Animal Assisted Therapy: It’s Implications among Disorders, for Thera­peutic Practice, and in Health and Well-being

Till the time one has not loved an animal,a part of one’s soul remains unborn.Animal Assisted Therapy can be used in amalgamation with other forms of therapy.The animal becomes an assimilation of the therapeutic plan with AAT.Many psychological disorders have been shown to react well to Animal-Assisted Therapy(AAT).The article is a concise literature review on Animal Assisted Therapy of database available from the studies that were integrated and provided a general understanding of the perceived benefits of Animal Assisted Therapy and includes topics that are categorised as an Introduction to Animal Assisted Therapy:how it can help people with disorders,it’s utilisation in therapeutic practice and its relation to our health and well-being.Papers were considered eligible if they satisfied the following pre-determined criteria:(1)Talked about Animal Assisted Therapy in context to well-being of an individual,(2)Talked about implications of Animal Assisted Therapy in context to disorders and(3)Showed benefits of Animal Assisted Therapy in counselling.This paper further provides an overall review of Animal Assisted Therapy.Relevant data was summarized and collated to make a narrative account of the findings that animal in the therapy would not make it more difficult,but rather make it easier,the therapist be aware of any animal-related allergies when employing animals as adjuncts and animals can help have a better emotional and physical healing experience by the patient.

Effects of equine-assisted interventions on older adults’health:A systematic review

Objective:Equine-assisted interventions(EAI)can improve a variety of health problems in older adults and thus promote their well-being.This systematic review aimed to synthesize studies on EAI to understand better their effects on the health of older adults.Method:A systematic search guided by the PRISMA 2020 approach was performed on specific databases:Medline(PubMed),EMBASE,PsycINFO,and Cochrane Library.Peer-reviewed articles published in the English language from inception to June 2022 were retrieved.Methodological quality was established using the modified version of the Downs and Black checklist.Results:A total of 244 studies were retrieved,and 13 eligible studies were finally included.Three health domains were investigated:physical(balance,gait,and muscular strength),psychological(quality of life and cognitive assessment),and physiological(hormonal measures,cerebral and muscular activity).Among the eight studies investigating the physical dimension,four studies highlighted a positive effect of EAI on balance,four for gait,and three for strength.Regarding the three studies investigating the psychological dimension,two studies showed a positive effect of EAI on quality of life.Lastly,the four studies investigating the physiological dimensions all demonstrated a positive effect of EAI on hormonal measures and cerebral and muscular activity.Conclusion:Nevertheless,this systematic review provides promising findings regarding the positive effects of EAI on physical,psychological,and physiological health in older adults.Research on EAI should therefore be pursued rigorously to promote this non-pharmacological intervention in an older adult population.

Intensive Care Management of Acute Liver Failure:Considerations While Awaiting Liver Transplantation

Acute liver failure is a unique clinical phenomenon charac-terized by abrupt deterioration in liver function and altered mentation.The development of high-grade encephalopathy and multisystem organ dysfunction herald poor prognosis.Etiologic-specific treatments and supportive measures are routinely employed;however,liver transplantation remains the only chance for cure in those who do not spontaneously recover.The utility of artificial and bioartificial assist therapies as supportive care—to allow time for hepatic recovery or as a bridge to liver transplantation—has been examined but stud-ies have been small,with mixed results.Given the severity of derangements,intensive critical care is needed to success-fully bridge patients to transplant,and evaluation of candi-dates occurs rapidly in parallel with serial reassessments of operative fitness.Psychosocial assessment is often subopti-mal and relative contraindications to transplant,such as ventilator-dependence may be overlooked.While often em-ployed to guide evaluation,no single prognostic model dis-criminates those who will spontaneously recover and those who will require transplant.The purpose of this review will be to summarize approaches in critical care,prognostic model-ing,and medical evaluation of the acute liver failure trans-plant candidate.

Long-term assist device patients admitted to ICU: Tips and pitfalls

Left ventricular assist device(LVAD)therapy is well-established in the treatment of end-stage cardiac failure.Indications are bridge to transplant(BTT),bridge to candidacy(BTC),bridge to recovery(BTR),and destination therapy(DT).The durability and adverse event(AE)rate of LVADs have improved over the years.However,due to donor shortage,the duration of support in the BTT population has increased tremendously;similarly,DT patients are on the device for a long time.Consequently,the number of readmissions of long-term LVAD patients has increased.In cases of severe AEs,intensive care unit(ICU)treatment can be necessary.Infectious complications are the most common AE.Furthermore,embolic or hemorrhagic strokes can occur due to foreign surfaces,acquired von Willebrand syndrome,and anticoagulation treatment.Another consequence of the coagulative status,in combination with the continuous flow,are gastrointestinal bleeding events.Moreover,in most patients,an isolated LVAD is implanted,and this involves the risk of late right heart failure.Adjustment of pump speed and optimization of the volume status can help solve this issue.Malignant arrhythmias,pre-existing or de novo after LVAD implantation,can be a life-threatening AE.Antiarrhythmic medical therapy or ablation are potential treatment options.As for specific LVADs,the Medtronic HeartWare TM ventricular assist device(HVAD)is not manufactured and distributed currently;however,4000 patients are still on the device.Pump thrombosis can occur,wherein thrombolytic therapy is the first-line treatment option.Additionally,the HVAD can fail to restart after controller exchange due to technical issues,and precautions must be taken.The Momentum 3 trial showed superior survival without pump exchange or disabling stroke in patients treated with the HeartMate 3■(HM3;Abbott,Abbott Park,IL,USA)device in comparison to the HeartMate II(HMII).However,in a few cases,a twisted graft or bio debris formation between the outflow graft and bend relief could be observed,causing outflow graft obstruction.Patients on LVADs are still heart failure patients,in many cases with comorbidities.Therefore,many situations can occur requiring ICU treatment.Ethical aspects should always be the focus when taking care of these patients.