The Characteristics of Post-Intensive Care Syndrome to Inform Occupational Therapy Practice During the Post-Intensive Care Period: A Systematic Scoping Review.

Background: As the demand for intensive care treatment increases, so too does the number of people surviving critical illness. Since 2010, the term “post-intensive care syndrome” has been used to describe the constellation of new or worsening physical, cognitive, and psychological impairments that persist after intensive care discharge. This review aimed determine the characteristics of PICS present during the first year following discharge from the ICU to inform occupational therapists working with this population during the post-intensive care period. Methods: A systematic scoping review has been conducted according to the PRISMA-ScR Checklist. Seven key databases were searched from inception to 2020. A single reviewer screened available literature against eligibility criteria then cross-checked by a second reviewer. Data were abstracted from relevant publications and results were narratively synthesised through application of a biopsychosocial model.Results: Twenty-five studies were identified for inclusion. Characteristics were categorised as biological, psychological, or social and contextual. Overarching outcomes were also considered. Results demonstrated that characteristics were complex and interwoven between domains. Results were grouped into four key themes: 1) An increased worldwide demand for intensive care, 2) ADL performance, 3) HRQOL, and 4) Consideration of social and contextual characteristics. No studies were found to detail the role of occupational therapists working with post-intensive care survivors.Conclusions: The complex and interwoven nature of post-intensive care syndrome highlights the need to consider a holistic rehabilitation approach. Considering the COVID-19 pandemic, occupational therapists have the potential to play an increased role during the post-intensive care period to reduce the global healthcare burden and improve patient outcomes. Future research is needed to determine the best model of care to support occupational therapists working with survivors of critical illness.Trial Registration: NA

Spatio-Temporal Recruitment Of Adult Neural Stem Cells For Transient Neurogenesis During Pregnancy

Neural stem cells (NSCs) in the adult mouse brain contribute to lifelong brain plasticity. NSCs in the adult ventricular-subventricular zone (V-SVZ) are heterogeneous and, depending on their location in the niche, give rise to different subtypes of olfactory bulb interneurons. Here, we show that during pregnancy multiple regionally-distinct NSCs are dynamically recruited at different times. Coordinated temporal activation of these NSC pools generates sequential waves of short-lived olfactory bulb interneuron subtypes that mature in the mother around birth and in the perinatal care period. Concomitant with neuronal addition, oligodendrocyte progenitors also transiently increase in the olfactory bulb. Thus, life experiences, such as pregnancy, can trigger transient neurogenesis and gliogenesis under tight spatial and temporal control, and may provide a novel substrate for brain plasticity in anticipation of temporary physiological demand.

Studi Ekologi Faktor Pejamu, Kondisi Fisik Hunian dan Pneumonia pada Balita Provinsi Jawa Barat Tahun 2014-2017

Provinsi Jawa Barat merupakan wilayah peringkat keempat dengan kasus pneumonia terbanyak di Indonesia. Walaupun setiap tahunnya mengalami penurunan kasus, cakupan penemuan kejadian pneumonia pada balita masih jauh berada di bawah target nasional. Penelitian ini bertujuan untuk mengetahui gambaran faktor pejamu dan kondisi hunian dengan kejadian pneumonia balita di Provinsi Jawa Barat. Penelitian ini menggunakan desain studi ekologi dengan melakukan analisis deskriptif data yang bersumber dari Profil Kesehatan Provinsi Jawa Barat dan BPS Statistik Kesejahteraan Rakyat Jawa Barat tahun 2014 – 2017. Hasil penelitian menunjukkan distribusi frekuensi kejadian pneumonia balita di Provinsi Jawa Barat cenderung fluktuatif. Variabel yang mengalami trend peningkatan adalah: cakupan imunisasi, BBLR, cakupan ASI eksklusif, jenis atap tidak memenuhi syarat. Sedangkan gizi buruk, kepadatan hunian, jenis dinding yang tidak memenuhi syarat dan jenis lantai yang tidak memenuhi syarat cendrung mengalami penurunan. Penelitian ini menunjukkan pentingnya antenatal care, pendampingan ibu selama kehamilan hingga masa pengasuhan bayi. Selain itu, kersediaan rumah sehat akan berperan dalam meminimalisir pneumonia pada balita. West Java Province is the fourth ranked region with the most pneumonia cases in Indonesia. Although every year there is a decrease in cases, the coverage of finding pneumonia in children under five is still far below the national target. This study aims to determine the description of host factors and residential conditions with the incidence of pneumonia under five in West Java Province. This study uses an ecological study design by conducting a descriptive analysis data sourced from Health Profile of West Java Province and BPS West Java People's Welfare Statistics in 2014 – 2017. The results show that the frequency distribution of the incidence of pneumonia under five in West Java Province tends to fluctuate. Variables that experienced an increasing trend were: immunization coverage, LBW, exclusive breastfeeding coverage, bad type of roof. Meanwhile, poor nutrition, occupancy density, bad types of wall and floors are decrease trend. This study shows the importance of antenatal care, maternal assistance during pregnancy and the baby care period. In addition, healthy home will play a role in minimizing pneumonia in toddlers.

THE EFFECT OF MASSAGE ON THE PREVENTION OF COMPRESSION STOCKINGASSOCIATED PRESSURE INJURY IN INTENSIVE CARE PATIENTS

AIM:Effect of massage on prevention of antiembolic stockings- associated pressure injury (AES-API). MATERIALS AND METHODS: It is a quasi-experimental design design. The massage group (n=30) received skin massage and skin protective care with a moisturizer at least 3 times or at every change of position (every 2 hours a day) in a day during the period they wore AES.The nonmassage group(n=39),no massage was performed. RESULTS: There was no significant difference between the sociodemographic and clinical characteristics of the massage group and nonmassage groups during ICU admission. The duration of AES use in the massage group was longer than that of the nonmassage group during the treatment and care period (p>0.05). However, AES-API only observed in the nonmassage group (n=5;12.8%). CONCLUSION:The short superficial skin massage may beneficial for its prevention for AES-API.

AN OVERVIEW ON CHATURVIDHASHENHA (AYURVEDIC CLASSICAL FOUR TYPES OF FATS) IN SUTIKAPARICHARYA (PUERPERIUM)

Introduction : A group of human is nothing but society. Ayurveda not only explains individuals health but well commented on community health. In this context, Ayurveda described about Supraja (Healthy and Cultured progeny). Female has got an opportunity to nurture Supraja as she has capability of giving birth because of typical genetic development. For mother and child care diet, remedies, medicines, rules are mentioned in Ayurveda. (Aim). Hence topic was selected to review Chaturvidhasneha ( internal and external) in Sutikapricharya. Material and Method: Sutikaparicharya and Sheh Varga (group of unctuous food) were reviewed. Observation: A female, after expulsion of placenta at the end of labour is known as Sutika . According to classical references Sutika Kalavadhi is from 5th day to up to 45 th day. Involvement Trishosha, Saptadhatu, Upadhatu are observed during labour and Sutikaawastha. In Ayurvedic compendia, twenty four types of herbal unctuous substances are mentioned. Postnatal care period is indicated for consumption of these unctuous substances. Discussion: : In such condition, internal and external oleation helps to alleviate Tridosha, give strength to bodily tissues and rejuvenate deteriorated body organs involved during labour. Vegetable and animal are two sources of fats. Ghrita (cow ghee), Tila Taila (Sesame oil), Vasaa (animal muscle fat) and Majja (marrow) are described. Conclusion: Chaturvidhasneha plays an important role in Sutikaparichary., In this process, extensive depletion of Dhatu, Updhatu (Supportive tissue) and aggravation of Tridosha occurs. Chaturvidhasheha allivates Tridosha, recover depleted supportive tissue and helps in rejuvenation of body strength.

528 Smoking on Home Oxygen and Burn Related Injuries. A Single Center Experience

Introduction Oxygen therapy is a mainstream treatment for many cardiopulmonary disease processes in the United States with COPD being most common. Despite various warnings against smoking on oxygen therapy, some patients continue to smoke on oxygen and sustain burn-related injuries. These patients are frequently intubated due to concern for inhalation injury. We aim to characterize the injury patterns, morbidities, and mortalities associated with burns sustained while on oxygen therapy at home. We hypothesize that the prevalence of these injuries is underrecognized. Methods We performed a retrospective review of all patients ≥45 years of age admitted to our regional burn center from 10/2018-4/2019. Injuries related to smoking on home oxygen were isolated and patient and injury characteristics are described. Results A total of 143 patients were included in this review, 20 patients (15%) had injuries related to smoking on home oxygen. Patient and injury characteristics are described in Table 1. Notably, 25% of patients were intubated and none of those patients had an inhalation injury documented on bronchoscopy. Four patients were extubated within a day of admission & one patient was extubated on hospital day 2. No patient died in the hospital. Nine patients (45%) required an escalation of care in the post-acute care period. Conclusions Smoking on home oxygen is an underrated problem and better education is needed for both patients receiving the therapy and providers prescribing the therapy. Due to the mechanism, inhalation injury is rare though a significant percentage of patients continue to receive prophylactic intubation.

Systemic Alterations in patients submitted to exodontics at the Bauru School of Dentistry (USP)

Objective: To verify the rate of systemic changes observed in individuals seen at the Oral and Maxillofacial Surgery and Traumatology clinics of the Undergraduate Dentistry course at the Faculty of Dentistry of Bauru (FOB-USP). Methodology: a retrospective study of the medical records of individuals seen at the Oral and Maxillofacial Surgery and Traumatology clinics of the third and fourth years of the Dentistry course at FOB-USP, from January 1, 2015, to June 30, 2017. Data collection was performed based on information from the anamnesis obtained during the initial care of the patients and recorded in the medical records. The selected data were name, age, address, diagnosed systemic disease, current and/or past medical treatments, proposed surgical treatment, and, if there was, patient return after medical treatment for surgery. The medical records of individuals under the age of 18, patients who did not have any systemic changes, or those with systemic changes observed outside the initial care period were excluded. RESULTS: The sample consisted of 266 medical records and 119 of these were from individuals who had systemic changes (44.7%), with systemic arterial hypertension being the most common (33.1%), followed by diabetes mellitus (17.8%). Conclusion: the high prevalence of individuals with systemic alterations and who require dental surgical intervention was proven, which implies the need for a correct anamnesis and preoperative evaluation so that these cases are managed to avoid trans and/or post-operative, systemic, and/or local.

Prenatal Markers of Foetal Complications

Prenatal markers are commonly used in practice to screen for some foetal abnormalities. They can be biochemical or ultrasonic markers in addition to the newly used cell free Deoxyribonucleic Acid (DNA) estimation. This review aimed to illustrate the applications of the prenatal screening, and the reliability of these tests in detecting the presence of abnormal chromosomes such as trisomy-21, trisomy-18, and trisomy-13 in addition to neural tube defects. Prenatal markers can also be used in the anticipation of some obstetrical complications depending on levels of these markers in the mother’s circulation. In the developed countries, prenatal screening tests are regularly used during antenatal care period. Neural tube defects, numerical and structural chromosomal abnormalities, in addition to some obstetrical problems are commonly screened for, by using prenatal tests. Maternal education about the importance of performing these tests should be done in order to improve the detection rate of foetal abnormalities and some pregnancy complications.