20 results on '"Orkin, Julia"'
Search Results
2. Mental health of caregivers of children with medical complexity: group-based trajectory modelling
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Nathwani, Apsara Ali, Fayed, Nora, Grandi, Sonia M, Orkin, Julia, and Cohen, Eyal
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ObjectiveTo describe the mental health trajectories of caregivers of children with medical complexity (CMC) and explore child characteristics associated with below-average caregiver mental health.DesignA secondary analysis of prospectively collected data from 123 caregivers of children aged <16 years with medical complexity from a multicentre randomised trial conducted from December 2016 to June 2021.Main outcome measureThe Patient-Reported Outcomes Measurement Information System Global Mental Health Scale was used to measure caregivers' self-reported mental health well-being. Group-based trajectory analysis was used to identify clusters of caregivers with similar changes in mental health across 24 months. Logistic regression was used to identify child-related predictors of mental health among caregivers.ResultsA final model with three distinct groups was selected, corresponding to caregivers with average (n=39), moderately below-average (n=65) and severely below-average (n=19) mental health scores, all with stable trajectories and high posterior probabilities (>90%). Moderately and severely below-average caregiver mental health groups, merged into one group, were associated with a greater number of child medical technology devices (adjusted OR (aOR) 1.44, 95% CI 1.01 to 2.04), gross motor difficulties (aOR 3.51, 95% CI 1.02 to 12.05) and worse child emotional (aOR 0.93, 95% CI 0.87 to 0.99) and psychological well-being (aOR 0.93, 95% CI 0.88 to 0.99).ConclusionMost caregivers of CMC reported persistently below-average mental health. The intensity of caregiving, as indicated by medical technology and child functional needs, is a potential risk factor for below-average caregiver mental health. Future design and evaluation of interventions focused on support for caregivers of CMC are warranted.
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- 2024
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3. Caring for the Caregiver (C4C): An Integrated Stepped Care Model for Caregivers of Children With Medical Complexity.
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Cardenas, Analyssa, Esser, Kayla, Wright, Elisabeth, Netten, Kathy, Edwards, Ashley, Rose, Julie, Vigod, Simone, Cohen, Eyal, and Orkin, Julia
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SERVICES for caregivers ,CHILD care ,SOCIAL support ,HEALTH services accessibility ,CHRONIC diseases in children ,PSYCHOLOGY of caregivers ,INTERPROFESSIONAL relations ,INTEGRATED health care delivery ,EARLY diagnosis ,SOCIAL case work ,PSYCHOTHERAPY ,MENTAL health services - Abstract
Children with medical complexity (CMC) are a medically fragile subset of children who rely on parental caregivers for substantial care needs. Caregivers of CMC often experience adverse health outcomes such as depression and anxiety, sleep deprivation, financial hardships, and social isolation. Caregivers of CMC are at risk of premature mortality, which is thought to be mediated by chronic and elevated stress, as well as psychiatric morbidity risk. Access to mental health care, where the needs of both the caregiver and child are considered, can enable caregivers to meet high caregiving demands and improve both child and caregiver outcomes. We describe the Caring for the Caregiver (C4C) model, a novel integrated stepped care model consisting of collaboration between a psychiatrist and a pediatric complex care program. This model provides support in 3 steps: 1) early identification of distress, 2) social work assessment, intervention and psychotherapy, and 3) psychiatric care, including diagnosis or medication initiation, for caregivers of CMC. This innovative model will be the first to embed support for the mental health needs of caregivers of CMC within a pediatric team, facilitating access to psychiatric care and serving as a foundation for future integrated stepped care models. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Effectiveness of Structured Care Coordination for Children With Medical Complexity: The Complex Care for Kids Ontario (CCKO) Randomized Clinical Trial
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Cohen, Eyal, Quartarone, Samantha, Orkin, Julia, Moretti, Myla E., Emdin, Abby, Guttmann, Astrid, Willan, Andrew R., Major, Nathalie, Lim, Audrey, Diaz, Sanober, Osqui, Lisa, Soscia, Joanna, Fu, Longdi, Gandhi, Sima, Heath, Anna, and Fayed, Nora
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IMPORTANCE: Children with medical complexity (CMC) have chronic conditions and high health needs and may experience fragmented care. OBJECTIVE: To compare the effectiveness of a structured complex care program, Complex Care for Kids Ontario (CCKO), with usual care. DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial used a waitlist variation for randomizing patients from 12 complex care clinics in Ontario, Canada, over 2 years. The study was conducted from December 2016 to June 2021. Participants were identified based on complex care clinic referral and randomly allocated into an intervention group, seen at the next available clinic appointment, or a control group that was placed on a waitlist to receive the intervention after 12 months. INTERVENTION: Assignment of a nurse practitioner–pediatrician dyad partnering with families in a structured complex care clinic to provide intensive care coordination and comprehensive plans of care. MAIN OUTCOMES AND MEASURES: Co-primary outcomes, assessed at baseline and at 6, 12, and 24 months postrandomization, were service delivery indicators from the Family Experiences With Coordination of Care that scored (1) coordination of care among health care professionals, (2) coordination of care between health care professionals and families, and (3) utility of care planning tools. Secondary outcomes included child and parent health outcomes and child health care system utilization and cost. RESULTS: Of 144 participants randomized, 141 had complete health administrative data, and 139 had complete baseline surveys. The median (IQR) age of the participants was 29 months (9-102); 83 (60%) were male. At 12 months, scores for utility of care planning tools improved in the intervention group compared with the waitlist group (adjusted odds ratio, 9.3; 95% CI, 3.9-21.9; P < .001), with no difference between groups for the other 2 co-primary outcomes. There were no group differences for secondary outcomes of child outcomes, parent outcomes, and health care system utilization and cost. At 24 months, when both groups were receiving the intervention, no primary outcome differences were observed. Total health care costs in the second year were lower for the intervention group (median, CAD$17 891; IQR, 6098-61 346; vs CAD$37 524; IQR, 9338-119 547 [US $13 415; IQR, 4572-45 998; vs US $28 136; IQR, 7002-89 637]; P = .01). CONCLUSIONS AND RELEVANCE: The CCKO program improved the perceived utility of care planning tools but not other outcomes at 1 year. Extended evaluation periods may be helpful in assessing pediatric complex care interventions. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02928757
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- 2023
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5. Utility of SARS-CoV-2 Genomic Sequencing for Understanding Transmission and School Outbreaks
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Campigotto, Aaron, Chris, Allison, Orkin, Julia, Lau, Lynette, Marshall, Christian, Bitnun, Ari, Buchan, Sarah A, MacDonald, Liane, Thampi, Nisha, McCready, Janine, Juni, Peter, Parekh, Rulan S, and Science, Michelle
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- 2023
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6. Housing Need Among Children With Medical Complexity: A Cross-Sectional Descriptive Study of Three Populations.
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Esser, Kayla, Moore, Clara, Hounsell, Kara Grace, Davis, Adrienne, Sunderji, Alia, Shulman, Rayzel, Maguire, Bryan, Cohen, Eyal, and Orkin, Julia
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CAREGIVERS ,HEALTH services accessibility ,CHRONIC diseases ,CROSS-sectional method ,RESEARCH methodology ,CHRONIC diseases in children ,TERTIARY care ,COMMUNITY health services ,INCOME ,EMPLOYMENT ,HOUSING ,NEEDS assessment ,LOGISTIC regression analysis ,SOCIODEMOGRAPHIC factors ,PSYCHOLOGICAL stress ,CHILDREN - Abstract
Objective: Children with medical complexity (CMC) are hypothesized to have unique housing and accessibility needs due to their medical fragility and medical technology dependency; however, research on prevalence and types of housing need in CMC is limited. The objective was to describe housing need in families of CMC, and to compare housing need across CMC, children with one chronic condition (Type 1 diabetes; CT1D) and healthy children (HC). Methods: This cross-sectional descriptive study assessed housing suitability, adequacy, affordability, stress, stability, and accessibility using survey methodology. Participants were caregivers of CMC, CT1D and HC at a tertiary-care pediatric hospital. The association of housing need outcomes across groups was analyzed using logistic and ordinal logistic regression models, adjusting for income, educational attainment, employment status, community type, immigration status, child age, and number of people in household. Results: Four hundred ninety caregivers participated. Caregivers of CMC reported increased risk of housing-related safety concerns (aOR 3.1 [1.3--7.5]), using a common area as a sleeping area (5.6 12.0--16.8]), reducing spending (4.6 [2.3 --9.5[) or borrowing money to afford rent (2.9 [1.2--6.7]), experiencing housing stress (3.3 [1.8--6.0]), and moving or considering moving to access health/community services (15.0 [6.4-37.6]) compared to HC. Conclusions: CMC were more likely to experience multiple indicators of housing need compared to CT1D and HC even after adjusting for sociodemographic factors, suggesting an association between complexity of child health conditions and housing need. Further research and practise should consider screening for and supporting housing need in CMC. [ABSTRACT FROM AUTHOR]
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- 2022
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7. Contemporary aetiologies of medical complexity in children: a cohort study
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Haque, Bushra, Khan, Tayyaba, Ushcatz, Inna, Curtis, Meredith, Pan, Amy, Wu, Wendy, Orkin, Julia, and Costain, Gregory
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- 2023
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8. Evaluating Curricular Modules in the Care of Children With Medical Complexity: A Mixed-Methods Randomized Controlled Trial.
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Huth, Kathleen, Audcent, Tobey, Long-Gagne, Sara, Sbrocchi, Anne Marie, Weiser, Natalie, Miller, Doug, Arje, Danielle, Stephens, Derek, Major, Nathalie, Issa, Kheirie, Cohen, Eyal, and Orkin, Julia
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CHRONIC diseases in children ,CLINICAL competence ,COMPARATIVE studies ,CONTENT analysis ,HOSPITAL medical staff ,INTERVIEWING ,RESEARCH methodology ,MEDICAL education ,MEDICAL protocols ,HEALTH outcome assessment ,PEDIATRICS ,STATISTICAL sampling ,SELF-efficacy ,TECHNOLOGY ,UNCERTAINTY ,CONTINUING medical education ,TRACHEOTOMY equipment ,PROFESSIONAL identity ,RANDOMIZED controlled trials ,COURSE evaluation (Education) ,DESCRIPTIVE statistics - Abstract
Children with medical complexity (CMC) are a growing population, yet training in complex care varies across pediatric residency programs. The purpose of this study was 1) to evaluate the effectiveness of a curriculum for pediatric residents in improving performance in a simulated clinical scenario, and 2) to explore residents' perceived self-efficacy in caring for CMC. A randomized controlled trial was conducted supplemented by qualitative inquiry. Pediatric residents from 2 residency programs were randomly assigned to participate in interactive modules on: 1) clinical assessment, care planning, and technological dependency or 2) noncomplex care topics. The primary outcome was mean score on an Observed Structured Clinical Examination (OSCE) of tracheostomy care. Semistructured interviews were conducted postintervention and analyzed using qualitative content analysis. Ninety-four eligible residents were randomized. Residents who attended all modules and the OSCE and consented to participate (intervention [n = 20] and control [n=24]) were included in the final analysis. At baseline, few (9%) reported being comfortable caring for CMC. There was no significant difference in mean OSCE score between intervention and control groups (39.0 ± 1.1 vs 38.0 ± 1.0, P =.48). Qualitative analysis revealed 3 emerging themes related to resident self-efficacy: building a system of care, navigating uncertainty, and professional identity formation. A standardized complex care curriculum delivered in a classroom setting did not lead to improved performance in an OSCE station despite increased resident-reported self-efficacy in approaching care for CMC. These findings highlight the need for multidimensional educational interventions and assessments in complex care. [ABSTRACT FROM AUTHOR]
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- 2020
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9. Characteristics of children admitted to hospital with acute SARS-CoV-2 infection in Canada in 2020
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Drouin, Olivier, Hepburn, Charlotte Moore, Farrar, Daniel S., Baerg, Krista, Chan, Kevin, Cyr, Claude, Donner, Elizabeth J., Embree, Joanne E., Farrell, Catherine, Forgie, Sarah, Giroux, Ryan, Kang, Kristopher T., King, Melanie, Laffin, Melanie, Luu, Thuy Mai, Orkin, Julia, Papenburg, Jesse, Pound, Catherine M., Price, Victoria E., Purewal, Rupeena, Sadarangani, Manish, Salvadori, Marina I., Top, Karina A., Viel-Thériault, Isabelle, Kakkar, Fatima, and Morris, Shaun K.
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Background:Risk factors for severe outcomes of SARS-CoV-2 infection are not well established in children. We sought to describe pediatric hospital admissions associated with SARS-CoV-2 infection in Canada and identify risk factors for more severe disease.Methods:We conducted a national prospective study using the infrastructure of the Canadian Paediatric Surveillance Program (CPSP). Cases involving children who were admitted to hospital with microbiologically confirmed SARS-CoV-2 infection were reported from Apr. 8 to Dec. 31 2020, through weekly online questionnaires distributed to the CPSP network of more than 2800 pediatricians. We categorized hospital admissions as related to COVID-19, incidental, or for social or infection control reasons and determined risk factors for disease severity in hospital.Results:Among 264 hospital admissions involving children with SARS-CoV-2 infection during the 9-month study period, 150 (56.8%) admissions were related to COVID-19 and 100 (37.9%) were incidental infections (admissions for other reasons and found to be positive for SARS-CoV-2 on screening). Infants (37.3%) and adolescents (29.6%) represented most cases. Among hospital admissions related to COVID-19, 52 (34.7%) had critical disease, 42 (28.0%) of whom required any form of respiratory or hemodynamic support, and 59 (39.3%) had at least 1 underlying comorbidity. Children with obesity, chronic neurologic conditions or chronic lung disease other than asthma were more likely to have severe or critical COVID-19.Interpretation:Among children who were admitted to hospital with SARS-CoV-2 infection in Canada during the early COVID-19 pandemic period, incidental SARS-CoV-2 infection was common. In children admitted with acute COVID-19, obesity and neurologic and respiratory comorbidities were associated with more severe disease.
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- 2021
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10. Caractéristiques des hospitalisations au Canada d’enfants ayant contracté une infection aiguë par le SRAS-CoV-2 en 2020
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Drouin, Olivier, Hepburn, Charlotte Moore, Farrar, Daniel S., Baerg, Krista, Chan, Kevin, Cyr, Claude, Donner, Elizabeth J., Embree, Joanne E., Farrell, Catherine, Forgie, Sarah, Giroux, Ryan, Kang, Kristopher T., King, Melanie, Laffin, Melanie, Luu, Thuy Mai, Orkin, Julia, Papenburg, Jesse, Pound, Catherine M., Price, Victoria E., Purewal, Rupeena, Sadarangani, Manish, Salvadori, Marina I., Top, Karina A., Viel-Thériault, Isabelle, Kakkar, Fatima, and Morris, Shaun K.
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RésuméContexte:Les facteurs de risque de complications graves de l’infection par le SRAS-CoV-2 n’ont pas été bien établis chez les enfants. Nous avons voulu décrire les hospitalisations pédiatriques associées au SRAS-CoV-2 au Canada et identifier les facteurs de risque de maladie grave.Méthodes:Nous avons procédé à une étude prospective nationale en utilisant l’infrastructure du Programme canadien de surveillance pédiatrique (PCSP). Les hospitalisations d’enfants ayant contracté une infection par le SRAS-CoV-2 confirmée en laboratoire de microbiologie ont été rapportées du 8 avril au 31 décembre 2020 au moyen de questionnaires hebdomadaires en ligne distribués au réseau du PCSP, qui compte plus de 2800 pédiatres. Nous avons catégorisé les hospitalisations comme suit : liées à la COVID-19, infections découvertes fortuitement, ou hospitalisations pour des raisons sociales ou de contrôle des infections, et dégagé les facteurs de risque associés à la gravité de la maladie chez les patients hospitalisés.Résultats:Sur les 264 hospitalisations d’enfants ayant contracté le SRAS-CoV-2 au cours de la période de l’étude de 9 mois, 150 (56,8 %) ont été associées à la COVID-19 et 100 (37,9 %) étaient des cas découverts fortuitement (admission pour d’autres raisons et découverte fortuite du SRAS-CoV-2 par dépistage positif). Les nourrissons (37,3 %) et les adolescents (29,6 %) représentaient la majorité des cas. Parmi les hospitalisations liées à la COVID-19, 52 patients (34,7 %) étaient atteints d’une forme grave de la maladie, dont 42 (28,0 % des cas liés à la COVID-19) ont eu besoin d’une forme d’assistance respiratoire ou hémodynamique, et 59 (39,3 %) présentaient au moins 1 comorbidité sous-jacente. Les enfants atteints d’obésité, de maladies neurologiques chroniques ou de maladies pulmonaires chroniques, à l’exclusion de l’asthme, étaient plus susceptibles de présenter une forme grave ou critique de la COVID-19.Interprétation:Parmi les enfants hospitalisés au Canada chez lesquels on a diagnostiqué une infection par le SRAS-CoV-2 au début de la pandémie de COVID-19, la découverte fortuite du SRAS-CoV-2 a été fréquente. Chez les enfants hospitalisés pour une COVID-19 aiguë, l’obésité et les comorbidités neurologiques et respiratoires ont été associées à une gravité accrue.
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- 2021
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11. R3 (Resident Advocacy Project) Evaluation of a Novel COVID-19 Vaccine Consult Service
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Gibbs, Danielle, Orkin, Julia, Dharmaraj, Blossom, Cinq-Mars, Lise, Clarke, Lindsay, Russett, Genevieve, Solomon, Donna, Boyce, Allison, and Beasley, Patricia
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- 2023
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12. Exploring Acceptance and Commitment Therapy for parents of preterm infants.
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Esser, Kayla, Barreira, Lesley, Miller, Doug, Church, Paige, Major, Nathalie, Cohen, Eyal, and Orkin, Julia
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The start of a parenting journey in the neonatal intensive care unit (NICU) presents many stressors to parents. Previous research has shown parents of infants admitted to the NICU experience heightened stress, anxiety, and depression. Mental health support varies across Canadian NICUs with mixed results. One promising intervention that has not been explored in the NICU is Acceptance and Commitment Therapy (ACT), a behavioural therapy that has had positive mental health-related outcomes in similar parental populations. ACT differs from previous mental health interventions such as traditional Cognitive Behavioural Therapy (CBT) as it involves mindfulness and acceptance to increase psychological flexibility. Increased psychological flexibility is linked to greater emotional well-being, a higher quality of life, and decreased stress, anxiety, and depression. There is a need for research investigating the utility of ACT in improving mental health outcomes for parents of preterm infants.
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- 2021
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13. Social vulnerability and COVID-19: A call to action for paediatric clinicians.
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Prodanuk, Michael, Wagner, Stephanie, Orkin, Julia, and Noone, Damien
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The COVID-19 pandemic has had dramatic effects on the lives of children globally. However, socially vulnerable children have been particularly impacted. Certain populations have increased vulnerabilities, including children and youth experiencing homelessness. Increased infection risk due to congregant living and challenges with physical distancing are contributing factors. An urgent need exists for a wholistic approach to care with unique cross-sectoral partnerships across disciplines. A recognition of the unintended consequence of the COVID-19 pandemic on this population is urgently required by all those supporting children. Families should receive direct support in clinical settings to identify their social needs. Partnership with community agencies and advocacy for appropriate isolation facilities for patients experiencing homelessness are critical.
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- 2021
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14. Caring about caregivers: the role of paediatricians in supporting the mental health of parents of children with high caregiving needs
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Rotberg, Benyamin, Wittenberg, Jean, Orkin, Julia, Saunders, Natasha Ruth, and Cohen, Eyal
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- 2020
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15. Clinical Health Outcomes of Siblings of Children with Chronic Conditions: A Systematic Review and Meta-Analysis.
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Martinez, Benjamin, Pechlivanoglou, Petros, Meng, Dorisa, Traubici, Benjamin, Mahood, Quenby, Korczak, Daphne, Colasanto, Marlena, Mahant, Sanjay, Orkin, Julia, and Cohen, Eyal
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Objective: The objective of the study was to assess clinical mental and physical health outcomes of siblings of children with chronic health condition(s) compared with siblings of healthy children or normative data.Study Design: We searched Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and CINAHL through August 9, 2021. We included English-language studies that reported clinically diagnosable mental or physical health outcomes among siblings of children (<18 years old) with a chronic health condition, included a comparison group, and used an experimental or observational study design. Two reviewers extracted data and independently assessed risk of bias using the Newcastle Ottawa Scale.Results: Of 9899 screened studies, 34 were included; 28 studies reported on mental health, 3 reported on physical health, and 3 reported on mortality. Siblings of children with chronic conditions had greater depression rating scale scores than their comparison groups (standardized mean difference = 0.53; 95% CI = 0.38-0.68; P < .001 [6 studies]), whereas anxiety scores were not substantially increased (standardized mean difference = 0.21; 95% CI = -0.02 to 0.43; P = .07 [7 studies]). The effects for confirmed psychiatric diagnoses (7 studies), mortality (3 studies), or physical health outcomes (3 studies) could not be meta-analyzed given the limited number of studies and between-study heterogeneity.Conclusion: Siblings of children with chronic health conditions may be at an increased risk of depression. Our findings suggest the need for targeted interventions to support the psychological well-being of siblings of children with chronic health conditions. [ABSTRACT FROM AUTHOR]- Published
- 2022
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16. Risk factors for severe COVID-19 in hospitalized children in Canada: A national prospective study from March 2020–May 2021
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Farrar, Daniel S., Drouin, Olivier, Moore Hepburn, Charlotte, Baerg, Krista, Chan, Kevin, Cyr, Claude, Donner, Elizabeth J., Embree, Joanne E., Farrell, Catherine, Forgie, Sarah, Giroux, Ryan, Kang, Kristopher T., King, Melanie, Laffin Thibodeau, Melanie, Orkin, Julia, Ouldali, Naïm, Papenburg, Jesse, Pound, Catherine M., Price, Victoria E., Proulx-Gauthier, Jean-Philippe, Purewal, Rupeena, Ricci, Christina, Sadarangani, Manish, Salvadori, Marina I., Thibeault, Roseline, Top, Karina A., Viel-Thériault, Isabelle, Kakkar, Fatima, and Morris, Shaun K.
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Children living with chronic comorbid conditions are at increased risk for severe COVID-19, though there is limited evidence regarding the risks associated with specific conditions and which children may benefit from targeted COVID-19 therapies. The objective of this study was to identify factors associated with severe disease among hospitalized children with COVID-19 in Canada.
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- 2022
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17. eP205: Pharmacogenetic profiling via genome sequencing in children with medical complexity
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Pan, Amy, Scodellaro, Sierra, Khan, Tayyaba, Ushcatz, Inna, Wu, Wendy, Curtis, Meredith, Cohen, Eyal, Cohn, Ronald, Hayeems, Robin, Meyn, M. Stephen, Orkin, Julia, Otal, Jaskiran, Reuter, Miriam, Walker, Susan, Scherer, Stephen, Marshall, Christian, Cohn, Iris, and Costain, Gregory
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- 2022
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18. Health Outcomes of Parents of Children with Chronic Illness: A Systematic Review and Meta-Analysis.
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Cohn, Liel N., Pechlivanoglou, Petros, Lee, Yuna, Mahant, Sanjay, Orkin, Julia, Marson, Alanna, and Cohen, Eyal
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Objective: To assess health outcomes of parents caring for children with chronic illnesses compared with parents of healthy children.Study Design: We searched OvidSP MEDLINE, EBM Reviews-Cochrane Central Register of Controlled Trials, EMBASE, and EBSCOHost CINAHL through September 2019. Included were English-language studies reporting health conditions or mortality of parents of affected children compared with healthy controls.Results: Of 12 181 screened publications, 26 met inclusion criteria. Eight studies reported on anxiety, 23 on depression, 1 on mortality, and 1 on cardiovascular disease. Parents of chronically ill children had greater anxiety (standardized mean difference 0.42; 95% CI 0.24-0.60; P < .001) and depression scores (standardized mean difference 0.35; 95% CI 0.26-0.45; P < .001) than parents of healthy children. Thirty-five percent of parents of affected children met cut-offs for clinical depression, compared with 19% in the control (relative risk 1.75; 95% CI 1.55-1.97). Fifty-seven percent of such parents met cut-offs for anxiety, compared with 38% in the control (relative risk 1.40; 95% CI 1.18-1.67). One study of mothers of children with congenital anomalies reported a greater mortality risk than a comparison (adjusted hazard ratio 1.22; 95% CI 1.15-1.29), and another reported that these mothers experience an increased risk of cardiovascular disease (adjusted hazard ratio 1.15; 95% CI 1.07-1.23).Conclusions: Parents of chronically ill children experience poorer mental health (more anxiety and depression), and mothers of those with congenital anomalies may have greater risk of cardiovascular disease and mortality than parents of unaffected children. Our findings suggest a need for targeted interventions to attenuate adverse parental caregiver health outcomes.Prior Registration: PROSPERO CRD42018094657 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=94657). [ABSTRACT FROM AUTHOR]- Published
- 2020
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19. PEDIATRIC TRACHEOSTOMY CARE: AN EVALUATION OF AN INNOVATIVE COMPETENCY-BASED EDUCATION PROGRAM FOR HOME CARE NURSES
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Shi, Jenny, Orkin, Julia, Chu, Stephanie, Walsh, Catharine, Keilty, Krista, McKay, Sandra, Mocanu, Cora, Ambreen, Munazzah, and Amin, Reshma
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- 2020
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20. Evaluating Curricular Modules in the Care of Children with Medical Complexity: A Mixed-Methods Randomized Controlled Trial
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Huth, Kathleen, Audcent, Tobey, Long-Gagne, Sara, Sbrocchi, Anne Marie, Weiser, Natalie, Miller, Doug, Arje, Danielle, Major, Nathalie, Issa, Kheirie, Cohen, Eyal, and Orkin, Julia
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- 2018
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