Sustainability of Community Engagement at Institutions of Higher Education: A Look at Compassion Fatigue and the College Student Mental Health Crisis

This study investigated one of the many factors contributing to the sustainability of community engagement efforts at institutions of higher education. Extensive literature shows that burnout and compassion fatigue disproportionately affect those in caring roles and helping professions. Moreover, studies have found significant correlations between levels of burnout and compassion fatigue and the likelihood of human error, which directly affects the safety and long-term outcomes of people within their care. However, there is still limited exploration of how these phenomena may manifest, and similarly, cause unintentional harm to vulnerable populations, in the context of student community engagement efforts. This paper considers the pervasiveness of the college student mental health crisis, particularly amid a year rife with grief and instability co-created by the COVID-19 pandemic and immense socio-political conflict. Participants included 46 college students, and data were collected between March and April 2020 using an anonymous online survey. Results revealed that participants had high compassion satisfaction scores (M=42.19 out of 50) and relatively low burnout (M=21.14 out of 50) and secondary traumatic stress scores (M=22.83 out of 50). Although these results differed from the authors’ original hypotheses, the information presented in this paper calls for further investigation into how students can be supported in ways that minimize compassion fatigue and boost compassion satisfaction. Katherine Chiu (she/her) earned her Bachelor of Science in Health Sciences with a concentration in Public Health Education and minors in Pre-Medicine and Medical Humanities from James Madison University in 2020. She recently finished working as the Engagement Fellow for Economic and Community Development at Professional & Continuing Education in Harrisonburg, Virginia. Briana Craig (she/her) is a proud alumnus of James Madison University, where she received a M.A. in Psychological Science (quantitative concentration) and a B.S. in Psychology with a statistics minor. She now works as a Research Associate for Westat, a research contracting company based in Rockville, Maryland. Naomi Rabago (she/her/hers) is a senior Social Work major and Service-Learning Coordinator with Community Service-Learning. She has been involved in and held leadership positions in groups all over campus, including Ethical Reasoning in Action, the Alternative Break Program, and the Marching Royal Dukes. Authors\u27 note We would like to thank all of the professional staff working in the Community Service-Learning office at James Madison University. Without their guidance, support, and encouragement over the course of several years, this project would not have been possible. We are deeply grateful for their mentorship, and they have inspired us beyond words. We would also like to thank the Virginia Engage Journal editors, Steve Grande and Emily Kohl, for providing thoughtful feedback, engaging in meaningful conversations, and supporting us through our first experience publishing research

La orejuela izquierda como fuente de accidentes cerebrovasculares: cerrar (y cómo), o no cerrar (y por qué)

The left atrial appendage is considered the main source of emboli in strokes in patients with atrial fibrillation. Oral anticoagulant therapy significantly reduces the risk of cerebral embolic events compared to aspirin, but it is associated with bleeding complications, and is not always used. Closure of the left atrial appendage reduces the rate of thromboembolic events, and it is currently recommended in patients with atrial fibrillation submitted to mitral valve surgery. However, the formation of emboli in these patients may be due to other causes, as the role of the atrial appendage could be less important than is assumed. Moreover, not all patients are candidates for oral anticoagulation, and not all are kept in a proper therapeutic range, which could justify the formation of atrial thrombi. There are several methods for performing the closure of the appendage: direct suture in concomitant mitral surgery, epicardial exclusion by stapling or clips, or endovascular occlusion by percutaneous application. However, the results seem inconclusive with regards to their effectiveness for complete occlusion of the appendage, safety, and efficacy in preventing cerebral embolic events. To add to the confusion, some authors reveal no clear benefit in suture closure, and even describe an increased risk of thromboembolism. We present a review of left atrial appendage closure for the prevention of strokes, as well as the different procedures described above

Giant left atrial thrombus 17 years after orthotopic heart transplantation

We present the case of a 66-year-old woman who underwent orthotopic heart transplantation 17 years earlier for dilated cardiomyopathy. After 7 years allograft coronary vasculopathy developed requiring coronary artery angioplasty. In year 15 postoperatively she experienced congestive heart failure and she became symptomatic requiring diuretics and digoxin treatment. In year 16 postoperatively a routine coronary computed tomography (CT) angiography study revealed a giant thrombus in the left atrium. The patient had had no thromboembolicrelated symptoms. Anticoagulation therapy was introduced and the patient has not presented any thromboembolic-related complication. As the symptoms of cardiac insufficiency worsened we decided to evaluate the patient for re-transplantation

Cirugía de la fibrilación auricular

Atrial fibrillation surgery is based on creating scars in the atrium, in order to avoid re-entry phenomena that may initiate and perpetuate arrhythmia, and driving the normal stimuli from the sinus node to the atrio-ventricular node. The complexity and increased risk of the initial surgical technique, based on a "cut-and-sew" procedure, have enhanced other current procedures, in which different energies are used making it possible to perform scars in a safer and less invasive way. At present, atrial fibrillation surgery is not performed routinely in all cardiothoracic surgical centers, and there is no consensus in which is the best type of technique. Even if the results are good, they depend on multiples factors such as duration of arrhythmia, atrial size and type of technique employed. In addition, there is some variability in the description within the scientific community of the results and procedures used, which makes its analysis confusing. In this paper we review the different techniques described, the results and their application in minimally invasive surgery

Cavity electromechanics with parametric mechanical driving

Microwave optomechanical circuits have been demonstrated to be powerful tools for both exploring fundamental physics of macroscopic mechanical oscillators, as well as being promising candidates for on-chip quantum-limited microwave devices. In most experiments so far, the mechanical oscillator is either used as a passive element and its displacement is detected using the superconducting cavity, or manipulated by intracavity fields. Here, we explore the possibility to directly and parametrically manipulate the mechanical nanobeam resonator of a cavity electromechanical system, which provides additional functionality to the toolbox of microwave optomechanics. In addition to using the cavity as an interferometer to detect parametrically modulated mechanical displacement and squeezed thermomechanical motion, we demonstrate that this approach can realize a phase-sensitive parametric amplifier for intracavity microwave photons. Future perspectives of optomechanical systems with a parametrically driven mechanical oscillator include exotic bath engineering with negative effective photon temperatures, or systems with enhanced optomechanical nonlinearities

Valoración global del corazón en el paciente con transplante cardiaco mediante tomografía computarizada de doble fuente

In routine clinical practice surveillance of heart transplant recipients is usually performed using echocardiography and conventional coronary angiography. The latter permits diagnosis and follow-up of coronary allograft vasculopathy. However, this procedure is invasive and is not free of complications. Conventional multislice computed tomography (MSCT) has been shown to be a useful non-invasive tool for ruling out coronary artery disease and evaluating cardiac function. However, due to its limited temporal resolution betablocker administration is required, and its usefulness in certain patient populations with restricted response to this medication, such as heart transplant recipients, may therefore be limited. Dual-source CT (DSCT) allows evaluation of the coronary arteries in all individuals independent of their heart rate. In the case presented here, we demonstrate that DSCT may be useful for evaluating cardiac function and ruling out coronary allograft vasculopathy in heart transplant recipients

Dual-source CT for visualization of the coronary arteries in heart transplant patients with high heart rates

OBJECTIVE. The purpose of this study was to evaluate the quality of dual-source CT images of the coronary arteries in heart transplant recipients with high heart rates. SUBJECTS AND METHODS. Contrast-enhanced dual-source CT coronary angiography was performed on 23 heart transplant recipients (20 men, three women; mean age, 61.1 ± 12.8 years). Data sets were reconstructed in 5% steps from 30% to 80% of the R-R interval. Two blinded independent readers using a 5-point scale (0, not evaluative; 4, excellent quality) assessed the quality of images of coronary segments. RESULTS. The mean heart rate during scanning was 89.2 ± 10.4 beats/min. Interobserver agreement on the quality of images of the whole coronary tree was a kappa value of 0.78 and for selection of the optimal reconstruction interval was a kappa value of 0.82. The optimal reconstruction interval was systole in 17 (74%) of the 23 of heart transplant recipients. At the best reconstruction interval, diagnostic image quality (score ≥ 2) was obtained in 92.1% (303 of 329) of the coronary artery segments. The mean image quality score for the whole coronary tree was 3.1 ± 1.01. No significant correlation between mean heart rate (ρ = 0.31) or heart rate variability (ρ = 0.23) and overall image quality score was observed (p = not significant). CONCLUSION. Dual-source CT acquisition yields coronary angiograms of diagnostic quality in heart transplant recipients. Mean heart rate and heart rate variability during scanning do not have a negative effect on the overall quality of images of the coronary arteries

Progresos en cirugía cardiaca

The development of cardiovascular surgery has been accompanied by a series of advances in complementary technology, which has made it possible to carry out safer and less aggressive surgery. In this article there is a review of the latest progress in coronary and valvular surgery, cardiac insufficiency, arrhythmia and the application of extracorporeal circulation in non-cardiac diseases. These advances can serve as the starting point in order to build a future adapted to the needs generated by both patient and diseas

Trasplante de homoinjertos valvulares cardiacos y vasculares

The advances in the manipulation of human tissues, the development of cryobiology, paediatric cardiac surgery, the impossibility of obtaining an ideal prosthetic cardiac valve and the surgical treatment of cardiovascular infections have revived interest in the use of homografts. The donors of these homografts can be: a) Live donors: aortic and pulmonary valve of the recipient of a heart transplant; b) Multiorgan donors with a diagnosis of death according to neurological criteria, whose heart is rejected for heart transplant; c) Cadaver donors with asystolia of less than 8 hours. Homograft cardiac valves are the substitute of choice in aortic valve endocarditis, patients with counter-indications for anticoagulation, reconstruction of the outflow tract of the right ventricle, aortic valve replacement in children and young adults through the Ross operation, and an optional indication is the aortic valve and/or rising aorta replacement in patients over 60 years of age. Although there are not sufficiently broad series of homogratfs with arterial substitutes, with respect to the number of patients and time of evolution, the results suggest that this can benefit patients with vascular infection, immunodepressed patients or complex patients whose technique during the operation might require a homograft

Association of cardiotrophin-1 with myocardial fibrosis in hypertensive patients with heart failure

Cardiotrophin-1 has been shown to be profibrogenic in experimental models. The aim of this study was to analyze whether cardiotrophin-1 is associated with left ventricular end-diastolic stress and myocardial fibrosis in hypertensive patients with heart failure. Endomyocardial biopsies from patients (n=31) and necropsies from 7 control subjects were studied. Myocardial cardiotrophin-1 protein and mRNA and the fraction of myocardial volume occupied by collagen were increased in patients compared with controls ( P <0.001). Cardiotrophin-1 overexpression in patients was localized in cardiomyocytes. Cardiotrophin-1 protein was correlated with collagen type I and III mRNAs ( r =0.653, P <0.001; r =0.541, P <0.01) and proteins ( r =0.588, P <0.001; r =0.556, P <0.005) in all subjects and with left ventricular end-diastolic wall stress ( r =0.450; P <0.05) in patients. Plasma cardiotrophin-1 and N-terminal pro-brain natriuretic peptide and serum biomarkers of myocardial fibrosis (carboxy-terminal propeptide of procollagen type I and amino-terminal propeptide of procollagen type III) were increased ( P <0.001) in patients compared with controls. Plasma cardiotrophin-1 was correlated with N-terminal pro-brain natriuretic peptide ( r =0.386; P <0.005), carboxy- terminal propeptide of procollagen type I ( r =0.550; P <0.001), and amino-terminal propeptide of procollagen type III ( r =0.267; P <0.05) in all subjects. In vitro, cardiotrophin-1 stimulated the differentiation of human cardiac fibroblast to myofibroblasts ( P <0.05) and the expression of procollagen type I ( P <0.05) and III ( P <0.01) mRNAs. These findings show that an excess of cardiotrophin-1 is associated with increased collagen in the myocardium of hypertensive patients with heart failure. It is proposed that exaggerated cardiomyocyte production of cardiotrophin-1 in response to increased left ventricular end-diastolic stress may contribute to fibrosis through stimulation of fibroblasts in heart failure of hypertensive origi