Royal Buckinghamshire Hospital

There is limited understanding of the impact of glucose monitoring technologies on relationships with food and eating behaviours for those with type 2 diabetes mellitus (T2DM). With previous reviews focused on T2DM treatment burden and self-management, this review aims to enhance understanding of the impact of flash or continuous glucose monitoring (FGM/CGM) on users' eating behaviours and relationships with food as this can inform important recommendations for CGM use amongst those with T2DM. A systematic search was conducted across four databases: Scopus, Medline, CINAHL and PubMed, from October-November 2024, following PRISMA guidelines. Studies were quality appraised and qualitative data was synthesized using thematic synthesis. Thirteen studies met inclusion criteria and their findings were included in the synthesis. The review revealed that F/CGM enhanced participants' nutritional awareness, supported personalised dietary experimentation, and fostered intentional eating behaviours. However, data overload and emotional burden were also reported, with some users experiencing restrictive or distressing impacts on their relationship with food. These insights inform practical recommendations for CGM implementation with those with T2DM. Further research should aim to identify factors that contribute to successful adaptation to CGM and explore the long-term effects of CGM use on food relationships.

Objective: Fecal microbiota transplantation (FMT) is an emerging treatment for Clostridioides difficile infection (CDI) through reconstruction of the gut microbiota, but its impact in people with spinal cord injury (PWSCI) is limited. The aim of this paper is to report the use of FMT in a PWSCI with CDI. Methods: The FMT was conducted on October 30, 2019. Results: A 72-year-old man with T8 complete paraplegia from compression of the spinal cord due to an epidural hematoma was referred. He has known severe pancreatic enzyme insufficiency, malabsorption, and a history of recurrent CDI. Despite intensive dietetic treatment (probiotics, enteral nutrition, and parenteral nutrition), and multiple courses of antibiotics (vancomycin and fidaxomicin at various doses and durations) for CDI, he continued to be CDI-positive. His CDI was successfully treated after 2 colonoscopically delivered FMTs. At the 24-month follow-up, he remains CDI-negative and reports improved independence. Although there has been considerable variability in the criteria for the FMT and its mode of delivery, FMT can be an option to treat recurrent CDI. Conclusion: This case report reports a PWSCI with recurrent CDI who has been successfully treated with FMT and remains in long-term remission. It supports the consideration of FMT in PWSCI with CDI when antibiotic treatment has been unsuccessful.

Abstract Hoarding disorder is a surprisingly common problem which impacts on most areas of life. People who hoard typically have multiple agencies involved in their care due to the complex health and safety impact and risks associated with hoarding. ‘Treatment’ involves finding ways of supporting discarding large amounts, typically underpinned by CBT principles. We evaluated the impact and outcomes of a conference designed to boost professionals’ confidence and understanding in working with hoarding problems, both individually and with other agencies with a view to improving inter-agency service provision. Changes in professionals’ confidence and understanding were evaluated immediately before and after the conference. Conference participants’ qualitative responses related to service improvements were analysed using content analysis. People with personal experience of hoarding issues subsequently participated in a focus group where the results of the conference were presented. These data were analysed using thematic analysis. Confidence and understanding in working with hoarding problems substantially increased from pre- to post-conference. Professionals identified a range of possible improvements, most commonly working more closely and improving communication with other agencies. People with personal experience suggested improvements across three over-arching themes: developing an improved understanding of hoarding, the need for improved resources, and improved multi-agency working. A multi-agency conference increased confidence and understanding in professionals working with hoarding problems, and improvements specified by both people with personal experience and professionals provide a useful guide to service improvement. Results provide a framework in which CBT approaches should be embedded. Key learning aims (1) To assess the effectiveness of a multi-agency hoarding conference at improving understanding and confidence in working with hoarding problems. (2) To explore professionals’ perceptions of improvements to multi-agency service provision. (3) To explore perceptions of improvements that could be made to multi-agency service provision from people with personal experience of hoarding problems.

Review of: Game Production Studies, Olli Sotamaa and Jan Švelch (eds) (2021) Amsterdam: Amsterdam University Press, 356 pp., ISBN 978-9-46372-543-9, e-book open access, h/bk, EU €109.00

Review of: Esport Play: Anticipation, Attachment and Addiction in Psycholudic Development, Veli-Matti Karhulahti (2020) New York: Bloomsbury Academic, 206 pp., ISBN 978-1-50135-934-7, h/bk, £72.00

Stephen Curran’s Screenwriting Teachers: 1910–1922: Origins, Contribution and Legacy provides an extensive and detailed analysis of the contributions of five key screenwriters to the history of the...