Occupational Therapy Assistant Research Articles

REHABILITATION IN NEPHROLOGY: HISTORY, CURRENT STATE, PROSPECTS

Rehabilitation assistance at healthcare institutions is a comprehensive package of measures designed to enhance the functional abilities of individuals who experience or may potentially experience limitations in their daily functioning within their surrounding environment. Nephrology is a branch of medical science that studies the etiology and pathogenesis of kidney damage, develops and improves diagnostic methods, treatments, and prevention strategies for congenital and acquired primary and secondary kidney damage at all stages of development. Pediatric urological disorders remain a signifi cant concern due to their high prevalence among children. Chronic kidney disease (CKD) is a particularly worrisome complication, as it is characterized by a relapsing nature and the potential for severe complications. The current system of healthcare is regarded as a costly branch of medical services, with expenditures on therapeutic and rehabilitative care (inpatient and outpatient stages) constituting a signifi cant proportion of the overall costs.The article presents the results of an analysis and a summary of the recommendations set forth in international and Ukrainian medicaltechnologicaldocuments based on evidence- based medicine with regard to rehabilitation care in pediatric nephrology. The methodology for establishing a clinical and rehabilitation patient pathway, comprising an individual rehabilitation patient plan, is presented. This pathway considers the most common urinary diseases among children at the hospital district level. The scientifi c research was conducted within the scientifi c focus of the Department of Pediatrics, Neonatology and Perinatal Medicine of Bukovinian State Medical University and the research project entitled «Chronobiological and Adaptive Aspects and Features ofAutonomic Regulation in Pathological Conditions in Children of Diff erent Age Groups.» The registration number is 0122U002245, and the project will run from January 1, 2022, to December 31, 2026.

Intelligent rehabilitation assistant: Application of deep learning methods in sports injury recovery

In recent years, sports injury rehabilitation has developed into a specialized field that has forced the combination of an orthopedic surgeon, sports physiotherapist, and sports physician. Determining the appropriate time for an injured athlete to resume practice or competition is regarded as sports rehabilitation. Discovering the best solutions to avoid injuries, maximize recovery, and enhance performance is crucial for sports activities. The study introduced an intelligent rehabilitation assistant (IRA) that leverages advanced deep learning (DL) methods to enhance sports injury recovery. In this study, the IRA incorporates redefined prairie dog optimized bidirectional long-short-term memory (RPDO-Bi-LSTM) to enhance accuracy, predicting sports injury recovery. The study collected data on the state of rehabilitation, physiological parameters, and general health using wearable sensors and movement patterns. The data was preprocessed using a median filter to remove noise from sensor data. Region-based segmentation using segmented images from preprocessed data. Convolutional neural networks (CNN) using extracted features from obtained data. The IRA provides personalized recovery plans and real-time feedback. The framework consists of the components, suggested models to create quality scores for motions, measurements to quantify motion performance, and scoring of performance measurement elements into numerical quality scores. The proposed method is implemented using Python software. RPDO-Bi-LSTM presentation is evaluated by various metrics, such as accuracy 94.2% recall 98.2%, precision 96.5%, and specificity 95.2%, f1 score 95.6%, he planned technique attained good performance and improved the accuracy of sports injury recovery.

Predictive Factors of State Licensure Board Disciplinary Actions in Occupational Therapy.

One primary function of occupational therapy state licensure boards (SLBs) is the discipline of ethical misconduct by licensed occupational therapy practitioners. However, SLB sanctioning is poorly understood by practitioners, regulators, and the public. To identify predictors of occupational therapy practitioner sanctioning outcomes in the United States. Retrospective study; all public final consent orders and database entries provided online by SLBs were analyzed. Supervised gradient boosting machine learning, logistic regression, and contingency tables were used to generate odds ratios for variables associated with each sanctioning outcome. Multinomial testing was used to identify attribute overrepresentation among cases and national practitioner distributions. A total of 2,400 cases were analyzed across 47 states and Washington, DC. None. Numerous complaint and respondent attribute variables were collected from final consent orders and database entries. Complaint reason, practice setting, and complaint source had the highest influence on predicting sanction outcome; geographic region, number of complaints in a given case, and length of investigation in months were secondarily influential. Being male or a certified occupational therapy assistant was associated with higher odds of severe sanctioning outcomes. Disciplinary actions against occupational therapy practitioners were determined by numerous contextual factors; however, the most influential factors were complaint reason, practice setting, and complaint source. These results provide direction for exploring factors that predict sanctioning outcomes in the United States and also provide occupational therapy practitioners and SLBs a basis of applied outcomes that may improve implementation and education regarding clinical practice ethics. Plain-Language Summary: Occupational therapy state licensure boards (SLBs) are responsible for disciplining licensed occupational therapy practitioners for ethical misconduct. SLB sanctioning is poorly understood by practitioners, regulators, and the public. In this study, we identify the factors that predict the sanctioning outcomes of occupational therapy practitioners. The results may help state regulators, educators, and national associations more effectively act in a way that protects the public faith in occupational therapy services by providing contextualized information on practitioner behaviors that result in specific sanctioning outcomes. The study findings also provide occupational therapy practitioners and SLBs a basis of applied outcomes that may improve the implementation of and education regarding clinical practice ethics.

Реабілітація: історія формування, сучасна стратегія розвитку

The history and defined stages of the formation and development of rehabilitation care from the 19th century have been studied. to modern times. The formation of the methodology for the organization of rehabilitation assistance in national health care systems is shown. The logistics of the WHO’s initiatives regarding the recognition of rehabilitation assistance as the main direction of the development of medical service delivery systems have been studied. What is connected with the provision of human rights in the field of health, the achievement of health for all. The role of national governments, the responsibility of communities and the importance of primary medical care in ensuring the availability of rehabilitation care are shown. The main provisions of the WHO documents on the problem of rehabilitation are presented.

Research on the Design of Lower Extremity Rehabilitation Assistive Devices Based on User Experience

With the aggravation of social aging, patients with lower extremity movement disorders are also increasing year by year. The elderly with lower extremity movement disorders have their own characteristics in physiology, psychology and behavior. Firstly, this paper analyzes the research and development status of lower extremity rehabilitation assistive devices by data analysis and induction. Secondly, the physiological, behavioral and psychological characteristics of the elderly were analyzed through interviews and observation to understand the use of lower extremity assistive devices, and in-depth analysis was made on user needs and product pain points. Based on this analysis, this paper puts forward the design principles and elements based on the theoretical basis of user experience elements, increases the humanized design of lower extremity rehabilitation assistive devices, improves the safety and interest of products, and enhances user experience.

Socio-demographic portrait of the applicant and the main motives for choosing the "Therapy and rehabilitation" speciality

Rehabilitation and psychological support are becoming today's most urgent issues due to russian armed aggression. These needs will be long-lasting and increasingly significant. Since 2023, the Program of Medical Guarantees in Ukraine has been expanded regarding rehabilitation assistance. Additionally, volumes of the state-commissioned training of bachelors and masters in the speciality of "Therapy and rehabilitation" have been increased. It is well known that the quality of specialists trained by higher educational institutions largely depends on the motives behind the career choice. Knowledge about a student's socio-demographic status and his/her motivations to become a physical therapy and occupational therapy specialist can help understand future challenges and opportunities for the profession's development. This information can aid in elaborating strategies to promote the profession in the educational services market and to attract more applicants to choose the speciality 227 "Therapy and rehabilitation". The research aimed to compose the socio-demographic characteristics of the applicant for training in the speciality 227 "Therapy and rehabilitation", to investigate the motivational aspects of career choice and to establish the factors significant for motivation formation. To achieve this goal, a voluntary anonymous survey of 39 domestic applicants enrolled to complete the bachelor's degree program in speciality 227 "Therapy and rehabilitation" at Dnipro State Medical University was conducted. It was determined that the contingent of applicants is represented mainly by persons aged 16-18 (74%) with an active life position (90%). Additionally, most are familiar with the specifics of medical professions (62%) and have had previous personal or professional contact with physical therapy and occupational therapy (78%). The future career decision was mostly independent (84%), conscious, and influenced by the balance of internal and external motivational factors. It was typically made one to two years before taking degree course (72%). The primary motives for choosing the speciality 227 "Therapy and rehabilitation" while understanding its demand in today's conditions by applicants (82%) were "interest in medical science" (95%), "the desire to help others" (95%), "the opportunity to obtain a prestigious profession" (90%), "possibility of guaranteed employment" (90%) and "material interest/financial independence" (87%). Future specialists are aware of the importance of controlled acquisition of knowledge and skills (90%), the need for daily independent work (80%), and the significance of gaining practical experience during training (95%). They aim to achieve professionalism (59%), enhance communication skills (31%), build endurance (31%), and cultivate persistence (28%) and empathy (28%). Most applicants entering the speciality 227 "Therapy and rehabilitation" are goal-oriented, highly motivated, and prepared for rigorous study, which is the key to developing into competent and competitive specialists.

An Innovative Preventive and Rehabilitative Model for Acute Care: The Independence Model.

The Independence Model (TIM) is a new rehabilitative model of care implemented in an acute care hospital to address patients' functional decline and a high vacancy rate for rehabilitation therapists. TIM was developed by a team with expertise in evidence, scope of practice and roles, population care needs, and current state related to rehabilitation. TIM utilizes rehabilitation assistants, supervised by physical therapists, occupational therapists or speech-language pathologists, to assist patients in functional areas such as ambulation, activities of daily living (ADLs), cognition and communication. The planning team ensured patient engagement, utilized change management principles, and evaluated the effectiveness of care. Preliminary evaluation of TIM was positive, with staff reporting improved caseload quality and patients feeling more prepared for discharge. This study suggests innovative models of care, such as TIM, can help address the functional needs of patients while navigating the global health human resource crisis.

Legal provision for the rights of persons who receive rehabilitation assistance

The research is devoted to the problems of legal provision of the rights of persons who receive rehabilitation assistance. The author examines the norms of international and national legislation that enshrine the rights of citizens in the field of healthcare. The works of scholars who have examined the peculiarities of exercising certain patients’ rights are studied. The article describes the legislative acts regulating the rights of a patient in a rehabilitation institution in Ukraine. It is indicated that certain patient rights are enshrined in the Civil Code of Ukraine and the Fundamentals of Healthcare Legislation. Special rights of the patients of rehabilitation institutions are provided for by the Laws of Ukraine “On Rehabilitation in the Healthcare Sector” and “On Rehabilitation of Persons with Disabilities in Ukraine”. The classification of patient's rights into socio-economic, legal, informational, ethical and those related to ensuring the quality of rehabilitation care is proposed. It is indicated that informational rights include the right to information about rights and obligations, diagnosis, functional limitations, nature of treatment, and preservation of medical confidentiality. It is concluded that socio-economic rights consist in the possibility of access to free rehabilitation services at the expense of budgetary funds under the programme of State medical guarantees. It is noted that ethical rights provide for a humane and respectful attitude of medical personnel towards patients. Among the legal rights of the patient is the possibility of judicial and administrative protection of the patient’s rights by applying to law enforcement agencies and courts. The patient has the right to qualified rehabilitation care. Proposals for amendments to the current legislation are made. The necessity to systematise patient rights and provide for them in a separate Law of Ukraine “On Protection of Patients’ Rights” is emphasised.

Legal regulation of rehabilitation in the field of health care

The article notes that the law guarantees everyone the right to health care and medical assistance. A full-scale invasion calls for the development and updating of legal acts on ensuring a person’s right to medical assistance, in particular, to the provision of rehabilitation services. It is noted that rehabilitation assistance is aimed at a number of main areas, firstly, at supporting the functions of the patient’s body during the exacerbation of chronic diseases. Secondly, for warning, early diagnosis of disorders of the organs and systems of the patient’s body. The third direction is aimed at full or partial restoration of damaged organs or systems and compensation of lost functions of affected organs or systems. The fourth direction is related to the prevention and reduction of the degree of disability. The author emphasizes that the lack of competent and effective medical rehabilitation in Ukraine is a multifactorial problem: there is an insufficient number of inpatient and outpatient rehabilitation departments; lack of medical personnel - rehabilitation specialists, psychologists; there is not enough rehabilitation equipment; there is a need for adequate educational programs for physicians. In the article, the author emphasizes that one of the tasks of the state is to help persons with disabilities realize their constitutional rights; implementation of state policy in the field of rehabilitation of persons with disabilities, support for their integration into society, and the full-scale war on the territory of Ukraine causes an increasing urgency and need for the rehabilitation of persons injured as a result of hostilities. Such factors of the population’s health, such as the increase in morbidity, injuries, temporary loss of working capacity, premature mortality of the population require the development of the rehabilitation medicine market of Ukraine and its legal regulation. The article notes that the positive aspects are the development of new medical rehabilitation technologies, including those based on telemedicine and IT technologies, the preparation of new professional standards for medical rehabilitation at the modern level in accordance with international recommendations. All this requires the effective functioning of the system, which first of all requires the improvement and development of regulatory and legal support in the field of rehabilitation.

Mixed-Method Evaluation to Understand Clinician Perspectives of a Program to Implement High-Intensity Resistance Rehabilitation Into Skilled Nursing Facilities

ObjectiveTo assess rehabilitation clinicians’ viewpoints regarding a multicomponent implementation program aimed at promoting high-intensity resistance rehabilitation (HIR), as well as practical implications for its use in skilled nursing facility (SNF) rehabilitation. DesignProspective convergent mixed-method design. SettingEight rural SNFs within the Department of Veterans Affairs. ParticipantsPhysical rehabilitation clinicians (physical and occupational therapists, physical and occupational therapy assistants, recreational therapists, and kinesiotherapists) who engaged with the implementation program (n=38). InterventionsClinicians engaged with the multicomponent implementation program to promote the use of HIR in clinical practice. The program components included clinician training (i.e., virtual didactic modules with synchronous case discussions), provision of resources (e.g., equipment, job aids), and facilitated implementation (e.g., external implementation facilitator support, distributed tips and tricks). Main Outcome MeasuresAcceptability of Intervention Measure, Training Acceptability Rating Scale, study-specific questionnaires, and qualitative focus groups exploring perceived acceptability, feasibility, and effect on work experience. ResultsQuestionnaires revealed high levels of implementation program acceptability and perceived effect, alongside moderate levels of feasibility. Focus group themes supported these findings, explaining high acceptability and effect through differentiation from other trainings and prolonged engagement. Feasibility results were explained qualitatively by facilitatory factors (i.e., team participation, reduced caseloads, training characteristics) and inhibitory factors (i.e., training timing, self-paced scheduling logistics, lack of protected time and space). There was no reported negative effect on clinician work experience. ConclusionsAccording to SNF clinician perspectives, a positive HIR implementation experience may be enhanced through implementation programs that provide prolonged engagement and a self-paced structure with built-in accountability. Leadership and organizational support appear important to protect time and space for clinicians who experience competing priorities to successfully facilitate evidence uptake. Future work can evaluate the applicability across various contexts beyond rural VA SNFs.

Hybrid Cooperative Control of Functional Electrical Stimulation and Robot Assistance for Upper Extremity Rehabilitation.

Hybrid systems that integrate Functional Electrical Stimulation (FES) and robotic assistance have been proposed in neurorehabilitation to enhance therapeutic benefits. This study focuses on designing a cooperative controller capable of distributing the required torque for movement between robotic actuation and FES, thereby eliminating the need for time-consuming calibration procedures. The control schema comprises three main blocks: a motion generation block that defines the desired trajectory, a motor control block including both a weight compensation feedforward and a feedback impedance controller, and an FES control block, based on trial-by-trial Iterative Learning Control (ILC), that adjusts the stimulation intensity according to a predefined stimulation waveform. The feedforward motor assistance can be dynamically regulated using an allocation factor. Experiments involving 12 healthy volunteers were conducted using a one-degree-of-freedom elbow testbed. The experimental results showcased the successful integration of Functional Electrical Stimulation (FES) with robotic actuation, ensuring precise trajectory tracking with a Root Mean Square Error (RMSE) below 7°. Notably, allocating more torque to FES led to a 51 % reduction in motor torque. In conditions where FES operated alone, there was poorer tracking performance with an RMSE of 24° and an early onset of muscle fatigue, as evidenced by a reduced number of achieved repetitions. Furthermore, the hybrid approach enabled 100 fatigue-free elbow flexion repetitions, underscoring the effectiveness of cooperative FES-motor control in extending the benefits of FES-induced exercises. This study proposes a flexible approach which can be extended to a multi-degree-of-freedom hybrid system. Furthermore, it underscores the significance of employing a straightforward and adaptable methodology with a rapid calibration procedure, making it easily transferable to clinical applications.

Legal regulation of rehabilitation assistance to military personnel during martial law

The scientific article delves into the legal regulation of rehabilitation assistance to military personnel during martial law. The research, aimed at establishing the legal basis for providing rehabilitation assistance to military personnel during martial law, is underpinned by a robust methodological basis. The research methods employed are not only general scientific but also special legal, including theoretical-legal, formal-dogmatic, and comparative-legal methods. This thorough approach instills confidence in the validity of the research. The results of the research consist in determining the legal basis for providing rehabilitation assistance to military personnel. It has been established that the legal regulation of providing rehabilitation assistance to military personnel is carried out by such Laws of Ukraine as "Basics of Ukrainian legislation on health care," "On rehabilitation in the field of health care," "On social and legal protection of military personnel and their family members." The specifics of providing rehabilitation assistance to military personnel during martial law are determined. It has been established that the Ministry of Defense of Ukraine’s structure includes a network of centers for medical rehabilitation and sanatorium-resort treatment of military personnel. It has been found that rehabilitation assistance for military personnel can occur in rehabilitation institutions and healthcare institutions with rehabilitation departments, subordinated to the Ministry of Health of Ukraine or other ministries. The legal grounds for sending military personnel to provide rehabilitation in foreign healthcare institutions have been analyzed. It is indicated that the decision to send military personnel to a rehabilitation institution for rehabilitation assistance is made based on the conclusion of the military medical commission. The importance of the existing state target program for providing rehabilitation assistance to defenders of Ukraine is emphasized. A conclusion was drawn on the necessity of enshrining a separate section in the Law of Ukraine, "On Rehabilitation in the Field of Health Care," dedicated to the specifics of the rehabilitation of military, injured in hostilities.

Perceptions and assessment of a novel robotic wheelchair transfer system

Objectives Wheelchair transfers risk injury to users and caregivers. Conventional transfer devices are injury-prone and time inefficient. The Powered Personal Transfer System (PPTS), utilizing a modified Electric Powered Wheelchair (EPW) and a hospital bed, provides a no-lift solution for bed-to-wheelchair transfers. Objective 1: Assess PPTS workload compared to existing methods. Objective 2: Evaluate PPTS EPW in daily mobility tasks. Objective 3: Perform Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) wheelchair standards testing for PPTS EPW stability and performance. Methods Fifteen professional and family caregivers, experienced in assisting EPW users, performed transfers between the bed and EPW using the PPTS. Subsequently, participants drove the PPTS EPW providing ratings on the ease of performing mobility tasks. Wheelchair testing was conducted following RESNA standards. Setting : Simulated bedroom in a laboratory setting. Results Participants reported low workload demands for employing the PPTS and indicated a preference for the PPTS over existing transfer devices/methods. Ease of performing everyday mobility tasks was not significantly different between the modified PPTS and the commercially available original manufacturer equipment EPW (p > 0.05). RESNA wheelchair standards testing confirmed that the PPTS EPW preserves functionality, stability and performance when compared to similar commercially available EPWs. Conclusion The PPTS demonstrated promise in offering a practical, low demanding, and safe solution for transfers. It has the potential to enhance user and caregiver safety by reducing the incidence of caregiver injuries associated with assisting in transfer tasks. In addition to its efficiency and ease of use, it is an advancement in assistive technology for wheelchair transfers.

Research on collaborative management technology of deep multi-coal seam mining and pre-reclamation in coal-grain composite area

Subterranean coal mining results in the occurrence of surface subsidence, soil degradation, and damage to agricultural lands, which is especially severe in regions with high groundwater levels. The collaborative reclamation scheme combining surface pre-reclamation and underground mining layout optimization can effectively control the problem of damage to farmlands. Hence, it is imperative to study the collaborative management technology. The research area for this study is Jiulishan Mine, located in coal-grain composite areas with a high groundwater table. Initially, a combined UAV and USV measuring system was utilized to acquire spatial data of the proposed reclamation area. Furthermore, we examined the evolution features of the subsidence ponding related to various mining methods using FLAC3D numerical modeling. Ultimately, the ArcGIS spatial analysis module was utilized to model and calculate the reclamation volume and rate for each plan. Our findings indicate that: (1) The extent of damage caused by shallow coal seam mining includes an area of 50.67 hm2 for farmland damaged area (FDA), 31.49 hm2 for seasonal subsidence ponding (SSP), and 23.51 hm2 for perennial subsidence ponding (PSP). Additionally, the boundary subsidence values for each damaged area are 0.8 m, 1.6 m, and 2.8 m, respectively. (2) Through the optimization of deep coal seam mining designs, the spatial configuration of the subsidence basin is successfully altered, creating the necessary condition for the development of a dynamic pre-reclamation plan. (3) The reclamation rate of the optimized pre-reclamation (PR) scheme is significantly higher, ranging from 40 % to 44 %, compared to the reclamation rate of 24 % of the traditional reclamation (TR). The choice of a suitable land reclamation and ecological restoration strategy was determined by optimizing mining plans and considering the characteristics of the subsidence area. This offers empirical evidence and specialized assistance for the ecological rehabilitation of coal-grain composite areas with high groundwater levels.

Protocol for a feasibility randomised controlled trial of the 'Outdoor' mobility intervention for older adults after hip fracture.

A high proportion of patients do not regain outdoor mobility after hip fracture. Rehabilitation explicitly targeting outdoor mobility is needed to enable these older adults to recover activities which they value most. The overarching aim of this study is to determine the feasibility of a randomised controlled trial which aims to assess the clinical- and cost-effectiveness of an intervention designed to enable recovery of outdoor mobility among older adults after hip fracture (the OUTDOOR intervention). This is a protocol for a multi-centre pragmatic parallel group (allocation ratio 1:1) randomised controlled assessor-blinded feasibility trial. Adults aged 60 years or more, admitted to hospital from- and planned discharge to- home, with self-reported outdoor mobility in the three-months pre-fracture, surgically treated for hip fracture, and who are able to consent and participate, are eligible. Individuals who require two or more people to support mobility on discharge will be excluded. Screening and consent (or consent to contact) will take place in hospital. Baseline assessment and randomisation will follow discharge from hospital. Participants will then receive usual care (delivered by physiotherapy, occupational therapy, or therapy assistants), or usual care plus the OUTDOOR intervention. The OUTDOOR intervention includes a goal-orientated outdoor mobility programme (supported by up to six in-person visits), therapist-led motivational dialogue (supported by up to four telephone calls), supported by a past-patient led video where recovery experiences are shared, and support to transition to independent ongoing recovery. Therapists delivering the OUTDOOR intervention (distinct from those supporting usual care) will receive training in motivational interviewing and behaviour change techniques. Baseline demographics will be collected. Patient reported outcome measures including health related quality of life, activities of daily living, pain, community mobility, falls related self-efficacy, resource use, readmissions, and mortality will be collected at baseline, 6-weeks, 12-weeks, and 6-months (for those enrolled early in the trial) post-randomisation. Exercise adherence (6- and 12- weeks) and intervention acceptability (12-weeks) will be collected. A subset of 20 participants will also support accelerometery data collection for 10 days at each time point. The trial findings will be disseminated to patients and the public, health professionals and researchers through publications, presentations and social media channels. The trial has been registered at ISRCTN16147125. 3.0.

System–informational representation of the problem of complex physiotherapy

Objective. To highlight the systemic information representation of the problem of complex physical therapy (CPT) in the practice of KNIIKiVL with the determination of the treatment and rehabilitation potential of the CPT carried out in it. The Kyrgyz Scientific Research Institute of Balneology and Rehabilitation Treatment (KSRIBRT) is the main institution of balneology, physiotherapy and medical rehabilitation in the Kyrgyz Republic, whose main tasks are to carry out fundamental and applied scientific research in the relevant field, as well as to provide specialized physiotherapy and rehabilitation assistance to the population. It should be noted that one of the main functions of the KSRIBRT is to make proposals on the formation of state policy in the field of balneology, physiotherapy and medical rehabilitation. In this regard, the institution has its own 65‑year history, an established tradition, a verified style of scientific and practical activity, a great potential for comprehensive rehabilitation treatment, and an appropriate staff. In the context of the fact that physiotherapeutic rehabilitation is adopted by the strategy of the XXI century, it is necessary to ensure that the rehabilitation goal and objectives of the KSRIBRT should become planned, specific, measurable, realistically achievable, determined in time. To do this, it was first necessary to have a general understanding of the evidence-based effectiveness of complex physiotherapy (CPT) in patients with polypathies (PP).

Understanding mobility and immobility choices in vulnerable coastal settlements: insights from southwest India

ABSTRACT This study explores the influence of social, environmental, governance, and other household factors on migration decision-making in hazard-affected coastal areas in southwest India. Through nearly 900 interviews with households residing in these vulnerable areas and with households that have migrated elsewhere, this paper analyses the determinants that influence the propensity for migration versus staying, as well as for voluntary immobility versus involuntary immobility. Logistic regression was used to distinguish significant factors. The results showed that governance factors and the extent of impact were the most influential in migration decision-making, while social and household factors were the most relevant in determining voluntary non-migrants. The decision to migrate was found to be strongly influenced by post-disaster rehabilitation assistance by the government, while the decision to stay was influenced by the kind of coastal protection measures that were in place. These insights have significant implications for migration and planned relocation policies and can be leveraged to design more effective interventions for both immobile and migrating populations.

Human-robot interaction in motor imagery: A system based on the STFCN for unilateral upper limb rehabilitation assistance

BackgroundRehabilitation training based on the brain-computer interface of motor imagery (MI-BCI) can help restore the connection between the brain and movement. However, the performance of most popular MI-BCI system is coarse-level, which means that they are good at guiding the rehabilitation exercises of different parts of the body, but not for the individual component. New methodsIn this paper, we designed a fine-level MI-BCI system for unilateral upper limb rehabilitation assistance. Besides, due to the low discrimination of different sample classes in a single part, a classification algorithm called spatial-temporal filtering convolutional network (STFCN) was proposed that used spatial filtering and deep learning. Comparison with existing methodsOur STFCN outperforms popular methods in recent years using BCI IV 2a and 2b data sets. ResultsTo verify the effectiveness of our system, we recruited 6 volunteers and collected their data for a four-classification online experiments, resulting in an average accuracy of 62.7 %. ConclusionThis fine-level MI-BCI system has good appli-cation prospects, and inspires more exploration of rehabilitation in a single part of the human body.

Economic and legal mechanisms of material and technical support of health care institutions

The paper shows that the formation of a network of state and communal health care institutions is a multifactorial process aimed at ensuring high quality, accessibility and efficiency of medical care for all citizens. It is shown that the state plays a key role in the organization of material and technical support of the health care system in order to guarantee the population an appropriate level of medical and rehabilitation assistance. It ensures the availability of the necessary resources to provide the population with a guaranteed level of medical and rehabilitation assistance to individuals and medical institutions, including in the form of equipment, tools, medicines and other necessary materials. The role and imperative of compliance with standards of medical care, clinical protocols, rehabilitation care protocols, as well as material and technical equipment reports in all health care institutions have been defined. It is shown that the record of material and technical equipment plays a key role in ensuring a high level of medical services, optimizing resources and increasing the efficiency of health care institutions and private medical practices. It has been proven that under the conditions of martial law, the role of the Ministry of Defense of Ukraine in the logistical support of health care facilities increases, as it ensures constant monitoring of the effectiveness of approved standards and lists, as well as their regular updating in accordance with new technologies and changes in combat tactics and medical science Medical products and aids must be suitable for use in combat environments, including extreme conditions, mobility and speed of care. The functions of the Ministry of Defense of Ukraine are an important component of ensuring the appropriate level of medical care for servicemen in combat conditions, which contributes to increasing their safety and effectiveness on the battlefield. A comprehensive approach to the logistical support of health care is proposed, which allows to ensure a high level of medical care, support innovations in the medical field, and promote the development of the national medical industry.

Wearable Sensors Based on Miniaturized High-Performance Hybrid Nanogenerator for Medical Health Monitoring.

Wearable sensors are important components, converting mechanical vibration energy into electrical signals or other forms of output, which are widely used in healthcare, disaster warning, and transportation. However, the reliance on batteries limits the portability of wearable sensors and hinders their application in the field of Internet of Things. To solve this problem, we designed a miniaturized high-performance hybrid nanogenerator (MHP-HNG), which combined the functions of triboelectric sensing and electromagnetic power generation as well as the advantages of miniaturization. By optimizing the design of TENG and EMG, the wearable sensor achieved a voltage output of 14.14 V and a power output of 49 mW. Based on the wireless optical communication and wireless communication technologies, the wearable sensor achieved the integration of sensing, communication, and self-powered function, which is expected to realize health monitoring, emergency warning, and rehabilitation assistance, and further extend the potential application value in the medical field.