Intensive Supervision Research Articles

Intensive Supervision Programs and Recidivism: How Michigan Successfully Targets High-Risk Offenders

The United States has witnessed enormous criminal justice system growth in the past 60 years. In response to calls for reform, several jurisdictions have implemented programs that provide intensive supervision for high-risk offenders, swiftly responding to violations with sanctions. This quasi-experimental study is the first comprehensive analysis of Michigan’s Swift and Sure Sanctions Probation Program (SSSPP), an alternative-to-incarceration program. The findings indicate that SSSPP participants had lower recidivism rates compared with individuals sentenced to probation-as-usual. Policy implications and suggestions for future research are offered.

The Impact of the Safe and Successful Youth Initiative (SSYI) on City-Level Youth Crime Victimization Rates

Background: The physical, emotional, and financial costs resulting from youth violence are well documented.
 Purpose: This article summarizes the results of a quasi-experimental evaluation study to test a youth violence intervention program in eleven cities in Massachusetts.
 Setting: In 2011, Massachusetts initiated the Safe and Successful Youth Initiative (SSYI), which provides a comprehensive public health approach for young men believed to be at “proven risk” for being involved with firearms.
 Intervention: The SSYI program components include: (1) Specific identification of young men, ages 14-24, at highest risk for being involved in firearms violence; (2) Use of street outreach workers to find these young men, assess their needs, and act as brokers for services; (3) The provision of a continuum of comprehensive services including education, employment, and intensive supervision. Eleven cities with the highest count of violent offenses reported to the police in 2010 were selected for SSYI funding in 2011 and began implementing the program.
 Research Design: Short-interrupted time series design with a comparison group. The observed and predicted trends in monthly violent victimization rates for the 11 SSYI cities were compared to the next 23 cities (as they ranked in reported violent crime in 2010).
 Data Collection and Analysis: Using police incident data, researchers examined SSYI's impact on monthly city level violent crime, aggravated assault and homicide rates for persons ages 14-24. 
 Findings: Results indicated that SSYI had a statistically significant and positive impact on reducing the number of victims of violent crimes, aggravated assaults, and homicides per month that were reported to the police. A city with SSYI has approximately 60 fewer victims of violence each year, ages 14-24, per 100,000 citizens over the post-intervention period.
 Keywords: quasi-experiment; interrupted time series; crime prevention; violence; Massachusetts

SOCIAL AND PSYCHOLOGICAL FACTORS ASSOCIATED WITH THE PHENOMENON OF MORAL CHAOS TO STAGE TEENS A FIELD STUDY AT THE SECONDARY SCHOOL STUDENTS

the phenomenon of moral mess adolescents phase of Secondary Education the product of many of the effects of the social, psychological and physical infrastructure of social variables. The study aims to identify the most important social variables, and physical infrastructure which affect the phenomenon of moral mess and identify the most important manifestations of the moral mess in adolescence on environmental factors that helped to spread the moral mess, as well as to identify the social factors that led to the spread of moral mess in adolescence, family upbringing, relatives, friends, identify external factors (the mechanisms of globalization), which helped in the spread of moral mess in the levels of adolescence. And economic factors that led to the spread of moral mess .with identify the differences between males and females in adolescence toward the phenomenon of moral mess. Where the study sample of (403) single sample of secondary schools, Ain Shams, educational, distributed as follows: (250 males and 153 females. Of the students in the secondary schools and the region. The study on a social survey sample, a group of students in the secondary stage. In the collection of data used, Researcher (direction) to know what attitudes toward the claim of social justice. Then the researcher adopted on the analysis of the content of the standard moral mess, study has to several results; there are no differences between males and females in the interpretation of the phenomenon of moral mess, the design of training programs for parents to help them on how to control of anger outbursts of violence with the statement of the most important methods of sound upbringing, non-violent to reduce the possibilities of attacking their children to physical or verbal or psychologically. Programs and psychological care list to play would have the opportunity to express their feelings to get rid of the negative phenomena with the consolidation of the students who suffer familiae*with students have the skills of strong social to attract them to participate in the fun activities and positive in order to learn of them these how to establish relations of positive interaction with others*intensive supervision on students in times prayer and the illegal activities including classroom supplies and urged them to cooperate and altruism and tolerance

Health promotion in Fiji: Is it feasible in the emergency department?

Complications of diabetes, hypertension and asthma are commonly seen in EDs in Fiji. Time spent in the ED offers an opportunity for health promotion activities. The aim of the intervention was to provide information on diabetes, hypertension and asthma to patients in the ED. The aim of the project was to determine whether such an intervention could be implemented using public health students. The aim of this paper is to document the experiences of those who delivered and supervised the intervention. This pilot project took place in the Colonial War Memorial Hospital, Suva, in August-October 2015. Patient suitability was assessed by the supervising emergency physician. Patients were invited to receive a 10-min information session relating to asthma, hypertension or diabetes. Once the project had concluded, the students and supervisor were given a questionnaire, requiring them to reflect on their experiences of the project. Data was analysed using an inductive approach with thematic content analysis. Students required intensive coaching to gain the skills and confidence to deliver the intervention. The intervention was well received by patients, whose knowledge of hypertension, diabetes and asthma was poor. Health literacy among patients in Fiji is low and measures to address this must be taken. Intensive training and supervision is required for public health students to be able to deliver such activities in the ED setting.

Tooth brushing motion patterns with manual and powered toothbrushes-a randomised video observation study.

Systematic reviews have shown that powered toothbrushes (PTs) are more effective than manual toothbrushes (MTs), but with only minor effect sizes. Whether PTs are used adequately, however, has not been investigated so far. The aim of the present study was therefore to analyse motion habits with PT in comparison to MT toothbrushes by video observation. One hundred subjects were enrolled in this observational trial and brushed their teeth in randomised order with a MT and PT while being video-filmed, resulting in 95 analysable sets of recordings. Parameters of interest were brushing duration (s; median (min;max)), type of brushing strokes, area of brushing, changes between areas (n; median (min;max)) and brushing sequence. Brushing duration was 145s (60;354) and 135s (48;271) for PT and MT, respectively (p≤0.001). Subjects brushed vestibular surfaces completely, but reached oral surfaces to a much lesser extent, regardless of the toothbrush type. With both toothbrushes, subjects moved frequently between areas (MT 35 (14;79); PT 33 (14;85); n.s.) and brushed predominantly with circling and horizontal strokes; with the PT, 50.5% of the subjects spent only <10% of the brushing duration with passive brushing (positioning the brush head on the teeth with ≤2 movements/s). Intra-individual motion patterns were similar with both MT and PT, and most subjects persisted in their habitual motion patterns regardless of the toothbrush type. The use of PT and MT may need intensive training and supervision from oral hygiene educators in order to help subjects taking full advantage from these devices.

Evaluation of rational prescribing and dispensing of medicines in Mali

Objective: The drug policy of Mali is based on the concept of essential generic drugs. The adoption of generic drugs in a program is often accompanied by irrational use of these drugs precisely because of the availability of these drugs. Thus, this study was initiated to assess the quality of prescribing and dispensing drugs in Mali. Methods: This is a descriptive cross-sectional study was conducted from 2004 to 2013, the survey was conducted in 20 primary health centers and 20 private pharmacies in three regions of the country. In each of these structures, 30 prescriptions filled at the time of the survey were collected. Results: The average number of drugs per prescription was 3.0 ± 1.3 and 2.4 ± 1.2, respectively, in the public and private sectors. Prescription of drugs under international name was 91.6% in the public sector and 37.2% in the private sector. The public sector prescribed 33.7% of injectable drug against 16.2% in the private sector (p &lt;0.001). The average cost of a prescription was lower in the public sector (3415.3 FCFA or 5.21euros) than in the private sector (7111 FCFA or 10.85 euros).Conclusion: Generic drugs are commonly used in the public, but much less in the private sector. The treatment guidelines are already available, should be introduced interactively to medical practitioners, through visits and intensive supervision by more experienced managers in the hierarchy, it would be likely to improve the quality of prescribing practitioners.

The ‘Sleepiness’ of George Sarawia: The Impact of Disease on the Melanesian Mission at Mota, c. 1870–1900

ABSTRACTGeorge Sarawia, ordained in 1873 as the Melanesian Mission’s first Indigenous priest, was a pioneering figure in the mission’s plans for an Indigenous-led Anglican Church in the region. Sarawia founded Kohimarama, a mission station on Mota in the Banks Islands, Vanuatu, where he taught Mota Islanders and hosted visiting teachers and clergy. By the 1890s, some of the European missionaries had become critical of Sarawia and his flock on Mota, underlining their ‘natural, sleepy condition’ and recommending more intensive European supervision. This article will explore the role of epidemic and endemic disease, as well as the shortage of water on Mota, in creating substantial challenges for Sarawia and his mission. As he grew more incapacitated in later life, these challenges were insufficiently acknowledged by Sarawia’s critics.

Forensic Psychiatric Patients with Comorbid Psychopathy: Double Trouble?

ABSTRACTPatients with psychopathy need intensive care and supervision. There is however reluctance to treat them because of (supposedly) limted chances of success and risk of therapy-interfering behavior. This study focused on inpatient disruptive behavior in mentally disordered offenders during medium security treatment. Patients (N = 224) were assessed using the Psychopathy Checklist-Revised total, factor and facet scores and divided into three groups depending on the presence of low, medium, and high psychopathy traits. Associations between psychopathy and criminogenic risk and need factors were analyzed. Additionally, the association between psychopathy and therapy-interfering behavior (non-compliance, drop-out, institutional misconduct) was investigated with correlational and logistic regression analyses. The results showed that psychopathy was associated with greater risk, needs, and therapy-interfering behavior. PCL-R Factor 2 predicted institutional misconduct, whereas PCL-R Factor 1 predicted drop-out from treatment. The study highlights the importance of responsive treatment climates in retaining this difficult-to-treat group in treatment.

Discrepancies between perceptions of students and deans regarding the consequences of restricting students\u2019 use of electronic medical records on quality of medical education

BackgroundElectronic medical records (EMR) are more used in university hospitals, but the use of EMR by medical students at the workplace is still a challenge, because the conflict of interest between medical accountability for hospitals and quality of medical education programs for students. Therefore, this study investigates the use of EMR from the perspective of medical school deans and students, and determines their perceptions and concerns about consequences of restricted use of EMR by students on quality of education and patient care.MethodsWe administered a large-scale survey about the existence of EMR, existing policies, students’ use for learning, and consequences on patient care to 42 deans and 789 Residency Physician Applicants in a private university in Colombia. Data from 26 deans and 442 former graduated students were compared with independent t tests and chi square tests.ResultsOnly half of medical schools had learning programs and policies about the use of EMR by students. Deans did not realize that students have less access to EMR than to paper-based MR. Perceptions of non-curricular learning opportunities how to write in (E)MR were significantly different between deans and students. Limiting students use of EMR has negative consequences on medical education, according to both deans and students, while deans worried significantly more about impact on patient care than students. Billing issues and liability aspects were their major concerns.ConclusionsThere is a need for a clear policy and educational program on the use of EMR by students. Discrepancies between the planned curriculum by deans and the real clinical learning environment as experienced by students indicate suboptimal learning opportunities for students. Creating powerful workplace-learning experiences and resolving concerns on students use of EMR has to be resolved in a constructive collaboration way between the involved stakeholders, including also EMR designers and hospital administrators. We recommend intense supervision of students’ work in EMR to take full advantage of the technological advances of EMR at the modern clinical site, both for patient care and for medical education.

Examining the Effects of Intensive Supervision and Aftercare Programs for At-Risk Youth: A Systematic Review and Meta-Analysis.

Community correctional sentences are administered to more juvenile offenders in North America than any other judicial sentence. Particularly prominent in juvenile corrections is intensive supervision probation and aftercare/reentry, yet the effects of these supervision-oriented interventions on recidivism are mixed. The purpose of this meta-analysis is to determine the effects of intensive supervision probation and aftercare/reentry on juvenile recidivism. An extensive search of the literature and application of strict inclusion criteria resulted in the selection of 27 studies that contributed 55 individual effect sizes. Studies were pooled based on intervention type (intensive supervision probation or aftercare/reentry) and outcome measure (alleged or convicted offenses). The pooled analyses yielded contradictory results with respect to outcome measure; in both cases, supervision had a beneficial effect on alleged offenses and negatively affected convicted offenses. These patterns across intervention type and outcome measure, as well as recommendations for future research, are discussed.

Education Status of the Farmer and the Probability of Getting Extension Service: An Endeavour Toward the Sustainable Agriculture in Bangladesh

The study measures the probability of receiving agricultural extension services with respect to the level of farmers’ rudimentary literacy, primary and secondary level of education, by utilizing survey data from 18 Unions in three agro-ecological regions of Northern Bangladesh. The econometric analysis is based on the application of qualitative response approach, the Logit model, explaining the probability of the educated farmers’ agricultural extension contact for improving their knowledge regarding input utilization and resource allocation decision. Application and utilization of farm inputs, involved in modern agriculture, such as chemical fertilizer, pesticide, irrigation, mechanized power tillers etc, requires intensive supervision, understandings, awareness and overall technological training supplied by the agricultural extension services. The study, therefore, reveals that the farmers with comparatively higher level of education generally keep a frequent contact with the agriculture extension service center for the betterment of their yield and the conservation of their fixed inputs like land and water than the other farmers possessing a lower level of educational status. Therefore, efforts to raise farmers’ educational status are expected to boost up productivity accruing from an environment friendly modern agriculture.

Discovery and Validation of Immunological Biomarkers in Milk for Health Monitoring of Dairy Cows - Results from a Multiomics Approach

At onset of milk production and in early lactation highly producing dairy cows are most susceptible for inflammatory diseases due to functional suppression of immune cells. Intensive supervision of the animals is essential and implementation of new technologies to on-farm routines will be the next step to provide automation and improvement of herd health monitoring programs. Objective of our study was to identify and validate immunological biomarkers in milk that indicate extra-mammary inflammatory diseases to characterize the general health status of highly-producing dairy cows. In total 89 healthy and 75 diseased animals (German Holstein cows) were included. Diseases were distinguished by either systemic (extra-mammary) occurrence or those affecting the mammary gland (mastitis) and further classified by their severity. For protein biomarker discovery we used a top-down approach to narrow down a broad range of secreted gene products of the milk cell transcriptome (microarray) and proteome to a few promising candidates which were validated using real-time PCR and ELISA. The most promising biomarker candidates were statistically evaluated. Receiver operating characteristic analysis revealed haptoglobin, secretory component, lactoferrin and vascular endothelial growth factor showing the highest discriminatory capability for diseased vs. healthy cows. Values for sensitivity at a specificity of 94% were 82% for haptoglobin, 59% for secretory component, 55% for lactoferrin and 67% for vascular endothelial growth factor. Statistical evaluation by multinomial logistic regression and k-nearest neighbor method confirmed haptoglobin as the best single-use biomarker. In combination with secretory component or lactoferrin an increase in overall sensitivity or specificity, depending on the classification method, could be achieved. The application of the validated health biomarkers in combination with an easy high-throughput detection system would offer a solution to adapt dairy herd management to changing requirements on animal welfare, farming efficiency, milk supply, and food safety in modern agriculture.

KAJIAN LINGKUNGAN HIDUP STRATEGIS KAWASAN PERUNTUKAN PERTAMBANGAN DI KABUPATEN BOLAANG MONGONDOW

This qualitative study was analyzed using semi-detailed method is based on the assessment of data and information that is more accurate, can be quantitative. Primary data was collected through interviews with the stakeholders starting from the government officials, the academics and community leaders to get information about important issues emerging in Bolaang Mongondow. Secondary data collected from various government agencies and institutions or personnel associated with the research. The results showed that the mining activities in BolaangMongondow both for exploration and exploitation cause negative impacts by 50%. Starting from the conversion of land that have growing increasingly by time which can certainly bring problems in the future. The implication of uncontrolled agricultural land conversion can threaten food supply capacity and even in the long term can cause social harm. The mining activities, plantation and cultivation will lead to fragmentation of forest landscapes. Forest fragmentation will cause the forest to be smaller in which to live for animals and resulted in less food available for wildlife. There are 6 rivers in Bolaang Mongondow indicated that some parameters that are already above the value of standard quality. They are River Toraut located in the Sub-district of West Dumoga, Totabuan River, Tombolango River located in the Lolak Sub-district, upstream and downstream sections of Wineru River and Nonapan River located in Poigar Sub-District. In addition, natural disasters often occur in Bolaang Mongondow including floods and landslides. This natural disaster resulted in tremendous losses for the community. This study concludes that need to enactment of Regions to regulate mining activities in the area. And also there are should be intensive supervision from the institution concerned. The most important thing is also necessary accomplishment of an alternative control strategies are based on community participation.

Routine Vaccination Coverage in Northern Nigeria: Results from 40 District-Level Cluster Surveys, 2014-2015.

BackgroundDespite recent success towards controlling poliovirus transmission, Nigeria has struggled to achieve uniformly high routine vaccination coverage. A lack of reliable vaccination coverage data at the operational level makes it challenging to target program improvement. To reliably estimate vaccination coverage, we conducted district-level vaccine coverage surveys using a pre-existing infrastructure of polio technical staff in northern Nigeria.MethodsHousehold-level cluster surveys were conducted in 40 polio high risk districts of Nigeria during 2014–2015. Global positioning system technology and intensive supervision by a pool of qualified technical staff were used to ensure high survey quality. Vaccination status of children aged 12–23 months was documented based on vaccination card or caretaker’s recall. District-level coverage estimates were calculated using survey methods.ResultsData from 7,815 children across 40 districts were analyzed. District-level coverage with the third dose of diphtheria-pertussis-tetanus vaccine (DPT3) ranged widely from 1–63%, with all districts having DPT3 coverage below the target of 80%. Median coverage across all districts for each of eight vaccine doses (1 Bacille Calmette-Guérin dose, 3 DPT doses, 3 oral poliovirus vaccine doses, and 1 measles vaccine dose) was <50%. DPT3 coverage by survey was substantially lower (range: 28%–139%) than the 2013 administrative coverage reported among children aged <12 months. Common reported reasons for non-vaccination included lack of knowledge about vaccines and vaccination services (50%) and factors related to access to routine immunization services (15%).ConclusionsSurvey results highlighted vaccine coverage gaps that were systematically underestimated by administrative reporting across 40 polio high risk districts in northern Nigeria. Given the limitations of administrative coverage data, our approach to conducting quality district-level coverage surveys and providing data to assess and remediate issues contributing to poor vaccination coverage could serve as an example in countries with sub-optimal vaccination coverage, similar to Nigeria.

Child Sexual Abuse and Exploitation: Knowledge, Confidence and Training within a Contemporary UK Social Work Practice and Policy Context

In 2014, research was undertaken to examine social workers’ confidence, understanding and awareness of child sexual abuse (CSA) as it was suggested that a decline in numbers of reported incidents might be due to a decline in levels of understanding and awareness. Semi-structured interviews were conducted with twenty-five first-line, middle and senior managers and two chairs of local safeguarding boards across six local authorities in England. Focus groups were conducted with fifty-four social workers. Key themes revealed a complex array of issues, ranging from the diverse forms of CSA and exploitation that social workers are required to address, the variable support and training available, and the inter-disciplinary nature of much of the work. Although social workers undertake this important work with a strong sense of commitment and concern for children, they face a number of challenges. Paradoxically, whilst their work on these cases is the source of intense scrutiny, the training, support and supervision, and role clarity required to undertake this work well are often overlooked. The aim of this paper is to discuss the research findings and to identify implications for social work practice, training, multi-agency work and future research.

Better at Home than in Prison? The Effects of Electronic Monitoring on Recidivism in France

Many countries have recently adopted electronic monitoring (EM) as an alternative sentence in order to reduce incarceration while maintaining public safety. However, the empirical evidence on the effects of EM on recidivism (relative to prison) is very scarce worldwide. In this paper, we adress this debated question using quasi-experimental data from France. Our empirical strategy exploits the incremental roll-in of electronic monitoring in France, which started as a local experiment in four courts in 2000-2001, and was later adopted by more and more courts (2002-2003). Our IV estimates show that fully converting prison sentences into electronic monitoring has long-lasting beneficial effects on recidivism, with estimated reductions in probability of reconviction of 6-7 percentage points (9-11%) after five years. There is also evidence that, in case of recidivism, EM leads to less serious offenses compared to prison. These beneficial effects are particularly strong on electronically monitored offenders who received control visits at home from correctional officers, were obliged to work while under EM, and had already experienced prison before. This pattern suggests that both rehabilitation and deterrence are important factors in reducing long-term recidivism, and that electronic monitoring can be a very cost-effective alternative to short prison sentences. However, the massive development of EM in France in recent years, with shorter and less intensive supervision, may reduce its effectiveness.

Decreased re-conviction rates of DUI offenders with intensive supervision and home confinement

ABSTRACTBackground: In some jurisdictions, persons who are convicted of driving under the influence of alcohol (DUI) are allowed to serve some portion of their prison sentence under home confinement as part of Intensive Supervision Programs (ISPs) which include pre-release psycho-education and close post-release supervision. Objectives: Test the hypothesis that persons convicted of DUI offenses who have spent some portion of their sentence under home confinement, as compared to a historical comparison group, will exhibit a relatively low re-conviction rate. Methods: Using administrative data for 1,410 repeat DUI offenders (302 members of the historical comparison group, 948 ISP members, and 160 persons who appear in both groups at different points in time), with a follow-up period of up to 3 years and 10 months, a marginal Cox model was employed to compare conviction rates of persons who experienced intensive supervision and home confinement with historical comparison group members. Results: Persons with ISP + home confinement experience a re-conviction rate that is less than half that observed in the comparison group. Age, ethnicity (white vs. non-white), and gender are also significant predictors of re-conviction. Conclusion: Home confinement, in conjunction with psycho-education and other program elements, is one means of reducing the costs of incarceration. The results of this study suggest that, in addition to cost savings, states may realize a public safety benefit in the form of a reduction in DUI offense rates.

AVALIAÇÃO DA ROTULAGEM DE LEITES UAT COMERCIALIZADOS POR ESTABELECIMENTOS VAREJISTAS NO MUNICÍPIO DO RIO DE JANEIRO – RJ

Labels are consumer’s information and when they are well presented allow choices to be made more thoroughly. The access to information must meet the requirements of laws and encourages investments by industries to improve the nutritional profile of products. The accuracy of the information presented by the food label should be guaranteed in order that the label supports consumers in their choices and health professionals in guidance for diet composition. Thus, a label that meets the requirements of the laws, which bring information legible, clear and reliable is essential in foods. The present study aimed to evaluate the compliance of the labeling of 46 different samples of UHT milk sold in the city of Rio de Janeiro – RJ, Brazil compared to current legislation. Products labels were evaluated in their entirety both the main display and the secondary display in accordance with Brazilian law requirements and constant legal specifications. None of the samples showed the label completely in accordance with the laws in force, demonstrating the necessity of the existence of a more intense supervision to ensure that the information on the labels are easily visible, reliable and enlightening.

Experience of clinical supervisors of international medical graduates in an Australian district hospital.

Objective Herein we record the experience of clinical supervisors of international medical graduates (IMGs) working as junior staff in a district hospital by examining supervisor perspectives on IMG performance, the factors affecting their performance and the requirements of supervision under these circumstances. Methods The present study had an open-ended exploratory qualitative design. Thirteen 13 open-ended, in-depth interviews were undertaken with supervisors of IMGs employed in a public district hospital in Queensland, Australia. Results The supervisors reported that, although performance was an individual and variable characteristic, IMGs tended to perform less well than Australian graduates and required more intensive supervision. Factors that affected performance were motivation and experience, and specifically lack of familiarity with the Australian healthcare system, lack of recent of practice, education, language, communication and cultural factors. English language proficiency was regarded as crucial to performance. Conclusions The additional work required to supervise IMGs in order to enable them to perform at a satisfactory level and successfully integrate into the Australian healthcare system needs to be recognised and resourced. Assistance with attaining proficiency in English and with communication skills over and above the standard required to pass the International English Language Testing System examination should be seriously considered as a means of improving performance. What is known about the topic? To date, there is little research available about the experience of supervisors of IMGs in Australia. What does this paper add? The findings of the present study make an important contribution to the literature by examining the critical role clinical supervisors of IMGs have in helping IMGs adapt to the Australian healthcare system and ensuring that they are able to provide quality health care. It identifies current challenges and highlights areas in need of attention to ensure a strong healthcare system for Australia. What are the implications for practitioners? Supervisors of IMGs need recognition of the extra time and expertise required in their role if they are to be effectively supported in their endeavours to integrate IMGs into the Australian health workforce. More attention needs to be given to the development of English language proficiency of IMGs, including colloquial usage, and communication in medical practice.

Early Active Mobilization Rehabilitation Protocol After Flexor Tendon Repair in Zone II of the Hand

Background: Achieving best outcomes for flexor tendon injuries in zone II of the hand remains a challenge to hand therapists and surgeons. With advances in the understanding of flexor tendon biomechanics and the development of multistrand core suture repair techniques, there has been a trend toward early active mobilization protocols post flexor tendon repair in zone II of the hand. Early active mobilization has been shown to minimize adhesion formation and increase repair strength. Many publications have also reported good outcomes when repaired flexor tendons in zone II were actively mobilized at an earlier stage. Objective: This systematic review seeks to identify an optimal early active mobilization protocol that brings about the best outcomes post flexor tendon zone II repair. Materials and Methods: PubMed, ScienceDirect, and Cochrane Library databases were searched to locate articles published from 1980 to February 2016. English studies that were included involved adult participants who (1) sustained flexor tendon injury to zone II of the hand, (2) had surgical repair done, and (3) underwent early active mobilization rehabilitation which was defined as any form of active digital flexion exercises within the first 4 weeks post repair, including place and hold. Studies that involved the thumb or lack details on the repair technique, rehabilitation protocol, and clinical outcomes were excluded. The primary outcomes were rupture rates and range of motion. In addition, surgical techniques, splint designs, therapy exercises, and regimes were also examined to identify the optimal early active mobilization rehabilitation protocol. Results: One hundred twelve articles were identified. Twelve studies met the inclusion criteria, with evidence ranging from level I to level IV. The rupture rates compared with number of core strand sutures were lowest with 6-strand repair (1.0%) compared with 4 (2.5%) and 2 (9.6%) strand repair. With a postoperative orthosis placing the wrist in neutral position, the rupture rate was low (2.7%) and had the highest excellent to good range of motion (90.6%) according to the original Strickland criteria. During the first 4 weeks of postoperative rehabilitation, a combination of high therapy frequency (daily to once a week) and low daily repetitions of active finger flexion exercises (not more than 2 repetitions per hour) involving active fisting, place and hold and synergistic wrist motion were shown to contribute to low rupture rates (&lt;5%) and excellent range of motion (&gt;85%) according to the original Strickland criteria. Conclusions: The optimal early active mobilization protocol is one that is used on flexor repairs with 4-strand core sutures and above, and a postrepair orthosis that puts the wrist in neutral position. With the integration of intensive therapist supervision and hourly low frequency active mobilization exercise program, this protocol can potentially improve the outcomes of flexor tendon repair in zone II.