Report of the New England Task Force on Reducing Heart Disease and Stroke Risk

Five years ago, a task force on reducing risk for heart disease and stroke was established by the six New England States. The task force included representatives from State public health departments, academia, the corporate sector, and voluntary organizations. This article is the final report of the task force. Heart disease and cerebrovascular disease are major causes of mortality in the New England region. Heart disease causes nearly 40 percent of all deaths in each of the six States and cerebrovascular disease, 7 percent of the deaths. Major risk factors for ischemic heart disease that have been identified--elevated serum cholesterol, high blood pressure, and cigarette smoking--are caused largely by lifestyle behaviors. Similarly, cerebrovascular disease results largely from uncontrolled high blood pressure, much of which is attributable to unhealthy lifestyle behaviors. In a series of studies evidence has accumulated that the reduction or elimination of these risk factors results in a decline in mortality rates. Many intervention programs have been mounted in the region, but there has been no population-wide effort to attack these risk factors. The task force proposed a broad range of activities for New Englanders at sites in the community and in health facilities. These activities would promote not smoking, exercising regularly, and maintaining desirable levels of serum cholesterol and blood pressure.     

Post-Traumatic Stress Disorder in Children: Controversies and Unresolved Issues

TOPIC: Questions regarding how severely traumatized children may meet diagnostic criteria for an accurate diagnosis of posttraumatic stress disorder (PTSD), the comorbidity of PTSD with many other psychiatric illnesses, and the possibility that PTSD is not a valid diagnostic formulation as it has been applied to children and adolescents demonstrate that the currently held concept of PTSD may not be operationally sound. PURPOSE: To explore recent empirical studies to demonstrate the current state of controversy and postulate future direction of the conceptual framework. SOURCES: Selected published literature. CONCLUSIONS: PTSD in children and adolescents, as it is popularly understood as a conceptual framework, is found to be undergoing a conceptual metamorphosis.     

Adjustment Difficulties of Adolescents With Sickle Cell Disease

TOPIC: The psychosocialfactors that affect adolescents with sickle cell disease (SCD). PURPOSE: To explore whether specific psychosocial factors can provide clues to the future adjustment of this population. SOURCES: Ovid Web, Medline, Psychinfo, and CINAHL databases for the years 1997 to 2001. CONCLUSIONS: Promoting effective psychosocial functioning is as important as managing the medical aspects of SCD, yet this is an area of care that is commonly overlooked. Nurses, therefore, have an opportunity to have a significant impact on the lives of adolescents with SCD if they intervene in ways to promote both biological and psychosocial adjustment.     

Modification of the Diagnostic Content Validity Model

Diagnostic content validation of nursing diagnoses is a recommended means to confirm the defining characteristics necessary to establish a specific nursing diagnosis. The diagnostic content validity model has been used in numerous studies to develop lists of major and minor defining characteristics recommended by experts as being present in patients with specific diagnoses. The authors provide an overview of the diagnostic content validity model, review the meaning and purposes of content validity, discuss problems with information processing, and suggest revisions to the diagnostic content validity model. Incorporation of these changes may improve the usability of nursing diagnoses in clinical practice, education, and research.