A Case of Bioprosthetic Mitral Valve Endocarditis with Severe Stenosis.

A 29-year-old female with a history of bioprosthetic mitral valve replacement was admitted with fever, chills, and shortness of breath of two weeks duration. Transthoracic echocardiography revealed a thickened bioprosthetic mitral valve with a 26 mmHg mean gradient consistent with severe mitral stenosis and associated large vegetation. Blood cultures demonstrated no growth. The patient underwent repeat mitral valve replacement surgery. At the time of operation, diffuse mitral valve thickening was observed, causing decreased mobility in both cusps with vegetation covering both sides of the valve. PCR with 16s rRNA sequencing of the tissue specimen revealed Gemella species DNA. Her recovery period was uneventful. Infective endocarditis very rarely causes obstructive/functional stenosis. When present, fungal organisms are typically implicated. These patients often present acutely with distinctive clinical evidence of obstruction, and they usually demonstrate rapid deterioration. Prompt diagnoses and timely surgery are essential.

Be You: A national education initiative to support the mental health of Australian children and young people.

Early learning services and schools provide unique settings for mental health promotion and early intervention due to the potential for population-level dosage and reach in terms of reducing multiple risk factors and enabling protective factors among young people. Educators play a key role in supporting children and young people's experiences of, and access to mental health promotion opportunities, and hold unparalleled opportunity in terms of creating mental health-promoting learning environments. In 2018, the Australian National Mental Health in Education Initiative, Be You, was launched. Be You is a multi-million-dollar Australian government-supported initiative, freely available to all 24,000 early learning services, primary and secondary schools throughout Australia. The potential for subsequent population reach is proposed to potentially exceed that of any mental health promotion initiative for children and young people previously observed in Australia. Be You aims to foster mentally healthy learning communities across Australia through building capacity among educators to embed mental health promotion strategies. The Initiative was developed based on a review and integration of previous national mental health promotion frameworks, with an overall alignment to existing state and territory education, social and emotional well-being frameworks, and the Australian Curriculum. In delivering facilitated support from specialised consultants to early learning services and schools participating in the initiative, Be You draws on professional learning principles designed to build capacity in educators and educational systems relating to mental health promotion. It uses an updated, multi-module online platform providing interactive, evidence-based resources. This paper presents the Be You framework, describes the evidence sources used to inform the underlying principles and objectives, discusses the specific components that form the initiative, details the professional learning modules and content, and discusses potential implications for population mental health and prevention efforts.