IMPORTANCE Newborn genomic sequencing (nGS) may provide health benefits throughout the life span, but there are concerns that it could also have an unfavorable (ie, negative) psychosocial effect on families. OBJECTIVE To assess the psychosocial effect of nGS on families from the BabySeq Project, a randomized clinical trial evaluating the effect of nGS on the clinical care of newborns from well-baby nurseries and intensive care units. DESIGN, SETTING, AND PARTICIPANTSIn this randomized clinical trial conducted from May 14, 2015, to May 21, 2019, at well-baby nurseries and intensive care units at 3 Boston, Massachusetts, area hospitals, 519 parents of 325 infants completed surveys at enrollment, immediately after disclosure of nGS results, and 3 and 10 months after results disclosure. Statistical analysis was performed on a per-protocol basis from January 16, 2019, to December 1, 2019.INTERVENTION Newborns were randomized to receive either standard newborn screening and a family history report (control group) or the same plus an nGS report of childhood-onset conditions and highly actionable adult-onset conditions (nGS group). MAIN OUTCOMES AND MEASURESMean responses were compared between groups and, within the nGS group, between parents of children who received a monogenic disease risk finding and those who did not in 3 domains of psychosocial impact: parent-child relationship (Mother-to-Infant Bonding Scale), parents' relationship (Kansas Marital Satisfaction Scale), and parents' psychological distress (Edinburgh Postnatal Depression Scale anxiety subscale).RESULTS A total of 519 parents (275 women [53.0%]; mean [SD] age, 35.1 [4.5] years) were included in this study. Although mean scores differed for some outcomes at singular time points, generalized estimating equations models did not show meaningful differences in parent-child relationship (between-group difference in adjusted mean [SE] Mother-to-Infant Bonding Scale scores: postdisclosure, 0.04 [0.15]; 3 months, -0.18 [0.18]; 10 months, -0.07 [0.20]; joint P = .57) or parents' psychological distress (between-group ratio of adjusted mean [SE] Edinburgh Postnatal Depression Scale anxiety subscale scores: postdisclosure, 1.04 [0.08]; 3 months, 1.07 [0.11]; joint P = .80) response patterns between study groups over time for any measures analyzed in these 2 domains. Response patterns on one parents' relationship measure differed between groups over time (between-group difference in adjusted mean [SE] Kansas Marital Satisfaction Scale scores: postdisclosure, -0.19 [0.07]; 3 months, -0.04 [0.07]; and 10 months, -0.01 [0.08]; joint P = .02), but the effect decreased over time and no difference was observed on the conflict measure responses over time. We found no evidence of persistent negative psychosocial effect in any domain. CONCLUSIONS AND RELEVANCEIn this randomized clinical trial of nGS, there was no persistent negative psychosocial effect on families among those who received nGS nor among those who received a monogenic disease risk finding for their infant.

An increasing number of U.S. news headlines report violence targeting Asian populations and harassment of health care workers, which suggests growing coronavirus disease (COVID-19)-related stigmatization of certain groups across the country. Empirical research characterizing the breadth of COVID-19-related stigma in the U.S. is lacking and yet is critically needed to inform interventions that mitigate known negative health impacts of such stigma. Using mixed methods, we explored experiences of COVID-19-related stigma reported in an online U.S.-based survey conducted in April 2020 (N = 1,366). Forty-two respondents (3.1%) reported experiencing COVID-19-related stigma. Qualitative analysis of open-ended responses revealed that perceived race and ethnicity was the characteristic most frequently connected to experiencing stigma followed by COVID-19 guideline adherence, suspected or confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, profession or place of employment, and age. Most COVID-19-related stigma connected to race and ethnicity was specific to anti-Asian, specifically anti-Chinese, sentiment. Exploratory quantitative analysis found identifying as Asian (OR = 6.96) and testing positive for COVID-19 (OR = 4.99) were associated with the highest odds of experiencing stigma (all p < .001). Employment as a health care worker and/or first responder, working with COVID-19 patients, being at high-risk of serious illness, or having COVID-19 symptoms (OR range = 2.50–2.94, all p < .01) were also associated with greater odds of experiencing stigma. Together, our quantitative and qualitative results suggest that Asian populations in the U.S. may be disproportionately affected by COVID-19-related stigma. Our findings also suggest associations between experiences of stigma and COVID-19-related health factors and vulnerability. This study may help inform future research that demonstrates the extent of COVID-19-related stigma and interventions to combat adverse effects.

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Background Information: Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus (DM). It is an acute complication of type 1 DM. Objective: This study was designed to identify the precipitating factors, clinical features and immediate outcomes of DKA in children and adolescents. Method: This was a retrospective study which was done in the department of Pediatrics, BIRDEM, from January 2002 to April 2007. Data were collected from the hospital record for all diabetic children below 18 years admitted with DKA. Result: Fourty nine children and adolescents were admitted with DKA. Sixty one percent were known cases and the remaining (39%) were new DM. Majority were female (63%). Most (49%) of the children were between 11-15 years. Infection was the commonest (49%) precipitating factor followed by insulin omission (24%). Major clinical features were kussmaul breathing (94%) and dehydration (94%).Eighty eight percent patients improved after treatment and mortality was 12%. Conclusion: Infection was the commonest precipitating factor of DKA. Kussmaul breathing and dehydration were the commonest clinical features. Most of the patients improved after treatment.