The comparative biology of New Zealand oystercatchers

Oystercatchers comprise a distinctive group of mollusc-eating shorebirds. They form an extremely uniform monogeneric family which has not undergone any major adaptive radiations into a diversity of ecological niches, but rather has dispersed from original centres of distribution to occupy identical niches in new geographical localities. The uniformity of structure and habit displayed within the group has been attributed by Larson (1957) to a high ecobiotic specialisation with centripetal selection involved. Throughout their range, oystercatchers exploit identical ecological niches which require specialised habits for successful utilisation. The specialised feeding habits of oystercatchers are well documented (Murphy, 1925; Dewar, 1940; Larson, 1957; Tinbergen and Norton-Griffiths, 1964; Dare, 1966), and a natural consequence of this specialisation is that it is restrictive to adaptive radiation

Het klinisch bloeddrukverschil en de geopereerde coarctatio aortae

status: publishe

De inschakeling van een verpleegkundig specialist binnen het zorgprogramma congenitale cardiologie voor volwassenen in UZ Leuven

After surgical or interventional treatment, patients with congenital heart diseases remain prone to complications. Therefore, these patients can not be considered as completely cured. To avoid complications and enhance overall health status, these patients need to perform an adequate self-management. In this respect, knowledge is a critical prerequisite. Empirical evidence indicated that many adults with congenital heart disease do not have sufficient knowledge regarding their disease, treatment and measures to prevent complications. A structured patient education programme is crucial to improve patients' knowledge. Within the interdisciplinary team, an advanced clinical nurse practitioner plays a key role in developing and implementing such an educational programme. The congenital heart disease programme of the University Hospitals of Leuven implemented the role of an advanced clinical nurse practitioner, who provides patient education, facilitates the transition from paediatric cardiology to adult cardiology, and improves social integration of the patients. A preliminary evaluation suggests that the integration of an advanced clinical nurse practitioner in congenital heart disease is feasible and cost-effective.status: publishe

Is the severity of congenital heart disease associated with the quality of life and perceived health of adult patients?

Objective: To explore whether the severity of congenital heart disease is associated with the quality of life and perceived health status of adult patients. Design: Descriptive, cross sectional study. Setting: Adult congenital heart disease programme in one tertiary care centre in Belgium. Patients: 629 patients (378 men, 251 women) with a median age of 24 years. Main outcome measures: Disease severity was operationalised in terms of initial diagnosis (classification of Task Force 1 of the 32nd Bethesda Conference), illness course (disease severity index), and current functional status (New York Heart Association (NYHA) class, ability index, congenital heart disease functional index, and left ventricular ejection fraction). Quality of life was measured by a linear analogue scale, the satisfaction with life scale, and the schedule for evaluation of individual quality of life. Perceived health status was also assessed with a linear analogue scale. Results: Scores derived from the disease severity classification systems were weakly negatively associated with quality of life and health status, ranging from −0.05 to −0.27. The NYHA functional class and ability index were consistently associated with quality of life and perceived health. Conclusions: This study showed that the severity of congenital heart disease is marginally associated with patients’ quality of life and perceived health. Functional status was more related to patients’ assessment of their quality of life than was the initial diagnosis or illness course

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

The future of adult patients after Mustard or Senning repair for transposition of the great arteries.

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