Parenting children with hypoplastic left heart syndrome: Finding a balance

Purpose. This study described the role normalization played for parents related to their young children with hypoplastic left heart syndrome. Design and Methods. The data source for this secondary analysis was 30 interviews with 16 parents. Results. Three themes were identified: normalization, parental perception of child vulnerability, and optimistic appraisal. Parents engaged in a balancing act between worrying about their children's vulnerability and marveling at their children's survival, using normalization as a coping strategy. Practice Implications. Nurses can collaborate with parents to determine strategies to restore a sense of normalcy to simultaneously promote child independence and parent well‐being.     

Peer Reviewed: Chronic Disease Surveillance Systems Within the US Associated Pacific Island Jurisdictions

In recent years, illness and death due to chronic disease in the US Associated Pacific Islands (USAPI) jurisdictions have dramatically increased. Effective chronic disease surveillance can help monitor disease trends, evaluate public policy, prioritize resource allocation, and guide program planning, evaluation, and research. Although chronic disease surveillance is being conducted in the USAPI, no recently published capacity assessments for chronic disease surveillance are available. The objective of this study was to assess the quality of existing USAPI chronic disease data sources and identify jurisdictional capacity for chronic disease surveillance. The assessment included a chronic disease data source inventory, literature review, and review of surveillance documentation available from the web or through individual jurisdictions. We used the World Health Organization''s Health Metric Network Framework to assess data source quality and to identify jurisdictional capacity. Results showed that USAPI data sources are generally aligned with widely accepted chronic disease surveillance indicators and use standardized data collection methodology to measure chronic disease behavioral risks, preventive practices, illness, and death. However, all jurisdictions need to strengthen chronic disease surveillance through continued assessment and expanded support for valid and reliable data collection, analysis and reporting, dissemination, and integration among population-based and institution-based data sources. For sustained improvement, we recommend investment and technical assistance in support of a chronic disease surveillance system that integrates population-based and institution-based data sources. An integrated strategy that bridges and links USAPI data sources can support evidence-based policy and population health interventions.     

2010-2011 Meetings and Conferences

Since meetings are our outlet as medical doctors and scientists to learn about the latest advances in our field, this issue highlights some worldwide meetings and conferences that may be of significant interest to put on your calendar during 2010 and 2011. These meetings are hosted by many of our affiliated societies throughout the world and have sessions dedicated to some form of pancreatic disease-related research. Many are annual meetings, so even if your travel calendar is booked for the year, utilizing their website to examine the program topics and abstracts for this year may prompt interest to attend one of the following year's meetings.     

Physician attitudes and practices and patient awareness of the cardiovascular complications of diabetes

OBJECTIVES: Studies were conducted to: 1) assess physicians' attitudes and practices in managing cardiovascular disease (CVD) risks in diabetes; and 2) determine the awareness of CVD risks among diabetic patients. BACKGROUND: Cardiovascular disease is the leading cause of premature death among diabetic patients. As diabetes is often seen as a "glucose-centric" disease, it is unclear whether diabetic patients are talking with their doctors about CVD and other key clinical parameters of diabetes care such as blood pressure and cholesterol. METHODS: An online survey was completed by a nationally representative sample of 900 physicians. The 95% confidence interval is approximately +/-2.5%. Before this study, a telephone survey of 2,008 people with diabetes was conducted using random, direct-dial screenings of U.S. households. RESULTS: Ninety-one percent of physicians believe that their patients with diabetes are "very" or "extremely" likely to have a cardiovascular event. Although physicians report discussing CVD risk factors with 88% of their diabetic patients, they perceive their diabetic patients as being only moderately knowledgeable about their increased CVD risks. Sixty-eight percent of the people with diabetes do not consider CVD to be a serious complication of diabetes; they are more likely to be aware of complications such as blindness (65%) or amputation (36%) rather than heart disease (17%), heart attack (14%), or stroke (5%). Physicians perceive "poor compliance" with behavioral modifications and medication regimens as the greatest barriers to the management of CVD risks in diabetic patients. CONCLUSION: Materials should be made available to help facilitate communication about CVD risks, and strategies for improving compliance with life-style modifications and multiple drug therapies should be explored. Efforts should continue to promote a comprehensive approach to the management of diabetes to include aggressive control of blood glucose and other CVD risk factors.     

Connecting the disconnect between hospital and home

Mr. D, 76 years old, underwent a colostomy in a local hospital after several weeks of preoperative outpatient radiation therapy that caused severe diarrhea. The nurses at the hospital managed his colostomy and told him he probably "would not need to wear a pouch" after he was taught how to irrigate. They showed him how to empty a two-piece system before he was discharged 7 days after his surgery. Mr. D was able to manage emptying but did not pay much attention to the procedure because he viewed wearing the pouch as a temporary situation. After his discharge, the home care nurse informed him that due to the diarrhea he was experiencing, colostomy irrigation would not be an option and he would have to use a pouching system - one different from the one he had learned to use in the hospital. Mr. D was disappointed and bewildered.