Nurses recognized the significance of their input into processes of change. Transformational leadership and frontline projects provide a vehicle for innovation through application of human capital.
Subcortical volumetric changes in major depressive disorder (MDD) have been purported to underlie depressive symptomology, however, the evidence to date remains inconsistent. Here, we investigated limbic volumes in MDD, utilizing high-resolution structural images to allow segmentation of the hippocampus and amygdala into their constituent substructures. Twenty-four MDD patients and twenty matched controls underwent structural MRI at 7T field strength. All participants completed the Montgomery-Asberg Depression Rating Scale (MADRS) to quantify depressive symptomology. For the MDD group, volumes of the amygdala right lateral nucleus ( p = 0.05, r 2 = 0.24), left cortical nucleus ( p = 0.032, r 2 = 0.35), left accessory basal nucleus ( p = 0.04, r 2 = 0.28) and bilateral corticoamygdaloid transition area (right hemisphere p = 0.032, r 2 = 0.38, left hemisphere p = 0.032, r 2 = 0.35) each displayed significant negative associations with MDD severity. The bilateral centrocortical (right hemisphere p = 0.032, r 2 = 0.31, left hemisphere p = 0.032, r 2 = 0.32) and right basolateral complexes ( p = 0.05, r 2 = 0.24) also displayed significant negative relationships with depressive symptoms. Using high-field strength MRI, we report the novel finding that MDD severity is consistently negatively associated with amygdala nuclei, linking volumetric reductions with worsening depressive symptoms.
Objective: To investigate the child nutrition concerns of Aboriginal families with young children attending Aboriginal health and early childhood services in Victoria; training needs of early childhood practitioners; and sources of nutrition and child health information and advice for Aboriginal families with young children. Method:Qualitative needs assessment involving consultation with Aboriginal parents of young children aged 0-8 years attending Aboriginal health and early childhood services, and early childhood practitioners from Aboriginal health and early childhood services in urban and regional Victoria. Focus groups were conducted with 35 Aboriginal parents and interviews conducted with 45 health and early childhood practitioners. Thematic analysis was used to generate and then refine distinct, internally consistent common themes from the data. Results:The most frequent issues identified were low levels of breastfeeding, inappropriate introduction of solids, reliance on bottles, sweet drinks, and energy-dense foods, poor oral health and overweight. Concerns about staff training and capacity, and access to maternal and child health services were also common. Conclusion and implication:This study identifies major gaps in service delivery for Aboriginal families with young children and points to the need for a coordinated, culturally responsive systems approach to providing support for breastfeeding and child nutrition advice and support for Aboriginal families, including capacity building for staff, and supportive systems and policy.
Although long-term follow-up data are available for cases with acute disseminated encephalomyelitis, the findings range widely because of the lack of consistent definitions. Using the International Pediatric Multiple Sclerosis Study Group definitions strictly, we determined the long-term prognosis of children with acute disseminated encephalomyelitis, especially concerning relapsing cases. In our cohort of 86 children who presented with a first event of inflammatory demyelinating disease of central nervous system, 33 patients (38%) met the Study Group criteria for acute disseminated encephalomyelitis of which 9 patients had relapses. The mean follow-up duration was 12.8 years for relapsing cases and 9.2 years for all patients with acute disseminated encephalomyelitis. The risk of developing relapses is 27% but the risk of developing multiple sclerosis from acute disseminated encephalomyelitis is low at 6%. All relapsing cases had a benign course on prolonged follow-up, in spite of multiple relapses in the first 3 years.
Current MRI studies into the fragile X premutation have been important in the diagnosis of FXTAS and identifying potential pathophysiological mechanisms. Associations with blood based measures have also demonstrated that neurodevelopmental and neurodegenerative aspects of the fragile X premutation could be functionally and pathologically separate. Larger longitudinal studies will be required to investigate these conclusions.
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