Journal of Community Genetics最新文献

Background: Genetic counseling is essential for patients and families with genetic disorders, providing accurate information and supporting informed decisions. However, limited access to counseling services in some countries can lead to confusion and anxiety, prompting many to seek information in online communities. This study analyzes user-generated questions from an online community in South Korea to understand the specific information needs of patients and families with genetic disorders.

Methods: This study analyzed 289 questions posted by 122 members on the Naver cafe < All About Genetic Disorders>( https://cafe.naver.com/geneticdx ) between November 27, 2022, and December 23, 2023. Quantitative analysis was performed to identify the types and frequencies of questions, while qualitative analysis examined detailed content.

Results: The most frequently requested information was about disease information (28.4%), followed by genetics knowledge (26.6%), genetic testing (26.3%), and other topics (18.7%). Qualitative analysis revealed that patients and families needed detailed information about long-term progression and symptom manifestation. Many expressed confusion and anxiety regarding the meaning of variants of uncertain significance (VUS) in genetic testing results. They sought real-life patient experiences, in-depth professional informations, and wanted to know how to efficiently find accurate information.

Conclusion: This study demonstrated the importance of providing patients and families with professional and easily understandable information, highlighting the necessity for a well-organized genetic counseling system. To support patients and their families, it is essential to develop patient-friendly online platforms and expand access to genetic counseling services.

With increasing demand for access to genetic services and the American College of Medical Genetics and Genomics' (ACMG) recommendation that individuals with autism spectrum disorder (ASD) and developmental delay be offered genetic evaluation, alternative service models for genetic care are needed to increase efficiency. Web-based tools have enhanced access to clinical genetics content and services, particularly for patients with common referral indications such as ASD. The Boston Medical Center pediatric genetics clinic reports on the creation of an Expedited ASD Genetics Clinic (EAGC) which includes a waiting room questionnaire, educational video, physical examination, and blood work for genetic testing. The educational video, created in English and Spanish, mirrors the genetic testing educational content of a typical genetics visit for ASD. As the EAGC allows for more patients to be seen per clinic session, the number of visits with ICD-10 F84.0 (ASD) increased from 18 patients seen October to December 2022 to 32 patients seen October to December 2023. There was also a significant decrease between the number of days from referral to first offered appointment date for the patients with ASD seen in the EAGC compared to all new patients, regardless of referral reason, seen October to December 2022 ([Formula: see text]). This decreased wait time for an appointment for ASD-related genetic testing increases access to genetics services for this patient population.

Colombia, an upper-middle-income country with over 52 million inhabitants, has made significant progress in consolidating medical genetics as a clinical specialty, with a growing presence in healthcare system, public health and academia. The development of specialized training programs, the establishment of a professional association, and the inclusion of genetic tests and treatments for rare diseases (RDs) within the health system have been key achievements. Birth defects (BD) remain one of the leading causes of infant morbidity and mortality, and alongside RDs, are recognized as public health priorities. Among regulatory milestones, the Newborn Screening (NBS) Law has strengthened early diagnosis efforts. Nevertheless, operational challenges persist, particularly in the nationwide implementation of genetic services, which remain concentrated in urban centers, creating significant gaps in rural areas. While technologies such as next-generation sequencing (NGS) are increasingly available in the private sector, a persistent fragmentation between molecular diagnosis and clinical care limits their impact. Furthermore, interoperability with health information systems is limited, and the country's low density of medical geneticists restricts service availability. The Colombian experience underscores the value of institutional coordination, investment in diagnostic infrastructure, and the active role of patient organizations. Despite existing challenges, regional cooperation within Latin America emerges as a strategic opportunity to strengthen medical genetics and expand access for populations affected by RDs and complex genetic conditions.

This study describes the experiences with the stigma attached to Machado-Joseph disease (MJD) in São Miguel Island, the Azores (Portugal). We draw on semi-structured interviews with persons with MJD, family members, healthcare professionals, and direct care providers recruited through the local patient's association (n = 28). Qualitative thematic analysis revealed three main themes: (i) the intense stigma associated with MJD in the past; (ii) the current tendency towards increased openness; and (iii) increased availability of information about MJD and support. The findings suggest that stigmatization was more frequent and intense in the past. Still, there is currently a decrease in the intensity of perceived stigma, accompanied by an increasing awareness about MJD within the community. The local patient's association is noted for playing a pivotal role in raising awareness about MJD in the community and fostering the confidence of individuals with MJD and their families to engage socially, which may help to reduce or mitigate feelings of stigma. This raises questions about whether the diminished stigma towards MJD in São Miguel results from heightened awareness about the condition, a decrease in the social acceptability of stigma, or a gradual internalization and normalization of stigma among individuals with MJD as a coping mechanism.

The rapid development of genomic medicine and simultaneous global diversification of societies present new and complex challenges for healthcare systems worldwide. Medical professionals are now expected to communicate highly complex and evolving genetic information while simultaneously addressing the diverse linguistic, cultural, and social needs of their patient populations. At the center of this effort is the genetic counselor, who must navigate cultural perceptions of genetics, varying levels of health literacy, language barriers, and socioeconomic disparities to deliver equitable and effective care. Research in this area is expanding. However, its global distribution remains uneven and disproportionately concentrated in certain regions. In Japan, where many sectors of society are not yet fully equipped to meet the needs of its increasing migrant population, i.e., foreign residents, research describing the factors that impact their genetic counseling experiences is scarce. To fill this gap, we conducted semi-structured qualitative interviews with ten individuals who have had genetic counseling in Japan for prenatal diagnosis/screening, hereditary cancer, or hereditary monogenic disease. Thematic analysis revealed five factors that impacted their experience with genetic counseling: (1) Japanese language proficiency, (2) genetic literacy, (3) digital health literacy, (4) global family connections, and (5) interactions with medical professionals. These findings not only provide nuance to existing literature but also suggest areas of improvement for the cultural competence training of genetic counselors in Japan and point towards the need for guiding resources at the international level.

To study attitudes among parents of probands with rare pediatric-onset neurological and neurodevelopmental disorders on Clinical Genetic Testing (CGT). We administered an 8-item direct structured questionnaire comprising statements regarding attitudes on CGT to 101 consenting parents of probands enrolled in the University College London (UCL) Central Asia and Transcaucasia Disease Diversity Project. The probands comprised pediatric-onset diseases that included cerebral palsy, epilepsy, severe physical, language, and intellectual developmental delays, and autism spectrum symptoms in children with rare neurological disorders. We studied correlations between parents' opinions and demographic and clinical characteristics. The majority of parents (82.1-91.9%) agreed on statements reflecting the positive effects of CGT (causal explanation, research support, treatment relevance, recurrence prevention, and family planning). The opinions on the negative effects (discrimination, parental concern, and family conflicts) were less uniform. A higher educational level of parents was negatively correlated with agreement on statements about causal explanation, research support, and family planning (p < 0.05). Individual concurrent symptoms (severe language delay, epilepsy, autism, and microcephaly) correlated with several statements (p < 0.05). Parents showed positive attitudes toward clinical genetic testing. Parents' educational level was the most significant factor influencing their opinions. The spectrum and severity of clinical symptoms may shape the attitudes of the parents toward individual aspects of CGT.

Hereditary conditions can pose several challenges to the individual and their family members. In addition to the symptoms of the condition itself, stigmatisation is often described by those who live with hereditary conditions as a major challenge. This study explores the stigmatisation experiences of people with inherited conditions and their families in Portugal. Seventeen semi-structured interviews were conducted with individuals affected with a hereditary condition, asymptomatic carriers and family members, recruited through patient support organizations and social media. The data were analysed through inductive content analysis, resulting in three major categories: (i) stigmatisation contexts; (ii) psychosocial impacts; and (iii) coping strategies to deal with the stigma. The findings suggest the perception of stigma in family and social life, including specific contexts and systems such as academic, work, health care, social security and insurance. The stigma is associated with embarrassment, sadness, and frustration at the personal level, and with social impacts such as isolation, interpersonal distance, and avoidance of relationships. Participants often resort to providing explanations about their condition and to social isolation as a coping strategy for dealing with stigma. This study provides insights that reinforce the continuous need to raise awareness about hereditary conditions at a societal level and their associated impacts, to provide specific training for healthcare professionals on the potential stigma attached to inherited conditions, and to implement national strategies to reduce stigmatisation.