Completion Of Program Research Articles

Mitigating Persistent Symptoms Following Rehabilitation in Musculoskeletal Disorders: A Scoping Review on After-discharge Strategies.

The majority of patients with musculoskeletal pain (62% to 64%) achieve their treatment goals upon completing rehabilitation. However, a high re-consultation rate after discharge is frequently reported. Numerous authors have recognized the necessity of secondary prevention programs (after-discharge strategy) to ensure that the gains are maintained or further pursued after the completion of a rehabilitation program. Little is known about the different strategies currently in use, and a detailed review of the existing strategies is needed for future integration into the healthcare systems. This review systematically scopes and synthesizes the after-discharge strategies reported in the literature following rehabilitation for individuals experiencing musculoskeletal pain. Four databases (OVID MEDLINE, EMBASE, Web of Sciences, and OVID PsycInfo) were screened from their inception until May 4, 2023. Literature search, screening, and extraction were performed according to the PRISMA extension for scoping review guidelines. Different after-discharge strategies were identified and grouped into 2 main categories: (1) in-person and (2) remote strategies. In-person strategies included (1.1) in-person booster sessions and (1.2) the use of existing community programs after discharge. Remote strategies included remote strategies that (2.1) involve a health care professional service or (2.2) strategies that do not involve any health care professional service. We identified various after-discharge strategies designed to sustain gains and improve patients' self-management skills following the completion of a rehabilitation program. The existence of numerous promising strategies suggests their potential suitability for various contexts.

Clinical research self-efficacy in academic veterinary clinicians in the United States.

Clinical research is a growing part of the academic clinician's job, and documenting areas of low self-efficacy can inform training initiatives. 182 US academic veterinary clinicians. A survey of academic veterinary clinicians was distributed to 31 US institutions. Self-efficacy was assessed with a modified Clinical Research Appraisal Instrument-12. The relationship between research self-efficacy and completion of formal research training and years of experience was evaluated. Respondents were predominantly junior to midcareer faculty. The lowest reported confidence was in performing advanced statistical analyses (3; 0 to 10). Other low-confidence tasks included designing a qualitative methods study (4; 0 to 10), terminating a collaboration that isn't working (5; 0 to 10), describing a funding agency's review/award process (5; 0 to 10), establishing a timeline for a grant application (5; 0 to 10), establishing collaborator and consultant agreements (5; 0 to 10), and asking staff to leave the project team (5; 0 to 10). Completion of a formal research training program was significantly associated with improved self-efficacy in many tasks. Years of experience was also associated, especially in project management and interpersonal interactions. These results highlight the need for targeted training opportunities for academic veterinary clinicians in biostatistical support, qualitative study design methods, and aspects of communication and interpersonal skills that are important for developing and leading effective research teams. Range of confidence suggests that development opportunities in all domains will improve self-efficacy for some clinicians. Future studies should focus on the impact of formal training sessions on various domains of self-efficacy and on targeted mentoring in supporting confidence in more experiential learning domains.

A Systematic Review of the Completion of Cardiac Rehabilitation Programs for Adults Aged 18-50 Years.

To perform a systematic review of completion rates of cardiac rehabilitation (CR) in adults aged 18 to 50yr and describe how core components were reported, measured, and tailored to those under 50yr. Database search of MEDLINE, Embase, Emcare, PsycINFO, CINAHL, Scopus, and the Cochrane Library based on keywords, including articles from January 1, 1990. The last search was performed on April 21, 2023. Following the Preferred Reporting Items for Systematic Review and Meta-Analyses protocol, eligible articles contained adults (aged between 18 and 50yr) who had participated in a CR program. Out of the articles screened (n=24,517), 33 reports across 31 independent studies were considered eligible (n=1958 patients aged ≤50yr). Cardiac rehabilitation completion rates ranged from 64% to 100%; however, only 5 studies presented a completion rate definition. The length of the program ranged from 7d to 20wk, with most (65%) ranging between 6 and 12wk. While the studies included in this systematic review indicated relatively high rates of completing CR, these are likely to overrepresent the true completion rates as few definitions were provided that could be compared to completion rates used in clinical practice. This systematic review also found that all interventions prescribed exercise (eg, aerobic alone or combined with resistance training or yoga) but had very limited inclusion or description of other integral components of CR (eg, initial assessment and smoking cessation) or how they were assessed and individualized to meet the needs of younger attendees.

Remediation of intrusive symptoms of PTSD in fewer than five sessions: A 30-person pre-pilot study of the RTM Protocol

Introduction: The Reconsolidation of Traumatic Memories (RTM) Protocol is a brief non-traumatizing intervention for the intrusive symptoms of post-traumatic stress disorder (PTSD). It is supported by nearly 25 years of anecdotal and clinical reports. This study reports the first scientific evaluation of the protocol. Methods: A 30-person pilot study using male Veterans with a pre-existing diagnosis of PTSD. Intake criteria included interviews and confirmatory re-diagnosis using the PTSD Checklist–Military version (PCL-M). Of 33 people who met the inclusion criteria, 26 completed treatment using the RTM protocol. A small ( n = 5) wait-list control group was included. All participants were reassessed following treatment using the PCL-M. Results: Of 26 program completers, 25 (96%) were symptom free at 6-week follow-up. Mean PCL-M score at intake was 61 points. At the 6-week follow-up, the mean PCL-M score was 28.8, with a mean reduction in scores of 33 points. Hedges’ g was computed for 6-week follow-up and showed a 2.9 SD difference from intake to follow-up. A wait-list control analysis indicated non-significant symptom changes during the 2-week wait period. Discussion: Results suggest that RTM is a promising intervention worthy of further investigation.

Effects of I AM TAP Program on Executive Function of Children 3-5 years in Bangkok Metropolitan Region Residential Care Homes: A Quasi-experimental Study

Executive function is important to the success of an individual. Children who have a history of being abused mentally and physically before entering a residential care home may have executive function deficits. They often face fear, stress, and a lack of interpersonal interaction, which affects their executive function. This quasi-experimental study aimed to increase children’s executive function through the I AM TAP Program. This program integrates sensory and physical activities, including working memory, inhibitory control, and cognitive flexibility. Two residential care homes of young children aged 3-5 years in the Bangkok Metropolitan Region were randomly assigned to experimental and control groups. Then, 36 children from each setting and 11 caregivers were selected according to the inclusion criteria. The experimental group received I AM TAP Program training twice weekly for 9 weeks, 20-30 minutes each session. The control group attended the routine activities provided in a residential care home. Executive function was assessed with the Mahidol University Executive Function-101 instrument. The data were analyzed using independent t-tests, paired t-tests, and covariance analysis. The results of this study, a testament to the effectiveness of the I AM TAP Program, revealed a significant increase in the mean scores of executive functions on 3 subscales in the experimental group. These scores not only improved from the pre-program levels but also surpassed those of the control group, as measured one week after program completion. This promising outcome suggests that the I AM TAP Program has the potential to enhance executive function in young children. Nurses can potentially apply this program to promote executive function, and caregivers can be equipped with information on how to support the children in the residential care home. However, it is crucial to conduct further testing with various groups of children in different settings before considering widespread implementation

“Pioneers, yes. We all should think that way” Improving Papua New Guinea Cancer Nurses Education through an International Partnership

ObjectivesFirst, to understand Papua New Guinea (PNG) oncology nursing issues perceived through the nurses’ lens of unmet supportive care needs of people affected by cancer and to identify nurses’ self-perceived educational priorities in cancer care. Second, to evaluate the tailored bidirectional learning and knowledge transfer among the participants of the Australia Capital Territory Health and PNG Oncology Nursing Development Program hosted in Australia in June 2023. MethodsA qualitative descriptive study was conducted. Two focus groups were audio-recorded, transcribed, and analyzed using inductive thematic analysis. Based on PNG oncology nurses’ experiences and self-assessed educational needs, the findings were analyzed and presented separately for Time 1 before the PNG Oncology Nursing Development program and Time 2 following the completion of the program. ResultsThe findings from the Time 1 focus group identified four themes: (1) educational priorities, (2) system-wide challenges, (3) patient unmet care needs, and (4) cultural beliefs. After the completion of the educational program, there were four emergent themes: (1) new educational experiences, (2) learnings into practice, (3) culturally sensitive nursing, and (4) leadership (PNG nursing trailblazers). This study, for the first time, provided the PNG RNs with a “voice,” to empower them to take more leading roles in important decision-making regarding care structures and management. ConclusionPolicymakers, government officials, and international cancer organizations must continue to work together to support cancer control in PNG in light of the current and projected limited resources and barriers to timely cancer diagnosis and treatment in PNG. Implications for Nursing PracticeThrough observing and learning from a modern cancer department, PNG oncology nurses have gained insight into what is needed for a safe cancer service for both patients and nurses. Oncology nursing education in PNG needs to be further developed, enhanced, and supported for sustainability of cancer nurses in the long term.

The Impact of the Implementation of Complete Systematic Land Registration on Legal Certainty in the Registration of Land Ownership Rights in Indonesia

The establishment of legal certainty is one of the goals of land registration. Both Article 19 of the UUPA and Article 3 of Government Regulation No. 24 of 1997 on Land Registration support this. Both methodical and haphazard land registration may lead to legal certainty in the form of certificates. Initiated in 2016, the Complete Systematic Land Registration Program is still running. The Impact of Complete Systematic Land Registration Implementation on Legal Certainty in the Registration of Property Rights in Indonesia is the title of this study. The purpose of this study is to look at how Complete Systematic Land Registration could affect Indonesia's property rights registration system's legal certainty. Normative legal research employing secondary data is what this work does. According to a 2024 study, the National Land Agency, the government, saw both good and negative effects from the implementation of Complete Systematic Land Registration, in addition to benefits for participating landowners.

A hybrid maintenance approach for key components of the train bogie to optimize fleet availability

In the context of intelligent transport systems and the rapid development of the global economy, railways face increasing demand to become safer, more efficient, and more sustainable. As a critical structure of the railway vehicle, the bogie, designed to support the vehicle body and transmit dynamic loads through the wheels, houses several components that are vital for the reliability and safety of the train. The maintenance of such a structure is complex and can greatly benefit from hybrid approaches that leverage the potential of condition-monitoring data in proactively identifying faults or irregularities whilst ensuring appropriate intervals that maximize the availability of resources. This paper proposes a hybrid maintenance approach that combines preventive maintenance, condition-based monitoring, and predictive maintenance for the key components of the bogie, aiming to optimize costs while exploiting potential economic savings of maintenance decisions for different grouping strategies, therefore, maximizing fleet availability. The model aims to study the feasibility and measure the expected economic returns of shifting from a complete preventive maintenance program to a hybrid program incorporating predictive maintenance tasks in selected components of the bogie. A deterioration model, along with failure rate estimation, is proposed and integrated into the optimization formulation. A case study of a railway company operating in Catalonia, Spain, is presented. The framework demonstrates flexibility in tackling current maintenance practices, including hierarchy and periodicity of maintenance tasks according to the intervention type and flexible hazard rates with three stages to mimic the bathtub curve behaviour. The results show that shifting to a hybrid maintenance plan has great potential to reduce costs.

Community Participation in the Complete Systematic Land Registration Program (PTSL) in Rumbai District, Pekanbaru City

Community Participation in the Complete Systematic Land Registration Program (PTSL) in Rumbai District, Pekanbaru City

Sociodemographic, Health, and Lifestyle-Related Characteristics Associated With the Commencement and Completion of a Web-Based Lifestyle Educational Program for People With Multiple Sclerosis: Randomized Controlled Trial.

Digital health interventions increase access to multiple sclerosis (MS)-related knowledge for people living with MS; however, our understanding of factors associated with engagement in web-based learning is limited. This study aims to examine associations between participant sociodemographic, health, and lifestyle-related characteristics and the commencement and completion of the Multiple Sclerosis Online Course (MSOC) in a randomized controlled trial (RCT). An intervention course was developed based on the Overcoming MS Program-an evidence-based lifestyle modification program for MS, and a standard care course was developed based on international MS website information. An RCT was conducted to compare the effectiveness of the intervention course versus the standard care course in improving health outcomes in people living with MS. Participant data were collected from a baseline survey. Associations between baseline participant characteristics and MSOC commencement and completion, respectively, were assessed using multivariate log-binomial regression. Overall, 1893 participants enrolled in the RCT, and 45.27% (n=857) completed the baseline survey: 23.5% (n=444) in the intervention course and 21.8% (n=413) in the standard care course. Of these 857 participants, 631 (73.6%) commenced the standard care course or intervention course, and 49.1% (218/444) and 54.2% (224/413) completed the intervention course and standard care course, respectively. University education, partnered relationship status, and higher mental and physical quality of life were associated with 19%, 12%, 20%, and 22% higher rates of course commencement, respectively. Clinically significant fatigue was associated with a 10% reduction in the likelihood of commencement. Strongest associations with intervention course completion included middle and older adulthood, male sex, fatigue, and preexisting adherence to a diet program, with 96%, 27%, 24%, and 19% higher rates of completion observed, respectively, whereas higher self-efficacy was associated with up to 35% lower intervention course completion. Associations with standard care course completion included practicing meditation (20% higher completion), whereas employment was associated with 22% lower completion. Sociodemographic and clinical factors, as well as lifestyle-related factors, were important factors in MSOC commencement and completion. These data may help guide the design and enhancement of digital health interventions tailored for people living with MS. Australian New Zealand Clinical Trials Registry ACTRN12621001605886; https://tinyurl.com/2vyve9p9. RR2-10.1186/s12883-023-03298-0.

Development of Extemporaneous Compounding as an Initiating Factor in the Transformation of Pharmaceutical Education: International Experience and Current Trends

INTRODUCTION. Currently, stakeholders across the Russian medical and pharmaceutical community are focusing on the restoration of national pharmaceutical compounding. The Russian pharmaceutical compounding market, with its great potential for growth, requires highly qualified professionals able to ensure the operation of compounding pharmacies and the proper quality of extemporaneous medicinal products. The effectiveness of training for such specialists can be improved by analysing the experience of educational institutions in countries with developed pharmaceutical compounding systems.AIM. This study aimed to analyse the distinguishing features of training for pharmaceutical compounding specialists, as well as determine the main trends in pharmaceutical compounding education in leading international academic institutions.MATERIALS AND METHODS. The study used methods of logical, comparative, structural, and content analysis. The analysis covered 106 pharmacy and pharmacology curricula of the top-25 higher education providers from the QS World University Rankings by Quacquarelli Symonds. The curricula were analysed using open data published online, particularly, on the official websites of the selected universities.RESULTS. The article presents the distinguishing features of pharmaceutical compounding education at different academic qualification levels; these features include the requirements for applicants, time to degree, competence standards, structure of exams, and specifics of students’ professional engagement, with consideration of the national context. The key trends in the education of specialists in pharmaceutical compounding include a decrease in training time for mid-level specialists; a tendency towards concentrating on clinical disciplines due to the expansion of the roles of pharmacy professionals; a growing focus on specialisation in the areas of paediatric, dental, sterile, veterinary, radiopharmaceutical, and orphan drug compounding; increasing use of simulated practice experiences and online learning technologies; and the development of continuing professional education systems.CONCLUSIONS. Pharmaceutical education programmes of leading international educational organisations include disciplines related to extemporaneous compounding. Current international trends—pharmaceutical education with further specialisation in extemporaneous compounding, integration of simulation technologies and online learning into the educational process, and development of continuing professional education—coincide with the development directions of pharmaceutical education in the Russian Federation. Whereas international pharmacy specialists complete additional professional education programmes to gain an additional specialisation in the extemporaneous preparation of paediatric medicinal products, sterile dosage forms, chemotherapy products, radiopharmaceuticals, veterinary products, and dental products, Russian specialists can acquire these additional competencies through further education programmes at the levels of advanced training and residency.

The impact of an online doctoral writing group

Abstract Challenges with writing have been identified as a key factor in the timely completion of PhD programs. Doctoral writing groups, where students provide peer feedback on drafts, are increasingly being implemented as a potential solution to support and develop student writing. This paper presents an exploration of the impact of an online doctoral writing group program at a large Australian university. The group supports students in writing a research article for publication in an academic journal and includes both facilitator-led instruction and peer feedback. We explored the group’s impact on the participants’ writing ability, feedback literacy, and general well-being. Data were drawn from two doctoral writing groups and derived from several sources: session transcripts, focus groups, anonymous surveys, student drafts, and published samples of students’ academic journal articles. We found that instruction was key to demystifying the writing process and developing feedback literacy. Furthermore, the online delivery mode provided access to support for cohorts traditionally excluded from these opportunities, as well as a safe space that fostered a sense of well-being. This approach suggests a sustainable and effective model for implementation in graduate programs.

Experimental and numerical study of aluminium alloy angle-section stub columns

This paper reports experimental and numerical studies on the behaviour and compression resistances of aluminium alloy angle-section stub columns. A testing programme was firstly carried out, including material coupon tests and stub column tests. Both equal-leg and unequal-leg angle-sections were considered in the testing programme. The member lengths of the angle-section stub column specimens were selected based on a preliminary elastic buckling analysis prior to testing, in which their predominant failure buckling mode was analytically found to be torsional buckling. The torsional buckling failure mode was also clearly observed in the testing programme, indicating that angle-section stub columns exhibit different failure mode from their hollow-section and T-section counterparts that are susceptible to local buckling. Upon completion of the testing programme, a numerical modelling programme was conducted, where finite-element models were developed and validated against the test results. The validated models were then adopted to conduct parametric studies to generate more numerical data. The obtained test and numerical data were used to perform a design analysis, where the relevant design rules in the European, American, Australian/New Zealand and Chinese standards were evaluated. The analysis results indicate that both the European and Australian/New Zealand standards result in conservative resistance predictions for angle-section stub columns with low and high torsional slendernesses. Meanwhile, they offer unsafe resistance predictions for some angle-section stub columns with intermediate torsional slendernesses. In contrast, the American and Chinese standards yield a high level of design conservatism over the full range of torsional slendernesses.

Outpatient Pediatric Palliative Care Development: Guidance on Building Sustainable Programs.

Context: As pediatric palliative care (PPC) expands within institutions and nationally, little guidance is available on building outpatient programs. Objectives: We asked outpatient PPC (OPPC) program leaders in the United States about clinic development experiences to gather advice for growing programs. Methods: As part of a larger OPPC study, 48 freestanding children's hospitals with inpatient PPC programs were invited to complete a survey on OPPC. Self-selected participants were sent a follow-up survey soliciting free-text responses about development experiences. Quantitative data were analyzed with descriptive statistics. Qualitative data underwent inductive content analysis. Results: Thirty-six hospitals completed the initial survey, and 28 (78%) reported practicing clinic-based OPPC. Twenty-two of 28 completed program development questions. More than half (12/22, 55%) recommended a minimum total billable full-time equivalent (FTE) ≥3 before expanding into the outpatient setting. About two-thirds (14/22, 64%) suggested a minimum billable FTE ≥4 for 24/7 coverage. Half (50%) reported that their program grew from subspecialty clinics, most frequently hematology-oncology (10/11, 91%). Half (50%) placed initial limits on referrals, with many restricting schedule availability (7/11, 64%). Six of 12 participants (50%) willing to share more about their development experience completed a follow-up survey, from which three themes emerged: program logistics, expectations and boundaries, and establishing role and workflow. Participants focused advice on slow programmatic growth to optimize sustainability. Conclusion: Program leaders offer tangible guidance informed by their OPPC development experience. Future work is needed to leverage this advice within institutions to promote resilient and sustainable PPC growth.

Impacts of Peer Support on Coping and Cortisol Levels for Women Affected by Domestic Violence and Coercive Control.

Gendered domestic violence and coercive control are prevalent public heath concerns in Canada with dire consequences for survivors. Peer support groups may address and reduce negative impacts of domestic violence and coercive control on women's stress, coping, safety, and alliances with social support network members, the focus of this study. A one-group, pre-test/post-test quasi-experimental study was undertaken to evaluate the effectiveness of Growth Circle, a 14-week peer support program offered at an agency serving women affected by domestic violence in a major western Canadian city. Through convenience sampling, women 18 years and older who experienced domestic violence were recruited and provided data on stress, coping, safety-related empowerment, and social support/alliances. Thirty-five participants provided all pre-test and post-test data, with a subsample of 14 providing repeated hair samples. Hair was employed to determine stress hormone (cortisol) levels. A significant reduction in self-reported levels of perceived stress and stress hormone levels following completion of the Growth Circle program was revealed. Participants also reported a significant increase in safety-related empowerment, and supportive alliances with group members. The Growth Circle peer support program was demonstrated to be effective. Further implementation and research into the Growth Circle program across Canada is recommended.

Does format matter? A naturalistic study of digital and provider-led cognitive behavioral therapy for insomnia implemented in a healthcare system

ABSTRACT Objectives Cognitive Behavioral Therapy for Insomnia (CBTi) is a first-line treatment for a prevalent and impairing disorder. Digital CBTi programs increase access to internet-based self-directed care. However, the clinical effect of offering different forms of CBTi in a healthcare setting is not clearly understood. This study examines treatment engagement and clinical outcomes for individuals referred to either digital or provider-led CBTi. Methods Over two years, providers at a Veterans Health Administration (VHA) facility referred patients to digital CBTi with telephone coaching support or traditional provider-led CBTi. Characteristics of those referred, proportions engaging in and completing treatment, as well as insomnia severity were compared among those referred to each format. Results Providers referred 139 individuals to digital CBTi, 340 to provider-led CBTi, and 14 to both formats. Individuals referred to digital CBTi were older with less severe insomnia. Despite lower levels of program engagement and completion in the digital CBTi cohort, measures of insomnia symptom change were similar between the groups. Conclusions This is the first study to evaluate both digital and provider-led evidence-based treatments for insomnia disorder simultaneously deployed in a healthcare setting. While engagement in digital CBTi lagged that for provider-led CBTi, offering both formats may expand access to different groups, while fostering similar outcomes.

Emergency Medicine Milestones Final Ratings Are Often Subpar.

The emergency medicine (EM) milestones are objective behaviors that are categorized into thematic domains called "subcompetencies" (eg, emergency stabilization). The scale for rating milestones is predicated on the assumption that a rating (level) of 1.0 corresponds to an incoming EM-1 resident and a rating of 4.0 is the "target rating" (albeit not an expectation) for a graduating resident. Our aim in this study was to determine the frequency with which graduating residents received the target milestone ratings. This retrospective, cross-sectional study was a secondary analysis of a dataset used in a prior study but was not reported previously. We analyzed milestone subcompetency ratings from April 25-June 24, 2022 for categorical EM residents in their final year of training. Ratings were dichotomized as meeting the expected level at the time of program completion (ratings of ≥3.5) and not meeting the expected level at the time of program completion (ratings of ≤3.0). We calculated the number of residents who did not achieve target ratings for each of the subcompetencies. In Spring 2022, of the 2,637 residents in the spring of their last year of training, 1,613 (61.2%) achieved a rating of ≥3.5 on every subcompetency and 1,024 (38.8%) failed to achieve that rating on at least one subcompetency. There were 250 residents (9.5%) who failed to achieve half of their expected subcompetency ratings and 105 (4.0%) who failed to achieve the expected rating (ie, rating was ≤3.0) on every subcompetency. When using an EM milestone rating threshold of 3.5, only 61.2% of physicians achieved the target ratings for program graduation; 4.0% of physicians failed to achieve target ratings for any milestone subcompetency; and 9.5% of physicians failed to achieve the target ratings for graduating residents in half of the subcompetencies.

Transformative impact of positive psychotherapy-based hope placement program on life goals and hope level of individuals with multiple sclerosis.

This study aimed to assess the impact of a positive psychotherapy-based hope placement program on life goal setting and hope levels in individuals diagnosed with multiple sclerosis (MS). A Solomon Four-Group experimental design was used, involving 50 individuals diagnosed with MS who sought treatment at a university hospital's neurology outpatient clinic. Experimental (1-2) and control (1-2) groups were randomized, and pretests were administered exclusively to the experimental and control groups. Data were collected using a Personal Information Form, the Herth Hope Scale, and the Scale for Determining Life Goals in the Context of Positive Psychotherapy. A 5-week/10-session Positive Psychotherapy-Based Hope Placement Program was conducted online for the Experimental groups. The research was conducted in the form of group therapy. Post-tests were administered to all groups upon program completion. The experimental 1-2 group exhibited statistically significant improvements in the Scale for Identifying Life Goals in the Context of Positive Psychotherapy and Herth Hope Scale scores (p<.05). The Positive Psychotherapy-Based Hope Placement Program effectively enhances hope levels and life goal setting for individuals diagnosed with MS. The results indicate that the program increased the sense of purpose in life and elevated levels of hope among MS patients. These findings suggest that positive psychotherapy-based interventions significantly improve the quality of life for MS patients. This study examines the impact of a Positive Psychotherapy-based hope placement program on determining hope and life purpose in patients with Multiple Sclerosis (MS). This research shows that HOPP (Hope Placement Program), an intervention based on Positive Psychotherapy, can significantly improve the quality of life of MS patients. These findings support the consideration of Positive Psychotherapy-based approaches as a potential therapeutic option that can positively influence the life experiences of MS patients. Therefore, this article makes an important contribution to researchers interested in using Positive Psychotherapy-based interventions in clinical practice and related research.

Factors in successful programme completion for postsecondary students with disabilities: A systematic review of the literature

Factors in successful programme completion for postsecondary students with disabilities: A systematic review of the literature

Readmission after discharge from a medium secure service between 1999 and 2017: A retrospective cohort study.

Previous research into outcomes after treatment in medium secure psychiatric hospitals has mostly relied on pre-millennium data. To examine patient and inpatient service-related factors associated with readmission within 2 years following discharge to the community or open conditions from conditions of medium security. A retrospective cohort study of 137 patients discharged either to the community or to open conditions from one 64-bed South Wales Regional Medium Secure Hospital Unit between July 1999 and November 2017 was completed using data from healthcare records to document demographics, diagnosis and nature of index offences together with researcher-completed ratings of inpatient progress using the Dangerousness Understanding Recovery and Urgency Manual (DUNDRUM) Programme Completion and DUNDRUM Recovery scales. Binary logistic regression analyses were used to identify independent associations between inpatient progress according to these measures and readmission. Forty-three patients (31%) were readmitted within 2years of discharge and 23 (17%) in breach of legal conditions on discharge. Most readmitted patients (n=29, 67%) returned directly to medium secure care. There were significant binary level associations between readmission and severity of the index offences (lower), number of adverse childhood experiences (higher), history of drug misuse (more likely) and number of previous psychiatric admissions (higher). Binary logistic regression confirmed that these relationships were not independent. No inpatient service-related variables, according to DUNDRUM scale scores, showed an independent association with readmission within 2years post-discharge. The proportion of medium security hospital patients who were readmitted within 2years of discharge aligns with estimates found in earlier national research using the same follow-up period. Since levels of inpatient progress bore little if any relationship to longer term outcomes, our findings highlight the need for investigating factors in the discharge environment that are linked to readmission. It is possible that readmission may indicate effective monitoring and responsive care to the changing needs of patients, but a better understanding of this is essential.