Diagnosis to death: family experiences of paediatric heart disease

2020 ◽  
Vol 30 (11) ◽  
pp. 1672-1678
Author(s):  
Kathryn Neubauer ◽  
Erin P. Williams ◽  
Pamela K. Donohue ◽  
Elliott M. Weiss ◽  
Mithya Lewis-Newby ◽  
...  
Keyword(s):  
United States ◽  
Heart Failure ◽  
Heart Disease ◽  
Prenatal Diagnosis ◽  
Qualitative Study ◽  
The United States ◽  
Structured Interviews ◽  
Family Experiences ◽  
New Normal ◽  
Causes Of Mortality

AbstractCHD remains one of the leading causes of mortality of children in the United States. There is limited research about the experience of parents from the diagnosis of their child with CHD through the death of their child. A prior study has shown that adults with heart failure go through a series of four transitions: 1) learning the diagnosis, 2) reframing the new normal, 3) taking control of the illness, and 4) understanding death is inevitable. In our qualitative study, we performed semi-structured interviews with parents who have a child die of CHD to determine whether the four transitions in adults apply to parents of children with CHD. We found that these four transitions were present in the parents we interviewed and that there were two novel transitions, one that proceeded the first Jones et al transition (“Prenatal diagnosis”) and one that occurred after the final Jones et al transition (“Adjustment after death”). It is our hope that identification of these six transitions will help better support families of children with CHD.

Outcomes of Heart Failure-Related Hospitalization in Adults with Congenital Heart Disease in the United States

2012 ◽  
Vol 8 (6) ◽  
pp. 513-519 ◽  
Author(s):  
Fred H. Rodriguez ◽  
Douglas S. Moodie ◽  
Dhaval R. Parekh ◽  
Wayne J. Franklin ◽  
David L.S. Morales ◽  
...  
Keyword(s):  
United States ◽  
Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
The United States

Heart Failure Related Hospitalizations in Children With Single Ventricle Heart Disease in the United States: Costly and Getting More Expensive

2012 ◽  
Vol 18 (8) ◽  
pp. S73 ◽  
Author(s):  
J.W. Rossano ◽  
D.J. Goldberg ◽  
A.R. Mott ◽  
K.Y. Lin ◽  
R.E. Shaddy ◽  
...  
Keyword(s):  
United States ◽  
Heart Failure ◽  
Heart Disease ◽  
Single Ventricle ◽  
The United States

scholarly journals COVID-19 Pandemic Adversely Affects the Provision of Desired Newborn Circumcision: Perinatal Physician Perspectives

2022 ◽  
Vol 1 ◽  
Author(s):  
Lauren E. Corona ◽  
Ilina Rosoklija ◽  
Ryan F. Walton ◽  
Derek J. Matoka ◽  
Catherine M. Seager ◽  
...  
Keyword(s):  
United States ◽  
Qualitative Study ◽  
The United States ◽  
Structured Interviews ◽  
Newborn Period ◽  
Policy Makers ◽  
Urban City ◽  
Physician Perspectives ◽  
Interview Guide ◽  
Hospital Policies

Over half of boys in the United States undergo circumcision, which has its greatest health benefits and lowest risks when performed during the newborn period under local anesthesia. The COVID-19 pandemic has affected delivery of patient care in many ways and likely also influenced the provision of newborn circumcisions. Prior to the pandemic, we planned to conduct a qualitative study to ascertain physician perspectives on providing newborn circumcision care. The interviews incidentally coincided with the onset of the pandemic and thus, pandemic-related changes emerged as a theme. We elected to analyze this theme in greater detail. Semi-structured interviews were conducted with perinatal physicians in a large urban city from 4/2020 to 7/2020. Physicians that perform or counsel regarding newborn circumcision and physicians with knowledge of or responsibility for hospital policies were eligible. Interviews were transcribed verbatim and qualitative coding was performed. Twenty-three physicians from 11 local hospitals participated. Despite no specific COVID-19 related questions in the interview guide, nearly half of physicians identified that the pandemic affected delivery of newborn circumcision care with 8 pandemic-related sub-themes. The commonest sub-themes included COVID-19 related changes in: (1) workflow processes, (2) staffing and availability of circumcision proceduralists, and (3) procedural settings. In summary, this qualitative study revealed unanticipated COVID-19 pandemic-related changes with primarily adverse effects on the provision of desired newborn circumcisions. Some of these changes may become permanent resulting in broad implications for policy makers that will likely need to adapt and redesign the processes and systems for the delivery of newborn circumcision care.

scholarly journals Rural-Urban Differences in Mortality From Ischemic Heart Disease, Heart Failure, and Stroke in the United States

2021 ◽  
Vol 14 (4) ◽  
Author(s):  
Muhammad Shahzeb Khan ◽  
Pankaj Kumar ◽  
Jayakumar Sreenivasan ◽  
Safi U. Khan ◽  
Khurram Nasir ◽  
...  
Keyword(s):  
United States ◽  
Heart Failure ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
The United States ◽  
Ischemic Heart

Abstract 163: High Burden of Valvulopathy in Heart Failure: A Moving Target

2016 ◽  
Vol 9 (suppl_2) ◽  
Author(s):  
Enoch Agunanne ◽  
Aamer Abbas ◽  
Debabrata Mukherjee
Keyword(s):  
United States ◽  
Heart Failure ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Heart Diseases ◽  
Medical Center ◽  
Care Facility ◽  
The United States ◽  
Study Objective ◽  
Valvular Heart Diseases

Background: The lifetime risk of developing Heart Failure (HF) is 20% for Americans ≥40 years of age. In the United States, greater than 650,000 new HF cases are diagnosed annually. About 5.1 million persons in the United States have clinically manifest HF. Additionally, HF has high absolute mortality rates of approximately 50% within 5 years of diagnosis. HF carries substantial health and economic burden. It is the primary diagnosis in >1 million hospitalizations annually. Patients hospitalized for HF are at high risk for all-cause re hospitalization. The total cost of HF care in the United States exceeds $30 billion annually. Objective: The study objective was to investigate the prevalence of valvular heart disease among patients hospitalized for HF in a largely Hispanic population. Methods: This is a retrospective study with aims inclusive of: analyzing the hospitalization and 4 months, 6 months, 2 year- re-hospitalization rates of HF in University Medical Center between Oct 2010 and Oct 2013; evaluating the association between valvular heart disease and hospitalizations for HF. Inclusion criteria were: admission/re hospitalizations with HF (with reduced, preserved and borderline EF). Echocardiographic determination of at least moderate valvular disease was utilized in this study as significant. Exclusion criteria were: patients lost to follow-up, death in hospital, transfer to another acute care facility, and discharge against medical advice. Demographics were also collected. Results: Hospitalizations involving 195 patients (120 men and 75 women) were randomly analyzed. The racial spread showed 77.4% (151 of 195) Hispanics and 22.6% (44 of 195) non-Hispanics. Out of the 195 index hospitalizations, the 4 month, 6 months and 2 years rehospitalization visits were 17.4% (34 of 195), 22.5% (44 of 195) and 38.5% (75 of 195) respectively. The prevalence of significant valvular heart disease was 45.9% (90 of 195), while the prevalence of no valvular heart disease was 54.1% (105 of 195) (p < 0.05). Conclusion: Multiple, prior studies have shown that valvular heart diseases have a comparatively low association with clinical Heart Failure. This study raises a valid point that in some population groups (the Hispanic), the burden of valvular heart disease may be greater than has been published in other groups. This calls for more studies, and has lots of potential implications in Heart Failure management.

scholarly journals Outpatient Management of Heart Failure in the United States, 2006–2008

2014 ◽  
Vol 41 (3) ◽  
pp. 253-261 ◽  
Author(s):  
Kailash Mosalpuria ◽  
Sunil K. Agarwal ◽  
Sirin Yaemsiri ◽  
Bredy Pierre-Louis ◽  
Samir Saba ◽  
...  
Keyword(s):  
United States ◽  
Heart Failure ◽  
Heart Disease ◽  
The United States ◽  
Primary Reason ◽  
Outpatient Management ◽  
Heart Failure Management ◽  
Visit Duration ◽  
Β Blocker ◽  
Β Blockers

Better outpatient management of heart failure might improve outcomes and reduce the number of rehospitalizations. This study describes recent outpatient heart-failure management in the United States. We analyzed data from the National Ambulatory Medical Care Survey of 2006–2008, a multistage random sampling of non-Federal physician offices and hospital outpatient departments. Annually, 1.7% of all outpatient visits were for heart failure (51% females and 77% non-Hispanic whites; mean age, 73 ± 0.5 yr). Typical comorbidities were hypertension (62%), hyperlipidemia (36%), diabetes mellitus (35%), and ischemic heart disease (29%). Body weight and blood pressure were recorded in about 80% of visits, and health education was given in about 40%. The percentage of patients taking β-blockers was 38%; the percentage taking angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARBs) was 32%. Medication usage did not differ significantly by race or sex. In multivariate-adjusted logistic regression models, a visit to a cardiologist, hypertension, heart failure as a primary reason for the visit, and a visit duration longer than 15 minutes were positively associated with ACEI/ARB use; and a visit to a cardiologist, heart failure as a primary reason for the visit, the presence of ischemic heart disease, and visit duration longer than 15 minutes were positively associated with β-blocker use. Chronic obstructive pulmonary disease was negatively associated with β-blocker use. Approximately 1% of heart-failure visits resulted in hospitalization. In outpatient heart-failure management, gaps that might warrant attention include suboptimal health education and low usage rates of medications, specifically ACEI/ARBs and β-blockers.

scholarly journals OUTCOMES OF HEART FAILURE RELATED ADMISSIONS IN ADULTS WITH CONGENITAL HEART DISEASE IN THE UNITED STATES: A POPULATION BASED STUDY

2011 ◽  
Vol 57 (14) ◽  
pp. E460 ◽  
Author(s):  
Fred H. Rodriguez ◽  
Douglas S. Moodie ◽  
Dhaval R. Parekh ◽  
Wayne J. Franklin ◽  
David L.S. Morales ◽  
...  
Keyword(s):  
United States ◽  
Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
The United States ◽  
Population Based ◽  
Population Based Study

Atrial Fibrillation: Epidemiologic Considerations and Rationale for Conversion and Maintenance of Sinus Rhythm

2003 ◽  
Vol 8 (1_suppl) ◽  
pp. S13-S26 ◽  
Author(s):  
Bramah N. Singh
Keyword(s):  
United States ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Disease ◽  
Sinus Rhythm ◽  
Surgical Techniques ◽  
Hypertensive Heart Disease ◽  
Fold Increase ◽  
The United States ◽  
Lone Atrial Fibrillation

Atrial fibrillation is now the most common cardiac arrhythmia for which a patient is hospitalized. Clinically, it presents in a form that is paroxysmal, persistent, or permanent and may be symptomatic or asymptomatic, occurring in the setting of either no cardiac disease (“lone atrial fibrillation”) or, most often, in association with an underlying disease. Atrial fibrillation is associated with a 2-fold increase in mortality and, in the United States alone, causes over 75,000 cases of stroke per year. The annual prevalence of stroke is 5% to 7%, but the use of adequate anticoagulation can reduce this to less than 1%. Atrial fibrillation is a disorder of the elderly, with almost equal prevalence in men and women. In the United States, 80% of atrial fibrillation occurs in patients over the age of 65 years, and its prevalence tracks that of heart failure, which may be the cause, as well as the result, of the arrhythmia. Both conditions are increasing in epidemic proportions in the aging population. The most common causes of atrial fibrillation are hypertensive heart disease, coronary artery disease, and heart failure with a miscellany of lesser conditions, with about 10% lacking structural heart disease. Unlike other supraventricular arrhythmias, cure by the use of catheter ablation and surgical techniques has not been a reality except in a relatively small number of cases. However, restoration and maintenance of sinus rhythm remain the initial goal of therapy for most patients. Pharmacologic approaches remain the mainstay of therapy for rate control and anticoagulation as well as for maintenance of sinus rhythm following pharmacological or electrical conversion. The changing epidemiology of atrial fibrillation is highlighted, with the focus on its conversion by the use of newer and novel antifibrillatory agents relative to the mechanisms of the arrhythmia, to restore the stability of sinus rhythm.

scholarly journals Emojis As Evidence in Trial

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gabriela Zeidler
Keyword(s):  
United States ◽  
Grounded Theory ◽  
Qualitative Study ◽  
The United States ◽  
Appellate Court ◽  
Court System ◽  
Structured Interviews ◽  
Use Of Technology ◽  
Southwest Region ◽  
Made In

As the sophistication and use of technology increases, communication through technology becomes more common, leading to the increasing use of emojis. In turn, this has led to an increase of emojis being used as evidence in court, with little guidance of how they can be interpreted within the law. This study examines the ways judges perceive emojis in court, especially when they are used as evidence. Through a grounded theory qualitative study, semi-structured interviews of judges throughout the Southwest region of the United States were conducted and analyzed according to Charmaz grounded theory guidelines (Charmaz, 2006) to determine judges’ perceptions of the use of emojis in court as evidence. This seeks to determine how emojis are used within the court system as they can carry and convey many different meanings to different people.  This study found that many judges find it necessary to have context with emojis for the purposes of interpretation by the jury, but it is not necessary for special instructions to be made in regards to emojis. Additionally, this study found other aspects of trial including jury selection and the appellate court are being affected by the increasing usage of emojis as evidence due to their highly subjective nature. Further research is needed to assess the broader implications of advancements in technology on the legal system.

Abstract 2157: Racial Differences in Hospitalizations for Atrial Fibrillation in the United States

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Paul B Tabereaux ◽  
Todd M Brown ◽  
Jose Osorio ◽  
G. N Kay ◽  
Dawn M Bravada
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
The United States ◽  
Principal Diagnosis ◽  
Common Risk Factors

Introduction: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the United States; however a paucity of population-based data about nonwhite individuals exist. The objectives of this study were to compare hospitalizations among Whites and African Americans (AA) and to determine whether race is an independent predictor of hospitalization for AF in the United States. Methods: Data was obtained from the National Hospital Discharge Survey (years 1996 –2005) and included hospitalizations with a principal diagnosis of AF for patients aged ≥18 yrs and race designated as either White or AA. Codes from the International Classification of Diseases -9th revision were used to define AF (427.31), hypertension (401– 405), ischemic heart disease (410 – 414), diabetes mellitus (250), heart failure (425,428) and valvular heart disease (424). Multivariable analysis with logistic regression was used to identify factors that were independently associated with AF hospitalizations Results: Among 297,962,043 hospitalizations between 1996 –2005, 3,676,787 (1.2%) had a principal diagnosis of AF. Among the hospitalizations for AF, white race was more common than AA race (2,393,659/186,904,962 of whites (1.3% of white’s hospitalized) and 209,788/33,972,665 of African Americans (0.6% of AA’s hospitalized), p<0.0001). After adjusting for the most common risk factors for AF (age, sex, hypertension, ischemic heart disease, diabetes mellitus, heart failure and valvular heart disease) AA race was independently associated with a decreased odds of hospitalizations for AF (Table 1 : adjusted OR=0.49, 95%CI 0.46 – 0.51). Conclusions: After adjusting for the most common risk factors for AF, the odds of hospitalization for AF in AA’s remained half that of whites. Race may be a novel and unaccounted risk factor for atrial fibrillation.

Sign in / Sign up

Export Citation Format

Share Document