Integrating psychosocial health services into paediatric surgical specialty care is essential for addressing behavioural and psychological aspects of illness and reducing healthcare disparities. This is crucial for patients facing CHD, who are at higher risk for depression, anxiety, and attention-deficit/hyperactivity disorder, which is significantly influenced by their caregivers’ mental well-being.

The Pediatric Psychosocial Preventative Health Model framework was utilised by a psychosocial team to assess biopsychosocial needs in CHD patients during their first cardiac surgery evaluations. Patient and family needs were categorised into universal, targeted, and clinical tiers, allowing for responsive interdisciplinary services. Screening tools such as the Psychosocial Assessment Tool, Pediatric Quality of Life Inventory, and Depression, Anxiety, and Stress Scales were used during initial consultations to guide appropriate interventions and referrals.

Universal-tier patients received comprehensive support focused on preventive measures, resource access, and education to promote resilience. Targeted-tier care involved intensive, collaborative efforts, providing specialized psychological evaluations, and one-on-one time with experts. Clinical-tier families required specialised, intensive interventions such as advanced cognitive behavioural therapy and medication management. The Pediatric Psychosocial Preventative Health Model framework and psychosocial team workflow allow for individualised management strategies, ensuring that each family received timely and appropriate interventions based on their unique needs.

Integrating psychosocial services into initial surgical evaluations is critical for addressing CHD patients’ psychological and social needs, promoting an interdisciplinary approach that enhances overall family functioning and well-being.

Single ventricle CHD requires lifelong care, yet its broader impact on patients and families remains unclear. Engaging patients in care improvement can strengthen relationships and outcomes.

This study evaluates how individuals with single ventricle CHD prioritise gaps in care based on personal and family impact.

Using Mery et al.’s identified care gaps, a survey was distributed to parents of children with single ventricle CHD and adults with single ventricle CHD in English or Spanish. Participants rated each gap from 1(not important) to 10(extremely important), with a “Not Applicable” option. Responses were analysed using median, weighted, and total rating scores. Sociodemographic data were examined, and univariate analysis and a race/ethnicity and insurance matrix were conducted on parent responses.

Among 36 complete responses, 30(83.3%) were parents and 6(16.7%) patients. Most parents were female(29,96.7%), White non-Hispanic(24,80.0%), with 17(6.7%) having privately insured children. Median child age was 6.5[interquartile range: 3.0–12.8] years, and 55.3% had Hypoplastic Left Heart Syndrome. The highest-rated gap was “Uncertainty of prognosis in adulthood” (9.5[interquartile range: 8.0–10.0]). The lowest was “Pregnancy termination presented repeatedly” (1.0[interquartile range: 1.0–7.0]). Non-White parents rated “Transition to adult healthcare” (p = 0.017) and “Navigating resources” (p = 0.037) higher. Patients (median age 33.0 years) prioritised “Rescheduling surgical procedures” and “Transition to adult healthcare” (both 10.0). “Support in family planning” had the highest total rating score(12). The lowest-rated was “Limited guidance on transition to adolescence” (0.0[interquartile range:0.0–0.0]).

Patients and families prioritise care gaps differently. Aligning their perspectives with clinical expertise can guide tailored solutions to improve outcomes for single ventricle CHD patients.

Risks and priorities change during the management of public health incidents. Here we describe a new tool, the Incident Management Measurement Tool (IMMT), that can be used to inform midcourse corrections during public health emergencies and realistic exercises.

We developed the IMMT through a literature review and subject matter expert interviews. We field tested the tool in 23 incidents ranging in size, duration, and complexity, making changes based on user feedback.

The IMMT consists of 2 modular data collection methods, a survey of the incident management team and a protocol for a peer assessor. Pilot testing suggested that the tool is valid, reliable, feasible, and useful.

Measurement of public health incident management is feasible and may be useful for improving response times and outcomes. Moreover, a limited set of standard measures is relevant to a wide range of incident response contexts.

The population of adults with single-ventricle congenital heart disease (CHD) is growing. This study explores their lived experiences through an adult developmental psychology framework.

Individuals aged 18 and older with single-ventricle CHD participated in Experience Group sessions and 1:1 interviews. Sessions were transcribed and analysed thematically. Themes were categorized by developmental domains and age group.

Of the 29 participants, 18 (62%) were female, 10 (35%) were emerging (18–29 years), 13 (45%) were established (30–45 years), and 6 (21%) were midlife adults (46–60 years). Emerging adults expressed reluctance to initiate romantic relationships and fear of burdening partners, while established adults reported strong relationships with partners deeply involved in caregiving. Emerging adults struggled with finding fulfilling work that meets their health needs, whereas established and midlife adults faced unemployment or early retirement due to health limits. Family dynamics shifted, with established and midlife adults educating their children to become caregivers. Physical limitations and low self-rated health were consistent across life stages, and midlife adults did not worry about traditional chronic conditions. Mental health concerns, including anxiety and depression, persisted across all life stages, but resiliency and positive affect were also evident.

Adults with single-ventricle CHD experience developmental milestones differently, indicating the need for early anticipatory guidance in these domains to achieve optimal outcomes in adulthood.

Identifying patients at imminent risk of death is critical in the management of trauma patients. This study measures the vital sign thresholds associated with death among trauma patients.

This study included data from patients ≥15 years of age in the American College of Surgeons Trauma Quality Improvement Program (TQIP) database. Patients with vital signs of zero were excluded. Documented prehospital and emergency department (ED) vital signs included systolic pressure, heart rate, respiratory rate, and calculated shock index (SI). The area under the receiver operator curves (AUROC) was used to assess the accuracy of these variables for predicting 24-hour survival. Optimal thresholds to predict mortality were identified using Youden’s Index, 90% specificity, and 90% sensitivity. Additional analyses examined patients 70+ years of age.

There were 1,439,221 subjects in the 2019-2020 datasets that met inclusion for this analysis with <0.1% (10,270) who died within 24 hours. The optimal threshold for prehospital systolic pressure was 110, pulse rate was 110, SI was 0.9, and respiratory rate was 15. The optimal threshold for the ED systolic was 112, pulse rate was 107, SI was 0.9, and respiratory rate was 21. Among the elderly sub-analysis, the optimal threshold for prehospital systolic was 116, pulse rate was 100, SI was 0.8, and respiratory rate was 21. The optimal threshold for ED systolic was 121, pulse rate was 95, SI was 0.8, and respiratory rate was 21.

Systolic blood pressure (SBP) and SI offered the best predictor of mortality among trauma patients. The SBP values predictive of mortality were significantly higher than the traditional 90mmHg threshold. This dataset highlights the need for better methods to guide resuscitation as initial vital signs have limited accuracy in predicting subsequent mortality.

This study investigated the challenges and support needs of adults aged 75 and older during and after treatment for a blood cancer to aid targeted supportive resource development.

Adults aged 75 and older with a blood cancer participated in in-depth, semi-structured interviews about challenges and unmet support needs. Participants recruited through The Leukemia & Lymphoma Society were (1) in treatment or previously in treatment for a blood cancer at age 75 or older and (2) living in the United States or its territories. A thematic analysis was conducted with findings compared between 2 groups: (1) chronic -living with a chronic blood cancer; (2) acute -living with an acute blood cancer or both an acute and chronic blood cancer.

Participants (n = 50) ranged from 75 to 91 years old. Both groups described similar experiences and identified 5 challenges and support needs: (1) socioemotional impact, (2) activities of daily living and instrumental activities of daily living (ADLs/iADLs), (3) uncertainty management, (4) treatment-related stressors, and (5) COVID-19-related strain. Properties for these themes illustrate challenges and support needs, with some differences between groups. For instance, those living with a chronic blood cancer highlighted financial strain with treatment-related stressors, while those with an acute blood cancer focused more on iADLs.

Findings inform an agenda for targeted resource development for older adults with a blood cancer nearing the end of the life span. Results demonstrate the need for supportive services and family communication interventions to help patients manage iADLs and navigate socioemotional needs and challenges.

With advances in care, an increasing number of individuals with single-ventricle CHD are surviving into adulthood. Partners of individuals with chronic illness have unique experiences and challenges. The goal of this pilot qualitative research study was to explore the lived experiences of partners of individuals with single-ventricle CHD.

Partners of patients ≥18 years with single-ventricle CHD were recruited and participated in Experience Group sessions and 1:1 interviews. Experience Group sessions are lightly moderated groups that bring together individuals with similar circumstances to discuss their lived experiences, centreing them as the experts. Formal inductive qualitative coding was performed to identify salient themes.

Six partners of patients participated. Of these, four were males and four were married; all were partners of someone of the opposite sex. Themes identified included uncertainty about their partners’ future health and mortality, becoming a lay CHD specialist, balancing multiple roles, and providing positivity and optimism. Over time, they took on a role as advocates for their partners and as repositories of medical history to help navigate the health system. Despite the uncertainties, participants described championing positivity and optimism for the future.

In this first-of-its-kind pilot study, partners of individuals with single-ventricle CHD expressed unique challenges and experiences in their lives. There is a tacit need to design strategies to help partners cope with those challenges. Further larger-scale research is required to better understand the experiences of this unique population.