Objectives To identify MRI biomarkers associated with long-term disability progression in patients with multiple sclerosis (MS), and to define the rate of evolution of global, tissue-specific and regional atrophy in patients with MS over long-term. Methods MRI of the brain and clinical neurological assessment was performed in 81 patients at time of first visit and after 5 and 10 years of follow-up. MRI was acquired on 1.5 T scanners. T1-lesion and T2-lesion volumes (LVs) were calculated. Global and tissue-specific atrophy changes were longitudinally assessed, using a direct measurement approach, by calculating percentage volume changes between different time points. Regional tissue volumes for the subcortical deep grey matter (SDGM) structures were also obtained. Disability progression was defined as an increase in Expanded Disability Status Scale of ≥1.0 compared to baseline at 5-year and 10-year follow-up. Results Over 5 years, patients with disability progression showed significantly increased loss of whole brain (−3.8% vs −2.0%, p<0.001), cortical (−3.4% vs −1.8%, p=0.009) and putamen volume changes (−10.6% vs −3.8%, p=0.003) compared to patients with no disability progression. No significant change in white matter (WM) volume was observed when comparing progressing and non-progressing patients. Over 10 years, there was a trend for greater decrease in whole brain volume (−5.5% vs −3.7%, p=0.015) in the progressing patients. No significant changes in LV measures were detected between the patients with and without disability progression. Conclusion This long-term study shows that whole brain, cortical and putamen atrophy occurs throughout the 10-year follow-up of this MS cohort and is more pronounced in the group that showed disability progression at 5, but not at 10 years of follow-up. Overall, GM atrophy showed better association with disease progression than WM atrophy over 5-year and 10-year follow-up.
Patients with recently diagnosed MS reported significantly lower on both physical and mental aspects of HRQoL compared with controls. Depression, fatigue and apathy were more common and more severe in MS. We found no correlation between cognitive decline and HRQoL scores.
The aim of this study was to identify and evaluate evidence of clinical nurses' research capacity building in practice. A systematic review of studies of nurses' research capacity building in practice was performed. The quality of the articles was evaluated and reflected on in accordance with the Quality Assessment and Validity Tool for Correlation Studies. The literature searches identified a total of 4748 abstracts and titles. Eight quantitative studies were included in the evaluation. Three themes emerged from the analysis: Failure to ensure research quality and standards, Developing a research culture and Collaboration and organization of research utilization. The first theme has one sub-theme: Lack of knowledge about how to increase research utilization. The second theme is based on three sub-themes: Ability to identify clinical problems, changing nurses' attitudes to research and research supervision. Finally, the third theme has one sub-theme: Funding as a success factor. In conclusion, research capacity building requires the development of research competence to generate knowledge that enhances quality and patient safety. Nurse leaders are essential for establishing evidence-based practice and a research culture, thus enhancing nurses' scientific attitudes and capacity.
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