The mother has never worked outside the home.  She's currently caring for 10 children at home.  The family had little life insurance and no medical insurance.

One of the family's daughters married one of the Dutton family and the Duttons are going to be hosting a special fundraising show in memory of Carl and Ryan.  It's happening on Saturday and tickets are $15 a person or $40 for a family pass (two adults and all children under 18 in the household.)  Call 332-2772 for more information.

If you would like to give to the family, there is Carl R. Chapman Memorial Fund set up at Metropolitian Bank.

Alternatively you could click the tab/button right above the title of this post! It's just up there ^...

Kanske den bästa tolkning av Dylans Chimes Of Freedom som jag hört. Iofs är jag ruskigt svag för Youssous tolkning av den med, klart i samma klass som den han och de andra framförde under Human Rights Now-turnén. Titta nedan, och döm själva. Själv är jag svag för den, riktigt svag.

Steven Yip          Andy Tan
Maurice Wong      Melvin Kwan

Outline:

Introduction
Current Practice
“Burning Question”
Reasons For Change
Literature Review
Appraisal and Synthesis of Evidence
Recommendations for Best Practice
Integration of New Practice
Summary
References

Clinical Best Practice - NGT

Introduction

Critically ill patients are difficult to feed often resulting in MALNUTRITION!
Giner et al., Barr et al., 2004, found out that ICU patients, 43% to 88% are often malnourished.

Enteral nutrition is acknowledged as the preferred route of feeding (Heyland et al., 2003a).
However, underfeeding and intolerance are common problems (McClave et al., 1999).
Underfeeding and Overfeeding have been associated with undesirable outcomes.
Compromise the immune response, nutritional status, glycaemic control and diarrhea.

Besides under and over feeding, the delivery and tolerance of enteral nutrition is important.
Gut dysfunction, high gastric aspirates, vomitting, and abdominal distension are common problems.
This presentation attempts to investigate the best clinical practice in feeding a post stroke patient.
It is worthwhile to note that patient preferences are often neglected in the decision to use enteral feeding.
Current practice – Enteral Feeds

Indications for enteral nutrition:

Impaired swallowing or gag reflex
Cancer
Underlying condition may prevent eating
Ventilator-dependent or post operative patients
Stroke patients

Types of Nasogastric Tubes

Nasogastric tube (NG Tube) passes through the nose, down the throat and to the stomach;
Nasojejunal tube (NJ Tube) passes through the nose, down the throat, through the stomach and to the small intestine;
Gastrostomy Tube (G Tube) passes through a small cut in the skin directly into the stomach;
Gastroenteric or Transgastric jejunal tube (GJ Tube) passes through a cut in the skin directly into the stomach and extends into the small intestine;
Jejunostomy tube (J tube) passes through a cut in the skin directly into the small intestine;
Poor nutrition is common…

Silicone may cause slower flow and more frequent clogging…

But is anything being done to better the process??

“The Burning Question“

Reasons for Change
Improvements in delivery systems for enteral feeding, formulas and understanding of complications have made enteral feeding widely used, however,…Is there a better solution?

Literature Review
Bolus Feeding:

Also called intermittent feeding.
Given over short periods of time several times throughout the day.
Given by pump or gravity.
Timing of feeds can be changed 2-3hrs between feeds to allow stomach to empty.
Resembles normal pattern of eating-digestion.

Continuous Feeding:

Given at a steady rate for as many hours as needed.
A pump is used over the 24hr duration.

Continous Feeding and Bolus Feeding Combined?

Sometimes bolus tube feeds are given during the day and continous feeds at night.

Complications of Enteral Feeding

Aspiration Pneumonia
Cause serious local and systemic infections
Difficult to insert NGT
Risk of death (1%)
Uncomfortable and hence prone to being pulled out
Patient distress
Enteral Feeding

Klodell (2000) found that the preference for enteral nutrition, as opposed to parenteral, is universal.
Strict attention to patient positioning, as well as vigilant nursing care helps to minimize rates of complications with enteral access. 
However, controversy still remains regarding the route of administration.
Clinician driven decisions.
No strong evidence to support the preferential use of jejunal or gastric feeding tubes in Traumatic Brain Injury patients.

Enteral Feeding

Klodell et al (2000) also found that prokinetic agents such as metroclopramide in the initial 48hrs of enteral nutrition to  augment gastric emptying.
Klodell et al (2000) notes that gastric feeding in neurologically injured patients may be successful as early as 24hrs after the injury with the co-administration of drugs to facilitate gastric emptying.

Batson, S. (1997) found that gut dysfunction and elective stoppages for procedures were main reasons for preventing delivery of feeds.
Average daily gastric aspirate were compared over one month.
Average daily gastric aspirate were higher on the first few days of feeding.
The aspirate volumes then settled to a steady state at an average of +/-105mls.

Where a specific feeding protocol was employed, the average volume of feed delivered was 1418 +/- 505ml., the percentage of optimal feed delivered was 78 +/- 31%.
Where there was an absence of specific feeding protocol, the average volume of feed delivered was 1179 +/- 674ml, and the percentage of optimal feed delivered was 66 +/- 34%.
Discrepancies exist between the delivered and prescribed volume of feed. 
Causes suggested include the onset of diarrhea and nursing workload.

Diarrhea is invariably blamed on enteral feed.
Kandil et.al found that health volunteers did not show signs of diarrhea until they were fed more than 275ml/h.  This rate is far greater than any patient would receive, suggesting that feed is unlikely the cause.
Other causes have been identified:
Antibiotic, and other drug therapy, feed formula, contamination of feed.
No clear cause but it seems likely that there are other more complex factors involved.

The percentage of prescribed feeds delivered depends on the volume of prescription. 
When smaller volumes are prescribed, the percentage delivered is higher.  1200ml over 24hrs versus 2000ml over 24hrs.
Rest periods are used to “catch-up” on feed schedules. 
Use of a rest period seems an effective way of ensuring the patients receive the prescribed amount of feed.
Delivery rate was 95-75% of prescribed feed with a rest period.
The researcher also notes that this aspect requires further investigation. 

In another study by Serpa, et al (2003), it was found that it was acceptable practice that whenever 80% of the energy needs are supplied by 72hrs, the replenishment program should be considered adequate.
Undeniably there will be deficits of actual supplied and prescribed amounts, but according to the researcher, this shortcoming is small and justified in circumstances of critical disease.
(Note:  Two groups of 14 critically ill patients were randomly assigned to intermittent or continuous tube feeding.)

Chapman (1992) found that written protocols are a simple and effective method of increasing enteral feed delivery.
Delivery rate of >85% was achieved for patients with written protocols.
Delivery rate of >75% was achieved for patients without written protocols.
All researchers agree that more research is need to be done in this area for results to be more conculsive.

Appraisal and Synthesis of Evidence
Bolus versus Continuous Feeding
Bolus Feeding
Preferred by most clinicans.
Promote the cyclical surges of gut hormones.
However, delayed gastric emptying may hinder ability to handle bolus milk feeds resulting in feeding intolerance – (Dumping Syndrome).
Causes diarrhea if given too fast and too much.
Higher risk of aspiration if feeding intolerant.

Continuous Feeding
May be more efficient by increasing energy absorbed and improved nutrient absorbtion.
But may alter the cyclical pattern of gut hormones affecting metabolic homestasis.
Should not be given overnight in patients who are at risk of aspiration.

The Evidences speak for Themselves
The use of electronic pumps, slow administration even in cases of bolus prescription, careful selection of diet and positioning of tube, prevention of abdominal distension or high gastric residues and constant monitoring of patients.

Recommendations – Best Practices
Health care professionals should aim to provide adequate nutrition to every patient.
It should be the hospital policy that results of an admission nutritional screening are recorded in the notes of all patients with serious illness or those needing major surgery.
Nutritional support is needed when oral take is absent or likely to be absent for a period of >5-7 days.  Earlier intervention may be needed in malnourished patients.
Choice of route in consultation with clinician and dietician.
Adoption of a written protocol for feed regimes in conjunction with the clinical care pathway.
The use of electronic pumps to administer feeds.
Proper positioning into semi-fowler position (if not contra-indicated) for feeding.
Use of prokinetics to encourage gastric emptying.
Constant monitoring of patient for abdominal distension.
Consultation with dietician and clinician if patient develops feeding intolerance or diarrhea.
Allowing breaks in feeding to let gastric PH fall will help prevent bacterial overgrowth during ETF.
Allows the gut to “rest’

Ethical Issues

Enteral feeding should not be started without consideration of all related ethical issues and must be in a patient’s best interests.
In cases where a patient cannot express a wish regarding Enteral feeding, consulting widely with all carers and family is essential.

Integration of New Practice

Presentation to the Medical Board and governing body, PTs, Dieticians.
Propose changes to current hospital protocols and guidlines.
Provide education, roadshows.
Monitor for compliance, audits.
Competency audits for nurses.

Enteral feeding is the preferred modality of support for seriously ill patients, Who have acceptable gastrointestinal function but are unable to maintain oral diet.
Further future studies conducted should include longer periods and populations with different risk factors to advance the knowledge about these widely adopted therapeutic techniques.

REFERENCES

Axelsson, K., Asplund, K., Norberg, A., Eriksson, S. (1989) Eating problems and nutritional status during hospital stay of patients with severe stroke.  Journal of American Dietary Association. 8.1092

Giner, M., Lavino, A., Meguild, M.M. & Gleanson J.R. (1996)  In 1995 a correlation between malnutrition and poor outcome in critically ill patients still exists.  Nutrition 12, 23-29.

Heyland, D.K., Dhaliwal, R., Drover, J.W., Gramlich L. & Dodek, p. (2003)  Canadian Clinical practice guidelines for nutritonal support in mechanically ventilated, critically ill patients. JPEN 27, 355-373.

McClave, S.A. & Snider, H.L. (2002) Clinical use of gastric residue volumes as a monitor for patients on enteral tube feeding. JPEN 26, S43-S50.

Reid, C. (2006) Frequency of under and over feeding in mechanically ventilated ICU patients:  Causes and possible consequences.  The British Dietetic Association 19 pp 13-22.

Serpa L., Kimura, M., Faintuch, J., (2003).  Effects of continuous versus bolus infusion of enteral nutrition in critical patients.  Clinc. FAC, MED S. Paulo 58(1): 9-14, 2003.

Thomas, D. (2007)  Annals of Long-term Care, Clinical Care and Aging.  Retrieved from www.annalsoflongtermcare.com/article/857 on april 11, 2007.

Kandil HE, Oper FH, Switzer BR, Heitzer WD (1993) Marked resistance of normal subjects to tube-feeding induced diarrhea; the role of magnesium. Am J Clin Nutr 57:73-80.

Klodell, C., Carroll, M., Carrillo, E., Spain, D. (2000)  Routine intragastric feeding following traumatic brain injury is safe and well tolerated.  The American Journal of Surgery.  Vol 179, Issue 3, pp. 168-171.

Chapman G, Curtas S, Meguild M (1992) Standardized enteral orders attain caloric goals sooner:  a prospective study, JPEN J Parenter Enteral Nutr 16:  149-151.

INFO:
High Strung and Drum
1931 E Seminole
417-866-1150
blugrassdaddy.com
myspace.com/highstrungmusic 

From what I hear the new space is awesome and I look forward to popping in there this Friday. Dave has revamped the store...and what a revamp he's made. Read all the amazing (and some of it is exclusive to High Strung and Drum) stuff he's bringing in and offering after the break.

So here's the scoop...

High Strung will no longer be High Strung Music as it was. And it will no longer be dealing in primarily acoustics, mandolins, fiddles, banjos, and miscellany items. Instead High Strung Music will be changing its name to High Strung and Drum. Drum-wise, Dave will now be the area's exclusive dealer of MAPEX drums [begin rant] MAPEX!!!! Being a drummer, this is awesome. Recently I had to buy my new Mapex 14 ply all maple Black Panther Bluebird snare from an online dealer because the closest dealer with that snare was in Memphis! Mapex is a very high quality drum (except their cheapo line, but every major company has that) and this make me very very happy to have in Springy Dingy [/end rant], and will be selling Zildjian and Sabian cymbals. And just like as it was when he was at the Percussion Shop-and a bit his downtown High Strung location, Dave will again offer all drum and hardware repairs, re-covers, and cleaning. CLEANING DRUMMERS! Don't let your awesome gear look like crap. Take care of it!

For the "not drummers," Dave will also be selling Washburn Electrics, Rocktron and Randall amps. They'll also be a great location to Buy/Sell/Trade equipment (don't go to a pawn shop silly). And in addition to this, they have lessons available for just about any instrument you can jam on in a band. Here's the list of who's teaching what at the new High Strung and Drum:

• GUITAR INSTRUCTION:
  CHRIS MAY
  JOHN CHAPMAN
   
• DRUM INSTRUCTIONS:
  DAVE HARP
   
• VIOLIN/VIOLA INSTRUCTION:
  MOLLY HEALY
   
• FIDDLE INSTRUCTION:
  JOHN CHAPMAN
   
• MANDOLIN INSTRUCTION:
  JEREMY CHAPMAN
   
• BASS INSTRUCTION:
  JASON CHAPMAN
   
• DOBRO INSTRUCTION:
  BRIAN GRIM 

Much love to Guitar Center, but they put local guys out of business because they can get you stuff cheap b/c they sell so much in volume. Be an awesome person and an awesome musician and go to High Strung and support a guy that not only knows his stuff about music (being he's been in bands in the area for over 12 years that I know of) but he knows his stuff about equipment. Sit in on a jam session or just stop by to talk gear and music. These guys are awesome and you WILL have a good time. All this without having punky salesperson trying to get you to buy stuff you don't need.

Anh Duong

Hilary Duff

Hana Soukupova

Diana Taylor

Candace Bushnell

Paula Patton

Carolina Herrera

Alina Locklear

Linda Fargo

Tory Burch

Eva Longoria

Katie Lee Joel

Lauren Bush

Victoria Beckham

Mandy Moore

Kim Cattrall

Joyce Varvatos

Zani Gugelmann

Georgina Chapman

(For those of you who might be a little late on the news (no pun intended) Grammy Award winning artist Steven Curtis Chapman, lost his just-turned-5, adoptive daughter, Maria Sue Chapman, to a tragic car accident last week. To read more on the accident click here, here, or here. To visit Steven Curtis Chapman's site click here. To visit the page written in memorial of Maria Sue Chapman click here.) 

Steven and family,

Chances are you may never read this, but in case you do, know that you have my deepest sympathies and condolences and I share and carry your pain and grief with you.

A little after I heard about the news, I decided to pull up my iTunes and listen to your album Declaration. As I came to the song God is God and began listening intently to it I began to weep as my heart filled with sadness, once more. Yet, as the song came alive in my head the answer to the question I had been asking all along came to me. The answer to the why? Why so early? Why the pain? Why so young? Why her brother? Why did God allow it? Why to this family? Why to the righteous? The answers to these questions did not come, but this became clear to me= although we may never know the answer to the why we do know one thing— God is God. He knows why it happened and He's aware of your pain. Remember that He has full control of the situation. Can we even take a breath without God giving it to us?

In Christ, 

Pablo

PS Dear friends, please take heart and remember life is short, don't take it for granted.

HT: Chris Brauns

The Chapman's have a web page for you to visit and share your prayers and thoughts! Stand with them in prayer in the days, weeks, and months ahead. Bookmark this site and schedule in your calendar times to pray for them. Her site here

Brad Symes- A very popular DT player at the start of the year who in the following weeks did not dissapoint until he was struck down with an ankle sprain. Whilst it may seem for a big tough footy player an ankle sprain would me a mediocre issue, this is not always the case as shown with Brad Ottens and now Brad Symes. He hasnt played since round 5 and was expected to miss 3 weeks, this has stretched out to 6 weeks and is expected to return round 12. He has been wearing the big moon boot on his foot for a while until just today when he finally got it off. Its expected he should be able to start some running later on this week. Many will be a tad disapointed in seeing he is still two weeks away, especialy those who have had him on the bench for four weeks now.

Cameron Cloke- The big man from the blues who has been in surprisingly good form this year will have a test this week for his injured wrist which he had surgery on a few weeks ago. He was expected to return this week and it seems as though he has recovered well and should hopefully play.

Bret Thornton- The knee which he injured in round 6 should be right this week for a return. Thornton was listed in the blues starting 22 last week but pulled out at the last minute. He is listed as a 'test' for this week but i expect a definate return from him, the blues will need it as well due to key defender Waite being outed for a week at the tribunal.

Scott Lucas- The big could be back this week, the bombers have sorely missed him since he injured his posterior crutiate ligament (knee) in round one this year. He will be tested this week and i would think the bombers would be keen on getting him right to play, although the bombers do play friday night in adelaide which wouldnt help his case, clubs arent usually to keen on bringing a guy straight back from injury to play interstate. Scotty could be a decent buy in a few weeks, even though his price is a hefty 384k, he scored 18 in his only game of the year so his price will plummet very quickly.

Ricky Dyson- Had his appendix taken out and is expected to miss 3, bit week id say from Dyson, a champ named Jimmy B had his appendix out a while ago and missed only one week, they build them tough down at Geelong.

Paul Chapman- Pulled out late last week to the dismay of many with hammy tightness, chappy will have a test this week for the blues game on saturday night but i would be very surprised if he didnt play should be available. BUT WAIT, this return could have a great negative impact on many dream teamer's, Bomber Thomson likes to move his young gun's from VFL to AFL quite consistently, he has done so over the years with such guns as Bartel and Ablett, the both of them didnt play every game in their first year even though they were probably capable. Its very common for the cats to constantly drop their young guys down to the VFL for a few weeks even if they have been playing pretty well in the AFl, with the exception of genuine superstars (Selwood). Since Chappy and Gamble are similar players in that they often wind up in the forward pocket and flank, Gamble may find him at the raw end of the stick in a Chapman inclusion and might find himself in the VFL. Gamble's game against the pies was not the most impressive he has had, but hopefully he holds his spot as i see a big score for him if he plays the blues.

Stuart Dew- Hammy again for Dew, but this time not as bad it seems as though it is simply hamstring tightness. He is still to be assessed about it, hammy's can take their time before the doc's can really understand the severity of the injury. The hawks stated that he could be right to play this week but will not know for a couple of days. Stayed tuned on the couch for more details about this.

Shane Crawford- Crawf pulled out last week with some knee swelling, sounds a bit like an old man's injury, he will be tested this week.

Jordan Lewis- In the same boat as Crawf in that he pulled out last week and will be tested this week with his corked thigh.

Luke Hodge- Another struck down with a hammy at the hawks, he is expected to return in 1-2 weeks. He injured it in the third quater in round 7, at this stage it was seen as a 3-4 week injury and this presumption looks on target at this stage. It may be known exactly when he should return later on this week.

Brent Guerra- Hawks Hammy again, Guerra looks to miss 3 more weeks. Still got him on the sidelines? you may want to rethink that, 3 consecutive donuts is about as filthy as a seedy 60 year old man standing out the front of a primary school.

Nathan Carroll- Was supposed to be accepted back into the dee's side last week as he had booked an appointment for the hairdressers thursday arvo but sadly missed this appointment so his hair still looks shit. Has booked in for a cut on wednesday and should hopefully have a socially acceptable haircut by the weekend so he can be allowed to play, (hammy 1 week away).

Colin Sylvia- The hammy is doing its rounds in the AFL, sylvia will be tested with his hammy this week.

Daniel Wells- After a great start against the dogs last week injured his knee, he is expected to miss 1-2.

Brett Ebert- Booted 6 on the weekend in his best game for a while, whilst doing this also managed to injure his ankle. Was expected to miss 2 weeks, but it has obviously come up much better than though and will be tested this week, i dont know about his chances of playing though.

Andrew Raines- His knee which he injured in round 3 has finally come up. He will be available to play this week.

Tadhg Kennelly- His dislocated knee is coming along as expected and will be tested this week. I would think he would be around a 50/50 at this stage, could be a very big inclusion for many DTer's.

Barry Hall- Just a reminder he is only two weeks away from playing with his broken wrist, his suspension would be up by this stage, his comeback game will be a spectacle, watch out if you have henry playfair i cant see him holding his spot at the return of Hall.

Daniel Kerr- His ankle will be tested this week, hasnt been the greatest year for Kerr, struggling with the tag's and missing his midfield buddie's a fair bit.

 view all the teams injuries issue at http://www.afl.com.au/tabid/208/Default.aspx?newsid=60352

Sharon Stone

Hofit Golan

Mylene Jampanoi

Caroline Gruosi Scheufele

Elsa Pataki

Georgina Chapman

Dita Von Teese

Michelle Yeoh

Mary J. Blige

Estelle Lefebure

Lamia Khashoggi

Carine Roitfeld

Eva Herzigova

Linda Batista

Victoria Silvstedt

Afef Jnifen

Tamara Mellon

Petra Nemcova

Michelle Yeoh

Caroline Gruosi Scheufele

Catalina Sandino

Chiling Lin

Dee Ocleppo

Donatella Versace

Michelle Yeoh

Julia Ormond

Catalina Sandino

Margherita Missoni

Petra Nemcova

Hofit Golan

Denise Rich

Elsa Pataki

Elsa Zylberstein

Victoria Duffy

Natasha Poly

Michelle Yeoh

Victoria Duffy

Phoebe Price

Doutzen Kroes

Victoria Silvstedt

Star Jones

Dita Von Teese

Natalie Oreiro

Natasha Poly

Tamara Beckwith

Julia Ormond

Joely Richardson

Georgina Chapman

Zineb Oukach

Madonna

Vahina Giocante

Sharon Stone

Hofit Golan

Emily Cole

This Youtube video was posted by the Chapman Family on Thursday, just one day after the tragic accident that ended their 5 year old daughter's life on earth. Her older brother was driving the vehicle that struck her, please keep them in your prayers.

 The world doesn't seem right when a child dies.  Five year old Maria Chapman, daughter of gospel singer Steven Curtis Chapman,  passed away after being struck by a vehicle driven by her older brother.  The Chapman's pastor, Scotty Smith told CBN News that the outpouring of love and support for the family is overwhelming and spoke of the grief the family is experiencing.  Of the son who hit Maria he said:

"He understandably is just devastated.  Their beautiful home has a couple of bends in the road.  It just was totally an accident and this young man's heart is crushed."

Mr. Smith has been a friend of the family's for over 20 years.  He urges people not to forget Maria's brother in their prayers.

"I encourage all to just redouble their prayers. because we all can predict how the enemy will try and whisper in his heart," he said.

Visitation for Maria will start today, May 23 at the Christ Presbyterian Church in Nashville.  Her memorial service will be held Saturday, May 24 at 11 a.m.

Our prayers for Maria's brother hope he can forgive himself and know that he has thousands upon thousands of people praying for him.

This post is anything but that.

Steven Curtis Chapman

As we all know: sometimes bad things happen to good people; please see:

Tragedy in steven curtis chapman’s family

The girl, Maria Sue, was hit in the driveway of the family's home Wednesday afternoon by a Toyota Land Cruiser driven by her teenage brother, said Laura McPherson, a spokeswoman for the Tennessee Highway Patrol.

A video of Christian star Steven Curtis Chapman's 5-year old daughter Maria was posted by the family on Thursday. Maria Sue Chapman was killed in a tragic car accident on Wednesday after being accidentally hit by an SUV driven by her brother.

Source

Our hearts go out to the Steven Curtis Chapman family who are enduring an awful tragedy this week in the loss of their 5 year old adopted daughter from China, Maria Sue.   The news story is pasted below.  Our thoughts and prayers are with them this evening.  

West Michigan Christian music fans are expressing their sympathy for Grammy-winning singer-songwriter Steven Curtis Chapman after the death of his 5-year-old daughter in an accident Wednesday in the family's driveway.

"We opened up the phone lines and people called in and wanted to pray right over the air," said Troy West, morning show co-host on contemporary Christian music radio station WJQK-FM (99).

Maria Sue Chapman was struck by a car driven by one of her teenage brothers, according to authorities in Franklin, Tenn., who added they believe no charges will result from what they termed "a tragic accident."

The child died 10 days after her fifth birthday. Chapman's manager, Jim Houser, also noted in a Web site posting the family had been hours away from hosting a high school graduation party for their son Caleb when the accident occurred.

Maria was the youngest of three Chinese girls the family had adopted, two of them through the the Nashville, Tenn., office of Bethany Christian Services. Chapman and his wife, Mary Beth, also have three biological children -- two teenage sons and a 21-year-old daughter.

"They are loving and wonderful parents and a great family -- they must be devastated," said Brian De Vos, manager of Michigan operations for Bethany Christian Services. "He's been such an advocate for adoption -- I know their commitment to kids."

DeVos has known the Chapmans for eight years and worked with them on Shaohannah's Hope, a foundation the couple named for one of their adopted daughters and established to help families through the often expensive adoption process.

During Chapman's most recent concert tour -- which included a stop at Sunshine Community Church last September -- the singer raised $340,000 for the foundation. While here, he awarded a grant of about $3,000 to a local family for adoption expenses.

He also has raised funds for construction of an orphanage in China for special-needs children who likely will never be adopted.

Chapman, 45, has sold more than 10 million albums, has had dozens of No. 1 Christian radio hits, and has won more than 50 Dove Awards -- exceeding any other individual artist.

Yet he would much rather talk about his family or his work with adoptions and orphans.

"I have sung a lot of his songs," said local Christian singer Marty Miller, of Belmont, posting comments on an area Christian musicians' Web site. "Please be in prayer for the family."

Chapman's current hit song on Christian radio is "Cinderella," a ballad about precious times spent together by father and daughter. It was inspired by a real family moment.

Tennessean:

Steven Curtis Chapman’s youngest child died Wednesday evening after being struck by a car driven by her teenage brother in the driveway of the family’s Williamson County home.

Maria, one of the Christian singer’s six children, was taken by LifeFlight to Vanderbilt Hospital, which confirmed the death, according to Laura McPherson, a spokeswoman for the Tennessee Highway Patrol.

The 5-year-old was hit by an SUV driven by her teenage brother, she said. Police did not give the driver’s name.

The teen was driving a Toyota Land Cruiser down the driveway of the rural home at about 5:30 p.m. and several children were playing in the area, McPherson said. He did not see Maria in the driveway before the vehicle struck her, she said.

“It appears to be a terrible accident,’’ McPherson said.

 

The Chapman's founded the Shaohannah's Hope in 2000.  Below is there mission statement:

To care for orphans by engaging the church and helping Christian families reduce the financial barrier to adoption.

We are dedicated to helping prospective adoptive parents overcome the financial barriers associated with adoption. We accomplish this by awarding financial grants to qualified families already in the process of adopting. The size of the grant awarded is determined by several factors, the most important being need.

To donate to Shaohanah's Hope click here.  There is also a site in memory of Maria.  Click here to be directed.