Avoiding procrastination station.

Procrastination is a temptation to which many of us succumb, frequently with an impact on our wellbeing. But according to Jane Davidson, there are techniques that can help. Claire Read reports.

The human connection.

For Roeland Wessels, being a successful and happy vet involves mastering one species in which little training is provided. Claire Read reports.

A new start.

Fifteen years ago a financial crisis swept the world. It was a hard time for Jamie Crittall's practice but, as he tells Claire Read, adversity can bring new and positive opportunities.

In the present.

For Laura Woodward, practising vet and counsellor to the veterinary profession, mindfulness is a powerful way to deal with the pressures of day-to-day life - including at Christmastime. Claire Read reports.

The gift of giving.

Being kind, and reflecting on that kindness, can offer real benefits to both giver and receiver. Laura Woodward, vet and counsellor to the vet profession, tells Claire Read more.

The power of gratitude.

For Katie Ford, no achievement ever felt like it was enough - and it was making her miserable. So she started on a personal development journey which took her into coaching and to discovering the impact of gratitude. Claire Read reports.

Good natured.

A whole host of evidence shows that time in nature can improve both physical and mental wellbeing. Catriona Mellor, a child and adolescent psychiatrist, tells Claire Read more.

Necessary support.

A survey found one in 10 women had left work because of symptoms caused by the menopause. As World Menopause Awareness Month continues, Laura Black of Vets Now says it's crucial to introduce support to avoid losing expertise from the workforce. Claire Read reports.

Lending an ear.

After Charles Chavasse discovered people seemed to find it easy to talk to him about their worries, he decided to train as a mental health and wellbeing champion - taking on a more formal role in supporting his colleagues. He tells Claire Read more.

Building a supportive workplace.

As veterinary practices up and down the country prepare to take part in Macmillan's Coffee Morning, Victoria Bowes tells Claire Read about her experience with cancer - and the importance of workplaces supporting those experiencing ill health.

Supporting mind and body.

Claire Gillvray has dedicated her career to exploring the link between physical and mental wellbeing. Claire Read speaks to her to find out how being active can impact on the mind as well as the body.

A spectrum of support.

Debbie Martin, a veterinary nursing student who is autistic, says supporting neurodiverse people often requires very little adjustment but yields great benefits. Claire Read speaks to her to find out more.

Creating inclusive workplaces.

How can we build veterinary workplaces that are equally welcoming to all, and in which all are supported to excel? That's the question at the heart of this month's Balance. Here Claire Read speaks to a number of vets from minority ethnic backgrounds to discuss possible answers to this vital question.

Clinical effects of hypertonic saline boluses in children with severe traumatic brain injury.

AIM: To quantify the effects of 3% hypertonic saline (HTS) boluses on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in children. METHODS: A retrospective study of patients admitted to a regional neurosurgical children's intensive care unit. RESULTS: A total of 156 HTS boluses were given to children with traumatic brain injury. ICP decreased 6 mmHg (P < 0.01) and CPP increased 4 mmHg (P = 0.003) 1-h post-bolus. Effects persisted for 3 h post-dose ICP was 5 mmHg lower) and 4 h post-bolus CPP was 3 mmHg higher. ICP change was not associated with pre-bolus serum sodium concentration. CONCLUSIONS: Hypertonic saline 3% at 5 mL/kg is an effective osmolar therapy for reducing ICP and increasing CPP in children for up to 3 h. '53-53' is a suitable guide - 5 mL/kg of 3% HTS will on average decrease ICP by at least 5 mmHg for 3 h. Pre-bolus serum sodium concentration is not correlated with effect size.

Investigation of synovial fluid lubricants and inflammatory cytokines in the horse: a comparison of recombinant equine interleukin 1 beta-induced synovitis and joint lavage models.

BACKGROUND: Lameness is a debilitating condition in equine athletes that leads to more performance limitation and loss of use than any other medical condition. There are a limited number of non-terminal experimental models that can be used to study early inflammatory and synovial fluid biophysical changes that occur in the equine joint. Here, we compare the well-established carpal IL-1ß-induced synovitis model to a tarsal intra-articular lavage model, focusing on serial changes in synovial fluid inflammatory cytokines/chemokines and the synovial fluid lubricating molecules lubricin/proteoglycan 4 and hyaluronic acid. The objectives of this study were to evaluate clinical signs; synovial membrane and synovial fluid inflammation; and synovial fluid lubricants and biophysical properties in response to carpal IL-1ß synovitis and tarsal intra-articular lavage. RESULTS: Hyaluronic acid (HA) concentrations, especially high molecular weight HA, and synovial fluid viscosity decreased after both synovitis and lavage interventions. Synovial fluid lubricin concentrations increased 17-20-fold for both synovitis and lavage models, with similar changes in both affected and contralateral joints, suggesting that repeated arthrocentesis alone resulted in elevated synovial fluid lubricin concentrations. Synovitis resulted in a more severe inflammatory response based on clinical signs (temperature, heart rate, respiratory rate, lameness and joint effusion) and clinicopathological and biochemical parameters (white blood cell count, total protein, prostaglandin E2, sulfated glycosaminoglycans, tumor necrosis factor-α and CC chemokine ligands - 2, - 3, - 5 and - 11) as compared to lavage. CONCLUSIONS: Synovial fluid lubricin increased in response to IL-1ß synovitis and joint lavage but also as a result of repeated arthrocentesis. Frequent repeated arthrocentesis is associated with inflammatory changes, including increased sulfated glycosaminoglycan concentrations and decreased hyaluronic acid concentrations. Synovitis results in more significant inflammatory changes than joint lavage. Our data suggests that synovial fluid lubricin, TNF-α, CCL2, CCL3, CCL5, CCL11 and sGAG may be useful biomarkers for synovitis and post-lavage joint inflammation. Caution should be exercised when performing repeated arthrocentesis clinically or in experimental studies due to the inflammatory response and loss of HA and synovial fluid viscosity.

How to Put a Value on the Priceless.

A webinar brought together senior figures to consider how we assess the value of sophisticated drugs when the area is such an intellectual and moral maze.