Rehabilitation Institute Research Articles

Factors Influencing Discharge Destination and Length of Stay in Stroke Patients in Restorative Rehabilitation Institution

Factors Influencing Discharge Destination and Length of Stay in Stroke Patients in Restorative Rehabilitation Institution

Mexican Multicenter Experience of Metastatic Spinal Disease.

Background Spinal metastatic disease is a silent progressive cancer complication with an increasing prevalence worldwide. The spine is the third most common site where solid tumors metastasize. Complications involved in spinal metastasis include root or spinal cord compression, progressing to a declining quality of life as patient autonomy reducesand pain increases. The main objective of this study is to report the incidence of patients and typology of spinal metastases in three reference centers in Mexico. Methodology Retrospective cohorts of patients diagnosed with spinal metastases from January 2010 to February 2017 at the National Cancer Institute, National Rehabilitation Institute, and the Traumatology and Orthopedics Hospital "Lomas Verdes" in Mexico City were analyzed. Results A total of 326 patients (56% males) with spinal metastases were reported. The mean age was 58.06 ± 14.05 years. The main sources of spinal metastases were tumors of unknown origin in 53 (16.25%) cases,breast cancer in 67 (20.5%) cases, prostate cancer in 59 (18%) cases, myeloma in 24 (7.4%) cases, and lung cancer in 23 (7.1%) cases. Conclusions The data obtained in this analysis delivers an updated standpoint on Mexico, providing the opportunity to distinguish the current data from global references. Collecting more epidemiological information for better recording of cancer and its associated complications, as well as further studies on them, is necessary.

Károly Mirnics: Many medications and chemicals might not be as safe for the developing brain as we think they are; this will greatly depend on your genotype, habits, and environmental factors

Károly Mirnics is Director and Hattie B. Munroe Professor of Psychiatry, Biochemistry & Molecular Biology, Pharmacology & Experimental Neuroscience, Munroe-Meyer Institute for Genetics and Rehabilitation at the University of Nebraska Medical Center (UNMC). Dr. Mirnics earned his medical degree from the University of Novi Sad School of Medicine (in the former war-torn country of Yugoslavia that does not exist anymore) and his Ph.D. from Semmelweis University in Budapest, Hungary. He completed his postdoctoral fellowship at the University of Pittsburgh, where he established his laboratory in 2000. In 2006, his laboratory moved to the Department of Psychiatry at Vanderbilt University in Nashville, TN. In 2010, Dr. Mirnics was named James G. Blakemore Professor of Psychiatry and served as the departmental vice chair for research and the associate Director of the Vanderbilt Kennedy Center for Human Development. In 2016, he joined UNMC, becoming the Director of the Munroe-Meyer Institute for Genetics and Rehabilitation (MMI). With over 1,000 employees and trainees and roots tracing back to 1919, MMI is among the world's most extensive clinical, research, education, and outreach institutes for intellectual and developmental disabilities (IDD). Funded by the National Institutes of Health (NIH), Dr. Mirnics's innovative research uses a variety of genetic, molecular, cell biology, and behavioral tools across multiple disease models; he has authored over 150 scientific publications, which have been cited more than 17,000 times. As a passionate advocate for diversity, access, and inclusion of individuals with intellectual and developmental disabilities, he currently serves on the board of directors of Special Olympic International (SOI). He chairs the SOI Global Medical Advisory Committee that develops strategies to address the health challenges of more than six million athletes across over 200 countries. He led UNMC's effort to build a highly advanced, award-winning, 20,000 m2 multidisciplinary building that serves individuals with intellectual and developmental disabilities across the lifespan. We are delighted that Dr. Mirnics shares his personal and professional paths with our readers.

The role of clinical and demographic predictors for understanding the cognitive impairment in Spinal Cord Injury (SCI) patients.

Using a cross-sectional design, we extracted sociodemographic and clinical data from 488 Spinal Cord Injury (SCI) patients during their initial assessment before receiving intensive rehabilitation treatment. The primary objectives of this study were to ascertain the prevalence of cognitive impairment in the study sample and specify the key clinical and demographic predictors of cognitive functioning in SCI patients. Lucy Montoro Rehabilitation Institute (LMRI), University of Sao Paulo, Sao Paulo, Brazil. We utilized independent univariate and multivariate regression models with the Montreal Cognitive Assessment (MoCA) scale, adapted for individuals with visual impairment. Moreover, we consider scores from the execution tasks (visuospatial/executive) as the dependent variable. Our findings demonstrate that approximately 80% of the evaluated study sample exhibited cognitive impairment. Through the multivariate regression models, we show that several factors, including age, education, depression levels, and the use of analgesics and/or opioids, are significant predictors of total cognitive scores. These factors are independent of the clinical features associated with SCI, such as age, sex, education, and time since the injury. The results indicate a high prevalence of significant cognitive impairment within the sample, with age, education, depression levels, and the use of analgesics and/or opioids emerging as the primary predictors of total cognitive scores, independent of the clinical features correlated to SCI. These findings hold significant implications for both clinical research and practice, offering valuable guidance for comprehensive management throughout hospitalization and rehabilitation.

LAYANAN PASCA REHABILITASI NARKOBA BAGI KLIEN BAPAS KELAS I MEDAN: SELF-CARE DAN KESEJAHTERAAN PSIKOLOGIS

Drug rehabilitation is a way to help users recover from drug addiction. The rehabilitation process takes a considerable amount of time, especially for patients who have been addicted to drugs for a long time. Individuals undergoing rehabilitation in correctional institutions will undoubtedly face challenges in their daily lives, such as self-care issues. The stress experienced by students in correctional institutions can be prevented with several self-care management techniques, which will help the students achieve psychological well-being. Psychological well-being is expected to help correctional students accept themselves, build warm relationships with others, develop independence in problem-solving, adapt to their current environment, and have life goals. The purpose of this activity is to ensure that all clients of the Medan Class I Probation Supervision Agency (Bapas) are informed about Self-Care and Psychological Well-being. This activity was conducted on March 4, 2024, with a total of 30 participants from the Medan Class I Probation Supervision Agency (Bapas). The results of the activity showed that the level of knowledge of all clients of the Medan Class I Probation Supervision Agency (Bapas) regarding Self-Care and Psychological Well-being became very good, as measured by a questionnaire, and they were able to apply Self-Care and Psychological Well-being to themselves according to the material provided. This activity requires regular monitoring of the psychological well-being of prisoners and intervention if necessary.

Impact of Cognitive Impairment on Functional Outcomes of Stroke Patients at a Tertiary Care Rehabilitation Institute

Impact of Cognitive Impairment on Functional Outcomes of Stroke Patients at a Tertiary Care Rehabilitation Institute

Migraine among women with endometriosis: a hospital-based case-control study in Bangladesh

BackgroundEndometriosis is a disease among women of reproductive age, which causes several health problems like dysmenorrhoea, dyspareunia and subfertility. It also increases psychological stress and often results in marital disharmony. Similarly, migraine is more frequent among this group of women. Several studies have shown an association between endometriosis and migraine among groups of population completely different from Bangladesh. ObjectiveThe present study was conducted to identify the association between endometriosis and migraine among Bangladeshi population. Study DesignThis non-randomized case-control study was performed with cases of endometriosis and controls without endometriosis who were confirmed by laparoscopy or laparotomy. Among the study participants, we identified as cases of migraine in one group of respondents who were already diagnosed as patients of migraine and the others with complaints of headache were further confirmed by a medicine specialist. Patients were recruited from the department of obstetrics and gynaecology at the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital & Ibrahim Medical College. The study was approved by the Ethical Review Committee of BIRDEM. Multivariate logistic regression was used to identify the association between endometriosis and migraine using odds ratios and 95% confidence intervals. ResultsIn our study, out of the 1496 patients who underwent laparoscopy or laparotomy during the study period, the frequency of endometriosis was found to be 12.7%. We enrolled 190 confirmed endometriosis cases and an equal number of controls without endometriosis, maintaining the age distribution of the controls similar to that of the cases. The distribution of age, BMI, education and marital status of the patients with endometriosis were similar to that of controls. The average ages of respondents were 30.6 years in both the case and control groups. Regarding occupation, cases included more students than in controls (12% vs 0%). The odds of suffering from dysmenorrhoea and dyspareunia among the cases were 3.3 (P value <0.001, 95% CI: 2.66-4.15) and 9.5 (P value <0.001, 95% CI: 5.3-17.9) times higher than that of controls respectively. In addition, the odds of menstrual irregularity was 60% lower among the cases compared to that of controls (OR = 0.4, P value <0.001 95% CI: 0.24-0.64). No significant difference was observed in having primary subfertility and secondary subfertility among the two groups of respondents. Univariate regression analysis showed patients with endometriosis have 6.13 times higher odds (P value <0.001, 95% CI: 2.5-18.4) of having migraine, 2-time higher odds for headache (P value = 0.01, 95% CI: 1.2-3.2) compared to control patients. Further, the age and BMI-adjusted multivariate model showed subjects with endometriosis have 5.4 times higher odds of having migraine compared to non-endometriosis patients (P value <0.001, 95% CI: 2.11-16.4). Also, the higher the age of reproductive age of women, the more the odds of having migraine. For one year increase in age increases the odds of having migraine by 23% (OR = 1.23. 95% CI: 1.13-1.16, p-value = <0.001). ConclusionThe study results support the association between endometriosis and migraine among the Bangladeshi population, which is similar to relevant studies conducted in other geographical locations. The groups of physicians who treat patients suffering from the two diseases, endometriosis and migraine, should keep this interrelationship in mind to ensure a better quality of a patient's life.

Kepatuhan Pasien pada Program Therapeutic Community

This research aims to determine the factors that influence the compliance of drug abuse patients in participating in therapeutic community programs at social drug rehabilitation institutions. This research is a systematic journal using the preferred item reporting method for systematic and meta-analysis (PRISMA) from online databases. Therapeutic community programs in social drug rehabilitation institutions do not all run smoothly, so it is necessary to know the factors that influence the compliance of patients who are victims of drug abuse in participating in therapeutic community programs in social drug rehabilitation institutions. The results of this research show that the factors that influence patient compliance in participating in a therapeutic community program include family factors, a counselor's skills in interacting with counselors, economic factors, peer factors, environmental factors including social support, social relationships and social interactions. The conclusion of this research is that there are factors that influence patient compliance in participating in the therapeutic community program in social drug rehabilitation. Keyword: Adherence, Drug Abuse, Therapeutic Community

PENERAPAN PERATURAN KEJAKSAAN NOMOR 18 TAHUN 2021 TERKAIT REHABILITASI NARKOTIKA BERDASARKAN KEADILAN RESTORATIF

Restorative Justice is utilized as an approach to resolve criminal cases involving offenders, victims, families, and relevant parties to seek a fair resolution, prioritizing rehabilitation over retribution. The Guidelines for Narcotics Rehabilitation based on Restorative Justice guide Prosecutors in the stages of pre-prosecution, prosecution, and rehabilitation supervision. In practice, there are differences in the interpretation and application of the dominus litis principle by Prosecutors in handling narcotics cases with a restorative justice approach. The limitations in understanding and applying the dominus litis principle can affect the consistency and uniformity of rehabilitation policies provided by the Prosecutor's Office in narcotics criminal cases. Moreover, this issue can also lead to inconsistent treatment of narcotics defendants in need of rehabilitation. The issue concerning the authority of the prosecutor's office in implementing rehabilitation policies in narcotics criminal cases with a restorative justice approach and enforcing the law in narcotics criminal cases with a restorative justice approach. This research method employed a normative juridical research type using legislative and conceptual approaches as the basis for analysis in addressing the issues. The conceptual approach used includes the concept of narcotics rehabilitation by the Indonesian Prosecutor's Office based on theories of authority and law enforcement, serving as analytical tools in addressing the issue of prosecutor's authority in law enforcement rehabilitation in narcotics criminal cases. In conclusion, the Prosecutor's Office has the juridical authority to conduct rehabilitation in narcotics criminal cases with a restorative justice approach. This is regulated in the Indonesian Prosecutor's Regulation Number 18 of 2021. Prosecutors play a central role in controlling cases, from investigation to court judgment execution, based on the dominus litis principle. Public prosecutors have a significant role in ensuring that medical and social rehabilitation efforts are carried out appropriately by designated rehabilitation institutions or health services, as well as in issuing warnings and taking further action if suspects fail to comply with the prescribed rehabilitation process. Law enforcement in cases of narcotics abuse requires a thorough understanding and strict application of the requirements based on the Indonesian Prosecutor's Regulation Number 18 of 2021

Application of the ICF on students with disabilities at school in India

ICF serve as the basis for both the assessment and measurement of disability in many scientific, clinical, administrative and social policy contexts. However, few studies have used the application of ICF on students with disabilities in scientific and clinical context in India. The objective of this study is to identify the problems and record information by implementing the ICF as the basis for both the assessment and measurement of barriers/facilitator in students with disability in educational setting on clinical and social policy contexts. Method &amp; procedure - A focus group of participants selected as to represent each level of school and each type of disability service provider working in rehabilitation institute. The group for the Identification Card included only teachers; that for the Functional Diagnosis was constituted only by multi-disciplinary health professionals from Disability Services; that for the Achievable Functional Goal Setting Profile and the Individual Educational Action Plan were mixed, including both teachers and operators from Disability Services. Results- In the school year 2021-23, the school sent 206 identification cards to disability services using the ICF model; the disability services issued 118 new disability certifications (57.3% of the received 206 identification cards). The school received 220 Functional Diagnosis from the disability services. The number of achievable functional goal setting profile stands at 132 and reached 54 number of Individual Educational Action Plan. Conclusion- In summary, the study suggested that to make any treatment effective for students with disabilities the medical, allied health expert like occupational therapist and the skilled teacher need to work hand in hand.

Інститут реабілітації незаконно засуджених осіб як важлива компонента розвитку правової системи України

This article examines the institution of rehabilitation of illegally convicted persons in the legal system of Ukraine. It was determined that the rehabilitation of illegally convicted persons in the legal system of Ukraine is an important step for ensuring justice and restoring trust in justice. It has been studied that the institution of rehabilitation of illegally convicted persons plays an important role in the legal system of Ukraine, having a significant impact on the development of justice and the protection of human rights. It is highlighted that the purpose of rehabilitation is to make decisions that will contribute to the full or partial restoration of all rights and freedoms of illegally convicted or illegally persecuted persons, as well as compensation for property and moral damage caused to them, and their integration into society as full-fledged citizens. The main values of the institution of rehabilitation of illegally convicted persons in the legal system of Ukraine are highlighted: 1) restoration of justice; 2) provision of compensation; 3) strengthening of trust in the judicial system; 4) prevention of judicial errors; 5) guaranteeing human rights. The article emphasizes two types of rehabilitation: 1) full rehabilitation, which provides for the complete release of a person from criminal responsibility or from serving a sentence (after an acquittal is rendered or after the proceedings are closed on rehabilitation grounds); 2) partial rehabilitation - occurs when only some measures of procedural coercion are recognized as illegal, but the criminal proceedings are ongoing at the same time. It is concluded that the institution of rehabilitation of illegally convicted persons in the legal system of Ukraine is a key mechanism for ensuring justice and protecting human rights. It is designed to restore the violated rights and freedoms of victims, giving them the opportunity to rehabilitate in society and return to a normal life. This institution also plays an important role in improving citizens' trust in the judicial system and state institutions.

The dual competence profile: A support of collaboration between practice and science. A qualitative descriptive study

The dual competence profile: A support of collaboration between practice and science. A qualitative descriptive study Abstract. Background: To ensure orientation towards needs existing in the realm of practice, the dual competence profile is mandatory at universities of applied sciences (UAS): in addition to academic qualifications, entrenchment in professional practice is demanded. However, it is unclear how needs, attitudes, and expectation of clinical practice regarding the interface between UAS and practice looks like. Thus, it is necessary to shed light on the cross-institutional and cross-divisional cooperation as well as on its participants. Aim: This article shows what needs and attitudes people from clinical practice have with regard to cooperation with the UAS and what they expect from persons with a dual competence profile. Methods: Guided individual and focus group interviews with 24 selected representatives from acute, rehabilitation and geriatric care institutions took place. The interviews address the following five block themes: "current state", "need for change", "areas for action", "needs" and "sustainability". Results: Practice institutions demonstrated a clear need for networking and knowledge circulation with the UAS, with a bilateral influence of four subcategories: overall goal, staff development, resources and general regulations. Conclusions: Persons with dual competency profiles provide a valid way for interconnecting higher education and practice institutions in a concrete manner. Their complex work environments require meaningful frameworks, shared goals, and the inclusion of key stakeholders.

Prenatal, perinatal and parental risk factors for autism spectrum disorder in China: a case- control study.

Autism spectrum disorder (ASD) is heritable neurodevelopmental disorders (NDDs), but environmental risk factors have also been suggested to a play a role in its development. Prenatal, perinatal and parental factors have been associated with an increased risk of ASD in children. The aim of the present study was to explore the prenatal, perinatal, and parenting risk factors in children with autism spectrum disorder (ASD) from Beijing, China by comparing them with typically developing (TD) children. A sample of 151 ASD children's parents who from rehabilitation institutions in Beijing were enrolled in this study, and an additional 151 children from kindergartens in Beijing were recruited as a control group (child age: mean = 4.4 years). TD children were matched according to age, sex and maternal education. We explored the maternal AQ (Autism Spectrum Quotient) scores (mean:19.40-19.71, no significant difference between two groups) to referring the genetic baseline. This study evaluated 17 factors with unadjusted and adjusted analyses. Birth asphyxia was associated with a more than a thirteen-fold higher risk of ASD (adjusted odds ratio (AOR) = 13.42). Breastfeeding difficulties were associated with a higher risk of ASD(AOR = 3.46). Parenting influenced the risk of ASD, with low responding (LR) and harsh or neglectful parenting associated with a higher risk of ASD in offspring (AOR = 2.37 for LR, AOR = 3.42 for harsh parenting and AOR = 3.01 for neglectful parenting). Maternal fever during pregnancy was associated with a higher risk of ASD in offspring (AOR = 3.81). Many factors were associated with ASD in offspring. Further assessment is needed to elucidate the role of modifiable environmental factors to inform prevention strategies.

Features of physical education and sports rehabilitation for teenagers with hearing impairments

The number of children suffering from partial or complete hearing loss is steadily increasing according to the Worldwide organization protection health. This trend is a cause for concern, as this condition can hinder a child's overall development and social adaptation. The aim of this article was to characterize the features of physical and sports rehabilitation for adolescents with hearing impairments. Scientific publications on physical and health rehabilitation of children with partial or complete hearing loss were analyzed. The effectiveness of physical exercises, massage, the use of technical rehabilitation means, methods of correction of motor disorders, swimming training, and activation of cognitive activity were revealed. It was indicated that hearing impairment leads to underdevelopment of speech, slowing down or specific development of other functions associated with the affected organ, which slows down mental development as a whole. Underdevelopment in the functioning of some sensory organs and the relative preservation of others are also characteristic. A correlation was found between hearing impairments and the characteristics of the development of the emotional sphere, attention, memory, and thinking. Such features negatively affect the quality of life of a child, especially during adolescence, since this stage is considered critical. Attention is drawn to the fact that modern Ukrainian state policy is aimed at the formation and strengthening of democratic egalitarian attitudes, as well as the recognition of each person regardless of their physical, mental, or intellectual state. This leads to the expansion of the infrastructure of social rehabilitation institutions to help families raising children with disabilities. The implementation of this strategy lies in the development of a rehabilitation process that takes into account the individual capabilities of each child with problems in physical, intellectual, social, and psychological status. The conclusion was made about the necessity and relevance of developing a program of physical and sports rehabilitation for adolescents with hearing impairments.

Exploring the Relationship Between Anxiety Levels and Sleep Quality During the Covid-19 Pandemic; A cross-sectional Survey

Background: The COVID-19 pandemic has exerted unprecedented stress on global health, with significant implications for mental health and sleep quality. Prior research has established a link between anxiety levels and sleep disturbances, yet the pandemic's full impact on these aspects remains underexplored, particularly among university students. Objective: This study aims to investigate the relationship between anxiety levels and sleep quality among university students during the COVID-19 pandemic, providing insights into the prevalence of sleep-related issues and anxiety and their interconnection. Methods: A cross-sectional survey was conducted at the South City Institute of Physical Therapy and Rehabilitation, involving 281 participants aged between 17 and 25 years. Data collection was facilitated through self-administered, online questionnaires, employing the Beck Anxiety Inventory and the Insomnia Severity Index to measure anxiety levels and sleep quality, respectively. The study utilized a convenience sampling technique, with SPSS version 25.0 employed for data analysis, including Pearson correlation tests to examine the relationship between sleep quality and anxiety levels. Results: The study revealed that 82.9% of participants were female, with a significant portion of the population aged between 24 and 26 years. Regarding COVID-19 impact, 23.49% reported being affected by the virus. A majority (44%) reported obtaining 8-10 hours of sleep, while 55.2% exhibited moderate anxiety levels. A notable negative correlation (r = -0.510, p &lt; 0.01) between anxiety levels and sleep quality was identified, indicating that higher anxiety was associated with poorer sleep quality. Conclusion: The findings underscore a significant negative correlation between anxiety levels and sleep quality among university students during the COVID-19 pandemic. These results highlight the necessity for mental health and sleep hygiene interventions aimed at mitigating the adverse effects of pandemics on student populations.

The foreign literature in the school: towards intertextual reader-student thesaurus problem statement

Introduction. The importance of intercultural dialogue as a basis for mutual understanding between representatives of different countries was emphasized in International Commission on the Futures of Education (UNESCO) report «Reimagining Our Futures Together: A New Social Contract for Education» [15]. Foreign literature is an integral part of school literary education system in Russia and an important element in the development of intercultural dialog. The aim of the article is to actualize the educational potential of studying foreign literature at school and to raise the problem of methodological research of intertextual thesaurus of high school and college students. The aim of the article is to foreground the educational potential of studying foreign literature at school and to raise the methodological research problem of intertextual senior pupils’ and students’ thesaurus. Materials and methods. Comprehensive analysis of scientific and educational literature about the history of Russian methodology of the XIX-XXI centuries; analysis of curricula, scientific publications about studying world literature at school, including dissertation research, were analyzed. 172 students of the Institute of Defectology Education and Rehabilitation of Herzen Russian State Pedagogical University took part in the pilot survey. The aim of this survey is to identify students’ intertextual thesaurus in the field of foreign literature. The materials for the survey were questions and tasks on the knowledge of foreign writers' names and quotations from the dictionary-guide for schoolchildren. Results. The study has shown that a system of studying foreign literature has been formed in Russian school at the beginning of the XXI century. On the basis of the scientific researches analysis the trends in reading and studying foreign literature in modern school as well as directions of contemporary methodological research were identified. The pilot survey revealed students’ insufficient level of foreign literature knowledge. The same low level of students’ knowledge of literary quotations from the world classics works was also established. For instance, among the names of foreign classical writers which were known to the respondents only 35 percent named Shakespeare, 7 percent – Goethe, less than 5 percent – Dante. 48 percent of the total number of respondents recognized quotations from world classics. The necessity of building an intertextual thesaurus system development of modern reader-schooler on the basis of the principle of cultures dialog is substantiated. Conclusion. At the end of the research the further directions of work in the field of intertextual thesaurus of modern reader-schooler were defined. It can be accomplished with the practices of reading and studying foreign literature texts.

Outcomes of Pressure Sore Surgery in Patients with Spinal Cord Injury and Spasticity.

Spasticity is a serious complication of spinal cord injury/disease (SCI/D) that affects 60%-80% of patients with this condition. The presence of spasticity can have a significant impact on the outcomes of reconstructive surgical interventions, such as those on pressure sores (PSs). Moreover, in the conservative treatment of PSs, spasticity may prevent maintaining adequate postures to avoid skin friction or traction. The aim of this study is to describe the PS reconstruction outcomes in a cohort of patients with SCI/D affected by spasticity. In this retrospective study of patients with SCI/D consecutively admitted to Montecatone Rehabilitation Institute between October 2013 and March 2022, 54 PSs were treated in 46 people with spasticity. Postsurgery complications occurred in 26 of 54 treated PS, of which seven were major. Eleven patients experienced more than one complication. The overall incidence of postsurgical complications was 48.1%, and the incidence of major complications was 13%. Median length of hospital stay was 3.8 versus 1.8 months. Compared with other reports in the literature of PS reconstruction in patients with SCI/D, we found higher rates of overall, minor, and major complications. Spasticity proved to be an important condition to consider, and its treatment requires specialized physicians. The collaboration between plastic surgeons and spasticity specialists is crucial to define the best treatment to reduce postoperative complications.

Social larping as an author's method of forming the social competence of children with complex developmental disorders

The article presents the author's own practical experience and description of experimental work with children with complex disorders (autism, ADHD, intellectual disability, Down syndrome, childhood schizophrenia, cerebral palsy). The author has created his own method of forming the social competence of children with complex developmental disorders, implemented as part of an experiment within a rehabilitation institution. The essence and advantages of social larping are defined. The scientific studies related to the research topic are briefly reviewed. The method of forming social competence for autistic children - Creative drama - is analysed. A comparative analysis of the method of "live" game LARP and Creative drama is carried out. The concept of "social larping" is defined for the first time. The criteria and indicators of the level of formation of the social competence of children with complex developmental disorders are outlined (cognitive: knowledge of ways of behaviour, rights and responsibilities; basic ideas and knowledge to meet their own needs; knowledge of ways of social interaction; emotional and motivational: understanding of emotions, self-control skills (self-esteem), social values; behavioural: social interaction, orientation in social roles, social skills). The descriptive characteristics of the levels of formation of the social competence of children with complex developmental disorders in accordance with the above criteria are provided.&#x0D; The importance of introducing social larping as an author's method of forming the social competence of children with complex developmental disorders within the correctional and developmental work of rehabilitation institutions is proved. The impact of social larping on improving the interaction between children with complex developmental disorders within a mini-group, catching up with the child's own social experience in a rehabilitation centre is analysed.&#x0D; The conclusions and suggestions demonstrate the essence and advantages of social larping as a method of forming the social competence of children with SCD, as well as the effectiveness of its implementation

Ego-perspective enhanced fitness training experience of AR Try to Move game

AR, a recent emerging technology, has been widely used in entertainment to provide users with immersive, interactive, and, sometimes, engaging experiences. The process of rehabilitation treatment and motor training process is often boring, and it is well known that users exercise efficiency is often not as efficient as in a rehabilitation institution. Thus far, there is no effective upper limb sports rehabilitation training game based on the ego-perspective. Hence, with the objective of enhancing the enjoyment experience in rehabilitation and more effective remote rehabilitation training, this work aims to provide an AR Try to Move game and a convolutional neural network (CNN) for identifying and classifying user gestures from a self-collected AR multiple interactive gestures dataset. Utilizing an AR game scoring system, users are incentivized to enhance their upper limb muscle system through remote training with greater effectiveness and convenience.

Relation of Serum Bilirubin in Physiological Range with Spot Urine Albumin to Creatinine Ratio and eGFR Among Diabetic Patients with or without Nephropathy

Recent studies have suggested a potential role of bilirubin as an antioxidant to protect diabetic patients from hyperglycemia-induced oxidative stress thereby preventing diabetic complications. Diabetic nephropathy is a serious microvascular complication which is determined by increased urinary albumin to creatinine ratio and reduced eGFR. The present work aimed to study the relation of the simple biochemical parameter of serum bilirubin level with the estimated glomerular filtration rate (eGFR) and spot urine albumin to creatinine ratio in diabetic patients with or without nephropathy. This cross sectional study was done in the department of Biochemistry and Molecular Biology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) Academy from July 2017 to June 2018. We have taken 63 diabetic patients without nephropathy and 63 diabetic patients with nephropathy.Data about clinical and biochemical parameters (blood pressure, BMI, fasting serum glucose, estimated GFR, serum bilirubin and spot urine ACR etc.) were measured by appropriate methods. We used student’s t test and Pearson’s correlation coefficient to detect the relationship of serum bilirubin with other variables All statistical tests were considered at 5% level of significance. We found diabetic patients with nephropathy have significantly lower serum bilirubin (p&lt;0.001) than diabetic patients without nephropathy (0.46±0.18 and 0.64± 0.21 mg/d respectively). Pearson’s correlation test showed that serum bilirubin positively correlated with eGFR (r=0.312, p=0.013) in diabetic patients with nephropathy. This study concluded that low serum bilirubin level is associated with eGFR in diabetic patients with nephropathy.&#x0D; Bangladesh J Med Biochem 2019; 12(2): 16-22