Search

Objective: The COVID-19 pandemic brought unparalleled pressure, stress, and a dramatic change in practice to health care systems across the world. National Health Service (NHS) staff have reported higher levels of burnout, stress, and other mental health issues that they relate directly to the impact of the pandemic. Burnout is often used as a "catch-all" term for psychological distress in the workplace, and it has been suggested that, during the pandemic, experience of "burnout" may be influenced by "moral injury": the distress that can arise from actions, or lack of action, that are seen to violate one's ethical code. This study investigates NHS staff experiences of burnout and betrayal-based moral injury, in which a trusted authority betrays "what is right.", Method: Sixteen NHS staff members were interviewed in relation to their experiences during the COVID-19 pandemic, and data were thematically analyzed., Results: Three themes were identified: abandonment as betrayal; dishonesty and lack of accountability; and fractured relationship to management or the NHS., Conclusions: This analysis concludes that self-identified "burnout" in NHS staff may include a significant moral component, and that failure to engage in moral repair following betrayal-based moral injury may relate to a long-term loss of trust or fractured relationship with the organization. In addition to traditional trauma-informed psychological support, leadership at all levels should be trained to be aware of betrayal-based moral injury and to engage in moral repair to reduce staff intent to leave and encourage mutual trust. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

We report the case of a 33-year-old man who had received multiple gunshot wounds to the abdomen; consequently, he was diagnosed with a traumatic dissection of the abdominal aorta at the level of the superior mesenteric artery (SMA) extending to just below the renal arteries with a posterior pseudoaneurysm of the aorta. He had wounds in the right upper quadrant and in the left lower back. He demonstrated signs of peritonitis for which he was taken to the operating room for exploratory laparotomy. A right common iliac to SMA bypass with a 7-mm ringed polytetrafluoroethylene (PTFE) graft was created. The celiac trunk was then ligated, and through the right groin sheath, a thoracic endograft stent (Cook Medical, Bloomington, IN) was inserted at the level of the thoracic aorta with resolution of the blood flow to the aorta, visceral and iliac arteries, as well as retrograde flow into the bypass graft. The literature on traumatic abdominal aortic pseudoaneurysm was reviewed, and based on that, we believe this report describes a unique case of a traumatic aortic pseudoaneurysm at the level of the celiac trunk, as well as our operative approach., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Nabati et al.)

A perineal fluid-filled structure was discovered in a 6-year-old intact female Irish water spaniel suffering from intermittent constipation. Diagnostic tests revealed the structure was immediately caudal to the vagina and compatible with a cyst. Surgical excision was required for resolution of clinical signs. Histology confirmed the structure was a cyst. The exact origin is unknown; however, the variety of lining epithelia, including sections with mucin production, and a well-differentiated smooth muscle layer, were most consistent with development from the lower hindgut or urogenital sinus during embryonic growth. The histologic and anatomical similarities with human retrorectal cystic hamartomas were key in establishing the diagnosis of a perineal cystic hamartoma. Following removal, constipation resolved, and the cyst did not recur., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

Objectives: The aim of this study was to determine the presence and prevalence of heartworm infection in the feral cat population of Grand Cayman., Methods: During the study period, feral cats were routinely trapped and euthanized for population control by the municipal animal shelter. Cats older than 6 months of age were obtained for post-mortem examination shortly after euthanasia. The heart, lungs, pulmonary vasculature, thoracic and abdominal cavities were examined for the presence, location and number of mature heartworms. Sections of caudal lung were evaluated histologically and serologic tests were performed to screen for additional evidence of heartworm exposure., Results: Mature heartworms were identified in the pulmonary vasculature of 4/36 cats (11.1%). An additional nine cats showed histopathologic changes in the lungs consistent with heartworm exposure, and one cat had a positive antibody test., Conclusions and Relevance: The results indicate a minimum heartworm prevalence of 11.1% within this population of feral cats, consistent with published necropsy reports from other endemic localities. Considering the histopathologic changes observed in this group, the true prevalence is likely higher and underscores the importance of heartworm prevention for the companion cat population of the island., Competing Interests: Conflict of interest: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This report describes a case of severe rhabdomyolysis in a pregnant mare associated with histopathologic and biochemical features of both selenium deficiency and acquired multiple acyl-CoA dehydrogenase deficiency (MADD) due to seasonal pasture myopathy (SPM). This case highlights the importance of assessing plasma selenium levels in horses with clinical signs of pasture myopathy as this deficiency may be a contributing or exacerbating factor.

A 10-year-old golden retriever dog was presented for evaluation of progressive panting, inspiratory stridor, and gagging. Oropharyngeal examination revealed a soft, nonulcerated, pedunculated mass arising from the right tonsillar fossa. The mass was completely excised and histopathology was consistent with a sialolipoma. No regrowth of the mass was evident 6 months after surgery.

This paper addresses the assessment and verification of health informatics professional competencies. Postgraduate provision in Health Informatics was targeted at informatics professionals working full-time in the National Health Service, in Northern Ireland, United Kingdom. Many informatics health service positions do not require a formal informatics background, and as we strive for professionalism, a recognized qualification provides important underpinning. The course, delivered from a computing perspective, builds upon work-based achievement and provides insight into emerging technologies associated with the 'connected health' paradigm. The curriculum was designed with collaboration from the Northern Ireland Health and Social Care ICT Training Group. Material was delivered by blended learning using a virtual learning environment and face-to-face sessions. Professional accreditation was of high importance. The aim was to provide concurrent qualifications: a postgraduate certificate, awarded by the University of Ulster and a professional certificate validated and accredited by a professional body comprising experienced health informatics professionals. Providing both qualifications puts significant demands upon part-time students, and a balance must be achieved for successful completion.

A 13-year-old, neutered male domestic cat presented with signs of weight loss, anemia, and hepatomegaly. Pathognomonic signs of porphyria were identified. Charcoal-like renal calculi and severe liver changes were observed, neither of which has been previously reported in association with feline porphyria.

We evaluated the effects of immunostimulation in the development of postweaning multisystemic wasting syndrome (PMWS) in 930 pigs 53 to 54 d old in a grower/finisher barn with a history of PMWS. The pigs were allocated to 5 treatment groups: 4 groups received a single intramuscular injection of RespiSure-ONE (a commercial Mycoplasma hyopneumoniae vaccine; n = 197), Emulsigen (an oil-based adjuvant; n = 172), Alhydrogel (an aluminum-hydroxide-based adjuvant; n = 172), or physiologic saline (n = 218); 1 group received no treatment (n = 171). Pigs affected by PMWS were found in all the groups. Antigen to Porcine circovirus type 2 (PCV-2) was detected by immunohistochemical testing within lesions of mesenteric lymph node, spleen, Peyer's patch, and lung of affected pigs. There was no significant difference in the incidence of PMWS among the groups. The findings indicate that immunostimulation did not influence the expression of PMWS in this study. Thus, routine vaccination against swine diseases may not significantly contribute to the occurrence of PMWS under field conditions.

A 1.5-year-old dog was evaluated for abnormal mentation, collapse, and weight loss. Radiographs and ultrasonographs revealed soft tissue masses in the mid abdomen. Ultrasound-guided fine-needle aspirates provided a diagnosis of malignant epithelial or round cell neoplasia. Histopathologic and immunohistochemical findings on the tumors were consistent with a primitive neuroblastoma.