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Objective: A genetics service wanted to gain an insight into the experiences of families with an inherited cardiac condition in order to design a new pilot service around family needs. Design: A focus group was held to understand from a family perspective what was important within the service. Interventions: Five families that had already been through the service were invited to share their experiences. Results: Three families attended. The facilitators noted the main points of what was discussed. The common themes were the time taken from the diagnosis or death of the family member to getting help and support. The lack of awareness of where to get the help required. Families felt unsupported after a sudden death. Conclusions: The families welcomed the opportunity to share their stories and the chance to improve the service for future users. An action plan was devised to include what they saw was important in a service.

The Allegheny County Sanitary Authority (ALCOSAN) is committed to reducing extraneous sources of stormwater that enter their interceptor system and subsequently are conveyed to the treatment plant. The entry of large quantities of stormwater contributes to combined sewer overflows (CSO's), hydraulic overloading, sediment buildup and increased treatment costs. One major source of stormwater inflow to the system occurs where natural streams have been intercepted by municipal combined sewer systems and subsequently conveyed to the ALCOSAN interceptor system. In most cases, these direct stream connections were built in an era prior to the establishment of ALCOSAN, when municipal sewer systems simply discharged to the rivers and streams. When ALCOSAN built the sewage treatment plant and interceptor sewer system in the 1950's, these stream inflow points were often distant from rivers and creeks, and therefore they were either unknown or difficult if not impossible to remove. The CSO diversion structures enabled the ALCOSAN interceptor system to take sanitary sewer flow during dry weather periods while allowing the drastically greater wet weather flow to simply overflow through flap gates.As the regulations for CSO's have changed and become much more stringent since the construction of the ALCOSAN system, it has become necessary to seriously re-evaluate the locations where streams enter the combined sewer system and determine the feasibility of removing them and conveying them to a waterway. This paper details the process of performing a feasibility study for removal of a direct stream connection to a municipal combined sewer system that flows into the ALCOSAN system. When the original scope of work was developed, it seemed to be a relatively simple problem to approach in that a single location had been identified where the stream entered the sewer system. Despite the availability of many sources of sewer system data, one of the most interesting discoveries was just how many discrepancies there were with regards to the existing system configuration. For example, as the system was investigated, a major highway drainage system was found to be connected to the combined sewer system, yet not shown on any maps. Ultimately, the scope of the feasibility study virtually doubled in magnitude simply due to the findings from the intense field reconnaissance work.

As well as diagnosing and supporting individuals with inherited cardiac conditions, it is important to identify family members that may be at risk. Hypertrophic cardiomyopathy is a complex and common cardiac genetic disorder that affects one out of every 500 people. Inherited cardiac condition clinics identify families at high risk of developing an inherited cardiac condition in order to reduce sudden cardiac deaths and detect early life threatening problems experienced by relatives. This article will explain inherited cardiac conditions, looking at hypertrophic cardiomyopathy in particular.

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