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"Newborn infants Medical examinations Social aspects United States."
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Saving babies? : the consequences of newborn genetic screening
2013,2012
It has been close to six decades since Watson and Crick discovered the structure of DNA and more than ten years since the human genome was decoded. Today, through the collection and analysis of a small blood sample, every baby born in the United States is screened for more than fifty genetic disorders. Though the early detection of these abnormalities can potentially save lives, the test also has a high percentage of false positives—inaccurate results that can take a brutal emotional toll on parents before they are corrected. Now some doctors are questioning whether the benefits of these screenings outweigh the stress and pain they sometimes produce. In Saving Babies?, Stefan Timmermans and Mara Buchbinder evaluate the consequences and benefits of state-mandated newborn screening—and the larger policy questions they raise about the inherent inequalities in American medical care that limit the effectiveness of this potentially lifesaving technology.
Drawing on observations and interviews with families, doctors, and policy actors, Timmermans and Buchbinder have given us the first ethnographic study of how parents and geneticists resolve the many uncertainties in screening newborns. Ideal for scholars of medicine, public health, and public policy, this book is destined to become a classic in its field.
A Prospective Investigation of Physical Health Outcomes in Abused and Neglected Children: New Findings From a 30-Year Follow-Up
2012
Objectives. We investigated whether abused and neglected children are at risk for negative physical health outcomes in adulthood.
Methods. Using a prospective cohort design, we matched children (aged 0–11 years) with documented cases of physical and sexual abuse and neglect from a US Midwestern county during 1967 through 1971 with nonmaltreated children. Both groups completed a medical status examination (measured health outcomes and blood tests) and interview during 2003 through 2005 (mean age = 41.2 years).
Results. After adjusting for age, gender, and race, child maltreatment predicted above normal hemoglobin, lower albumin levels, poor peak airflow, and vision problems in adulthood. Physical abuse predicted malnutrition, albumin, blood urea nitrogen, and hemoglobin A1C. Neglect predicted hemoglobin A1C, albumin, poor peak airflow, and oral health and vision problems, Sexual abuse predicted hepatitis C and oral health problems. Additional controls for childhood socioeconomic status, adult socioeconomic status, unhealthy behaviors, smoking, and mental health problems play varying roles in attenuating or intensifying these relationships.
Conclusions. Child abuse and neglect affect long-term health status—increasing risk for diabetes, lung disease, malnutrition, and vision problems—and support the need for early health care prevention.
Journal Article
Ethics, Evidence, and Cost in Newborn Screening
2008
When deciding what disorders to screen newborns for, we should be guided by evidence of real effectiveness, take opportunity cost into account, distribute costs and benefits fairly, and respect human rights. Current newborn screening policy does not meet these requirements.
Journal Article
Two faces of patient advocacy: the current controversy in newborn screening
2014
Newborn screening programmes began in the 1960s, have traditionally been conducted without parental permission and have grown dramatically in the last decade. Whether these programmes serve patients’ best interests has recently become a point of controversy. Privacy advocates, concerned that newborn screening infringes upon individual liberties, are demanding fundamental changes to these programmes. These include parental permission and limiting the research on the blood samples obtained, an agenda at odds with the viewpoints of newborn screening advocates. This essay presents the history of newborn screening in the USA, with attention to factors that have contributed to concerns about these programmes. The essay suggests that the rapid increase in the number of disorders screened for and the addition of research without either public knowledge or informed consent were critical to the development of resistance to mandatory newborn screening and research. Future newborn screening initiatives should include public education and comment to ensure continued support.
Journal Article
Improving Healthcare for Children Entering Foster Care
2007
Despite the fact that children in foster care are, perhaps, the most vulnerable children, healthcare for them has been lacking woefully for many years. A growing body of research has documented the need for such care as well as the failure of child welfare agencies to make major improvements in providing healthcare to foster children. Nonetheless, current efforts are being made to change this situation. This article reports on one effort to improve the provision and timeliness of health exams for children entering care. One rural and one urban county served as project treatment sites, with two additional rural and urban counties serving as control sites. The treatment sites achieved a statistically significant improvement in their rate of exam completion as compared to the control sites. The study finds that despite an existing policy for healthcare for children entering foster care, legislation mandating additional efforts, shortened time frames, and provision for judicial oversight are needed for improvement.
Journal Article
Exploring options for expanded newborn screening
by
Becker, Jr, William
,
Grosse, Scott
,
Clayton, Ellen Wright
in
3-Hydroxyacyl CoA Dehydrogenases - metabolism
,
Acetyl-CoA C-Acyltransferase - metabolism
,
Babies
2005
A panel discussion exploring options for expanded newborn screening featuring Mary Ann Bailey, William Becker Jr, Maxine Hayes, Ellen Wright Clayton, and moderated by Scott Grosse, is presented. Becker Jr discusses how Ohio had expanded their screening programs.
Journal Article