Compassion satisfaction and fatigue: An investigation into levels being reported by radiotherapy students

Introduction: Studies have investigated the prevalence of compassion satisfaction and compassion fatigue in various healthcare professions. However, the majority of evidence is linked to the nursing profession and little is known about paramedical professions such as radiography and even less is known about its prevalence in students. The purpose of this study was to describe the levels of compassion satisfaction and compassion fatigue in the student population and how they varied in time. Methods: Students undertaking radiotherapy training at the researcher’s host sites were surveyed using the Professional Quality of Life questionnaire at the end of each final clinical bock in each year of their training. Results & Conclusion: During the three years of training compassion satisfaction falls and burnout increases in the student population, although the change is not significant. Secondary traumatic stress increases significantly during the 3 years of training, F=5.725, p=0.005. Considerable variation also exists in the three scores dependent on the student’s clinical training site. Relationships are also observed between some personality traits, particularly conscientiousness and neuroticism and compassion scores

Pre-Treatment With Glucagon-Like Peptide-1 Protects Against Ischemic Left Ventricular Dysfunction and Stunning Without a Detected Difference in Myocardial Substrate Utilization

AbstractObjectivesThis study sought to determine whether pre-treatment with intravenous glucagon-like peptide-1 (GLP-1)(7-36) amide could alter myocardial glucose use and protect the heart against ischemic left ventricular (LV) dysfunction during percutaneous coronary intervention.BackgroundGLP-1 has been shown to have favorable cardioprotective effects, but its mechanisms of action remain unclear.MethodsTwenty patients with preserved LV function and single-vessel left anterior descending coronary artery disease undergoing elective percutaneous coronary intervention were studied. A conductance catheter was placed into the LV, and pressure-volume loops were recorded at baseline, during 1-min low-pressure balloon occlusion (BO), and at 30-min recovery. Patients were randomized to receive an infusion of either GLP-1(7-36) amide at 1.2 pmol/kg/min or saline immediately after baseline measurements. Simultaneous coronary artery and coronary sinus blood sampling was performed at baseline and after BO to assess transmyocardial glucose concentration gradients.ResultsBO caused both ischemic LV dysfunction and stunning in the control group but not in the GLP-1 group. Compared with control subjects, the GLP-1 group had a smaller reduction in LV performance during BO (delta dP/dTmax, –4.3 vs. –19.0%, p = 0.02; delta stroke volume, –7.8 vs. –26.4%, p = 0.05), and improved LV performance at 30-min recovery. There was no difference in transmyocardial glucose concentration gradients between the 2 groups.ConclusionsPre-treatment with GLP-1(7-36) amide protects the heart against ischemic LV dysfunction and improves the recovery of function during reperfusion. This occurs without a detected change in myocardial glucose extraction and may indicate a mechanism of action independent of an effect on cardiac substrate use. (Effect of Glucgon-Like-Peptide-1 [GLP-1] on Left Ventricular Function During Percutaneous Coronary Intervention [PCI]; ISRCTN77442023

Implantable Therapeutic Reservoir Systems for Diverse Clinical Applications in Large Animal Models

Regenerative medicine approaches, specifically stem cell technologies, have demonstrated significant potential to treat a diverse array of pathologies. However, such approaches have resulted in a modest clinical benefit, which may be attributed to poor cell retention/survival at the disease site. A delivery system that facilitates regional and repeated delivery to target tissues can provide enhanced clinical efficacy of cell therapies when localized delivery of high doses of cells is required. In this study, a new regenerative reservoir platform (Regenervoir) is described for use in large animal models, with relevance to cardiac, abdominal, and soft tissue pathologies. Regenervoir incorporates multiple novel design features essential for clinical translation, with a focus on scalability, mechanism of delivery, fixation to target tissue, and filling/refilling with a therapeutic cargo, and is demonstrated in an array of clinical applications that are easily translated to human studies. Regenervoir consists of a porous reservoir fabricated from a single material, a flexible thermoplastic polymer, capable of delivering cargo via fill lines to target tissues. A radiopaque shear thinning hydrogel can be delivered to the therapy reservoir and multiple fixation methods (laparoscopic tacks and cyanoacrylate bioadhesive) can be used to secure Regenervoir to target tissues through a minimally invasive approach.In this study, a new regenerative reservoir platform (Regenervoir) is described for use in large animal models that are easily translated to human studies, with relevance to cardiac, abdominal, and soft tissue pathologies. Regenervoir incorporates multiple novel design features essential for clinical translation, with a focus on scalability, mechanism of delivery, fixation, and filling/refilling with a therapeutic cargo.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155890/1/adhm202000305.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155890/2/adhm202000305_am.pd

Patient decision-making about emergency and planned stoma surgery for IBD: a qualitative exploration of patient and clinician perspectives

Background: Many IBD patients worry about stoma forming surgery (SFS), sometimes enduring poor bowel-related quality of life to avoid it. Anticipation of SFS and whether expectations match experience is under-reported. This qualitative study explored influences on patients’ SFS decision-making, and compared pre-operative concerns with post-operative outcomes. Methods: We purposively recruited participants with IBD from UK hospital outpatient and community sources, and IBD clinicians from public hospitals. Four focus groups and 29 semi-structured patient participant interviews, and 18 clinician interviews were audio recorded, transcribed, and analysed thematically. Participants had a current temporary, recently-reversed, or permanent stoma, or were stoma naïve. Results: Four themes emerged: Pre-operative concerns and expectations, Patient decision-making, Surgery and recovery, and Long-term outcomes. Participants and clinicians agreed about most pre-operative concerns, that outcomes were often better than expected, and support from others with a stoma is beneficial. Patient decision-making involves multiple factors, including disease status. Some clinicians avoid discussing SFS, and the phrase ‘last resort’ can bias patient perceptions; others recommend early discussion, increasing dialogue when medical management becomes ineffective. The post-operative period is particularly challenging for patients. Stoma acceptance is influenced by personal perceptions and pre- and post-operative clinical and social support. Conclusion: Patients need balanced information on all treatment options, including surgery, from an early stage. Early multi-disciplinary team dialogue about SFS, and contact with others living well with a stoma, could enable informed decision-making. Life with a stoma is often better than anticipated, improving quality of life and control. Ongoing specialist nursing support aids recovery and adjustment

Development of a Digital Counterpart to Aid Decision Support on Energy Consumption of an Active Manufacturing Process

This research focused on the development of a Digital Model (DM) of a production line at a medical device company, with the objective of providing decision support to stakeholders based on their energy consumption. This model aims to reduce energy consumption by bringing operational data to process engineers, allowing them to make efficient improvement decisions while in production. In order to achieve this objective, the twin transition of digital integration and energy efficiency was enacted by organisations such as the International Energy Agency (IEA). This two-pronged approach involved working with process owners to understand the decision-making process that they undertook to streamline performance and develop the means to digitalise this data while also working with facilities and maintenance engineers to understand which equipment played the most important roles in the production process from an energy consumption perspective. By bringing the process data and energy data together in a digital model of the process, a decision support system could be developed which would unlock the potential to streamline operations not just from an output perspective, but also from an energy efficient perspective. When examining the process step with data catagorised as energy, operational and maintenance, it was found that only operational data was sufficient to support digital modelling in its current state. Therefore, the installation of a wireless energy metering network would be required to support digital modelling and further digital integration

Preliminary results of a randomised controlled trial to evaluate the efficacy of a dietary and physical activity intervention in prostate cancer patients receiving androgen deprivation therapy

Androgen deprivation therapy (ADT) is a common treatment for prostate cancer that may be associated with unfavourable changes in body composition, including increased fat and decreased lean mass; and increased fatigue. These changes can negatively affect quality of life. The impact of a diet and physical activity intervention on these side effects related to ADT has not been examined in any study to date. Therefore, this study investigated whether a 6-month diet and physical activity intervention is effective at reducing ADT related side effects and improve overall quality of life in prostate cancer patients. Prostate cancer patients prescribed ADT treatment for at least 6 months were recruited from Belfast Cancer Centre, Northern Ireland and randomised either to receive the dietary modification and physical activity intervention or standard care (control group) with a 1:1 allocation ratio. The intervention consisted of an individually tailored home-based one-to-one counselling delivered by a nutritionist to help the patients in the intervention group to modify their diet to meet healthy eating guidelines and achieve 30 min of brisk walking, five or more days per week. The primary outcomes were body composition, fatigue and quality of life at baseline, 3 and 6 months. Changes in dietary intake, perceived stress, functional capacity and energy expenditure were investigated as secondary outcomes. This preliminary analysis included forty-two patients (twenty-one patients in each group) who have completed a 6-month follow-up. Analysis of covariance was used to compare outcomes for groups at 3 and 6 months adjusted for baseline values. Statistically significant differences were noted between the intervention and the control group for body composition. The patients in the intervention group had a statistically significant reduction in mean body weight (- 3.8�7 kg), while weight increased in the control group (0.8�8 kg) (P<0.001). Both BMI (P<0.001) and waist?hip ratio (P = 0.01) decreased significantly in the intervention group compared with the control group. The mean changes in % fat and total fat were - 2.2�3% and - 3.3�6 kg, respectively, in the intervention group compared with 1.1�6% and 1.1�1 kg in the control group (P<0.001). There was a reduction in mean fatigue scores in the intervention group (- 1.8�5) compared with the controls (2.3�1), with no significant difference between the groups. Results on quality of life scores showed no statistically significant differences between the groups on any general quality of life subscales; however, the prostate cancer specific subscale showed a worsening of prostate cancer related symptoms in the control group compared with the intervention group (P = 0.001). Patients undergoing intervention showed an increase energy expenditure (P = 0.04) and functional capacity (P = 0.002) compared with the control group. Intervention patients had significantly improved their diet by decreasing energy, fat, saturated fat, cholesterol sugar and salt consumption compared with the controls. Furthermore, the mean intake of fruits and vegetables increased in the intervention group (1.4�5 servings/d), while there was a decrease in the control group (- 0.07�5 servings/d) (P = 0.002). Preliminary results suggest that a 6-month dietary and physical activity intervention may have favourable effects on ADT related side effect, especially in reducing the negative body composition changes among prostate cancer patients. However, only 44.7% (total sample?ninety-four patients) of patients completed the intervention to date and the analysis was underpowered to detect significant differences in fatigue and quality of life. The results of the completed study are eagerly awaited and will help to inform future guidelines for prostate cancer patients treated with ADT