Child and family outcomes of a long-term nurse home visitation programme: a randomised controlled trial

OBJECTIVE

To investigate the impact of a long-term nurse home visiting programme, embedded within a universal child health system, on the health, development and well-being of the child, mother and family.

DESIGN

Randomised controlled trial.

SETTING/PARTICIPANTS

208 (111 intervention, 97 comparison) eligible at-risk mothers living in a socioeconomically disadvantaged area in Sydney, booking into the local public hospital for confinement.

INTERVENTION

A sustained and structured nurse home visiting antenatal and postnatal parenting education and support programme.

CONTROL

Usual universal care.

MAIN OUTCOME MEASURES

The quality of the home environment for child development (12-24 months), parent-child interaction and child mental, psychomotor and behavioural development at 18 months.

RESULTS

Mothers receiving the intervention were more emotionally and verbally responsive (HOME observation) during the first 2 years of their child's life than comparison group mothers (mean difference 0.5; 95% CI 0.1 to 0.9). Duration of breastfeeding was longer for intervention mothers than comparison mothers (mean difference 7.9 weeks; 95% CI 2.9 to 12.9). There was no significant difference in parent-child interaction between the intervention and comparison groups. There were no significant overall group differences in child mental, psychomotor or behavioural development. Mothers assessed antenatally as having psychosocial distress benefitted from the intervention across a number of areas.

CONCLUSION

This sustained nurse home visiting programme showed trends to enhanced outcomes in many, but not all, areas. Specifically, it resulted in clinically enhanced outcomes in breastfeeding duration and, for some subgroups of mothers, women's experience of motherhood and children's mental development.

TRIAL REGISTRATION NUMBER

ACTRN12608000473369.

GP and community nurse co-location in a disadvantaged community

People living in socioeconomically disadvantaged communities have a high burden of disease but often receive ‘inverse care’. We explored a model of general practitioner and community nurse co-location in a disadvantaged community in south-west Sydney, Australia. Co-location resulted in increased referrals from doctors to the community nurse, including an increase in referrals related to psychosocial issues. This small study suggests integrated primary health care might have an impact on specialised state-based psychosocial health services.

The acoustic scatter from single biSphere microbubbles

Single microbubble acoustic acquisitions provide information on the behaviour of microbubble populations by enabling the generation of large amounts of data. Acoustic signals from single polylactide-shelled and albumin coated biSphere™ microbubbles have been acquired. The responses observed from a range of incident frequencies and acoustic pressures varied in duration. Partial echoes shorter than the incident pulse duration have been observed for low frequency pulses of sufficient amplitude, suggesting release of gas from bubbles. The results presented suggest that the mechanism of scatter from hard shelled agents may be shell disruption and gas release, or partly from gas leaking from defected shell sites, which has previously not been observed optically. These results can provide the basis for improved imaging through optimization of incident pulse parameters, with potential benefits to both diagnostic and therapeutic techniques.

Thrombocytosis in neonates and young infants: a report of 25 patients with platelet counts of > or = 1000000 microl(-1)

OBJECTIVE

Thrombocytosis has been reported in neonates and young infants, but little is known of its prevalence, timing of onset, associated conditions, sequelae and outcomes. To better understand this condition, we used the data repositories of a multi-hospital health-care system to identify all individuals <or=140 days old (20 weeks) who, during the past 6 years, had a platelet count of >or=1000000 microl(-1).

STUDY DESIGN

We identified all infants with extreme thrombocytosis (using the Sutor definition of a platelet count of >or=1000000 microl(-1)) during the period of January 2003 through December 2008 in any Intermountain Healthcare facility. We obtained the information provided in this report from electronic and paper records.

RESULT

Among 40 471 infants who had one or more platelet counts performed in this period, 25 had extreme thrombocytosis. No cases were identified in the first week after birth, 40% were recognized between the second and fourth weeks and 40% between the fifth and eighth week. The prevalence of thrombocytosis had no relationship with birth weight or gestational age but a slight predominance of female patients (15/25) was noted. In all, 26 episodes were found among the 25 infants: 12 episodes involved an antecedent infectious disease, 8 had an antecedent surgical procedure, 4 had the anemia of prematurity and 1 each had congenital adrenal hyperplasia and opiate withdrawal syndrome. No pathological thromboses or hemorrhages or other sequelae were detected and all episodes resolved with no deaths.

CONCLUSION

The thrombocytosis cases that we report were all consistent with reactive thrombocytosis (also known as secondary thrombocytosis); none seemed to be essential (primary) thrombocytosis. We speculate that the pathogenesis involves increased platelet production due to megakaryopoietic stimulators induced by an infectious or inflammatory condition. From this series and previous reports, young infants with platelet counts up to 1300000 microl(-1) do not seem to have a significant risk of thrombotic or hemorrhagic problems, and do not generally require anti-platelet or cytoreductive treatment.

Target-specific, histology-independent, randomized discontinuation study of lapatinib in patients with HER2-amplified solid tumors

3541

Background: The current paradigm of histology-specific drug development may not be optimal in the era of targeted therapeutics. We sought to explore the activity of lapatinib, an oral tyrosine kinase inhibitor of HER2, with a trial design focused on the target rather than on tumor-type. Methods: Patients (pts) with HER2-amplified treatment-refractory metastatic gastro- esophageal (G/E), bladder (B), ovarian (O), or uterine (U) tumors were enrolled into a double-blinded randomized discontinuation study of lapatinib 1500 mg PO daily (malignancies selected based on reported frequencies of HER2 amplification). The planned sample size was 250 HER2+ pts, with the goal of then randomizing 100 pts with SD at week (wk) 12 to either lapatinib or placebo until progressive disease (PD). Pts who responded at wk 12 (CR or PR) continued on lapatinib; those who progressed were discontinued from study. Primary objectives were response rate at 12 wks and percentage of pts who remain progression free at 24 wks. Secondary objectives were duration of response, progression free survival (PFS) after randomization, and determination of the incidence of HER2 amplification in multiple tumor types. Futility analyses were preplanned to ensure feasibility of screening and of randomization (i.e. a sufficient rate of non- progression at 12 wks). Results: A total of 145 pts were screened (G/E=47, B=35, O=58, U=5); 42 were HER2-amplified (G/E=16, B=13, O=13, U=0) and 32 (G/E=13, B=9, O=10) were enrolled. At wk 12, 1 (3%) patient had a CR, 10 (31%) had SD, 19 (59%) had PD, and 2 (6%) were unknown. Median time to progression during open-label lapatinib was 78 days, 95% CI (42, 92). Only 7 pts with SD underwent randomization. Two pts with esophageal cancer remain on study; one (CR at wk 12) remains a CR at wk 60 and the other (SD at wk 12) remains with SD at wk 36. Low response rate coupled with slow screening and enrollment led to early study closure. Conclusions: Basing trial eligibility on a target, versus histologic classification, is challenging. While HER2 amplifications appear to be prevalent in select non-breast tumors, lapatinib monotherapy in refractory disease is associated with a low level of objective responses.

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Drugs in the aetiology of agranulocytosis and aplastic anaemia

Agranulocytosis and aplastic anaemia are rare but serious conditions known to be caused by numerous drugs. Most of what is known or suspected about the aetiology is based on case reports, with only a few formal epidemiological studies that provide quantitative estimates of risk. Updated results have been obtained from a combined analysis of data from 3 case-control studies that used similar methods: the International Agranulocytosis and Aplastic Anemia Study (IAAAS), conducted in Israel and Europe; a study conducted in the northeast US; and a study conducted in Thailand. Totals of 362 cases of agranulocytosis, 454 cases of aplastic anaemia and 6458 controls were included in the analyses. The IAAAS and Thai study were population-based, providing estimates of the incidence of the 2 dyscrasias. The overall annual incidence of agranulocytosis in the ambulatory population was 3.4/10(6) in the IAAAS and 0.8/10(6) in Thailand; by contrast the incidence of aplastic anaemia was 2.0/10(6) in the IAAAS and 4.1/10(6) in Thailand. A total of 21 compounds were significantly associated with an increased risk of agranulocytosis in the IAAAS and US studies. Excess risks ranged from 0.06 to 13 cases/10(6) users/wk; the most strongly associated drugs were procainamide, anti-thyroid drugs and sulphasalazine. An association with drugs that had previously been suspected was also seen in Thailand. The overall aetiologic fractions of agranulocytosis due to drug use were 62% in the IAAAS, 72% in the US and 70% in Thailand. Eleven drugs were significantly associated with an increased risk of aplastic anaemia, with excess risks ranging from 1.4 to 60 cases/10(6) users in a 5-month period. The most strongly associated drugs were penicillamine, gold and carbamazepine. Aetiologic fractions were 27% in the IAAAS, 17% in the US and 2% in Thailand, which paralleled the prevalence of use of associated drugs in the 3 populations. The present results confirm that agranulocytosis is largely a drug-induced disease, with similar proportions accounted for in 3 disparate geographic regions. By contrast, although many of the expected associations were observed for aplastic anaemia, most of the aetiology is not explained by drugs. For all associated drugs, the excess risks are sufficiently low that blood dyscrasias should not figure prominently in the balancing of risks and benefits.

Incidence and non-drug aetiologies of aplastic anaemia in Thailand. The Thai Aplastic Anaemia Study Group

A population-based, case-control study of aplastic anaemia has been conducted in Thailand since 1989. Up to December 1994, the overall annual incidence was 3.9/10(6) in Bangkok, 5.0/10(6) in Khonkaen and 3.0/10(6) in Songkla. In Bangkok, the incidence peaked in 2 age groups (at 15-24 yr and > or = 60 yr), whereas in Khonkaen and Songkla there was a consistent increase in incidence with increasing age. The results of case-control analyses for non-drug risk factors indicate a strong inverse association with socio-economic status present in all 3 areas; a strong association with grain farming in the 2 rural areas that does not appear to be explained by pesticides; an association with occupational exposure to solvents in Bangkok; and a positive association with hepatitis A seropositivity.

Single microbubble response using pulse sequences: initial results

The study of acoustic scattering by single microbubbles has the potential to offer improved signal processing techniques. A microacoustic system that employs a hydrodynamically-focused flow was used to detect radiofrequency (RF) backscatter from single microbubbles. RF data were collected using a commercial scanner. Results are presented for two agents, namely Definity (Lantheus Medical Imaging, N. Billerica, MA, USA) and biSphere (Point Biomedical Corp, San Carlos, CA, USA). The agents were insonified with amplitude-modulated pulses, and it was observed in both agents that a subpopulation of microbubbles did not produce a measurable echo from the first-half amplitude pulse, but did produce a response from the full amplitude pulse and from a subsequent half amplitude pulse. The number of microbubbles in this subpopulation was seen to increase with increasing transmit amplitude. These results do not bear out the simple theory of microbubble-pulse sequence interaction and invite a reassessment of signal processing approaches.

Miller Early Childhood Sustained Home-visiting (MECSH) trial: design, method and sample description

BACKGROUND

Home visiting programs comprising intensive and sustained visits by professionals (usually nurses) over the first two years of life show promise in promoting child health and family functioning, and ameliorating disadvantage. Australian evidence of the effectiveness of sustained nurse home visiting in early childhood is limited. This paper describes the method and cohort characteristics of the first Australian study of sustained home visiting commencing antenatally and continuing to child-age two years for at-risk mothers in a disadvantaged community (the Miller Early Childhood Sustained Home-visiting trial).

METHODS AND DESIGN

Mothers reporting risks for poorer parenting outcomes residing in an area of socioeconomic disadvantage were recruited between February 2003 and March 2005. Mothers randomised to the intervention group received a standardised program of nurse home visiting. Interviews and observations covering child, maternal, family and environmental issues were undertaken with mothers antenatally and at 1, 12 and 24 months postpartum. Standardised tests of child development and maternal-child interaction were undertaken at 18 and 30 months postpartum. Information from hospital and community heath records was also obtained.

DISCUSSION

A total of 338 women were identified and invited to participate, and 208 were recruited to the study. Rates of active follow-up were 86% at 12 months, 74% at 24 months and 63% at 30 months postpartum. Participation in particular data points ranged from 66% at 1 month to 51% at 24 months postpartum. Rates of active follow-up and data point participation were not significantly different for the intervention or comparison group at any data point. Mothers who presented for antenatal care prior to 20 weeks pregnant, those with household income from full-time employment and those who reported being abused themselves as a child were more likely to be retained in the study. The Miller Early Childhood Sustained Home-visiting trial will provide Australian evidence of the effectiveness of sustained nurse home visiting for children at risk of poorer health and developmental outcomes.

TRIAL REGISTRATION

ACTRN12608000473369.

The use of cognitive behavioural therapy techniques for anxiety and depression in hospice patients: a feasibility study

Anxiety and depression are common in palliative care patients. Cognitive behavioural therapy (CBT) has been recommended as one possible treatment, and it has been suggested that non-mental health professionals may be able to treat milder disorders with CBT. The aim of this study was to assess whether the use of CBT techniques in hospice patients is an acceptable intervention, and whether a palliative care professional with short CBT training can usefully apply such techniques. A feasibility study of a brief CBT intervention following training was conducted. Qualitative analysis was carried out on patient feedback from semi-structured interviews. Hospital Anxiety and Depression Scale scores pre-and post-intervention were analysed statistically. Eleven patients completed a short course using CBT techniques. The intervention was acceptable for 10 patients. One patient found it unacceptable due to advanced disease, lethargy and severe depression. Anxiety or depression symptoms were helped in eight patients. This study showed that a palliative care professional with short training in CBT was usefully able to apply CBT techniques to hospice patients with mild-to-moderate anxiety or depression.

A profile of neuropsychiatric problems and their relationship to quality of life for Parkinson's disease patients without dementia

Neuropsychiatric problems are common in Parkinson's disease (PD) but there is little information regarding how they impact on quality of life. PD patients without dementia (49) were assessed for low mood/depression, fatigue, apathy, sleep problems and hallucinations. Measures of quality of life and motor function were also obtained. Over 77% of the patients reported symptoms consistent with one or more neuropsychiatric problems. Low mood/depression, anxiety and the presence of hallucinations predicted poorer quality of life after controlling for motor symptoms. Additional to the motor symptoms, we found that specific neuropsychiatric problems may impact on quality of life for PD patients.

Cytotoxicity induced by grape seed proanthocyanidins: role of nitric oxide

Grape seed proanthocyanidin extract (GPSE) at high doses has been shown to exhibit cytotoxicity that is associated with increased apoptotic cell death. Nitric oxide (NO), being a regulator of apoptosis, can be increased in production by the administration of GSPE. In a chick cardiomyocyte study, we demonstrated that high-dose (500 microg/ml) GSPE produces a significantly high level of NO that contributes to increased apoptotic cell death detected by propidium iodide and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining. It is also associated with the depletion of intracellular glutathione (GSH), probably due to increased consumption by NO with the formation of S-nitrosoglutathione. Co-treatment with L-NAME, a NO synthase inhibitor, results in reduction of NO and apoptotic cell death. The decline in reduced GSH/oxidized GSH (GSSG) ratio is also reversed. N-Acetylcysteine, a thiol compound that reacts directly with NO, can reduce the increased NO generation and reverse the decreased GSH/GSSG ratio, thereby attenuating the cytotoxicity induced by high-dose GSPE. Taken together, these results suggest that endogenous NO synthase (NOS) activation and excessive NO production play a key role in the pathogenesis of high-dose GSPE-induced cytotoxicity.

Trends in opioid-related fatal overdoses in Massachusetts, 1990-2003

Since 1997, poisoning, particularly from heroin and other opioids, has been the leading cause of injury mortality in Massachusetts. Our aim was to describe recent trends in opioid-related poisoning deaths among Massachusetts residents.

METHODS

Massachusetts death files for the years 1990-2003, as coded by International Classification of Disease, Ninth Revision and International Classification of Disease, Tenth Revision, were used to identify all poisoning deaths and opioid-related poisoning deaths; rates were age-adjusted and grouped by year, sex, and race/ethnicity.

RESULTS

From 1990 to 2003, opioid-related fatal poisoning rates increased by 529% from 1.4 per 100,000 in 1990 to 8.8 per 100,000 in 2003. The proportion of total poisoning deaths associated with opioids rose from 28% in 1990 to 69% in 2003.

CONCLUSIONS

Massachusetts experienced a significant increase in opioid-related poisoning death rates. To guide future public health interventions, further investigation is necessary to better delineate the specific opioids involved, the circumstances surrounding these deaths, and the medical and behavioral health care options available.

Manufacture and acoustical characterisation of a high-frequency contrast agent for targeting applications

The aim of this study was to develop and acoustically to optimise an ultrasonic contrast agent for research imaging applications at 40 MHz. A range of liposomal dispersions were manufactured and the mean backscatter power was measured using a Boston Scientific ClearView Ultra intravascular scanner with a 40 MHz, 2.5 Fr Atlantis SR Plus catheter. The scanner had been modified to allow access to the unprocessed ultrasound data, which were digitised, and the mean backscatter power was calculated over a region-of-interest centred at 2 mm from the transducer. Mean backscatter power was normalised to the data collected from a water-air interface. The effects of sonication and rapid shaking on six liposomal samples were also studied and this indicated that both techniques significantly reduced the size of the liposomes within the dispersions. Maximum mean backscatter power was measured for sonicated liposomal dispersions with 60% by weight of phosphatidylethanolamine. Moreover, this dispersion had greater mean backscatter power than sheep blood at 40 MHz.

Effectiveness of follow-up booster sessions in improving physical status after cardiac rehabilitation: health, behavioral, and clinical outcomes

There is limited research on booster interventions designed to maintain/improve health outcomes following cardiac rehabilitation (CR). The purpose of this study was to examine the effects of a booster intervention on health, behavioral, and clinical physical status outcomes among CR graduates randomly assigned to one of three groups: structured educational/counseling sessions by telephone ( n = 24), clinic ( n = 20), or usual care ( n = 20). The sessions were provided at 3 and 9 weeks following Phase II CR. A repeated measures experimental design was used to examine outcomes at baseline (completion of CR) and at 3 and 6 months. Although the effects of the booster interventions were not significant, there was evidence to suggest that a booster intervention, compared with usual care, had a positive effect on patients' physical functioning, adherence to the exercise program, frequency of exercise, heart rate, and blood pressure.

Sustained Nurse Home Visiting in Early Childhood: Exploring Australian Nursing Competencies

Abstract There is strong evidence that a comprehensive model of sustained nurse home visiting (SNHV) in early childhood can improve child and family outcomes for vulnerable and at-risk families. There is also evidence that nurse home visitors experience challenges in delivering SNHV. This article aims to identify the nursing competencies needed for delivering a comprehensive model of SNHV and highlight the areas where further competency development is required. Qualitative analysis compared the content and language of published registered generalist and child and family nursing competency statements for Australian nurses with the work experiences of a team of community-based nurses delivering SNHV. Development of competencies is needed in the areas of (a) enhanced knowledge of child development, social determinants of health, and broader outcomes for individuals and populations; (b) advanced skills in fine observation, anticipatory guidance, negotiating, modelling and experimentation, holistic case management, and working in interdisciplinary teams; and (c) attitudinal competency for working "with" and supporting risk taking. The current published competencies for general and child and family nurses do not encompass the different and advanced competencies required for performing SNHV. Competency development and associated nurse training and support are needed for delivery of quality SHNV services.

Sex change strategy and the aromatase genes

Sequential hermaphroditism is a common reproductive strategy in many teleosts. Steroid production is known to mediate both the natural and induced sex change, yet beyond this the physiology directing this process has received little attention. Cytochrome P450 aromatase is a key enzyme in the hormonal pathway catalysing the conversion of sex steroids, androgens to oestrogens, and thus is highly relevant to the process of sex change. This study reports the isolation of cDNA sequences for aromatase isoforms CYP19A1 and CYP19A2 from teleost species representing three forms of sexual hermaphroditism: Lates calcarifer (protandry), Cromileptes altivelis (protogyny), and Gobiodon histrio (bi-directional). Deduced amino acid analysis of these isoforms with other reported isoforms from gonochoristic (single sex) teleosts revealed 56-95% identity within the same isoform while only 48-65% identity between isoforms irrespective of species and sexual strategy. Phylogenetic analysis supported this result separating sequences into isoform exclusive clades in spite of species apparent evolutionary distance. Furthermore, this study isolates 5' flanking regions of all above genes and describes putative cis-acting elements therein. Elements identified include steroidogenic factor 1 binding site (SF-1), oestrogen response element (ERE), progesterone response element (PRE), androgen response element (ARE), glucocorticoid response elements (GRE), peroxisome proliferator-activated receptor alpha/retinoid X receptor alpha heterodimer responsive element (PPARalpha/RXRalpha), nuclear factor kappabeta (NF-kappabeta), SOX 5, SOX 9, and Wilms tumor suppressor (WTI). A hypothetical in vivo model was constructed for both isoforms highlighting potential roles of these putative cis-acting elements with reference to normal function and sexual hermaphroditism.

The first eighteen months of a paediatric ambulatory and community service

Hospital admission is distressing and traumatic for children as they are separated from their families and home. Internationally, and in Australia, alternative models of health care are being developed to meet the needs of children and their families. We describe the first eighteen months of the establishment of a paediatric ambulatory and community service in a district health service in New South Wales. Key outcomes include: increased referral to the service from acute hospital and primary care services; parental satisfaction and saved hospital beddays. Lessons learnt in the setting up of this service include the need for proactive engagement of consumers and stakeholders; clear definition of roles and responsibilities; and measurable and reasonable performance indicators.

Dental treatment in Medieval England

Medieval (12th-14th century) medical literature suggests that care of the teeth was largely limited to non-invasive treatment. Cures, mainly for toothache and "tooth worm" were based on herbal remedies, charms and amulets. Bloodletting was advised for certain types of toothache. There is also documentary evidence for powders to clean teeth and attempts at filling carious cavities. Surgical intervention for oral cancer and facial fracture is also known. Post-operative infection and abscess formation can be identified and early forms of false teeth are mentioned.

Dental treatment in Anglo-Saxon England

Anglo-Saxon medical literature suggests that care of the teeth was largely limited to non-invasive treatment. Cures, mainly for toothache, were based on herbal remedies, charms and amulets. Herbal potions also treated oral problems as diverse as caries and facial deformities. However, surgical intervention for cleft lip is mentioned in the later documents. Skeletal evidence confirms that cleft lip and palate was definitely known to the Anglo-Saxons. A possible dentist's grave has been identified.

Bulk glasses and ultrahard nanoceramics based on alumina and rare-earth oxides

Although often regarded as a network-former in conventional silicate glasses, Al(2)O(3) alone cannot be obtained as a bulk glass. Until now, glasses comprising continuously linked [AlO(x)] polyhedra have been prepared in only a few systems under very fast cooling conditions, which limits their dimensions to a few millimetres. Yet it is desirable to prepare bulk, or monolithic, alumina-rich glasses, with the prospect of superior mechanical, chemical and optical properties. Here we report a novel process for preparing very-high-alumina glasses and nanoscale glass-ceramics. Fully dense bulk articles in net shape are obtained through viscous sintering of glass microbeads. Additional heat treatment of the consolidated glasses leads to fully crystallized transparent glass-converted nanoceramics with a hardness similar to that of alumina. This method avoids the impracticably high applied pressures (more than 1 GPa) that have been required in most cases to prepare nanocrystalline ceramics by sintering, owing to the concurrent nature of densification and grain growth under pressureless conditions. The reported techniques can be extended to form glasses and nanoceramics in other oxide systems that do not include a conventional glass-forming component.

An unusual medieval mandibular pathology

A medieval mandible with an unusual bilateral periosteal reaction, probably related to chronic inflammation or infection, is presented.

Peak mean myocardial velocities and velocity gradients measured by color M-mode tissue Doppler imaging in healthy cats

We sought to assess the feasibility of recording the myocardial velocity gradients (MVGs) and mean myocardial velocities (MMVs) measured by color M-mode tissue Doppler imaging (TDI) in the free wall of unsedated normal cats (n = 18) with a 7.4-MHz probe equipped to record TDI images. The peak MVG and MMV values during the different phases of the cardiac cycle corresponded to certain color velocity patterns occurring in the left ventricular free wall (LVFW). Biphasic shifts were recorded in the tracings of both the MVG and MMV during early diastole (E1 and E2) as well as during the isovolumic relaxation (IVR) and isovolumic contraction (IVC) phases. Stepwise regression analysis showed that age was the only significant predictor for the peak MVG values during the 2nd phase of early diastole (E2) (r = -0.79, r2 = 0.63, and P < .001). The peak late diastolic MVG values were associated positively with age (r = 0.50, r2 = 0.25, and P < .05). The peak MMV values showed a negative association with age during E2 (r = -0.71, r2 = 0.50, and P < .001) as well as during early systole (Se) (r = -0.55, r2 = 0.30, and P < .05) and late systole (SI) (r = -0.62, r2 = 0.39, and P < .01). A positive association was found between age and the peak MMV values during late diastole (r = 0.54, r2 =- 0.29, and P < .05). The MVG values showed cyclic variations consistent with wall thickness changes. The accuracy of velocity determination and the spatial resolution of the system used were validated with a phantom. To our knowledge, this study is the 1st report of the application of this technique to the myocardium of cats,providing insights into the physiology of myocardial motion. It provides reference ranges of the peak MVG and MMV values for future studies of feline myocardial diseases.