Swanson ME, Grosse SD, Kulkarni R. Disability among individuals with sickle cell disease: literature review from a public health perspective. Am J Prev Med 2011; 41:S390-7. [PMID: 22099363 DOI: 10.1016/j.amepre.2011.09.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 08/13/2011] [Accepted: 09/07/2011] [Indexed: 11/28/2022]
Abstract
CONTEXT Young people with blood disorders face challenges in maintaining their physical health as they age. Sickle cell disease has well-documented complications in various organ systems. Increasingly, professionals, consumers, and advocates involved in blood disorders are concerned about the cumulative and ongoing effect of organ-specific complications on function and participation. EVIDENCE ACQUISITION Publications were identified that looked at the relationship between sickle cell disease and associated impairments and restrictions in participation as defined by the International Classification of Function, Disability, and Health (ICF). EVIDENCE SYNTHESIS This article organizes a literature review in PubMed using ICF terms that define functional limitations and participation restrictions in sickle cell disease. CONCLUSIONS Individuals with sickle cell disease experience complications in multiple organ systems that affect related functions and, consequently, participation in community living. The effects begin early in childhood and accumulate across the life course into adulthood. Intervention research is needed to understand how contextual factors can promote optimal function and participation in the face of mounting impairments.
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Affiliation(s)
- Mark E Swanson
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia 30333, USA.
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Knight-Madden JM, Lewis N, Tyson E, Reid ME, MooSang M. The possible impact of teachers and school nurses on the lives of children living with sickle cell disease. THE JOURNAL OF SCHOOL HEALTH 2011; 81:219-222. [PMID: 21517859 DOI: 10.1111/j.1746-1561.2011.00582.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Jennifer M Knight-Madden
- Sickle Cell Unit, Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston 7, Jamaica.
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Tanabe P, Porter J, Creary M, Kirkwood E, Miller S, Ahmed-Williams E, Hassell K. A qualitative analysis of best self-management practices: sickle cell disease. J Natl Med Assoc 2011; 102:1033-41. [PMID: 21141291 DOI: 10.1016/s0027-9684(15)30730-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sickle cell disease (SCD) is associated with serious comorbidities resulting in a shortened lifespan, and many clients suffer from frequent pain episodes. However, others successfully manage their disease in the outpatient setting without the need for frequent health care utilization. The purpose of this project was to describe specific strategies used by adult clients with sickle cell disease to achieve optimal physical health. METHOD A Best Self-management Practices workshop was held in conjunction with the Sickle Cell Disease Association of America meeting. A panel discussion was organized; adult clients were recruited for participation. The workshop was divided into 3 topics: complementary and alternative medicine, psychosocial issues, and work/education/training. Panel discussions were audiotaped, transcribed, and analyzed using the constant comparative method. RESULTS Seven adult patients with sickle cell disease and 1 social worker participated. The following themes emerged: self-awareness, emotional support, career selection and success factors, nutrition, advocacy, knowledge, physical, and complementary and alternative medicine. Self-awareness was the most reported strategy with emphasis on journaling and body awareness. Emotional support included spiritual support, friends, family, professional counseling, and spiritual support. A variety of suggestions were discussed related to the other themes. All participants used many strategies daily to maintain optimal health.
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Affiliation(s)
- Paula Tanabe
- Department of Emergency Medicine, Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
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Abstract
Health-related stigma is increasingly becoming a major public health issue that is receiving more attention. Young adults with sickle cell disease (SCD) are at risk for health-related stigmatization due to the many challenges of the disease. SCD includes the lifelong challenges of managing the chronic illness while accessing and navigating the health care system. The burdens of the disease can affect all aspects of the lives of individuals with SCD to include physiological, psychological, and social well-being. Although others may be involved in the process of stigmatization, the purpose of this paper was to support the need to develop patient-oriented interventions to prevent and treat health-related stigma in young adults with SCD, as these individuals may face health-related stigma throughout their lives, but especially immediately after transitioning from pediatric to adult care. Additionally, the Revised Theory of Self-Care Management for Sickle Cell Disease is offered as a framework from which theory-based interventions can be derived.
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Affiliation(s)
- Coretta M Jenerette
- School of Nursing, The University of North Carolina at Chapel Hill, CB 7460, Chapel Hill, NC, USA.
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Boulet SL, Yanni EA, Creary MS, Olney RS. Health status and healthcare use in a national sample of children with sickle cell disease. Am J Prev Med 2010; 38:S528-35. [PMID: 20331954 DOI: 10.1016/j.amepre.2010.01.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Revised: 12/14/2009] [Accepted: 01/02/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND There is a paucity of population-based data describing health status and use of health services among children with sickle cell disease (SCD). PURPOSE This study provides estimates of co-occurring conditions, health impact and utilization, and barriers to care for a national sample of children with SCD. METHODS Data were derived from the 1997-2005 National Health Interview Survey Child Sample Core. The study included 192 children aged 0-17 years with SCD whose race was reported as black or African-American, and 19,335 children without SCD of the same age and race. Parents or other knowledgeable adults reported on medical and developmental conditions, health status, and healthcare use and access. RESULTS After adjusting for demographic characteristics, black children with SCD had higher odds of frequent severe headaches or migraines, intellectual disabilities, regular use of prescription medication, and fair or poor health status compared with black children without SCD. While healthcare and special education services use were generally higher for black children with SCD than for black children in the general population, those with SCD also had higher odds of reporting delays in accessing health care. CONCLUSIONS The health burden for children with SCD and their families is profound and may be exacerbated by barriers to accessing comprehensive medical care. Additional study of the extent of unmet needs for U.S. children with SCD is warranted.
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Affiliation(s)
- Sheree L Boulet
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, GA 30333, USA.
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Newland JA. Factors influencing independence in adolescents with sickle cell disease. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2008; 21:177-85. [PMID: 18667050 DOI: 10.1111/j.1744-6171.2008.00149.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PROBLEM Factors that predict successful transition from pediatric to adult care for adolescents with sickle cell disease are not fully understood, making transfer decisions difficult. METHODS Seventy-four adolescents (14-21 years) participated in this descriptive correlational study to investigate the relationships of age, gender, knowledge about sickle cell disease, disease severity, and family relationships to independence. FINDINGS Knowledge, severity, and family relationships explained only 25% of the variance for independence in the final model; family relationships were inversely correlated. CONCLUSIONS Factors exerting stronger influences on independence remain unknown. Cultural factors may be important among this predominantly African American population.
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