58 research outputs found

    Cortical gray and subcortical white matter associations in Parkinson's disease

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    Cortical atrophy has been documented in both Parkinson’s disease (PD) and healthy aging, but its relationship to changes in subcortical white matter is unknown. This was investigated by obtaining T1- and diffusion-weighted images from 76 PD and 70 controls at baseline, 18-, and 36-months, from which cortical volumes and underlying subcortical white matter axial (AD), radial (RD) diffusivities, and fractional anisotropy (FA) were determined. Twelve of 69 cortical subregions had significant group differences, and for these underlying subcortical white matter was explored. At baseline, higher cortical volumes were significantly correlated with lower underlying subcortical white matter AD, RD, and higher FA (Ps ≤0.017) in PD. Longitudinally, higher rates of cortical atrophy in PD were associated with increased rates of change in AD RD, and FA values (Ps ≤ 0.0013) in two subregions explored. The significant gray-white matter associations were not found in controls. Thus, unlike healthy aging, cortical atrophy and subcortical white matter changes may not be independent events in PD

    Moral Injury and Moral Resilience in Health Care Workers during COVID-19 Pandemic.

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    BACKGROUND: The 2019 coronavirus (COVID-19) pandemic placed unprecedented strains on the U.S. health care system, putting health care workers (HCWs) at increased risk for experiencing moral injury (MI). Moral resilience (MR), the ability to preserve or restore integrity, has been proposed as a resource to mitigate the detrimental effects of MI among HCWs. OBJECTIVES: The objectives of this study were to investigate the prevalence of MI among HCWs, to identify the relationship among factors that predict MI, and to determine whether MR can act as buffer against it. DESIGN: Web-based exploratory survey. SETTING/SUBJECTS: HCWs from a research network in the U.S. mid-Atlantic region. MEASUREMENTS: Survey items included: our outcome, Moral Injury Symptoms Scale–Health Professional (MISS-HP), and predictors including demographics, items derived from the Rushton Moral Resilience Scale (RMRS), and ethical concerns index (ECI). RESULTS: Sixty-five percent of 595 respondents provided COVID-19 care. The overall prevalence of clinically significant MI in HCWs was 32.4%; nurses reporting the highest occurrence. Higher scores on each of the ECI items were significantly positively associated with higher MI symptoms (p < 0.05). MI among HCWs was significantly related to the following: MR score, ECI score, religious affiliation, and having ≥20 years in their profession. MR was a moderator of the effect of years of experience on MI. CONCLUSIONS: HCWs are experiencing MI during the pandemic. MR offers a promising individual resource to buffer the detrimental impact of MI. Further research is needed to understand how to cultivate MR, reduce ECI, and understand other systems level factors to prevent MI symptoms in U.S. HCWs

    Witness, Warning, and Prophecy: Quaker Women’s Writing, 1655–1700

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