Expectations and experiences of adolescents with congenital heart disease on being transferred from pediatric cardiology to the adult congenital heart disease

PURPOSE: To investigate the expectations and experiences of adolescents on transferring from a pediatric cardiology program to an adult congenital heart disease program. METHODS: A qualitative, phenomenologic study was conducted, in which semi-structured, in-depth interviews were performed with 14 adolescents (aged 15-17 years) with congenital heart disease. Interviews were tape-recorded and transcribed verbatim. Data were analyzed using procedures described by Colaizzi. RESULTS: The study identified six themes that characterized adolescents' views of the transfer process: leaving pediatric cardiology was viewed as normal; leaving behind familiar surroundings; a positive wait-and-see attitude toward the adult congenital heart disease program; adjusting to a new environment; a need for better information; and a shift in roles between the adolescent and his parents. CONCLUSION: Although adolescents with congenital heart disease have a positive attitude toward transferring to an adult congenital heart disease program, they identified aspects of the transfer that healthcare professionals need to address. Patients and their families should be prepared for the transfer by informing them about the adult program and its healthcare providers. A formal transition program can play a role in this respect.status: publishe

Pollination of Habenaria tridactylites on the Canary Islands

We investigated the pollination of Habenaria tridactylites, an endemic orchid of the Canary Islands. The entirely green, widely open flowers have a long spur containing nectar. We carried out fieldwork, a molecular clock analysis, herbarium surveys, identified pollinators by both morphology and DNA barcoding, and measured the length of floral spurs and insect tongues using a combination of traditional and innovative micro‐CT scanning methods to 1) determine the pollinator of this orchid and 2) investigate correlations between local mean spur length and age, altitude and longitude of the island. Habenaria tridactylites was found to be pollinated on Tenerife by both small and intermediate sized moth species with variable tongue lengths and mostly belonging to Geometridae and to a lesser extent Crambidae, Erebidae, Noctuidae and Tortricidae. Of the sixteen moth species identified, nine are endemic to the Canary Islands or Macaronesia. The different local populations of H. tridactylites on the islands of Gran Canaria, El Hierro, La Gomera, La Palma and Tenerife with different ages and distances from mainland Africa, did not show a significant correlation of mean spur length and altitude, but did show a significant and positive linear correlation with longitude and the geological age of the island. The latter is congruent with the evolutionary arms race theory first proposed by Darwin, suggesting that flowers gradually evolve longer spurs and pollinators longer tongues

Pollination of Habenaria tridactylites on the Canary Islands

We investigated the pollination of Habenaria tridactylites, an endemic orchid of the Canary Islands. The entirely green, widely open flowers have a long spur containing nectar. We carried out fieldwork, a molecular clock analysis, herbarium surveys, identified pollinators by both morphology and DNA barcoding, and measured the length of floral spurs and insect tongues using a combination of traditional and innovative micro‐CT scanning methods to 1) determine the pollinator of this orchid and 2) investigate correlations between local mean spur length and age, altitude and longitude of the island. Habenaria tridactylites was found to be pollinated on Tenerife by both small and intermediate sized moth species with variable tongue lengths and mostly belonging to Geometridae and to a lesser extent Crambidae, Erebidae, Noctuidae and Tortricidae. Of the sixteen moth species identified, nine are endemic to the Canary Islands or Macaronesia. The different local populations of H. tridactylites on the islands of Gran Canaria, El Hierro, La Gomera, La Palma and Tenerife with different ages and distances from mainland Africa, did not show a significant correlation of mean spur length and altitude, but did show a significant and positive linear correlation with longitude and the geological age of the island. The latter is congruent with the evolutionary arms race theory first proposed by Darwin, suggesting that flowers gradually evolve longer spurs and pollinators longer tongues