Systematic Review: Occupational Therapy & Improving Social Participation for At-Risk Youth in School

Objectives of Presentation: 1. Describe occupational therapists’ role in working with at-risk youth. 2. Identify 1-2 effective interventions for increasing social participation amongst at-risk youth. 3. Discuss how the current evidence regarding interventions within the scope of occupational therapy for at-risk youth can be best integrated into practice. PICO: What school-based interventions within the scope of occupational therapy practice aid in improving social participation for at-risk youth? Methods: Creation of clinical question, list of search terms for literature search Systematic search of databases: CINAHL, PubMed, Cochrane, & Scopus List of inclusion/exclusion criteria created Presentation: 50 minute

Improving identification & management of familial hypercholesterolaemia in primary care: pre- and post-intervention study

Background and Aims: Familial hypercholesterolaemia (FH) is a major cause of premature heart disease but remains unrecognised in most patients. This study investigated if a systematic primary care-based approach to identify and manage possible FH improves recommended best clinical practice. Methods: Pre- and post-intervention study in six UK general practices (population 45,033) which invited patients with total cholesterol >7.5 mmol/L to be assessed for possible FH. Compliance with national guideline recommendations to identify and manage possible FH (repeat cholesterol; assess family history of heart disease; identify secondary causes and clinical features; reduce total & LDL-cholesterol; statin prescribing; lifestyle advice) was assessed by calculating the absolute difference in measures of care pre- and six months post-intervention. Results: The intervention improved best clinical practice in 118 patients consenting to assessment (of 831 eligible patients): repeat cholesterol test (+75.4%, 95% CI 66.9-82.3); family history of heart disease assessed (+35.6%, 95% CI 27.0-44.2); diagnosis of secondary causes (+7.7%, 95% CI 4.1-13.9), examining clinical features (+6.0%, 95% CI 2.9-11.7). For 32 patients diagnosed with possible FH using Simon-Broome criteria, statin prescribing significantly improved (18.8%, 95% CI 8.9-35.3) with non-significant mean reductions in cholesterol post-intervention (total: -0.16 mmol/L, 95% CI -0.78-0.46; LDL: -0.12 mmol/L, 95% CI -0.81-0.57). Conclusions: Within six months, this simple primary care intervention improved both identification and management of patients with possible FH, in line with national evidence-based guidelines. Replicating and sustaining this approach across the country could lead to substantial improvement in health outcomes for these individuals with very high cardiovascular risk

Diabetic foot ulceration with osteomyelitis: the importance of early detection

This case study explores the management of a chronic diabetic foot ulcer complicated by severe soft tissue infection (cellulitis) and bony infection (osteomyelitis) in a patient with type 2 diabetes

Decolonizing road safety for transportation justice in Australia

Australia has a fundamental, deep, and enduring transport injustice. First Nations people endure road deaths and injury figures at vastly higher rates than the figure for non-First Nations people, suggesting that road safety research has not translated into successful policies and programs that sustainably reduce First Nations road trauma. In this paper, we argue that the decolonization of road safety research can only occur with First Nations people using culturally appropriate methodologies. We evaluate the scope and possibility of First Nations methodologies for decolonizing road safety, finding that yarning, or the ubiquitous use of conversation and storytelling to generate, pass on, and exchange knowledge, is a promising research methodology for decolonizing Australian road safety

Evolution and impact of COVID-19 outbreaks in care-homes: population analysis in 189 care-homes in one geographic region

Background: COVID-19 has affected care home residents internationally, but detailed information on outbreaks is scarce. We aimed to describe the evolution of outbreaks of COVID-19 in all care homes in one large health region in Scotland. Methods: We did a population analysis of testing, cases, and deaths in care homes in the National Health Service (NHS) Lothian health region of the UK. We obtained data for COVID-19 testing (PCR testing of nasopharyngeal swabs for severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) and deaths (COVID-19-related and non-COVID-19-related), and we analysed data by several variables including type of care home, number of beds, and locality. Outcome measures were timing of outbreaks, number of confirmed cases of COVID-19 in care home residents, care home characteristics associated with the presence of an outbreak, and deaths of residents in both care homes and hospitals. We calculated excess deaths (both COVID-19-related and non-COVID-19-related), which we defined as the sum of deaths over and above the historical average in the same period over the past 5 years. Findings: Between March 10 and Aug 2, 2020, residents at 189 care homes (5843 beds) were tested for COVID-19 when symptomatic. A COVID-19 outbreak was confirmed at 69 (37%) care homes, of which 66 (96%) were care homes for older people. The size of care homes for older people was strongly associated with a COVID-19 outbreak (odds ratio per 20-bed increase 3·35, 95% CI 1·99–5·63). 907 confirmed cases of SARS-CoV-2 infection were recorded during the study period, and 432 COVID-19-related deaths. 229 (25%) COVID-19-related cases and 99 (24%) COVID-related deaths occurred in five (3%) of 189 care homes, and 441 (49%) cases and 207 (50%) deaths were in 13 (7%) care homes. 411 (95%) COVID-19-related deaths occurred in the 69 care homes with a confirmed COVID-19 outbreak, 19 (4%) deaths were in hospital, and two (<1%) were in one of the 120 care homes without a confirmed COVID-19 outbreak. At the 69 care homes with a confirmed COVID-19 outbreak, 74 excess non-COVID-19-related deaths were reported, whereas ten non-COVID-19-related excess deaths were observed in the 120 care homes without a confirmed COVID-19 outbreak. 32 fewer non-COVID-19-related deaths than expected were reported among care home residents in hospital. Interpretation: The effect of COVID-19 on care homes has been substantial but concentrated in care homes with known outbreaks. A key implication from our findings is that, if community incidence of COVID-19 increases again, many care home residents will be susceptible. Shielding care home residents from potential sources of SARS-CoV-2 infection, and ensuring rapid action to minimise outbreak size if infection is introduced, will be important for any second wave

The silicon cycle impacted by past ice sheets.

Globally averaged riverine silicon (Si) concentrations and isotope composition (δ30Si) may be affected by the expansion and retreat of large ice sheets during glacial-interglacial cycles. Here we provide evidence of this based on the δ30Si composition of meltwater runoff from a Greenland Ice Sheet catchment. Glacier runoff has the lightest δ30Si measured in running waters (-0.25 ± 0.12‰), significantly lower than nonglacial rivers (1.25 ± 0.68‰), such that the overall decline in glacial runoff since the Last Glacial Maximum (LGM) may explain 0.06-0.17‰ of the observed ocean δ30Si rise (0.5-1.0‰). A marine sediment core proximal to Iceland provides further evidence for transient, low-δ30Si meltwater pulses during glacial termination. Diatom Si uptake during the LGM was likely similar to present day due to an expanded Si inventory, which raises the possibility of a feedback between ice sheet expansion, enhanced Si export to the ocean and reduced CO2 concentration in the atmosphere, because of the importance of diatoms in the biological carbon pump

Arts and Craft in Occupational Therapy (Activity Analysis)

Ergoterapie je profese, která se snaží o dosažení co největší soběstačnosti a samostatnosti jedince. Působí ve třech oblastech: soběstačnost, práce a produktivní aktivity a volnočasové činnosti. Historie ergoterapie sahá do 18. století, ale již i v době před naším letopočtem se vědělo o příznivém vlivu smysluplné činnosti v podobě práce či výtvarných a rukodělných činností. V České republice se začátek využití činnosti jako léčebného prostředku připisuje Priessnitzovi. V době komunismu ergoterapie nebyla potřebná a tak novou éru ergoterapie v České republice je možné datovat až od roku 1992. Pro ergoterapeuty je zásadní nástroj léčby činnost, lépe řečeno, smysluplná činnost. O významu činnosti pro ergoterapeuty psal již v roce 1922 AdolfMeyer. Vývoj ergoterapie je spjat s využíváním výtvarných a rukodělných činností. Jejich využívání se v průběhu vývoje společnosti, který ergoterapie reflektuje, snižuje, ale v Čechách je v jejich využívání stále silná tradice. Mezi důležité nástroje ergoterapeuta patří analýza činnosti, která pomáhá za prvé porozumět základní charakteristice jakékoliv činnosti. Za druhé pomáhá porozumět jedinci v co nejširším kontextu. Výsledkem použití analýzy činnosti je zvolení vhodné terapeutické činnosti pro konkrétního klienta, včetně navržení potřebných úprav pomůcek či..