Does the intervention of mindfulness reduce levels of burnout and compassion fatigue and increase resilience in pre-registration students? A pilot study.

INTRODUCTION: In the current clinical working environment it is important that therapeutic radiography students are fully prepared not just clinically but emotionally for a working professional life. Mindfulness has shown promise, as a self-care strategy, in the improvement of burnout, resilience and compassion fatigue in other professions; however, it has not been used with therapeutic radiography students. METHODS: Eight pre-registration therapeutic radiography students were recruited to undergo a five week mindfulness course; six students from the year below were recruited to act as a control arm (no mindfulness). Data was collected using a series of validated tools at baseline, week five, month three and 12 months after the start of the study: RESULTS: The MBI-SS scale demonstrated 29% of the sample experienced emotional exhaustion and 43% increased cynicism. The other tools showed a positive trend with the intervention; however, these were not statistically significant. CONCLUSION: Although no statistically significant differences were demonstrated between the study arms, some interesting trends have been noted. The key finding was the identification of burnout experienced by almost a third of the study sample. This suggests that a new area of study is warranted to further investigate the factors contributing to burnout in the student population.

Late deviance detection in rats is reduced, while early deviance detection is augmented by the NMDA receptor antagonist MK-801.

One of the most robust electrophysiological features of schizophrenia is reduced mismatch negativity, a component of the event related potential (ERP) induced by rare and unexpected stimuli in an otherwise regular pattern. Emerging evidence suggests that mismatch negativity (MMN) is not the only ERP index of deviance detection in the mammalian brain and that sensitivity to deviant sounds in a regular background can be observed at earlier latencies in both the human and rodent brain. Pharmacological studies in humans and rodents have previously found that MMN reductions similar to those seen in schizophrenia can be elicited by N-methyl-d-aspartate (NMDA) receptor antagonism, an observation in agreement with the hypothesised role of NMDA receptor hypofunction in schizophrenia pathogenesis. However, it is not known how NMDA receptor antagonism affects early deviance detection responses. Here, we show that NMDA antagonism impacts both early and late deviance detection responses. By recording EEG in awake, freely-moving rats in a drug-free condition and after varying doses of NMDA receptor antagonist MK-801, we found the hypothesised reduction of deviance detection for a late, negative potential (N55). However, the amplitude of an early component, P13, as well as deviance detection evident in the same component, were increased by NMDA receptor antagonism. These findings indicate that late deviance detection in rats is similar to human MMN, but the surprising effect of MK-801 in increasing ERP amplitudes as well as deviance detection at earlier latencies suggests that future studies in humans should examine ERPs over early latencies in schizophrenia and after NMDA antagonism.

Early life programming of pain: focus on neuroimmune to endocrine communication.

Chronic pain constitutes a challenge for the scientific community and a significant economic and social cost for modern societies. Given the failure of current drugs to effectively treat chronic pain, which are based on suppressing aberrant neuronal excitability, we propose in this review an integrated approach that views pain not solely originating from neuronal activation but also the result of a complex interaction between the nervous, immune, and endocrine systems. Pain assessment must also extend beyond measures of behavioural responses to noxious stimuli to a more developmentally informed assessment given the significant plasticity of the nociceptive system during the neonatal period. Finally integrating the concept of perinatal programming into the pain management field is a necessary step to develop and target interventions to reduce the suffering associated with chronic pain. We present clinical and animal findings from our laboratory (and others) demonstrating the importance of the microbial and relational environment in programming pain responsiveness later in life via action on hypothalamo-pituitary adrenal (HPA) axis activity, peripheral and central immune system, spinal and supraspinal mechanisms, and the autonomic nervous system.

Prelimbic prefrontal cortex mediates respiratory responses to mild and potent prolonged, but not brief, stressors.

The prefrontal cortex is one of the key areas of the central mechanism of cardiovascular and respiratory control. Disinhibition of the prelimbic medial prefrontal cortex elicits tachypnoeic responses in anesthetized rats (Hassan et al., J. Physiol. 591: 6069-6088, 2013). The current study examines the effects of inhibition of the prelimbic prefrontal cortex during presentation of stressors of various lengths and intensities in conscious unrestrained rats. 8 Wistar rats were implanted with bilateral guide cannulas targeting the prelimbic prefrontal cortex and received microinjections of either saline of GABAA agonist muscimol prior to recording sessions. Inhibition of the prelimbic prefrontal cortex significantly attenuated respiratory responses to a novel environment stress, 30s light stimulus and restraint stress. It did not affect respiratory responses to 500 ms acoustic stimuli of varying intensities (40-90 dB). We conclude that the prelimbic prefrontal cortex contributes to generation of tachypnoeic responses to prolonged stressors, but does not contribute to respiratory arousal in response to brief stressors.

Prescribing 131Iodine based on neck uptake produces effective thyroid ablation and reduced hospital stay.

PURPOSE: The aim of this study was to determine if thyroid cancer patients with low percentage neck uptake of iodine on postoperative thyroid scans can be treated with lower doses of 131Iodine while maintaining a high ablation rate. MATERIALS AND METHODS: We reviewed the records of 58 patients with differentiated thyroid cancer treated with 131I at the Princess Margaret Hospital. The activity of 131I was prescribed based on the 48 h percentage neck uptake in postoperative thyroid scans. Patients with < or =2% uptake received 1.07 GBq, patients with 2.1-4% uptake received 1.85 GBq, patients with 4.1-6% uptake received 2.80 GBq, patients with 6.1-8% uptake received 3.70 GBq and patients with >8% uptake received 4.60 GBq. When the scan suggested cervical lymph node metastases or residual tumor, 7.40 GBq was prescribed. Follow-up scans were performed at least 5 months after 131I therapy. Successful ablation was defined as the absence of visible uptake in the neck above background. RESULTS: Forty-nine patients were included in this analysis. The ablation rate according to the prescribed activity was as follows: 1.07 GBq, 16/20 (80%); 1.85 GBq, 4/5 (80%); 2.80 GBq, 1/1 (100%); 3.70 GBq, 0/1 (0%); 4.60 GBq, 7/8 (88%); 7.40 GBq, 13/14 (93%). The ablation rate for all patients treated on the protocol was 41/49 (84%, 95% CI 70-93%). For the group treated for remnant ablation, the overall ablation rate was 28/35 (80%, 95% CI 63-92%). Twenty-two (38%) of the 58 eligible patients received 1.07 GBq as outpatients. This saved 38 hospitalization days compared to a policy of treating all patients requiring remnant ablation with 3.70 GBq. CONCLUSIONS: We conclude that patients with less iodine uptake in postoperative thyroid scans can receive lower activities of 131I, allowing a significant proportion of patients to be treated on an outpatient basis while maintaining a high ablation rate.

Induced diarrhoea in horses. Part 1: Fluid and electrolyte balance.

Sodium, potassium and water balance, and measurements of acid-base status, haematocrit, packed cell volume and plasma total protein, were studied in four adult standardbred geldings following castor oil induced diarrhoea. Castor oil (2 mL kg-1) administration resulted in signs consistent with mild to moderate acute colitis. The total (combined faecal and urinary losses) losses of sodium and potassium ions were 2169 and 2864 mmol, respectively. Faeces constituted the major route for sodium loss, while urine was the major route for potassium loss at all times. Faecal dry matter potassium concentration did not vary significantly at any stage. Faecal dry matter sodium concentration increased significantly, coinciding with the onset of clinical diarrhoea. Faecal water loss increased significantly from 2.15 +/- 0.44 mL kg-1 h-1 to 5.15 +/- 0.92 mL kg-1 h-1 while clinical diarrhoea was observed. While plasma volume (PV) did not vary significantly in this study, there was a trend for PV to decrease while horses were clinically dehydrated.

Induced diarrhoea in horses. Part 2: Response to administration of an oral rehydration solution.

Hydration status, electrolyte balance and acid-base balance were studied in four adult standardbred geldings with castor oil-induced diarrhoea. The horses received an oral rehydration solution (ORS) at a point when signs consistent with mild decreases in effective circulating fluid volume were first detected. Within 1.5 h of ORS administration, all horses exhibited a significant metabolic acidosis. At this time, mean values for venous blood pH, [HCO3], and standard base excess were 7.264 +/- 0.011, 17.7 +/- 0.3 mmol L-1, and -8.2 +/- 0.4 mmol L-1, respectively. Throughout the duration of the study, plasma volume did not change significantly, despite a decreasing trend, which tended to recover towards normal values 8 h after administration of the ORS. Signs of abdominal discomfort were observed in all horses following the last of three doses of ORS (8-10 L) administered at 30 min intervals. Faecal fluid sodium concentration increased significantly with diarrhoea, and reached values fourfold those in normal horses, while faecal dry matter sodium concentration increased exponentially following the onset of clinical signs. Despite this increase in sodium concentration, faecal fluid remained hypotonic at all stages. Our findings suggest that, while ORS can help restore systemic fluid balance, several factors influence their effectiveness. Two likely factors identified in this study were the ionic composition of the ORS as well as the rate of administration. We concluded that the electrolyte composition of current ORS may not be ideal to treat diarrhoea in horses and that administration of 8-10 of ORS every 30 min via nasogastric tube may result in too rapid small intestinal transit to allow sufficient time for absorption.

Failure of passive transfer in foals: incidence and outcome on four studs in New South Wales.

OBJECTIVE: To determine the regional incidence and effectiveness of treatment of failure of passive transfer (FPT) in foals. DESIGN: A study of disease incidence. ANIMALS: Eighty-eight foals and 57 mares from four studs in the practice area of the Rural Veterinary Centre were tested. PROCEDURE: Foals were tested for their serum IgG and total serum protein (TSP) concentration within the first 72 hours of life. Colostrum was collected from mares and specific gravity determined. FPT and partial failure of passive transfer (PFPT) of immunoglobulins was diagnosed when serum IgG concentrations were < 4 g/L and 4 to 8 g/L respectively. Owners of foals diagnosed with FPT were offered treatment with 1 to 2 L plasma (TSP > 70 g/L); 9 (64%) of the affected foals were treated. RESULTS: Fourteen foals (16%) had FPT whereas 15 (17%) had PFPT. There were significant differences between the mean TSP concentration in foals with FPT (42.6 +/- 4.2 g/L), PFPT (48.1 +/- 3.9 g/L) and those acquiring adequate passive immunity (58.9 +/- 5.5 g/l) (p < 0.01). Sixteen (29%) mares had pre-suck colostral specific gravity < 1.060 and 12 (71%) foals raised by these mares had FPT or PFPT. The incidence of severe disease (categorised by a sepsis score > 11, positive culture of bacteria from blood or disease requiring hospitalisation) in all foals in the first 2 months of life was 10%. However, none of the nine foals with FPT that received plasma experienced severe disease. In contrast, foals with PFPT had an increased susceptibility to severe disease (p < 0.001) when compared with normal foals. CONCLUSION: Treatment of foals with FPT may reduce the subsequent incidence of severe disease. Pre-suck colostral specific gravity and foal TSP may be used to predict the likelihood of FPT and PFPT. Even though the number of foals studied is small the results highlight the importance of optimal management practices in reducing the incidence of FPT and disease associated with this process.

Serum alpha-tocopherol, vitamin A, and blood selenium concentrations, and glutathione peroxidase activity in llamas fed alfalfa hay.

OBJECTIVES: To measure blood selenium concentration and glutathione peroxidase (GSH-Px) activity and serum concentrations of vitamin A and alpha-tocopherol, and to determine the correlation between blood selenium concentration and GSH-Px activity of llamas fed alfalfa hay. DESIGN: Mean (+/- SD) serum vitamin A and alpha-tocopherol concentrations, blood selenium concentrations, and GSH-Px activity were calculated from 9 sequential blood samples collected from llamas fed a diet of alfalfa hay. ANIMALS: 15 clinically normal llamas (8 males, 7 females) between 10 and 14 months of age. PROCEDURE: Llamas were fed alfalfa hay for 40 days prior to sample collection and then for the duration of the trial. Vitamin E, selenium, and concentrations of vitamin A precursors were measured in the hay. Blood samples were collected on days 0, 6, 7, 9, 13, 20, 42, 64, and 98. Blood selenium concentrations were measured, using an inductively coupled spectrometric method. Blood GSH-Px activity was measured with a spectrophotometer, using a modification of a previously described assay. Isocratic high-performance liquid chromatography with florescent detection was used to determine serum alpha-tocopherol and vitamin A concentrations. RESULTS: The alfalfa hay contained 0.2 mg/kg of selenium, 5 mg/kg of vitamin E, and 0.9 mg/kg of vitamin A precursors. The mean (+/- SD) blood selenium concentration and GSH-Px activity were 0.179 +/- 0.032 micrograms/ml and 25.76 +/- 6.53 mU NADPH oxidized/min/mg of Hb, respectively, with a correlation coefficient of 0.97. The mean (+/- SD) concentrations for serum alpha-tocopherol and vitamin A were 128.1 +/- 41.7 and 74.8 +/- 5.5 micrograms/dl, respectively. CONCLUSIONS: Blood selenium concentrations in llamas are highly correlated to GSH-Px activity. Blood selenium concentrations in llamas appear to be similar to other domestic ruminants and diets containing 0.2 mg/kg of selenium appear to provide an adequate dietary source. The concentrations of vitamin A precursors and vitamin E in the hay were below currently recommended dietary levels for llamas, and alfalfa hay appears to provide an unreliable source of vitamins A and E in this species. Further studies are required to determine optimal dietary concentrations and to substantiate a reference range for these vitamins in llamas.

Genetic analysis and characterization of a Caulobacter crescentus mutant defective in membrane biogenesis.

A mutant of Caulobacter crescentus has been isolated which has an auxotrophic requirement for unsaturated fatty acids or biotin for growth on medium containing glucose as the carbon source. This mutant exhibits a pleiotropic phenotype which includes (i) the auxotrophic requirement, (ii) cell death in cultures attempting to grow on glucose in the absence of fatty acids or biotin, and (iii) a major change in the outer membrane protein composition before cell death. This genetic lesion did not appear to affect directly a fatty acid biosynthetic reaction because fatty acid and phospholipid syntheses were found to continue in the absence of supplement. Oleic acid repressed fatty acid biosynthesis and induced fatty acid degradation in the wild-type parent, AE5000 . The mutant strain, AE6000 , was altered in both of these regulatory functions. The AE6000 mutant also showed specific inhibition of the synthesis of outer membrane and flagellar proteins. Total phospholipid, DNA, RNA, and protein syntheses were unaffected. The multiple phenotypes of the AE6000 mutant were found to cosegregate and to map between hclA and lacA on the C. crescentus chromosome. The defect in this mutant appears to be associated with a regulatory function in membrane biogenesis and provides evidence for a direct coordination of membrane protein synthesis and lipid metabolism in C. crescentus.