Background: Breast cancer surgery results in numerous acute and long-term adverse outcomes; the degree to which these can be mitigated or prevented through prehabilitation is unknown. Methods: We conducted a longitudinal, single-arm, mixed-methods study to examine the feasibility of prehabilitation in 22 women undergoing breast cancer surgery. All participants received an individualized exercise prescription including upper quadrantspecific resistance and mobility training and aerobic exercise for the duration of their surgical wait time. Feasibility was assessed by recruitment, adherence, attrition, and intervention-related adverse event rates. An exploratory investigation of intervention efficacy was conducted via a 6-min walk test, upper-quadrant strength and range of motion, volumetric chances associated with lymphedema, and participant-reported quality of life, fatigue, pain, and disability. Outcome assessments were conducted at baseline, prior to surgery, and at six and 12 weeks after surgery. Semi-structured interviews with a subset of participants (n = 5) and health-care providers (H; n = 2) were conducted to provide further insights about intervention feasibility. Qualitative data were analyzed using a hybrid inductive and deductive thematic analysis approach. Results: Recruitment and attrition rates were 62 and 36%, respectively. Average prehabilitation duration was 31 days (range = 7-69 days). Seventy six percent of participants complied with at least 70% of their prehabilitation prescription. There was a clinically significant increase in the 6-min walk distance from baseline to the preoperative assessment (57 m, 95% CI = −7.52, 121.7). The interviews revealed that the intervention was favorably received by participants and HCPs and included suggestions that prehabilitation (i) should be offered to all surgical candidates, (ii) is an avenue to regain control in the preoperative period, (iii) is a facilitator of postoperative recovery, and (iv) is an opportunity to provide education regarding postoperative rehabilitation protocols. A preference for multimodal prehabilitation (including dietetic and psychological counseling) was also highlighted.

Background: Doctors are known to have poor mental health compared with the general population. Psychiatrists are exposed to a number of unique stressors that may increase the risk of poor mental health. The aim of this study was to undertake a meta-analysis of burnout rates in psychiatrists. Methods: Electronic databases (including MEDLINE, PsycINFO and Embase) were searched. Only studies published since 1999 and using the 22-item Maslach Burnout Inventory were included in the analysis. A meta-analysis was conducted using the Comprehensive Meta-Analysis software. Results: A total of 11 studies, across nine publications, were included in the final analysis. Studies were significantly heterogenous but there was no indication of publication bias. The pooled mean for emotional exhaustion was 22.03 (95% confidence interval (CI): 19.71–24.34, tau = 3.74). For depersonalisation, the pooled mean was 7.41 (95% CI: 5.91–8.90, tau = 2.45). The pooled mean for personal accomplishment was 30.00 (95% CI: 24.75–35.27, tau = 8.87). Conclusions: The high level of psychiatrist emotional exhaustion is a significant concern. Further research is needed to consider the role of modifiable risk factors in the aetiology of psychiatrist burnout.

The majority of psychiatrists and trainees appear to be satisfied with their current work. However, there are many factors creating increased work stress and affecting welfare. The role of the college in protecting the welfare of its members should be further considered.